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Background: Evaluations have shown that the severity of pulmonary involvement is very important in the mortality rate of patients with coronavirus disease 2019 (COVID-19). The purpose of this study was to evaluate the value of chest CT severity score in assessment of COVID-19 severity and short-term prognosis. Materials and Methods: This study was a cross-sectional study with a sample size of 197 patients, including all patients admitted to Rasoul Akram Hospital, with positive polymerase chain reaction, to investigate the relationship between computed tomography (CT) severity score and mortality. The demographic data and CT scan findings (including the pattern, side, and distribution of involvement), co-morbidities, and lab data were collected. Finally, gathered data were analyzed by SPSS-26. Results: 119 (60.4%) patients were male, and 78 (39.6%) were female. The mean age was 58.58 ± 17.3 years. Totally, 61 patients died; of those, 41 (67.2%) were admitted to the intensive care unit (ICU), so there was a significant relation between death and ICU admission (P value = 0.000). Diabetes was the most common co-morbidity, followed by hypertension and IHD. There was no significant relation between co-morbidities and death (P value = 0.13). The most common patterns of CTs were interlobular septal thickening and ground glass opacities, and a higher CT severity score was in the second week from the onset of symptoms, which was associated with more mortality (P value < 0.05). Conclusion: Our study showed that a patient with a higher CT severity score of the second week had a higher risk of mortality. Also, association of the CT severity score, laboratory data, and symptoms could be applicable in predicting the patient’s condition.

Purpose: The rapid spread of the COVID-19 omicron variant virus has resulted in an overload of hospitals around the globe. As a result, many patients are deprived of hospital facilities, increasing mortality rates. Therefore, mortality rates can be reduced by efficiently assigning facilities to higher-risk patients. Therefore, it is crucial to estimate patients' survival probability based on their conditions at the time of admission so that the minimum required facilities can be provided, allowing more opportunities to be available for those who need them. Although radiologic findings in chest computerized tomography scans show various patterns, considering the individual risk factors and other underlying diseases, it is difficult to predict patient prognosis through routine clinical or statistical analysis.Method: In this study, a deep neural network model is proposed for predicting survival based on simple clinical features, blood tests, axial computerized tomography scan images of lungs, and the patients' planned treatment. The model's architecture combines a Convolutional Neural Network and a Long Short Term Memory network. The model was trained using 390 survivors and 108 deceased patients from the Rasoul Akram Hospital and evaluated 109 surviving and 36 deceased patients infected by the omicron variant.Results: The proposed model reached an accuracy of 87.5% on the test data, indicating survival prediction possibility. The accuracy was significantly higher than the accuracy achieved by classical machine learning methods without considering computerized tomography scan images (p-value

Background: During the coronavirus disease 2019 (COVID-19) pandemic, Iran reported its first confirmed cases of syndrome coronavirus 2 (SARS-CoV-2) infections on 19 February 2020 in Qom. Although the numbers of cases are increasing, no report about clinical manifestations, laboratory results, and imaging findings of the children infected with COVID-19 in Iran has been published. The aim of this study was to evaluate the epidemiological, clinical, and radiological and laboratory findings of 24 children who had proven SARS-CoV-2 infection and performed chest computed tomographic (CT) in Qom, Iran. Methods: Demographic information and clinical characteristics of the patients including signs and symptoms, chest CT scan manifestation, laboratory findings and clinical outcomes were collected. Diagnosing of the confirmed case was based on positive real-time reverse-transcriptase-polymerase-chain-reaction test for SARS-CoV-2. Findings: During the first 3 months of the epidemic in Qom, Iran, 24 children with confirmed diagnosis of COVID-19 were included. The median age of the cases was 6 years [inter-quartile range 3.5–9.5 years]. The most common presenting symptoms were fever (100%), dry cough (62.5%), tachypnea (29%), abdominal pain (21%), and vomiting (21%). Three cases (12.5%) presented with a history of diarrhea in addition to fever and cough. According to the chest CT findings, 2 cases (8%) showed no abnormality. Typical CT findings were found in 6 patients (25%), 2 patients showed indeterminate appearance, and 14 patients (58%) showed atypical findings. Two children with SARS-CoV-2 infection manifested as a hyperinflammatory syndrome with multi-organ involvement similar to Kawasaki disease shock syndrome. Seventy-one percent of the patients showed severe SARS-CoV-2 infection and the mortality of 12.5% (3 cases) were reported. Interpretation: High frequency of atypical chest CT finding in children should raise concern for pediatricians. Early recognition of patients with SARS-CoV-2 infection is of crucial importance in controlling of the outbreak and atypical imaging features should be interpreted with caution.

