مجله تعالی بالینی
سال پنجم شماره 2 (پیاپی 11، پاییز 1395)

The Fig (Ficus carica) is one of the oldest and most commonly consumed fruit in the world and Iran is one of the most important countries in the world in production of figs. By increasing development of science in various fields in recent years, new aspects of medical and nutritional properties of fig have been founded. It was found that many of proven properties of fig in modern science have already been mentioned in the Quran, narrations and hadiths of the Imams(AS). Fig is mentioned in the holy books of Jews and ancient Greeks and the god has sworn to it in the holy Quran. This fruit is laxative and it is effective to treat numerous diseases including hemorrhoids, gout, leprosy and epilepsy in traditional medicine. Other medicinal benefits for fig are including is lowering blood pressure, fever, weight, inflammation, increasing the bone density and preventing muscle weakness. The aim of this article was to study the Quran, hadith and narrations about fig properties to the importance and consistency of their recommendations with the latest scientific findings in modern medicine will be more proved. In this study, medical properties of fig were investigated in the Quran, hadiths, traditional medicine as well as recent scientific researches (1999 - 2016). Despite the recommendations of the Quran and Prophet, Imams and traditional sciences to the consumption of fig, findings of recent studies also indicate that this fruit is effective in the treatment of various diseases such as cancer, cardiovascular disease, infectious diseases, diabetes, Schizophrenia, epilepsy, insomnia, stress, constipation and hepatotoxicity. It also has anti-inflammatory, antimicrobial and antioxidant properties. Scientific findings of researchers in recent years confirm the recommendations of the Quran and Hadith of the Imams (AS) about the fig and it represent the necessity of thinking in the Islamic and traditional medicine resources.

Diabetes mellitus (DM) is one of the most important metabolic diseases and also a major public health alarm, characterized by hyperglycemia. DM can produce several complications on heart tissue, vascular disease, kidney, eyes and oral cavity by hyperglycemia condition. The periodontal diseases are the most prevalence chronic infectious inflammatory diseases and oral manifestations of diabetes in human. Also, it has been shown one risk factor for diabetes mellitus. The other oral manifestations of diabetes are oral and dental infections, erythema, inflammation of gingiva and dilation of ulcer repaired that deficiency of blood to the tissues can be expressed its causes. Therefore, current research aimed to review the available evidence regarding the relation between diabetes and its complications and oral manifestation. In this regards, it will be important all dentists recognize every aspects of disease, and their management outcome to provide low risk treatments and well control to patients with DM.

Pain is the unpleasant sensation that we experience in association with actual or potential tissue damage, while nociception is the neural process of encoding a noxious stimulus. Suffering and disability resulting from pain lead to decrease quality of life for many people. Many of the researchers, physiologic mechanisms in response to pain, anatomical pathways and neurotransmitters were studied. Neurotransmitters such as 5-hydroxy-tryptamine, Bradykinin, Histamine, Eicosanoids, the leukotrienes and hydroxy acid and cytokinins are associated with pain. Therefore pain control or pain relief is one of the important targets in the treatment of diseases and It is important for clinicians, Despite the pathological point is not curable. Qualified medical personnel using medication for pain reduction. These drugs are divided into five groups: Opioid drugs, Steroids, Non-steroidal anti-inflammatory drugs(NSAIDs), Topical anesthetics and General anesthetics. Sometimes, traditional methods other drugs and traditional methods are used to reduce pain. The pathophysiology of pain and effective drugs in its control and integration of information and Optimization, It is necessary.

One of the four principles of modern medical ethics is to honor the principle known as patient participation in decision-making related to their own treatment. Euthanasia or "Mercy Killing" refers to the practice as helping a person experiencing a quiet, pain free and comfortable death. Due to the subject being important and few studies available in this area, the current study has been designed, which is a systematic narrative review. Using keyword search about the title or abstract in the databases like Magiran, SID, Medline, Iranmedex for Persian language studies and the articles with their full text in English on the databases as ProQuest, Elsevier, Ovid, PubMed, Science direct using the following key words, the search was done. The Persian words included favorable death, sweet death, good death, easy death. The key words in English language covered Mercy killing, Easy death, Euthanasia with the individual terms aging, older people and the elderly. After searching the available databases with the appropriate key words in two languages as Persian and English and with no time limitation, 56 articles have been obtained. Out of these ones, 38 articles have been selected and analyzed as the most relevant to our desired objectives. The identical studies were excluded and or integrated as much as possible at the investigator's discretion. All those dealing with the dying patients have to be equipped with enough skill and access the sophisticated consultants in the symptomatic treatment and take the due actions, if necessary. Knowing a society health care provider's attitude towards the issue called euthanasia, it is possible to take effective actions through a well-established planning in order to promote the care of the patients about whom euthanasia is set forth.

