Iranian Red Crescent Medical Journal
Year:2014 | Volume:16 | Issue:3|Papers Count:20

Background: Professionalism in nursing is critical for creating credibility and a positive image.Objectives: This study was carried out to explain the use of hidden curriculum in teaching professionalism in nursing students.Materials and Methods: This qualitative study was conducted through purposeful sampling strategy by the participation of 32 nursing students. The data were collected by using semi-structured interviews, and this process was continued until achieving data saturation and themes' emergence. Content analysis method was used for data analysis.Results: Data analysis revealed three main themes: Development of understanding the professionalism elements, Variety of influenceability strategies, and Influenceability to various resources. Each theme consisted of some subthemes.Conclusions: The nursing students learnt the professionalism elements by different methods from different resources through the hidden curriculum. Therefore, exploration of the currently administered hidden curricula is suggested.

Background: Timely diagnosis of leptospirosis is essential for early and effective treatment, for there are many differential diagnoses for it.. Leptospiral researchers have an increasing interest in developing new serological methods with recombinant antigens to improve the Leptospirosis diagnosis. Several serological tests have been developed for the proper diagnosis of leptospirosis.Objectives: To improve the previous works we developed an enzyme linked immunosorbent assay (ELISA) with novel recombinant leptospiral surface adhesion (Lsa63) protein to offer a new test.Materials and Methods: In an experimental study, Recombinant Lsa63 (rLsa63) was produced in E scherishia coli (E.coli) BL21 (DE3). By using rLsa63, we generated IgM and IgG ELISA. Performance of these tests was compared to microscopic agglutination golden test (MAT). Two hundred twenty human serum samples were obtained from individuals suspicious of leptospirosis who were referred to Guilan Province Central Leptospira Laboratory for definitive diagnosis. The sensitivity, specificity and other statistical indexes of Lsa63-ELISAs were also determined.Results: Among 220 serum samples, 30% (n=65) had positive MAT responses, and also 38% (n=84) and 40.9% (n=90) showed positive reaction to IgG and IgM rLsa63-ELISA, respectively. The sensitivity, specificity and accuracy were 93.8%, 81.29 % and 85.0 for IgM-Lsa63- ELISA and 83.07, 80, 64 and 81.36 for IgG-Lsa63- ELISA, respectively.Conclusions: Our results demonstrated that the sensitivity and specificity of Lsa63-ELISAs are promising for the detection of Leptospira serovars.

Background: No comprehensive study has been conducted on risk factors of sexual dysfunction in women with diabetes mellitus.Objectives: The aim of this study was to consider all possible influencing variables including hormonal, physical and, psychological status, socioeconomic status, and dietary intake to get more accurate and reliable results.Patients and Methods: Sexual function was assessed by Iranian validated female sexual function index (FSFI).The variables of the study were demographic and diabetes-related factors, stress-depression, physical activity, blood pressure, anthropometric measurements, lipid profile, cortisol, sex and thyroid hormones, 25-hydroxy vitamin D, and dietary intake.Results: Among all investigated variables, partner relationship showed a strong positive association with FSFI (b=1.93±0.41, P<0.0001). In addition, not considering partner relationship, FSFI showed a significant negative association with age (b=-0.19±0.20, P=0.04), stress-depression score (b=-0.08±0.04, P=0.04), DD (b=-0.03±0.01, P=0.04), and systolic blood pressure (b=-0.14±0.06, P=0.03). Significant associations between FSFI and serum sex hormones and other biochemical were found in neither postmenopausal nor non-menopausal women. The means of SFSI in postmenopausal women were greater than non-menopausal (P=0.02).Conclusions: It seems that in our population, female sexual function was much more than just a hormonal or physical problem and psychological factors, especially partner relationship and stress-depression, are the most determinants. In addition, age, duration of challenging with disease, and the lack of controlling systolic blood pressure were common factors that decreased sexual function.