The aim of this study was to investigate the magnetic resonance imaging (MRI) findings for the diagnose uremic encephalopathy and describe the usefulness of MRI findings in the ultimate diagnosis of uremic encephalopathy (UE). A total of 20 patients with uremic encephalopathy admitted to the hospital were evaluated in this prospective study. The clinical manifestations, laboratory and MRI imaging findings, demographic information, and clinical outcome were analyzed for each patient. We observed that the 20 prospectively reviewed patients with UE had no involvement of the basal ganglia or the lentiform fork sign (LFS). However, two-thirds of the patients had white matter involvement, and 80% of the subjects had cerebral or cortical atrophy. The arterial blood gas (ABG) analysis revealed that 50% of the patients suffered from metabolic acidosis (n=10). The results of the present study demonstrated that although the observation of Lentiform Fork Sign and Basal Ganglia involvement in MRI of UE patients is a specific finding the absence of which does not rule out UE. Thus, simultaneous examination of clinical manifestation and laboratory test analyses, along with imaging findings, should also be taken into account.

The outbreak of coronavirus disease 2019 (COVID-19) in late 2019 rapidly turned into a global pandemic. Although the symptoms of COVID-19 are mainly respiratory ones, the infection is associated with a wide range of clinical signs and symptoms. The main imaging modality in COVID-19 is lung computed tomography (CT) scanning, but the diagnosis of the vast spectrum of complications needs the application of various imaging modalities. Owing to the novelty of the disease and its presentations, its complications—particularly uncommon ones—can be easily missed. In this study, we describe some uncommon presentations of COVID-19 diagnosed by various imaging modalities. The first case presented herein was a man with respiratory distress, who transpired to suffer from pneumothorax and pneumomediastinum in addition to the usual pneumonia of COVID-19. The second patient was a hospitalized COVID-19 case, whose clinical condition suddenly deteriorated with the development of abdominal symptoms diagnosed as mesenteric ischemia by abdominal CT angiography. The third patient was a case of cardiac involvement in the COVID-19 course, detected as myocarditis by cardiac magnetic resonance imaging (MRI). The fourth and fifth cases were COVID-19-associated encephalitis whose diagnoses were established by brain MRI. COVID-19 is a multisystem disorder with a wide range of complications such as pneumothorax, pneumomediastinum, mesenteric ischemia, myocarditis, and encephalitis. Prompt diagnosis with appropriate imaging modalities can lead to adequate treatment and better survival.

Background. Tilted implants have been recommended as an alternative to the bone graft procedures in implant sites although with possibly higher stress concentrations. This study reviews finite element studies to evaluate patterns of stress and strain in complete-arch prostheses supported by 4‒6 implants. Methods. A literature search was performed using the online databases. Articles published in English from 2003 to 2015 were reviewed. A total of 100 articles were found related to the subject and after evaluating the titles and abstracts, 18 studies were selected. Results. By increasing the number of implants, a reduction was detected in the amount of stress in the bone and implants, while in others, the stress level did not change with the increase in the number of implants. Conclusion. According to finite element analyses, placing a distal implant in an angular position results in better distribution of forces and stresses. Using less cantilever lengths would reduce the stress.

