Female pattern hair loss (FPHL) is a common, multifactorial condition with a complex pathophysiology that remains not entirely understood. This study aimed to evaluate the diagnostic and prognostic values of several biomarkers (TGF-β1, DHEA, testosterone, SHBG, and the Free Androgen Index) in patients with FPHL. A case-control study was conducted in Iraq, involving 60 Iraqi women with FPHL and 60 healthy controls. Serum levels of the biomarkers were determined using ELISA. The Ludwig scale was employed to measure disease severity and its correlation with polycystic ovary syndrome (PCOS) or family history. Women diagnosed with FPHL exhibited significantly elevated levels of total testosterone, DHEA, TGF-β1, and FAI, alongside reduced SHBG and estradiol levels (P<0.0001 for all, except estradiol where P=0.0145). Following cross-validation and adjustment for multiple comparisons, FAI demonstrated excellent diagnostic accuracy (Adjusted AUC=0.96), while DHEA, total testosterone, and SHBG also displayed remarkable diagnostic efficacy (Adjusted AUCs> 0.90). TGF-β1, DHEA, total testosterone, and estradiol levels were positively correlated with disease severity. A significant correlation was observed between a positive family history and elevated Ludwig grades (P=0.0074). FPHL is associated with multiple hormonal imbalances that are not limited to increased androgen levels. FAI serves as a robust diagnostic marker, and the panel of TGF-β1, DHEA, SHBG, and E2 has potential diagnostic and prognostic value in clinical settings to guide personalized management. These findings support a multifactorial theory of FPHL and underline the importance of a comprehensive hormonal evaluation as part of the diagnostic algorithm for FPHL.
The COVID-19 pandemic has caused several health problems, including new diagnoses of diabetes mellitus and new-onset hyperglycemia. According to previous research, some individuals with COVID-19 recover from hyperglycemia. To examine the long-term outcomes and predictive parameters for recovery from new-onset hyperglycemia following COVID-19 infection over a three-year follow-up period. A prospective longitudinal cohort study was conducted involving 50 patients newly diagnosed with COVID-19 infection based on a positive RT-PCR test and lung computed tomography (CT) scan. All patients developed new-onset hyperglycemia at admission, had no previous history of diabetes mellitus, had normal recent HbA1c levels, and had not used steroids prior to diagnosis. All patients were treated with insulin and/or oral hypoglycemic agents during the period of COVID-19 infection and hyperglycemia. The study included 50 COVID-19 patients with new-onset hyperglycemia; 62% were male, 50% were young, 52% were overweight, and 36% had CT lung severity scores between 20 and 30. After 6 months, 54% of patients recovered from hyperglycemia; this rate increased to 60% after 1 year and 64% after 3 years. A higher likelihood of recovery from diabetes mellitus was observed in younger patients (P=0.003), those without a family history of diabetes mellitus (P=0.008), and those with lower CT lung severity scores (P<0.001). Most patients with new-onset hyperglycemia following COVID-19 infection recovered from diabetes mellitus, and the recovery rate progressively increased over the three-year follow-up period.
Postoperative pain is a complex physiological response to tissue damage. Providing effective postoperative analgesia prevents complications and improves patients’ quality of life. The present study aimed to compare the effects of intravenous dexamethasone and magnesium sulfate on pain after laparoscopic cholecystectomy (LC). In this double-blind randomized controlled clinical trial, 60 patients aged 18 to 70 years undergoing laparoscopic cholecystectomy were randomly divided into two groups, (dexamethasone group and magnesium sulfate group) after obtaining written consent. The magnesium sulfate group received 50 mg/kg of magnesium sulfate diluted in 100 mL of 0.9% normal saline after endotracheal intubation for 15 min, and group D received 0.1 mg/kg (up to a maximum of 8 mg) intravenous dexamethasone 15 minutes before anesthesia induction. Pain levels were compared between the two groups based on a Visual Analog Scale (VAS). Pain intensity decreased in both groups, but VAS scores was significantly lower in the dexamethasone group at 1, 2, and 24 hours after surgery. The incidence of complications including chills, itching, and nausea and vomiting was lower in the dexamethasone group, but no statistically significant difference was found. Heart rate and mean arterial pressure decreased in both groups. Hemodynamic stability was significantly higher in the magnesium sulfate group at 1, 2, and 24 hours after surgery. Although magnesium sulfate has fewer effects on patients’ hemodynamics and reduces pain intensity, the administration of dexamethasone has greater and more extensive effects in controlling pain and reducing complications in patients after laparoscopic cholecystectomy.
