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Purpose: We aimed to build a machine learning-based model to predict radiation-induced optic neuropathy in patients who had treated head and neck cancers with radiotherapy. Materials and methods: To measure radiation-induced optic neuropathy, the visual evoked potential values were obtained in both case and control groups and compared. Radiomics features were extracted from the area segmented which included the right and left optic nerves and chiasm. We integrated CT image features with dosimetric and clinical data subsequently, ranked 5 supervised ML models Bernoulli Naive Bayes, Decision Tree, Gradient Boosting Decision Trees, K-Nearest Neighbor, and Random Forest on 4 input datasets to predict radiation-induced visual complications classifiers by implementing 5-fold cross-validation. The F1 score, accuracy, sensitivity, specificity, and area under the ROC curve were compared to access prediction capability. Results: radiation-induced optic neuropathy affected 31 % of the patients. 856 radiomic characteristics were extracted and selected from each segmented area. Decision Tree and Random Forest with the highest AUC (97 % and 95 % respectively) among the five classifiers were the most powerful algorithms to predict radiation-induced optic neuropathy. Chiasm with higher sensitivity and precision was able to predict radiation-induced optic neuropathy better than right or left optic nerve or combination of all radiomic features. Conclusion: We found that combination of radiomic, dosimetric, and clinical factors can predict radiation-induced optic neuropathy after radiation treatment with high accuracy. To acquire more reliable results, it is recommended to conduct visual evoked potential tests before and after radiation therapy, with multiple follow-up courses and more patients.

ABSTRACT Mucosa‐associated lymphoid tissue lymphoma or MALToma occurs in 8% of B‐cell non‐Hodgkin lymphoma according to the latest WHO classification. The most involved site of MALToma is stomach. We describe a rare case of concurrent gastric and orbital mucosa‐associated lymphoid tissue lymphoma (MALToma) of a female who presented with progressive proptosis and abdominal pain. We performed six courses of chemotherapy (Rituximab) and gastric and orbital radiation with a dose of 34 Gy/20 Fr and 30 Gy/20 Fr, respectively. This case underscores the efficacy of a multimodal treatment strategy in achieving successful outcomes.

ABSTRACT Pure gallbladder squamous cell carcinoma is rare. Adenocarcinoma is the foremost malignant pathology of gallbladder cancer. Simultaneously, squamous cell carcinoma accounts for only 1% of malignant gallbladder tumors. They are often advanced at diagnosis and associated with a poor prognosis. The patient was a 37‐year‐old man diagnosed with poorly differentiated squamous cell carcinoma of the gallbladder. Cholecystectomy, right hemicolectomy, hepatic wedge resection, and regional lymph node dissection were performed, and then he received six courses of adjuvant chemotherapy with the FOLFOX regimen. After 2 months, liver metastasis was diagnosed, and a chemotherapy regimen consisting of gemcitabine, cisplatin, and pembrolizumab was started. After three courses, stable disease was seen. Surgery is the main treatment. There is no consensus about the best adjuvant treatment. The results obtained from this patient might help elucidate the role of adjuvant therapies in treating this rare case report.

Abstract Background Prostate cancer is the second most common cancer in men. Central nervous system (CNS) involvement in prostate cancer which manifests as cerebral, leptomeningeal, or dural involvement is uncommon and occurs late in the course of disease. Case A 60‐year‐old patient with castration resistant prostate cancer (CRPC) presented with headache and fatigue. Evaluation revealed bone marrow and leptomeningeal involvement. The patient treated by whole brain radiotherapy, leuprolide, weekly docetaxel and daily 1000 mg abiraterone. Complete blood count (CBC) and CNS symptoms improved and the patient is alive after 11 months with excellent performance status. Conclusion Leptomeningeal involvement in prostate cancer is rare and is associated with a poor prognosis but the possibility of such event should be considered in patients with new onset progressive CNS symptoms. New treatment strategies such as combination of docetaxel and abiraterone added to androgen deprivation therapy (triplet therapy) might improve outcome in these patients.

Abstract Background Primary cardiac myxofibrosarcoma is a rare and aggressive malignancy, with the majority of approaching strategies relying on case reports. This article provides insights into its diagnosis and treatment. Case Presentation This paper presents the case of a 40‐year‐old man with sudden onset hemoptysis, leading to the diagnosis of primary cardiac myxofibrosarcoma. Treatment involved open‐heart surgery to excise the left atrium tumor, followed by 6 cycles of adjuvant chemotherapy. Unfortunately, brain metastasis developed, leading to the patient's death 1 year after initial diagnosis. Conclusion Primary cardiac myxofibrosarcoma remains a clinical challenge with an unfavorable prognosis. Early diagnosis through advanced imaging is crucial, and research is needed to explore innovative treatments. This case underscores the complexities of managing this rare cardiac malignancy and highlights the necessity for ongoing investigations to enhance patient outcomes.

