A Graph-Based Statistical Approach to Identifying Functional Connectivity Networks in Patients with Traumatic Brain Injury

ObjectivesTraumatic brain injury (TBI) is one of the most common types of brain injuries associated with cognitive impairments. Functional magnetic resonance imaging (fMRI) studies can provide a unique opportunity to examine brain connectivity patterns and understand the neural substrates of cognitive outcomes following traumatic injury. Therefore, this study aims to determine changes in functional connectivity patterns in patients with TBI compared to healthy individuals using two graph models, adaptive dense subgraph discovery (ADSD) and variance component.Materials & MethodsThis study used fMRI data downloaded from https://openneuro.org. These data included 14 patients with TBI aged between 18 and 36 and 12 healthy individuals (female: N=6, male: N=6) aged between 19 and 52. Out of the 74 regions examined, a cluster of 18 regions related to TBI was identified using the ADSD model. Subsequently, these identified regions were used as input for the variance component model to investigate changes in connectivity patterns.ResultsFunctional connectivity between an 18-brain region cluster, such as the Rectus (Left, Right), Supp_Motor_Area (Left, Right), and Middle Cingulum (Left, Right), differed between the patient and healthy groups. Based on the analysis of functional connectivity between pairs of brain regions, 153 connections between pairs of brain regions were compared in the two groups, out of which 63 connections showed significant differences between the two groups. Compared to other regions, Supp_Motor_Area_Right and Rectus_Left had more connections.ConclusionThe study’s results indicate that the functional connectivity between the Cingulum, Hippocampus, Fusiform, Supp_Motor_Area, and Precentral regions differs between the two groups. Since these regions are involved in processes such as memory, learning, spatial orientation, face recognition, coordination, and motor control, changes in their functional connectivity may lead to impairments in these areas

بررسی وضعیت بهداشت و سلامت در زندان‌های دوره قاجار

Background and Aim: Public health and healthcare developments during the Qajar era are among the significant topics in the social history of this period. This study aimed to investigate the state of public health and healthcare services in Qajar-era prisons. Methods: This descriptive-analytical research utilized primary documents, travelogues and recent studies to examine hygiene and healthcare conditions in Qajar-era prisons. Ethical Considerations: Throughout the study, principles of academic integrity including trustworthiness, citation accuracy, source originality and impartiality in data analysis were strictly adhered to. Results: The findings revealed that prison locations and sanitary standards were largely neglected by the Qajar government. Prisons primarily served as tools for torture, punishment and retribution, with rehabilitation and hygiene considerations deemed irrelevant. High mortality rates among prisoners stemmed from inadequate sanitation, overcrowded and pest-infested environments (e.g., lice and rodents) and a lack of healthcare access. These dire conditions even provided a sense of "peace of mind" for wardens tasked with tormenting inmates. Travelogues documented prisoners enduring years of deplorable conditions, deprived of basic amenities such as grooming, which led to the spread of diseases within their families upon release. Conclusion: The study underscores the severe deficiency or complete absence of public health infrastructure and healthcare services in Qajar prisons. While personal hygiene was practiced in society due to religious norms, the absence of prison baths, infestations of pests and rampant disease outbreaks exacerbated the squalid conditions. Historical records and travelogues corroborate widespread illness among prisoners and the government’s indifference to substantive reforms, even in the late Qajar period.زمینه و هدف: بهداشت عمومی و سلامت و تحولات این حوزه از موضوعات مهم در تاریخ اجتماعی دوره قاجار است. این پژوهش با هدف بررسی وضعیت بهداشت عمومی و خدمات بهداشتی ـ سلامتی در زندان‌های عصر قاجار انجام شده است. روش: این مطالعه با رویکرد توصیفی ـ تحلیلی و با استفاده از اسناد، سفرنامه‌ها و تحقیقات جدید، به بررسی وضعیت بهداشت و خدمات سلامت در زندان‌های دوره قاجار پرداخته است. ملاحظات اخلاقی: در فرایند پژوهش، اصول امانتداری، صداقت در استناد به منابع، اصالت منابع، و پرهیز از جانبداری در تحلیل داده‌ها رعایت شده است. یافته‌ها: یافته‌ها نشان داد که مکان زندان‌ها و معیارهای بهداشتی آن‌ها در دوره قاجار، چندان مورد توجه حکومت نبود. هدف اصلی زندان‌ها، شکنجه، تنبیه و انتقام از زندانیان بود و ابعاد تربیتی یا رعایت بهداشت در اولویت قرار نداشت. مرگ و میر بالای زندانیان ناشی از نبود بهداشت مناسب، فضای نامناسب (پر از شپش و موش) و عدم دسترسی به خدمات سلامت بود. این شرایط حتی برای زندان‌بانانی که مأمور آزار زندانیان بودند، «آسودگی‌ خاطر» محسوب می‌شد. بر اساس سفرنامه‌ها، زندانیان سال‌ها در شرایطی رقت‌بار زندگی می‌کردند؛ محرومیت از امکانات اولیه مانند تراشیدن ریش و مو و انتقال بیماری‌های خود به خانواده‌ها پس از آزادی، از پیامدهای این بی‌توجهی بود. نتیجه‌گیری: نتایج پژوهش گویای ضعف شدید یا فقدان بهداشت عمومی و خدمات سلامت در زندان‌های قاجار است، هرچند بهداشت فردی به دلیل باورهای دینی در جامعه رواج داشت، اما نبود حمام در زندان‌ها، حضور حشرات موذی و شیوع بیماری‌ها، وضعیت ناگوار این محیط‌ها را تشدید می‌کرد. اسناد تاریخی و سفرنامه‌ها، شواهدی از ابتلای گسترده زندانیان به بیماری‌ها و بی‌توجهی حکومت به اصلاحات اساسی، حتی در اواخر دوره قاجار، ارائه می‌دهند

