Iranian Red Crescent Medical Journal
Year:2014 | Volume:16 | Issue:2|Papers Count:20

Background: In diabetes mellitus because of the absence or insufficient sensitivity to insulin, glucose transporter protein in cell membrane, glucose transporter 4, is decreased. GLUT4 is the major glucose transporter in skeletal muscle and adipose tissue, which is under control of insulin. It remains, however, unclear whether cinnamaldehyde plays a regulatory role (s) or not.Objectives: The objective of this study was to investigate the effects of cinnamaldehyde on GLUT4 gene expression.Materials and Methods: This study was an experimental trial. Tests were performed in triplicates. This study examined effects of cinnamaldehyde on Glut4 gene expression in C2C12 skeletal muscle cells by using Real Time PCR. C2C12 myoblasts were cultured in DMEM+10% FBS. After differentiation of myoblasts to myotubes, the cells were serum deprived for 5 hours and then treated with 10, 20, or 50 mM of cinnamaldehyde for 1 hour.Results: Our data revealed a significant increase in the expression of Glut4 in cinnamaldehyde treated cells. In addition, GLUT4 mRNA level was increased in a dose dependent manner. Analyses were performed using the SPSS 16 for Windows software. Differences between the groups were determined by one-way ANOVA.Conclusions: These results demonstrate that cinnamaldehyde up regulates the expression of mouse skeletal muscle GLUT4 gene expression.

Background: Anti-inflammatory effect of natural adjuvants has been reported. Lung inflammation is the most characterized pathological feature in asthma.Objectives: The effects of three natural adjuvants (PC, G2, and G2F registered as a patent in the Iranian Patent Office) on sensitized guinea pigs lungs were examined in the present study.Materials and Methods: Lung pathological changes were examined in control and five groups of randomly divided guinea pigs including: sensitized animals (S, receiving normal saline, 0.5 ml i.p.), sensitized animals treated with adjuvant PC, G2F (0.1 ml i.p. for both cases), G2 (0.4 ml i.p.), and PC+G2 (receiving both PC and G) adjuvants (twice a week for 4 weeks for all groups). Sensitization of animals was done by injection and inhalation of ovalbumin (OA).Results: All pathological changes in S group including the eosinophil infiltration (scoring 3.28±0.28), lymphocyte infiltration (2.82±0.26), local epithelial necrosis (2.71±0.47) and mucosal plug (2.75±0.37) were significantly higher than control group (0.64±0.18, 1.36±0.24, 0.36±0.18 and 0.28±0.18 for eosinophil infiltration, lymphocyte infiltration, epithelial necrosis and mucosal plug respectively, P<0.001 for all cases). Treatment with all adjuvants improved all pathological changes significantly (P<0.05 to P<0.001).Conclusions: These results indicate preventive effects of all natural adjuvants (especially G2) on pathological changes of the lung in sensitized guinea pigs.

Background: Palpitation is a sign of a disease and is very common in general population. For this purpose we decided to explain it in this study.Objectives: The purpose of this study was to describe the palpitation in both modern and traditional medicine aspect. It may help us to diagnose and cure better because the traditional medicine view is holistic and different from modern medicine.Materials and Methods: We addressed some descriptions to the articles of traditional medicine subjects which have published recently. Palpitation in modern medicine was extracted from medical books such as Braun wald, Harrison and Guyton physiology and some related articles obtained from authentic journals in PubMed and Ovid and Google scholar between1990 to 2013.Results: According to modern medicine, there are many causes for palpitation and in some cases it is cured symptomatically. In traditional medicine view, palpitation has been explained completely and many causes have been described. Its aspect is holistic and it cures causatively. The traditional medicine scientists evaluated the body based on Humors and temperament. Temperament can be changed to dis-temperament in diseases. Humors are divided in 4 items: sanguine, humid or phlegm, melancholy and bile. Palpitation is a disease, it is heart vibration and is caused by an abnormal substance in the heart itself or its membrane or other adjacent organs that would result in the heart suffering.Conclusions: Our data of this article suggests that causes of palpitation in the aspect of traditional medicine are completely different from modern medicine. It can help us to approach and treat this symptom better and with lower side effects than chemical drugs. According to this article we are able to detect a new approach in palpitation.

