Search

Abstract Relapsing polychondritis (RP) is a systemic immune mediated disease characterized by recurrent episodes of inflammation in various cartilage-rich areas. RP may cause extensive tissue destruction and is associated with significant morbidity and mortality. In this multicenter study, we considered the remission status and long-term outcomes of RP in patients who were followed-up in six referral rheumatology centers in Iran. Outcomes of disease was assessed by remission status and RP induced damage. A total of 29 patients with RP were examined for enrollment in the study, and 26 patients with a minimum follow-up period of 6 months were included in the RP outcome analysis. Median time to control of symptoms and sustained remission were 5 and 23 weeks, respectively. Prednisolone was discontinued in 8 (30.8%) patients and medication-free remission was achieved in 7 (23.1%) patients. Regarding the disease course, 34.6% of patients had a relapsing–remitting course, 42.3% had a monophasic course, and 23.1% had an always-active course. Despite extensive treatment with immunosuppressive medications, RP induced damage was developed in 21 (80.8%) patients. Ear deformity and osteoporosis were the most common RP induced damage. Long-term remission and medications-free remission in RP is accessible. However, RP related damage occur in majority of patients.

This study examined the comparative effect of recasts and prompts on EFL learners' pronunciation accuracy of consonants and vowels. Eighty-nine elementary EFL learners were selected among 117 through their performance on a piloted sample KET and were randomly assigned into two experimental groups (recast, prompt), and a control group. A piloted researcher-made pronunciation pre-treatment test was administered to the three groups to measure their pronunciation accuracy before the treatment. The three groups underwent the same amount of teaching time and received the same material. The participants in the recast group received recast and those in the prompt group received prompt. However, the participants in the control group received no specific type of corrective feedback. At the end of the treatment, the participants took a pronunciation post-test parallel with the pre-treatment test. An Analysis of Covariance (ANCOVA) was run. The results indicated that both recast and prompt had a significantly positive effect on EFL learners' pronunciation accuracy of consonants and vowels. Moreover, the results showed that there was no significant difference between the effect of recast and prompt on EFL learners' pronunciation accuracy of consonants and vowels.

Abstract This study assessed the association between atherosclerosis indices, serum uric acid to high‐density lipoprotein cholesterol ratio (UHR) and triglyceride‐glucose (TyG) index and the prevalence of hypertension among MASHAD cohort participants. In this cross‐sectional study, the participants were divided into hypertensive and non‐hypertensive subjects. The atherosclerosis indices, UHR and TyG index of the two groups were compared. Logistic regression analyses were used to determine the associations of these indices with hypertension in both sex. Receiver operating characteristic (ROC) curve analysis was used to establish the cut‐off values for differentiating hypertensive from non‐hypertensive subjects. p‐values

Abstract High systolic blood pressure (HSBP) is associated with several metabolic and non-metabolic disorders. This research aimed to document the deaths and disability-adjusted life-years (DALYs) attributable to HSBP in the Middle East and North Africa (MENA) region between 1990 and 2019, by age, sex, underlying cause and socio-demographic index (SDI). We used the methodological framework and data drawn from the Global Burden of Disease study 2019 to identify the burden of diseases attributable to HSBP, from 1990 to 2019, in the MENA region. The estimates reported were presented as counts, population-attributable fractions, and age-standardised rates (per 100,000), along with 95% uncertainty intervals. In 2019, 803.6 thousand (687.1 to 923.8) deaths were attributed to HSBP in MENA, which accounted for 25.9% (22.9–28.6%) of all deaths. The number of regional DALYs caused by HSBP in 2019 was 19.0 million (16.3–21.9 million), which accounted for 11.6% (10.1–13.3%) of all DALYs, and was 23.4% (15.9–31.5%) lower than in 1990. The highest age-standardised DALY rate for 2019 was observed in Afghanistan, with the lowest in Kuwait. Additionally, the DALY rate in MENA rose with age for both sexs. Furthermore, a negative linear relationship was found between SDI and the age-standardised DALY rates. The region has a substantial HSBP-related burden. Policymakers and healthcare professionals should prioritize interventions that effectively promote the early detection of HSBP, access to quality healthcare, and lifestyle modifications to mitigate the HSBP burden in the MENA countries.

