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بررسی اثر عصاره خام پیاز بر بافت بیضه موش Effects of Crude Onion Extract on Murine Testis 2 1 زمینه و هدف: بنابر باور پیشینیان، پیاز علاوه بر سایر خواص دارویی فراوانی که دارد، ميل جنسي را در مردان نیز افزایش می‌دهد. از آنجاییکه سودمندی داروهای گیاهی باید با ارزيابي‌هاي آزمایشگاهی و بالینی اثبات شود؛ لذا در پژوهش حاضر سعي گرديد تا اثرات عصاره پياز به صورت تجويز خوراكي بر بافت بیضه موش‌هاي نر بالغ مورد مطالعه قرار گرفته و تأثير آن بر فعاليت توليد مثلي بررسی شود.روش بررسي: در این پژوهش از 24 موش بالغ نر (40 روزه) از نژاد Balb/c استفاده شد كه به صورت تصادفي در دو گروه تجربي و كنترل قرار گرفتند. بررسي گروه تجربی به مدت 10 روز عصاره پیاز به صورت خوراكي به مقدار g/BW100 ml1/0 تجويز شد و مشابه اين عمل در گروه كنترل فقط با مقدار مشابهي از سرم فيزيولوژي صورت گرفت. پس از پايان دوره، همه موشها پس از بيهوشي، قطع نخاع شدند و بيضه‌هاي آنان پس از آماده‌سازي بافتي و رنگ‌آمیزی مورد مطالعه میکروسکوپی قرار گرفت. سپس داده‌ها با استفاده از نرم افزار SPSS و آزمون t تجزیه و تحلیل شد. سطح معنی‌داری 05/0p< در نظر گرفته شد.نتایج: اين مطالعه نشان داد كه ميانگين قطر داخلي مجاري اسپرم ساز گروه تجربي در مقايسه با گروه كنترل (m42/1±32/56 در مقابل m16/3±27/31) به شكل معني‌داري افزایش نشان مي‌دهد (05/0p<)؛ در حالیکه میانگین قطر خارجی توبول‌های دو گروه تفاوت معنی‌داری نداشت. علاوه بر اين ميزان تكثير سلول‌هاي جنسي در رده‌هاي اسپرماتوسيت I و II نیز در گروه تجربي نسبت به کنترل دارای افزایش معني‌داري بود (05/0p<).نتيجه‌گيري: نتايج حاصل از اين پژوهش نشان داد كه تجویز عصاره خام پیاز ضمن تأثیرگذاری بر ساختار مجاری اسپرم ساز بر تكثير سلولي در توبول‌هاي بيضه موشها اثر می‌گذارد و روند اسپرماتوژنز را در آنها نسبت به گروه كنترل سرعت بيشتري می‌بخشد. 2 Introduction: Ancestral beliefs have tied onion consumption and its medicinal properties to increases in sexual desire. The present study tries to put this old belief to test. Therefore, this study has explored the effects of oral consumption of onion extract on the reproductive activity and testicular structure of adult male mice.Materials & Methods: In this study, twenty-four 40-day old male Balb/C mice were randomly divided into two experimental and control groups. The experimental group received daily doses of onion (Allium cepa) extract (1ml/100gr/B.W.) for 10 days. The controls received the same volume of normal saline. At the end of the study, all the animals were anesthetized and scarified by cervical dislocation and their testes were harvested for histological study. For statistical analysis, t-tests were used to compare the means of the two groups while the significance level was set at p<0.05.Results: The mean internal diameter of seminiferous tubules showed a significant increase in the experimental (56.321.42μm, p<0.005) relative to the control group (31.273.16), whereas their mean external diameters did not show any significant difference. In addition, proliferation of spermatogonial cells and spermatocytes I and II increased significantly in the experimental group (264±14.11, p<0.0005).Conclusion: It seems that administration of onion extract affects both structure and proliferation of cells in tubules and enhances spermatogenesis in the murine. 239 245 Mohammad-Reza MR Nikravesh محمدرضا نیکروش Department of Anatomy and Cell Biology, Faculty of Medicine, Mashad University of Medical Sciences Department of Anatomy and Cell Biology, Faculty of Medicine, Mashad University of Medical Sciences Iran Mehdi M Jalali مهدی جلالی Department of Anatomy and Cell Biology, Faculty of Medicine, Mashad University of Medical Sciences Department of Anatomy and Cell Biology, Faculty of Medicine, Mashad University of Medical Sciences Iran Shabnam Sh Mohammadi شبنم محمدی Department of Anatomy and Cell Biology, Faculty of Medicine, Mashad University of Medical Sciences Department of Anatomy and Cell Biology, Faculty of Medicine, Mashad University of Medical Sciences Iran mohammadish1@mums.ac.ir Allium cepaGonadOnionPlant extractsSperm maturationSpermatidSpermiogenesisSpermatozoaTestis 391.pdf Shaath NA, Flores FB. Egyptian onion oil. Dev Food Sci. 1998;40:443-53.##Zargari A. Medicinal plants. 5th ed. Vol. 4, Tehran: Tehran University; 1993. 623 p.##Corzo-Martinez M, Corzo N, Villamiel M. Biological properties of onions and garlic. Trends Food Sci Technol. 2007;18(12):609-25.##Ali M, Thomson M, Afzal M. Garlic and onions: their effect on eicosanoid metabolism and its clinical relevance. Prostaglandins Leukot Essent Fatty Acids. 2000;62(2):55-73.##Jakubowski H. On the health benefits of Allium sp. Nutrition. 2003;19(2):167-8.##Lanzotti V. The analysis of onion and garlic. J Chromatogr A. 2006;1112(1-2):3-22.##Nuutila AM, Puupponen-Pimia R, Aarni M, Oksman-Caldentey KM. Comparison of antioxidant activities of onion and garlic extracts by inhibition of lipid peroxidation and radical scavenging activity. Food Chem. 2003;81(4):485-93.##Taylor PR, Parnes HL, Lippman SM. Science peels the onion of selenium effects on prostate carcinogenesis. J Natl Cancer Inst. 2004;96(9):645-7. Review.##Ola-Mudathir KF, Suru SM, Fafunso MA, Obioha UE, Faremi TY. Protective roles of onion and garlic extracts on cadmium-induced changes in sperm characteristics and testicular oxidative damage in rats. Food Chem Toxicol. 2008;46(12):3604-11.##Izawa H, Kohara M, Aizawa K, Suganuma H, Inakuma T, Watanabe G, et al. Alleviative effects of quercetin and onion on male reproductive toxicity induced by diesel exhaust particles. Biosci Biotechnol Biochem. 2008;72(5):1235-41.##Wing TY, Christensen AK. Morphometric studies on rat seminiferous tubules. Am J Anat. 1982; 165(1):13-25.##Behnam-Rasouli M, Nikravesh MR, Mahdavi-Shahri N, Tehranipour M. Post-Operative Time Effects after Sciatic Nerve Crush on the Number of Alpha Motoneurons, Using a Stereological Count-ing Method (Disector). IBJ. 2000;4(1):41-49.##Kidd SA, Eskenazi B, Wyrobex AJ. Effects of male age on semen quality and fertility: a review of the literature. Fertil Steril. 2001;75(2):237-48.##Khaki A, Fathiazad F, Nouri M, Khaki AA, Khamenehi HJ, Hamadeh M. Evaluation of androgenic activity of allium cepa on spermatogen-esis in the rat. Folia Morphol (Warsz). 2009;68(1): 45-51.##World Health Organization. WHO monographs on selected medicinal plants. 1st ed. Geneva: WHO; 1999. p. 77-85.##Amin A, Hamza AA. Effects of Roselle and Ginger on cisplatin-induced reproductive toxicity in rats. Asian J Androl. 2006;8(5):607-12.##Kaur R, Kaur K. Effects of dietary selenium (SE) on morphology of testis and cauda epididymis in rats. Indian J Physiol Pharmacol. 2000;44(3):265-72.##Agarwal A, Nallella KP, Allamaneni SS, Said TM. Role of antioxidants in treatment of male infertil-ity: an overview of the literature. Reprod Biomed Online. 2004;8(6):616-27.##Agarwal A, Prabakaran SA, Said TM. Prevention of oxidative stress injury to sperm. J Androl. 2005; 26(6):654-60.##Osinubi AA, Noronha CC, Okanlawon AO. Mor-phometric and stereological assessment of the effects of long-term administration of quinine on the morphology of rat testis. West Afr J Med. 2005;24(3):200-5.##

