1 Effects of Resveratrol on Recovery from Acute Ischemic Stroke Among Patients Who Received Delayed Alteplase: A Double-Blind Placebo-Controlled Randomized Clinical Trial Study https://brieflands.com/journals/jkums/articles/170810 10.5812/jkums-170810 1 Background and Objective :Neuroprotective effects of resveratrol in the context of cerebrovascular conditions has been reported. In the present study, the effect of resveratrol on functional outcomes was investigated among a group of acute ischemic stroke patients who received recombinant tissue plasminogen activator (rt-PA) after 3 hours of stroke onset. Methods :This clinical trial study (trial registration number: IRCT20191020045162N1) was registered on 2020-03-12. Sixty patients with acute ischemic stroke who underwent rt-PA therapy between 3 to 4:30 hours after stroke onset participated in the study. They were allocated into resveratrol and placebo groups by permuted block randomization method. The first group received 450 mg of resveratrol in three daily doses and the other group received a placebo containing excipient for 30 days. Outcomes were measured by the national institute of health stroke scale (NIHSS), modified Rankin Scale (MRS), and Barthel index (BI) at discharge as well as three and six months after the stroke. The outcomes were compared between groups by repeated measures analysis. Results :Although the NIHSS score significantly decreased over time in both groups, resveratrol had no significant therapeutic effect on NIHSS outcomes compared to placebo (P = 0.99). After three- and six-month reexaminations, MRS decreased and Barthel index increased significantly over time in the resveratrol group, indicating less handicap and more functional recovery compared to the placebo group. Conclusion :Resveratrol improved long-term functional recovery measured by MRS and Barthel index. 1 10 Payam Sariaslani Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran Neuroscience Research Center, Health Policy and Promotion Institute, Kermanshah University of Medical Sciences, Iran Iran Iran psariaslani@gmail.com Hiwa Mohammadi Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran Neuroscience Research Center, Health Policy and Promotion Institute, Kermanshah University of Medical Sciences, Iran Iran Iran hiwa.mohamadi@gmail.com Dalir Parsa Neuroscience Research Center, Health Policy and Promotion Institute, Kermanshah University of Medical Sciences, Iran Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran Iran Iran drdparsa68@gmail.com Amirhosein Rostami Lal Abadi Neuroscience Research Center, Health Policy and Promotion Institute, Kermanshah University of Medical Sciences, Iran Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran Iran Iran amirhfdr@gmail.com Shahab Rezaeian Infectious Diseases Research Center, Health Policy and Promotion Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran Iran shahab.rezayan@gmail.com Shahla Mirzaei Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran Iran shahla_mirzaeei@yahoo.com No Keyword 1.pdf [0]Tian X, Fan T, Zhao W, Abbas G, Han B, Zhang K, et al.Recent advances in the development of nanomedicines for the treatment of ischemic stroke. 