Original Article / Research Article


Investigating Awareness Level and Attitudes Toward Induced Abortion in Patients Admitted to Medical Centers in Tehran, Iran

Fares Najari, Dorsa Najari, Rana Fazleh Hashemi, Elsay Najari

Men's Health Journal, Vol. 7 No. 1 (2023), 22 January 2023, Page e10
https://doi.org/10.22037/mhj.v7i1.41758

Background: Abortion is recognized as a social and cultural problem across societies, posing risks to people’s health. This study aims to explore various facets of induced abortion in patients admitted to medical centers in Tehran. Method: This descriptive-cross-sectional study surveyed referred patients at Mahdieh, Taleghani, and Shohada-e-Tajrish Hospitals in Tehran, Iran.  Information was collected using a researcher-made questionnaire. Data were analyzed employing the chi-square test, t-test, and Pearson's correlation coefficient, considering a P-value <0.05 as significant.  Results: Among the 1,200 examined patients, 75% were in favor of induced abortion but within legal bounds (95%, CI=58-90). Furthermore, 65% of the participants demonstrated adequate knowledge about induced abortion and its associated side effects (95%, CI=55-75), yet they advocated it due to financial and welfare problems. Meanwhile, there was a statistically significant correlation between awareness scores and age, education, and gestational age (P-value<0.04).   Conclusion: The awareness and attitude toward abortion vary among individuals. However, enforcing different severe restrictions and stringent abortion laws may lead to destructive consequences.  

Introduction: Radical cystectomy as a crucial treatment approach for high-grade bladder cancer is often associated with substantial blood loss and a frequent necessity for blood transfusion. Investigating the correlation between perioperative blood transfusion and surgical outcomes is an area of contention. We aimed to examine the relationship between blood transfusion timing and mortality in patients undergoing radical cystectomy.  Materials and methods: The clinical records of 274 patients who underwent radical cystectomy at Modarres Hospital in Tehran, Iran, during 2011-2021 were reviewed. Among them, 191 patients received perioperative blood transfusions. The 90-day mortality rate was compared between these groups, and the association between transfusion timing and mortality was assessed.  Results: The 90-day mortality rate was 14% in the blood recipient group and 11% in the non-transfusion group. However, no statistically significant relationship was observed between blood transfusion and 90-day mortality (P=0.4). The most prevalent timeframe for blood transfusion was before and during surgery. Mortality was highest in the group receiving blood before and during the operation, with a rate of 18%. Nevertheless, no statistically significant association was found between transfusion timing and mortality (P=0.346). When comparing the Charlson Comorbidity index (CCI) between the two groups, significantly higher CCI levels were observed in the blood recipient group (P=0.003). Conclusion: In our retrospective review, no significant relationship was identified between blood transfusion, its timing, surgical outcomes, and 90-day mortality. However, the blood recipient group had higher CCI scores compared to non-transfused patients.   

Introduction: The purpose of this research was to explain the identification process in young homosexual men. Material & Methods: The method of this study was phenomenological. The data was categorized and processed based on Strauss and Glaser's interpretive analysis approach. In this research, participants were selected with a purposeful sampling method. Finally, a semi-structured interview was conducted with 15 referred homosexual men with a mean age of 23.9. 

Result: results were classified into two aspects of the identification process, and challenges/risks. The process of identity formation in young homosexual men included three steps: a. childhood exploration, b. adolescent confusion and identity crisis, and c. youth encounter and acceptance. Also based on the challenges and risks, the experience of negative emotions, such as feeling frustrated, anxiety, guilt, and depression were achieved in the emotional dimension. Conclusion: Iranian homosexual men pass difficult periods to seek identity. And finally, they may not achieve a complete identity, their challenges include: 1) a. becoming sensitive and feeling differently from others, b. realizing his orientation, c. suffering a great deal of religious conscience and selflessness, d. starting to change orientation without success, e. accepting identity desperately. 2) a. realizing they cannot reveal gay identity in family and society, b. having to put on a mask and play a role, c. facing individual and social challenges and due to these tensions, d. facing emotional and behavioural challenges, e. referring to counsellors for getting help and finding his real and correct identity.

