Ectopic pregnancy is considered the most common cause of pregnancy-related deaths in the first trimester. Methotrexate is recognized as an effective drug for the treatment of ectopic pregnancy. The aim of this study was to determine the associated and predictive factors for success in medical treatment among patients with ectopic pregnancy (EP). After collection of Demographic information, serum β-hCG levels and ultrasound findings were evaluated and compared between two groups: those with successful medical treatment and those without. The mean β-hCG level have not significant difference between the two groups (P=0.806). The frequency of previous IUD use in the successful treatment group was 8%, while there were no cases in the failure group; however, this difference was not statistically significant (P=0.547). The frequency of prior EP, the observed frequency of hematoma and the frequency of tubal ring observation, which also showed no significant difference (respectively P=0.9, P=0.9 and P=0.111). Logistic regression analysis revealed that none of the investigated variables were significant predictors of treatment success. However, the presence of a tubal ring (OR: 6.500, 95% CI: 0.799-52.897, p = 0.080) and increased endometrial thickness (OR: 1.317, 95% CI: 0.971-1.786, p = 0.077) showed borderline significance. Commonly considered factors, such as gestational age, β-hCG levels, patient age, parity, and gravidity, did not significantly influence treatment success. The study highlights a high success rate for single-dose methotrexate therapy and the potential utility of tubal ring and endometrial thickness as clinical indicators, warranting further investigation. The results of this study indicate that single-dose methotrexate treatment for tubal ectopic pregnancy leads to a high success rate. Given the sample size of this study, none of the variables had a significant impact on treatment success or predictive power.
Post-modern medicine signifies a paradigm shift in healthcare by integrating the strengths of both modern biomedical science and traditional medical systems. This article explores the potential of a holistic approach that combines evidence-based practices with time-tested methodologies rooted in historical medical traditions. Emphasis is placed on prevention, diagnosis, and treatment to achieve a more comprehensive and personalized understanding of health and disease. By examining the unique contributions of each system, this integrative perspective aims to enhance patient outcomes in both human and veterinary medicine. Post-modern medicine signifies a paradigm shift in healthcare by integrating the strengths of both modern biomedical science and traditional medical systems. This article explores the potential of a holistic approach that combines evidence-based practices with time-tested methodologies rooted in historical medical traditions. Emphasis is placed on prevention, diagnosis, and treatment to achieve a more comprehensive and personalized understanding of health and disease. By examining the unique contributions of each system, this integrative perspective aims to enhance patient outcomes in both human and veterinary medicine.
Anatomical terminology is often assumed to be structurally precise and historically stable. However, the anterior thoracic region demonstrates significant semantic transformation across time. In classical Latin, pectus referred broadly to the chest without sexual specification. In modern English, the term "breast" predominantly denotes the female mammary gland. This study investigates how a structurally stable anatomical region underwent progressive linguistic gendering. A qualitative historical-anatomical analysis was conducted integrating: (1) philological examination of classical Latin and Greek texts, including the Aeneid; (2) review of medical writings attributed to Hippocrates and Galen to assess early structural differentiation between thorax and mammary gland; (3) comparative analysis of medieval to 19th-century anatomical atlases to evaluate visual and terminological separation of thoracic and mammary structures; and (4) conceptual review of contemporary clinical framing in thoracic trauma and breast reconstruction. No human subjects were involved. Classical terminology (pectus, stēthos) denoted the anterior thorax without inherent sexual coding, while mastos specified mammary tissue. Renaissance dissection reinforced structural separation between thoracic wall and glandular appendage. Despite increasing anatomical precision, vernacular English progressively narrowed "breast" toward female mammary meaning. Modern anatomical standards maintain structural neutrality, but linguistic asymmetry persists in clinical and cultural discourse. The thorax has remained anatomically stable, whereas its linguistic representation has undergone gender-specific specialization. The transition from pectus to "breast" illustrates how anatomical regions may acquire cultural coding independent of structural change.