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1 Effectiveness of Cognitive-Behavioral Therapy on Emotional Distress in Women with Polycystic Ovary Syndrome https://brieflands.com/journals/jkums/articles/170413 10.5812/jkums-170413 1 Background :Emotional distress is common among women with polycystic ovary syndrome (PCOS) and may adversely affect their overall psychological well-being. Cognitive-behavioral therapy (CBT) has been proposed as an effective intervention for improving emotional functioning in this population. Objectives :This study aimed to evaluate the effectiveness of CBT in reducing emotional distress in women with PCOS. Methods :This quasi-experimental study used a pretest–posttest design with a control group. Thirty women diagnosed with PCOS in Kermanshah in 2025 were recruited using convenience sampling and then randomly assigned to an experimental group (n = 15) or a control group (n = 15). Emotional distress was assessed using the Simmons and Gaher Emotional Distress Questionnaire (2005). The experimental group participated in eight 45-minute CBT sessions, whereas the control group received no intervention during the study period. Data were analyzed using multivariate analysis of covariance in SPSS version 26. Results :Compared with the control group, CBT significantly reduced overall emotional distress and yielded significant improvements in distress tolerance, emotional absorption, negative emotion appraisal, and emotion regulation in women with PCOS (p < 0.01). Conclusions :CBT was associated with reduced emotional distress and improved emotion regulation in women with PCOS, underscoring its potential clinical value as a psychological intervention in this population. 1 7 Asma Pishbahar Department of Clinical Psychology, Ker.C., Islamic Azad University, Kermanshah, Iran Iran asma.pishbahar@iau.ir Maryam Seidy Department of Exceptional Children Psychology, Ker.C., Islamic Azad University, Kermanshah, Iran Iran seidymaryam@gmail.com No Keyword 2.pdf [0]Hosseini SA, Kazemi N, Shadmehri S, Jalili S, Ahmadi M.The effect of resistance training in water and land with vitamin D supplementation on anti-Müllerian hormone in women with polycystic ovary syndrome. Womens Health Bull. 2019;6(2). e84882. doi: 10.5812/whb.84882.##[1]Burnatowska E, Wikarek A, Oboza P, Ogarek N, Glinianowicz M, Kocelak P, et al.Emotional eating and binge eating disorders and night eating syndrome in polycystic ovary syndrome: a vicious circle of disease: a systematic review. Nutrients. 2023;15(2):295. [PubMed ID: 36678165]. [PubMed Central ID: PMC9865055]. doi: 10.3390/nu15020295.##[2]Akbari Naskaran Z, Fathi M.The effect of 12 weeks of aerobic training on body composition, aerobic capacity, and some hormonal factors in infertile women with polycystic ovary syndrome. Iran J Obstet Gynecol Infertil. 2016;19(5):1-10. doi: 10.22038/ijogi.2016.6924.##[3]Grassi G, Polledri E, Fustinoni S, Chiodini I, Ceriotti F, D’Agostino S, et al.Hyperandrogenism by liquid chromatography tandem mass spectrometry in PCOS: Focus on testosterone and androstenedione. J Clin Med. 2021;10(1):119. [PubMed ID: 33396396]. [PubMed Central ID: PMC7795755]. doi: 10.3390/jcm10010119.##[4]Sirmans S, Pate K.Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol. 2013;6:1-13. [PubMed ID: 24379699]. [PubMed Central ID: PMC3872139]. doi: 10.2147/CLEP.S37559.##[5]Teede H, Deeks A, Moran L.Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med. 2010;8(1). 41. [PubMed ID: 20591140]. [PubMed Central ID: PMC2909929]. doi: 10.1186/1741-7015-8-41.##[6]Saei Ghare Naz M, Ramezani Tehrani F, Ahmadi F, Alavi Majd H, Ozgoli G.Threats to feminine identity as the main concern of Iranian adolescents with polycystic ovary syndrome: a qualitative study. J Pediatr Nurs. 2019;49:e42-7. [PubMed ID: 31645273]. doi: 10.1016/j.pedn.2019.08.010.##[7]Ahadian fard P, Asgharnejad farid AA, Lavasani F, Ashoori A.[Role of cognitive, metacognitive, and meta-emotional components in prediction of emotional distress in students (Persian)]. Iran J Psychiatry Clin Psychol. 2017;23(2):178-191. doi: 10.29252/NIRP.IJPCP.23.2.178.##[8]Mizokami-Stout K, Choi H, Richardson CR, Piatt G, Heisler M.Diabetes distress and glycemic control in type 2 diabetes: mediator and moderator analysis of a peer support intervention. JMIR Diabetes. 