An overview on sexually transmitted infections in Iran

Sexually transmitted infections (STIs) cause a large proportion of the global burden of ill-health, disability, and death. This paper reviews the status of STIs in Iran in the three groups of infections are caused by bacterial, viral, and parasitic pathogens and then focuses on human immunodeficiency virus (HIV) infection. This review was carried out in the period of 1977-2015 by searching in PubMed, Scopus, Embase, Web of sciences, Google scholar, the Iranian databases such as MagIran, IranMedex and SID using relevant English and Persian key words. Articles, reports, fact sheets, and official publications of World Health Organization (WHO), the United Nations Program on HIV and AIDS (UNAIDS), The United Nations Children's Fund (UNICEF), and the Ministry of Health and Medical Education (MOHME) of Iran were reviewed.Data on the prevalence of STIs in Iran is sparse with very limited generalizability to the general population. But studies show that these infections are concentrated in high risk sub-groups of the population. Iran has a low national HIV prevalence, but an increased prevalence among people who inject drugs, shifting the country from low prevalence to a concentrated prevalence.It seems that the more improvement of HIV/AIDS prevention, care and treatment programs in Iran need to more attention toward controlling HIV/AIDS through sexual health, proper linkage among HIV/AIDS, STIs, and SRH programs, reduction of stigma and discrimination toward people living with HIV/AIDS, and increase to access at risk populations

Repeated use of medications for ovulation induction after unsuccessful treatment: A cause of concern for infertile couples

This is a Letter to Editor and does not have an abstract

The Shadow of Silence on the Sexual Rights of Married Iranian Women

There has been a recent shift in the field of sexual health, representing a move away from biomedical concerns to sexual rights frameworks. However, few studies on sexuality are based on a rights framework. The unspoken nature of sexuality in Iranian culture has led to a lack of national studies on the topic. The objective of this study was to explore the perceptions and experiences of married Iranian women on sexual rights in their sexual relationships. In this grounded theory study, 37 participants (25 married women, 5 husbands, and 7 midwives) were selected. Data were collected through in-depth interviews and analyzed through open, axial, and selective coding using MAXQDA software version 2007. The analysis revealed the core category of "sexual interaction in the shadow of silence. " The interrelated categories subsumed under the core category included adopting a strategy of silence, trying to negotiate sex, seeking help, and sexual adjustment. The silence originating from women's interactions with their families and society, from girlhood to womanhood, was identified as the core concept in Iranian women's experiences of sexual rights. A focus on husbands' roles seems salient because they can direct or alter some learned feminine roles, especially silence regarding sexual matters, which then affects the realization of women's sexual rights

Infertile couples' perceived needs after unsuccessful fertility treatment: A qualitative study

Introduction: Infertility is a major medical issue. Investigations and treatment of infertility are the beginning of a complex, time-consuming and stressful process for couples that may fail well. The present study explored the needs of infertile couples following treatment failure with Assisted Reproductive Technologies (ARTs). Methods: A descriptive qualitative study was conducted in an Iranian infertility center, in the Northeast of the country between April 2016 and June 2017. The researchers recruited 29 individuals including 9 couples, 9 women and two men with primary infertility through purposive sampling. The data were collected using semi-structured interviews and analyzed iteratively, using conventional content analysis with MAXQDA software. Results: The main concepts obtained from the data were classified into one theme titled: ""The need for support"" and four main categories along with their subcategories, and included the need for psychological support, the need for more useful information, the need for social support and the need to access to supplementary services. Conclusion: The findings show that following treatment failure, the infertile patients’ expressed needs and preferences were not met. Identifying and meeting their needs may help the infertile couples to deal with ARTs failure and to reach a decision about future treatment

Iranian infertile couples' strategies to manage social interactions after unsuccessful treatments with assisted reproductive technologies

Many infertile couples feel vulnerable after failed treatment cycles and find insensitive remarks or inappropriate support distressing. They fear that the stress of failed treatment cycles may affect their marriage and lead to marriage breakdown. This study explored the strategies a sample of infertile couples used to manage social interactions after unsuccessful treatment with assisted reproductive technologies. A descriptive qualitative study was conducted with 34 participants including nine infertile couples, nine infertile women and two infertile men with primary infertility, two relatives, and three fertility clinic staff. The participants were selected through purposive sampling at an infertility centre in Iran, between 2016 and 2017. Data were collected using semi-structured face-to-face interviews and analysed by qualitative content analysis approach. Participants found some social interactions after failed assisted reproductive treatment cycles to be distressing and painful. They described tolerating painful emotions which cause them sadness and sorrow as well as feeling embarrassed. As a result, they found they needed to maintain their adopting concealment strategies with their families through not permitting speculation, selective disclosure, not giving details and hiding the truth. This study showed that social interactions following failed assisted reproductive cycles can be upsetting for infertile couples. Couples use different strategies to manage potentially distressing social interactions. Healthcare providers and psychologists may provide a space for safe social interactions in order to help couples to use appropriate strategies in these circumstances