بررسی اثر ال‌ـ کارنیتین در بهبود پارامترهاي اسپرم مردان نابارور: یک کارآزمایی بالینی متقاطع Effects of L-carnitine on Infertile Men’s Spermogram; a Randomized Clinical Trial 2 1 زمينه و هدف: کاهش ميزان باروری مردان یکی از مسائل مهم علم ناباروري و اختلال در تولید اسپرم از علل اصلي ناباروري مردان است. علت نقص تولید اسپرم در اکثر موارد ناشناخته است. درمان‌های دارويي متعددی از جمله تجويز ال‌ـ كارنيتين برای افزایش تعداد و تحرک اسپرم معرفی شده‌اند. کارنیتین در مواد غذایی وجود دارد و از اسید آمینه لیزین و متی‌یونین مشتق می‌شود و ال‌ـ کارنیتین که در اپیدیدیم متمرکز شده سبب انتقال اسیدهای چرب به درون میتوکندری و در اکسیداسیون اسيدهاي چرب به عنوان منبع اصلي انرژي اسپرمها دخالت دارد. کارنیتین سبب حفاظت غشای سلول در برابر صدمات ناشی از رادیکال‌های آزاد اکسیژن نیز می‌شود. با توجه به تأثیر کارنیتین در متابولسیم سلولی، این مطالعه براي بررسی اثر ال‌ـ کارنیتین در بهبود پارامترهاي غیرطبیعی اسپرموگرام انجام شد.روش بررسي: این مطالعه به روش کارآزمایی بالینی، دوسوکور و تصادفی و به صورت متقاطع در 30 مرد نابارور مراجعه کننده به کلینیک ناباروري بیمارستان امام خمینی شهر ساری در سال 86-1385 انجام شد. بیماران داراي اسپرموگرام غیرطبیعی براساس معیارهای WHO حداقل در دو نمونه به فاصله 4 هفته كه سطح گنادوتروپینها و تستوسترون و پرولاکتین آنها نرمال بود وارد مطالعه و به طور تصادفي به دو گروه A و B تقسيم شدند. معیارهای خروج از مطالعه عبارت بود از: 1ـ وجود عامل زمینه‌ای مثل واریکوسل درجه 3 و4، آتروفی بیضه، اختلال انزال، 2ـ مصرف هرگونه دارو در 2 ماه گذشته، 3ـ بیماران مبتلا به آزواسپرمی، اختلالات اندوکرین و آناتومیک یا عفونت، 4ـ بیماران کاندید ICSI به علت اختلال شدید اسپرموگرام یا سایر علل ناباروري. دو گروه به ترتیب تحت درمان با قرص کارنیتین g2 در روز و دارونما به مدت دو ماه قرار گرفتند. سپس به مدت دو ماه مصرف دارو و دارونما قطع شد. پس از آن به مدت دو ماه افرادی که قبلاً دارو دریافت کرده بودند دارونما و افرادی که دارونما دریافت کرده بودند دارو مصرف نمودند. بررسی اسپرموگرام در 4 مرحله قبل از ورود به طرح، بعد از مداخله اول، بعد از قطع دارو و دارونما و بعد از مداخله دوم انجام شد. تجزیه و تحلیل آماری توسط آمار توصیفی (MSD) زوج و مستقل t-test با 05/0p< صورت گرفت.نتايج: در بيماران مورد مطالعه بعد از 2 ماه مصرف داروي كارنيتين، افزايش معني‌داري در غلظت اسپرم، حركت كلي و حركت رو به جلو ديده شد ولي تغييري در حجم و اشكال طبيعي اسپرم ديده نشد ( 0005/0p=) اين تغييرات 2 ماه بعد از قطع مصرف دارو به حالت اوليه برگشت. در همه این بيماران حین مصرف دارونما تغييري در هيچ‌كدام از پارامترهاي اسپرموگرام مشاهده نشد. نتيجه‌گيري: در مطالعه حاضر کارنیتین دارویی مؤثر در افزایش تعداد اسپرم و افزایش قدرت تحرک و حرکت رو به جلوی اسپرم بود. انجام مطالعات وسیع‌تر بالینی جهت شفاف شدن بیشتر نقش کارنیتین در درمان ناباروری مردان توصیه می‌شود. 2 Introduction: Male infertility is one of the most challenging problems in andrology. The common cause of male infertility is related to disorders in sperm production and its improvement is synonymous with better treatment outcomes. Although, the etiology of infertility is not clear in most cases but different treatment options have been suggested to increase sperm count and motility. L-carnitine, which is found in different food items and it is derived from lysine and methionine, is a substance essential for the oxidation of long-chain fatty acids in the mitochondria and protection of cell membranes from damages caused by free oxygen radicals. This study was done to evaluate the efficacy of L-carnitine in improving sperm quality in infertile men.Materials and Methods: This double blind randomized cross-over, clinical trial was conducted on 30 infertile men attending Sari Imam Khomeini Hospital’s Infertility Clinic during 2005- 2006. Subjects that had at least two abnormal spermograms, based on WHO criteria, with a two-week interval during four weeks and their gonadotropins, testosterone an prolactin concentrations were within normal range were recruited for the study. The exclusion criteria were composed of individuals with medical conditions other than infertility such as grade 3 or 4 varicocele, testicular atrophy, ejaculatory disorders, use of any medications in the past two months prior to the study, azoospermia, endocrinological disorders, ICSI candidacy for severe spermogram abnormalities or other causes of infertility.The patients were randomly allocated to two groups of A and B. Group A and B received L-carnitine and placebo 2g/day for 8 weeks respectively. After a washout period of 8 weeks, the two groups, changed place and received placebo and L-carnitine (2g/day×8w). Sperm analyses were done in four stages: Before and after the first intervention, at the end of washout period and after the second intervention.Results: There were significant improvements in mean sperm concentration and progressive sperm motility upon two months of L-carnitine intake (p<0.05) but no significant changes were found in sperm volume or morphology. The aforementioned changes retracted to the primary status after two months. No changes were seen following the intake of placebos in the cases.Conclusion: L-carnitine intake effectively improved the mean sperm count and progressive sperm motility. However, confirmation of these results warrants more thorough clinical trials. 245 252 Sepideh S Peivandi سپیده پیوندی Department of Obstetrics and Gynecology, Faculty of Medicine, Mazandaran University of Medical Sciences Department of Obstetrics and Gynecology, Faculty of Medicine, Mazandaran University of Medical Sciences Iran dr_peyvandi@yahoo.com Abasali A Karimpour عباسعلی کریمپور Department of Anatomy and Embryology, Faculty of Medicine, Mazadaran University of Medical Sciences Department of Anatomy and Embryology, Faculty of Medicine, Mazadaran University of Medical Sciences Iran Narges N Moslemizadeh نرگس مسلمی‌زاده Department of Obstetrics and Gynecology, Faculty of Medicine, Mazandaran University of Medical Sciences Department of Obstetrics and Gynecology, Faculty of Medicine, Mazandaran University of Medical Sciences Iran GonadotropinL-carnitineMale infertilityOligoastenospermiaProlactinSperm analysisSperm motilityTestosterone 392.pdf Rowe PJ, Comhaire FH, Hargreave TB, Mahmoud Ahmed MA. WHO manual for the standardized investigation, diagnosis and management of the infertile male. London: Cambridge University Press; 2000. p. 37-60.##Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. 1334 p.##Sinclair S. Male infertility: nutritional and environ-mental considerations. Altern Med Rev. 2000;5(1):28-38.