A Study of the Incidence and Outcome of Fungal Infections in the Neonatal Intensive Care Units; A Seven-year Surveillance: Fungal Infections in NICU

Background and Aim: Candida infections are rare in the neonatal period, but they are animportant cause of morbidity and mortality in neonatal intensive care units. Invasive fungalinfections are extremely difficult to diagnose. It is suggested to start empirical treatmentwith antifungal therapy in high-risk, low-birth-weight infants who do not respond rapidly toantibacterial therapy or in those who are in a septic state due to an unknown source, basedon regional guidelines. The aim of this study was to facilitate the earlier detection of at-risknewborns to initiate antifungal therapy as soon as possible, thereby lowering mortality ratesand serious permanent disabilities.Methods: This is a retrospective cross-sectional observational study on newborns admittedto the neonatal intensive care unit (NICU) from March 2010 to February 2016. Risk factors,such as birth weight, sex, route of delivery, the timing of oral feeding, total parental nutrition(TPN), prescribed drugs (such as antibiotics, H2 blockers, methylxanthine, vasopressors, andcorticosteroids), underlying diseases, history of surgery, urinary catheter insertion, centralvenous catheterization, and mechanical ventilation were extracted from patients’ files. Also,we analyzed the blood groups of patients to find any possible relation to fungal infections.Results: During the seven-year period, 2927 newborns were admitted to the NICU, of whom32 patients (1.1%) were infected by fungal microorganisms. All but one of these neonateswere infected by C. albicans. Most of them had positive urine or blood cultures for C.albicans (48.8% and 27.9%, respectively). All of our patients received amphotericin B asstandard therapy, resulting in a 75% recovery rate.Conclusion: Surveillance of newborns with underlying risk factors aids in early decisionmakingto start treatment for fungal infections in high-risk groups, thereby decreasingmortality rates and long-term devastating complications

A Case Series of Congenital Pouch Colon- A Rare Regional Variant of Covered Bladder Exstrophy