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

An overview on sexually transmitted infections in Iran

Sexually transmitted infections (STIs) cause a large proportion of the global burden of ill-health, disability, and death. This paper reviews the status of STIs in Iran in the three groups of infections are caused by bacterial, viral, and parasitic pathogens and then focuses on human immunodeficiency virus (HIV) infection. This review was carried out in the period of 1977-2015 by searching in PubMed, Scopus, Embase, Web of sciences, Google scholar, the Iranian databases such as MagIran, IranMedex and SID using relevant English and Persian key words. Articles, reports, fact sheets, and official publications of World Health Organization (WHO), the United Nations Program on HIV and AIDS (UNAIDS), The United Nations Children's Fund (UNICEF), and the Ministry of Health and Medical Education (MOHME) of Iran were reviewed.Data on the prevalence of STIs in Iran is sparse with very limited generalizability to the general population. But studies show that these infections are concentrated in high risk sub-groups of the population. Iran has a low national HIV prevalence, but an increased prevalence among people who inject drugs, shifting the country from low prevalence to a concentrated prevalence.It seems that the more improvement of HIV/AIDS prevention, care and treatment programs in Iran need to more attention toward controlling HIV/AIDS through sexual health, proper linkage among HIV/AIDS, STIs, and SRH programs, reduction of stigma and discrimination toward people living with HIV/AIDS, and increase to access at risk populations