Availability of trustworthy information has a critical role during public health emergency events. Science communication and trust in information sources, health experts and governments significantly influence public adherence to preventive measures and vaccine uptake. To investigate these effects on vaccine confidence in Southeast Asia, a region with diverse governance structures, trust levels and health literacy, this study examines trust in science and authority across six countries. Between January and June 2023, we conducted online surveys in Singapore, Philippines, Indonesia, Thailand, Malaysia and Vietnam with a total of 6611 respondents to measure their attitudes and trust towards science, vaccines, the government's management of COVID-19 and international health institutions. Our analyses explored the relationship between population trust in science, authorities and vaccine confidence. We found generally high trust in science and authority, along with strong confidence in vaccines. Trust in science increased by 0.98 (95% CI 0.93 to 1.03) for every unit increase in trust in government. Trust in information from medical staff and scientists was highest, while information from politicians and social media was least trusted. We found a positive association between the three indices across some, but not all countries. The perception of scientific support for the vaccine rollout was positively associated with vaccine confidence in nearly all contexts, with effect sizes ranging from 0.55 (in Thailand and Indonesia) to 1.07 (in Singapore). Our findings indicate that to enhance resilience against future public health emergencies and improve adherence to directives for non-urgent health concerns, health authorities should focus on communicating scientific support behind health guidelines and build trust in science and authority in the long term.
The sub-occipital transtentorial approach for pineal and pineal region tumours is reported as realized in Lyon. The approach described by C. Lapras is still performed today with a large skin flap and a large bone flap, which is sawn flush with the superior longitudinal sinus and the transverse sinus.The large bone flap allows elevation and separation of the hemisphere, avoiding its compression against the internal edge of the parietal bone.Opening the tentorium allows broad visualization of the pineal region space and of the venous arch formed by the basilar veins and the Galen vein.Protecting the occipital lobe with a rubber blade and cottonoids prevents compression of the calcarine scissure and has helped to reduce the incidence of the homonymous lateral hemianopia, which was the main criticism of this approach. In recent years, endoscopy assistance at the end of surgery has helped increase the rate of complete tumour removal by detecting pieces of tumour that were left in place.In Lyon, it was realized in more than 300 procedures.
The revival of psychedelic medicalization is often narrated as a story of scientific legitimacy and neurotherapeutic promise, yet the unusual sensitivity of psychedelics to environmental conditions has encouraged research on music, therapy, setting, and other contextual factors. Treating setting and context as the building blocks of felt atmospheres, this article examines how regulation actively shapes atmospheres of consumption for substances that alter affective and sensory perception. Debates over drug-centric versus therapy-centered models are situated within the broader issue of how law shapes contexts and settings of psychedelic consumption. Policy developments in the United States and Australia show how emerging legal pathways have variably defined personnel, setting, access, substance, and the permitted forms of "holding space" or providing support or therapy. We introduce the concept of regulatory atmospheres to describe the diffuse and sometimes invisible ways in which policy shapes the contextual conditions of psychedelic use. Although policy rarely addresses atmospheres directly, we argue that it powerfully conditions them, which the case of psychedelic drug policy makes particularly clear. Alongside emerging legal pathways, the persistent shadow cast by prohibition over underground and traditional contexts reveals how some ontologies of risk and efficacy are privileged over others.
Heavy menstrual bleeding (HMB) is a common problem existing in nearly 30% of women worldwide. An underlying bleeding disorder has been identified as a cause of HMB in a significant proportion of women seeking gynecological care for HMB. In practice, however, there is a significant underdiagnosis of bleeding disorders in these patients, highlighting a need for improvement in awareness and detection. To present a comprehensive review of the literature on HMB and bleeding disorders and to increase awareness of their interrelation. In addition, to propose a standardized diagnostic approach to help identify which women with HMB may have an underlying bleeding disorder and require further hemostatic evaluation. A literature review was performed using PubMed to identify relevant primary research and review articles on the topic of HMB and bleeding disorders in English. This was supplemented by manual reference searches and review of relevant guidelines in English and Dutch. A significant proportion (10% to as much as 62%) of women with HMB have an underlying bleeding disorder, yet many such disorders go unrecognized. Various screening instruments, particularly the validated PBAC, Philipp tool or self-BAT, can help distinguish between HMB with or without a suspected bleeding disorder, and indicate who needs additional hemostatic evaluation. An underlying bleeding disorder is far more frequent in HMB than currently appreciated. Gynecologists should be aware of this and be familiar with screening instruments and a diagnostic workflow for bleeding disorders. Multidisciplinary collaboration between gynecology and hematology is crucial for accurately diagnosing and managing potential bleeding disorders in women with HMB.