Developing a Health Marketing Model to Foster a Culture of Timely Prostate Cancer Prevention

Elham Sahafi, Tahmoores Hasanqolipour Yasuri, Jalil Hosseini, Ali Shams

Men's Health Journal, Vol. 7 No. 1 (2023), 22 January 2023, Page e9
https://doi.org/10.22037/mhj.v7i1.41872

Introduction: Prostate cancer poses a significant global public health concern for men. Despite advancements in medical knowledge and screening techniques, a considerable number of prostate cancer cases are diagnosed at advanced stages, leading to compromised treatment outcomes and increased mortality rates. This study aimed to develop and introduce a model focused on preventing prostate cancer in men. Methods: This mixed-methods study comprises two phases. In the initial phase, grounded theory was employed to identify and define the influential factors based on the prospectives of both experts and patients. The data were continuously analyzed during data collection using the Strauss & Corbin method (1998) encompassing open, axial, and selective coding. Subsequently, a systematic review and a qualitative study were conducted and the data were integrated to develop a cohesive model. Results: In the qualitative phase, axial coding yielded three axial subcategories: “Underlying factors”, “Causal conditions”, and “Intervening factors”. All extracted categories and codes were linked to the causal, background, intervention factors, strategies, and consequences adopting an approach focused on fostering a culture of timely prostate cancer prevention. A systematic review generated a final scale of 23 questions organized into four subscales: “Life conditions”, “Physical problems”, “Mental injuries”, and “Efficiency of hospitals” developed by the researcher in the second step. All steps of validity and reliability were undertaken. Following the integration of results from the systematic review and qualitative study (phases 1 and 2), the current research model measures the relationships between several latent variables (the primary variables of the research). Simultaneously, structural equation modeling was employed to analyze the data and test the hypotheses. Conclusion: The developed study model is validated and reliable, encompassing all the factors influencing prostate cancer prevention in men. Tailored to our context, this model was developed to prevent prostate cancer in men. Further testing in diverse societies is recommended.

Background: Spinal anesthesia is the common method in outpatient surgeries, which has complications such as back pain. We aimed to evaluate the relationship between low back pain (LBP) with spinal anesthesia and its related factors in patients undergoing urological surgery. Materials and methods: In this cross-sectional study, 1000 patients undergoing urological surgery were enrolled. The severity of LBP was measured using the VAS (visual analog scale) pain on the 1st day, the 1st week, and the 1st month postoperatively. Patients’ age, sex, and the duration of surgery were collected. data analysis was performed using SPSS software, version 17. Results: Of the 1000 patients undergoing urological surgery, 636 (63.6%) patients and 364 (36.5%) patients underwent spinal and general anesthesia, respectively. In patients under general anesthesia, the LBP prevalence was higher than in patients under spinal anesthesia on the 1st week and the 1st month after surgery (P<0.05). So, the LBP prevalence was as follows: on the 1st day (general anesthesia: 14.5% vs spinal anesthesia: 24.1%, p=0.09), at the 1st week (general anesthesia: 24.9% vs spinal anesthesia:13.5%, P=0.001) and the1th month (general anesthesia: 13.8% vs spinal anesthesia: 4%, P=0.001). On 1st day and 1st week after surgery, the rate of LBP was significantly higher in the >45-year age group than in the age group less than 45 years (P<0.05). The pain rate was higher in patients who had surgery duration of more than 2.5 hours in all three time periods (P=0.001). Conclusion: Although the LBP prevalence on 1st day after surgery in patients undergoing urological surgeries under spinal anesthesia was higher than in patients who underwent general anesthesia, there was a significant decrease in pain levels during the first week and month following the surgery in patients under spinal anesthesia. Older age and longer duration of surgery were related factors to pain.

Comparison of Lidocaine-triamcinolone Injection with and without Magnesium Sulfate in Ankle Joint Osteoarthritis

Amir Sabaghzadeh, Faramarz Mosaffa, Behnam Hosseini, AhmadReza Rezaeian

Men's Health Journal, Vol. 7 No. 1 (2023), 22 January 2023, Page e4
https://doi.org/10.22037/mhj.v7i1.40235