Abstract Background In patients with uterine adenosarcoma, a total abdominal hysterectomy (TAH) with bilateral salpingo‐oophorectomy (BSO) is typically recommended as an initial treatment. There is no consensus on adjuvant therapies. Case We report the case of a patient with uterine adenosarcoma with postoperative residual disease. We performed four courses of adjuvant chemotherapy, including Ifosfamide, Mesna, and Adriamycin, and whole pelvic radiation with a dose of 50.4 Gy/28 Fr. Conclusion A combination of chemotherapy and radiotherapy may be a promising treatment option for uterine adenosarcoma with postoperative residual disease.

Background: Coronavirus disease 2019 (COVID-19) emerged in December 2019 in China and exhibited as a highly contagious viral infection which led to a high level of mortality and morbidity. It is followed by a great deal of complications, such as serious psychological disorders. There are a few studies evaluating the psychological status of COVID-19 on the patients with cancer in Iran.Method: This was a cross-sectional study carried out on 94 patients with cancer who referred to Haft-e-Tir hospital for radiotherapy and chemotherapy from 20 April to 15 may, 2020. The data collection tool was the impact of events scale-revised (IES-R).Results: The prevalence of anxiety disorders and obsessive compulsive disorder based on past psychiatric history in the patients was 11.7% and 2.1%, respectively. The results revealed that age was significantly related to avoidance dimension score (B = -0. 209, 95% CI: -0.084 to - 0.335). Regarding hyper arousal dimension score, the results were as follows: rural residency (B = 5.091, 95% CI: 0.610 to 9.573), past psychiatric history (PPH) (B = 8.312, 95% CI: 4.314 to 12.310), and radiotherapy (B = -2.976, 95% CI: -5.878 to -0.074) had a statistically significant relationship with the hyper arousal dimension score.Conclusion: The patients with cancer had a severe form of COVID-19. Individuals with cancer who had a previous psychiatric history are more vulnerable to post-traumatic stress disorder symptoms after trauma.

Abstract In this report, we shared our experience in the treatment of a patient with unresectable sinonasal melanoma, in whom a complete radiographic response was seen after a course of conventional external beam radiotherapy. Given that local control has an important role in maintaining the quality of life of patients.

Transurethral lithotripsy (TUL) surgery, which is used to crush ureteral stones, can have complications, including bleeding, infection, ureteral stenosis, ureteral rupture, and ureteral avulsion. In this study, we present a 45-year-old woman who was referred, due to a right ureteral rupture during transurethral lithotripsy surgery. At first, the patient underwent ureteroneocystostomy surgery by a combination of boari flap and psoas hitch techniques. Due to the obstruction and necrosis at the anastomosis site, the patient underwent calicovesicostomy surgery.

Simultaneous herniation of the bladder and ureter into the scrotum is a rare condition. In this study, we present a 60-year-old man who has been suffering from pain and swelling in the right hemi-scrotum. The patient needed to squeeze his scrotum for urination and he had difficulty in emptying his bladder. Ultrasound and Computed Tomography(CT) was performed for the patient, which confirmed the diagnosis. The patient underwent herniorrhaphy and partial cystectomy. His urinary problems were completely eliminated with surgery.

Abstract Denosumab, a monoclonal antibody that specifically targets cytokine receptor activator of nuclear factor‐kappa B ligand (RANKL), is a potentially viable option in resistant aneurysmal bone cysts.

Background and Objective: Education is one of the most basic methods of prevention, treatment, and control of chronic diseases, including diabetes. Telephone follow-up plays an effective role not only in reducing costs but also in providing nursing care and patients’ self-efficacy. This study was conducted to investigate the effect of telenursing training and follow-up on the self-efficacy and quality of life of diabetic pregnant patients referred to the Fatemieh Hamadan Education-Treatment Center during the COVID-19 pandemic in 2022. Materials and Methods: In this clinical trial study, 83 mothers with diabetes were randomly divided into two control and intervention groups. The research tool was a 3-part questionnaire including a demographic/disease information form, Diabetes Management Self-Efficacy Scale, and quality of life of diabetic patients. Initially, in the first meeting, both groups completed the questionnaire. In the intervention group, an in-person training session was held first. Telephone follow-up with training was done immediately after discharge, twice a week in the first month and once a week in the second month in the intervention group. Then, at the end of the intervention, the questionnaire was completed again by both test and control groups. SPSS version 23 software was used for data analysis. Results: The average self-efficacy and quality of life in both groups did not show a statistically significant difference before the intervention. After providing training to the intervention group, the average self-efficacy and quality of life in one month and two months later improved significantly compared to the control group (P