Trauma, an external assault's corporeal aftermath, manifests as wounds or injuries, breaching or not breaching the skin, wrought by environmental forces upon the human, and is considered One of the world's foremost public health challenges intertwines complex societal, environmental, and medical issues. In order to evaluate the severity of trauma, it seems necessary to have a quantitative scale that can be measured. Therefore, the aim of this study is to look into the predictive power of two scoring indices, The Injury Severity Score (ISS) and MGAP, in patients with multiple traumas. This research is a cross-sectional type and was conducted on trauma patients, aged 18 and over, with at least two traumas, hospitalized for over 24 hours in Taleghani Hospital in Mashhad in the period of one year from October 2020 to October 2021. For ISS, the Abbreviated Injury Scale (AIS) scores for affected organs in six body areas were determined, and the three highest AIS scores were calculated. For the MGAP score, data on injury mechanism, age, Glasgow Coma Scale (GCS), and systolic blood pressure were extracted. A chi-square test was conducted to ascertain the correlations between categorical variables and the status of survival. Additionally, Positive Triage Accuracy was measured and compared for ISS and MGAP. In this research, 699 cases were investigated. Among the patients, 567 (81%) were male and 132 (19%) were female. Also (92%) 641 patients were discharged alive and (8%) 58 patients died. Among the 114 patients admitted to the ICU, 45 (39%) died. Cases mislabeled as medium or low risk that experienced death happened in 7 cases (of 598 available records; 1.17%) based on the ISS risk stratification system with 98.18% Positive Triage Accuracy and 44 cases (of 698 available records; 6.30%), based on the MGAP risk stratification system with 32.75% positive triage accuracy. The findings show the robust predictive power of ISS, with a low mislabeling rate and high triage accuracy. Conversely, the MGAP system demonstrated a higher mislabeling rate, suggesting that its application may yield incorrect results in certain situations and settings. This shows the need for cautious consideration when applying the MGAP risk stratification system, as its performance may not be universally applicable across all scenarios.
Iron deficiency during pregnancy poses a significant risk to maternal and fetal health, especially among anemic women whose physiological demand for iron increases drastically. This study aimed to evaluate the serum iron profile of non-anemic pregnant women at the time of delivery and to identify associated demographic and clinical factors. Conducted at Baharloo Hospital between 2022 and 2023, this cross-sectional study involved pregnant women who met the primary inclusion criteria of being non-anemic in the first and second trimesters and were admitted for scheduled labor. Serum ferritin, serum iron, and total iron-binding capacity (TIBC) were quantified, alongside comprehensive analysis of hemoglobin (HB) levels and red blood cell (RBC) indices. Data on demographic characteristics, and prenatal supplement usage were collected through medical records and analyzed using SPSS software. This study of 120 pregnant women (mean age 28.85 ± 6.34 years, gestational age 39.21 ± 0.8 weeks) found that most participants regularly consumed iron (93.33%) and multivitamin supplements (81.67%), with average serum iron levels of 98.73 ± 20.7 μg/dL at 3rd trimester. Key correlations included negative associations between gestational age and maternal age (r=-0.26) and between ferritin and gestational age (r=-0.18), while hemoglobin and hematocrit levels were strongly positively correlated. Logistic regression identified lower second-trimester hemoglobin as protective against delivery-time anemia (OR=0.29), and lower second-trimester MCV significantly predicted iron-deficiency anemia (IDA) (OR=0.70), when adjusting for age, gestational age, BMI, supplements or iron usage, multiparity, and educational level. As iron and multivitamin supplementation did not significantly reduce anemia risk and it was basically related to second-trimester MCV and hemoglobin, higher thresholds of these markers should be assigned as the goal of anemia prevention programs for Iranian women.
