Background: Due to the fear of childbirth (FOC) and failure to provide painless delivery in Iran, the prevalence rate of elective cesarean section (C-section) performed on request by pregnant women is on the rise. However, no systematic review assessing the results of studies in this respect has been thus far developed. Objective: To systematically review published psychological intervention research reflecting on FOC in Iran. Materials and Methods: In this systematic review, the databases of PubMed, MEDLINE, PsycINFO, Wiley, ISI Web of Science, Scopus, Science Direct, Cochrane Library, Google Scholar, and Scientific Information Database were searched to retrieve the relevant studies. Manual searches were performed to find the relevant articles and finally 21 intervention studies were reviewed. Results: Based on the modified Jadad Scale, a methodological quality (risk of bias) assessment tool, 14 and 7 studies had acceptable or good and low quality, respectively. The included articles covered fear, fear of childbirth, pregnancy, and psychological intervention in Iran. Cognitive behavioral therapy, relaxation techniques, psychological counseling, childbirth preparation classes (CPCs), mindfulness programs, and psychoeducation had been also practiced as the main types of psychological interventions for reducing FOC in pregnant women. Conclusion: There was no clear evidence to establish the most effective method for minimizing levels of FOC in pregnant women. Based on the assessment tool and since most of the studies had moderate or low quality, conducting standard and high-quality randomized controlled trials focusing on FOC in pregnant women is of most importance in Iranian population. Key words: Fear, Childbirth, Pregnancy, Psychological intervention, Iran.

Introduction: Neuroleptic malignant syndrome (NMS) is a rare and unpredictable adverse reaction associated with the use of firstgeneration and second-generation antipsychotics. Atypical antipsychotics may create atypical forms of NMS due to their different pharmacological characteristics. Decreased dopaminergic tone in the brain is coincided with a dysregulation of autonomic nervous system in this syndrome. This study reports on a case, in which current views occurred during the course of the disease is among rare symptoms. This paper reports on an NMS case, in which current views and symptoms that occurred during the course of the disease were rare symptoms that are not usually found in NMS. Case Presentation: The patient was a 43-year-old male with schizoaffective disorder under treatment with clozapine and risperidone. He had lead pipe muscle rigidity, stupor, fever and autonomic dysfunction, increased levels of creatinine phosphokinase, leukocytosis, and microglobulina. Levenson's criteria is widely accepted for diagnosis of NMS. Six days after admission to the psychosomatic ward, the patient had ileus. Due to lack of response to neomycin and GI rest and embedding NG tube, the patient underwent therapeutic sigmoidoscopy and colonoscopy for decompression. Conclusions: Diagnosis of NMS is largely based on clinical history and the presence of specific clinical symptoms. Antipsychotics polypharmacy increases the NMS risk. Mechanisms underlying the development of ileus in the patient are speculative and multifactorial. Paralytic ileus can be one of the autonomic dysfunctions in NMS. Furthermore, NMS is categorized in differential diagnosis of acute abdomen caused by the pseudo-obstruction. All physicians should be aware of this possibility when faced with patients under treatment with neuroleptics.

Background: Fasting has certain effects on metabolic and anthropometric parameters in diabetic patients. It is, therefore, necessary for patients to receive proper education related to their physical activities, eating habits, blood glucose monitoring, and medications. The aim of this study was to investigate the effects of Ramadan fasting on metabolic and anthropometric indices in type ΙΙ diabetic patients.Methods: This prospective observational study was performed during Ramadan 2018. The study population consisted of diabetic patients who desired to fast and received information on physical activity, eating habits, blood glucose monitoring, and taking their medications before Ramadan. Fasting blood sugar (FBS), blood sugar 2-hour postprandial (BS2hpp), glycosylated hemoglobin (HbA1C), and the lipids profile were assessed before and after Ramadan month. FBS and BS2hpp were also evaluated on the fifteenth day of Ramadan. The significance level for data analysis was considered p<0.05.Results: Out of 40 diabetic cases who completed the study, 6 (15%) were male and 34 (75%) were female. The mean age of participants was 55.2 ± 9.3 years. The anthropometric variables, including weight, BMI, waist, and blood pressure, decreased significantly after Ramadan fasting (p<0.05). FBS decreased significantly (125.1 ± 27.4 vs 105.2 ± 21.4, p<0.0001) and serum triglyceride increased significantly (127.5 ± 45.5 vs 166.5±53.5 mg/dl, p<0.001) after fasting compared to pre-Ramadan measurement. Other variables remained unchanged.Conclusion: The results of this study indicate that type II diabetic patients who have controlled blood sugar and received information based on clinical guidelines about their lifestyle and medications can fast safely during the holy month of Ramadan.