Individuals infected with Coronavirus Disease 2019 (COVID-19) may exhibit a wide range of clinical symptoms, from asymptomatic cases to severe complications. This variation is likely associated with differences in immune response intensity, where specific long noncoding RNAs (lncRNAs) are known to regulate the interferon (IFN) signaling pathway. The present study aimed to comparatively investigate the relationship between Glucokinase 1 (GCK1) lncRNA expression and immune system activity in individuals with COVID-19. A total of 100 participants were included in the study. The expression of the GCK1 lncRNA gene was quantified using quantitative real-time polymerase chain reaction (qPCR), and the concentrations of IL-12, IFN-α, IFN-γ, and tumor necrosis factor-alpha (TNF-α) in cell culture supernatants were measured via Enzyme-Linked Immunosorbent Assay (ELISA). The findings revealed a significant upregulation of lncRNA-GCK1 expression in COVID-19 patients compared with the control group. Additionally, the levels of IL-12, IFN-α, TNF-α, and IFN-γ were considerably higher in patients, suggesting a potential association between increased lncRNA-GCK1 expression and an intensified inflammatory response. Collectively, the findings highlight lncRNA-GCK1 as a potential key regulator of immune activation in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and a promising biomarker candidate for monitoring disease dynamics and treatment outcomes.
Hydatid disease is a parasitic zoonosis caused by Echinococcus granulosus, most commonly affecting the liver and lungs. Involvement of the thyroid gland is extremely rare and can mimic more prevalent conditions such as multinodular goiter (MNG). A 26-year-old Iranian woman with a history of consuming contaminated water presented with a painless anterior neck nodule in the thyroid area. Initially diagnosed with multinodular goiter, she underwent total thyroidectomy under general anesthesia. later diagnosed histopathologically as a hydatid cyst of the thyroid, with concurrent cysts identified in the liver and spleen. This case highlights the importance of considering hydatid disease in the differential diagnosis of cystic thyroid lesions, particularly in endemic areas, and discusses diagnosis and management methods.
Body dissatisfaction is a major concern among individuals with gender dysphoria, for the assessment of which psychometric tools with appropriate reliability and validity are needed. This study aimed (1) to translate and culturally adapt both gender versions of the English-language “Body Image and Satisfaction Questionnaire” (BIQ-M and BIQ-F: Meyer-Bahlburg, 2008) into Persian and (2) to conduct a psychometric validation study of the Persian versions. After translation and cultural adaptation, content and face validity were assessed. A total score for each gender version was calculated by summing responses to Likert-scaled dissatisfaction items. The Dissatisfaction Scales were analyzed for internal consistency (Cronbach’s alpha) and discriminant validity in a sample of 51 individuals with gender dysphoria (25 transgender women, 26 transgender men) and 43 cisgender individuals (20 men, 23 women). Group differences were examined using t-tests and ANCOVA. Explanatory factor analysis has been used to assess the construct validity of the questionnaires. Cronbach’s alpha coefficients for the Dissatisfaction Scales of BIQ-M and BIQ-F were 0.931 and 0.948, respectively. EFA showed four domains for each BIQ-M and BIQ-F questionnaires, describing more than 75% of the variations. Transgender participants scored significantly higher on the scales than cisgender controls (P<0.001). Item-level analyses confirmed these differences, and ANCOVA showed no significant confounding effect of age. The Persian versions of the BIQ-M and BIQ-F demonstrated excellent reliability and plausible construct and criterion validities, thus making them suitable for clinical and research use among Persian-speaking individuals with gender dysphoria.