##Lenzi A, Sgrò P, Salacone P, Paoli D, Gilio B, Lombardo F, et al. A placebo-controlled double-blind randomized trial of the use of combined l-carnitine and l-acetyl-carnitine treatment in men with asthenozoospermia. Fertil Steril. 2004;81(6): 1578-84.##Jeulin C, Lewin LM. Role of free L-carnitine and acetyl-L-carnitine in post-gonadal maturation of mammalian spermatozoa. Hum Reprod Update. 1996;2(2):87-102. Review.##Jeulin C, Dacheux JL, Soufir JC. Uptake and release of free L-carnitine by boar epididymal spermatozoa in vitro and subsequent acetylation rate. J Reprod Fertil. 1994;100(1):263-71.##Arduini A. Carnitine and its acyl esters as secondary antioxidants? Am Heart J. 1992;123(6):1726-7.##Sigman M, Glass S, Campagnone J, Pryor JL. Carnitine for the treatment of idiopathic astheno-spermia: a randomized, double-blind, placebo-controlled trial. Fertil Steril. 2006;85(5):1409-14.##Hinton BT, Snoswell AM, Setchell BP. The concen-tration of carnitine in the luminal fluid of the testis and epididymis of the rat and some other mammals. J Reprod Fertil. 1979;56(1):105-11.##Zöpfgen A, Priem F, Sudhoff F, Jung K, Lenk S, Loening SA, et al. Relationship between semen quality and the seminal plasma components carnitine, alpha-glucosidase, fructose, citrate and granulocyte elastase in infertile men compared with a normal population. Hum Reprod. 2000;15 (4):840-5.##Lewin LM, Beer R, Lunenfeld B. Epididymis and seminal vesicle as sources of carnitine in human seminal fluid: the clinical significance of the carni-tine concentration in human seminal fluid. Fertil Steril. 1976;27(1):9-13.##Menchini-Fabris GF, Canale D, Izzo PL, Olivieri L, Bartelloni M. Free L-carnitine in human semen: its variability in different andrologic pathologies. Fertil Steril. 1984;42(2):263-7.##Lenzi A, Lombardo F, Sgrò P, Salacone P, Caponecchia L, Dondero F, et al. Use of carnitine therapy in selected cases of male factor infertility: a double-blind crossover trial. Fertil Steril. 2003; 79(2):292-300.##Moncada ML, Vicari E, Cimino C, Calogero AE, Mongioì A, D'Agata R. Effect of acetylcarnitine treatment in oligoasthenospermic patients. Acta Eur Fertil. 1992;23(5):221-4.##Vitali G, Parente R, Melotti C. Carnitine supple-mentation in human idiopathic asthenospermia: clinical results. Drugs Exp Clin Res. 1995;21(4): 157-9.##Costa M, Canale D, Filicori M, D'lddio S, Lenzi A. L-carnitine in idiopathic asthenozoospermia: a multicenter study. Italian Study Group on Carnitine and Male Infertility. Andrologia. 1994;26(3):155-9.##Balercia G, Regoli F, Armeni T, Koverech A, Mantero F, Boscaro M. Placebo-controlled double-blind randomized trial on the use of L-carnitine, L-acetylcarnitine, or combined L-carnitine and L-acetylcarnitine in men with idiopathic asthenozoo-spermia. Fertil Steril. 2005;84(3):662-71.##Zhou X, Liu F, Zhai S. Effect of L-carnitine and/or L-acetyl-carnitine in nutrition treatment for male infertility: a systematic review. Asia Pac J Clin Nutr. 2007;16(Suppl 1):383-90.##

بررسی تأثیر ریشه گیاه سنبل‌الطیب (Valeriana Officinalis) بر شدت دیسمنوره اولیه Effects of Valeriana Officinalis on the Severity of Dysmenorrheal Symptoms 2 1 زمینه و هدف: دیسمنوره اولیه به کرامپ‌های دردناک قاعدگی بدون علت ارگانیک گفته می‌شود. با توجه به شیوع بالای دیسمنوره اولیه و پیامدهای نامطلوب آن بر کیفیت زندگی و نیز شواهدی دال بر خاصیت سنبل‌الطیب به عنوان گیاه دارویی آرام‌بخش و ضداسپاسم عضلات صاف، این مطالعه به منظور تعیین تأثیر کپسول سنبل‌الطیب بر شدت دیسمنوره در دانشجویان دانشگاه آزاد اسلامی زنجان در سال 1388 انجام گرفت.روش بررسی: این مطالعه از نوع کارآزمایی بالینی دو سوکور روی 100 نفر از دانشجویان دانشگاه آزاد زنجان از بهمن 1387 لغایت تیر 1388 انجام شد. نمونه‌ها از نظر شدت دیسمنوره مشابه‌سازی شده و سپس به صورت تصادفی در دو گروه 49 و 51 نفری قرار گرفتند. افراد دو گروه از لحاظ سن، سن منارک ،سن اولين دیسمنوره، شاخص توده بدنی، تحصیلات و شغل پدر و مادر، طول، فاصله و میزان خونریزی قاعدگی در دو گروه يكسان شدند. برای افراد گروه مورد، کپسول‌های محتوی mg 255 پودر ریشه گیاه سنبل‌الطیب سه بار در روز به مدت سه روز با شروع خونریزی تجویز گردید و به افراد گروه كنترل، کپسول‌هایی مشابه با همان دستورالعمل و حاوی نشاسته و در طی دو سیکل تجویز شد. شدت درد براساس معیار آنالوگ بینایی (0 تا 10 سانتی‌متر) و علایم سیستمیک با استفاده از سیستم معیار چند بعدی گفتاری قبل از مطالعه و در طی دو سیکل متوالی پیگیری و مقایسه گردید. اطلاعات به‌دست آمده با استفاده از نرم افزار SPSS 16 و توسط آماره‌های توصیفی و استنباطی از جمله شاخص‌های میانگین و انحراف معیار و تست‌های من ویتنی، فریدمن و ویلکاکسون مورد تجزیه و تحلیل قرار گرفت. سطح معني‌داري 05/0 در نظر گرفته شد.نتایج: میانگین شدت درد قبل از مصرف دارو در گروه مورد و كنترل تفاوت معنی‌داری نداشت. اما پس از مصرف دارو میانگین شدت درد در دو گروه کاهش یافت (001/0p<). ولی این کاهش در گروه مورد بیشتر و اختلاف بین دو گروه به لحاظ آماری معنی‌دار بود (05/0p<). همچنين مجموع نمرات شدت کل علايم سيستميک همراه با ديسمنوره نسبت به قبل از درمان کاهش پيدا کرد؛ اما اين کاهش از لحاظ آماري بين دو گروه مصرف‌كننده سنبل‌الطيب و دارونما معني‌دار نبود. به جز در مورد متغير شدت غش که اختلاف آماري بين دو گروه معني‌دار بود (05/0p<).نتیجه‌گیری: با توجه به نتایج بررسی حاضر به نظر می‌رسد سنبل‌الطیب می‌تواند باعث کاهش شدت دیسمنوره شود که به نظر می‌رسد به علت اثرات ضد انقباضی سنبل‌الطیب است. انجام مطالعات بعدي با استفاده از ماده مؤثره اين گياه دارويي براي كاربرد گسترده آن توصيه مي‌شود. 2 Introduction: Primary dysmenorrhea refers to painful cramps during menstruation with no organic origin. Regarding the high prevalence of dysmenorrhea and its adverse effects on the quality of life of sufferers and the evidence on sedative and antispasmodic properties of Valerian officinalis on smooth muscles, this double-blind clinical trial was conducted to determine the effects of the herb on the severity of dysmenorrheal symptoms in Zanjan Islamic Azad University students during 2009. Materials & Methods: The subjects included 100 students who were matched for dysmenorrheal severity, age, menarche onset, body mass index (BMI), duration, interval and amount of bleeding as well as occupation and educational achievements of their parents. The subjects were randomly divided into experimental (49 subjects) and control (51 subjects) groups. The experimental group took 255mg capsules of the herb, three times a day for three days at the onset of menses while the controls similarly took placebo (capsules containing starch). Pain severity was evaluated by a visual analogue scale (0 to 10cm) and systemic manifestations by a multidimensional verbal scale before and during two consecutive menstrual cycles. The severity and duration of symptoms were analyzed and compared between the two groups. Results: There were no significant differences in pain severity between the two groups before the intervention. However, pain severity was reduced in both groups after the intervention (p<0.001) with significantly more relieving results in the experimental group (p<0.05). In addition, the total scores for systemic manifestations associated with dysmenorrhea, insignificantly decreased in both groups, except occurrence of syncope (p<0.05). Conclusion: Valeriana officinalis decreased dysmenorrheal symptoms, which it might be attributed to its antispasmodic effects. Further studies are warranted for the use of Valerian officinalis in decreasing dysmenorrheal symptoms. 