Background: Sequence variations in glycoproteins of influenza virus surface impel us to design new candidate vaccines yearly. Ectodomain of influenza M2 protein is a surface and highly conserved protein. M2e in influenza vaccines may eliminate the need for changing vaccine formulation every year.Objectives: In this study, a recombinant baculovirus containing M2e and cholera toxin subunit B fusion gene was generated with transposition process to express in large amounts in insect cell lines.Materials and Methods: M2e-ctxB fusion gene was created and cloned into pFastBac HT. The recombinant vector was transformed into DH10Bac cells to introduce the fusion gene into the bacmid DNA via a site-specific transposition process. The recombinant bacmid was then extracted from white colonies and further analyzed using PCR, DNA sequence analyzing, and indirect immunofluorescence assay.Results: PCR and DNA sequence analyzing results showed that the fusion gene was constructed as a single open reading frame and was successfully inserted into bacmid DNA. Moreover, indirect immunofluorescence results showed that the fusion gene was successfully expressed.Conclusions: Baculovirus expression vector system is valuable to produce M2e based influenza vaccines due to its simple utilization and ease of target gene manipulation. The expressed protein in such systems can improve the evaluating process of new vaccination strategies.

Background: Chronic infection with hepatitis C virus (HCV) is increasingly recognized as a major global health problem. Illicit injection drug use is an important risk factor for the rising hepatitis C virus (HCV) prevalence in IR Iran.Objectives: The objective of this study was to determine the long-term effectiveness (total quality adjusted life years (QALYs) gained) of methadone maintenance treatment (MMT program) in prevention of HCV infection among injecting drug users (IDUs).Materials and Methods: A number of Markov models were developed to model morbidity and mortality among IDUs. The input data used in modeling were collected by a self-reported method from 259 IDUs before registration and one year after MMT and also from previous studies. One way and probabilistic sensitivity analyses were done to show the effects of uncertainty in parameters on number of life years and QALYs saved. The expected consequences were estimated using a life-time time horizon for the two strategies including implementation and not implementation of the MMT program.Results: Our model estimated that total number of discounted life years lived per IDU with and without the MMT program would be 5.15 (5.05-5.25) and 4.63 (4.42-4.81), respectively. The model also estimated that total number of discounted QALYs lived per IDU with and without the MMT program would be 4.11 (3.86-4.41) and 2.45 (2.17-2.84). Simulation results indicated that all differences in life years and QALYs lived between the two strategies were statistically significant (p<0.001). Based on our model, total discounted life years and QALYs saved in a cohort of 1000 IDUs were 1790 (1520-2090) and 1590 (1090-2090), respectively.Conclusions: Considering the high prevalence of illicit injecting drug use in Iran and MMT effectiveness in prevention of HCV infection, it is necessary to develop MMT centers at regional and national levels.

Background: Chest pain is one of the most common causes of the admission to the emergency departments. It, however, can be due to numerous diseases some of which are life threatening.Objectives: In the current study, we evaluated the prognostic value of TIMI (Thrombolysis in Myocardial Infarction) and Modified TIMI risk scores to stratify the risk for patients with atypical chest pain being discharged from the emergency department.Patients and Methods: In a prospective-analytic study, we collected data from 1020 patients with atypical chest pain enrolled to the study. All eligible patients were visited by the emergency medicine residents who were trained for this study. Based on the criteria in both systems, the emergency medicine attending decided on either discharging or hospitalizing patients. Patients were allocated into 2 equal groups randomly. In order to predict the opposing accidents in 30 days (coronary revascularization, myocardial infarction, and all-cause death) TIMI risk scores and Modified TIMI risk scores were assessed based on TIMI risk score (0 or 1) and Modified TIMI risk score (0 or 1).Results: No significant difference could be observed between both groups regarding demographic characteristics, ejection fraction, left ventricle hypertrophy, TRS criteria, risk factors and the history of coronary artery stenosis. None of the atypical chest pain patients discharged based on TIMI and modified TIMI risk scores experienced any adverse events.Conclusions: The results obtained from this study support the idea that the TIMI and modified TIMI risk scores might be valuable tools that could be used to stratify the risk of patients with atypical chest pain in the emergency department.

Background: Applying Prevention and Control of Infection (PCI) standards in hospitals reduces probable risks to patients, staff and visitors, it also increases efficiency, and ultimately improves productivity of hospitals.Objective: The current study aimed to determine the status quo of international standards of PCI in hospitals located in the north of Iran.Materials and Methods: This cross-sectional study was conducted in 23 hospitals. Data collection tool was a questionnaire with confirmed validity and reliability.. In this regard, 260 managers, section supervisors and infection control nurses participated in the study according to census basis. SPSS software version 16 was employed to analyze the data through descriptive and analytical statistics.Results: Among the studied hospitals, 18 hospitals were public. Hospitals enjoyed 77.2% of leadership and programming, 80.8% of focus of programs, 67.4% of isolating methods, 88.2% of hand health and protection techniques, 78.8% of improving patient’s safety and quality, 90.3% of training personnel, and 78.7% of the average status quo of PCI standards.Conclusions: This study revealed that PCI standards were significantly observed in the studied hospitals and that there were necessary conditions for full deployment of nosocomial infection surveillance.