Ovarian cancer is among the most lethal gynecologic malignancies, and its etiology remains poorly understood. Viral infections, including herpes simplex virus type 2 (HSV-2), have been hypothesized as potential risk factors. This study aimed to evaluate the association between HSV-2 infection and ovarian cancer risk in an Iranian population. A case-control study was conducted at Fatemieh Hospital, Hamadan, Iran, from 2021 to 2022, involving 38 women with histologically confirmed ovarian cancer and 38 age- and marital status-matched healthy controls. Data on demographic characteristics, obstetric history, sexually transmitted diseases (STDs), and family history of genital cancers were collected. HSV-2 serology was assessed using enzyme-linked immunosorbent assay (ELISA). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using univariate and multivariate logistic regression. A post-hoc power analysis was performed. Baseline characteristics were similar between cases and controls. Among cases, 52.6% had epithelial ovarian cancer, 26.3% serous tumors, and 21.1% borderline tumors. Univariate analysis indicated increased odds of ovarian cancer with Chlamydia trachomatis (OR 4.2, 95% CI: 1.04-16.6), HSV-2 (OR 3.1, 95% CI: 0.7-12.8), and STDs overall (OR 4.8, 95% CI: 1.8-12.7). In multivariate analysis adjusting for age, menopausal status, family history, and urban residence, STDs remained significantly associated (adjusted OR 4.8, 95% CI: 1.7-13.2, P=0.003). No significant associations were observed between infections and cancer subtypes. Post-hoc power analysis indicated approximately 35% power to detect the observed HSV-2 difference. Sexually transmitted infections may contribute to ovarian cancer etiology. However, due to low statistical power, the non-significant finding for HSV-2 should be interpreted with caution. Further studies with larger sample sizes are needed to clarify the role of HSV-2 infection.
Prostate cancer is the second most frequent malignancy in men worldwide. Approximately 20% of patients present with metastatic disease. The most common metastatic sites of prostate cancer are bone, lung and pleura, non-regional lymph nodes, liver, adrenals, and brain. Metastasis of prostate cancer to the stomach and intestines is rare. Differentiation between primary and secondary colorectal cancers is difficult. Here we report a 70-year-old man who was referred to the hospital with abdominal pain, weakness, and melena. An abdominopelvic computed tomography scan was done for further investigation. As a result, colon wall thickness was increased and multiple metastatic bone foci were present. Microscopically, the results revealed malignant tumor of atypical cells with hyperchromatic nuclei. The pathologist reported a malignant undifferentiated tumor and suggested immunohistochemistry (IHC) for differentiation between malignant lymphoma and carcinoma. According to high serum PSA level, a PSA staining was also suggested and performed. IHC results showed positivity for CK (Cytokeratin) and PSA, but negativity for CK7, CK20, and LCA (Leukocyte Common Antigen) in favor of metastatic carcinoma to the colon of prostate origin.
The fibrinogen/albumin ratio (FAR) serves as a fine marker for systemic inflammation and coagulation. Its capacities in distinguishing the subjects with recurrent miscarriage from those with a first-time spontaneous miscarriage still remain to be established. To compare FAR between women with RPL and women who underwent a first miscarriage within the first trimester, and to assess the discriminative performance of FAR via an ROC analysis. A cross-sectional study for diagnostic comparison design, enrolling 120 first-trimester women into three groups (RPL, first-time miscarriage, healthy early pregnancy; n=40 each). Plasma fibrinogen and serum albumin levels were measured, and the FAR calculated. Differences between groups were tested through the appropriate parametric or nonparametric method. ROC analysis then evaluated AUC, optimal cut-points (Youden index), sensitivity, specificity, positive predictive value, and negative predictive value. Women with RPL in comparison to healthy pregnant controls were characterized by significantly elevated fibrinogen (403.50±15.62 mg/dL vs 307.25±45.35 mg/dL), decreased albumin (332.25±32.78 mg/dL vs 376.25±44.36 mg/dL), and remarkably increased FAR levels (1.2425±0.0699 vs 0.8289±0.1566) (all P<0.001). Compared with first miscarriage, the RPL group also recorded higher fibrinogen (403.50±15.62 mg/dL vs 354.75±28.99 mg/dL), lower albumin (332.25±32.78 mg/dL vs 345.50±39.68 mg/dL), and higher FAR (1.2425±0.0699 vs 1.0434±0.1023) (P≤0.002). ROC analysis was used to determine an FAR cut-point value of 0.975 for discriminating between RPL and healthy pregnancy (AUC=0.875; sensitivity 82.5%; specificity 87.5%) and 1.083 between RPL and first-time miscarriage (AUC=0.777; sensitivity 57.5%; specificity 65.0%). FAR is significantly elevated in women with RPL and greatly discriminates RPL and a healthy early pregnancy. It moderately discriminates between RPL and first-time miscarriage, suggesting that it could be useful as a screening/stratification biomarker but should not be used as a single diagnostic test for discriminating between miscarriage subtypes. External multicenter validation, harmonized assay methods, and incorporation of FAR into multimarker predictive models are recommended prior to clinical implementation.