Background: Trauma is a major healthcare challenge worldwide. In developing countries, most road deaths happen during the pre-hospital phase, consequently, pre-hospital trauma care has received considerable attention during the past decades.Objectives: The aim of this study was to investigate the quality of pre-hospital oxygen therapy in patients with multiple trauma.Patients and Methods: This cross-sectional study was conducted in the year 2013. The study population consisted of all patients with multiple trauma who had been transferred by emergency medical services to the central trauma department in Shahid Beheshti Medical Center, Kashan, Iran. The data collection instrument had three parts including demographic, a trauma assessment, and an oxygen therapy quality assessment questionnaires that were designed by the researchers. In total, 350 patients with multiple trauma were recruited from March through July 2013. Data were described by using frequency tables, central tendency measures, and variability indices. Moreover, we analyzed data by using the Chi-square test, Mann-Whitney U test, and the logistic regression analysis.Results: The study sample consisted of 263 (75.1%) male and 87 (24.9%) female patients. Overall, 211 patients needed oxygen therapy during the pre-hospital phase, however, only 35 (16.60%) patients had received oxygen. The quality of oxygen therapy was undesirable in 92.42% of cases. In addition, 83.4% of patients, whose pre-hospital records indicated the administration of oxygen, reported that they had not received oxygen therapy. Logistic regression analysis revealed that the place of accident and the level of patients' education were significant predictors for administration of oxygen during the pre-hospital phase (P<0.001).Conclusions: The quality of pre-hospital oxygen therapy had been provided for the patients with multiple trauma was poor while these patients, particularly patients with chest traumas and head injuries, were in urgent need of oxygen therapy. Consequently, developing and implementing standard evidence-based oxygen therapy protocols and administrating continuous education programs are recommended.

Background: Nowadays, hypertension is considered as a global public health issue and in recent decades, it has shown a growing trend due to changes in lifestyle.Objectives: The purpose of this investigation was to compare symptoms of hypertension with known diseases in ancient medical texts and to find a disease that had the maximum overlap of symptoms with hypertension.Materials and Methods: In this qualitative study, reliable sources of traditional medicine such as The Canon of Medicine by Avicenna, The Complete Art of Medicine (Kitab Kamil as-Sina'aat-Ṭibbiyya) by Haly Abbas, Facilitating Treatment and a letter for Health preservation (Tahsil Al-Elaj and Resale Hafez Al-Sehha) by Mohammad Taghi Shirazi, and some reliable resources of conventional medicine such as Harrison’s principles of internal medicine and databases such as Pubmed, Scopus, SID, and Magiran were probed base on keywords to find a disease that had the most overlapping symptoms with hypertension. By taking notes from the relevant materials, the extracted texts were compared and analyzed.Results: Findings showed that hypertension has the most overlap with Imila (accumulation of normal or abnormal fluid in the body) symptoms in Iranian traditional medicine. Although this is not a quietly perfect overlap and there are other causes and reasons including dry dystemperament of vessel wall (atherosclerosis), hot dystemperament of heart or damages to other organs like liver, kidney and nervous system that could also lead to hypertension according to Iranian traditional medicine.Conclusions: Finding the equivalent disease to HTN based on Iranian traditional medicine, could suggest a better strategy for preventing, treating and reducing debilitating its complications in the future. In conclusion, we can approach to hypertension with recommendations for reducing Imtila when we are dealing with a kind of hypertension that corresponds to Imtila. Therefore, if patient is suffering from another type of hypertension like dry dystemperament of vessel wall, it surely requires another treatment approach for reducing vessel wall dryness.

Dear Editor: Foreign body aspiration (FBA) is a common problem among children or infants. Nearly 85% of all FB aspiration occurs in childhood. Common organic aspirated materials include nuts and seeds while inorganic materials include plastic pieces or parts of toys (1). In adults, most of FBAs are seen in the 6th or 7th decade of life when the airway protection mechanism is impaired due to central nervous system dysfunction, intubation or facial trauma (2). Infants are more vulnerable because of immature swallowing coordination and lack of adequate dentition and they like to put objects into their mouths (3).

