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This study aimed to explore whether the temperament of the body is related to and can cause stress urinary incontinence (SUI) in reproductive-age women. Urinary incontinence (UI) is defined as involuntary loss of urine. SUI is defined as ‘‘the complaint of involuntary leakage on effort or exertion, or on sneezing or coughing.” In Unani medicine, one of the causes that lead to UI is temperament (mizaj) of the body or organ..
This study was a single-center, observational trial conducted at the outpatient department of the National Institute of Unani Medicine, Bangalore, India, between March 2012 and November 2012. A total of 60 women presenting with SUI for at least 6 months, who fulfilled the inclusion criteria, were recruited. Their general temperament was assessed using a prestructured proforma designed for assessing temperament that was based on 10 determinants (alamat ajnase ashra).
Of 60 patients, sanguine and phlegmatic temperament was found in 31 (52%) and 29 (48%) patients, respectively. None of the patients had choleric and melancholic temperament. Maximum number of women were in the age group of 31–40 years (n = 38, 63%) in which 55% (n = 17) and 72% (n = 21) had sanguine and phlegmatic temperament, respectively. All patients had anterior vaginal wall prolapse.
It is concluded that SUI occurs in reproductive-age women with sanguine and phlegmatic temperament. Also, using objective parameters for temperament assessment and conducting randomized studies with a larger sample size are recommended.

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Many families threaten young children with a needle prick as the means of making them disciplined and avoiding unacceptable behavior. Due to this adult behavior, children avoid medical care and are difficult to be examined medically.
This study aimed to investigate how the threat of using a needle might change children's behavior toward medical examination.
The mothers of 88 children, ages 2–12 years who came for a health checkup, were asked whether they ever threatened their children with a needle prick or an injection. Then, the children underwent a standard medical examination. The threatened and nonthreatened children were 33 and 55, respectively. The threatened children were found to be less cooperative and difficult to be examined. They were scared, crying, agitated, or panicky.
Children who were threatened with a needle or an injection were noncooperative or even hostile to doctors. Hence, it is recommended that therapeutic and prophylactic injections be kept to the minimum and replaced with oral or rectal medications. The means to reduce needle pain ought to be used more freely to ameliorate pain and establish a more cooperative response to doctor`s examination. Parents of young children should stop threatening children with a needle prick or an injection as the means of teaching them acceptable behavior and discipline.

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Urinary incontinence (UI) is defined as the complaint of any involuntary loss of urine. UI can be slightly bothersome or totally debilitating. For some women, the risk of public embarrassment prevents them from enjoying many activities with their family and friends.Women are four times more likely to be affected by UI compared with men. Stress urinary incontinence (SUI) is the most common type of UI in women below age 60 and accounts for almost 50% of incontinence in all women. The minimum evaluation in women with symptoms of uncomplicated SUI includes history, urinalysis, physical examination, assessment of urethral mobility, demonstration of SUI, and measurement of postvoid residual urine volume. Additional diagnostic evaluation with multichannel urodynamic testing is helpful in women with complicated SUI, especially before surgical treatment. Clinical decision should help the health care providers to perform preoperative multichannel urodynamic testing or refer to an expert in urology who is skilled in female pelvic medicine and reconstructive surgery.

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Prior to the Islamic Revolution, hardly any health care system existed in Iran. Preventive health care was very limited, and a fairly decent curative care could only be found in Tehran and, to a lesser extent, in a few large cities where a great majority of the 12–14 thousand Iranian physicians were practicing. The people living in smaller towns and large villages had to seek the advice of expatriate physicians speaking a different language. Poor people in general and residents of more than 65,000 villages had virtually no access to medical care.
When the Islamic Revolution materialized, people rightfully began to expect social justice and health equity, and the Ministry of Health in response started to establish a primary health care (PHC) system throughout the country. However, the main problem was inadequate healthy manpower. As the Ministry of Higher Education was unable to increase the number of students, in 1985, the Parliament passed a law taking away all health education schools from the Ministry of Higher Education and integrated them into the Ministry of Health, forming the Ministry of Health and Medical Education. Almost simultaneously at least one university of medical sciences and health services was established in each province. Since then the chancellors of the universities are responsible for not only health education and research, but also the health care of the entire province.
As a result of the integration, not only Iran became self-sufficient in healthy manpower, but research also became more public health oriented and medical education more community oriented. The integration also led to an improvement in the health condition throughout the country, particularly in the villages, remote areas, and less developed provinces.
Now all villages and towns with less than 20,000 people have access to family practice physicians through the PHC system, and the plan is to do the same for all cities to move closer to the universal health coverage. Effort is also being made to decrease the out-of-pocket expenses from 52% to 30%.
Recently, the general health policies endorsed by the supreme leader have been communicated. By implementing these policies, a noticeable improvement is expected to materialize in different aspects including management.

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Congenital anomalies of the nose are very rare and include the bifid nose, complete absence of the nose, and unilateral absence of the nose.
A 23-year-old medical school student was diagnosed with a rare congenital nasal anomaly including left alar full-thickness defect.
Under general anesthesia, a posteroinferiorly based V-Y flap was selected to cover the outer surface. To make the inner lining, another anteroinferiorly based V-Y flap from the internal coverage tissue was elevated, including alar cartilages remnants and soft tissues around it. These two V-Y flaps were called double-opposing V-Y flaps. To support the alar wing, a cartilaginous graft was inserted taken from the anterior septal edge.
The treatments of the nasal alar defects resulting from oncological surgery and those from congenital anomalies significantly differ. The expectations of the patients from the surgery are higher in the second situation than in the first one. A technique using minimal donor site morbidity should be searched.

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This study aimed to present the case of a patient with trigonocephaly who was operated at 6 months of age with bifrontal craniotomy and fronto-orbital advancement. Trigonocephaly is a premature fusion and ossification of the metopic suture. The calvarial growth restriction causes decreased intracranial volume. Thus, a surgical intervention is indicated to restore the volume of the skull along with appearance.

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