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Abstract Background Neurobrucellosis, a serious central nervous system infection caused by Brucella species, presents significant challenges due to its diverse clinical manifestations and the risk of long-term complications and poor outcomes. Identifying predictors of adverse outcomes is critical for improving patient management and overall prognosis. Objectives This study aimed to evaluate the long-term morbidity and mortality associated with neurobrucellosis and to identify key predictors of adverse outcomes. Methods We performed a retrospective cohort study of 106 neurobrucellosis patients treated at two major referral centers in Mashhad, Iran, from March 21, 2011, to March 20, 2022. We analyzed clinical, neuroimaging, and laboratory data, and estimated survival probabilities using Kaplan–Meier analysis. Long-term morbidity was evaluated using the Glasgow Outcome Scale. Results The median age of the cohort was 30 years (IQR: 21.8–46.3). The median length of hospital stay was 11 days (IQR: 7–19.8), with an in-hospital mortality rate of 4.7% (n = 5). Survival probabilities were 92.2% (SE = 0.027) at 1 month and 90.1% (SE = 0.030) at 6 months. The median follow-up duration was 52 months (IQR: 35–77). At follow-up, 23.5% (n = 20) of patients had an unfavorable outcome based on the Glasgow Outcome Scale. Predictors of mortality included older age, altered level of consciousness, seizures, elevated body temperature on admission, and white matter changes on neuroimaging. Conclusion Neurobrucellosis is associated with significant long-term morbidity and mortality. Key predictors of mortality include older age, altered level of consciousness, seizures, elevated body temperature on admission, and white matter changes. Identifying these predictors can help in targeting therapeutic strategies and improving patient outcomes through early intervention and close monitoring.

Abstract Background This study aimed to design and implement a gamified application about the theoretical aspects of laser applications in dentistry and investigate students' satisfaction with their learning experience. Methods An engaging educational program named Essential Skills and Knowledge in Learning Laser (ESKILLD) was developed to teach laser applications in dentistry. The program comprises two primary components: a “Tutorial and Quiz” section and a “Games” section. Final-year dental students were tasked with installing and using this application. A 29-item validated questionnaire (Cronbach's alpha = 0.97, ICC = 0.94) was used to evaluate students' perceptions of the applications' design and functionality. The influence of participants' gender and Grade Point Average (GPA) on their satisfaction levels was examined via the student t-test and Pearson's correlation, with a significance level of 0.05. Results The study had 56 participants, of which 37 were female (66.07%), and 19 were male (33.92%). The students' average GPA was 15.16 out of 20. The mean rating for ESKILLD's design and functionality was 1.39 ± 0.47 and 1.37 ± 0.46, respectively, signifying a high satisfaction level. Female students rated the application's coherence and learning perception significantly higher than their male counterparts (p

Background: COVID-19 is a highly infectious and contagious disease. Since the outbreak of COVID-19, most studies on children have focused on the incidence and prognosis of the disease, and few studies have investigated the epidemiological characteristics of the disease. Objectives: This study aimed to investigate some epidemiological aspects of the disease in children with COVID-19. Methods: We examined children with COVID-19 (under 18 years) hospitalized in the North East of Iran from the beginning of the outbreak until the end of September 2020. Study information was collected from patients’ medical records and interviews with their parents. We recorded demographic data; history of diseases and taking medicine in children; educational, occupational, and smoking status of parents; patients’ residence conditions; and any report of COVID-19 in patients’ families and relatives. Results: Of 107 children studied, 57% were male, and 52.3% had no underlying disease. The mean age of patients was 67 months. The Mean±SD weight of the children was 20.36±13.75 kg, and their Mean±SD length of hospital stay was 9±8 days. Multisystem inflammatory syndrome in children (MIS-C) was observed in 34.6% of patients, and its relationship with death was highly significant (P=0.001). The length of hospital stay was influenced by the history of medication consumption (P=0.013) and underlying disease (P=0.001), and its increase was associated with an increased risk of MIS-C (P=0.032) and death (P=0.047). Conclusions: Male sex, length of hospital stay, and MIS-C were identified as risk factors associated with worsening the outcome of COVID-19 disease in children.

Background: The inflammatory processes of brain contribute to the aetiopathogenesis of acute mania. Cyclooxygenase-2 (COX-2) inhibitors such as celecoxib reduce the production of pro-inflammatory cytokines. The purpose of the present study is to assess the efficacy of celecoxib in treating acute mania. Methods: A triple-blind and placebo-controlled trial was conducted for 58 patients who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for acute mania screening to participate in the trial used by the study. Twenty three patients were assigned to a study group and were given valprovate sodium 200 mg /BD as well as celecoxib 400 mg/day (200 mg BID). The control group included 22 patients who were administered with valprovate sodium 200 mg /BD and placebo. The patients were assessed by a psychiatrist at baseline 0, after 9, 18 and 28 days from starting to receive the medication .The data were analyzed using the Statistical Package for Social Sciences (SPSS )version 11.5,.the two-way repeated measure analysis of the variance, the Fisher's exact test, and the t-test .P≤0.05 was considered to be statistically significant. Results: A total of 58 patients were screened, and 45 patients were randomized. Most of the participants in celecoxib group were male (55%), and most of them in the placebo group were female (75%). There were no statistically significant differences among the groups regarding the number of episodes, gender, marital status, the past medical history and the family history (P value ≥0.05). A significant difference was observed in the change of the scores on the Young mania rating scale (YMRS) at week 4, compared with the baseline in the groups of patients (P value= 0.04). Conclusion: The results of the current study suggested that celecoxib can be an effective adjuvant agent in managing patients with acute mania and that anti-inflammatory therapies should be further investigated in treating patients. [ABSTRACT FROM AUTHOR]