Abstract Kidney cancer, a type of urogenital cancer, imposes a high burden on patients. Despite this, no recent research has evaluated the burden of this type of cancer in the Middle East and North Africa (MENA) region. This study explored the burden of kidney cancer from 1990 to 2019 according to age, sex and socio-demographic index (SDI). The Global Burden of Disease (GBD) 2019 data was utilized to estimate the incidence, death, and disability-adjusted life-years (DALYs) caused by kidney cancer. These estimates were reported as counts and as age-standardised rates with 95% uncertainty intervals (UIs). The estimated age-standardised incidence, mortality, and DALY rates of kidney cancer in 2019 were 3.2 (2.8–3.6), 1.4 (1.2–1.6), and 37.2 (32.0–42.6) per 100,000, respectively. Over the period from 1990 to 2019, these rates have increased by 98.0%, 48.9%, and 37.7%, respectively. In 2019, the United Arab Emirates, Qatar, and Lebanon had the largest age-standardised incidence, mortality, and DALY rates. The smallest age-standardised incidence rates were seen in Yemen, Afghanistan, and the Syrian Arab Republic. Additionally, the smallest age-standardised mortality and DALY rates were observed in the Syrian Arab Republic, Yemen, and Morocco. The highest incidence rates were found among individuals aged 75–79 in both males and females. In 2019, the MENA/Global DALY ratio exceeded one for females aged 5–19 age and males aged 5–14, compared to 1990age groups in males. The burden of kidney cancer consistently rose with increasing SDI levels from 1990 to 2019. The increasing burden of kidney cancer highlights the urgent need for interventions aimed at improving early diagnosis and treatment in the region.

Abstract The intersection of nanotechnology and pharmacology has revolutionized the delivery and efficacy of chemotherapeutic agents, notably docetaxel, a key drug in cancer treatment. Traditionally limited by poor solubility and significant side effects, docetaxel’s therapeutic potential has been significantly enhanced through its incorporation into nanoplatforms, such as nanofibers and nanoparticles. This advancement offers targeted delivery, controlled release, and improved bioavailability, dramatically reducing systemic toxicity and enhancing patient outcomes. Nanofibers provide a versatile scaffold for the controlled release of docetaxel, utilizing techniques like electrospinning to tailor drug release profiles. Nanoparticles, on the other hand, enable precise drug delivery to tumor cells, minimizing damage to healthy tissues through sophisticated encapsulation methods such as nanoprecipitation and emulsion. These nanotechnologies not only improve the pharmacokinetic properties of docetaxel but also open new avenues in regenerative medicine by facilitating targeted therapy and cellular regeneration. This narrative review highlights the transformative impact of docetaxel-loaded nanoplatforms in oncology and beyond, showcasing the potential of nanotechnology to overcome the limitations of traditional chemotherapy and pave the way for future innovations in drug delivery and regenerative therapies. Through these advancements, nanotechnology promises a new era of precision medicine, enhancing the efficacy of cancer treatments while minimizing adverse effects. Graphical Abstract

Abstract Schizophrenia ranks as the third-most common cause of disability among mental disorders globally. This study presents findings on the prevalence, incidence and years lived with disability (YLDs) as a result of schizophrenia in the Middle East and North Africa (MENA), stratified by age, sex and sociodemographic index (SDI). We collected publicly accessible data from the Global Burden of Disease (GBD) study 2019. This study reports the burden of schizophrenia, from 1990 to 2019, for the 21 countries that comprise MENA. In 2019, MENA exhibited an age-standardised point prevalence of 248.2, an incidence rate of 14.7 and an YLD rate of 158.7 per 100,000, which have not changed substantially between 1990 and 2019. In 2019, the age-standardised YLD rate was highest in Qatar and lowest in Afghanistan. No MENA countries demonstrated noteworthy changes in the burden of schizophrenia from 1990 to 2019. Furthermore, in 2019, the highest number of prevalent cases and the point prevalence were observed among those aged 35–39, with a higher prevalence among males in almost all age categories. Additionally, in 2019, the age-standardised YLD rates in MENA were below the worldwide average. Finally, there was a positive correlation between the burden of schizophrenia and the SDI from 1990 to 2019. The disease burden of schizophrenia has remained relatively stable over the past thirty years. Nevertheless, as the regional life-expectancy continues to increase, the burden of schizophrenia is also expected to rise. Therefore, early planning for the increase in the burden of the disease is urgently needed in the region.