Background: Training provided in medical faculties is mainly composed of two phases: preclinical and clinical. Preclinical period, or the first three years, consists of theoretical classes and practical implementations to develop vocational skills. In the clinical period, students are given applied courses.Objectives: This study aimed to determine the role of demographic characteristics and medical students’ life habits on their academic achievement.Patients and Methods: For this purpose, a 20-item survey form with two sections developed by the researchers was used. Students were also asked to identify the averages of committee exams as the academic achievement indicator. Participating students (n=287) were from Mersin University Medical Faculty during 2012-2013 session.Results: Totally, 60.3% of the students were males with an average age of 21.16±1.39, and their general grade point average was 63.39±9.08. Students in their second year (P=0.000), who were females (P=0.000), graduated from Anatolian Teachers High Schools (P=0.002), financially well off (P=0.026), stayed in state hostels (P=0.032), did not smoke (P=0.042) and regularly did sports (P=0.016) were significantly more successful compared to others.Conclusions: Students’ socioeconomic resources and habits play roles on academic achievement. Solutions that incorporate economic support which can eliminate negative situations leading to inequality of opportunity among students would increase students' achievement.

Background: Various treatments such as hemodialysis prolong the life of chronic renal failure disease patients who must tolerate many physical, emotional, social and economic difficulties. Therefore, social support is considered as a vital area of investigation for such patients.Objectives: In this qualitative research, a grounded theory approach was used and written as a content analysis form to study hemodialysis patients and family experience of perceived social support.Patients and Methods: Three nurses, 4 general practitioners, a specialist and two family members who participated were interviewed from April to September 2012 in Urmia, Iran. Interviews were guided to divulge the perception of changes in their lives, needs for social support for disease complications, and the type of treatment process. Purposive sampling continued up to data saturation. Data analysis was performed based on Strauss and Corbin Method. Constant comparison analysis was performed until data saturation.Results: The research results are shown in 3 steps. In the first step, 113 categories and four main themes from 993 first codes were explored. Social support was explored based on the implications of five general themes including "Perceived Threats Caused by Disease Complications", "Searching for Social Support", "Accessible Social Support", "Beliefs and Values", and "Perceived Social Support".Conclusions: The core variable of our research is acceptance of the reality of the conditions caused by the disease. The research finalized our knowledge about patient problems regarding social support and revealed many problems of supporting patients by Health Team Members, family members and organizations. The findings suggest that individual aspects of patient experiences must be considered if social support is to be given and Healthcare Providers have to facilitate positive health services.

Background: Inequality in households' and individuals' consumption expenditures is one of the most important aspects of health status difference among households and individuals.Objectives: We investigated the impact of some macro-economic factors specially inequality factors on the Iranian rural health status since 1986 through 2012.Patients and Methods: We conducted a longitudinal ecological and analytical study. The average sample size was 14602 households whom Iranian Statistics Center selected by a multi-stages clustering sampling approach. All required data has been collected from Iranian Statistics Centre and Deputy for Curial Affaires of Iranian Ministry of Health. We calculated the Gini coefficients for the rural food and health expenditures, then conducted a transloge autoregressive order one (AR1) to investigate the association between the Iranian rural households' key mortality rates and the food and health expenditure Gini coefficients, time trend, GDP per capita (PPP), and GDP per capita Gini coefficients.Results: The mean of Gini coefficients were 0.137 and 0.21 for the rural food expenditures inequality based on current and constant price, respectively. In addition, the mean of Gini coefficients were 0.26 and 0.31 for the rural health expenditures inequality based on current and constant price, respectively. The time trend, transloged form of Gini coefficients for health expenditures and GDP per capita Gini coefficients presented a significant negative correlation with transloged form of neonatal mortality rate. With regard to the transloged form of under five mortality we observed a significant negative correlation with time trend and transloged form of Gini coefficients for health expenditure and GDP per capita. Finally, there was a significant negative correlation between transloged forms of maternal mortality rate.Conclusions: Iranian policy makers should consider the rural health and food expenditures inequality and try to adopt more effective policies and plans to decrease it. In addition, they should improve the macro-economic factors to improve the rural households' health status.

