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Background: Non-suicidal self-injury (NSSI) is an intentional act that results in physical damage to one's body, without the intent to commit suicide. In recent years, self-injurious behaviors, including non-suicidal self-injury (NSSI), have increased, especially among adolescents and young adults. The objective of this study was to investigate the motives for NSSI among adolescents with psychiatric disorders. Methods: Adolescents aged 12 to 18 years including patients admitted to the Department of Child and Adolescent Psychiatry at a state hospital in Babol (northern Iran) and outpatients referring to this center were included in the research. Data collection occurred between February 2021 and September 2021 from a sample of 140 participants. All subjects were given a demographic questionnaire and an inventory of statements about self-injury (Klonsky and Glenn). Moreover, a structured interview was conducted with all to diagnose the nature of the underlying disorder by a child and adolescent psychiatrist. Results: A total of 140 adolescents with mean age 16.25 ± 1.48 years were assessed. Eighty-five (60.7%) of them were girls. Sixty-five (46.4%) individuals were inpatients and 75 (53.6%) were outpatients; 78 (55.8%) had a history of NSSI and 62 (44.2%) cases had no history of self-injury. The most common method of self-injury was Wounding or cutting a part of the body (n = 56(40.0%)). Attention-deficit/hyperactivity disorder (ADHD) emerged as the most common psychiatric diagnosis among individuals with a history of NSSI. Emotion regulation was the most common motive for self-injury (p = 0.004). The prevalence of self-injury was higher among adolescent girls (p = 0.049). There was no significant relationship between self-injury and inpatient or outpatient status (p = 0.342). Conclusions: Our findings indicate that NSSI in adolescents is not limited to a specific or single motive; instead, multiple factors contribute to its occurrence. NSSI methods can also vary, and all should be considered when examining this behavior. [ABSTRACT FROM AUTHOR]

Background: Renal Cell Carcinoma is one of the most common malignancies worldwide. To date, multiple attempts had been made to accurately diagnose it and predict its behavior. One of the most intriguing biomarkers that have been assessed since 90s, is galectin-3. This study aimed to increase the prior knowledge of galectin-3 expression association with patient's clinicopathologic factors. Methods: In this single-center cross-sectional study, 71 patient samples from hospital archive were assessed for galectin-3 expression by immunohistochemistry assay. Pathologic slides were evaluated for histologic subtype, grade, stage, tumor size, presence of necrosis, and invasion of the renal vein. By adding cytoplasmic staining score to the color intensity score, a final score was recorded as galectin-3 positivity score. Results: 88 pathological slides of patients with confirmed RCC were screened and 71 were finally assessed. The mean age of the patients was 58.52 years (lowest 30 and highest 87). 67.6% were males and 32.4% were females. 68% of tumors were clear cell carcinoma, and only one oncocytoma was present. All 9 chromophobe cases showed a strong galectin-3 expression. Except for female gender (47.8% vs 18.8% in men; P=0.01), no statistically significant association was found between patient age, tumor grade, tumor size, tumor stage, and renal vein invasion with the level of galectin-3 expression. Conclusion: Considering the contradictory findings between this study and other similar studies, it can be concluded that the physiological role of galectins is very complex and the need for larger and more comprehensive evaluations is felt. [ABSTRACT FROM AUTHOR]

Background: Anemia in pregnancy is associated with psychiatric symptoms and poor psychiatric symptoms, this study investigates the 6-month trends of anxiety and birth outcomes. Considering the controversies surrounding the impact of anemia on psychiatric symptoms, this study investigates the 6-month trends of anxiety and depression in anemic pregnant women with threatened abortion (TA). Methods: A case-control retrospective cohort study conducted among 282 participants who enrolled in a registry of pregnant women with TA in Babol city from December 2022 to October 2023. Fifty individuals with anemia (hemoglobin < 11 g/dL) who were matched with 50 without anemia based on age, pregnancies, education, and gestational age, were included. The BSI-18 (Brief Symptom Inventory) was used to assess depression, anxiety, and psychological distress at the beginning, three and six-month follow-ups. Results: The prevalence of anemia among women diagnosed with TA was found to be 17.7%. At the beginning, compared to normal individuals, anemic women had higher rates of depression (32% vs. 14%), anxiety (34% vs. 22%), and psychological distress (66% vs. 48%). Moreover, at 3- and 6-month follow-ups, the frequency of psychiatric symptoms in anemic women was significantly higher. The Generalized Estimating Equations model showed that although both groups had a decreasing trend of frequency anemic women experience a slower rate of decrease in psychiatric symptoms compared to non-anemic women. Conclusion: Anemia in women with TA is associated with high rates of depression, anxiety, and psychological distress, as well as a slow recovery rate. [ABSTRACT FROM AUTHOR]