253 260 Parvaneh P Mirabe پروانه میرابی M.Sc. Student, International Branch, Shaheed Beheshti University of Medical Sciences M.Sc. Student, International Branch, Shaheed Beheshti University of Medical Sciences Iran Mahrokh M Dolatian ماهرخ دولتیان Department of Midwifery, International Branch, Shaheed Beheshti University of Medical Sciences Department of Midwifery, International Branch, Shaheed Beheshti University of Medical Sciences Iran mhdolatian@yahoo.com Faraz F Mojab فراز مجاب Department of Pharmacogenosy, Faculty of pharmacy, Shaheed Beheshti University of Medical Sciences Department of Pharmacogenosy, Faculty of pharmacy, Shaheed Beheshti University of Medical Sciences Iran Hamid H Alavimajd حمید علوی‌مجد Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences Iran Dysmenorrheal painPrimary dysmenorrheaSpasmValeriana officinalisVisual analogue pain scale 393.pdf French L. Dysmenorrhea. Am Fam Physician. 2005; 71(2):285-91.##Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. Chapter 14, Dysmenorrhea; p. 539.##Berek JS, Novak E. Novak’s Gynecology. 14th ed. Philadelphia: Lippincott Williams & Wilkins; 2007. Chapter 29, Dysmenorrhera; p. 516.##Agarwal A, Venkat A. Questionnaire study on men-strual disorders in adolescent girls in Singapore. J Pediatr Adolesc Gynecol. 2009;22(6):365-71.##Singh A, Kiran D, Singh H, Nel B, Singh P, Tiwari P. Prevalence and severity of dysmenorrhea: a problem related to menstruation, among first and second year female medical students. Indian J Physiol Pharmacol. 2008;52(4):389-97.##Loto OM, Adewumi TA, Adewuya AO. Prevalence and correlates of dysmenorrhea among Nigerian college women. Aust N Z J Obstet Gynaecol. 2008; 48(4):442-4.##Poureslami M, Amin E, Sarmast H. [Assessment of knowledge ,attitudes, and behaviour of adolescent girls in suburban districts of Tehran regarding dysmenorrhea and menstrual hygiene]. J Shaheed Sadoughi Univ Med Sci. 2001;9(Suppl 4):S23-30. Persian.##Panahande Z, Pakzad Z, Ashoori R. [Survey the prevalence, knowledge and practice of Gilan univer-sity students about dysmenorrheal]. J Gilan Univ Med Sci. 2007;17(2):87-94. Persian.##Noroozi A, Tahmasebi R. [Pattern of menstruction, hirsutism and dysmenorrhea in students of Boushehr Medical and Khalig-e-Fars universities (2002-2003)]. Med J Hormozgan Univ. 2004;7(4):203-9. Persian.##Hsu CS, Yang JK, Yang LL. Effect of a dysmenor-rhea Chinese medicinal prescription on uterus contractility in vitro. Phytother Res. 2003;17(7): 778-83.##Neville F, Hacker J, Moore G. Essentials of obstetrics and gynecology . 4th ed. Malek Mohammadi S, Arian Mehr S, Ghaem Maghami F, translator. Tehran: Teymour zadeh & Tabib; 2004. p. 290.##DeCherney AH, Nathan L. Current obstetric & gynecologic diagnosis & treatment. 9th ed. New Yourk: McGraw-Hill Professional; c2003. Chapter 3, Dysmenorrhea; p. 625.##Ebadi M. ‎Pharmacodynamic basis of herbal medicine. 1st ed.London: CRC Press; 2001. Chapter 58, Valerian for sleep disorders; p. 938.##Samsam Shariat H. Collection of medicinal herbs. 1st ed. Tehran: Char Bagh; 2007. p. 938.##DerMarderosian A, Beutler JA. The review of natural products: the most complete source of natural product information. 1st ed. Philadelphia: Facts and Comparisons; 2001. p. 609.##Mills S, Bone K. The essential guide to herbal safety. 1st ed. Philadelphia: Elsevier Health Sciences; 2005. p. 616.##Braun L, Cohen M. Herbs & natural supplements: an evidence-based guide. 1st ed. Sydney: Elsevier Australia; 2005. p. 373.##Thomson Healthcare (Firm). PDR for herbal medicines. 3rd ed. Montvale: Thomson; 2004. p. 852.##Barnes J, Anderson LA, Phillipson JD, Newall CA. Herbal medicines: a guide for healthcare professionals. 2nd ed. London: Pharmaceutical Press; 2002. p. 468.##de Smet P. ‎Adverse effects of herbal drugs. 1st ed. Tafaghodi M, Amiri R, Hossein zadeh H, translator. Mashhad: Mashhad University of Medical Sciences; 2006. p. 220.##Hadley S, Petry JJ. Valerian. Am Fam Physician. 2003;67(8):1755-8. Review.##de Smet P. Adverse effects of herbal drugs. 2nd ed. Vol. 3. Valeriana. Michigan: Springer-Verlag; c1997. p. 210.##Gilani AH, Khan AU, Jabeen Q, Subhan F, Ghafar R. Antispasmodic and blood pressure lowering effects of Valeriana wallichii are mediated through K channel activation. J Ethnopharmacol. 2005; 100(3):347-52.##Beckmann CR, Barzansky BM, Herbert WN. Obstetrics and Gynecology‎. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 205.##Amanzadeh Y. Herbal Pharmacopoeia. 1st ed. Tehran: Food and Drug Department of the Ministry of Health and Medical Education; 2003. p. 456.##Occhiuto F, Pino A, Palumbo DR, Samperi S, De Pasquale R, Sturlese E, et al. Relaxing effects of Valeriana officinalis extracts on isolated human non-pregnant uterine muscle. J Pharm Pharmacol. 2009;61(2):251-6.##Andreatini R, Sartori VA, Seabra ML, Leite JR. Effect of valepotriates (valerian extract) in generalized anxiety disorder: a randomized placebo-controlled pilot study. Phytother Res. 2002;16(7): 650-4.##Circosta C, De Pasquale R, Samperi S, Pino A, Occhiuto. Biological and analytical characterization of two extracts from Valeriana officinalis. J Ethnopharmacol. 2007;112(2):361-7.##Roozbahani N, Jabbari Z, Yazdi S. [The compari-son of Shirazi Thymus Vulgaris and Mefenamic acid effects on primary dysmenorrhea]. J Arak Univ Med Sci. 2005;8(3):1-6. Persian.##Torkzahrani Sh, Akhavan-Amjadi M, Mojab F, Alavi Majd H. [Clinical effects of Foeniculum vulgare extract on primary dysmenorrheal]. J Reprod Infertil. 2007;8(1):45-51. Persian.##Shahraz S, Ghaziani T. Generic Pharmacopoeia of Iran. 1st ed. Tehran: Teymourzadeh. 2004. p. 51.##