Inguinal hernia repair is common, but postoperative complications such as pain, seroma, and recurrence remain concerns. Hernia belts have been proposed to provide external support and reduce these risks, though evidence is inconsistent. This study aimed to evaluate whether routine postoperative hernia belt use following laparoscopic transabdominal preperitoneal (TAPP) repair influences complication rates and recovery compared with standard care alone. This quasi-experimental study was conducted at Sina Hospital, Tehran University of Medical Sciences, between June 2023 and June 2024. Adult patients with primary inguinal hernia undergoing elective laparoscopic TAPP repair with mesh placement were enrolled and followed for 12 months. Participants were allocated to an intervention group (standard care plus hernia belt for six weeks) or a control group (standard care only). Primary outcomes included seroma, acute pain, hematoma, surgical site infection (SSI), chronic postoperative inguinal pain (CPIP), and recurrence. Secondary outcomes were length of hospital stay and time to return to normal activity. Statistical analyses included Fisher’s exact test, Poisson regression, and Mann-Whitney U test, with significance set at P<0.05. A total of 82 patients were included (52 in the hernia belt group, 30 in the control group). Baseline demographic and clinical characteristics were comparable between groups. Rates of complications were not significantly different: seroma (23.1% vs. 20.0%, P=0.790), acute pain (23.1% vs. 10.0%, P=0.235), hematoma (17.3% vs. 3.3%, P=0.084), SSI (7.7% vs. 3.3%, P=0.648), CPIP (17.3% vs. 20.0%, P=0.774), and recurrence (7.7% vs. 20.0%, P=0.159). The hernia belt group had a significantly longer median hospital stay (2 vs. 1 days, P=0.001) and a non-significant delay in return to normal activity (5 vs. 4 days, P=0.062). Postoperative hernia belt use following laparoscopic TAPP inguinal hernia was not associated with a statistically significant difference in complication rates and was associated with prolonged hospital stay. Routine use of hernia belts is not supported by current findings, though selective use in high-risk patients may warrant further investigation. Selective application in subgroups such as obese patients or those with large hernia defects may warrant further evaluation in multicentric trials.
This study was conducted with the aim of investigating the pattern of smoking and its relationship with chronic pain in patients with atypical facial pain (AFP). This descriptive cross-sectional study was conducted on patients with AFP referred to the Oral and Maxillofacial Medicine department of Mashhad Dental faculty. Patients whose disease was confirmed through clinical and psychiatric examinations, and standard diagnostic criteria were included in the study. The information based on the designed checklist includes demographic characteristics, pain characteristics, and information related to tobacco use was extracted and recorded. Out of 77 patients included in the study, 23 were smokers and 54 were non-smokers. The most common site of pain in the smoking group was the face and, in the non-smoking group was the mandible. The most reported pain type was sharp pain in both groups. In non-smokers, a history of mental stress at the same time as the onset of pain was reported in 56% of people, and in the population of smokers, it was reported in 73% of people. In both groups, most people reported that pain does not affect sleep patterns. No significant difference was observed between the smoking and non-smoking groups in terms of pain intensity. According to the findings of present study, Smoking does not play a role in the pain intensity and sleep pattern of people with AFP, and other factors such as economic status, stress, anxiety, and smoking compounds may be effective, which should be investigated in future studies.