Introduction: The clinical, radiologic and cystourethroscopic (CUS) findings regarding the colonic pouch, its terminal colovesical fistula (CVF) and lower urinary tract (LUT) in 27 boys with congenital pouch colon (CPC) and associated anorectal malformation (ARM) are described and discussed. Material and Methods: Records of 27 boys with CPC in whom radiologic studies and/ or CUS yielded information about the colonic pouch, CVF, and the LUT were studied. Relevant clinical findings were recorded. Results: CPC subtypes were Type I (n=1); Type II (n=13); Type III (n=1), and Type IV (n=12). Five patients (18.5%) had hypospadias and 3 (11.1%) unilateral undescended testis. X-Rays spine (n=25) showed normal sacrum (n=21) and partial sacral agenesis (n=4). Ultrasound (n=27) showed normal kidneys (n=21), unilateral malrotated kidney (n=1), unilateral hydronephrosis (n=2), and hydroureteronephrosis (n=3). Micturating cystourethrogram (n=12) showed a large, lobulated, smooth-walled urinary bladder (n=7) and vesicoureteral reflux (n=6). Contrast study of the colonic pouch (n=16) showed the pouch ending in a long wide CVF opening at the bladder neck with, in 11 patients (68.75%), filling of a large, lobulated urinary bladder. CUS (n=22) showed a competent bladder neck and an abnormal verumontanum pulled-up into the bladder neck. In 16 patients, the CVF opened in the trigone, just cranial to the right (n=13) or left (n=3) of the verumontanum. Conclusion: CPC likely results from an early, ‘localized’ error in cloacal septation by the uro-rectal septum with faulty development of adjacent developing structures. The long-term clinical consequences on bladder dynamics and male fertility need attention

In silico Approaches to Identify Phthalic Acid Derivatives as Inhibitors Tyrosinase, α-Glucosidase, and Dipeptidyl peptidase-4: In silico Approaches to Identify Phthalic Acid Derivatives

Integrating scientific and technological development in medicinal chemistry implies a great leap forward and speeds up the low-cost drug discovery process from natural resources. Therefore, in silico approaches were performed through molecular docking involving receptors crucial in metabolic processes, aiming to gain insights into how free radicals bind and how blood sugar levels can be lowered. The research aims to study the inhibitory mechanisms of phthalic acid derivatives such as tyrosine enzymes, alpha-glucosidase, and dipeptidyl peptidase-4 with in silico predictions. The in silico prediction instrument is in the form of computing software. Additional ligand sources were gained from a database of tyrosinase enzyme receptor (6JU9), alpha-glucosidase receptor (2JKE), and dipeptidyl peptidase-4 (1N1M). The active ingredients of Kenikir and Yacon leaves are used as test compounds with comparison drugs such as acarbose. The Diisooctyl Phthalate compound has an antioxidant potential through the 6JU9 target protein, with the most stable docking score of -81, 07. The target proteins for reducing blood sugar levels each have a value of -61.606 (2JKE ligand) and -86.945 (1N1M ligand). It is concluded that natural resources (Cosmos caudatus and Smallanthus sonchifolius) showed potential as natural drugs with an in silico approach study

Comparative Immunomodulatory Activity of Methanolic Extract obtained from Tabernaemontana alternifolia Leaves and Stem: Immunomodulatory Effects of Methanolic Extracts from Tabernaemontana alternifolia Leaves and Stem