Background: Threatened abortion (TA) is associated with adverse pregnancy outcomes. Despite the attention paid to the adverse outcomes of obstetrics, only a few studies have been conducted on the psychological status of women with threatened abortion. This study aimed to compare the symptoms of depression and anxiety in women with TA and those without threatened abortion. Materials and Methods: In a case-control study, 136 women with TA (the case group) and 136 women without TA (the control group), were matched with the case group in terms of gestational age, education level, age, and number of pregnancies, were examined from Obstetric clinics of Babol University of Medical Sciences. Demographic information and pregnancy history were obtained from all participants. Additionally, the women filled out the BSI-18 questionnaire. Statistical analysis was performed using SPSS version 22 software. Results: The results showed that in women with threatened abortion, the likelihood of experiencing depression symptoms was 1.9 times higher [odds ratio (OR)=1.91, 95% confidence interval (CI)=1.13-3.23, P=0.015], anxiety symptoms were 1.8 times higher (OR=1.83, 95% CI=1.08-3.10, P=0.024), and somatization was 2.6 times higher (OR=2.65, 95% CI=1.61-4.37, P<0.001) compared to pregnant women without threatened abortion. Additionally, in women with threatened abortion, the risk of psychological distress was 3.3 times higher (OR=3.30, 95% CI=1.96-5.56, P<0.001) than in women without threatened abortion. Conclusion: This study suggests that gynecologists, midwives, and healthcare providers, in addition to providing medical care for women threatened with abortion, should identify women at risk of experiencing symptoms of depression and anxiety. Providing appropriate psychological support should be prioritized in the management of women with threatened abortion. [ABSTRACT FROM AUTHOR]

Background: Treatments for acute bronchitis is usually a supportive care to relieve upper respiratory symptoms. This study aimed to evaluate the effect of Plantago major syrup (PMS) on cough severity in acute bronchitis. Methods: Patients (20-75 years-old) referred to the clinic of infectious diseases in Ayatollah Rouhani Hospital, Babol, Iran with a complaint of cough and the Bronchitis Severity Scale (BSS) =5 entered the study. The patients randomly received PMS or placebo 30 ml/day for 10 days. Patients were visited before treatment and on days 5 and 10 after treatment. The primary outcome was BSS score and secondary outcome was the life quality that was measured by means of the Persian version of the Leicester Cough Questionnaire (LCQ) at the first visit and on the 10th day. Results: Of the 121 patients diagnosed with acute bronchitis, 80 eligible patients (42.87±11.75 years-old) were randomly divided into PMS and placebo groups. The BSS score in the PMS group after 10 days was significantly lower than that of the placebo group (P=0.001). Frequency of cough (P=0.001), sputum production (P=0.005), and chest wall pain (P=0.008) were significantly lower in the PMS group than in the placebo group. In terms of quality of life, all items, including psychological, physical, and social domains, as well as total scores, were altered significantly in the PMS group compared to placebo. During monitoring of side effects, no significant adverse effects were stated in either group. Conclusion: The study indicates the palliative effects of PMS in relieving the symptoms of acute bronchitis and improving quality of life. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine the volumetric parameters of platelets including MPV (Mean Platelet Volume) and PDW (Platelet Distribution Width) in diabetic children with and without diabetic ketoacidosis (DKA) and to evaluate their relationship with the severity of DKA. Materials and Methods: A case-control study was conducted on 112 children with type 1 diabetes mellitus (T1DM), with and without DKA, who referred to Amirkola Children's Hospital, Iran, in 2016-2021. Of them, 43 were boys, and 69 were girls. The diagnosis of diabetes was based on clinical symptoms and diagnostic criteria, and DKA was diagnosed through the analysis of arterial blood gas. The patients' MPV and PDW were also evaluated, and the P values less than 0.05 were considered significant. Results: Out of 112 children with diabetes (with the mean age of 8.71 ± 3.22 years), 56 persons had DKA. In terms of DKA severity, 17 patients (30.4%) had mild, 29 (51.8%) had moderate, and 10 (17.8%) had severe DKA. The children with DKA had the mean blood glucose of 490.98±46.11mg/dL, MPV of 10.02± 1.19fl), and PDW of 13.07± 1.18flwere significantly higher (P<0.001). It was found that, an increase in the severity of DKA would raise the mean MPV (P = 0.006) and PDW(P<0.001) significantly. Conclusion: Based on the results of this study, as the severity of DKA increases in diabetic children, the mean levels of MPV and PDW increase significantly. Therefore, it is suggested that MPV and PDW be used to predict the severity of DKA in diabetic children. [ABSTRACT FROM AUTHOR]