2021;6(1). e21400. [PubMed ID: 33427667]. [PubMed Central ID: PMC7834928]. doi: 10.2196/21400.##[9]Hashemi M, Forozandeh E, Heiaeropur M.[Comparison of the effectiveness of autobiographical memory specificity training and acceptance and commitment therapy on the emotional distress of diabetic patients with depression (Persian)]. J Res Behav Sci. 2023;20(4):660-670. doi: 10.52547/rbs.20.4.8.##[10]Behboodi Moghadam Z, Fereidooni B, Saffari M, Montazeri A.Polycystic ovary syndrome and its impact on Iranian women's quality of life: a population-based study. BMC Womens Health. 2018;18(1). 164. [PubMed ID: 30305063]. [PubMed Central ID: PMC6180458]. doi: 10.1186/s12905-018-0658-1.##[11]Majidzadeh S, Mirghafourvand M, Farvareshi M, Yavarikia P.The effect of cognitive behavioral therapy on depression and anxiety of women with polycystic ovary syndrome: a randomized controlled trial. BMC Psychiatry. 2023;23(1). 332. [PubMed ID: 37170227]. [PubMed Central ID: PMC10174601]. doi: 10.1186/s12888-023-04814-9.##[12]Marek-Banach J.Effectiveness of cognitive behavioural therapy in improving the functioning of patients with polycystic ovary syndrome. J Sex Ment Health. 2024;22(0):39-49. doi: 10.5603/jsmh.87943.##[13]Abdollahi L, Mirghafourvand M, Babapour JK, Mohammadi M.Effectiveness of cognitive-behavioral therapy (CBT) in improving the quality of life and psychological fatigue in women with polycystic ovarian syndrome: a randomized controlled clinical trial. J Psychosom Obstet Gynecol. 2019;40(4):283-293. [PubMed ID: 30175648]. doi: 10.1080/0167482X.2018.1502265.##[14]Moran LJ, Lombard CB, Lim S, Noakes M, Teede HJ.Polycystic ovary syndrome and weight management. Womens Health (Lond). 2010;6(2):271-283. [PubMed ID: 20187731]. doi: 10.2217/WHE.09.89.##[15]Clark DA, Beck AT.Cognitive theory and therapy of anxiety and depression: convergence with neurobiological findings. Trends Cogn Sci. 2010;14(9):418-424. [PubMed ID: 20655801]. doi: 10.1016/j.tics.2010.06.007.##[16]Eidelman P, Talbot L, Ivers H, Bélanger L, Morin CM, Harvey AG.Change in dysfunctional beliefs about sleep in behavior therapy, cognitive therapy, and cognitive-behavioral therapy for insomnia. Behav Ther. 2016;47(1):102-115. [PubMed ID: 26763501]. doi: 10.1016/j.beth.2015.10.002.##[17]Hayes SC, Villatte M, Levin M, Hildebrandt M.Open, aware, and active: Contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annu Rev Clin Psychol. 2011;7(1):141-168. [PubMed ID: 21219193]. doi: 10.1146/annurev-clinpsy-032210-104449.##[18]Rappaport BI, Pagliaccio D, Pine DS, Klein DN, Jarcho JM.Discriminant validity, diagnostic utility, and parent-child agreement on the Screen for Child Anxiety Related Emotional Disorders (SCARED) in treatment- and non-treatment-seeking youth. J Anxiety Disord. 2017;51:22-31. [PubMed ID: 28886420]. [PubMed Central ID: PMC5761277]. doi: 10.1016/j.janxdis.2017.08.006.##[19]Manning K, Rogers AH, Bakhshaie J, Hogan JBD, Buckner JD, Ditre JW, et al.The association between perceived distress tolerance and cannabis use problems, cannabis withdrawal symptoms, and self-efficacy for quitting cannabis: The explanatory role of pain-related affective distress. Addict Behav. 2018;85:1-7. [PubMed ID: 29787925]. [PubMed Central ID: PMC12826624]. doi: 10.1016/j.addbeh.2018.05.009.##[20]Wallace DD, Carlson RG, Ohrt JH.Culturally adapted cognitive-behavioral therapy in the treatment of panic episodes and depression in an African American woman: a clinical case illustration. J Ment Health Couns. 2021;43(1):40-58. doi: 10.17744/mehc.43.1.03.##[21]Barlow DH, Farchione TJ, Sauer-Zavala S, Murray Latin H, Ellard KK, Bullis JR, et al.Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide. New York: Treatments That Work; 2017. doi: 10.1093/med-psych/9780190685973.001.0001.