Evaluation of Emotional Divorce in Male Patients with Urethral Distraction Defect in a Referral Center

Background: Emotional divorce is the first stage of divorce in which the marital relationship deteriorates and the couple's relationship lacks love and affection. Given that the family is one of the foundations of the society, emotional divorce can have devastating effects on society and negative effects on family members. Therefore, it is essential to study this issue. Methods: Patients with Pelvic Fracture Urethral Distraction Defect (PFUDD) admitted consecutively to Shohada-e-Tajrish Hospital (Tehran, Iran) from May 2020 to May 2021 were enrolled in the study. In this study all patients were evaluated by two questionnaires: Gottman emotional divorce questionnaire to assess the patient's marital status, and the International Index of Erectile Function (IIEF-5) questionnaire to assess the patient's sexual situation.  Results: The mean score for the IIEF-5 scores in the case and control groups were 18.32 and 21.04, respectively. The mean Gottman Scores in the case and control groups were 3.84 and 2.12, respectively. There was no significant difference between IIEF-5 and Gottman Scores between the two groups. Conclusions: Considering the lack of differences between the two groups, it can be inferred that the effect of the spiritual and emotional dimension in strengthening marriage was more than the physical dimension. When a man encounters a physical problem, his wife will play a supportive role and seek to strengthen relationship and solve problems

Effect of Magnesium Sulfate Added to Tincture of Opium and Buprenorphine on Pain and Quality of Life in Women with Dysmenorrhea: A Prospective, Randomized, Double-blind, Placebo-controlled Trial

Background: Adding magnesium sulfate (MgSO4) to opioid receptor agonists increases the opioid analgesiceffects via blocking this receptor. The current study aimed to evaluate the effectiveness of adding MgSO4 totincture of opium (TOP) and buprenorphine (BUP) on pain and quality of life (QOL).Methods: In prospective, randomized, double-blind, placebo-controlled clinical trial, one hundred andsixty-three women with secondary dysmenorrhea caused by endometriosis were selected using a respondentdriven sampling (RDS) and assigned into six groups using block randomization. Patients received 50 mg/kgMgSO4 in 100 ml saline by micro set in six monthly menstrual periods and completed the visual analoguescale (VAS) and QOL Questionnaire (QOLQ). Data were analyzed by repeated measures analysis of variance(ANOVA) and hierarchical regression.Findings: The primary outcomes showed that pain scores in magnesium (MAG) + opium tincture (OT)[F = 5.7(1,162), P = 0.004] and MAG+ BUP [F = 4.5(1,162), P = 0.006] groups showed a significant decreasecompared with control group. Also, QOL scores in MAG + OT [F = 4.8(1,162), P = 0.005] and MAG + BUP[F = 5.9(1,162), P = 0.003] showed a significant increase. However, there was no significant differencebetween the two groups (P = 0.140) and the changes did not persist until follow-up (P = 0.810). Secondaryoutcomes indicated that the low scores of the two components of QOL including physical and psychologicalcomponents were predictors of pain (P = 0.011, Beta > 3.09).Conclusion: Simultaneous use of MAG with opioids is associated with pain reduction and the improvement ofQOL. However, this hypothesis requires careful handling in a randomized controlled tria