Tabernaemontana alternifolia, a plant of the Apocynaceae family and commonly referred to as Kampillakah, is a medicinal plant recognized for its remarkable therapeutic benefits. The plant stems, roots, and leaves are abundant in alkaloids, which have been traditionally used to treat cancer, diarrhea, and syphilis. Due to bioactive alkaloids and phenolic compounds, the current study aimed to evaluate the immunomodulatory effects of methanolic extracts from Tabernaemontana alternifolia leaves (TAL). It stems (TAS) in mitigating cyclophosphamide-induced myelosuppression in rats. Preliminary phytochemical analyses revealed the presence of compounds known for immunomodulatory properties. The administration of these extracts resulted in a notable recovery of hemoglobin levels and red and white blood cell and platelet counts, with TAL demonstrating greater effectiveness compared to TAS. Body weight measurements corroborated the protective effects, such as TAL and TAS significantly increased rat body weight during treatment. Furthermore, TAL and TAS enhanced neutrophil adhesion, an important marker of immune system activation. Overall, the results indicate that TAL, in particular, offers notable immunomodulatory benefits that may help mitigate the adverse effects of chemotherapy-induced myelosuppression and boost immunity against infections, delineating its potential for therapeutic use in integrative medicine

Liver fibrosis, insulin resistance and cardiovascular risk scores in obese and non-obese patients with non-alcoholic fatty liver disease

Background: Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. Obese children and adolescents, particularly those with metabolic syndrome (MetS), commonly report NAFLD, which can lead to various other problems and diseases. There are different opinions on how the liver fibrosis score, insulin resistance indices, and risk of cardiovascular disease are related in people with NAFLD who have different body mass index (BMI) levels. This study aimed to investigate the relationship between liver fibrosis score, insulin resistance indices, and cardiovascular disease risk in patients with NAFLD, specifically focusing on two groups with normal and high BMI. Materials and Methods: This analytical cross-sectional study was conducted on patients with NAFLD referred to Taleghani Hospital (Tehran-Iran) between 2019 and 2020. Data such as age, gender, BMI, height, weight, blood sugar level, hemoglobin A1C level, lipid profile, liver fibrosis level, insulin resistance level, liver aminotransferases level, Framingham risk score, and presence of MetS were evaluated. The significance level was considered less than 0.05. Results: We evaluated 140 patients, 14 of whom had normal BMI, and the rest had high BMI. There was a significant relationship between the homeostatic model assessment for insulin resistance (HOMA-IR) index and the liver fibrosis score. For a one-unit increase in the liver fibrosis score, the HOMA-IR score increased by 0.287 times (P-value=0.001). There was a significant relationship between MetS and the risk of cardiovascular diseases based on the Framingham risk score and liver fibrosis (P-values<0.05). Conclusion: High BMI levels can increase the incidence of NAFLD, Framingham, and HOMA-IR indices

Ophthalmic Manifestations of Multiple Sclerosis: A Case Series

Purpose: This case series study reports the ophthalmic manifestations observed in multiple sclerosis (MS) patients and their diagnostic implications.Patients and Methods: A cross-sectional case series included 15 MS patients from Negah Eye Hospital, Tehran, Iran. Each patient underwent a comprehensive ophthalmic evaluation, including best-corrected visual acuity (BCVA), pupillary response, ocular motility, slit-lamp biomicroscopy, fundoscopy, visual field testing, optical coherence tomography (OCT), and visual evoked potentials (VEP). Patient demographics, systemic conditions, and treatment history were also analyzed.Results: Our study included 15 patients with MS (11 females, 4 males, aged 18–56 years). BCVA ranged from 20/20 to 20/100, with objective color vision impairment in 6 % of cases. Relative afferent pupillary defect was observed in 6 % of patients. Optic neuritis and visual disturbances were common findings. Optic nerve atrophy was observed in 20 % of patients.  Ocular motility disturbances, including internuclear ophthalmoplegia and diplopia, were present in 20 %. Visual field abnormalities were detected in 26 %, while VEP testing showed delayed latency in all tested eyes. OCT results were normal in 20 % of cases. Uveitis was noted in 6 %, and 13 % had concurrent COVID-19 infection.Conclusion: This case series highlights the diverse ophthalmic manifestations of MS, with optic neuritis and ocular motility disturbances as key findings. VEP and OCT provide valuable diagnostic insights, especially for subclinical cases. A comprehensive ophthalmic assessment is crucial in MS management to improve diagnosis and prevent unnecessary treatments