##[22]Sakiris N, Berle D.A systematic review and meta-analysis of the Unified Protocol as a transdiagnostic emotion regulation based intervention. Clin Psychol Rev. 2019;72. 101751. [PubMed ID: 31271848]. doi: 10.1016/j.cpr.2019.101751.##[23]Cooney LG, Milman LW, Hantsoo L, Kornfield S, Sammel MD, Allison KC, et al.Cognitive-behavioral therapy improves weight loss and quality of life in women with polycystic ovary syndrome: a pilot randomized clinical trial. Fertil Steril. 2018;110(1):161-171. [PubMed ID: 29908771]. [PubMed Central ID: PMC6443091]. doi: 10.1016/j.fertnstert.2018.03.028.##[24]Alavi MS, Jabal Ameli S.The effectiveness of cognitive-behavioral therapy on emotional control of MS patients in the city of Isfahan. Jorjani Biomed J. 2018;6(1):44-54. doi: 10.29252/jorjanibiomedj.6.1.44.##

1 Dietary Factors and Parkinson's Disease Risk: Systematic Review of Verified Observational Evidence https://brieflands.com/journals/jkums/articles/169730 10.5812/jkums-169730 1 Background :Dietary exposures have been proposed as modifiable factors influencing Parkinson’s disease (PD) risk, yet observational evidence remains heterogeneous and often inconsistent. Methods :We conducted a systematic review of PubMed, Embase, and Web of Science for studies published between January 1, 2015, and June 30, 2025. Eligible studies included prospective cohorts, case–control, and cross-sectional studies that used validated or semi-validated dietary assessment instruments to evaluate dietary intake in relation to PD. Studies lacking verifiable publication metadata (DOI, PMID, or retrievable records) were excluded. Data extraction was performed independently in duplicate. Study quality was assessed using a modified Newcastle-Ottawa Scale and the ROBINS-I framework, with certainty of evidence evaluated via GRADE. Due to anticipated heterogeneity in exposures, outcomes, and study designs, a narrative thematic synthesis was pre-specified as the primary analytic approach. Heterogeneity was not quantitatively pooled in this review; the included meta-analysis (Hong et al.) reported I² = 58%. Formal sensitivity analysis excluding unverifiable studies was not feasible (they were excluded a priori), but comparison of exposure categories showed no unique dietary domains among unverifiable reports. Results :Six verified studies (total n >1.2 million participants; >25,000 incident PD cases) and one meta-analysis met inclusion criteria. Consistent evidence from high-quality prospective cohorts indicated that higher coffee or caffeine consumption was inversely associated with PD risk. In contrast, frequent dairy intake, particularly low-fat milk, was associated with modestly elevated risk. Evidence regarding alcohol, dietary fats, micronutrients, and overall dietary patterns was limited, heterogeneous, or of lower certainty. Most studies were rated moderate risk of bias, with large prospective cohorts providing the most robust findings.Conclusions :Verified observational evidence suggests that habitual caffeine intake may confer neuroprotective effects, whereas high consumption of specific dairy products may modestly increase PD risk. Associations for other dietary exposures remain inconclusive. Future studies should incorporate biomarker-validated dietary assessment, mechanistic endpoints, and harmonized cohort designs to clarify causal pathways and inform evidence-based dietary guidance for PD prevention. 