Septoplasty is a common otolaryngological procedure in which a bloodless surgical field is critical for safe and accurate surgery. Deliberate hypotension is widely used to minimise intra-operative bleeding and optimise visibility, but the relative haemodynamic stability, blood-conservation efficacy, and postoperative nausea and vomiting (PONV) profile of total intravenous anaesthesia (TIVA) compared with combined intravenous–inhalational techniques in septoplasty are not fully established. This study aimed to compare propofol–remifentanil TIVA with a combined intravenous–inhalational technique (isoflurane plus metoprolol and glyceryl trinitrate) in patients undergoing septoplasty, with regard to haemodynamic stability, intra-operative blood loss, and PONV. A prospective, single-centre, parallel-arm, open-label randomised clinical trial was conducted at Al-Najaf Teaching Hospital, Iraq, between December 2022 and October 2023, and is reported in accordance with the CONSORT 2010 statement. Forty patients aged 16–50 years (ASA physical status I–II) were randomly allocated 1:1 by an independent biostatistician using a computer- generated block-randomisation sequence (block size 4). Allocation was concealed in sequentially numbered, opaque, sealed envelopes, which were opened only after enrolment and immediately before induction. Patients were assigned to combined intravenous–inhalational anaesthesia (Group A, n=20) or TIVA with propofol and remifentanil (Group B, n=20). The pre-specified primary endpoint was the proportion of patients achieving and maintaining the deliberate-hypotension target (MAP 50-65 mmHg) for ≥90% of the intra-operative period. Secondary endpoints were intra-operative blood loss, PONV incidence within 24 h, operative time, and recovery profile. Heart rate, systolic and diastolic blood pressure, MAP, intra-operative blood loss, and PONV up to 24 h after surgery were recorded. Both groups achieved the deliberate- hypotension target within five minutes of induction and maintained stable haemodynamics throughout surgery. Intra-operative blood loss did not differ significantly between groups (TIVA 119.0±14.10 mL vs combined 121.5±14.60 mL; P=0.548). PONV occurred in 25% of TIVA patients and 35% of combined- anaesthesia patients (P=0.503); no episodes of vomiting were recorded in either group within 24 h. Female sex was significantly associated with PONV (P=0.014). Operative time and recovery profiles were similar between the two groups. Both TIVA and combined intravenous–inhalational anaesthesia, when titrated to identical haemodynamic targets, showed no statistically significant differences in haemodynamic stability, intra-operative blood loss, or PONV outcomes during septoplasty. Because the study was not designed or powered as a formal equivalence or non-inferiority trial, these findings should be interpreted as hypothesis- generating rather than as proof of clinical equivalence. Either technique may be selected on the basis of patient-specific factors, drug availability, and clinician preference.
Medical students face multiple academic and clinical stressors that can compromise their psychological well-being. Identifying protective psychological factors is crucial for developing effective mental health promotion and prevention strategies in university settings. This study examined the relationships between personality traits, self-compassion, and psychological well-being among medical students, focusing on their potential preventive roles. A cross-sectional correlational study was conducted with 162 medical students. Participants completed the NEO Five-Factor Inventory (NEO-FFI), the Self- Compassion Scale (SCS), and the Psychological Well-Being Scale (PWB). Data were analyzed using descriptive statistics, Pearson’s correlations, and multiple regression analyses (α<0.05). Mean scores were Neuroticism 22.96±4.87, Extraversion 26.15±5.02, Openness 27.78±4.65, Agreeableness 29.89±5.41, Conscientiousness 30.23±5.12, Self-Compassion 41.13±5.94, and Psychological Well-Being 67.52±8.91. Psychological well-being correlated positively with Openness to Experience (r=0.21, P=0.02) and Conscientiousness (r=0.25, P=0.01). Gender differences were significant for Extraversion, Openness, and the “Common Humanity” dimension of self-compassion (P<0.05). Regression analysis indicated that personality traits significantly predicted psychological well-being (β=0.19, P=0.04), whereas self-compassion was not a direct predictor (β=0.03, P=0.93). Conscientiousness and Openness to Experience play pivotal roles in medical students’ psychological well-being. Notably, this study found no direct predictive relationship between self-compassion and well-being. Rather than a lack of relevance, this finding suggests that in the rigorous context of medical education, self-compassion may function through indirect mechanisms or act as a moderating factor. These findings underscore the importance of interventions that enhance adaptive personality traits, while highlighting the need for a more nuanced understanding of how self-compassion contributes to resilience and sustainable mental health in high-pressure academic settings. Conscientiousness and Openness to Experience play pivotal roles in medical students’ psychological well-being. Notably, this study found no direct predictive relationship between self-compassion and well-being. Rather than a lack of relevance, this finding suggests that in the rigorous context of medical education, self-compassion may function through indirect mechanisms or act as a moderating factor. These findings underscore the importance of interventions that enhance adaptive personality traits, while highlighting the need for a more nuanced understanding of how self-compassion contributes to resilience and sustainable mental health in high-pressure academic settings.