Dear Editor: The purpose of the authors of this letter is to give a clear definition and classification of body parts from the viewpoint of Muslim and Iranian physicians during the Islamic Civilization era and to examine the views of Muslim scholars such as Ahvazi, Avicenna, and Amoli on the issue of the reconstruction power (regeneration) of organs. We aim to extract and bring into practice any useful and valuable points that can be found in their writings. Avicenna has discussed human body organs in the framework of the seven natural principles, elements, temperaments, humors, organs, vital spirits, faculties of power, and functions (1). The formation of the organs from the four humors takes place throughout the digestion steps in the body. Body organs are divided into two categories, simple organs and compound organs (2).

Background: Nutrition is among the most important factors influencing coronary artery disease.Objectives: Here we aimed to study the nutritional status of patients with and without coronary artery disease (CAD).Patients and Methods: We performed a cross-sectional study on 600 patients referred to a cardiology clinic with the signs of ACS. The patients were then classified in to two groups (CAD group and the normal group) based on angiographic findings. The amount of nutritional profile was questioned from all participants.Results: Men were more often diagnosed with CAD compared to women (198.362 vs.102.238, P<0.01). Patients with coronary artery disease were mostly older, smoker, coffee and black tea drinker had a higher BMI and more frequently diagnosed with hypertension, hyperlipidemia and diabetes. On the other hand, green tea consumption was seen more in women (92.238 vs.115.362, P<0.05) and those with regular physical activity (119.299 vs.88.301, P<0.01). Backward regression modeling was employed to study the predictors of CAD. Type of tea and meat remained as one the most important nutritional factors predicting CAD.Conclusions: White mean and type of tea were the most important predictors of CAD. Dietary prevention strategies from childhood could prevent early CAD.

Background: Adulterated herbal weight loss products with containing undeclared synthetic drugs are common and responsible for many serious health damages.Objectives: The purpose of the study was to determine five synthetic adulterants in eight common herbal weight loss supplements, which are currently sold in Iran markets, to verify their presence in supplements, without mentioning on the labels.Materials and Methods: Eight common herbal weight loss samples were obtained from the Iran pharmaceutical market after advertising in the Persian language on satellite channels and internet. Five pharmacological classes of drugs used for weight loss, namely sibutramine, phenolphthalein, phenytoin, bumetanide and rimonabant, were investigated and quantified by GC-MS for the first three and LC-MS for the last two medications.Results: The most undeclared ingredients, which were illegally added include sibutramine, phenolphthalein, bumetanide, and phenytoin in the original super slim, herbaceous essence, super slim green lean, and fat loss, supplements, respectively. Rimonabant was not found. Caffeine, pseudoephedrine, theobromine and amfepramone were also found in the supplements using GC-MS assay.Conclusions: Adulterated synthetic substances were detected in the herbal weight loss products. Health care professionals should make people aware of the risks of taking herbal weight-loss supplements.