1 10 Odochi Chukwu Ogbu Department of Physiology, Faculty of Basic Medical Sciences, College of Medical Sciences, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria Nigeria chukwuoo46@gmail.com Chioli Paschal Chijioke Department of Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, University of Nigeria Enugu Campus, Enugu State, Nigeria Nigeria chiolichijioke@unn.edu.ng Raphael Anakwue Chinedu Department of Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, University of Nigeria Enugu Campus, Enugu State, Nigeria Nigeria raphaelanakwue@unn.edu.ng Gertrude Onyeji Nneka Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, College of Medical Sciences, David Umahi Federal University of Health Sciences, Ebonyi State, Nigeria Nigeria gertrudeonyeji@gmail.com No Keyword 3.pdf [0]Regensburger M, Csoti I, Jost WH, Kohl Z, Lorenzl S, Pedrosa DJ, et al.Motor and non-motor fluctuations in Parkinson's disease: the knowns and unknowns of current therapeutic approaches. J Neural Transm. 2025;132(2):xxx-xxx. [PubMed ID: 40719828]. [PubMed Central ID: PMC12855397]. doi: 10.1007/s00702-025-02990-4.##[1]Gros P, Armengou Garcia L, Fox SH.Motor fluctuations in Parkinson disease: a mini-review of emerging drugs. Expert Opin Emerg Drugs. 2025;30(3):179-190. [PubMed ID: 40500235]. doi: 10.1080/14728214.2025.2517582.##[2]Houser MC, Tansey MG.The gut-brain axis: is intestinal inflammation a silent driver of Parkinson's disease pathogenesis? NPJ Parkinsons Dis. 2017;3(1). 3. [PubMed ID: 28168157]. [PubMed Central ID: PMC5445611]. doi: 10.1038/s41531-016-0002-0.##[3]Pajares M, I. Rojo A, Manda G, Boscá L, Cuadrado A.Inflammation in Parkinson's disease: mechanisms and therapeutic implications. Cells. 2020;9(7):1687. [PubMed ID: 32792173]. [PubMed Central ID: PMC7408280]. doi: 10.3390/cells9071687.##[4]Alcalay RN, Gu Y, Mejia‐Santana H, Cote L, Marder KS, Scarmeas N.The association between Mediterranean diet adherence and Parkinson's disease. Mov Disord. 2012;27(6):771-774. [PubMed ID: 22314772]. [PubMed Central ID: PMC3349773]. doi: 10.1002/mds.24918.##[5]Maraki MI, Yannakoulia M, Stamelou M, Stefanis L, Xiromerisiou G, Kosmidis MH, et al.Mediterranean diet adherence is related to reduced probability of prodromal Parkinson's disease. Mov Disord. 2019;34(1):48-57. [PubMed ID: 30306634]. doi: 10.1002/mds.27489.##[6]Ascherio A, Zhang SM, Hernán MA, Kawachi I, Colditz GA, Speizer FE, et al.Prospective study of caffeine consumption and risk of Parkinson's disease in men and women. Ann Neurol. 2001;50(1):56-63. [PubMed ID: 11517547]. doi: 10.1002/ana.1052.##[7]Hong CT, Chan L, Bai CH.The effect of caffeine on the risk and progression of Parkinson's disease: a meta-analysis. Nutrients. 2020;12(6):1860. [PubMed ID: 32547848]. 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1 Sustainable Production of Compost From Animal Waste Using an In-vessel Bioreactor: A Health Policy Brief https://brieflands.com/journals/jkums/articles/168421 10.5812/jkums-168421 1 Background :Livestock manure, particularly from cattle and poultry, represents a major source of organic waste, and improper disposal can pose significant environmental risks. Composting offers a sustainable solution by stabilizing manure, enhancing nutrient availability, and reducing pathogen load. Objectives :This study aimed to evaluate the effects of biochar amendment and varying cattle-to-poultry manure (CM/PM) ratios on compost quality, pollutant removal, and microplastic dynamics. Methods :Twelve treatments combining three CM/PM ratios (1:1, 3:1, and 1:3) with biochar levels (5%, 10%, and 15%) were composted under controlled aerobic conditions. Physicochemical properties, nutrient dynamics, heavy metals, and microplastics were monitored throughout the co-composting process. Results :Biochar significantly improved compost maturity, humification, nutrient stabilization, and pollutant reduction, with total organic carbon, humic acid content, and C/N ratio showing enhanced trends in biochar-amended treatments. Heavy metal removal efficiencies increased with biochar, while microplastic abundance decreased moderately. Conclusions :These findings demonstrate that animal manure compost produces environmentally safe, nutrient-rich compost, offering a practical strategy for sustainable waste management, soil fertility improvement, and circular bioeconomy promotion. 