Background: The study aimed to assess salivary glutathione levels and the pattern of feeding on molar incisor hypomineralization among healthy children aged 7-9 years. Materials and Methods: The study was a cross-sectional study. A total of 90 children sample was further sub classified into two groups: the study group, including 60 children with molar incisor hypomineralization, classified into two subgroups, 30 children with mild type and 30 children with severe type of molar incisor hypomineralization. In addition to the control group involving 30 children without incisor hypomineralization and free of caries. Examination and diagnostic criteria for hypominerlization of the molar incisor and assessment of severity were according to European Academy of Pediatric Dentistry (EAPD) guidelines in 2003. The salivary glutathione ELISA kit was used to assess the amount of glutathione in unstimulated saliva samples. After an oral examination, the parents of each child completed a self-administered questionnaire that included information on the child's feeding pattern during the first year of life. The questionnaires were returned to the researcher the following day. The child who received a mixed feeding pattern was excluded from the study. Results: The ordinal logistic regression model (Overall model test: p

Background Stroke, a major global health issue, is broadly categorized into ischemic and hemorrhagic types. The volume of hemorrhage on noncontrast computed tomography guides the treatment options and hints at prognosis. Conventional approaches to calculate intracerebral hemorrhage (ICH) volume, like the ABC/2 method, typically rely on an assumed standard shape and might be inaccurate. Advances in deep learning have significantly improved noncontrast computed tomography's capabilities in ICH volume estimation. This study conducts a comprehensive systematic review and meta‐analysis to evaluate the precision of deep learning algorithms in delineating ICH on noncontrast computed tomography. Methods A systematic review and meta‐analysis, adhering to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, was conducted on literature from 2000 to October 2023. Studies were selected on the basis of strict inclusion and exclusion criteria. Performance evaluation was done using the Dice Similarity Coefficient, and the Prediction Model Risk of Bias Assessment Tool was used for quality assessment. Statistical analysis was carried out using Stata 17.0. Results The review included 28 studies, mainly retrospective cohorts, with a focus on convolutional neural network architectures, particularly U‐Net variants. A meta‐analysis of 14 studies revealed a combined Dice Similarity Coefficient of 0.85 (95% CI, 0.82–0.88). Performance was consistent across various methodologies but varied on the basis of ICH pathogenesis, with spontaneous ICH having higher accuracy. Conclusion Deep learning models are highly effective in segmenting ICH on noncontrast computed tomography, demonstrating potential improvements in clinical neuroimaging. Despite their efficacy, challenges in segmenting smaller hemorrhages remain. The findings suggest that deep learning could reduce health care professional workloads and enhance patient care, although further research is needed to address limitations and extend clinical utility.

ith the formation and development of the Internet of Things, the smart city has been manifested as an emerging concept that monitors various aspects of human life and intelligent information processing and control systems. A smart city can monitor the physical world and provide smart services for citizens, transform services such as healthcare, transportation, entertainment and energy and make them available to the government in a new way. The technologies used in smart cities raise some concerns and challenges regarding the security and privacy of citizens because applications in smart cities provide a wide range of information related to citizens' privacy. They collect to meet the interests and benefits of the public, but they also have comprehensive control over the city, and naturally, the lives of citizens will be affected by serious supervision and restrictions. In this article, we identified the international and domestic laws and regulations by investigating books and articles and using the available sources. We examined the laws and regulations in international law and Iranian law regarding privacy in smart cities. The study's most important finding is identifying gaps related to this area in Iranian laws and the need for more speed of updating laws at both the international and Iranian levels with the speed of advancement of technologies used in smart cities.