The aim of this study was to recognize the identity and frequency of etiologic agents of the pertussis-like syndrome in children < 2 years of age. A cross-sectional hospital-based study conducted from August 2014 to August 2015. All children < 2 years of age (n=100) who were suspected as pertussis infected were enrolled in this study and tested for Bordetella pertussis, adenovirus (Adv), respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and influenza virus A (INF-A) by real-time PCR technique. RSV was the most detected pathogen (20%), followed by B. pertussis (18%), Adv (16%), INF-A (11%), and hMPV (10%). Co-infection was observed in 8 patients (11%) and the combinations of RSV/INF-A (n=3, 4%), and AdV/B. pertussis (n=3, 4%) were more frequent. RSV, B. pertussis, and hMPV were more frequent pathogens among infants < 4 months of age. However, Adv and INF-A were more frequent pathogens among children > 6 months of age. In this study, RSV was the most frequent identified pathogen (n=20, 20%), followed by B. pertussis (n=18, 18%) and AdV (n=16, 16%). Pertussis was more frequent in spring (8%) and summer (6%). In addition, clinical symptoms of pertussis were the same as some viral pathogens, which can lead to misdiagnosis of infection. Therefore, diagnosis of pertussis should be established on the bases of both the clinical symptoms and the laboratory methods.

It is known that liver biopsy is the gold standard of diagnosing liver iron deposition. By considering liver biopsy complication and cost, introducing a method to restrict unnecessary biopsy or even an alternative for liver biopsy can be useful. This study examined the relationship between serum iron profile and liver density on CT-Scan without contrast material injection. In this study, 76 patients were referred from different Rasoul-Akram Hospital parts in 2015-2016 (People who have undergone abdominal CT-scan for any reason, and blood tests included iron and lipid profiles). To calculate the liver mean density of a CT-scan, densities of 12 sites with an individual area of 1 cm2 on 3 different sections of the liver were obtained, and their average was recorded. Data were analyzed by SPSS V.16 using Kolmogorov-Smirnov, independent T-test, and two-sample T-tests with a significance level of P

Abstract Smartphone addiction is a public health problem and is increasing globally. It is important to know the latest status of this phenomenon in different region of the world. This study aimed to investigate smartphone addiction in an Iranian student population. The participants were a random sample of Shahroud Schoolchildren Eye Cohort study in 2018. Smartphone addiction was measured by the Smartphone Addiction Scale Short Version (SAS-sv) questionnaire. The prevalence and mean estimates were reported with 95% confidence intervals. The analysis of variance, t-test and multiple logistic regression were used for analysis of data. The mean age of 2682 participating students was 13.5 year with an age range of 10 to 15 year, and 1197 (44.6%) of them were girls. The mean SAS-sv score was 27.96 (95% CI: 27.36–28.58) for boys and 26.10 (95% CI: 25.34–26.80) for girls. This score follows a U-shaped pattern with a lower mean score observed at age 8. The Prevalence of smartphone addiction was 29.8% (95% CI: 28.1–31.5) in studied population. Compared to 10 year old students, smartphone addiction was higher in 14 (Odds Ratio (OR) = 1.7, 95% CI: 1.1–2.7) and 15 (OR = 2.4, 95% CI: 1.5–3.8) years old students. Smartphone addiction was higher in boys (OR = 1.9; 95% CI, 1.5–3.0; P value

Providing public services continuously and without interruption is one of the most important forms of citizenship rights. Among these services, there is the provision of instrument and property registration services that should never be delayed. Sometimes the notary does not find the possibility to be serve the office. In these cases, the institution of an alternative of a notary has been established. Here, the question that arises is what is the proper legal structure of the institution of an alternative of a notary public? as a hypothesis, it should be said that identifying the necessary independence on the one hand, and drawing a clear competence is appropriate to the position of holding the registration services on the other hand, are the most important aspects of the legal structure that oversees the institution of an alternative of a notary public. our research show that the of Iran legal order, by a classic view of the notary system, insist on the implementation of the individual-based of a notary system by creating an inchoate overlap between the notary and its alternatives along with the lack of necessary independence, take an improper policy to meet the needs of citizens relate to registration services. On the other hand, the france legal order has established a right strategy of providing registration services to the society by identifying the cooperative notary system and creating a complete overlap in the jurisdiction of the notary and his alternative.