Background: Propofol is a most widely used intravenous anesthetic drug. One of its most common complications is the pain upon injection, therefore, different methods, with various effects, have been proposed in order to alleviate the pain.Objectives: This study investigates the effects of paracetamol, ondansetron, granisetron, magnesium sulfate and lidocaine drugs on reducing the pain of propofol injection during anesthetic induction. Also, the hemodynamic changes will be analyzed.Patients and Methods: This is an interventional study containing 336 patients underwent elective orthopedic surgeries in Educational Hospitals of Mashhad University, using systematic sampling, the patients were divided into six groups. A 20-gauge needle was inserted into a venous vessel in the back of the hand and 100 cc of Ringer serum was injected into the vein, which was applied proximal to the injection site. Afterwards, paracetamol 2 mg/kg (group p), magnesium sulfate 2 mmol (group M), ondansetron 4 mg (group O), granisetron 2 mg (group G), lidocaine 40 mg (group L) and 5 cc saline (group S) were injected into the vessel, after 60 seconds, the tourniquet was opened. One quarter of the total dose of propofol (2.5 mg/kg) was injected with a flow rate of 4 mg/sec and then the injection pain was measured. Finally, the fentanyl (2 mg/kg), atracurium 0.5 mg/kg, and the remaining dose of propofol were injected and the vital signs were recorded before the administration of propofol and 1, 3, 5 and 10 minutes after the propofol injection.Results: The six groups did not significantly differ, regarding their gender, weight or age. Propofol injection pain was less in L and G groups, in comparison with the others (P≤0.001). By analyzing the hemodynamic changes, it was observed that the least amount of change in mean arterial pressure was observed in the paracetamol group.Conclusions: The reduction of propofol injection pain was observed by using medications (in comparison with normal saline), but it was more significant in groups G and L. Moreover, Hypotension was higher in groups S and G and it was lessened in group P.

Background: Premature birth is one of the most important unresolved reproductive health problems. Premature birth is often traumatic and a source of distress for parents. Increased parental stress during the first year of their infant's life is a risk factor for later behavioral problems in infants.Objectives: This study was designed to compare anxiety, post-traumatic stress, and social supports in parents of premature and mature infants.Patients and Methods: This was a comparative descriptive study conducted at healthcare centers of Qom city, in 2012. In this study, 82 couples (164 parents) divided into two groups including parents who have preterm and term infants. Questionnaires including items such as demographic characteristics, obstetric and post-traumatic stress disorders, Spiel berger anxiety and Multidimensional Scale of Perceived Social Support were completed two months after childbirth. Data were analyzed using c2 test, Fisher's exact test, Mann-Whitney test, independent t-test, and regression logistic using SPSS18 software.Results: The levels of anxiety was not significantly different in mothers and fathers in the two groups, but the trait anxiety level of mothers (P<0.001) and fathers who had preterm infants (P=0.01) was significantly greater than the parents of full-term infants. Post-traumatic stress disorder was significantly greater in mothers of preterm infants than those of term infants (P=0.03), but this amount was not significantly different between the two groups of fathers. Mothers' social support did not differ significantly (P=0.08), however, it was significantly different in fathers (P=0.01).Conclusions: Premature infants' parents are more at risk of mental disorders than term infants' parents. This result shows the need of interventions, so these parents can better deal with the problems of premature infants.

Background: The contribution of neuroinflammation in Alzheimer's disease (AD) has been widely reported. The effects of female gonadal hormones in both neuroinflammation and brain cognitive functions have also been well considered.Objectives: In the present study, the possible protective role for endogenous ovarian hormones against learning and memory impairment as well as brain tissues oxidative damage induced by lipopolysachride (LPS) was investigated in rats.Materials and Methods: The rats were divided into four groups: Sham-LPS, Ovariectomized (OVX) -LPS, Sham, and OVX. The animals of sham group were in proestrous phase in which the serum concentration of estradiol is high. The Sham-LPS and OVX-LPS groups were treated with LPS (250 mg/kg) before acquisition. The animals were examined using passive avoidance (PA) test. The brains were then removed and malondialdehyde (MDA) and total thiol groups concentrations were measured.Results: The time latency to enter the dark compartment by OVX-LPS group was shorter than that of OVX at both first and 24th hours after the shock (P<0.05-P<0.001). In Sham-LPS and OVX-LPS groups, total thiol concentration in hippocampal and cortical tissues were significantly lower while MDA concentrations were higher than that of Sham and OVX groups (P<0.05-P<0.001).). The hippocampal MDA concentration in OVX-LPS group was higher than Sham- LPS group (P<0.01).Conclusions: Brain tissue oxidative damage contributed in deleterious effects of LPS on learning and memory. Some protective effects for the endogenous ovarian hormones against damaging effects of LPS on learning and memory function, as well as brain tissues oxidative damage could be postulated, however, it needs more investigation.

