The objective of the study is to determine the effects of clomiphene citrate (CC) on preventing premature luteinizing hormone (LH) surge in infertile patients with polycystic ovary syndrome (PCOS) undergoing intrauterine insemination (IUI). This was a randomized clinical trial being performed at Shiraz Mother and Child Hospital. We included 162 women with PCOS selected for IUI cycles. Patients were randomly allocated to receive 150 mg/day CC from the 8^th of the cycle though the day of human chorionic gonadotropin (hCG) injection (n = 81) or nothing in the same period (n = 81). Main outcomes included the incidence of premature LH surge, pregnancy rate, abortion and ongoing pregnancy rates, number of maturing follicles, and endometrial thickness. The incidence of premature LH surge was significantly lower in those who received CC (3.0% vs. 14.9%; P= 0.021). The pregnancy rate was 10 (15.1%) and 6 (8.9%) in CC and control groups, respectively (P = 0.342). The ongoing pregnancy rate found to be comparable between two study groups (12.1% vs. 5.9%; P= 0.068). Serum level of estradiol (E₂) level at the time of hCG administration was significantly higher in those who were treated with CC when compared to control (1153.5 ± 326.4 vs. 943.2 ± 215.3; P < 0.001). Patients who received CC also had higher number of mature follicles >18 mm when compared to controls (3.85 ± 1.3 vs. 2.94 ± 1.01; P < 0.001). Administration of CC from the 8^th day of the cycle to the day of hCG injection in combination with Gonal-f in infertile patients with CC-resistant PCOS undergoing IUI cycles is associated with decreased incidence of premature LH surge, higher E₂levels, and higher number of mature ovarian follicles. This protocol is safe and simple and could be considered to be cost-effective.

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Oral debriefing (OD) and video-assisted debriefing (VAD) are commonly used debriefing methods, with no evidence of superiority of one to another. The present study aimed to compare the effects of OD and VAD on the development of learning outcomes in nursing students. This is a quasi-experimental study. A total of 50 first-year nursing students participated in this study. Participants in the control group participated in OD and those in the intervention group took part in VAD. Debriefing improved psychomotor skills, self-confidence, and student satisfaction in both groups. There was no statistically significant difference between OD and VAD in the study outcomes. Both OD and VAD methods have significantly positive impact on simulation outcomes and can increase preparedness of nursing students before entering the clinical settings. Given the widespread use of simulation, more studies are needed to evaluate different methods of debriefing to optimize the usefulness of simulation-based learning.

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Rhinoplasty is done with external and endonasal methods. One of the main stages of rhinoplasty in both external and endonasal methods is the lateral nasal osteotomy. Lateral nasal osteotomy is the main cause of edema and ecchymosis after rhinoplasty, which is annoying and unpleasant for patients. Piezosurgery is a new method that uses electronic-ultrasonic waves to perform nasal osteotomies. The aim of this study was to compare of edema and ecchymosis after lateral nasal osteotomy using piezosurgery with external osteotomy in rhinoplasty candidates. In this clinical trial, 66 experimental patients for rhinoplasty surgery were selected from Imam Reza hospital in Tabriz, Iran. After examination, the patients were randomly divided into two groups. One group of patients had lateral nasal osteotomy by using the piezosurgery technique, and the other group had a lateral osteotomy with the conventional method of external subcutaneous. On the third and 7 days after the operation, the level of edema and ecchymosis in the patients were examined as per the Gökalan questionnaire (adopted by Yucel) by two persons who were not aware of the goals of the study, and then, they evaluated and scored the questionnaire. The obtained data were analyzed by the SPSS 19 software. The highest level of edema and ecchymosis was observed 3 days after surgery in both groups. Meanwhile, the findings revealed a significant difference between the two groups in the amount of edema and ecchymosis on day 3 after surgery. Furthermore on day 7, the amount of edema and ecchymosis compared to that of the 3^rd day was statistically significant for both groups. In general, in all studied groups, edema, and ecchymosis decreased in 7 days compared to 3 days and also piezosurgery is more promising and effective than osteotomy.

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Type 2 diabetes mellitus (T2DM) is a metabolic disorder associated with abundant adipocytokine changes which may play an important role in the progression of insulin resistance and micro- and macro-vascular complications. Therefore, the objective of this study was to assess the differential effect of metformin alone or in combination with glyburide on apelin serum levels in patients with T2DM. In this case–control study, fifty patients with T2DM in the age range of 45–65 years and twenty-five healthy controls matched for age and body weight were recruited from single endocrinology center, subdivided according to the diabetic pharmacotherapy into: Group I: healthy controls (n = 25), Group II: T2DM patients on metformin (n = 15), Group III: T2DM patients on glyburide (n = 17), and Group IV: T2DM patients on metformin plus glyburide (n = 28). Biochemical and anthropometric variables in relation to apelin serum levels were estimated. Apelin serum levels were low in normal healthy controls compared to T2DM patients (P < 0.01). The differential effect of diabetic pharmacotherapy on apelin serum level was statistically significant (P < 0.01) compared to the controls, but insignificant when compared among used drugs (P > 0.05). Apelin level was high in T2DM compared to the controls; both metformin and glyburide might play a role in this elevation.