Background: Internet addiction causes a variety of social, interpersonal, psychological, and physical issues. We are confronting a worldwide crisis about internet addiction and its effects. Objectives: Utilizing five questionnaires to survey university students during the COVID‐19 epidemic, the current study sought to evaluate internet addiction and associated risk variables. Methods: At the University of Medical Sciences in North Iran, a cross‐sectional analytical investigation was carried out. The sample was done among 318 students, selected through the random cluster sampling method. Data collection was done during August and September 2021. Results: Based on our findings, the prevalence of internet addiction was 28.9% (92/318). Our results revealed that women are at twice the twice the risk of internet addiction as men (p = 0.028). Students in the medicinal field (p = 0.043; students with a positive history of mental illness in the family) p = 0.001 (and students with a fear of COVID‐19) p = 0.002 (recognized in the risk of Internet addiction, thus depression) p < 0.001 (anxiety) p < 0.001 (somatization) p = 0.001 (and psychological distress) p < 0.001 are risk factors for internet addiction. Age, marital status, place of living, total social support, and use of Alcohol/cigarettes are not risk factors for internet addiction. Conclusions: The findings suggest that university students with a fear of COVID‐19, depression, anxiety, somatization, psychological distress and a positive history of mental illness in the family, particularly medicinal field students, are at significant risk for Internet addiction. [ABSTRACT FROM AUTHOR]

Objective: Mothers of neonates admitted to the intensive care unit are prone to sleep disorders due to stress and anxiety. Some herbs have anti-anxiety and sedative properties. This study aimed to investigate the effect of bitter orange blossom distillate on anxiety and sleep disorders in mothers with infants admitted to the neonatal intensive care unit. Methods: This randomized controlled clinical trial was conducted from 2021 May 15 to 2022 February 2, on 60 mothers with NICU-admitted infants in one of the medical teaching centers affiliated with Babol University of Medical Sciences, Iran. Permuted block randomization was used to assign the mothers to the experimental (bitter orange blossom distillate syrup) and control groups (syrup prepared from water and sugar). Given the impossibility of blinding the participants, allocation concealment was used to prevent the researcher from predicting the future allocation of the samples to the groups. In addition, the statistical consultant received coded data pertaining to the type of intervention in each group. A demographic questionnaire, the Spielberger State and Trait Anxiety Inventory (STAI), and the General Sleep Disorder Scale were employed to collect data. We assessed the level of anxiety and sleep disorder (in both groups before the intervention and again after the last day of the intervention). Data were analyzed using SPSS V22 software. A P-value less than 0.05 were considered significant. Results: The mean and standard deviation of the sleep disorder score in the intervention group from (50.26±5.81) to (44.70±6.94) and in the control group from (50.46±6.95) to (48.53±8.62) changed. The covariance test showed that bitter orange blossom distillate syrup has a significant effect on the improvement of sleep disorders (P = 0.01, Effect size = 0.09), but there was no significant difference in the State and Trait anxiety level of mothers (P = 0.122, 0.144 and Effect size = 0.04, 0.03) respectively. Conclusions: Due to the positive effect of bitter orange blossom distillate syrup on sleep disorders of mothers with hospitalized babies, this low-cost and low-risk intervention is recommended. Trial registration: This study is registered at clinicaltrials.gov as Trial ID = IRCT20201209049666N1. [ABSTRACT FROM AUTHOR]