تعیین مدلی برای پیشگویی‌ زودرس بروز پره‌اکلامپسی A Predictive Model for the Diagnosis of Preeclampsia 2 1 زمینه و هدف: پره‌اکلامپسی یکی از سه علت اصلي مرگ زنان باردار است و عوارض جبران‌ناپذیری برای مادر و جنین به همراه دارد. تاکنون روش قطعی برای تشخیص این بیماری، ارائه نشده است. با توجه به اينكه در ایران مطالعه‌ای به منظور بررسی اثر همزمان متغیرهای مختلف برای پیش‌بینی و جدا سازی افراد مبتلا به پره‌اکلامپسی انجام نشده؛ لذا هدف این مطالعه بررسي تأثیر همزمان این متغیرها در بروز پره‌اکلامپسی است.روش بررسی: این مطالعه روی ۴۶۶ نفر از زنان نخست‌زاي به تصادف انتخاب شده انجام گرفت که جهت دريافت خدمات پره‌ناتال در سال ۱٣۸۶-۱٣۸۷ به درمانگاه پره‌ناتال بيمارستان مريم شهر تهران مراجعه کرده، فاقد بیماری‌های زمینه‌اي بودند و به طور منظم قرص آهن مصرف می‌کردند. متغیرهای سن، شغل، تحصیلات، وضعیت درآمد، تعداد ازدواج، شاخص توده بدنی در سه ماهه اول بارداری، سن بارداري افراد در زمان ورود به مطالعه، تغییرات میزان هماتوکریت در شروع بارداری و هفته ۲4-۲8 بارداری، فشار خون و آزمون غلتیدن در هفته ٣۲-۲۸ و سن بارداري افراد در زمان انجام این دو آزمون به‌عنوان متغیرهای پیش‌بینی‌کننده و بروز پره‌اکلامپسی به‌عنوان متغیر وابسته دو حالتی وارد مدل شدند. به منظور تحلیل داده‌ها از آزمون‌های t، 2، دقیق فیشر و من‌ویتنی، و براي بررسی اثر همزمان متغیرهای مورد بررسی در پیش‌بینی بیماری از مدل رگرسیون لجستیک چندگانه استفاده شد. از منحنی راک برای تعیین نقطه برش مناسب جهت تعیین حساسیت و ویژگی این مدل استفاده شد. نرم افزار (ويرايش ۵/۱۱) SPSS مورد استفاده قرار گرفت و سطح معنی‌داری ۰۵/۰ در نظر گرفته شد.نتایج: در این مطالعه شیوع پره‌اکلامپسی ۴/۶% (۶/۸-۲/۴: فاصله اطمینان ٩۵%) برآورد شد. مشاهده شد که متغیرهای نتیجه مثبت آزمون غلتیدن، داشتن تحصیلات دانشگاهی، تعداد ازدواج بیشتر از یکبار، افزایش فشار خون در هفته ۲۸-۲۴ بارداري، خانه‌دار بودن، رضایت از وضع درآمد، انجام دیرتر آزمون غلتیدن و افزایش شاخص توده بدنی به ترتیب می‌توانند شانس ابتلا به پره‌اکلامپسی را ۶۱/۸، ۹۸/۷، ۶۵/۲، ۸۴/۱ و ۵۶/۱ و ۲۸/۱ و ۲۱/۱ و۱۱/۱ برابر كنند. مدل رگرسیون لجستیک پیشنهادی برای غربالگری پره‌اکلامپسی با حضور همه متغیرهای فوق دارای حساسیت ۸٣% و ویژگی ۷۶% بود.نتیجه‌گیری: با توجه به عوارض جبران‌ناپذیر این بیماری برای مادر و جنین و بالا بودن میزان حساسیت مدل رگرسیون لجستیک پیشنهادی و اینکه اندازه‌گیری متغیرهای مورد مطالعه هزینه‌ای را به فرد تحمیل نمی‌کند این مدل برای غربالگری مناسب به نظر می‌رسد. 2 Introduction: Preeclampsia is one of the three main causes of death in pregnant women. The medical condition is identified by hypertension and proteinuria with serious effects on the health of mother and the fetus. There seems to be no precise methods to diagnose preeclampsia at its onset. This study was done to evaluate the simultaneous measurement of some variables thought to be responsible in the pathogenesis of preeclampsia for predicting or screening those at risk. Materials and Methods: In this study, 466 primiparas were selected randomly among the bulk of pregnant women who attended Maryam Hospital for prenatal care in Tehran, Iran during 2007-2008. The subjects had no history of chronic health conditions and regularly took Iron supplements. The predictive variables included age, job, education, income, number of pervious marriages, BMI during the first trimester of pregnancy, age at the time of recruitment for the study, changes in hematocrit concentration at the beginning and the 24th to 28th weeks of pregnancy, blood pressure and roll-over test during 28th to 32nd week of gestation but the onset of preeclampsia was considered as a dependent variable. For analyzing the overall effects of the mentioned variables on prediction of the disease, multivariate logistic regression analysis was employed and ROC curves were used for determining a suitable cut-off point for determining the sensitivity and specificity of the model. Results: The prevalence of preeclampsia was 6.4% (95% CI: 4.2-8.6). Variables such as positive roll-over test, fulfillment of university education, marriage more than once, high blood pressure during the 24th-28th weeks of gestation, being a housekeeper, satisfaction with income, positive roll over test at a late stage of gestation and increase in BMI raised the risk of preeclampsia 8.61, 7.98, 2.65, 1.84, 1.56, 1.28, 1.21 and 1.11 times respectively. The proposed logistic regression model had a sensitivity of 83% and a specificity of 76% regarding the inclusion of all the mentioned variables.Conclusion: Regarding the serious complications and negative effects of preeclampsia on both the mother and the fetus and the high sensitivity of this logistic regression model and imposition of no costs on the person for the measurement of the variables, this model seems to be suitable for the screening of preeclampsia. 261 268 Elahe E Allahyari الهه الله یاری Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Iran Abbas A Rahimi Foroushani عباس رحیمی فروشانی Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Iran rahimifo@tums.ac.ir Hojjat H Zeraati حجت زراعتی Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Iran Kazem K Mohammad کاظم محمد Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences Iran Ziba Z Taghizadeh زیبا تقی‌زاده Department of Midwifery, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences Department of Midwifery, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences Iran Blood pressureBody Mass IndexDiagnosisLogistic modelsPredictivePreeclampsiaPregnancy complicationsRisk factor 394.pdf Heilmann L, Siekmann U. 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Am J obstet Gynecol. 2005;(217):141-62.##Hatfield A, Robinson E. The 'debriefing' of clients following the birth of a baby. Pract Midwife. 2002; 5(5):14-6.##Rudra CL, Williams MA. BMI as a modifying factor in the relations between age at menarche, menstrual cycle characteristics, and risk of preeclampsia. Gynecol Endocrinol. 2005;21(4):200-5.##Mittendorf R, Lain KY, Williams MA, Walker CK. Preeclampsia. A nested, case-control study of risk factors and their interactions. J Reprod Med. 1996; 41(7):491-6.##Klonoff-Cohen HS, Cross JL, Pieper CF. Job stress and preeclampsia. Epidemiology. 1996;7(3):245-9.##Zhang J, Patel G. Partner change and perinatal outcomes: a systematic review. Paediatr Perinat Epidemiol. 2007;21 Suppl 1:46-57.##Lachmeijer AM, Crusius JB, Pals G, Dekker GA, Arngrímsson R, ten Kate LP. Polymorphisms in the tumor necrosis factor and lymphotoxin-alpha gene region and preeclampsia. Obstet Gynecol. 2001;98(4):612-9.##Kazemi A. 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مقايسه رضايت جنسی در زنان بارور و نابارور مراجعه‌كننده به مراكز دولتی شهر مشهد Sexual Satisfaction in Fertile and Infertile Women Attending State Clinics in Mashad 2 1 زمينه و هدف: رضايت زناشويي يكي از فاكتورهاي مهم مؤثر بر سلامتي زنان و از مهمترين شاخص‌هاي رضايت از زندگي است كه بر ميزان سلامت رواني زوجين نيز تأثير مي گذارد. از سويي ناسازگاري در روابط زناشويي موجب اختلال در روابط اجتماعي گرايش به انحرافات اجتماعي و افول ارزش‌هاي فرهنگي بين زن و شوهرها مي‌شود. جهت تداوم و استحكام زندگي زناشويي رضايت جنسي مورد نياز است. برخي از محققين بر اين باورند كه علت اصلي و حقيقي 80% اختلافات زناشويي، عدم رضايت جنسي زوجين است. از طرف ديگر وضعيت باروري يكي از متغيرهاي مؤثر بر رضايت جنسي است. براساس مطالعات متعدد، ناباروري سبب اختلالات روانشناختي مختلف از جمله عدم رضايت جنسي مي‌شود. در مقابل، تعدادي از مطالعات بر اين نكته تأكيد دارند كه شركت زوجين در مراحل گوناگون تشخيص و درمان ناباروري، مي‌تواند سبب افزايش صميميت و ارتباط بهتر آن دو با يكديگر گردد. از آنجا كه در ايران مطالعات كمي روي رضايت جنسي زنان نابارور، به ويژه در مقايسه با گروه زنان بارور به عنوان گروه كنترل صورت گرفته است، مطالعه حاضر با هدف مقايسه رضايت جنسي زنان بارور و نابارور انجام پذيرفت.