Background: Promoting mental health and preventing mental disorders are of the main concerns for every country. Achieving these goals requires effective indexes for evaluating mental health. Therefore, to develop mental health enhancement programs in Iran, there is a need to measure the state of mental health in Iran.Objectives: This study aimed to select a set of mental health indicators that can be used to monitor the status of mental health in Iran.Materials and Methods: This research work used Q-methodology which combines both quantitative and qualitative research methods for establishment of mental health indicators in Iran. In this study, 30 participants were chosen by purposive sampling from different types of professionals in the field of mental health.Results: Twenty seven mental health indicators were obtained from the Q-methodology. The most important indicators obtained in this study are as follows: annual prevalence of mental disorders, suicide rates, number of mental health professionals, mental health expenditures and suicide related deaths.Conclusions: This study provides mental health indices for measuring mental health status in Iran. These mental health indices can be used to measure progress in the reform policies and community mental health services.

Background: Chronic diseases are usually accompanied by psychological abnormalities. Anxiety and depression occur in a significant number of patients with rheumatoid arthritis (RA). These psychological problems are likely, to be the results of chronic physical symptoms such as pain and disability.Objectives: The aim of this study was the evaluation of mental health in patients with rheumatoid arthritis in Iran.Patients and Methods: One hundred women with definite diagnosis of RA were evaluated in the outpatient clinic of the Tabriz University of Medical Sciences during one year period. Activity of RA disease was determined according to the Disease Activity Score-28 (DAS-28) scaling system and mental health was evaluated using the General Health Questionnaire-28 (GHQ-28). Based on the cut of point score of 22, prevalence of psychological problems was determined and a comparison was made the between two groups (with and without psychological problems).Results: GHQ28 screening test showed that psychological problems were seen in 49% of studied patients. There were significant difference between duration of disease and DAS-28 score between the two groups (P=0.001 and P=0.001, respectively). Somatic symptoms were more frequent in patients with psychological problems (P=0.001). Somatic symptoms in patient with high disease activity was also more frequent than the other group (P=0.002). There was a significant positive correlation between the scores of DAS-28 and GHQ-28 (r=0.329, P=0.001).Conclusions: This study showed that a considerable portion of patients with RA may have mental problems. The probability of these problems increased with more severe and more prolonged disease.

Background: Advancement in the treatment of various types of cancer has led to greater patient survival. These treatments essentially have toxic effects on different kinds of cells, such as germ cells. Infertility as one of the side effects of cancer treatment has changed the quality of life of young cancer survivors dramatically. Melatonin is an antioxidant with receptors in the reproductive systems.Objectives: We supposed that melatonin, as an antioxidant, may protect testis against the toxic effects of the drugs.Materials and Methods: In this experimental study, three groups with seven mice each, were allocated. The control group received normal saline for two months, and the busulfan group received a single dose of 40 mg/kg busulfan intra-peritoneally, and the melatonin group received 20 mg/kg melatonin daily for two months, 45 days after a single dose of busulfan. Next, after decapitation and removal of the testis, tissues were fixed in Bouin's solution and stained by H& E and TUNEL. The sections were evaluated, assessing morphology and spermatogenesis.Results: In this research, a significant reduction in Johnson's criteria in the busulfan group (Mean rank=15.50) was found versus the control group (Mean rank=45.50), P<0.001 and in the melatonin group (Mean rank=45.50) compared to the busulfan group (Mean rank=15.50), P<0.001. There was a significant difference between the melatonin and control groups, P<0.05. In addition, a significant decrease in seminiferous tubule diameter was observed in the busulfan group (763.2±104.41) versus the control group (855.4±52.35), P<0.01 and melatonin group (834.2±87.26), P<0.05. Testicular epithelium height was significantly decreased in the busulfan group (Mean rank=14.60) compared to the control group (Mean rank=26.40), P<0.01 and in the busulfan group (Mean rank=14.95) in comparison with the melatonin group (Mean rank=26.05), P<0.01. Also melatonin group (Mean rank=25.42) showed a significant reduction in epithelium height compared to the control group (Mean rank=35.58), P<0.05. Spermatogenesis was impaired in the busulfan group. Although melatonin reduced the rate of apoptosis in the busulfan group, yet it could not remove all apoptotic cells.Conclusions: This study indicated that melatonin ameliorates the cytotoxic effects of busulfan on germ cells.