The present study aimed to estimate the global prevalence of ocular toxoplasmosis in the general population and patients with uveitis. Four electronic databases were searched and 130 studies for evaluating the prevalence of OT among the general population and uveitis patients were included. The pooled prevalence of OT among the general population was estimated at 2% (95% CI, 2–3%; 762/486 051). The highest prevalence rate was observed in America 6% (95% CI, 1–11%). In uveitis patients, a prevalence rate of 9% (95% CI, 8–10%; 5668/88 006) was reported. The countries with a lower middle income had higher prevalence rates. The prevalence of OT in posterior uveitis 33% (95%CI, 24–42%) was substantially higher than in panuveitis 7% (95% CI, 5–8%). Our results provide a new perspective on the prevalence of OT. Knowledge of international and regional patterns of disease is essential for the establishment of precise diagnostic protocols and control programs. [ABSTRACT FROM AUTHOR]

Testicular torsion, as one of the medical emergencies, needs prompt diagnostic and treatment measures. This cross-sectional study aimed to assess the clinical and paraclinical findings and the treatment measures performed in the community of hospitalized patients who underwent surgery in Shahid Beheshti Hospital of Babol from 2012 to 2021 with the initial diagnosis of testicular torsion. The research sample was selected via the convenience sampling method. The necessary information was collected from patients' medical records in the form of a checklist. Thereafter, the data were analyzed in SPSS software (version 22) using descriptive and graphical indicators, as well as Chi-square and Fisher's exact tests at a significance level of 0.05. The findings demonstrated that 197 patients with a mean age of 18.91 years were included in the study. The majority of them (n=121; 61.42%) had torsion on the right side. More than 98% of patients experienced pain, while most of them did not have fever (n=160; 81.22%) and vomiting (n=153; 77.66%). In 148 (75.13%) patients, the final diagnosis was testicular torsion, and in 101 (68.24%) patients, the testicle was preserved. Moreover, the result of the surgery had a significant relationship with the degree of rotation and the duration of the onset of symptoms until hospitalization and from hospitalization to surgery (P>0.001, 0.001 and 0.026, respectively). It can be concluded that an understanding of clinical characteristics of testicular torsion cases and as a result, informing the treatment staff involved in the treatment process, reduce the duration of delay in surgery and leads to more appropriate clinical treatment and improved results in testicular torsion patients. [ABSTRACT FROM AUTHOR]

Background: Prenatal and postnatal depression (PND) is associated with adverse outcomes for mother, fetus, and child. The aim of study was to examine the prevalence and risk factors of prenatal and postnatal depressive symptoms. Materials and Methods: This was a cross-sectional and hospital-based survey of 2305 pregnant women and post-partum women (18-48 years) that was registered in the Babol Pregnancy Mental Health Registry (BPMHR) database from June 2020 to March 2021. Two questionnaires, including demographics and depression, were analyzed in this study. Also, the Edinburg Postnatal Depression Scale (EPDS) was used to assess the depressive symptoms. Independent t test and the analysis of variance were used to compare the means. Multiple logistic regressions were used to determine risk factors for depressive symptoms. Results: According to the EPDS scale, the prevalence of depressive symptoms was 19.8% in the pregnant woman group in comparison with the postpartum period (11.6%). Risk factors for antenatal depressive symptoms were parity (women with parity ≥ 4 vs. 1 parity, ß=1.808, P=0.020), two groups of gestational age (gestational age ≤12 weeks vs. 28 weeks, ß=1.562 P=0.030) as well as (gestational age 21-27 weeks vs. 28 weeks (ß=1.586, P=0.033), and high-risk pregnancy (high-risk vs. low-risk pregnancy, ß=1.457, P=0.003). For postnatal depressive symptoms, none of the factors were a significant risk. Conclusion: Prenatal and postnatal depressive symptoms should be screened, particularly for women in the first and second trimesters, with high parity, and those with a high-risk pregnancy, as recommended by the present study. [ABSTRACT FROM AUTHOR]