روش بررسي: اين مطالعه از نوع مقطعي با روش نمونه‌گيري غيراحتمالي و مبتني بر هدف است و روي 100 زن بارور و 100 زن نابارور مراجعه كننده به مراكز دولتي شهر مشهد در سال 1386 انجام شد. افراد مورد بررسي زنان 22 تا 45 ساله و تنها همسر شوهرشان بودند. همچنين زنان بارور از يك روش جلوگيري استفاده مي‌كردند و زنان نابارور مشمول تعريف ناباروري بودند. بعد از توضيح در مورد اهداف و چگونگي انجام پژوهش و داشتن رضايت نسبت به شركت در مطالعه، پرسشنامه بررسي سلامت عمومي (GHQ28) و فرم رضايت جنسي، تكميل و سپس داده‌ها با استفاده از آزمون‌هاي 2 و من‌ويتني تجزيه و تحليل شد. در آزمون‌هاي انجام شده سطح معني‌داري، 05/0p< مد نظر قرار گرفت.نتايج: دو گروه از نظر مشخصات دموگرافيكي و ساير متغيرهاي مداخله‌گر و نيز سلامت عمومي، اختلاف آماري معني‌داري نداشتند. امتياز حاصل از مقياس رضايت جنسي در هر دو گروه، متوسط (در زنان بارور 23/12±66/59 و در زنان نابارور 62/11±65/61) و تفاوت آماري غير معني‌دار بود. نتيجه‌گيري: در مطالعه حاضر، رضايت جنسي هر دو گروه در حد متوسط بود كه نشان دهندة سطح آگاهي پايين تمامي افراد از مسائل جنسي و عدم آموزش كافي به زوجين قبل و بعد از ازدواج است؛ لذا پيشنهاد مي‌شود با ترتيب دادن امكان مشاوره و آموزش در زمينه مسائل مرتبط با رضايت جنسي در افزايش رضايت جنسي زوجين برنامه‌ريزي گردد. 2 Introduction: Marital satisfaction is correlated with mental health, general happiness, professional achievements and successful social interactions. It seems that sexual satisfaction is one of the necessities for a healthy and sustainable marital relationship. Some studies have revealed that sexual dissatisfaction is the underlying cause of nearly 80% of marital conflicts, while, some other studies have suggested infertility as one of the key factors affecting sexual satisfaction. This study was undertaken to compare marital and sexual satisfaction in fertile and infertile women.Materials & Methods: In this cross-sectional analytical study carried out during 2007, one hundred fertile women attending the family planning units of Mashad Urban Health Centers, and one hundred infertile women, attending Montaserieh Infertility Center were chosen by quota sampling. The participants were 22-45 years old and had no extramarital relationships. The fertile women used a contraceptive method but the infertile ones had been unable to conceive a child after a year of regular and unprotected intercourse. The subjects who were willing to participate in the study were asked to complete two sexual satisfaction and general health questionnaires (GHQ28).Results: There were no significant statistical differences between the fertile or the infertile women regarding the demographic data and the general health status of the participants. Sexual satisfaction was not significantly different between the fertile and infertile groups and both showed average degrees of sexual satisfaction (59.66±12.23 and 61.65±11.62, respectively; p=0.24).Conclusion: Average sexual satisfaction was noted in both fertile and infertile individuals, which depicts the inadequate sexual knowledge of the subjects and insufficient provision of pre- and post-marriage consultations. Holding educational sessions and providing consultations on subjects related to sexual satisfaction is suggested to increase the feeling in couples. 269 278 Shahla Sh Nourani شهلا نورانی‌سعدالدین Department of Midwifery, Faculty of Nursing and Midwifery, Mashad University of Medical Sciences Department of Midwifery, Faculty of Nursing and Midwifery, Mashad University of Medical Sciences Iran Elham E Jonaidy الهام جنیدی Department of Midwifery, Faculty of Nursing and Midwifery, Mashad University of Medical Sciences Department of Midwifery, Faculty of Nursing and Midwifery, Mashad University of Medical Sciences Iran elham_bj@yahoo.com Mohammad Taghi MT Shakeri محمدتقی شاکری Department of Biostatistics, Faculty of Medicine, Mashad University of Medical Sciences Department of Biostatistics, Faculty of Medicine, Mashad University of Medical Sciences Iran Naghmeh N Mokhber نغمه مخبر Department of Psychiatry, Faculty of Medicine, Mashad University of Medical Sciences Department of Psychiatry, Faculty of Medicine, Mashad University of Medical Sciences Iran InfertilityMarital conflictMarital relationshipSexual disordersSexual healthSexual satisfaction 395.pdf Salehy Fadardy J. 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بررسی ارتباط اضطراب زنان نابارور با موفقیت فن‌آوري‌هاي كمك باروري (ART) در مراجعین به مراکز درمان ناباروری منتخب شهر تهران Association between Infertile Women’s Anxiety with ART Success Rates 2 1 زمينه و هدف: شواهدي وجود دارد كه اضطراب با افزايش كورتيزول و پرولاكتين به تشديد ناباروري مي‌انجامد و سطح اضطراب پايين‌تر به باروري طبیعی كمك مي‌كند.با وجود این هنوز شواهد تجربی قاطع وجود ندارد که سطح اضطراب پایین‌تر موجب پیامد بهتر درمان با فن‌آوري‌هاي كمك باروری می‌شود.هدف از انجام این پژوهش، تعیین ارتباط بین اضطراب زنان نابارور با موفقیت درمان ART در مراجعین به مراکز درمان ناباروری منتخب شهر تهران در سال1387 بود.روش بررسي: در این مطالعه آینده‌نگر180 زن نابارور متقاضی استفاده از روش‌های کمک باروری مراجعه‌کننده به دو مرکز درمانی منتخب شهر تهران به روش نمونه‌گيري سهميه‌اي انتخاب شدند و در روز آخرین ویزیت قبل از انجام درمان توسط پرسشنامه اضطراب اسپیل برگر مورد غربالگری اضطراب آشکار و پنهان قرار گرفتند و براساس نمره 49-20 و نیز 80-50 به گروه‌های اضطراب پایین و بالا تقسیم شدند. تست بارداری مثبت به‌عنوان موفقیت درمان در نظر گرفته شد و در گروه هاي داراي اضطراب آشكار و پنهان بالا و پايين مورد مقايسه قرار گرفت. جهت تجزیه و تحلیل داده‌ها از نرم افزار کامپیوتری SPSS11.5 استفاده شد. مدل رگرسیون لجستیک برای بررسي وجود ارتباط بین نتیجه درمان و سطح اضطراب آشکار و پنهان مورد استفاده قرار گرفت و 05/0 p<به‌عنوان سطح معنی‌داری در نظر گرفته شد.نتايج: میانگین سطح اضطراب آشکار و پنهان در زنان نابارور متقاضی انجام ART، به ترتیب 33/47 و 89/43 بود. از مجموع 180 زوج متقاضی درمان، 6/10% (19 زوج) در پی درمان، باردار شدند؛ که این میزان در گروه دارای سطح اضطراب آشکار بالا و پایین به ترتیب 1/11% و 1/10% بود و در گروه دارای سطح اضطراب پنهان بالا و پایین به ترتیب 5/14% و 9% بود. میزان موفقیت بین گروه‌های دارای سطح اضطراب آشکار بالا و پایین و نیز گروه‌های دارای سطح اضطراب پنهان بالا و پایین تفاوت آماری معنی‌داری نداشت.