Percentages play a crucial role in medical research by providing a clear and concise way to present data and analyze findings.
Background: Provincial mortality profiles are essential for local prevention and health-service planning. However, they are reported less frequently than national summaries in Iran. We described cause-of-death patterns and temporal changes in Fars Province from 2015 to 2024, including the disruption during the coronavirus disease 2019 pandemic.Methods: We analyzed death registration records from the Fars provincial civil registration system, including age, sex, residence status, place of death, and an underlying cause coded using the International Classification of Diseases (ICD), 10th revision, and mapped to major cause groups. We summarized distributions by key strata and assessed temporal patterns using annual counts and within-registry proportions. Trend tests and multivariable logistic regression evaluated associations of calendar year and pandemic period with major cause groups, while unsupervised clustering summarized mortality profiles among non-neonatal records.Results: After cleaning, 199,107 records were included. Diseases of the circulatory system accounted for 45.4% of deaths, followed by respiratory diseases, neoplasms, and external causes. All-cause deaths rose sharply in 2020-2021, with concurrent increases in respiratory and infectious causes. Cause composition varied by residence status and place of death, and clustering distinguished younger external-cause deaths from older disease-dominant profiles.Conclusion: Mortality in Fars Province during 2015-2024 was dominated by circulatory diseases, with heterogeneity by demographic and contextual factors and a major pandemic-era increase in deaths. The findings supported prioritizing cardiovascular risk reduction and timely acute care, targeted injury prevention for younger groups, strengthened rural access to prevention and emergency services, and preparedness for future infectious surges.
Background: Percutaneous vertebroplasty (PVP) for upper and middle thoracic osteoporotic vertebral compression fractures (OVCFs) is challenged by technical difficulties and safety concerns, which drive the need for innovative techniques to optimize its efficacy. The purpose of this study was to delineate the technical characteristics of a novel methodology and to conduct a comparative analysis of its efficacy against bilateral transpedicular puncture PVP.Methods: A retrospective study was conducted on consecutive patients undergoing PVP for upper/middle thoracic OVCFs at the Second Affiliated Hospital of Chongqing Medical University (Chongqing, China) between January 2019 and December 2024. Patients were allocated to either the unilateral transpedicular puncture lateral injection (UTPLI) or the conventional bilateral transpedicular puncture (BTP) group based on the surgical timeline, with earlier cases undergoing BTP and later ones UTPLI. Baseline characteristics, operative time, estimated blood loss, cement volume, visual analogue scale (VAS), Oswestry disability index (ODI), vertebral and segmental kyphosis angles, anterior/middle/posterior vertebral heights, and postoperative cement distribution indices were recorded and compared between the two groups. Data were analyzed with SPSS software (version 26.0) using Chi square, t tests, and non-parametric tests.Results: A total of 57 patients were enrolled (UTPLI group=21, BTP group=36). The UTPLI group had a shorter operation time (18.00±9.00 min vs. 25.00±9.00 min, P=0.002) and less estimated blood loss (3.93±1.22 mL vs. 5.13±1.37 mL, P=0.002). No significant intergroup differences were found in VAS, ODI, kyphosis angles (vertebral, segmental, thoracic), vertebral heights (anterior, middle, posterior), baseline data, bone cement leakage, cement dispersion index, or spatial distribution scores, either preoperatively or postoperatively (P>0.05).Conclusion: The UTPLI technique is a viable alternative to BTP PVP for upper and middle thoracic OVCFs. It reduced operative time and blood loss while achieving comparable outcomes.
Clinical (Medical) toxicology is a dynamic and ever-changing field that focuses on drug overdoses, poisonings, adverse drug effects, and substance use disorders, including addiction and withdrawal.