1 5 Mitra Mohammadi Social Development and Health Promotion Research Center, Health Policy and Promotion Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran Iran mitramohammadi.kums@gmail.com Ali Almasi Social Development and Health Promotion Research Center, Health Policy and Promotion Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran Iran alialmasi@yahoo.com Parviz Mohammadi Department of Environmental Health Engineering, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran Iran parvizmohammadi@yahoo.com Seyyed Alireza Mousavi Department of Environmental Health Engineering, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran Iran seyyedarm@gmail.com No Keyword 4.pdf [0]Sadeghpour A, Afshar RK.Livestock manure: From waste to resource in a circular economy. Journal of Agriculture and Food Research. 2024;17:101255. doi: 10.1016/j.jafr.2024.101255.##[1]Manea EE, Bumbac C, Dinu LR, Bumbac M, Nicolescu CM.Composting as a sustainable solution for organic solid waste management: Current practices and potential improvements. Sustainability. 2024;16(15):6329. doi: 10.3390/su16156329.##[2]Congilosi JL, Aga DS.Review on the fate of antimicrobials, antimicrobial resistance genes, and other micropollutants in manure during enhanced anaerobic digestion and composting. Journal of Hazardous Materials. 2021;405:123634. [PubMed ID: 33153790]. doi: 10.1016/j.jhazmat.2020.123634.##[3]Valverde-Orozco V, Gavilanes-Terán I, Idrovo-Novillo J, Ramos-Romero S, Valverde-Quiroz D, Idrovo-Gavilanes J, et al.Approach to the circular economy through agro-livestock waste composting with heat recovery and agricultural use of the resulting compost. Sustainable Chemistry and Pharmacy. 2024;41:101730. doi: 10.1016/j.scp.2024.101730.##[4]Gautam VP, Mishra S, Ahmed H.Comparison of total nitrogen estimation by kjeldahl method and chns analyzer in dry tropical grassland. International Journal of Plant and Environment. 2023;9(2):180-2. doi: 10.18811/ijpen.v9i02.13.##[5]Miltojević A, Zoraja B, Raos M, Krstić I.Application of thermogravimetry for determination of carbon content in biomass ash as an indicator of the efficiency of the combustion process. Tehnički vjesnik. 2021;28(5):1762-8. doi: 10.17559/TV-20200508110940.##[6]Vegia H, Abbaraju VK, Andrewsb B, Venugopalb N.Analysis of heavy metals in compost soil using inductively coupled plasma and flame atomic absorption spectrometry: Physicochemical properties of composts in enhancing soil fertility. Analytical Methods in Environmental Chemistry Journal. 2025;8(3):105-18. doi: 10.24200/amecj.v8.i03.1015.##[7]Zhou Y, Shen Y, Wang H, Jia Y, Ding J, Fan S, et al.Biochar addition accelerates the humification process by affecting the microbial community during human excreta composting. Environmental Technology. 2024;45(25):5332-45. [PubMed ID: 38100615]. doi: 10.1080/09593330.2023.2291418.##[8]Sajjadi SA, Mohammadi A, Khosravi R, Zarei A.Distribution, exposure, and human health risk analysis of heavy metals in drinking groundwater of Ghayen County, Iran. Geocarto International. 2022;37(26):13127-44. doi: 10.1080/10106049.2022.2076916.##