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The aim of the article was to study and model solvent effects on phytocompounds' extraction from Glycyrrhizae radix for substantiation of rational choice of the extractant in the technology of drugs obtained from this type of plant raw material. The process of extraction was carried out by simple maceration for 24 h at temperature 25°C ± 1°C and extractant/plant raw material ratio 5:1 (v/w). The content of hydro-ethanolic extracts based on ethanol solutions with concentration of 22, 41, 50, 71, 82, and 96% ± 1% v/v and some other solvents was studied by reversed phase high-performance liquid chromatography. The optimal range of solvent concentration for simultaneous extraction of chalcones and glycyrrhizic acid derivatives from Glycyrrhizae radix was determined. It was found that dielectric constant of the solvent plays a key role in the distribution process of phytocompounds between the phases; there is a certain range of dielectric constant values of the solvent-water solution, within which maximum phytocompound concentration in the extract can be observed; the dependency between phytocompound concentration in the extract and dielectric constant of the solvent-water solution can be described by equation lnC = a + b/ε+d/ε².

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Postpartum hemorrhage is one of the main causes of mothers' death mostly in developing country. The frequency of postpartum hemorrhage after natural pregnancy and cesarean are reported 2%–4% and 6%, respectively. The main goal of this study is to compare two regimens of oxytocine: One with high dose and the other with normal one to prevent uterine atony. The study has been done via a clinical trial method on 150 pregnant women in Zahedan, Iran. The society is randomly divided into two groups. The patients having risk factors of uterine atony and postpartum hemorrhage were omitted from the list. Oxytocin with 80 and 30 dose was, respectively, infused in 500 cc Ringer serum for control and witness group immediately after infant emersion during a period of 30 min. Decline of hemoglobin 6 and 24 h after cesarean section, uterine atony, blood infusion, and extra uterotonic drug needs after oxytocin infusion have been measured for both groups. The data have been analyzed using Chi-square via SPSS software. The result indicates that there exist meaningful differences between control and witness group in uterine atony and extra utertonic drug need while and after surgery (0 as compared with 22.6% and P= 0); whereas there is no significant difference between control and trial group in decline of hemoglobin 6 and 24 h after cesarean section (P = 0.714 and 0.231, respectively). It means that oxytocin infusion with 80 dose has a good impact on the above four variances. It is recommended that oxytocin infusion with 80 dose during a period of 30 min could be a good substitution for oxytocin infusion with 30 dose for the prevention of uterine atony during and after cesarean delivery, especially when utertonic drug is not accessible and in the case of counterindication of other drugs' use.

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Primary hypothyroidism is associated with oxidative stress and insufficient antioxidant capacity. This study was conducted to evaluate the effects of levothyroxine replacement therapy on paraoxonase 1 (PON-1) serum levels in a patients with primary hypothyroidism. Thirty-one patients with primary hypothyroidism compared to 20 healthy controls were recruited from. A venous blood sample were taken after an overnight fasting for biochemical parameters, before and after starting levothyroxine therapy (100 μ g/day) for 3 months duration. The biochemical variables were PON-1 serum levels, lipid profiles, triiodothyronine (T3), thyroxin (T4), and thyroid stimulating hormone (TSH) serum levels. Levothyroxine replacement therapy leads to a significant amelioration of thyroid functions, lipid profile, cardiometabolic measures P < 0.05 in patients with primary hypothyroidism. Levothyroxine leads to significant elevation in PON-1 serum levels from 188.42 ± 19.81 (U/mL) to 361.23 ± 33.62 (U/mL) P < 0.0001. This study concluded that levothyroxine replacement therapy significantly increases PON-1 serum levels in patients with primary hypothyroidism and attenuating hypothyroidism-induced oxidative stress.

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Developing health programs based on the beliefs and values of communities has a great impact. Given the priority and importance of AIDS and its transmission through high-risk sexual behaviors, we sought to design a religious/spiritual intervention for preventing AIDS. Relevant statements were extracted from the literature and spiritual/religion documents, and the study questions were reviewed by a modified Delphi consensus panel. The statements were arranged in four areas of recipients, main components, providers, and settings for spiritual interventions. Using the existing capacities for Islamic spiritual interventions to prevent and control AIDS requires the development of executive factors along with underlying factors, such as infrastructure and facilities for the provision of interventions. The results of this study can lay the groundwork for supplementary studies.

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