Background:Patients with type 2 diabetes (T2D) and recent ST-elevation myocardial infarction (STEMI) face accelerated atherosclerosis and a high risk of recurrent cardiovascular events. Sodium-glucose cotransporter-2 inhibitors (SGLT2i), particularly empagliflozin, offer proven cardioprotection in T2D. This study investigated the 3-month effects of empagliflozin on carotid intima-media thickness (CIMT) and Doppler hemodynamic parameters (resistive index [RI] and pulsatility index [PI]) in T2D patients post-STEMI. Methods:In this randomized clinical trial, 80 patients with T2D and a recent STEMI from Ayatollah Mousavi Hospital, Zanjan, Iran (from July to December 2025), were randomized in a 1:1 ratio to empagliflozin 10 mg daily or an identical placebo, in addition to standard therapy. The primary endpoint was the change in CIMT at 3 months, assessed using B-mode ultrasound. Secondary endpoints included changes in RI and PI, measured via Doppler ultrasound. Results:Follow-up data were available for 78 patients (two deaths in the intervention arm, both unrelated to the study drug). In the primary intention-to-treat analysis (n=80), empagliflozin was associated with a significant reduction in left CIMT compared with controls (median change=-0.13 mm vs. -0.01; within-group P=0.002; between-group ΔCIMT P=0.004; ANCOVA-adjusted P<0.001) versus controls (-0.01 mm). A smaller though statistically significant difference was also observed for right CIMT (ΔCIMT, P=0.021; ANCOVA-adjusted P=0.006). These findings remained consistent in the per-protocol analysis. After Bonferroni correction, the reduction in left CIMT remained significant, whereas the effect on right CIMT became more modest. No significant changes were observed in RI or PI. Conclusion:Short-term empagliflozin suggested favorable changes in CIMT in high-risk T2D patients post-STEMI, without detectable effects on RI or PI.Iranian Registry of Clinical Trials: IRCT20230727058945N1.
Although the association between diabetes and cutaneous squamous cell carcinoma (cSCC) is well recognized, the specific role of insulin resistance (IR) as an independent driver of cSCC pathogenesis remains underexplored. This review synthesized emerging evidence on the ultraviolet (UV)-independent molecular mechanisms by which IR promotes cSCC initiation and progression. Hyperinsulinemia activates the insulin-like growth factor-1 receptor (IGF-1R), which triggers both the mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK) and phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) pathways, stimulating keratinocyte proliferation and suppressing apoptosis. In parallel, hyperglycemia-driven formation of advanced glycation end products (AGEs) and oxidative stress cause deoxyribonucleic acid (DNA) damage and impair tumor suppressor functions, notably that of tumor protein p53 (TP53). The resulting reactive oxygen species (ROS) activate nuclear factor-kappa B (NF-κB), establishing a chronic inflammatory milieu that remodels the tumor microenvironment through cytokines, including interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), and by upregulating matrix metalloproteinases (MMPs). These processes collectively facilitate the malignant transformation of actinic keratosis (AK) to invasive cSCC. The analysis in the present study identified novel therapeutic targets and reaffirmed the importance of further studies on microbiome interactions and lifestyle interventions for IR-associated cSCC.
Leiomyosarcoma of the superior vena cava (SVC) is an exceptionally rare vascular tumor. Fewer than 20 cases were reported worldwide. Because of the nonspecific nature of the presenting symptoms and their deep mediastinal location, a pre-operative diagnosis is often difficult or impossible. A 63-year-old woman presented with progressive facial and upper-limb edema. Computed tomography (CT) demonstrated a hyper vascular intraluminal mass originating in the SVC and extending towards the right atrium. Percutaneous biopsy was considered unsafe due to the risk of hemorrhage. Therefore, radical surgical resection of the SVC and brachiocephalic veins with xenopericardial patch reconstruction was performed. Histological and immunohistochemical examination confirmed a grade two leiomyosarcoma. No adjuvant therapy was given. At 8-month follow-up, there was no evidence of recurrence. Primary SVC leiomyosarcoma is a rare and diagnostically challenging condition. Pre-operative biopsy is often not feasible, and radical en bloc resection with vascular reconstruction remains the cornerstone of treatment, offering the best chance of recurrence-free survival. Histopathological confirmation is required to establish the diagnosis, and the role of adjuvant therapy remains uncertain.