1 Evaluating the Long-Term Outcomes of Hysteroscopic Myomectomy in Women with Submucosal Myomas: A Retrospective Study https://brieflands.com/journals/jkums/articles/168205 10.5812/jkums-168205 1 Background :Submucosal fibroids are a major cause of abnormal uterine bleeding, anemia, pelvic pain, and infertility. Hysteroscopic myomectomy is the preferred minimally invasive treatment, but data on its long-term outcomes and reproductive benefits remain limited. Objective :This study aimed to evaluate the effectiveness, safety, and reproductive outcomes of hysteroscopic myomectomy in patients with submucosal myomas. Methods :A retrospective study was conducted on 327 women who underwent hysteroscopic myomectomy at Shahid Beheshti and Alzahra hospitals. Data on preoperative symptoms, intraoperative complications, postoperative outcomes, and follow-up were collected from medical records and phone interviews. Results :The mean age of patients was 43.2 ± 7.0 years. The most common presenting symptom was abnormal uterine bleeding (96%), followed by anemia (61.8%), pelvic pain (22.3%), infertility (14.1%), and urinary complaints (2.4%). Complication rates were low, with uterine perforation (0.3%), hemorrhage (1.8%), prolonged hospitalization (0.6%), and postoperative fever (0.3%) occurring infrequently. Repeat myomectomy was necessary in 7.6% of cases, while 10.7% required subsequent total laparoscopic hysterectomy (TLH). Overall, 70.6% of patients achieved complete symptom resolution, and 95.4% reported satisfaction with the procedure. Among 44 infertile women, 28 (63.6%) conceived after surgery, including 22 spontaneous and 6 assisted reproductive technology (ART) pregnancies. Conclusions :Hysteroscopic myomectomy is an effective and minimally invasive treatment for submucosal fibroids, offering substantial symptom relief, high patient satisfaction, and favorable fertility outcomes. With low complication and reoperation rates, it remains a valuable therapeutic option for women seeking both symptom control and fertility preservation. 1 7 Safoura Rouholamin Department of Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran Iran s_rouholamin@med.mui.ac.ir Maryam Hashemi Department of Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran Iran maryam.hashemi88@gmail.com Mansooreh Kaboodsaz Department of Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran Iran mkaboodsaz1365@gmail.com Mohammad Javad Tarrahi Department of Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran Iran mj.tarrahi@gmail.com No Keyword 5.pdf [0]Freytag D, Günther V, Maass N, Alkatout I.Uterine Fibroids and Infertility. Diagnostics. 2021. [PubMed ID: 34441389]. [PubMed Central ID: PMC8391505]. doi: 10.3390/diagnostics11081455.##[1]Navarro A, Bariani MV, Yang Q, Al-Hendy A.Understanding the Impact of Uterine Fibroids on Human Endometrium Function. Frontiers in cell and developmental biology. 2021. [PubMed ID: 34113609]. [PubMed Central ID: PMC8186666]. doi: 10.3389/fcell.2021.633180.##[2]Alkhrait S, Malasevskaia I, Madueke-Laveaux OS.Fibroids and Fertility. Obstetrics and Gynecology Clinics. 2023. [PubMed ID: 37914486]. doi: 10.1016/j.ogc.2023.08.006.##[3]Don EE, Mijatovic V, Huirne JA.Infertility in Patients with Uterine Fibroids: a Debate About the Hypothetical Mechanisms. Human Reproduction. 2023. [PubMed ID: 37771247]. [PubMed Central ID: PMC10628498]. doi: 10.1093/humrep/dead194.##[4]Zanolli NC, Bishop KC, Kuller JA, Price TM, Harris BS.Fibroids and Fertility: a Comparison of Myomectomy and Uterine Artery Embolization on Fertility and Reproductive Outcomes. Obstetrical & gynecological survey. 2022. [PubMed ID: 35932289]. doi: 10.1097/OGX.0000000000001052.##[5]Bulun SE, Yin P, Wei J, Zuberi A, Iizuka T, Suzuki T, et al.Uterine Fibroids. Physiological reviews. 2025. [PubMed ID: 40214304]. [PubMed Central ID: PMC12419501]. doi: 10.1152/physrev.00010.2024.##[6]Ahmad A, Kumar M, Bhoi NR, Badruddeen, Akhtar J, Khan MI, et al.Diagnosis and Management of Uterine Fibroids: Current Trends and Future Strategies. Journal of basic and clinical physiology and pharmacology. 