Background Marital quality reflects the individual’s overall evaluation of marital relationship. The aim of study was examine the effect of cognitive behavioral counseling on marital quality among women. Materials and Methods The experimental study was a randomized clinical trial with two groups, on 198 qualified women who referred to selected health care centers in Hamadan, Iran in 2016. The intervention participants attended four 90-minute sessions of cognitive behavioral counseling. Demographic information questionnaire and marital qual- ity scale [Revised Dyadic Adjustment Scale (RDAS)] were completed by the two groups before and after the interven- tion. To perform the comparisons, t test, Chi-square test and Fisher’s test, Logistic Regression and covariance analysis were used. Covariance analysis or change analysis were employed. Statistical analysis was done using SPSS Software, version 21.0. The significance level was set at 5% (P < 0.05). Results According to the results of the present study, the mean age in the control group and the intervention group was 23.58 ± 7.54 and 35.04 ± 7.91 years old, respectively. Covariance analysis was utilized to examine the marital quality scores. In this analysis, after modification of the variables of age, marital quality score of agreement and sat- isfaction before the intervention, and income status, the total marital quality score experienced a significant change in all dimensions (P < 0.05) and the mean scores increased remarkably. Moreover, according to the cut-off point of the dimensions, the scores of all dimensions increased remarkably and the proportion of individuals with high marital quality before and after the intervention changed significantly (P < 0.05). Conclusion Due to the role of sexual relations in stabilizing marriage, cognitive behavioral consultation was effective in improving marital quality especially after agreement and can be used in health care centers in order to improve the relationship between couples and reduce divorce rates (Registration number: IRCT201610209014N125).

Introduction: Sexual dysfunction is one of the commonest causes of family breakdown. In recent years, various approaches have been proposed to resolve this conflict. Given the negative effects of sexual dysfunction on women and its complications, the present study was carried out in order to examine the effect of cognitive-behavioral consultation on sexual function among women who had referred to health centers in Hamadan. Method:The present study was a randomized clinical trial including two groups, a pretest, and a posttest. It focused on 198 qualified women who had referred to selected health centers of Hamadan in 2016. The intervention group received four 2-hour sessions of cognitive-behavioral group consultation. The required data were collected using a questionnaire of demographic characteristics and Female Sexual Function Index (FSFI). To analyze the collected data, SPSS 21.0 was employed; t-test was used for independent samples. ANCOVA was also utilized. Significance level was set at 0.05. Results: The results of the present study showed that the two groups were not significantly different in terms of mean pretest scores in all domain, except for sexual satisfaction and total sexual function .However, after cognitive-behavioral consultation sessions, the intervention group experienced a significant increase in all behavioral domains and total sexual function compared to the control group (p

Background: Fertility plays an important role in sexual and psychological function in families. Infertility can result in major emotional, social, and mental disorders, including a reduction in satisfaction with marital life and quality of life. The present study aimed to compare the quality of life and marital satisfaction and sexual satisfaction between fertile and infertile couples. Materials and Methods: This analytical cross-sectional study was conducted on 250 couples at the Fatemiyeh Educational Research Center affiliated to Hamadan University of Medical Sciences, Hamadan, Iran, from May to August in 2014. The subjects were randomly selected from the patients referred to this center using a table of random numbers. They were then allocated into two groups of infertile group (n=125) and fertile group (n=125). The study participants completed World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, Linda Berg’s Sexual Satisfaction Scale, and Enrich Marital Satisfaction Scale. Then, the data were entered into the SPSS version16 for statistical analysis. The Chi-square and Mann-Whitney tests were also applied to compare the data between the groups. Results: The results revealed no significant difference between the two groups regarding demographic and general health variables. The mean scores of sexual satisfaction were 63.67 ± 13.13 and 46.37 ± 7.72 in the fertile and infertile couples, respectively. Furthermore, the mean scores of marital satisfaction were also 44.03 ± 9.36 and 36.20 ± 4.03 in the fertile and infertile groups, respectively. Our finding demonstrated that the fertile couples obtained significantly higher mean scores of quality of life as well as lower mean scores of sexual satisfaction and marital satisfaction as compared to the infertile ones (P < 0.001). Conclusion: According to the results, the fertile couples obtained significantly higher quality of life and lower sexual satisfaction and marital satisfaction as compared to the infertile ones. Therefore, holding consultation programs and conducting more studies are necessary for improving the quality of life and promoting sexual and marital satisfaction in infertile couples.

Introduction: Sexual satisfaction is an important factor in the prevention of sexual dysfunction in women. It is an important factor in the healthy emotional and physiological aspects of sexual relationship. Aim: The aim of this study was to assess the effect of sexual counselling by cognitive behavioural approach on sexual satisfaction of women. Materials and Methods: This randomised clinical trial was conducted in two groups with pre-test and post-test on 198 women referred to selected health centres of Hamadan, 2016. The centres were randomised and taken as experimental and control group, three centres were selected as a control group and three as experimental group. The participants were selected by simple random sampling. The intervention group received four sessions (two hours) of group sexual counselling. Before and after the intervention, the demographic and sexual satisfaction questionnaires were completed. Results: After intervention, there were significant difference between two groups regarding sexual satisfaction (p