Colorectal cancer (CRC) is diagnosed as one of the most prevalent cancers in the world. Theapplication of radiotherapy in cancer treatment might be limited due to its radio resistance. Specificradiosensitizers are important factors in increasing the radiation therapy (RT) efficiency. In this study,Fe3O4@CuS-PEG nanoparticles in combination with the RT were evaluated for the treatment of CRC cells(HT-29 cells). HT-29 cells were treated with 2, 4, and 6 Gy of X-ray irradiation and/or a minimal toxicconcentration of Fe3O4@CuS-PEG nanoparticles. The cytotoxic effect of various treatments was evaluated byMTT assay. Moreover, the malondialdehyde (MDA) level, superoxide dismutase (SOD) activity, and lacticacid level were assessed in single and combined treatments. Furthermore, the epidermal growth factor receptor(EGFR) gene expression level was measured by Quantitative Real-time PCR. Based on our results, cytotoxicityof Fe3O4@CuS-PEG nanoparticles was increased in a dose dependent manner. The nanoparticles were lesscytotoxic in the concentration of 5 mg/mL compared to other examined concentrations. According to the resultsof MTT assay, the viability in the combined treatment groups was significantly lower than that of the singletreatment groups. EGFR mRNA expression level was downregulated in radiation+nanoparticles groups in allexamined doses of radiation. The level of MDA increased in the combined treatments compared to the alonetreatments. Moreover, lactic acid level and SOD activity decreased in double agent combination treatmentsversus radiation alone. Based on our study, Fe3O4@CuS-PEG nanoparticles can be introduced as an effectiveradiosensitizer agent for targeted treatment of CRC cells. Moreover, combination treatment could efficientlytreat cancerous cells and inhibit tumor growth in vitro.
Iron deficiency is the most prevalent nutritional deficiency worldwide ,affecting populations in both developing and developed .despite the absence of anemia, pregnant women may still experience depleted iron stores, which can have significant health implication for both mother and fetus This study aimed to assess the prevalence of iron deficiency among non-anemic pregnant women in their second trimester by analyzing serum ferritin concentrations and identifying related clinical and demographic factors. This cross-sectional study included 246 non-anemic pregnant women at 24-28 weeks’ gestation visiting Baqiatallah Hospital in Tehran for routine diabetes screening in 2022. Blood samples were analyzed for complete blood count, ferritin, iron, and total iron binding capacity. Demographic data and supplement use were recorded. Participants were divided into low ferritin (<30 ng/mL) and normal ferritin (≥30 ng/mL) groups. Demographic characteristics, clinical parameters, and laboratory findings were compared between these two groups using Student's t-test, Mann- Whitney U, and Chi-square tests, Mann-Whitney U, and Chi square tests. Of the participants, 64.4% had low ferritin levels despite 94.3% reporting regular iron supplement use. There were no significant differences in demographic characteristics or supplement use between low and normal ferritin groups (P>0.05). Women with low ferritin had significantly lower platelet counts (213.1±43.4 vs 231.0±59.1 thousand/μL, P=0.04) and serum iron levels (97.5±41.9 vs 105.8±34.9 μg/dL, P=0.018) compared to those with normal ferritin. No significant differences were found in hemoglobin, hematocrit, or other red blood cell indices between groups (P>0.05). A high prevalence of iron deficiency was observed among non-anemic pregnant women despite regular supplement use. Current iron supplementation strategies may be inadequate in addressing iron deficiency during pregnancy. Regular monitoring of serum iron profiles is recommended to identify at-risk women and allow for timely interventions.