هیجانات پرستاران در موقعیت‌های اورژانسی بیمارستان‌های شهرستان نهاوند: رویکرد پدیدار‌شناسی

Background and Aims: Nurses experience a wide range of emotions in emergency situations that can affect their professional performance and the quality of care. Exploring these emotions can help improve nurses' emotional well-being and enhance the quality of healthcare services. Accordingly, this study aimed to explain the emotional experiences of nurses in emergency situations in the hospitals of Nahavand County. Materials and Methods: This qualitative study was conducted using a phenomenological approach on 17 emergency department nurses in hospitals of Nahavand County. Data were collected through purposive sampling and semi-structured interviews and analyzed using Colaizzi’s method. Ethical considerations were observed throughout all stages of the study. Results: The results showed that nurses, in emergency situations, experienced a wide range of positive and negative emotions, as well as job-related stress stemming from workplace conditions, lack of support, and their personality traits. Three main themes were identified: positive emotions, negative emotions, and job-related stress. Conclusion: The study concluded that to improve the condition of emergency nurses and enhance the quality of care, it is necessary to provide emotional management training, psychological support, stress assessment, and a supportive work environment. Reducing nurses’ workload was also suggested as a key measure to improve their mental health and efficiency. These actions can lead to significant improvements in care quality and job satisfaction among nurses.زمینه و اهداف: پرستاران در موقعیت‌های اورژانسی هیجانات متنوعی را تجربه می‌کنند که بر عملکرد حرفه‌ای و کیفیت مراقبت تاثیر می‌گذارد. بررسی این هیجانات می‌تواند به بهبود سلامت هیجانی پرستاران و ارتقا کیفیت مراقبت‌های درمانی کمک کند. بر این اساس، هدف از این مطالعه تبیین هیجانات پرستاران در موقعیت‌های اورژانسی در بیمارستان‌های شهرستان نهاوند می‌باشد. مواد و روش‌ها: پژوهش حاضر به صورت کیفی و با رویکرد پدیدار شناسی بر روی 17 پرستار بخش اورژانس بیمارستان‌های شهرستان نهاوند انجام گرفت. داده‌ها از طریق نمونه‌گیری هدفمند و انجام مصاحبه‌های نیمه ساختار‌یافته جمع‌آوری و با روش کلایزی تحلیل شدند. رعایت ملاحظات اخلاقی نیز در تمام مراحل اجرای مطالعه درنظر گرفته شد. یافته‌ها: نتایج نشان داد که پرستاران در موقعیت‌های اورژانسی طیف وسیع از هیجانات مثبت و منفی و همچنین تنش‌های شغلی که ناشی از شرایط محیط کاری، کمبود حمایت و ویژگی‌های شخصیتی پرستاران بودند را تجربه نموده‌اند. سه مضمون اصلی شناسایی شدند که شامل هیجانات مثبت، هیجانات منفی و تنش‌های شغلی بود. نتیجه‌گیری: پژوهش به این نتیجه رسید که برای بهبود وضعیت پرستاران اورژانس و افزایش کیفیت مراقبت‌ها، نیاز به آموزش مدیریت هیجانات، پشتیبانی روانی، ارزیابی استرس و ایجاد محیط کاری حمایتی وجود دارد. همچنین کاهش بار کاری پرستاران به عنوان پیشنهادات اساسی برای ارتقای سلامت روانی و کارایی آنان مطرح شد. این اقدامات می‌توانند بهبود قابل توجه‌ای در کیفیت مراقبت‌ها و رضایت شغلی پرستاران به همراه داشته باشند

Visual Evoked Potential Findings in a Vitiligo Patient

A 45-year-old man was referred to the Basir Eye Clinic in Tehran, Iran, for a visual evoked potential (VEP) assessment due to complaints of blurred vision in his left eye. His condition remained untreated because of his corticosteroid phobia, despite medical recommendations. VEP results revealed a delay of VEP P100 peak in both eyes, indicating optic nerve involvement, a finding observed in some patients with this condition