Background: Prenatal and postnatal depression (PND) is associated with adverse outcomes for mother, fetus, andchild. 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-partumwomen (18-48 years) that was registered in the Babol Pregnancy Mental Health Registry (BPMHR) database from June2020 to March 2021. Two questionnaires, including demographics and depression, were analyzed in this study. Also, theEdinburg Postnatal Depression Scale (EPDS) was used to assess the depressive symptoms. Independent t test and theanalysis of variance were used to compare the means. Multiple logistic regressions were used to determine risk factors fordepressive symptoms.Results: According to the EPDS scale, the prevalence of depressive symptoms was 19.8% in the pregnant womangroup 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-riskpregnancy (high-risk vs. low-risk pregnancy, ß=1.457, P=0.003). For postnatal depressive symptoms, none of the factorswere a significant risk.Conclusion: Prenatal and postnatal depressive symptoms should be screened, particularly for women in the first andsecond trimesters, with high parity, and those with a high-risk pregnancy, as recommended by the present study.

ABSTRACT Introduction With the spread of COVID‐19, certain population groups, including pregnant women, were more susceptible than others. This disease can lead to postpartum complications, including mental disorders, in mothers. Few studies have investigated the impact of mindfulness‐based interventions on mental health, and the most effective counseling approach to promote mental health has not been identified. Objective This study aimed to determine the impact of online mindfulness‐based counseling on improving mental health among women with a history of COVID‐19 during pregnancy in Iran. Methods The present study was a quasi‐experimental design conducted on 100 women with a history of coronavirus infection during pregnancy referred to the Mother's Clinic of Yahya Nejad and Ayatollah Rouhani Educational‐Treatment Hospital, affiliated with Babol University of Medical Sciences, Iran, via convenience sampling. The women were randomly assigned to the intervention (mindfulness‐based counseling) and control groups. The intervention group received eight 45‐min weekly mindfulness‐based counseling sessions over 8 weeks. Data were collected via a demographic information questionnaire and the Goldberg General Health Questionnaire before and after the intervention, which were completed by both groups. Independent t‐tests and analysis of covariances (ANCOVAs) were used to compare the outcomes of the two groups. Results After controlling for confounding variables, the mean mental health scores before and after counseling were 29.42 ± 4.49 and 19.80 ± 3.88, respectively, in the intervention group and 26.26 ± 2.29 and 25.92 ± 2.15, respectively, in the control group. The mean mental health score in the intervention group was significantly lower than that in the control group (F = 266.7, p

Background and Objective: Three-Stage Theory explains development of suicidal ideation and suicidal attempt. According to Three-Stage Theory, high levels of pain and high levels of hopelessness lead to suicidal ideation. Belongingness plays a protective role against suicidal ideation and individual's suicide capacity predicts suicidal attempt. The purpose of this research was to investigate the relationship between pain, hopelessness, belongingness with suicidal ideation and attempt. Materials and Methods: In this cross-sectional study, 224 patients hospitalized in psychiatric department of Shahid Yahya Nejad Hospital with suicidal ideation were selected through convenience sampling between March to August 2021. All participants completed suicidal attempt question of Self-Injurious Thoughts and Behaviors Interview, Beck Scale for Suicide Ideation, Scale of Psychache, Beck Hopelessness Scale, Interpersonal Need Questionnaire and Suicidal Capacity Scale-3. Pearson's correlation, t-tests, hierarchical regression, analysis of variance and logistic regression were used to analyze the data and data were analyzed using SPSS software version 27. Results: There was a significant interactive effect between pain and hopelessness in predicting suicidal ideation (P< 0.01, t = 5.01). Additionally, belongingness and burdensomeness had significant interactive effects in predicting suicidal ideation (P< 0.01, t = 2.16). Pain and hopelessness accounted for 63.6% of the variance of suicidal ideation, while belongingness and burdensomeness explained 49.8% of variance in suicidal ideation. According to logistic regression, psychological pain (P