Abstract Background The screening process for systematic reviews and meta-analyses in medical research is a labor-intensive and time-consuming task. While machine learning and deep learning have been applied to facilitate this process, these methods often require training data and user annotation. This study aims to assess the efficacy of ChatGPT, a large language model based on the Generative Pretrained Transformers (GPT) architecture, in automating the screening process for systematic reviews in radiology without the need for training data. Methods A prospective simulation study was conducted between May 2nd and 24th, 2023, comparing ChatGPT’s performance in screening abstracts against that of general physicians (GPs). A total of 1198 abstracts across three subfields of radiology were evaluated. Metrics such as sensitivity, specificity, positive and negative predictive values (PPV and NPV), workload saving, and others were employed. Statistical analyses included the Kappa coefficient for inter-rater agreement, ROC curve plotting, AUC calculation, and bootstrapping for p-values and confidence intervals. Results ChatGPT completed the screening process within an hour, while GPs took an average of 7–10 days. The AI model achieved a sensitivity of 95% and an NPV of 99%, slightly outperforming the GPs’ sensitive consensus (i.e., including records if at least one person includes them). It also exhibited remarkably low false negative counts and high workload savings, ranging from 40 to 83%. However, ChatGPT had lower specificity and PPV compared to human raters. The average Kappa agreement between ChatGPT and other raters was 0.27. Conclusions ChatGPT shows promise in automating the article screening phase of systematic reviews, achieving high sensitivity and workload savings. While not entirely replacing human expertise, it could serve as an efficient first-line screening tool, particularly in reducing the burden on human resources. Further studies are needed to fine-tune its capabilities and validate its utility across different medical subfields.

Abstract Bone metastasis is considered as a considerable challenge for breast cancer patients. Various in vitro and in vivo models have been developed to examine this occurrence. In vitro models are employed to simulate the intricate tumor microenvironment, investigate the interplay between cells and their adjacent microenvironment, and evaluate the effectiveness of therapeutic interventions for tumors. The endeavor to replicate the latency period of bone metastasis in animal models has presented a challenge, primarily due to the necessity of primary tumor removal and the presence of multiple potential metastatic sites. The utilization of novel bone metastasis models, including three-dimensional (3D) models, has been proposed as a promising approach to overcome the constraints associated with conventional 2D and animal models. However, existing 3D models are limited by various factors, such as irregular cellular proliferation, autofluorescence, and changes in genetic and epigenetic expression. The imperative for the advancement of future applications of 3D models lies in their standardization and automation. The utilization of artificial intelligence exhibits the capability to predict cellular behavior through the examination of substrate materials' chemical composition, geometry, and mechanical performance. The implementation of these algorithms possesses the capability to predict the progression and proliferation of cancer. This paper reviewed the mechanisms of bone metastasis following primary breast cancer. Current models of breast cancer bone metastasis, along with their challenges, as well as the future perspectives of using these models for translational drug development, were discussed.

Abstract Background There are several types of dermatitis, each capable of causing enduring changes that extend beyond physical discomfort. In severe cases, dermatitis can significantly affect mental health, social interactions, and the overall quality of life. This study reports the burden of dermatitis in the Middle East and North Africa (MENA) region from 1990 to 2019, according to sex, age category, and socio-demographic index (SDI). Methods Publicly available data regarding the point prevalence, incidence, and years lived with disability (YLDs) were collected from the Global Burden of Disease 2019 study for both the MENA region and its constituent countries. The point prevalence, incidence, and YLDs of dermatitis were represented as counts and age-standardised rates with 95% uncertainty intervals (UIs). Results In 2019, the age-standardised point prevalence of dermatitis was 2744.6 (2517.8–3003.1) per 100,000 population, which was 2.3% lower than in 1990. The YLD rate was 92.3 (55.6–143.4) per 100,000 population, which was 3.1% lower than in 1990. The largest point prevalence rates were observed among those aged 70–74, for both sexes. The 2019 MENA/Global DALY ratio was not above one in any age group for either sex. During the period 1990 to 2019, there was no clear correlation between the burden of dermatitis and the SDI level. Conclusion The dermatitis burden in the MENA region remained relatively stable from 1990 to 2019. Future prevention efforts should focus on improving healthcare access, health education, and workplace safety regulations.