Background: Currently available pharmacological therapies for osteoarthritis mainly target palliation of pain and include analgesics, intra-articular therapy, and topical treatment. We aimed to evaluate the effect of the concomitant use of magnesium sulfate in addition to a combination of triamcinolone and lidocaine. Methods: To evaluate the changes in pain factor levels, sixty patients with ankle osteoarthritis were randomly divided into two control (Triamcinolone + Lidocaine) and intervention (Triamcinolone + Lidocaine + Magnesium sulfate) groups (n= 30, each group). In both groups, patients were injected with 80 mg triamcinolone and 0.5 cc of 2% lidocaine, while in the intervention group, 500 mg of magnesium sulfate was added to the injecting solution, and in the control group, an equivalent volume of 0.9% normal saline was added to the injecting solution. Patients were monitored after one week and one month and each completed the visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) pain score questionnaires in addition to their demographic characteristics. The results were evaluated based on the design of the questionnaire and data were analyzed employing SPSS software, version 21, and using independent ttest. Results: AOFAS and VAS scores were significantly different between the intervention and control groups within one week after treatment (p value= 0.018) but AOFAS and VAS scores after one month were not significantly different. Conclusion: Using magnesium sulfate was effective in controlling the pain caused by ankle osteoarthritis at short intervals.

Clinical Outcomes of Remdesivir in COVID-19 Patients with Acute Kidney Injury or Chronic Kidney Disease: A Randomized Clinical Trial

Mahboobeh Freidoon, Toktam Alirezaei, Mahdi Khatuni, Sara Assadiasl

Men's Health Journal, Vol. 7 No. 1 (2023), 22 January 2023, Page e7
https://doi.org/10.22037/mhj.v7i1.42554

Background: remdesivir is an RNA polymerase inhibitor approved to treat moderate to severe Coronavirus Disease 2019 (COVID-19); however, it has not yet been authenticated to apply to patients with acute kidney injury (AKI) or chronic kidney disease (CKD). Regarding some positive results obtained from previous studies, we aimed to evaluate the efficacy and safety of remdesivir in patients with COVID-19 with severe renal impairment.  Methods: In a randomized clinical trial, remdesivir was added to the standard regimen of treating patients with COVID-19 with AKI or CKD. 200 mg remdesivir was given on the first day of admission to 50 patients followed by 100 mg every other day until resolution of the symptoms. Clinical and paraclinical evaluation was performed daily and the findings were compared with the 50 patients on standard treatment regimen. Results: the rates of intensive care unit (ICU) admission (P: 0.02), and mortality (P: 0.007) were significantly reduced in patients who received remdesivir. Moreover, a substantial decrease of aspartate transaminase (AST) (P: 0.004), lactate dehydrogenase (LDH) (P: 0.004), ferritin (P: 0.007), erythrocyte sedimentation rate (ESR) (P<0.0001), alkaline phosphatase (ALP) (P: 0.006) were observed in the patients receiving remdesivir compared to the baseline values which was absent in case of non-remdesivir group. No serious side effects were observed, except for one patient who showed elevated liver enzymes. Conclusion: remdesivir appears to be well tolerated in patients with AKI and CKD. Administration of this drug resulted in reduced mortality and ICU admission as well as clinical and paraclinical improvement in these patients.

The Effect of Cinnamon Supplementation on Hemoglobin A1c in Patients with Type 1 Diabetes Mellitus

Shadab Salehpour, Hedyeh Saneifard, Mohammadreza Alaei, Marjan Shakiba, Shirin Ghanefard

Men's Health Journal, Vol. 7 No. 1 (2023), 22 January 2023, Page e3
https://doi.org/10.22037/mhj.v7i1.38991

Introduction: Type 1 diabetes mellitus (T1DM), one of the most common endocrine disorders in children, is an autoimmune disease that manifests itself as an increase in blood sugar as a result of impaired insulin production due to the destruction of the islets of Langerhans in the pancreas. To treat this disease, along with the use of insulin and numerous drug protocols, the use of herbal medicinal supplements has always been considered. However, due to the lack of studies related to these supplements, there is not enough evidence for their therapeutic use. Method: We investigated the therapeutic effectiveness of a cinnamon medicinal supplement with a dose of 50 mg every 8 hours per day, on glucose hemostasis in patients with T1DM . Thirty patients with T1DM were enrolled. They are subjected to sampling and examination of blood sugar indicators, including fasting blood sugar and hemoglobin A1c, as well as indicators of insulin consumption (total daily dose of insulin) and insulin resistance, including the ratio of insulin to carbohydrates on days 0, 90 and 180 of the start of treatment with cinnamon. Results:  The level of hemoglobin A1c in this group had a significant decrease. Also, there was no significant increase in the amount of insulin consumption in the drug supplement-consuming groups in contrast to the control group during six months. Conclusion: The use of cinnamon supplements along with treatment protocols has a significant effect in reducing hemoglobin A1c during six months of treatment in these patients. These results can be useful in promoting the use of therapeutic supplements in the treatment of patients with diabetes.