Introduction:The Seljuk era, was a prosperous time in case of dealing with art; during this time art reached to higher level, as numerous and diverse artworks with cosmological concepts were created, which represents the significance of cosmology in this time. The artists in this era, by considering the position of astronomy and cosmological issues, frequently reflected the relevant concepts and contents as practical decorations and motifs in their works. This study aims to comprehend the concepts of cosmological motifs to target the mutual influence of Seljuk artists on each other while designing these patterns; Therefore, the manner these artists influence each other in designing the planet motifs and their meanings has been addressed in two artworks related to Seljuk era; in this regard, the following questions arises: Which kind of hypertextuality is more likely to be influenced by the design of the target motifs of the planets? And what changes have been made in these motifs while influencing each other? The research aims to understand the manner the design of planets' motifs influence each other and the alterations in the two target works by focusing on the hypertextuality theory of Gerard Genette.Research Method: A descriptive-analytical method has been adopted and the data was collected by using library sources; The results were analyzed relying on a qualitative method.Findings: According to the research findings, the cosmological motifs that appeared in the Seljuk manuscripts are rather compatible with other built-in arts, in the case of decoration, besides considering the cosmological criteria; however, some changes have been made according to the artist's priorities. The artists in the Seljuk era were completely aware of the art developments of their own time and also the previous eras, as they tried their best to improve the art of their time by benefiting from the experiences of other artists.Conclusion: the research finding showed that the planet motifs in «Ajaib al-Makhluqat» (hypertext) which is inspired by the planet motifs in the enamel bowl (pre-text or hypotext) have a transposition or transformation with serious function according to the hypertextuality of Genette. The created transformation in hypertext includes a variety of changes (gender, form, composition, and color). The miniature painter of «Ajaib-ul-Makhluqat» has not simply adopted an imitation attitude in creating a new and independent hypertext, as it has been designed differently.

Muscle fatigue is considered to be one cause of shoulder pain, and subjects with generalized joint hypermobility (GJH) are affected more by shoulder pain. The purpose of this study was to examine the effects of muscle fatigue on acromiohumeral distance (AHD) and scapular dyskinesis in women with GJH. Thirty-six asymptomatic participants were assigned to either a GJH (n = 20) or control group (n = 16) using the Beighton scale. Before and after elevation fatigue trials, AHD was measured with ultrasonography at rest and when the arm was in 90° active elevation. A scapular dyskinesis test was used to visually observe alterations in scapular movement. Our results showed that in both groups, the fatigue reduced AHD in the 90° elevation position and increased the presence of scapular dyskinesis; however, no differences were found between the two groups. Although GJH has been identified as a factor for developing musculoskeletal disorders, generalized joint hypermobility did not result in changes to scapular dyskinesis or AHD, even after an elevation fatigue task. More studies are needed to evaluate the effects of muscle fatigue in subjects with GJH and a history of shoulder instability. [ABSTRACT FROM AUTHOR]

Abstract Background Psychological distress (PD) is a significant issue during pregnancy and postpartum, adversely affecting both children and mothers. This study aims to determine PD's prevalence and risk factors in a large Iranian population sample during pregnancy and postpartum. Methods A cross-sectional study was conducted using data from the Babol Pregnancy Mental Health Registry (located in the north of Iran) between June 2020 and March 2021. A total of 2305 women were included, with 1639 during pregnancy and 666 during postpartum. Psychological distress was assessed using the Brief Symptoms Inventory (BSI-18), and data were analyzed using independent t-tests and multiple logistic regressions. Results The prevalence of psychological distress, defined by a cut-off score of BSI ≥ 13, was 19% during pregnancy and 15% during postpartum. Multivariate logistic analysis revealed that high-risk pregnancy was the leading risk factor for psychological distress during the antenatal period (β = 1.776, P

Abstract Background Previous studies have demonstrated that excessive gestational weight gain (GWG) increases the risk of gestational diabetes mellitus (GDM). This study aimed to determine the effect of using health coaching on the prevention of GDM in overweight pregnant women. Methods In this quasi-experimental study, 64 eligible overweight women at 12–14 gestational weeks were randomly divided into 2 groups: the coaching group and the control group (usual care group). The intervention group received 8 weeks of the phone coaching program, which integrated GWG and physical activity to reduce the incidence of GDM. The Pregnancy Physical Activity Questionnaire (PPAQ) was used to assess physical activity during pregnancy. The occurrence of gestational diabetes was determined based on the 75-g 2-hour oral glucose tolerance test (OGTT) at 24–28 weeks of gestation. The primary outcome was the incidence of GDM, and the secondary outcomes included physical activity, GWG, and neonatal and maternal birth outcomes. Results The incidence of GDM in the control and intervention groups was 24.1% and 22.6%, respectively. The relative risk (RR) was 0.93 (95% CI, 0.37–2.34; P = 0.887). The post survey results indicated that GWG decreased more considerably in the coaching than in the control group between pre-trial (T0) and post-trial (T1), (MD; -2.49 with 95% CI, -4.38 to -0.60; P