Abstract Iran's Mashhad Plain faces a severe water crisis due to the excessive exploitation of groundwater, leading to the depletion of its aquifer. While water demand management is recognized as a superior solution compared to supply projects, its implementation presents notable challenges. This study addresses the urgent necessity to curtail water demand in the Mashhad Plain by alleviating conflicts among various stakeholders, including water resource managers and consumers. Initially, the research identifies key water resource actors who collaborate in devising a comprehensive roadmap and conceptual model for efficient water resource management. An analysis uncovers significant conflicts among actors, representing approximately 6% of identified issues, with minor conflicts in 30% of cases. Encouragingly, stakeholders demonstrate potential for consensus on the remaining conflict items, with specific actors emerging as pivotal in conflict resolution. Efficient water resource management in regions facing scarcity, diverse interests, and sustainability challenges demands a multifaceted strategy. Future endeavors involve developing a dynamic system model to simulate policy impacts and strengthen conflict resolution efforts. This research introduces a roadmap-driven approach aimed at resolving conflicts and implementing water demand management in the Mashhad Plain. It emphasizes the critical need to address water scarcity challenges while effectively mitigating conflicts among water resource stakeholders.

Abstract Background and objective Cervical cancer is the most preventable and ovarian cancer is the most lethal gynecological cancer. However, in the world, there are disparities in health care performances resulting in differences in the burden of these cancers. The objective of this study was to compare the health-system quality of care and inequities for these cancers using the Quality of Care Index (QCI). Material and methods The 1990–2019 data of the Global Burden of Disease (GBD) was analyzed to extract rates of incidence, prevalence, mortality, Disability-Adjusted Life Years (DALYs), Years of Life Lost (YLL), and Years of healthy life lost due to disability (YLD) of cervical and ovarian cancer. Four indices were developed as a proxy for the quality of care using the above-mentioned rates. Thereafter, a Principal Components Analysis (PCA) was applied to construct the Quality of Care Index (QCI) as a summary measure of the developed indices. Results The incidence of cervical cancer decreased from 1990 to 2019, whereas the incidence of ovarian cancer increased between these years. However, the mortality rate of both cancers decreased in this interval. The global age-standardized QCI for cervical cancer and ovarian cancer were 43.1 and 48.5 in 1990 and increased to 58.5 and 58.4 in 2019, respectively. QCI for cervical cancer and ovarian cancer generally decreased with aging, and different age groups had inequitable QCIs. Higher-income countries generally had higher QCIs for both cancers, but exceptions were also observed. Conclusions Uncovering disparities in cervical and ovarian cancer care across locations, Socio-Demographic Index levels, and age groups necessitate urgent improvements in healthcare systems for equitable care. These findings underscore the need for targeted interventions and prompt future research to explore root causes and effective strategies for narrowing these gaps.

The purpose of the present study was to investigate the comparative effect of dynamic and negotiated assessment on EFL learners' writing complexity and fluency. To this end, 72 female intermediate EFL participants, selected from a larger group of 103 learners based on their performances on a piloted PET, in Tak language institute in Dezfoul, Iran participated in the present study and received either dynamic assessment, negotiated assessment, or traditional instruction during a term. Both of the experiments were process-oriented; however, in the dynamic assessment, the negotiation was done through teacher's provision of feedback wherein the negotiated assessment group peer-negotiation was encouraged. The participants' writing complexity and fluency were measured both before and after the instruction through essay writing pre-treatment test and posttest in accordance with Larsen-Freeman's (2006) T-Unit protocol. A Multivariate Analysis of Variance (MANOVA) was run on the posttest scores to test the null hypotheses of the study, the results of which indicated that while dynamic assessment was significantly effective in improving writing complexity (p = 0.007 < 0.05), negotiated assessment yielded significantly better results in boosting writing fluency compared to the results obtained from both control (p = 0.000 < 0.05) and dynamic assessment groups (p = 0.042 < 0.05). Nevertheless, dynamic assessment did not show significantly better results in comparison to negotiated assessment in improving writing complexity (p = 0.084 > 0.05). Learners, teachers, and syllabus designers who are engaged in the process of language pedagogy may use these results. Depending on the focus of their learning, i.e., fluency or complexity, they may choose the optimal choice between these two types of assessment.