Background:Digital hearing aids require precise fitting to enable realistic speech processing. The international speech test signal (ISTS) provides a standard reference, yet does not fully capture the phonetic and prosodic features of Persian. This study aimed to create and acoustically verify a Persian version of the ISTS-termed the Persian speech test signal (PerSTS)-to enhance verification accuracy for Persian-speaking users. Methods:The North Wind and the Sun (NWS) passage was translated into Persian with careful phoneme distribution and natural syntax. Six native female speakers recorded the passage at 44.1 kHz and 24-bit resolution. These recordings were segmented, enhanced, and stitched into 10-15 second sequences that adhered to pitch and spectral criteria. Sequences that closely matched the Byrne female long-term average speech spectrum (LTASS; ±1 dB) and were rated as most natural by linguists were assembled into a 60-second PerSTS. The final audio was calibrated to 65 dB sound pressure level (SPL) and analyzed for its spectral, temporal, and amplitude characteristics in Tehran, Iran (2025). Results:The PerSTS exhibited spectral peaks between 200-400 Hz and 3-4 kHz, characteristic of female Persian speech. Its LTASS closely matches the Byrne LTASS and ISTS, with minor deviations below 500 Hz and above 8 kHz. The crest factor (16.7 dB) and dynamic range (27.1 dB) were consistent with those of natural speech. Experts rated its naturalness as 4.35±0.28 on a five-point scale. Conclusion:The PerSTS mimics the acoustic and temporal features of natural Persian speech within International Electrotechnical Commission (IEC) standards, providing a standardized tool for hearing aid verification and audiology.
In psychometric analysis, the concepts of reliability and validity are fundamental for assessing the quality of measurement instruments.
Background: Chronic non-communicable diseases (NCDs) are a major public health challenge, representing the leading cause of disability and premature mortality worldwide. Beyond direct medical expenses, NCDs generate substantial indirect costs through productivity losses and reduced workforce participation. This study aims to identify the indirect costs reported in scientific literature on NCDs in the economically active population between 2012 and 2022.Methods: A systematic literature review covering 2012 to 2025 was conducted in PubMed/MEDLINE, PubMed Central (PMC), Embase, Web of Science, and Scopus. Only primary studies in English or Spanish were included, and independent reviews were conducted by two authors.Results: Of 1980 identified articles, 42 met the inclusion criteria. Indirect costs were mainly represented by productivity losses (absenteeism and presenteeism) and disease burden measured with Disability-Adjusted Life Years (DALYs). The highest volume of research focused on ischemic heart disease, stroke, and chronic obstructive pulmonary disease.Conclusion: Evidence on indirect costs of NCDs remains limited despite their significant economic and social impact. These conditions reduce both the quality and availability of the workforce and generate high indirect costs. Addressing these challenges requires strategies across all levels of prevention, not only within healthcare systems but also in workplaces, to mitigate the economic burden of NCDs on the economically active population.
Background: Adipose tissue-derived stem cells (AdSCs) are widely used for regenerative medicine purposes. There is always a need to accelerate cell proliferation and protect the cells from apoptosis when cell transplantation, especially AdSCs, is targeted. Therefore, this study evaluated the effect of lithium chloride on the proliferation and growth kinetic of AdSCs. Methods: The study was undertaken in the Stem Cell Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, in 2020. Adipose tissue specimens were provided from the abdominal region of a 35-year-old woman. In an in vitro study, human AdSCs were characterized morphologically, by osteo- and adipogenic differentiation properties, and by flow cytometry. They were later treated with lithium chloride to evaluate its effect on cell proliferation and the growth kinetics of AdSCs. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay investigated lithium chloride effect on the proliferation rate and apoptosis of AdSCs. Quantitative Real Time Polymerase Chain Reaction (qPCR) was carried out to determine the expression of apoptosis genes of Apoptosis Regulator BCL2 Associated X (BAX) and B-cell lymphoma 2 (Bcl-2) protein family. Results: AdSCs showed mesenchymal characteristics, and lithium chloride at a dose of 6 µM had an increasing impact on cell proliferation and protected the cells from apoptosis. A non-significant increase in expression of the Bcl-2 gene (P=0.057) and a significant decrease in BAX gene (P=0.034) expression were visible. Conclusion: Our findings indicate that the addition of lithium chloride to the culture medium enhanced the proliferation of AdSCs and protected them against apoptosis.