نتیجه‌گیری: نتایج این مطالعه نشان داد که بین سطح اضطراب آشکار و پنهان زنان نابارور و نتیجه درمان‌های کمک باروری ارتباطی وجود ندارد. نتایج این مطالعه می‌تواند برای بیماران مضطرب دلگرم کننده باشد، اگرچه مشاوره و کاهش سطح اضطراب زنان نابارور برای بهبود کیفیت زندگی آنان ضروری به نظر می‌رسد. 2 Introduction: Anxiety increases blood cortisol and prolactin concentrations which may lead to infertility, but in contrast lower anxiety levels may help natural fertility. However, there is not much evidence that lower anxiety levels may lead to higher success rates in Assisted Reproductive Techniques (ART) among infertile women. This study aimed to determine the association between infertile women’s anxiety and ART success rates. Materials & Methods: This cohort study was done on 180 infertile women who enrolled as candidates for ART. The cases were recruited in their last visit before starting the treatment cycle by quota sampling in two select infertility treatment centers in Tehran, Iran. The individuals’ anxiety was assessed by using State and Trait Anxiety Inventories. They were allocated to high and low anxiety groups according to the achieved scores of 20-49 and 50-80, respectively. A positive pregnancy test was considered the criterion for treatment success.Results: The individuals’ state and trait anxiety scores were 47.33±10.6 and 43.89±9.8, respectively. Nineteen (10.6%) out of 180 women became pregnant. Pregnancy rates in the group with high and low levels of state anxiety were 11.1% and 10.1% and in groups with high and low levels of trait anxiety they were 14.5% and 9%, respectively. Pregnancy rates between high and low state or trait anxieties were not significantly different (p>0.05). Conclusion: There were no relationship between infertile women’s state and trait anxiety status with assisted reproductive technology outcomes. The results of this study can ensure infertile women that their anxiety would not affect their treatment success rates, although counseling and reducing infertile women’s anxiety are necessary to improve their quality of life. 279 286 Masumeh M Simbar معصومه سیمبر Department of Midwifery, Faculty of Nursing and Midwifery, Shaheed Beheshti University of Medical Sciences Department of Midwifery, Faculty of Nursing and Midwifery, Shaheed Beheshti University of Medical Sciences Iran msimbar@sbmu.ac.ir Somayeh S Hashemi سمیه هاشمی Department of Midwifery, Faculty of Nursing and Midwifery, Shaheed Beheshti University of Medical Sciences Department of Midwifery, Faculty of Nursing and Midwifery, Shaheed Beheshti University of Medical Sciences Iran Jamal J Shams جمال شمس Department of Psychiatry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences and Health Services Department of Psychiatry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences and Health Services Iran Hamid H Alavimajd حمید علوی‌مجد Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences Iran <i>In Vitro</i> fertilizationInfertilityState anxietyTrait anxietyZygote intrafallopian transferAssisted Reproductive TechniquesIntracytoplasmic sperm injection 396.pdf Gibson DM, Myers JE. 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تجربه زندگی با ناباروری: یک بررسی پدیدارشناسی Life Experience with Infertility; a Phenomenological Study 2 1 زمینه و هدف: باروری در اکثر فرهنگها از ارزش بالایی برخوردار است و آرزوی داشتن فرزند یکی از اساسی‌ترین محرک‌های انسانی در تداوم زندگی محسوب می‌شود. اگر تلاش در جهت باردار شدن با موفقیت همراه نشود می‌تواند منجر به یک تجربه احساسی مخرب شود. طبق گزارش سازمان جهانی بهداشت، حدود 80 ميليون نفر با شكست در باروری دست بگریبان هستند. ناباروري تأثیری منفی بر زندگی مردان و زنان دارد و افراد مبتلا را در معرض مشكلات عاطفي و رواني فراوانی قرار مي‌دهد. چالش‌های جسمی، روانی و مالی در روند استفاده از روش‌های کمک باروری نیز زوج‌های جوان را تحت تأثیر قرار می‌دهد. تلاش برای باردار شدن، اقدامات پزشکی گران قیمت و خسته کننده‌ای را به همراه دارد و تردید و نا امیدی در روند درمان می‌تواند اساس روابط یک زوج را به لرزه درآورد. با وجود این که مطالعات مختلف اهمیت ارتباط مسائل جسمی‌ـ روانی و ناباروری را نشان داده‌اند، جنبه‌های گوناگون آن هنوز در هاله‌ای از ابهام قرار دارد. این مقاله حاصل یک مطالعه کیفی با تمركز بر تجربه زندگی با ناباروی بوده و هدف آن دسترسی به تجربیات زندگی زوج‌های نابارور در طی دوران ناباروری بود.روش بررسي: یازده زوج نابارور در مرکز تحقیقات بهداشت باروری و ناباروری دانشگاه علوم پزشکی شهید بهشتی درباره تجربیات زندگی با ناباروری مورد مصاحبه قرار گرفتند. گفتگوها با کسب اجازه از افراد ضبط و روی کاغذ پیاده شد و با استفاده از روش کلایزی، جملات و عبارات مورد تجزیه تحلیل قرار گرفتند.نتايج: از تدوین مصاحبه‌های انجام شده، شش مضمون و یازده زیر مضمون استخراج شد. نتایج نشان داد که ناباروری روابط عاطفی و جنسی زوجها را تحت تاثیر قرار می‌دهد، ارتباط زوج با اطرافیان در واکنش به برخورد آنان با ناباروری تغییر می‌نماید. همچنین زوجها انتظارات ویژه‌ای از پرسنل درمانی داشتند که برآورده نمی‌شود، بهمین دلیل علاوه بر درمان طبی ممکن است به درمان‌های غیر معمول نیز متوسل شوند. نتیجه‌گیری: مضمون‌های استخراج شده مشخص نمود که ناباروری می‌تواند سراسر زندگی زوج نابارور را تحت تاثیر قرار می‌دهد. به نظر می‌رسد استفاده گسترده‌تر از خدمات مشاوره مامایی و روانشناسی برای زوج‌های نابارور و اطرافیان آنها در مراکز درمان ناباروری، برای این زوجها کمک‌کننده است. 2 Introduction: In most cultures, fertility has a great social value and parenting aones own biological child is considered the most basic motive in the process of human life. On the other hand, infertility could lead to a destructive emotional experience. According to the World Health Organization (WHO), about 80 million people in the world live with infertility. Infertility has a negative influence on the lives of both genders and predisposes them to emotional and psychological burdens. Physical, mental and economic challenges may affect young couples during infertility treatment. The purpose of this study was to examine the in-depth life experience of infertile couples.Materials and Methods: This qualitative, phenomenological study was conducted on 11 purposively selected couples attending the outpatient department of Reproductive Health Research Center at Taleqani Hospital on August-December 2008. The interviews were carried out to explore life experiences of the infertile couples who were under infertility treatment process. The data were generated from taped interviews and the researchers' observational field notes. The data were analyzed according to the procedure outlined by Colaizzi. Results: Interviews were categorized by examining the participants' interview transcripts and identifying significant statements and meanings. Themes emerging from the statements were identified, and cross-case comparisons were made to confirm or modify them. Six key themes followed by eleven sub-themes emerged from the data. The results showed that infertility, affects emotional and sexual relationships of infertile couples. The couples relationship with family members and relatives is affected when they realize about their problem. Sometimes the infertile couples resort to unusual and non-medical treatment options when their expectations form the medical team are not met. Conclusion: Thematically, infertility could deeply affect infertile couples' entire life. More widespread use of midwifery and psychological counseling services at infertility treatment centers seem to be of help to infertile couples and their relatives. 