BackgroundVitamin A deficiency (VAD) is a common micronutrient deficiency that imposes a substantial burden worldwide. This study examined the burden of VAD from 1990 to 2019 in the Middle East and North Africa (MENA) region by age, sex and sociodemographic index (SDI).MethodsThe data were obtained from the Global Burden of Disease (GBD) 2019 database. We reported the prevalence, incidence, and years lived with disability (YLDs) that were attributable to VAD for the MENA region, along with its constituent countries.ResultsIn 2019, the MENA region had 30.6 million prevalent cases of VAD, with an age-standardized prevalence rate of 5249.9 per 100,000 population. In addition, VAD was responsible for 62.2 thousand YLDs, with an age-standardized YLD rate of 10.2 per 100,000. The age-standardized prevalence [50.3% (−55.9 to −44.7)] and YLD [−49.3% (−55.3 to −43.1)] rates of VAD have significantly decreased since 1990. In 2019, the MENA region’s VAD-attributable YLD rate was below the global average for males and females across all age groups. Additionally, SDI was negatively associated the age-standardized YLD rate of VAD.ConclusionThis study underscores the necessity of frequently updating health data and developing guidelines and regulations to prevent, detect early, and effectively treat VAD in the MENA countries.

The increase in global demand consumption of sesame seeds as a nutritious food source and the limited areas suitable for cultivation have made the world face the challenge of determining the optimal storage conditions for sesame seeds. In this study, sesame seeds were stored in three different temperature and humidity conditions: High Temperature (HT: 60 °C, 100% humidity), Room Temperature (RT: 20 °C, 70% humidity), and Refrigerator Temperature (FT: 4 °C, 30% humidity), compared to the control (20 °C, 3% humidity). The soluble sugar, vitamins and protein contents of the sesame seeds were determined following standard methods. Fatty acids were determined by gas chromatography-mass spectrometry (GC-MS). Oil yield 11.2% increased under the HT storage condition, but no significant change was observed under the other storage conditions. HT conditions caused the degradation of fatty acids, while RT and FT conditions maintained the structure of fatty acids. Vitamin C levels decreased in FT, RT and HT storage conditions 0.0622, 0.0496, 0.0118 mg/100 g and vitamin B12 levels decreased 11.73, 12.02, 10.79 μM/100 g, respectively. Vitamin B9 levels increased in FT, RT and HT storage conditions 299.3, 222.3, 216.8 μg/100 g, respectively and vitamin E decreased 135.3, 30.7 mg/100 g under HT and FT conditions compared to control, however, no changes were observed under RT conditions. Total soluble sugar content increased 157.7 mg/100 g in FT conditions while it decreased 73.56 mg/100 g in HT conditions. This study showed storage conditions affected the nutritional value and phytochemical properties of sesame seeds. High temperature and humidity adversely affect the oil quality, fatty acid structure, and vitamin and sugar content of sesame seeds. Sesame intake in human dietary affected by the cooking process, such as roasting in dressing bread and confectionery reduce fatty acids, vitamins, and sugars in seeds. It seems that RT and FT are the optimal conditions for preserving fatty acids with high nutritional value in sesame seeds, although the moisture is different. The findings are important in controlling and maintaining the nutritional value of sesame during storage.

ABSTRACT Objective We aimed to compare the association of three novel inflammatory indicators with metabolic syndrome (MetS) among Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort participants. Methods According to the International Diabetes Federation (IDF) criteria, the cohort participants were divided into the MetS(+) and MetS(−) groups. The lymphocyte to high‐density lipoprotein cholesterol (HDL‐C) ratio (LHR), high‐sensitivity C‐reactive protein (hs‐CRP) to HDL‐C ratio (HCHR) and hs‐CRP to lymphocyte ratio (HCLR) were calculated and were compared between the groups. Binary logistic regression (LR) analysis was performed to find the association of the indices with the presence of MetS among men and women. Receiver‐operating characteristic (ROC) curve analysis was used to establish cut‐off values in predicting MetS for men and women. p‐Values