Endometriosis is a prevalent medical condition that significantly affect the quality of life in a substantial proportion of women, affecting their fertility and manifesting with many symptoms like gastrointestinal symptoms. The present study aimed to evaluate the impact of laparoscopic surgery for endometriosis on general and sexual quality of life, and gastrointestinal symptoms in patients diagnosed with deep infiltrating endometriosis (DIE). This prospective cohort study was conducted on 129 women diagnosed with DIE-associated infertility and referred to Yas Infertility Center in Tehran , from 2022 to 2023. Demographic data and the presence and severity of gastrointestinal symptoms were recorded. These symptoms were reassessed one month following endometriosis surgery. Participants were also asked to complete the SF-36 Quality of Life Questionnaire and Female Sexual Function Index (FSFI) questionnaires before the surgical procedure and one month later. Data were analyzed using SPSS version 24. This study of 129 patients (mean age 34.82±5.83 years, BMI 25.64±3.77 kg/m²) revealed near-universal ovarian involvement (99.2%) and adhesions (99.2%), primarily affecting rectosigmoid (24.1%) and cervix (29.5%). Pre-intervention, 98.4% reported abdominal pain (47.3% severe), 37.9% bloating, and 24.8% constipation. Post-intervention showed dramatic improvements: pain-free cases rose to 90.7%, bloating reduced to 9.3%, and constipation to 6.2% (all P0.0001). The FSFI score increased (57.6±28.8 to 65.2±27.4, P0.0001), and SF-36 pain scores halved (6.8±1.2 to 2.7±0.9, P0.0001), though vitality and emotional well-being remained unchanged. Surgical complications included hemoglobin drop (17.8%) and intestinal injury (6.2%). The findings of this study indicate that laparoscopic treatment of DIE not only alleviates gastrointestinal symptoms but also significantly enhances the quality of life and sexual function in affected women.
Global Developmental Delay (GDD) affects cognitive, language, motor, and adaptive functions in children under five years and is often a precursor to long-term neurodevelopmental disorders including intellectual disability and autism spectrum disorder. Early intervention can improve developmental outcomes, yet evidence regarding its effectiveness, especially in low-resource and diverse clinical settings, remains fragmented. To synthesize available evidence on the effectiveness of early intervention programs for children aged 0-6 years with GDD, and to identify intervention types, outcomes, and gaps in current research. A systematic review following PRISMA 2020 guidelines was conducted. PubMed, Web of Science, Scopus, and ClinicalTrials.gov were searched up to October 14, 2025, using predefined search terms. Eligible studies included children aged 0-6 years diagnosed with GDD or nonspecific developmental delay and involved an early intervention program assessing developmental outcomes. Data extraction and quality appraisal were performed using Joanna Briggs Institute (JBI) tools. Narrative synthesis was used due to heterogeneity across studies. Six studies involving a total of 689 participants were included. Interventions varied widely, including multidisciplinary rehabilitation, parent-mediated programs, community-based approaches, and combined medical-therapeutic methods. All studies reported improvements in at least one developmental domain (motor, language, cognitive, or social), with greater gains observed when interventions were initiated early (6 months) and sustained over longer durations. Parent-mediated and community-based models were feasible and effective in low-resource settings. However, no randomized controlled trials were identified, and most studies showed moderate to high risk of bias. Certainty of evidence was rated low to very low using GRADE. Early intervention programs demonstrate consistent benefits for children with GDD across settings, particularly when initiated early and involving caregivers. However, the current evidence base is limited by methodological weaknesses and lack of standardized outcome measures. High-quality randomized trials and long-term follow-up studies are urgently needed to inform best practices and policy implementation.
Acute Coronary Syndrome (ACS) remains a leading global cause of mortality, with multiple established risk factors. While smoking is widely recognized, opium use poses a significant health concern, particularly in developing nations. Despite traditional beliefs suggesting potential cardioprotective effects, growing evidence indicates a detrimental impact of opium consumption on cardiovascular health. This study aimed to investigate the association between opium dependence and the clinical outcomes of patients experiencing ACS. This study, conducted on 165 patients with ST-elevation myocardial infarction (STEMI) and Non-ST-elevation myocardial infarction (NSTEMI) referred to the Qom Heart Center, Qom, Iran from 2022 to 2024. The patients were categorized in two groups: 81 opium-dependent patients based on DSM-V criteria as a case group and 84 non-opium-dependent patients as a control group, and their clinical outcomes were compared. Coronary artery involvement was significantly more severe in opium-dependent patients ie three vessel disease (3VD) or left main stenosis (LM) involvement in the opium-dependent group was 48.1% versus 28.6% in the non-opium-dependent group, (P-value=0.01). Prevalence of atrial fibrillation (AF) and delay in hospital admission and the hospitalization days were higher in the opium-dependent group. LVEF at the admission did not differ between the two groups, but left ventricle ejection fraction (LVEF) three months later was higher in the opium-dependent group. Rehospitalization, arrhythmia, mechanical complications, need for CABG, and mortality during the initial hospitalization did not differ between the two groups. The mortality of the patients in the six-month follow-up was 6.5% in the opium-dependent group and 8.6% in the non-opium-dependent group (P-value=0.61) which did not show a significant difference. This issue shows the lack of significant role of opium consumption in the mortality of patients. Our findings suggest a strong association between opium dependence and a more severe clinical presentation of ACS, characterized by a higher burden of coronary artery disease. Although initial LVEF recovery appeared faster in opium-dependent individuals, the overall impact on long-term mortality remained inconclusive within the six-month follow-up period. These findings underscore the critical need for further research to elucidate the complex interplay between opium dependence and cardiovascular outcomes in ACS patients, including long-term follow-up and exploration of potential underlying mechanisms.