We investigate a class of three parameter metrics that contain both the γ-metric and Janis-Newman-Winicour (JNW) metric at special values of the parameters. To see the effect of the scalar field we derive some properties of this class of metrics such as curvature invariants, the effective potential, and epicyclic frequencies. We also introduce the five and higher dimensional forms of the class of metrics in the presence of a scalar field.

Abstract Background and Aims Pregnancy is a stressful experience, which can affect different aspects of a woman's life. Yet, women with a supportive network of friends and family may experience lower stress and improved self‐care behavior. The study aimed to investigate the relationship between perceived stress and pregnancy distress with the self‐care of pregnant women, as well as the mediating role of social support. Methods This cross‐sectional study was conducted from February to May 2022 in Babol, Iran. A total of 157 pregnant women participated in the study. The participants completed five questionnaires, including a demographic and obstetric questionnaire, a Self‐care questionnaire, Perceived Social support (PSS), Perceived Stress Inventory (PSI), and Pregnancy Specific Distress. Structural equation modeling was used to test the hypothesis relationships among the variables. Results We found that Perceived stress (β = −0.221, p = 0.012β) and pregnancy distress (β = −0.203, p = 0.002β) had a negative and significant effect on the self‐care of pregnant women. Also, perceived stress (β = −0.429, p

BACKGROUND: Body image concerns are accepted as a pervasive problem by a large segment of society. Problem-solving counseling is one of the practical counseling techniques that mainly focuses on improving people’s adaptability in stressful situations. We intend to determine the effectiveness of pubertal health group counseling based on problem-solving on body image concerns and anxiety in adolescent girls. MATERIALS AND METHODS: A semi-experimental study will be conducted on 12–13 years old students in Babol (Mazandaran, Iran). One hundred people were determined as the final Sample size (50 people in each group) and will be selected to enter the study. A multistage sampling method will be used. The students of the intervention group will receive the necessary training in the problem-solving method regarding pubertal health, once a week for six weeks. Students in the control group will not receive education during the intervention period. Sociodemographic questionnaire, Littleton’s body image concern, and Zong’s anxiety will be used to evaluate students’ body image concerns and anxiety. Analyzes will be done by statistical package for the social sciences (SPSS) version 25 software and a significance level of 5% will be considered. Descriptive statistics and frequency percentage will be determined for classification variables. Median, range, and mean along with standard deviations (SD) will be calculated. The Chi-square test, Repeated Measures ANOVA and ANCOVA test will be used in this study. Percentage prevalence for each categorical variable is calculated with 95% confidence interval (CI). DISCUSSION: The effectiveness of counseling based on problem-solving has been reported in various studies on adolescent puberty health concerns and common adolescent mental health problems, hence its application on girls’ body image can be effective.

Objectives: To investigate the prevalence of psychiatric symptoms/distress and posttraumatic stress (PTS) and associated factors among inpatients with COVID-19 before discharge from the hospital. Methods: This cross-sectional study was conducted in two teaching referral hospitals in Babol, Iran from July to November 2020. The subjects were inpatients diagnosed with COVID-19 who were clinically stable. Before their discharge from the hospital, the patients completed three questionnaires: demographic data, Brief Symptom Inventory, and Primary Care Post Traumatic Stress Disorder Screen for Diagnostic and Statistical Manual-5. Results: The subjects were 477 inpatients diagnosed with COVID-19 including 40 (8.4%) admitted to intensive care units. Their average age was 60.5±17.9 years; 53.9% were female. Most had symptoms of significant psychological distress (96.0%) and PTS (8.1%) prior to discharge. A higher level of education (-0.18; standard error (SE) = 0.05; p < 0.001) was a negative predictor of psychiatric distress. The admission to intensive care units (0.86; SE = 0.08; p< 0.001) was a positive predictor of psychiatric distress. Conclusions: Most COVID-19 inpatients suffered significant psychiatric distress and PTS symptoms before discharge. Appropriate mental health crisis interventions are recommended for COVID-19 patients during hospitalization.