287 298 Nahid N Khodakarami ناهید خداکرمی Department of Midwifery, Faculty of Nursing and Midwifery, Shaheed Beheshti University of Medical Sciences Department of Midwifery, Faculty of Nursing and Midwifery, Shaheed Beheshti University of Medical Sciences Iran khodakarami@sbmu.ac.ir Somayeh S Hashemi سمیه هاشمی Department of Midwifery, Faculty of Nursing and Midwifery, Shaheed Beheshti University of Medical Sciences Department of Midwifery, Faculty of Nursing and Midwifery, Shaheed Beheshti University of Medical Sciences Iran Seddighe S Seddigh صدیقه صدیق Department of Midwifery, Faculty of Nursing and Midwifery, Shaheed Beheshti University of Medical Sciences Department of Midwifery, Faculty of Nursing and Midwifery, Shaheed Beheshti University of Medical Sciences Iran Mostafa M Hamdiyeh مصطفی حمدیه Department of Psychiatry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences and Health Services Department of Psychiatry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences and Health Services Iran Robabeh R Taheripanah ربابه طاهری پناه Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences Iran Colaizzi’s methodInfertilityLife experiencePhenomenologyPsychological counselingQualitative study 397.pdf Ryan KJ, Kistner RW. 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نظريه حق A Theory of Rights 2 1 "حق" يکي از بنيادي ترين و مهم ترين مفاهيم در قلمرو حقوق و اخلاق زيستي است. اما به کارگيري اين مفهوم مستلزم ارايه نظريه اي است که آن را بر پايه اي استوار بنا کند. از اين رو، در اين نوشتار تلاش خواهيم کرد نظريه اي در باب حق به دست دهيم. اين نظريه بر دو مفهوم کليدي "کرامت ذاتي" و "فاعليت اخلاقيِ" انسان بنا خواهد شد. به ديگر سخن، حق آن جايي به ميان مي آيد که کرامت انساني و فاعليت اخلاقي او در خطر باشد. از يک سو، حق ادعايي تضمين شده است که در جاي خود بر ديگر ادعاهاي هنجاري حاکم مي شود. از ديگر سو، حق هويتي ابزاري، فردي، حداقلي و به لحاظ اخلاقي بي طرف است. بر اين اساس، حق در خدمت ارزشها و اصول عدالت به کار گرفته مي شود، در صورت تأمين و اجرا، بخشي محدود و البته کمينه از سرزمين عدالت را درخواهد نورديد. ارائه نظريه حق در اين نوشتار اين نکته را نيز آشکار خواهد ساخت که عناصر فلسفة حق در ارتباطي سازگار و متقابل با هم قرار دارد. 2 "Rights" constitute one of the most fundamental and significant concepts within the scope of law and bioethics. The theory of rights relies on two key concepts of "dignity" and "moral agency" of human beings. In other words, rights become important whenever human dignity and the individuals moral agency are at risk. Rights are composed of secured claims that override other normative claims on one hand, and they are instrumentalistic, individualistic, minimalistic and morally indifferent entities on the other hand. On this basis, rights are resorted in order to serve values and principles of justice and in case they are met, a limited and, of course, minimal part of the territory of justice is covered.This paper tries to explore and discuss the theory of rights and lay bare the point that elements of philosophy of rights are integratively connected. 299 317 Mohammad M Rasekh محمد راسخ Department of Public Law and Philosophy of Law, Faculty of Law, Shahid Beheshti University Department of Public Law and Philosophy of Law, Faculty of Law, Shahid Beheshti University Iran rasekh@avicenna.ac.ir BioethicsDignityJusticeLawMinimalisticRight 398.pdf Gewirth A. Human rights: essays on justification and applications. Chicago: University of Chicago Press; 1982.##Gallie WB. Essentially contested concepts. Proceed-ings of the Aristotelian Society. 1956;56:167-98.##Nietzsche F. On the genealogy of morals. London: Vintage Books; 1967. p. 80.##Jones P Rights. London: Macmillan; 1994. Chapters 1-2.##Rasekh M. Rights for "ends": towards an equality- based integrative theory of "rights justification", "persons" and "rights demarcation" [dissertation]. [Manchester]: University of Manchester; 1998. Chapter 2.##Flew A. The politics of Procrustes. London: Routledge; 1981.##Rees J. Equality. London: Pall Mall; 1971.##Sen A. Inequality reexamined. Cambridge, Mass.: Harvard University Press; 1992.##Freeden M. Rights. Minneapolis: University of Manchester Press; 1991. Chapter 2.##Dagger R. Rights. In: Ball T, Farr J, Hanson RL, editors. Political innovation and conceptual change. Cambridge: Cambridge University Press; 1989. p. 298-301.##Griffin J. Discrepancies between the best philo-sophical account of human rights and the inter-national law of human rights. Proceedings of the Aristotelian Society. 2001;CI (1):3.##Dworkin R. Foundations of liberal equality. In: The tanner lectures on human values. Salt Lake City: University of Utah Press; 1990.##Montazeri HA. Legal rulings of Grand Ayatollah Montazeri on the political legitimacy of the Islamic Republic of Iran [Internet]. Qum: Mohsen Kadivar; 2009 July 10 [updated 2009 November 13; cited 2009 December 29]. Available from: http://www. kadivar.com/Index.asp?DocId=2333&AC=1&AF=1&ASB=1&AGM=1&AL=1&DT=dtv##Kant I. Groundwork of the metaphysics of morals. Gregor MI, translator. Cambridge: Cambridge Uni-versity Press; 1996. 4: 440.##O'Neill O. Autonomy: the emperor's new clothes. In: The Aristotelian Society Supplementary Volume LXXVII. London: Blackwell; 2003. p. 1-21.##Kant I. Fundamental principles of the metaphysic of ethics. 10th ed. Abbot TK, translator. London: Longmans; 1969.##Acton HB. Kant's moral philosophy. London: Macmillan. 1970.##Paton HJ. The moral law: Kant's Groundwork of the metaphysic of morals. London: Hutchison; 1976.##Korsgaard CM. The sources of normativity. Cambridge: Cambridge University Press; 1996.##Collinson S. Up to Four Million Trapped in Global Slave Trade. Iran News. 2002 Saturday June 8, p. 7.##Kramer M. Rights without trimming. In: Kramer MH, Simmonds NE, Steiner H, editors. A debate over rights. Oxford: Clarendon Press; 1998. p. 76.##Arendt H. The origins of totalitarianism. 2nd ed. San Diego, CA: Harcourt Brace Jovanovich; 1968. p. ix.##Mill JS. On liberty and other essays. Edited with an introduction by John Gray. Oxford: Oxford University Press; 1991.##Feinberg J. Harm to Others, The Moral Limits of the Criminal Law, Vol. 1. Oxford: Oxford Univer-sity Press; 1984.##Dworkin R. Rights and Interests. The New York Review of Books 4. 1971:44-45.##Dworkin R. Taking rights seriously. 4th Impression ed. London: Duckworth; 1984.##Dowrkin R. Liberalism. In: Hampshire S, editor. Public and private morality. Cambridge: Cambridge University Press; 1978.##Kramer M. Rights without trimming. In: Kramer MH, Simmonds NE, Steiner H, editors. A debate over rights: Oxford: Clarendon Press; 1998. p. 101.##Simmonds NE. Rights at the Cutting Edge. 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