مقایسه رعایت اصول اخلاق پزشکی و ادراک درد زایمان از دیدگاه زنان قوم لر و فارس

زمینه و هدف: زایمان ایمن و رضایت‌‌بخش با کمترین تجربه درد از اصول مهم ارائه خدمات مامایی در هر جامعه و فرهنگی است. نکته کلیدی در مدیریت درد زایمان، تعهد اخلاقی ارائه‌دهندگان خدمات است. این مطالعه با هدف مقایسه ارتباط بین رعایت اخلاق پزشکی تیم درمان در فرایند زایمان و ادراک درد زنان دارای زایمان طبیعی، از دیدگاه زنان زائوی مراجعه‌کننده به مراکز زایمانی شهرستان‌های شیراز و یاسوج انجام شد. روش: این یک پژوهش توصیفی ـ مقایسه‌ای است. جامعه پژوهش شامل 400 زن زائوی مراجعه‌کننده به زایشگاه‌های وابسته به دانشگاه علوم پزشکی یاسوج و شیراز در سال 1399 بودند. روش نمونه‌گیری به صورت در دسترس بود. اطلاعات از طریق سه پرسشنامه دموگرافیک، پرسشنامه ادراک درد زایمان طبیعی یداللهی و همکاران و پرسشنامه دیدگاه مادران نسبت به رعایت اخلاق پزشکی در فرآیند زایمان میرزایی و همکاران جمع‌آوری شد. داده‌ها در نرم‌افزار SPSS 22 وارد شده و با آزمون‌های ضریب همبستگی پیرسون و تحلیل رگرسیون تحلیل شدند. سطح معنی‌داری p<0.05 بود. ملاحظات اخلاقی: ملاحظات اخلاقی شامل تکمیل فرم رضایت آگاهانه، شرکت داوطلبانه و بیان اهداف تحقیق رعایت شد. یافته‌ها: از نظر زنان زائوی شهرستان یاسوج (گروه 1)، احترام به استقلال فردی (001/0=P، 530/0=β) و رعایت سودرسانی و ضررنرساندن (002/0=P، 361/0=β) پیش‌بینی‌کننده منفی نمره ادراک درد زایمان بودند، در حالی که از نظر زنان شهر شیراز (گروه 2)، تنها رعایت سودرسانی و ضررنرساندن پیش‌بینی کننده منفی نمره ادراک درد زایمان بود (037/0P<، 267/0-=β). همچنین اصل رعایت احترام به استقلال فردی از نظر زنان زائو دو گروه تفاوت داشت (006/0=P). نتیجه‌گیری: با توجه به اهمیت یکسان اصل دوم و سوم اخلاق پزشکی، سودمندی و ضررنرساندن، در هر دو فرهنگ، تیم زایمان می‌تواند با توجه کامل به مادر و جنین و پرهیز از مداخله غیر ضروری در هر فرهنگی، از شدت درد زایمان بکاهد. بنابراین می‌توان در جهت ارتقای سلامت مادر و کودک گام برداشت و از آسیب‌های روانی جبران‌ناپذیر بیشتر به مادران جلوگیری کرد.Background and Aim: Safe and satisfactory delivery with the least pain experience is one of the important principles in providing midwifery services in any society and culture. The key point in the management of labor pain is the ethical commitment of the service providers. Therefore, this study was conducted with the aim of comparing the relationship between the observance of medical ethics on the part of the medical team during the delivery process and labor pain perception in the women having natural births from the perspective of the parturient women visiting the birthing centers in Yasuj and Shiraz. Methods: This research is a correlational descriptive study. The study population consisted of 400 parturient women visiting the maternity hospitals affiliated to Yasuj and Shiraz University of Medical Sciences in 2019. Sampling was done through convenience sampling method. The data collection tools included a demographic information questionnaire, the Perception of Labor Pain Questionnaire (PLPQ) by Yadollahi etal and Medical Ethics Attitude in Vaginal Delivery Questionnaire (MEAVDQ) by Mirzaee et al. The data were analyzed through SPSS 22 software using Pearson's correlation coefficient and regression analysis. The significance level was p<0.05. Ethical Considerations: Ethical considerations were observed through completing the informed consent form, voluntary participation and explaining the research objectives. Results: According to the parturient women in the city of Yasuj (group 1), respect for autonomy (β=-0.530, P=0.001) as well as the principles of beneficence and non-maleficence (β=-0.361, P=0.002) were the negative predictors of the score of labor pain perception. However, according to the women in Shiraz (group 2), only the principles of beneficence and non-maleficence (β=-0.267, P<0.037) were the negative predictors of the score of labor pain perception. In addition, observing the principle of respect for autonomy was different from the viewpoints of the parturient women in the two groups (P=0.006) Conclusion: Considering that the second and the third principles of medical ethics, beneficence and non-maleficence, are of equal importance in both cultures, the delivery team can reduce the severity of labor pain through paying complete attention to both the mother and the fetus, as well as avoiding unnecessary intervention in any culture. Therefore, it is possible to take a step towards promoting maternal and child health and prevent further irreparable psychological harm to mothers. Please cite this article as: Bozorgian L, Janghorban R, Yadollahi P. A Comparison between Observing Medical Ethics Principals and Labor Pain Perception from the Perspective of the Women of Lur and Fars Ethnicities. Faṣlnāmah-i akhlāq-i pizishkī, i.e., Quarterly Journal of Medical Ethics. 2022; 16(47): e21.زمینه و هدف: زایمان ایمن و رضایت‌‌بخش با کمترین تجربه درد از اصول مهم ارائه خدمات مامایی در هر جامعه و فرهنگی است. نکته کلیدی در مدیریت درد زایمان، تعهد اخلاقی ارائه‌دهندگان خدمات است. این مطالعه با هدف مقایسه ارتباط بین رعایت اخلاق پزشکی تیم درمان در فرایند زایمان و ادراک درد زنان دارای زایمان طبیعی، از دیدگاه زنان زائوی مراجعه‌کننده به مراکز زایمانی شهرستان‌های شیراز و یاسوج انجام شد. روش: این یک پژوهش توصیفی ـ مقایسه‌ای است. جامعه پژوهش شامل 400 زن زائوی مراجعه‌کننده به زایشگاه‌های وابسته به دانشگاه علوم پزشکی یاسوج و شیراز در سال 1399 بودند. روش نمونه‌گیری به صورت در دسترس بود. اطلاعات از طریق سه پرسشنامه دموگرافیک، پرسشنامه ادراک درد زایمان طبیعی یداللهی و همکاران و پرسشنامه دیدگاه مادران نسبت به رعایت اخلاق پزشکی در فرآیند زایمان میرزایی و همکاران جمع‌آوری شد. داده‌ها در نرم‌افزار SPSS 22 وارد شده و با آزمون‌های ضریب همبستگی پیرسون و تحلیل رگرسیون تحلیل شدند. سطح معنی‌داری p<0.05 بود. ملاحظات اخلاقی: ملاحظات اخلاقی شامل تکمیل فرم رضایت آگاهانه، شرکت داوطلبانه و بیان اهداف تحقیق رعایت شد. یافته‌ها: از نظر زنان زائوی شهرستان یاسوج (گروه 1)، احترام به استقلال فردی (001/0=P، 530/0=β) و رعایت سودرسانی و ضررنرساندن (002/0=P، 361/0=β) پیش‌بینی‌کننده منفی نمره ادراک درد زایمان بودند، در حالی که از نظر زنان شهر شیراز (گروه 2)، تنها رعایت سودرسانی و ضررنرساندن پیش‌بینی کننده منفی نمره ادراک درد زایمان بود (037/0P<، 267/0-=β). همچنین اصل رعایت احترام به استقلال فردی از نظر زنان زائو دو گروه تفاوت داشت (006/0=P). نتیجه‌گیری: با توجه به اهمیت یکسان اصل دوم و سوم اخلاق پزشکی، سودمندی و ضررنرساندن، در هر دو فرهنگ، تیم زایمان می‌تواند با توجه کامل به مادر و جنین و پرهیز از مداخله غیر ضروری در هر فرهنگی، از شدت درد زایمان بکاهد. بنابراین می‌توان در جهت ارتقای سلامت مادر و کودک گام برداشت و از آسیب‌های روانی جبران‌ناپذیر بیشتر به مادران جلوگیری کرد