Background: Diseases and tumors of the appendix vermiformis are very rare, except acute appendicitis.Objectives: This retrospective study was conducted to document the unusual findings in appendectomy specimens.Patients and Methods: Data of 1466 adult patients were gathered retrospectively. Appendectomy was performed in 1169 and in 297 patients following a diagnosis of acute appendicitis and during other abdominal operations, respectively. The data of 57 (3.88%) patients who were pathologically reported to have unusual appendix findings were retrospectively collected. The records were analyzed according to patients’ age, gender, clinical presentations, operative reports, pathological reports and follow up.Results: Unusual pathologic examination findings were detected in the appendectomy specimens of 57 patients with a mean age of 48.34±19. Twenty-nine patients (50.8%) were male and 28 (49.2%) were female. Normal appendix tissues were observed in specimens of 26 (45.6%) patients and inflamed appendix in 31 (54.3%). The most common unusual finding was parasitic diseases of the intestine. Pathological diagnosis of malignancy and benign features were reported in specimens of 14 and 43 patients, respectively. Macroscopic evaluation of appendectomy specimens during surgery might result in negligence of the presence of unusual pathology.Conclusions: Even if the macroscopic appearance of the specimen is normal or acute appendicitis, we suggest routine histopathological examination.

Background: Neonatal herpes infection is the most serious complication of Herpes Simplex Virus (HSV) infection during pregnancy and perinatal period. Few studies have reported neonatal HSV infection in developing countries.Objectives: The aim of this study was to detect the HSV infection among neonates and infants with sepsis.Materials and Methods: In a cross sectional study all infants aged less than 3 months, admitted to neonatal intensive care unit and pediatric emergency ward of Ghaem Hospital (a university hospital with 900 beds) in Mashhad (Northeast of Iran) with clinical diagnosis of sepsis and at least one inclusion criteria during one year from November 2009 to October 2010, were enrolled in the study. Polymerase chain reaction (PCR) was done on clinical samples obtained from patients.Results: Among 150 neonates and infants younger than 3 months old with sepsis, the PCR results for detecting the HSV DNA, were positive in 6 samples of 5 patients (3.3%). None of the mothers had symptomatic HSV infection during delivery. The mean age of the patients was 18 days. Two of them died due to shock and disseminated intravascular coagulation (DIC).Conclusions: In neonates and infants with primary diagnosis of sepsis, HSV infection should be considered especially if the clinical condition does not improve after 48 hours of antibiotic therapy, and sepsis still exists with elevated liver enzymes.

Dear Editor: Depression is a common mental disorder and leading cause of disability worldwide (1). As a definition, depression may be a mood state, a syndrome or a specific disorder that may be secondary to various medical illnesses (2, 3). Avicenna (980-1037 AD), a scholar in traditional medicine, believed that indigestion can lead to depression (4). Indigestion is a common gastrointestinal problem that consists of nausea, vomiting, heartburn, regurgitation and dyspepsia (5). Functional dyspepsia is one of the most common causes of indigestion (6).

Background: Postpartum depression (PPD) is a common problem after child's birth and may influence the quality of life (QOL). Investigation of postpartum QOL and depression can be useful for better care for mothers and improvement of their well-being.Objectives: The objective of this study was to assess the life quality in mothers with and without PPD.Patients and Methods: In a prospective study, women who had experienced child's birth with and without PPD were recruited in Kashan-Iran. PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS) and QOL was measured by SF-36 questionnaire. Data collection was conducted at two assessment points: second month (n=321) and fourth month (n=300) postpartum. Based on EPDS, a score of 13 or more was defined as PPD. Mean scores of SF-36 questionnaire were compared between women with and without PPD at two assessment points and within each group from the first to the second assessments. Moreover, correlation between scores of EPDS and scores of life quality dimensions were evaluated. Data were analyzed by using the Student's t-test, Mann–Whitney U-test, ANOVA, Kruskal-Wallis, Chi-square test, Pair t test, Wilcoxon, Pearson and Spearman Correlation Coefficient.Results: Differences in seven out of eight mean scores of QOL dimensions (except role-physical) between depressed and non-depressed women at the first and the second assessments were significant. Results of changes in mean scores of QOL dimensions from the first to the second assessments in each group showed that non-depressed women scored higher in all of eight dimensions with significant differences in two dimensions (bodily pain and role-emotional as well as mental health component). In depressed women, scores of life quality decreased in some of QOL dimensions but differences were not significant. There were significant negative correlations between EPDS scores and scores of seven out of eight SF-36 sub-scales (except role-physical) in addition to physical and mental health components at two assessments. The highest correlation was found between EPDS scores and emotional well-being and total scores of SF-36 dimension at the first and the second assessments (r=-0.489, r=-0.381), respectively.Conclusions: The findings demonstrated that postpartum depression leads to a lower life quality at second and fourth months postpartum. Integration of PPD screening into routine postnatal care is recommended.