Background. Tilted implants have been recommended as an alternative to the bone graft procedures in implant sites although with possibly higher stress concentrations. This study reviews finite element studies to evaluate patterns of stress and strain in complete-arch prostheses supported by 4-6 implants. Methods. A literature search was performed using the online databases. Articles published in English from 2003 to 2015 were reviewed. A total of 100 articles were found related to the subject and after evaluating the titles and abstracts, 18 studies were selected. Results. By increasing the number of implants, a reduction was detected in the amount of stress in the bone and implants, while in others, the stress level did not change with the increase in the number of implants. Conclusion. According to finite element analyses, placing a distal implant in an angular position results in better distribution of forces and stresses. Using less cantilever lengths would reduce the stress. [ABSTRACT FROM AUTHOR]

Abstract Background Chronic hepatitis C (CHC) is one of the most important comorbidities in patients with hereditary bleeding disorders (HBD). The present study aimed at evaluating the effectiveness of direct-acting antiviral agent (DAA)-based interferon-free HCV antiviral regimens in patients with HBD. Patients and methods The present study was performed on the patients with HBD and CHC between 2015 and 2019. Sofosbuvir-based interferon-free regimens with or without ribavirin were prescribed to treat HCV infection. The main endpoint of the study was to determine the sustained virologic response (SVR), assessed 12 weeks after the completion of treatment. Results A total of 147 patients with a mean age of 41.1 years were enrolled in the study; 4.1% of them were co-infected with HIV, 25.2% had cirrhosis, and 76.9% of them were diagnosed with hemophilia A. HCV genotype-1 includes the largest number (68.1%) of patients. 46.3% of patients were treatment-naïve and others had a treatment history with interferon-based regimens. Out of 147 patients, 15 patients were lost to follow-up during treatment or for SVR evaluation or discontinued treatment. 132 subjects completed treatment and were evaluated for SVR, 12 weeks after the completion of treatment. All of the patients achieved SVR 12 (SVR rate: 100%, 95% CI 97.2–100%). Conclusion Hepatitis C DAA-based regimens are the effective treatments for CHC in patients with HBD, regardless of the treatment modifiers such as previous treatment experience, cirrhosis, HIV co-infection, and HCV genotype.

A 48-year-old man was found to have elevated liver enzymes and clinical manifestations of icter, itching, nausea, and vomiting. He had developed a severe hepatotoxic reaction, liver fibrosis, and cirrhosis after treatment with acitretin 25 mg daily (oral retinoid, which is the derivative of etretinate). Elevated serum aminotransferase levels, which are usually reversible, have been reported during treatment with acitretin, however; the present study indicates a warning message that severe hepatotoxic injury may follow such a treatment. [ABSTRACT FROM AUTHOR]

Background and purpose: Multinodular goiter is a benign enlargement of thyroid gland and papillary thyroid carcinoma is the most common type of thyroid cancer. Today, immunohistochemical markers can be used in diagnosis and prognosis of tumors. The aim of this study was to compare the expression of CD117 in multinodular goiter and papillary thyroid carcinoma and its association with prognostic factors. Materials and methods: In this cross-sectional study, samples of thyroid tissue from 60 multinodular goiter and 60 papillary thyroid carcinoma cases who underwent thyroidectomy in Tehran Mostafa Khomeini Hospital during 2011-18, were evaluated for CD117 expression via immunohistochemistry. The expression intensity was scored 0-3. Results: CD117 was expressed in all samples with generally lower expression scores in malignant samples: 95% and 5% of malignant cases showed scores 1 and 2, respectively. Almost 52% and 48% of benign cases showed score 1 and scores 2 and 3, respectively (P