Background: Metabolic syndrome can cause cardiovascular disease and diabetes in the affected subjects. With 20 to 30% prevalence rate among the adult population of most countries, it is considered a pandemic problem. The guidelines currently available on the management of the specific components of metabolic syndrome highlight some lifestyle changes such as enhanced physical activity and weight reduction. Adherence to Mediterranean-style diet has been shown to be associated with lower risk of metabolic syndrome in some clinical studies.Objectives: The aim of this study was the evaluation of the effect Razavi dietary pattern, on metabolic syndrome. This is the first study performed to address this issue.Patients and Methods: Seventy five eligible subjects with metabolic syndrome were recruited into a single-blind randomized controlled clinical trial to determine the effect of Razavi diet on metabolic syndrome. Intervention was carried out by educating the Razavi diet in the experimental group while giving no dietary recommendations to the control group. The level of physical activity was similar between the two groups. Features of the metabolic syndrome as defined by the criteria of the Iranian National Committee of Obesity were assessed after two months.Results: The net reduction in the waist circumference (-2.85), weight (-1.44) and BMI (-0.58) in test group was significantly (P<0.001) higher than the control. Decreases in systolic and diastolic blood pressure, fasting blood sugar and triglycerides were observed but were not statistically significant.Conclusions: The results suggest that Razavi diet can improve some components of metabolic syndrome leading to reduced risk of cardiovascular disease and diabetes.

Background: Nausea and vomiting of pregnancy are amongst the most common complaints that effects on both the physical and mental conditions of the pregnant women. Due to the increasing tendency of women to use herbal medications during pregnancy, the effect of lemon inhalation aromatherapy on nausea and vomiting of pregnancy was investigated in this study.Objectives: The aim of this study was to determine the effect of lemon inhalation aromatherapy on nausea and vomiting during pregnancy.Materials and Methods: This was a randomized clinical trial in which 100 pregnant women with nausea and vomiting who had eligibility criteria were randomly divided into intervention and control groups based on four- and six-random block sampling method. Lemon essential oil and placebo were given to the intervention and control groups, respectively, to inhale it as soon as they felt nausea. The nausea, vomiting, and retch intensity were investigated 24 hours before and during the four days of treatment by means of PUQE-24 (24-hour Pregnancy Unique Quantification of Emesis).Results: There was a statistically significant difference between the two groups in the mean scores of nausea and vomiting on the second and fourth days (P=0.017 and P=0.039, respectively). The means of nausea and vomiting intensity in the second and fourth days in the intervention group were significantly lower than the control group. In addition, in intragroup comparison with ANOVA with repeated measures, the nausea and vomiting mean in the five intervals, showed a statistically significant difference in each group (P<0.001 and P=0.049, respectively).Conclusions: Lemon scent can be effective in reducing nausea and vomiting of pregnancy.