Background: Sex differences can influence the effects of opioid and non-opioid analgesics. This study evaluated the antinociceptive effects of L-menthol in male and female mice.Methods: This experimental study was conducted in 2024 at Shiraz University of Medical Sciences (Shiraz, Iran). Forty-two BALB/c mice (21 males, 21 females) were randomLy allocated into three groups of seven mice receiving intraperitoneal injection of vehicle 2 mL/Kg, L-menthol 2.5 mg/Kg, and L-menthol 5 mg/Kg. Chemical and thermal nociception were assessed using the acetic acid-induced writhing and the hot plate tests (55 ℃, with a cut-off point of 30 seconds). The number of abdominal writhing counted for 20 min, and the percent of maximum possible effect (%MPE) calculated from the hot plate test response were used as acute pain indexes, respectively. Possible side effects and motor coordination were assessed using video behavior recording and the rotarod test, respectively. Data were analyzed by ANOVA, Tukey’s post hoc test, McNamar’s, and Kruskal-Wallis tests. Statistical significance was defined as P<0.05. Results: L-menthol 2.5 (P<0.001) and 5 mg/Kg (P<0.001) showed significant antinociceptive effects in both male and female mice in the acetic acid and hot plate tests compared to the control groups. L-menthol 5 mg/Kg in the hot plate (P=0.027) and L-menthol 2.5 and 5 mg/Kg in the acetic acid (P<0.001) tests produced higher antinociceptive effects in males than in females. No significant differences were observed in the rotarod performance and other behavioral tests across groups.Conclusion: L-menthol produced sex dependent antinociceptive effects in mice, highlighting the importance of considering biological sex in clinical pain research.
Background:Selenium nanoparticles (SeNPs), compared to other forms of selenium, have shown promising antioxidant and anticancer properties with lower toxicity. However, SeNPs precipitate and aggregate in aqueous solutions due to their high surface energy. To overcome this limitation and improve stability, solubility, and enhance biological efficacy, we functionalized them with L-asparagine/tartaric acid (Asn-Tar). This study aimed to evaluate the antimicrobial, cytotoxic, and antioxidant properties of SeNPs conjugated to Asn-Tar on MDA-MB-231 breast cancer cells. Methods:This study was conducted at Lorestan, Iran, in 2023. SeNPs were synthesized using a co-precipitation method and then coated with Asn-Tar. Structural characterization was performed using Fourier transform infrared spectroscopy (FTIR), X-ray Diffraction (XRD), Scanning electron microscopy (SEM), Transmission electron microscopy (TEM), Dynamic light scattering (DLS), zeta potential analysis, and Ultraviolet-visible (UV-Vis) spectroscopy. Antioxidant activity was assessed. For biological evaluation, an in vitro experimental design was employed. Cytotoxicity against MDA-MB-231 breast cancer cells and normal fibroblast cells at various pH levels was determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay with three independent replicates per concentration (n=3). Antimicrobial activity against a panel of Gram-positive and Gram-negative bacteria, including antibiotic-resistant strains, was evaluated in triplicate using broth microdilution and well diffusion methods. Quantitative data are presented as mean±SD. Statistical significance was determined using Student's t test and one-way ANOVA, with P<0.05 considered significant. Results:The synthesized Asn-Tar/SeNPs nanocomposite exhibited a spherical morphology with an average size of 460.8 nm, a negative zeta potential (-9.37±0.44 mV), and successful coating was confirmed by FTIR and XRD. The nanocomposite demonstrated dose-dependent antioxidant activity, with an IC50 of 22.73±1.55 µg/mL in the DPPH assay. It exhibited potent and selective cytotoxicity against MDA-MB-231 breast cancer cells (IC50=3.47±0.28 µg/mL) compared to normal fibroblast cells (IC50=5.91±0.34 µg/mL; P=0.0051). The nanocomposite retained approximately 50% of its cytotoxic activity at acidic pH (4.5). Furthermore, it showed strong antimicrobial activity, with inhibition zones up to 36.9±1.2 mm against Staphylococcus saprophyticus and MIC values as low as 0.035 mg/mL against Pseudomonas aeruginosa. Conclusion:The produced Asn-Tar/SeNPs nanocomposite exhibited potent antimicrobial, selective cytotoxicity, and antioxidant properties. Our findings confirm the potential of these Asn-Tar/SeNPs nanocomposites for targeted therapy of breast cancer.