Poultry meat is recognized as a potential reservoir of Campylobacter jejuni and Campylobacter coli. This study was done to assess antibiotic resistance and virulence characteristics of C. jejuni and C. coli isolated from raw poultry meat. Raw poultry meat samples were collected. C. jejuni and C. coli were isolated after microbial examination. Disk diffusion was applied to apprise antibiotic resistance. Polymerase Chain Reaction was employed to determine the virulence and antibiotic resistance gene distribution. Raw poultry meat samples contamination rate with Campylobacter spp. was 19% (76 out of 400 samples). The highest contamination rate was observed amongst the raw duck meat samples (37.50%). Forty-three (56.57%) and twenty (26.31%) out of 76 Campylobacter spp. were recognized as C. jejuni and C. coli, respectively. C. jejuni and C. coli isolates harbored the uppermost rates of resistance toward tetracycline (67.44% and 50%), gentamicin (60.46% and 50%), ampicillin (48.89% and 40%), and erythromycin (48.89% and 35%), respectively. The prevalence of multidrug-resistant C. jejuni and C. coli was 81.39% and 75%, respectively. C. jejuni and C. coli bacteria harbored tetO (23.48% and 45%), cmeB (44.18% and 45%), and blaOXA (44.18% and 35%) antibiotic resistance genes, respectively. All isolates harbored fla and ciaB. Among the C. jejuni isolates, cadF (67.44%), racC (46.51%), and cdtB (46.51%) and amongst the C. coli isolates, pldA (50%), cdtA (35%), racC (30%), and cadF (30%) were major virulence factors. The role of raw poultry meat, particularly duck and goose, as antibiotic-resistant and virulent Campylobacter spp. reservoirs were confirmed.
Cardiovascular patients frequently suffer from xerostomia and several modalities has been tried to alleviate the symptom. Improving Oral Health Related Quality of Life (OHRQoL) is a subjective index and considered as the final achievement in oral treatments. The aim of the present study was to evaluate OHRQoL in these patients, as well as its relation to xerostomia and some other factors. In this cross-sectional study, 244 patients participated. OHRQoL was assessed by Oral Health Impact Profile 14 (OHIP-14). Xerostomia severity was quantified by the Xerostomia Inventory (XI). Consumed anti-hypertensive drugs, age and gender were also recorded. Data were analyzed using SPSS 22 (IBM version 22.0, Chicago, USA) and statistical significance level was considered P0.05. The mean age of participants was score of OHIP-14 was 58.90 ± 5.66 years, of whom 53% were male and 47% female. The mean total OHIP-14 score was 13.33 ± 11.11. Patients with xerostomia consisted 78% of the sample, with a mean XI score of 23.9 ± 5.1. Total and all domain scores of OHIP-14 were directly and significantly correlated with XI score (P0.001). Also, age had a direct and significant correlation with both OHIP-14 (P0.001) and XI (P=0.001) scores. Use of cardiovascular drugs was not significantly related to xerostomia presence or severity (P0.05). The majority of cardiovascular patients suffer from moderate xerostomia, regardless to the type of medication they consume. Xerostomia affects OHRQoL in these patients and should be treated properly to improve their life quality, especially among the elderly.