This case report details the remarkable long-term survival of a 73-year-old female who underwent bicaval heart transplantation 13 years ago due to severe heart failure caused by dilated cardiomyopathy (DCM) with an ejection fraction of 10%. Simultaneously, she was diagnosed with papillary thyroid carcinoma (PTC). Despite the potential complications, her case highlights the feasibility of heart transplantation in patients with concurrent, non-aggressive cancers. Post-transplant, she underwent successful total thyroidectomy and cervical lymph node dissection three months after heart transplantation to address her PTC. Over the 13 years following the transplantation, she maintained stable cardiac health, evidenced by consistent left ventricular ejection fraction improvements, peaking at 55%. However, she developed severe osteoporosis and experienced vertebral fractures due to significant hypocalcemia in the setting of hyperparathyroidism, which was managed with vertebroplasty. This case underscores the importance of a multidisciplinary approach in managing complex cases involving both severe cardiac and oncological conditions and emphasizes the potential for positive outcomes with comprehensive medical and surgical interventions.
Diarrheal disease: It is frequently unknown how often bacteria cause diarrhea when assessed in ambulatory settings. We attempted to develop criteria for bacterial culture and identify the microbiological causes of diarrhea in a clinic that primarily serves immigrant children and in a private pediatric practice. Diarrhea is often caused by infections, food intolerance, digestive disorders, or contaminated water and food. It can lead to dehydration, especially in young children and the elderly, making proper hydration and medical attention crucial in severe cases. A descriptive cross-sectional design was utilized. The study was conducted from 15 June 2024 to 13 August 2024. A non-probability (convenience) sample of 100 mothers of children under five years of age was selected. Data were collected via a questionnaire assessing mothers’ knowledge. The data were described statistically and analyzed using descriptive and inferential statistical procedures. The findings of the present study indicate that mothers demonstrated a moderate level of knowledge and practice related to diarrhea prevention, with 47.5% of participants falling within the moderate range. The level of mothers’ knowledge and practice showed a significant association with their educational level. However, the results section should include additional statistical details—such as mean scores, standard deviations, and P— to fully support the reported associations. The study concludes that mothers’ responses across the assessed domains were significantly associated with both their educational level and their children’s sociodemographic characteristics. Based on these findings, it is recommended that community-based diarrhea prevention programs adopt a mother’s self-efficacy assessment scale to identify perceived risks and to design targeted interventions aimed at strengthening and sustaining diarrhea prevention behaviors at the household level.