Background: The normal reference values for the thyroid uptake of radioactive iodine and Tc-99m pertechnetate in euthyroid patients vary by geographical location as well as the amount of iodine intake in the diet. The present study examines the normal reference values for thyroid uptake of Tc-99m pertechnetate in the North of Iran. Methods: The participants of this study were 64 patients (all over 20 years of age) who had referred to the Nuclear Medicine Center of the Shahid Beheshti Hospital for thyroid scan over the period between March 2018 and May 2020. It is worth mentioning that relying on laboratory test results, only patients with normal thyroid function were included in this cross-sectional study. Results: The median, the 5th and 95th percentiles and thyroid uptake range of 99mTc-pertechnetate in euthyroid patients were 0.9, 0.6 to 1.8% and 0.54 - 1.80%, respectively. Conclusion: The percentage of uptake in the thyroid gland in each geographical area varies based on race and diet content, so it is necessary to determine the percentage of uptake in each specific region and even check it periodically. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) is a pandemic outbreak of RNA coronaviruses (SARS-CoV-2), associated with acute respiratory distress syndrome, multiple organ failure, and death. The surface electrocardiogram is the first line assessment of cardiac electrical system. We aimed to interpret classically the electrocardiographic parameters at admission and during hospital course and association of them with prognosis in patients admitted with diagnosis of infection with SARSCoV- 2. Methods: Surface electrocardiograms (ECG) were obtained from 180 patients with SARS-CoV-2 infection at a large tertiary referral university hospital at north of Iran in Babol. The electrocardiographic waves, intervals and segments in addition to supraventricular and ventricular arrhythmias were depicted. Our cohort included two groups: discharged alive and dead during the hospital course. We compared the ECG characteristics of patients who died vs. survived ones. Results: Some ECG parameters of 180 hospitalized patients were significantly associated with mortality, like heart rate (p< 0.001), bundle branch block (P= 0.035), fragmented QRS (P= 0.015), ST elevation (P= 0.004), T p-e duration (P= 0.006), premature atrial and ventricular complexes (P= 0.030, P= 0.004) and atrial fibrillation (P= 0.003). Conclusion: The SARS-CoV-2 infection had several impacts on cardiac electrical system which may monitored with a simple and easily accessible tool like ECG. This tool also helpful in the risk stratification of patients. [ABSTRACT FROM AUTHOR]

Background: Medical students often experience high levels of psychological stress, which can significantly impact their professional lives. Objectives: This study aimed to investigate the quality of professional life among medical students and the influence of psychological self-care and resilience on both professional quality of life and psychological distress among medical clerks and interns at Babol University of Medical Sciences. Methods: This descriptive-cross-sectional study, conducted from May to September 2022, included 270 medical trainees from Babol University of Medical Sciences (Babol, Iran). Participants had not taken academic leave in the past year nor transferred to another university. They completed online questionnaires covering resilience, psychological self-care, quality of professional life, and psychological distress, along with demographic details such as age, gender, and marital status. Data were analyzed using SPSS software. Results: Results indicated a generally favorable quality of professional life among the students, characterized by low compassion fatigue (mean 17.43 ± 7.87 out of 36) and low psychological burnout (mean 15.34 ± 4.10 out of 24), but moderate compassion satisfaction (mean 34.52 ± 8.13 out of 50). Additionally, mean scores for depression (7.84 ± 3.50 out of 21) and anxiety (7.24 ± 3.76 out of 21) were low. Students demonstrated above-average psychological self-care (mean 127.47 ± 17.97 out of 180) but had low resilience against stress (mean 24.12 ± 5.28 out of 38). Regression analysis revealed that psychological self-care significantly influenced the quality of professional life (P < 0.001, β = 0.318). Furthermore, age (P < 0.001, β = 0.299), female gender (P = 0.013, β = -0.136), and self-care (P < 0.001, β = -0.327) significantly affected levels of anxiety and depression. Conclusions: Psychological self-care plays a crucial role in enhancing the quality of professional life and in mitigating anxiety and depression among medical clerks and interns. [ABSTRACT FROM AUTHOR]