Background: Prostate cancer (PCa) remains one of the most common malignancies among men worldwide, with lymph node invasion (LNI) serving as a critical prognostic factor influencing treatment decisions and outcomes. This study aimed to evaluate the prevalence of LNI and investigate associated risk factors in a cohort of intermediate-risk PCa patients. Methods: This retrospective cross-sectional study included intermediate-risk PCa patients treated at Imam Khomeini Hospital, Tehran, Iran, from 2019 to 2024, who underwent radical prostatectomy with pelvic lymph node dissection (PLND). Data were extracted from hospital clinical documents and compared between patients with and without LNI. The primary outcome was the prevalence of LNI, while the secondary outcome aimed to identify associated demographic, clinical, and pathological risk factors. Statistical tests such as univariate logistic regression and ROC curve analysis were used. Results: This study found a 12.10% prevalence ofLNI. Univariate analysis revealed significant associations between LNI and advanced clinical stage, higher Gleason score, greater core involvement, and elevated total prostate-specific antigen (PSA) (OR=1.33), with all P<0.05. In multiple logistic regression analysis, adjusting for confounders, only PSA remained an independent predictor. The receiver operating characteristic (ROC) analysis confirmed PSA's moderate diagnostic accuracy for LNI (area under the curve [AUC]=0.685, P<0.001), with an optimal cut-off of 16.52 ng/mL, 65% sensitivity, and 68% specificity. Conclusion: The results indicated that only total PSA remained an independent predictor. This finding highlighted total PSA as a key biomarker for assessing LNI risk in intermediate-risk PCa patients. Additionally, total PSA demonstrated moderate diagnostic accuracy in predicting LNI, supporting its clinical utility in risk stratification and decision-making.
Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD). Neutrophil extracellular traps (NETs) have been recognized as contributing to UC progression. This study aimed to identify key genes driving NET formation in UC and evaluate their potential as biomarkers. Methods: Gene expression profiles from colon biopsies of UC patients and healthy controls were obtained from the GSE224758 dataset. Differentially expressed genes (DEGs) were identified using the GEO2R tool. Hub genes involved in NET formation, including FCGR3B,AQP9, FPR1, FPR2, andNCF2, were validated through reverse transcription-quantitative polymerase chain reaction (RT-qPCR) using colon biopsy samples from healthy controls (n=20), newly diagnosed UC (n=20), and treatment-resistant UC patients (n=20) collected between November 8, 2022, and February 2, 2025, at Tohid Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran. Data normality was assessed using the Shapiro-Wilk test; Kruskal-Wallis test and Dunn's post hoc test were applied for group comparisons. ROC analysis was applied to determine the potential of genes for the differentiation of healthy people from patients. Results: RT-qPCR validation confirmed significantly increased expression of AQP9 (P <0.0001), FPR1, and FPR2 (P=0.03 and P=0.02) genes in patients with UC and those with refractory UC compared to healthy controls. Among these, AQP9 exhibited the most significant differential expression, demonstrating high sensitivity and specificity in distinguishing newly diagnosed and treatment-resistant UC patients from healthy individuals (sensitivity 83.49% and 80.98%, and specificity 67.77% and 64.24%, respectively), indicating its potential as a diagnostic biomarker. Conclusion: This study identifies NET-associated genes, particularly AQP9, FPR1, and FPR2, as candidate tissue biomarkers for UC, with AQP9 exhibiting the strongest ability to distinguish patients from healthy controls. These findings support the utility of NET-related genes as tissue biomarkers for UC, while emphasizing that any therapeutic targeting of these molecules lies beyond the scope of the present work and will require additional functional and in vivo validation.
Urogenital myiasis is a rare parasitic infestation caused by dipteran larvae and is infrequently reported in non-endemic regions. This case report documented the first diagnosed case of Psychoda albipennis-induced urinary myiasis in a 41-year-old man from Sanandaj, Iran. The patient presented with dysuria and recurrent passage of mobile black-grayish particles in his urine over 2 months, following prolonged exposure to freshwater environments during fishing activities in Kermanshah Province. Morphological examination of the expelled larvae confirmed identification of P. albipennis using standard taxonomic keys, with emphasis on characteristic morphological structures. Laboratory analyses, including urinalysis and hematological profiling, ruled out bacterial infections, and imaging studies revealed no urinary tract abnormalities of the urinary tract. Treatment with oral ivermectin (200 µg/Kg) along with adequate hydration resulted in symptom resolution and cessation of larval excretion. Clinical symptoms subsided within 48 hours, and no larvae were observed in the urine after 1 week. This case underscored the facultative role of P. albipennis in urogenital myiasis, potentially associated with environmental exposure and compromised hygiene conditions. It highlighted the diagnostic challenges in differentiating myiasis from conventional urinary infections and emphasized the need for increased clinical awareness in regions with suboptimal sanitation. The findings supported the implementation of integrated public health strategies, including improved sanitation infrastructure and community education, to mitigate the risk of infestation. Further studies incorporating molecular diagnostic methods are recommended to enhance species-specific identification and epidemiological surveillance, particularly in resource-limited settings.