Pneumothorax is one of the most common consequences of chest trauma, typically managed with chest tube insertion. However, the optimal timing for chest tube removal remains controversial. This study aimed to compare the incidence of clinical complications following chest tube removal at 48 hours versus 72 hours after insertion in trauma patients admitted to Sina Hospital. This prospective, single-center, parallel- group randomized controlled trial enrolled 194 trauma patients requiring tube thoracostomy. Participants were randomized in a 1:1 ratio using computer-generated block randomization with allocation concealment into two groups: removal at 48 hours (n=97) and removal at 72 hours (n=97). The primary endpoint was post-removal complications, defined as recurrent pneumothorax or incomplete lung re-expansion confirmed radiographically. Absolute risk differences (ARD) with 95% confidence intervals (CI) were calculated. Logistic regression analysis was performed to evaluate potential predictors of complications. Statistical significance was defined as P<0.05. The mean age of patients was 43.27±13.05 years. The 72-hour group had slightly higher mean oxygen saturation than the 48-hour group (94.89% vs. 94.76%, P=0.690), and higher mean heart rate (84.04 vs. 83.11, P=0.507) and respiratory rate (13.44 vs. 13.38, P=0.822). In contrast, mean pain intensity was higher in the 48-hour group (4.03 vs. 3.98, P=0.673). Recurrent pneumothorax occurred in 12 patients (12.4%) in the 48-hour group and 10 patients (10.3%) in the 72-hour group (ARD: 2.1%; 95% CI: −6.8% to 11.0%; P=0.651). Incomplete lung re-expansion occurred in 2 patients (2.1%) and 4 patients (4.1%), respectively (ARD: −2.0%; 95% CI: −6.7% to 2.7%; P=0.407). No statistically significant differences were detected between groups. Logistic regression analysis did not identify independent predictors of post-removal complications. Chest tube removal at 48 hours was not associated with a statistically significant increase in post-removal complications compared with removal at 72 hours. However, confidence intervals were wide, and the findings should be interpreted cautiously pending confirmation in larger adequately powered studies
Several factors have been reported to affect glycemic control, the significance of most of which is still a topic of discussion. Therefore, we aimed to investigate such effects in more detail. We conducted our cross-sectional analysis on 163 children and adolescents 2 to 18 with T1DM. Moreover, we obtained their demographic and clinical information in addition to glycated hemoglobin (HbA1C) levels and performed a multivariate regression analysis to determine their effects. Among the investigated factors parents living together (P<0.001), higher parental education (P<0.001), level of monthly income (P<0.001), and residing in urban areas (P<0.001), positive history of hospitalization due to ketoacidosis (P=0.001), injection site lipodystrophy (P=0.005), physical activity (P<0.001), regular endocrinology clinic visits (P<0.01), physician long distance access (P<0.001), social media usage (P<0.001), nutritionist supervision (P<0.001), regular visits by a mental health expert (P=0.02), body mass index (P=0.449, P<0.001), daily insulin units (r=0.447, P<0.001), height Z score (r= -0.177, P=0.024), and duration of Diabetes (r= -0.199, P=0.011) significantly affected HbA1C levels. Furthermore, the regression model significantly predicted 56.4% of the changes in HbA1C. With environmental and family-related factors proving pivotal, educational interventions and implementing relevant policies are crucial. Financial aid to those affected by facilitating access to healthcare- related technologies and state-of-the-art care centers can also pay substantial dividends.
The use of electronic cigarettes (e-cigarettes) has surged globally and is frequently marketed as a safer alternative to traditional tobacco smoking. Nonetheless, the health implications of e-cigarettes remain debated, and their increasing popularity among youth and medical students raises concerns, particularly in countries with limited local research. This study aims to assess the knowledge, attitudes, and practices (KAP) regarding e-cigarettes among dental students at Ashur University in Iraq, while also examining correlations with demographic factors and smoking behavior. A cross-sectional study was conducted from January to March 2025 involving 104 dental students in their fourth and fifth years. The research team developed a structured, self-administered questionnaire based on previous studies to assess demographic data, smoking status, and knowledge (17 items), attitudes (13 items), and practices related to e-cigarettes. Data analysis utilized descriptive statistics and chi-square tests, with a P of ≤0.05 considered statistically significant. Of the 100 valid responses, 50% of participants were male, 69% were aged 20 years or younger, and 91% were unmarried. Nearly half (47%) reported being current smokers, with dual use being the most common pattern at 20%. Knowledge levels regarding e-cigarettes were generally high: 88% acknowledged their harmfulness, 69% recognized their addictive potential, and 50% associated them with cancer risk. In contrast, attitudes were more permissive, with 49% believing that e-cigarettes are less harmful than traditional tobacco, 65% considering them a better option for patients, and 61% supporting a ban on their use. Initiation of e-cigarette use was significantly linked to the smoking habits of peers and family (P<0.001). Social media was identified as the primary source of information, cited by 51% of respondents. No significant associations were found between knowledge or attitudes and demographic factors such as age, gender, or income. Dental students at Ashur University demonstrated a solid understanding of e-cigarettes but held permissive attitudes toward their use, indicating misconceptions about their safety. To address these gaps and enhance preventive measures, awareness programs and integration of this topic into the curriculum are essential.