Objective: To assess the reporting quality of published RCT abstracts regarding patients with endometriosis pelvic pain and investigate the prevalence and characteristics of spin in these abstracts Methods: PubMed and Scopus were searched for RCT abstracts addressing endometriosis pelvic pain published from January 1st, 2010 to December 1st, 2023.The reporting quality of RCT abstracts was assessed using the CONSORT statement for abstracts. Additionally, spin was evaluated in the results and conclusions section of the abstracts, defined as the misleading reporting of study findings to emphasize the perceived benefits of an intervention or to confound readers from statistically non-significant results. Assessing factors affecting the reporting quality and spin existence, linear and logistic regression was used, respectively. Results: A total of 47 RCT abstracts were included. Out of 16 checklist items, only three items including objective, intervention and conclusions were sufficiently reported in the most abstracts (more than 95%), and none of the abstracts presented precise data as required by the CONSORT-A guidelines. In the reporting quality of material and method section, trial design, type of randomization, the generation of random allocation sequences, the allocation concealment and blinding were most items identified that were suboptimal. The total score for the quality varied between 5 and 15 (mean: 9.59, SD: 3.03, median: 9, IQR: 5). Word count (beta = 0.015, p-value = 0.005) and publishing in open-accessed journals (beta = 2.023, p-value = 0.023) were the significant factors that affecting the reporting quality. Evaluating spin within each included paper, we found that 18 (51.43%) papers had statistically non-significant results. From these studies, 12 (66.66%) had spin in both results and conclusion sections. Furthermore, the spin intensity increased during 2010–2023 and 38.29% of abstracts had spin in both results and conclusion sections. Conclusion: Overall poor adherence to CONSORT-A was observed, with spin detected in several RCTs featuring non-significant primary endpoints in obstetrics and gynecology literature. [ABSTRACT FROM AUTHOR]

Background: One of the common concerns of healthcare systems is the potential for re-admission of COVID-19 patients. In addition to adding costs to the healthcare system, re-admissions also endanger patient safety. Recognizing the factors that influence re-admission, can help provide appropriate and optimal health care. The aim of this study was to assess comorbidities that affect re-admission and survival in COVID-19 patients using a joint frailty model. Methods: This historical cohort study was done using data of patients with COVID-19 who were re-hospitalized more than twice in a referral hospital in North of Iran. We used the joint frailty model to investigate prognostic factors of survival and recurrence, simultaneously using R version 3.5.1 (library "frailtypack"). P-values less than 0.05 were considered as statistically significant. Results: A total of 112 patients with mean (SD) age of 63.76 (14.58) years old were recruited into the study. Forty-eight (42.9%) patients died in which 53.83% of them were re-admitted for a second time. Using adjusted joint model, the hazard of re-admission increased with cancer (Hazard ratio (HR) = 1.92) and hyperlipidemia (HR = 1.22). Furthermore, the hazard of death increased with hyperlipidemia (HR = 4.05) followed by age (HR = 1.76) and cancer (HR = 1.64). It Also decreased with lung disease (HR = 0.11), hypothyroidism (HR = 0.32), and hypertension (HR = 0.97). Conclusion: Considering the correlation between re-admission and mortality in the joint frailty model, malignancy and hyperlipidemia increased the risk of both re-admission and mortality. Moreover, lung disease probably due to the use of corticosteroids, was a protective factor against both mortality and re-admission. [ABSTRACT FROM AUTHOR]