Both poor oral health and cognitive decline are common problems among elders. The aim of this review article is to identify the role of oral health in the elderly cognitive decline. Available databases including Magiran, Google Scholar, SID, Medlib, Iranmedex, Proquest Elsevier, Ovid, Pubmed, and Science Direct was assayed by key words mouth and tooth, cognitive disorder, cognitive decline, cognitive impairment, dementia, oral health, aging, elder, ageing, older people, elderly. Relevant English and Persian articles from 2000 to the end of 2015 were used. Exclusion criteria included no access to full text and articles in other languages. 56 articles were extracted and finally 10 articles relevant to objectives of this study were examined. The results of all studies showed a significant relationship between the number of tooth loss and cognitive decline, however, only one study was designed longitudinally. Additional research seems necessary to prove relationship between oral health and cognitive decline.

Degeneration of the intervertebral disc results in initial relative instability, hypermobility, and hypertrophy of the facet joints, particularly at the superior articular process. This finally leads to a reduction of the spinal canal dimensions and compression of the neural ele­ments, which can result in neurogenic intermittent claudication caused by venous congestion and arterial hypertension around nerve roots. We make a decision to review of 66 articles from 1980 to 2016 in this condition. Most patients with symptomatic lumbar stenosis had neurogenic intermittent claudication with the risk of a fall. However, al­though the physical findings and clinical symptoms in lumbar stenosis are not acute, the radiographic findings are comparatively severe. Differentiation between neurogenic and ischemic claudication is important Magnetic resonance imaging is a noninvasive and good method for evaluation of lumbar stenosis. Though there are very few studies pertaining to the natural progression of lumbar spinal stenosis, symptoms of spinal stenosis usually respond favorably to non-operative management. In patients who fail to respond to non-operative management, surgical treatments such as decompression or decompres­sion with spinal fusion are required. Restoration of a normal pelvic tilt after lumbar fusion correlates to a good clinical outcome.currently, the interest to minimally invasive approaches like bilateral laminotomy, Trumpet laminectomy, and conventional laminectomy is increased.

Renal failure is a commonly and chronic disease. Dialysis is routine treatment for these patients. Adherence to treatment status is one of the problems of patient on dialysis. The aim at this study is determining of the most important causes of non-adherence in patients on dialysis, according to previous studies in Iran. At first all of the studies related to our title by using some keywords(dialysis, hemodialysis, adherence, and non-adherence) searched for Iranian databases; iranmedex, magiran, SID, Iran doc, google, google scholar. Inclusion and exclusion criteria were: 1. Publish articles related to adherence or non-adherence in Iran, Articles were Persian (published in Iran),Types of articles were original and All the articles were free full text and downloadable. As a result, related to inclusion and exclusion criteria 13 articles were found and analysises. The most important reasons for non-adherence to treatment were: psychological reasons (often depression), Lack of awareness and attitude of dialysis patients and lack of social support. Treatment for adherence is so important and can very significant role in health improvement in patients on dialysis.

Health System Performance Assessment can be usable for the creation of a common understanding of priorities for strengthening health systems, to provide a context for dialogue between programs and between different sectors, and to develop a common understanding of communication between the activities that impact on health outcomes. Health System Performance Assessment helps to decision-makers and policymakers to be ensure responsiveness of their decisions. History of Health System Performance Assessment returns to decade before 2000. Up to now different models of Health System Performance Assessment with different approaches and objectives, are presented and different countries have various experiences of developing and applying of his models.
In this study, using related key words and related electronic and library resources from 1998 to 2012 have been investigated in both Persian and English language. Initially, the most common and most important of international models of performance assessment in the health has been studied and compared, then the most important concepts and topics that are involved in the designing of the assessment's models is extracted. Finally, the experiences of some selected countries are reviewed and compared.
As a result, each country is required to design specific assessment model based on the political, economic, social structure and expected objectives of the health system. To transparency and accountability, designing and implementation of the performance assessment model at different executive levels of the health system are needed, until each executive unit accepts responsibility of their activities. To performance assessment, each executive unit must have clear objectives and appropriate planning of his activities. Because any assessment model is not perfect, therefore result of the assessment's models designing to constructive criticism of experts and to resolve of its defects should be published both before and after applying.