Background: Treatment of the nosocomial infections is complicated especially in children due to an increase in the antibiotic-resistant bacteria.Objectives: The aim of this study was to survey the nosocomial infections in children and determine the antibiotic susceptibility of their causative organisms in teaching hospitals in the north of Iran.Patients and Methods: The investigation was designed as a retrospective cross-sectional study. The study population consisted of patients under 12 years old, which were hospitalized in three teaching hospitals in the north of Iran and had symptoms of nosocomial infections in 2012. The required data of patients were extracted and entered in the information forms. The collected data were analyzed using SPSS (ver.16). Descriptive statistics and Fisher’s exact tests (Monte Carlo) were used.Results: Out of the total number of 34556 hospitalized patients in three teaching hospitals, 61 (0.17%) patients were children under 12 years old age with nosocomial infection from which 50.81% were girls and 49.18% were boys. Most of these patients (55.73%) were admitted to the burn unit. The most common type of nosocomial infection (49.18%) was wound infection. Pseudomonas spp. (36.84%) and Acinetobacter spp. (28.02%) were the most common bacteria isolated from the clinical specimens. All the Acinetobacter spp. were multidrug-resistant. All the gram negative and gram positive bacterial species in our study showed high resistance to antibiotics.Conclusions: The rate of nosocomial infections was low in our study because the detection of nosocomial infection was based on the clinical grounds in most cases and laboratory reports might contain false-negative results. These results provide useful information for future large scale surveillance in the context of prevention programs.

Background: Pemphigus is an autoimmune bullous disease and it is unclear what triggers and deteriorates it. The current study aimed to evaluate whether increasing the IgG antibody titer represents a good indicator of the pemphigus recurrence.Objectives: The current study aimed to evaluate whether increasing IgG titer is an indicator of the expected recurrence.Patients and Methods: The current study was conducted at the Department of Dermatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, between March 2007 and December 2012. A total of 112 patients with confirmed diagnosis of pemphigus based on clinical, histological and immuno-histological criteria were engaged in the study. The primary outcomes of the study were recurrent event times and IgG (Immunoglobulin G) antibody titer at each attendance. Joint model with shared random-effects was applied to assess the association between the two processes and investigate the affective factors.Results: Up to 8 recurrences were observed during the study time, but only 10% of the patients experienced more than 5 recurrences. A significant linear increasing trend in IgG antibody titer over time was found, IgG antibody titer increased 2.43% each month (P<0.0001). The results showed positive correlation between IgG antibody titer and recurrence of pemphigus (P<0.0001).Conclusions: The patients with higher IgG antibody titer were more likely to experience pemphigus recurrence. Therefore it can be concluded that titer of IgG and its increase may provide information regarding the progression of the pemphigus and the hazard of its recurrence.

Background: Labor laws and regulations have inevitable effects on employees’ work motivation as well as the overall efficiency and productivity of the organization.Objectives: This study was conducted to assess the effects of the "Countrywide Services Management Law" on the work motivation level of the employees of the Iranian Ministry of Health.Patients and Methods: This cross-sectional study was done in 2011 in the Iran's Ministry of Health. Data was collected by a 51-item Likert scale questionnaire, in five domains including: organizational structure, information technology, training patterns, salary and bonus system and re-engineering process. The reliability and validity of the questionnaire was evaluated (Cronbach's alpha=0.96). Data analysis was conducted using descriptive and inferential statistics (t-test).Results: Out of 192 samples examined, 55.2% of the respondents were female, 88 (45.8%) had BS degree and 116 (60.4%) had less than 10 years’ experience. The mean scores in the domains of organizational structure, information technology, training patterns, salary and bonus system and re-engineering patterns were: 3.11, 3.51, 3.05, 3.21 and 3.14, respectively. Relationship between the items related to manpower in the "Countrywide Services Management Law", with employees' work motivation was significant (P<0.0001). The training patterns did not show a significant relation (P<0.26) with any of five domains.Conclusions: According to our results and the views of the employees of the Iranian Ministry of Health, "Countrywide Services Management Law" positively affected the personnel's work motivation regarding all the factors associated with motivation including: organizational structure, information technology, training patterns, salary and bonus system and re-engineering pattern. Finally, to enhance the workforce motivation and satisfaction level, application and implementation of the rules and regulations should be based on the organizational needs.