Abstract Background and Aims Osteoarthritis (OA) is one of the most common debilitating diseases among the aging population. Nigella sativa is one potential treatment for OA. Here, we sought to evaluate the efficacy and safety of Nigella sativa for treating patients with OA. Methods PubMed, Scopus, Embase, and Web of Science were searched up to October 20, 2022. The primary outcome was changes in the pain score after receiving Nigella sativa or control agents based on the results of randomized controlled trials (RCTs). The secondary outcome was set as the frequency of adverse events reported during the follow‐up period. Results Six RCTs involving a total of 370 patients with knee OA were included in the present systematic review. Among the four screened studies, the topical administration of Nigella sativa oil was found to be more effective than the placebo in relieving pain in three trials. Additionally, the oral use of Nigella sativa oil was assessed in two trials, and an improvement in pain score relative to placebo was documented in only one of the studies. Also, the trial that evaluated the effectiveness of Nigella sativa oral capsules did not demonstrate any difference in pain reduction between the intervention and placebo groups. Overall, either topical or oral administration of Nigella sativa was well tolerated, and no serious adverse events were reported. Conclusion Nigella sativa is generally safe, but conflicting findings from low‐quality studies hinder the ability to make clinical recommendations for or against treating OA. Robust trials are needed for informed decisions.

Key Clinical Message Infectious diseases like leprosy can cause antiphospholipid antibodies, leading to blood clots. Clinicians should consider this for patients with unusual thrombotic events and prior infectious disease history. Abstract This case report details the diagnostic challenge of a 42‐year‐old man with a history of treated leprosy who presented with clinical features suggestive of antiphospholipid syndrome (APS). Vascular angiography revealed thrombosis, and serological tests were positive for APS antibodies. However, the patient subsequently developed symptoms, including thenar atrophy, paresthesia, and hypopigmented skin patches, which prompted further investigation. Electromyography detected sensorimotor polyneuropathy, while a nerve biopsy indicated a resurgence or chronic presence of leprosy. Despite initial APS management, the case evolved into a leprosy relapse confirmation after 20 years of remission, underscoring the diagnostic intricacies when concurrent autoimmune antibodies and infectious disease manifestations are present. This report emphasizes the importance of considering a broad differential diagnosis, including the potential for infectious disease relapse, in the presence of antiphospholipid antibodies. It illustrates the necessity of an interdisciplinary treatment approach in complex clinical scenarios.

Hospital-treated intentional self-poisoning is common. The possibility of changed (increased) suicidal behaviors during the COVID-19 pandemic has been raised. To compare frequencies in self-poisoning events (SPEs) and the proportions with in-hospital mortality, in the year prior to and following the official onset of the COVID-19 pandemic, in a population of hospital-treated self-poisoning patients in Iran. All self-poisoned patients admitted to Loghman-Hakim Hospital, a clinical toxicology specialty hospital in Tehran, were included. The frequency of SPEs was compared between the one-year periods immediately before and after the onset of COVID-19 pandemic using Poisson regression. Differences in proportions of in-hospital mortality were also compared using logistic regression. A total of 14,478 patients with 15,391 SPEs (8,863 [61.2%] females) were evaluated in the study. There was no difference in the overall frequency of SPEs (relative risk [RR] of 0.99 [CI95% 0.96-1.03]), but a small increase in males (RR 1.07; 1.02-1.13) and a minor decrease in females (RR 0.95; 0.91-0.99). In total, 330 patients died (2.3% of all SPEs). There was no difference in overall in-hospital mortality odds ratio (OR: 0.98 [0.79-1.22]), in females (OR = 1.14 [0.80-1.60]) or males (OR = 0.92 [0.69-1.23]). There was no change in the frequency of SPEs and no difference in the in-hospital mortality proportions, suggesting that the COVID-19 pandemic had little or no effect on these aspects of suicidal behavior in Iran., Author(s): Seyed Kaveh Hadeiy [sup.1] , Narges Gholami [sup.2] , Rebecca McDonald [sup.3] , Omidvar Rezaei [sup.4] , Ali-Asghar Kolahi [sup.5] , Nasim Zamani [sup.5] [sup.6] , Alireza Shamsi-Lahijani [sup.1] [...]