Stroke, as the second leading cause of death and the third leading cause of disability worldwide, poses anincreasingly heavy disease burden.
Background: Preeclampsia (PE) is a multisystem disorder of unknown cause, leading to maternal and fetal morbidity and mortality. This study aimed to measure the inflammatory biomarkers alpha1-acid glycoprotein (α1-AGP) and protein-bound hexose (PBH) in the maternal circulation of women with PE and normotensive pregnant women, as well as in postnatal umbilical cord blood, to compare levels between groups and assess their association with PE.Methods: A hospital-based case-control study was conducted from June 2024 to July 2025 at the Maternity Teaching Hospital in Erbil, Kurdistan Region, Iraq, including 104 preeclamptic and 99 normotensive pregnant women. Maternal and postnatal umbilical cord α1-AGP levels were measured using a BiotecSunlong ELISA kit (cut-off: 71.3 and 50.64 ng/mL, respectively), while PBH was measured using the orcinol colorimetric method (cut-off: 111 and 67.36 mg/dL, respectively).Results: Maternal α1-AGP and PBH levels were significantly higher in preeclamptic women (P<0.001). In postnatal umbilical cord blood, α1-AGP was elevated in PE, while PBH showed no significant difference. Maternal and postnatal α1-AGP demonstrated a moderate positive correlation (ρ=0.522, P<0.001), whereas PBH showed a weak correlation (ρ=0.242, P=0.016). Receiver Operating Characteristic (ROC) analysis indicated excellent discrimination between groups, with an Area Under the Curve (AUC) of 1.00 for maternal α1-AGP and 0.964 for maternal PBH.Conclusion: Maternal α1-AGP and PBH are significantly elevated in preeclampsia, with α1-AGP also higher in postnatal umbilical cord blood. The high AUC supports their relevance as biomarkers of maternal and postnatal inflammation in PE.
Background: Malaria drug resistance is one of the leading causes of malaria-related morbidity and mortality worldwide. Alpha-mangostin exhibits antimalarial and antioxidant activity in vitro. The soluble alpha-mangostin chitosan alginate nanoparticles (ACAN) exhibit proper antimalarial activity in vivo. This study aimed to explore the antimalarial activity of the chloroquine-ACAN combination and the interaction between them in various ratios. Methods: A 4-day suppressive test, according to Peter’s test, was conducted using P. berghei-inoculated Swiss Webster mice in Bandung, 2024. It was done for six different concentrations (in triplicate) of three kinds of the combinations respectively i.e.: ½ effective dose 50 (ED50) ACAN:½ED50 chloroquine (ratio-1, ACAN and chloroquine were used in a weight ratio of 189:1), ¼ ED50 ACAN:¾ ED50 chloroquine (ratio-2, weight ratio of 63:1), ¾ ED50 ACAN:¼ ED50 chloroquine (ratio-3, weight ratio of 567:1) to find out growth inhibitory percentage of each concentration. ED50 of each combination was determined using probit analysis in IBM SPSS Statistics 27 software. The sum of fractional effective dose 50 (∑FED50) was determined using a specific formula. ∑FED50 indicates the kind of interaction: <1, >1, or =1 means synergistic, antagonistic, or additive. Results: ED50 of ratio-1 (ACAN/Chloroquine weight ratio 189/1), ratio-2 (weight ratio 63/1), ratio-3 (weight ratio 567/1) is 9.196, 7.626, 82.13 mg/Kg BW (<100 mg/Kg BW). ∑FED50 of ratio-1, ratio-2, and ratio-3 is 0.069, 0.113, and 0.414 (far below 1).Conclusion: ACAN-chloroquine exhibits good and marked synergistic antimalarial activity, especially in a ratio-1. It offers a glimmer of hope for future research to combat and ultimately eliminate malaria.