Background: One of the most effective treatments for patients with acute ischemic stroke (AIS) is intravenous recombinant tissue plasminogen activator (rtPA) which can minimize mortality and morbidities. In this historical cohort study, we investigate the factors affecting clinical outcomes after IV thrombolysis for AIS. Methods: We included 87 patients with acute ischemic stroke who were treated with rtPA between 2015 and 2019. Demographic and clinical data were recorded. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the clinical outcomes. Results: 36 patients showed lack of improvement at discharge. In unadjusted model, hypercholesterolemia was the only predictor of lack of improvement (P= 0.043; OR=0.304; CI= 0.096-0.963). After adjusting, hypertension (P= 0.018; OR= 0.18; CI= 0.043-0.749) and hypercholesterolemia (P= 0.008; OR= 8.68; CI= 1.773-42.54) were independent determinants of lack of clinical response. To evaluate risk factors in association with the duration of hospitalization, we found variables which lengthened hospitalization span including; age over 60 years (HR= 0.42 P= 0.002), hypercholesterolemia (HR= 2.19 P= 0.031), Angiotensin-converting enzyme (ACE) Inhibitors consumption (HR= 1.87 P= 0.022), and type of infarction (non-lacunar) (HR= 0.51 P= 0.026). Results indicated no considerable relationship between dose of rtPA and the appropriate response to treatment (OR=8.686 P= 0.324). Conclusion: The closer dose of rtPA goes up to standard range, the more chance of improvement will gain without increasing the risk of symptomatic intra-cerebral hemorrhage (SICH). Determining factors involved in intravenous reperfusion outcomes help physicians to identify the patients who benefit the most from rtPA. [ABSTRACT FROM AUTHOR]

Background: Emergency use of remdesivir was approved for COVID-19 in some countries. Based on the promising results of remdesivir, the most common side effects were nausea, worsening respiratory failure, increased alanine aminotransferase levels, and constipation. The aim of this study was to determine the incidence of elevated liver enzymes in patients with COVID-19 receiving remdesivir. Methods: In this retrospective study, information was collected from patients' files. The study population included patients with moderate to severe COVID-19 who were admitted to Rouhani Babol Hospital. For daily patient selection, the list of patients was extracted from the system, and based on the census, the patient file was selected. Data were analyzed using Stata 16. Results: 620 patients suffering from moderate to severe COVID-19 were included in this study, 43% of whom were men. Of these patients, 120 were selected as the control group who did not receive remdesivir. The increase in liver enzymes in patients receiving remdesivir compared with the control, for alanine transaminase (ALT) and aspartate transaminase (AST), respectively, was 6.20 and 3.64 times, but it was not statistically significant for alkaline phosphatase (ALP). Also, the increase in bilirubin levels in patients receiving remdesivir was not statistically significant. Conclusion: The recipients of remdesivir had high liver enzymes, which is one of the possible side effects of this drug. The intensity of the enzymes was mild and moderate, and they were not dangerous to the health of any of the consumers. Deaths in patients with COVID-19 were not due to drug-induced liver complications but to other factors such as disease-related complications. [ABSTRACT FROM AUTHOR]

Pomegranate is widely used to preserve human health and help prevent many kinds of diseases. This study aims to review and assess the effects of pomegranate on women's health during and after menopause. PubMed, Web of science, Cochrane, Scopus, and Google Scholar were searched up to the end of 2022 with no language or study type restriction. All types of clinical research studies (randomized clinical trial [RCT], pre–post, case report, and case series) were included. The Cochrane RoB 2.0 tool was used for quality assessment of RCTs. A summary of intervention's effects for each study was provided by calculating standardized mean differences and accompanying 95% confidence interval using random effect model. Weighted mean differences and heterogeneity between studies were assessed using Hedges's method and Cochran's Q test, respectively. Pomegranate can significantly improve hot flashes severity and menopause symptoms and decrease FSH. It significantly improves high‐density lipoprotein but not low‐density lipoprotein, body mass index, and weight. Most of our results are inconclusive, and the small sample sizes and the lack of blinding and randomization have led to an increased risk of bias. Pomegranate can decrease menopause symptoms, but more well‐designed studies, with bigger sample sizes are needed to establish its other clinical benefits for menopausal women. [ABSTRACT FROM AUTHOR]