Intrauterine growth restriction (IUGR) refers to poor fetal growth characterized by a multitude of neonatal complications, necessitating timely diagnosis and intervention. This study aimed to compare the descending colon diameter and kidney length between fetuses with IUGR and normal growth. In this case-control study, a total of 60 participants, 30 pregnant women with IUGR fetuses and 60 women with normal fetuses, referring to an institutional tertiary hospital in eastern Iran, in 2023, were surveyed. Variables included demographic data, fetal kidney length, descending colon diameter, and the pulsatility index (PI) and resistance index (RI) of maternal and fetal arteries. Statistical analysis was performed using IBM SPSS 18.0, with a significance threshold of P<0.05. A total of 90 pregnant women with a mean age of 29.50 ± 6.61 years were included. The prevalence of patients with occupational employment was significantly higher in the IUGR group (P=0.012). The mean right and left kidney lengths and the anteroposterior diameter of the renal pelvis were significantly higher in normal fetuses compared to those with IUGR (P<0.05). However, no significant difference was found in descending colon diameter between the two groups (P=0.071). The RI and PI of the umbilical and uterine arteries were significantly higher in IUGR fetuses, while the RI and PI of MCA were higher in normal fetuses (P<0.05). Descending colon diameter is not a reliable marker for IUGR diagnosis. However, the use of RI and PI of umbilical, uterine, and cerebral arteries can be effective in identifying IUGR.
Background: Angiomyofibroblastoma (AMFB) is a rare, benign soft tissue tumor that belongs to the mesenchymal tumor category and affects the female genital tract. Aggressive angiomyxoma, a distinct stroma myxoedematous mesenchymal tumor with a significant risk of local recurrences, must be histomorphologically distinguished from AMFB. Radiography and histopathology are used for accurate diagnosis. The treatment depended on the complete surgical excision. Case Presentation: Herein, we presented a case of a 36-year-old female (P3+0) presented with a left vaginal mass noted two years prior. The radiology report suggested angiomyxoma or myxoid liposarcoma as possible differentials. Surgical resection revealed a benign genital stromal tumor, specifically angiomyofibroblastoma (AMFB). After complete surgical excision, the immunohistochemical analysis supported the diagnosis of angiomyofibroblastoma. Two months postoperatively, an MRI Post-resection images show complete resection with no feasible scar, residual tumour, or recurrence. Conclusion: Our case is rare AMFB. AMFB may be missed when diagnosed with other masses, such as angiomyxoma or myxoid liposarcoma, so we need to do the necessary tests to diagnose and differentiate AMFB accurately from other masses. Ultrasound and MRI are initial diagnostic tools, while histopathology ensures the correct diagnosis. Surgical removal with free margins remains the appropriate treatment. Long-term follow-up is essential to monitor for potential recurrence, though AMFB typically carries an excellent prognosis.
Major spine surgeries often involve significant blood loss, increasing transfusion risks and postoperative complications. Desmopressin, a synthetic vasopressin analog, may reduce bleeding by enhancing clotting factor release, but its efficacy in spine surgery remains understudied. This study evaluated the efficacy of preoperative intravenous desmopressin in reducing perioperative blood loss and transfusion requirements in patients undergoing major spine surgery. A double-blind, randomized, placebo-controlled trial was conducted at Shahid Rajaei Hospital, Iran. Fifty-five patients undergoing major spinal surgery were randomized to receive either 0.3 μg/kg desmopressin (n=25) or placebo (n=30) during anesthesia induction. Primary outcomes included intraoperative blood loss (measured hourly) and transfusion volume. Secondary outcomes included postoperative sodium levels, creatinine, urine output, and hospital stay. Statistical analyses used Student's t-test, Chi-square, and repeated measures ANOVA. Desmopressin significantly reduced intraoperative blood loss during the first hour (336.00± 125.43 vs. 398.33±85.58 mL, P=0.034) and second hour (530.95±188.07 vs. 756.67 ± 242.65 mL, P=0.003) compared to placebo. Total transfusion volume was lower in the desmopressin group (724.79 ± 429.06 vs. 1396.55±325.94 mL, P=0.001), with fewer intraoperative packed red blood cell transfusions (16% vs. 40%, P = 0.050). Postoperative creatinine levels were lower with desmopressin (1.16 ± 0.30 vs. 1.40 ± 0.32 mg/dL, P=0.009), but sodium levels and urine output were comparable. Hemodynamic stability and hospital stay did not differ significantly. Preoperative desmopressin reduced early intraoperative blood loss and transfusion requirements in major spine surgery without significant adverse effects. These findings support its use as a hemostatic adjunct, though further studies are needed to confirm long-term safety and efficacy.