2023. doi: 10.1515/jbcpp-2022-0219.##[7]Stewart E, Cookson C, Gandolfo R, Schulze-Rath R.Epidemiology of Uterine Fibroids: A Systematic Review. BJOG. 2017. [PubMed ID: 28296146]. doi: 10.1111/1471-0528.14640.##[8]Loddo Alessandro, Djokovic Dusan, Drizi Amal, De Vree Bart Paul, Sedrati Adel, van Herendael Bruno J.Hysteroscopic Myomectomy: The Guidelines of the International Society for Gynecologic Endoscopy (ISGE). European Journal of Obstetrics & Gynecology and Reproductive Biology. 2022. doi: 10.1016/j.ejogrb.2021.11.434.##[9]Ozcivit Erkan IB, Kuru O, Acar I, Oztas AM, Gezer A.An Alternative for Hysteroscopic Myomectomy: Ultrasound‐guided Single‐step Myomectomy for Submucous Myoma Uteri with Ring Forceps, a Retrospective Study. International Journal of Gynecology & Obstetrics. 2025. doi: 10.1002/ijgo.16179.##[10]Laughlin-Tommaso S.K.Lu D. Thomas L. 2020. [PubMed ID: 31678093]. doi: 10.1016/j.ajog.2019.09.052.##[11]Piecak K, Milart P.Hysteroscopic Myomectomy. Prz Menopauzalny. 2017. [PubMed ID: 29483854]. [PubMed Central ID: PMC5824682]. doi: 10.5114/pm.2017.72757.##[12]Qu K, Zou M, Wang Z, Gong C, Xiong Y, Zhang L.Evaluation of the Timing and Safety of Hysteroscopic Myomectomy of Large Submucosal Fibroids Pretreated by High Intensity Focused Ultrasound. International Journal of Hyperthermia. 2023. doi: 10.1080/02656736.2023.2249275.##[13]Loddo A, Djokovic D, Drizi A, De Vree BP, Sedrati A, van Herendael BJ.Hysteroscopic Myomectomy: the Guidelines of the International Society for Gynecologic Endoscopy (ISGE). European Journal of Obstetrics & Gynecology and Reproductive Biology. 2022. doi: 10.1016/j.ejogrb.2021.11.434.##[14]Fonge YN, Carter AS, Hoffman MK, Sciscione AC, Klebanoff J.Obstetrical Outcomes Are Unchanged After Hysteroscopic Myomectomy in Women with Submucosal Fibroids. American Journal of Obstetrics & Gynecology MFM. 2020. doi: 10.1016/j.ajogmf.2020.100192.##[15]Litta P, Conte L, De Marchi F, Saccardi C, Angioni S.Pregnancy Outcome After Hysteroscopic Myomectomy. Gynecological Endocrinology. 2014. doi: 10.3109/09513590.2013.863861.##[16]Yu D, Li TC, Xia E, Huang X, Liu Y, Peng X.Factors Affecting Reproductive Outcome of Hysteroscopic Adhesiolysis for Asherman's Syndrome. Fertil Steril 2008; 89(3): 715-22. 2008. doi: 10.1016/j.fertnstert.2007.03.070.##[17]Polena V, et al.Long-Term Result of Hysteroscopic Myomectomy in 235 Patients, European Journal of Obstetrics& Gynecology and Reproductive Biology130(2007)232-237. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2007. [PubMed ID: 16530319]. doi: 10.1016/j.ejogrb.2006.01.014.##[18]Derman SG, Rehnstorm J, Neuwirth RS.The Long-Term Effectiveness of Hysteroscopic Treatment of Menorrhagia and Leiomyomas. Obstet Gynecol 1991; 77:591–4. 1991. [PubMed ID: 2002983].##[19]Hart R, Molnar BG, Magos A.Long Term Follow Up of Hysteroscopic Myomectomy Assessed by Survival Analysis. Br J Obstet Gynecol 1999; 106:700–5. 1999. doi: 10.1111/j.1471-0528.1999.tb08370.x.##[20]Ghahiri.Reproductive Outcomes Following Hysteroscopic Repair of Uterine Lesions. Isfahan J Univ Med Sci. 2011. [PubMed ID: 25083176]. [PubMed Central ID: PMC4107685].##[21]Wegmüller B, Hug K, Meier Buenzli C, Yuen B, Maggiorini M, Rudiger A.Life‐Threatening Laryngeal Edema and Hyponatremia During Hysteroscopy. Critical care research and practice. 2011. [PubMed ID: 21541246]. [PubMed Central ID: PMC3085301]. doi: 10.1155/2011/140381.##[22]Liao CY, Lo CH, Yu MX, Chan WH, Wei KY, Tseng MF, et al.Life-Threatening Acute Water Intoxication in a Woman Undergoing Hysteroscopic Myomectomy: a Case Report and Review of the Literature. BMC Women's Health. 2020. [PubMed ID: 32164632]. [PubMed Central ID: PMC7069039]. doi: 10.1186/s12905-020-0895-y.##