Case Report


This case report presents the clinical course of a 54-year-old male patient diagnosed with posterior Nutcracker Syndrome (NCS). The patient experienced recurrent episodes of macroscopic hematuria and severe left flank pain. He was diagnosed with retro-aortic left renal vein (RLRV), an unusual congenital abnormality, which can result in the compression of the left renal vein between the aorta and the vertebra. Initial attempts at conservative management and endovascular interventions were unsuccessful. An open surgical intervention was ultimately performed. The surgery involved ligation of the left renal vein. Postoperatively, the patient experienced marked improvement in symptoms, with complete resolution of hematuria and pain. Furthermore, renal function remained stable, and no kidney-related complications were reported. This case suggests that, in certain situations where endovascular intervention and transposition of LRV or re-implantation of the left gonadal vein are not feasible, ligation of the LRV may provide a safe and practical treatment option for patients with posterior NCS. Future research is needed to validate these findings.

Letter to the editor


Physicians use a variety of para-clinical tests to confirm their diagnosis. There are some common ways to use these tests: 1- Parallel strategy means to request all the necessary tests in one step, and 2- Serial strategy, which is of two types: “serial or” and “serial and”. (1) In the former type, the doctor first requests test A and if it is negative, requests test B. But in the latter type (serial and), despite the positiveness of test A, they also ask for test B to eliminate possible doubts.

Systematic Review


Prevalence of Common Methods of Suicide among Iranian Men; a Systematic Review

Soraya Moamer, Ghazal Hajinasrollah, Freshet Aliakbari , Abbas Ali Nasehi, Keshvar Samadaee Gelehkolaee, Jalil Hosseini

Men's Health Journal, Vol. 7 No. 1 (2023), 22 January 2023, Page e2
https://doi.org/10.22037/mhj.v7i1.40209

Background: Suicide is one of the public health problems with a high rate worldwide. Sex is a risk factor for successful suicide, making it the seventh leading cause of death in men in the United States. Based on the increasing suicide rate in Iran, we aimed to investigate the common methods of suicide in Iranian men. Methods: This study is a systematic review with subgroup analysis based on the prevalence of methods of suicide in Iranian men during 2009-2019. Specific keywords based on medical subject headings (MeSH) were searched in Iranian and international databases including PubMed, Scopus, Google Scholar, SID, and MagIran by designing a search strategy. Selected studies were reviewed using the study evaluation tool. For data analysis, STATA software version 14 was used. Also, heterogeneity studies by Q and I2 statics were assessed. Results: In the first phase, 529 studies were extracted, and finally, data were extracted from 19 studies. Because of the heterogeneity of the studies, meta-analysis was not possible and the final results were extracted based on subgroup analysis. Drug abuse was the most common method of suicide and the use of firearms was the least prevalent among Iranian men. Conclusion: Currently, the most common method of suicide in Iranian men is drug abuse. Therefore, it is recommended to design preventive interventions based on gender and take into account commonly available methods.

Review Article


Every year lung cancer is a cause of high morbidity and mortality in the human population. However, since 31 December 2019, the coronavirus disease 2019 [COVID-19] had importantly affected various degrees of pulmonary regions. Therefore, patients with lung cancer must be the priority group for COVID-19 prevention, treatment, and vaccination during the COVID-19 pandemic. Until now, clinicians and patients know that most individuals with respiratory distress and/or those with a weakened immune system are more susceptible to COVID-19, however, the associations with lung cancer remain unclear. Here, we present the combination of common chemotherapeutic drugs with a historical antiviral activity that may be too immunosuppressive to eliminate COVID-19-infected cells in patients with lung cancer. This review will help understand the preferred chemoimmunotherapy drugs for severe forms of COVID-19 [SARS-CoV-2] in these patients.