In recent decades, the prevalence of diabetes, alcohol and tobacco consumption has increased in Iran and the world. This study aimed to investigate the relationship between diabetes with family history, alcohol and tobacco consumption in Iran. A cross-sectional study was carried out in the southeast of Iran in 2023_2024. The target population consisted of 10,016 individuals aged between 35 and 70 years. The data required for this study was obtained from the data collected by ZACS (Zahedan Adult Cohort Study) in the southeast of Iran (The Persian Cohort and ZACS data are the same. In fact, ZACS is part of the Persian Cohort). The data on general information, diabetes, family history of diabetes and alcohol consumption were collected through a standard questionnaire and were analyzed using descriptive statistics and independent t-tests, chi-square and logistic regression in SPSS 22 software. The prevalence of diabetes was 19.0% and it was more prevalent in women (20.1%), unemployed people (21.9%) and age groups of 60 years and older (P0.05). The prevalence of diabetes was 37.8% in first relatives and 19.4% in second relatives. Although only 2.4% of people consumed alcohol, diabetes was less common in people who consumed alcohol than in others (P0.001). In univariate results, drug use reduced the chance of developing diabetes (OR=0.86, P=0.026). However, there was not significant relationship between drug use and diabetes after adjusting for history of diabetes in relatives (OR=0.99, P=0.229). Family history had a positive effect on developing diabetes (P0.001). The findings showed the family history had a positive effect on developing diabetes. These results show the necessity of examining the family history of people, identifying people at risk, and also providing the necessary education for the prevention of diabetes. It is recommended that people with a family history of diabetes take diabetes preventive measures and modify their lifestyle.
Background: Strabismus, a common ocular disorder marked by misalignment of the visual axes, can impair depth perception and visual function, while also affecting facial appearance and psychosocial wellbeing. In recent years, the field has seen a growing body of research focusing on its pathogenesis, risk factors, and therapeutic approaches. However, the literature is still fragmented, making it difficult to assess overarching trends. Therefore, a comprehensive bibliometric analysis is needed to understand research developments and identify emerging hotspots in this domain. Materials and Methods: A bibliometric analysis was conducted using VOSviewer and CiteSpace on 6,540 English-language articles and reviews related to strabismus, published between 1995 and 2025, and retrieved from the Web of Science Core Collection (WOSCC). Results: The updated analysis revealed consistent growth in publication output, with particularly rapid expansion in recent years. While the United States remained a key contributor, China has overtaken the U.S. in annual output since 2023. Keyword co-occurrence and burst analysis identified both long-standing research interests (e.g., intermittent exotropia [IXT], AACE, surgical outcomes) and newer focus areas such as digital screen exposure, artificial intelligence in diagnostics, and individualized surgical planning. Conclusion: This study provides an updated and comprehensive bibliometric evaluation of global strabismus research through 2025. The results highlight evolving academic contributions, changing geographical trends, and shifting research priorities, offering guidance for future investigations and clinical advancements.
Diabetes presents a significant health challenge worldwide, with profound implications extending beyond glycemic control to impact various bodily systems. This review explores the intricate relationship between diabetes and musculoskeletal disorders, shedding light on their epidemiology, pathophysiology, and clinical implications. Individuals with diabetes face a heightened risk of developing musculoskeletal conditions, particularly tendon disorders such as adhesive capsulitis rozen shoulder, rotator cuff tears, muscle atrophy, osteoarthritis and diabetic hand syndrome. Mechanisms underlying these disorders include inflammation, glycation, and impaired tendon homeostasis, exacerbated by factors like insulin resistance and oxidative stress. Furthermore, diabetes poses challenges in orthopedic surgery, leading to increased rates of surgical complications and poorer outcomes. Understanding the interplay between diabetes and musculoskeletal health is crucial for developing targeted interventions aimed at optimizing patient care and outcomes in this population. Diabetes presents a significant health challenge worldwide, with profound implications extending beyond glycemic control to impact various bodily systems. This review explores the intricate relationship between diabetes and musculoskeletal disorders, shedding light on their epidemiology, pathophysiology, and clinical implications. Individuals with diabetes face a heightened risk of developing musculoskeletal conditions, particularly tendon disorders such as adhesive capsulitis rozen shoulder, rotator cuff tears, muscle atrophy, osteoarthritis and diabetic hand syndrome. Mechanisms underlying these disorders include inflammation, glycation, and impaired tendon homeostasis, exacerbated by factors like insulin resistance and oxidative stress. Furthermore, diabetes poses challenges in orthopedic surgery, leading to increased rates of surgical complications and poorer outcomes. Understanding the interplay between diabetes and musculoskeletal health is crucial for developing targeted interventions aimed at optimizing patient care and outcomes in this population.