Background: Uropathogenic Escherichia coli O- Serogroups with their virulence factors are the most prevalent causes of UTIs.Objectives: The present investigation was performed to study the virulence factors and O-Serogroups profiles of UPEC isolated from Iranian pediatric patients.Patients and Methods: This cross sectional investigation was performed on 100 urine samples collected from hospitalized pediatrics of Baqiyatallah Hospital, Tehran, Iran. Midstream urine was collected to decrease potential bacterial, cellular and artifactual contamination. All samples were cultured and those with positive results were subjected to polymerase chain reactions to detect pap, cnf1, afa, sfa and hlyA genes and various O- Serogroups.Results: We found that 37.5% of boys and 75% of girls had positive results for Escherichia coli. We also found that O1 (19.33%), O2 (13.33%), O6 (13.33%), O4 (11.66%), and O18 (11.66%) were the most commonly detected Serogroups. Totally, the serogroup of 5% of all strains were not detected. In addition, all of these O- Serogroups were pap+, cnf1+, hlyA+, and afa+. Totally, pap (70%), cnf1 (56.66%), and hlyA (43.33%) were the most commonly detected virulence genes in the both studied groups of children. The sfa (30 %) and afa (26.66%) genes had the lowest incidence rates.Conclusions: Special health care should be performed on UTIs management in Iranian pediatric patients. Extended researches should be performed to evaluate relation between other O-Serogroups and virulent genes.

Background: Results of various studies suggest that the hypertrophic and keloid scars are highly prevalent in the general population and are irritating both physically and mentally.Objective: Considering the variety of existing therapies, intense pulsed light (IPL) method along with corticosteroid injection was evaluated in treating these scars.Materials and Methods: 86 subjects were included in this clinical trial. Eight sessions of therapeutic intervention were done with IPL along with corticosteroid intralesional injection using 450 to 1200 NM filter, Fluence 30-40 J/cm2, pulse duration of 2.1-10 ms and palsed delay 10-40 ms with an interval of three weeks. To specify the recovery consequences and complication rate and to determine features of the lesion, the criteria specified in the study of Eroll and Vancouver scar scale were used.Results: The level of clinical improvement, color improvement and scar height was 89.1%, 88.8% and 89.1% respectively. The incidence of complications (1 telangiectasia case, 7 hyperpigmentation cases and 2 atrophy cases) following treatment with IPL was 11.6%. Moreover, the participants’ satisfaction with IPL method was 88.8%.Conclusions: This study revealed that a combined therapy (intralesional corticosteroid injection+IPL) increases the recovery level of hypertrophic and keloid scars. It was also demonstrated that this method had no significant side effect and patients were highly satisfied with this method.

Background: Decision making for timing motherhood is one of the vital aspects of reproductive health. Separating sexual relationship from having a child has led to a different and unprecedented lifestyle in human history.Objectives: The objective of this study was to determine the socioeconomic and emotional factors predicting decision making for timing motherhood among Iranian women using the statistical softwares of IBM SPSS 21 and LISREL 8.8.Patients and Methods: This cross-sectional study enrolled 820 primiparous women from different hospitals across the country using multistage random sampling method in 2013. The tools of the study were enrich marital satisfaction, socioeconomic status, perceived social support, hopefulness, and life regard index. The data was analyzed using SPSS 20 and LISREL 8.8.Results: The results revealed that among direct pathways, marital age (b=0.62) was the most effective predictor of timing motherhood. The hopefulness had an inverse association with timing motherhood through inverse effect of marital satisfaction. Moreover, marital satisfaction (b=-0.09), perceived social support (b=-0.09), and life regard index (b=0.01) had an inverse effect on timing motherhood. Marital satisfaction had a non-causal effect of 0.024.Conclusions: Marital age, and socioeconomic status had a direct association, and hopefulness and marital satisfaction had an indirect one with Iranian women's decision for timing motherhood. Therefore, this is the responsibility of policy-makers and healthcare providers to advise women by providing appropriate interventions and facilities.