Background: Matrix metalloproteinases (MMPs) are a group of endopeptidases which comprised of various types. These proteolytic enzymes are zinc-dependent and play role in degradation of extracellular matrix (ECM). Various types of cells such as macrophages, fibroblasts, neutrophils, synovial cells and some epithelial cells secrete MMPs. According to previous studies on bronchiolitis and respiratory tract lesions in these patients and unknown pathophysiology mechanism up to date, this cross–sectional study was performed.Objectives: The aim of this study was to compare the serum MMP level in patients with chemical injuries and normal people and also determine the role of these parameters in pulmonary disorders.Materials and Methods: In this cross–sectional study, 25 Iranian patients exposed to the sulfur mustard and 25 unexposed participants as the control group were enrolled. Serum samples were collected from two groups and stored at -70oC until the measurement of MMPs and TIMPs. ELISA kit was used for measurement of MMP and TIMP based on the kit's instruction. For validations in measurement, all samples were analyzed duplicate and in some cases triplicate.Results: The mean level of MMP-9 in serum of chemically-injured group was 1592.42 and this amount in normal group was 679.72.So there was a significant difference between two groups (P=0.001) and the mean level of MMP-8 in serum of patients group was 49.10 and in normal group was 35.53. Then there was no significant difference between two groups (P=0.197). The mean levels of MMP-1 and MMP-2 was not significantly different (P value>0.05) in the patient and normal groups. And also the mean levels of TIMP-1 and TIMP-2 was not significantly different (P>0.05) in the patients and normal groups.Conclusions: In summary, serum MMPs in chemically-injured has shown no significant difference with normal people except for the MMP-9.

Background: In Iranian Traditional Medicine, mizaj (temperament) plays a key role in preventive, therapeutic and lifestyle recommendations. A reliable self-reported scale for mizaj identification is critically needed to introduce ITM into the official medical and health care system especially in the case of designing national preventive protocols.Objectives: The present study aimed to design a preliminary self-administered mizaj questionnaire and assessed its reliability and validity in Iran.Patients and Methods: In this cross-sectional study, a questionnaire with 52 items was designed based on mizaj-related indices. Subsequent to content and face validity assessment, using qualitative and quantitative method, 47 items remained. Based on the non-randomly sampling, the test-retest reliability of each question and internal consistency of the questionnaire was examined by the participation of 35 volunteers. The reliable version questionnaire was filled up by 52 volunteers wherein they were divided into warm/cold and wet/dry groups based on their mizaj which was predetermined by a team of expert practitioners. Logistic regression analysis was performed for validity process between the experts’ assessment of mizaj and each of the items in the questionnaire that resulted to the final ten-item questionnaire divided into two subscales. By using ANOVA and post Hoc with Dunnet statistics, the optimum cut-off points were defined and their sensitivity and specificity was assessed.Results: The weighted kappa coefficients of the 39 items were between 0.40 and 0.82 showing their acceptable reliability and the Cronbach's a coefficient was 0.71 showing the internal consistency. The sensitivity and specificity of the final questionnaire cut-off points were 65% and 93% for the warm group, 52% and 97% cold group, 53% and 67% dry group and finally 53% and 76% wet group.Conclusions: Our results suggested that many of the designed questions according to the literature's mizaj identification indices had satisfactory reliability and the final ten-item questionnaire could discriminate the different groups of mizaj, therefore, this can be used as the first version of a brief self-report mizaj estimating scale.

Context: Insomnia is one of the most prevalent sleep disorders characterized by sleep difficulty that impairs daily functioning and reduces quality of life. The burden of medical, psychiatric, interpersonal, and societal consequences of insomnia expresses the importance of diagnosing and treatment of insomnia. The aim of study was to investigate causes of insomnia from the viewpoint of Iranian traditional medicine.Evidence Acquisition: In this review study, we searched insomnia in a few of the most famous ancient textbooks of Iranian traditional medicine from different centuries. This books include The Canon of Medicine by Avicenna (the first version of Beirut), Zakhire Kharazmshahi by Jurjani (the scanned version of Bonyade Farhang-e Iran), Malfaregh by Razes (the first version of Iran University of Medical Sciences), and Aqili's cure by Aqili (the first version of Iran University of Medical Sciences).Results: This study found that in Iranian traditional medicine manuscripts, insomnia was called sahar and even though many factors induce insomnia, most of them act through causing brain dystemperament.Conclusions: The brain dystemperament is considered one of the main causes of insomnia and insomnia can be well managed with an organized line of treatment, by correcting the brain dystemperament through elimination of causes. This study helps to find new solutions to treat insomnia.