Dear Mostafa

your problem is beginnins with the Helsinki-Declaration dating back to June 1964, when reasoning about ethical issues in medicine became to be a more and more recognised issue. The actual revised WMA Declaration of Helsinki has been made public in October 2013 (http://www.wma.net/en/30publications/10policies/b3/index.html) clearly states that an approval of an ethics committee is mandatory for studies where human beings are involved. Even the first declaration considered an a priori consideration by a specially appointed independent committee mandatory (www.upenn.edu/regulatoryaffairs/Documents/Declaration_Helsinki.doc – See: Basic Principles, sub-topic 2). Hence, arguing not being aware of a scientific recommendation unchanged since 50 years will be hard. Although I am aware that it is easy for me, with an education in Europe, to argue this stringently, as we had 'the luxury' to get such training at university. Wether this was the case for you is hard to guess, at least I could imagine that an upcoming nation like Iran has other urgent medical issues to focus on.

Yet, as I did not join this ethical forum to help cheating around ethical principles, I still wanna try to help you out of your dilemma.

1) Did you just not apply for an ethical approval, or was it declined? If the second one is the case, consider why the approval was declined, why you did not adapt the study design and prepare yourself to forget to publish your thesis, sorry.

2) Was there any possible harm associated with your study? e.g. I could not see any harm if heart frequency is compared to cycling speed, as both is recorded anyway by most triathletes on their own will.

3) If the study has a prospective design it is hard to argue why an ethical committee's decision is lacking (yet you still can consider my proposals). If the study has a retrospective design (i.e. possible harm would have happened, wether or not the study being carried out) your cards are better. In case of a retrospective design make sure that the study presentation is 'bullet prove' (i.e. proper hypothesis, proper methods-, and results-sections with stringent criteria for inclusion, exclusion, results gathered etc., and don't forget to make sure that any statistical evaluation – if applied – is carried out appropriate).

4) Make sure that there is informed consent, or, if you don't have it, for example due to a retrospective design, make sure that no participant can be identified by any possible means (e.g. don't compare the 'anonymous' winner of the triathlon xy with another subject, as the winner would be googled within 10 secs).

5) If in doubt, shorten the study without loosing the main goal. Often, exploiting additional data unrelated to the main hypothesis makes a study confusing and bears the risk to dilute its results (e.g. because the alpha error, the p-value, has to be split up between all analyses reported). To keep it simple, in many cases less is more.

6) Submit the manuscript and use the letter to the editor to briefly explain why your study is lacking an approval from an ethics committee. Maybe you have understandable reasons.

I hope I could help you sorting things out, best regards,

Bruno

P.S.: Point 2-5 I did not mention because I a priori assumed you don't know these principles. I mentioned them, because this points are also part of an ethic committee's considerations. Yet, as you lack this approval, it is important that where ever possible you present your data in such a manner that the editor would assume, an ethic committee would also have agree to it.