This study aimed to explore the association between serum uric acid to high-density lipoprotein cholesterol ratio (UHR) and minor and major ischemic electrocardiogram (ECG) changes. The data from the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) cohort study comprised 9035 participants aged 35 to 65 years. A 12-lead resting ECG was recorded at baseline for participants. ECG abnormalities were defined according to the Minnesota coding system and classified into three groups: none, minor, and major ischemic changes. Minor and Major ischemic changes were observed in 6.2% and 14.1% of participants, respectively. Participants in the major ischemic group had higher UHR levels compared to those without ischemic changes on their ECG (odds ratio (OR)=0.023, 95% confidence interval (95% CI)=1.011-1.035, P<0.001). UHR remained correlated with major ischemic ECG changes after adjustment for either age (OR=0.019, 95% CI=1.007-1.031, P=0.001) or various cardiovascular risk factors (OR=0.018, 95% CI=1.006-1.030, P=0.004). UHR was not significantly associated with minor ischemic changes. This research showed, for the first time, that UHR was significantly associated with major ischemic ECG changes. Indeed, the UHR provides additional information for risk stratification of subjects with myocardial ischemia.  

Iron deficiency is a common condition in women of reproductive age and has been associated with infertility and suboptimal pregnancy outcomes. Iron supplementation may improve fertility outcomes, but its effects on embryo quality and other reproductive parameters remain unclear. This study aimed to evaluate the effect of iron supplementation on pregnancy outcomes, embryo number, and embryo quality in women undergoing in vitro fertilization (IVF). This randomized, double-blind, controlled clinical trial included 112 women aged 20-39 undergoing IVF. Participants were divided into two groups: one receiving iron supplements and the other serving as a control group. The study assessed pregnancy outcomes, the number of embryos, and embryo quality. Data were analyzed using statistical tests, including two-way ANOVA and logistic regression, with a significance threshold of P<0.05. Women who received iron supplementation had significantly higher pregnancy rates (50%) compared to the control group (28.5%, P=0.020). The number of embryos was also significantly higher in the iron group (5.00±3.297) than in the control group (3.39±0.888, P=0.001). However, embryo quality did not differ significantly between the two groups (P=0.055). BMI was positively associated with the number of embryos (P=0.002). Still, other factors, including age, endometrial thickness, and years of infertility, showed no significant effects on pregnancy outcomes or embryo quality. Iron supplementation improves pregnancy outcomes and the number of embryos in women undergoing IVF, but does not significantly impact embryo quality. These findings highlight the potential of incorporating iron supplementation into IVF protocols; however, further research is needed to determine the optimal dosing and long-term effects.

Hypoxic-ischemic encephalopathy (HIE) is a leading cause of neonatal mortality with limited therapeutic options. This study evaluated the effect of melatonin on short-term outcomes in neonates with HIE. To determine whether adjunctive oral melatonin improves short-term clinical outcomes, including in-hospital survival, in neonates with HIE. A randomized controlled trial enrolled 80 neonates with HIE at Fatemieh Hospital, Hamadan, Iran (2021-2023). The intervention group (n=32) received standard treatment plus 10 mg/kg oral melatonin daily for 5 days, while the control group (n=48) received standard treatment alone. Outcomes included seizure frequency, hospital stay duration, time to initiate oral feeding, time to regain consciousness, adverse effects, and in-hospital survival. Baseline characteristics, HIE severity, medications for seizure control, and paraclinical/imaging findings were comparable between groups (all P>0.05). No significant adverse effects were observed. The intervention group had a higher survival rate (81.2%, 26/32) than the control group (52.1%, 25/48) (P=0.04). There were no significant differences in hospital length of stay, time to start feeding, or time to regain consciousness among surviving neonates (all P>0.05). Adjunctive melatonin may improve in-hospital survival in neonates with HIE and merits further evaluation as an additive therapy.

Fever is a common indication of disease among children and is considered harmful by many parents, occurring when the body temperature rises above the normal range. The normal range of body temperature varies with a child's age, measurement method, and time of day. To compare the effects of warm-water foot immersion versus vinegar compresses on reducing body temperature in febrile children. A quasi-experimental non-equivalent control group pre-test—post-test design was employed in this study, involving 180 children at Karbala Teaching Hospital for Children. Participants were selected through purposive sampling and divided into three groups. Participants in the control group (n=60) received only standard hospital care; participants in the WWFI group (n=60) received a warm foot bath for 15 minutes; and participants in the vinegar compress group (n=60) received cider apple vinegar compresses for 15 minutes. Axillary body temperature was measured by using a mercury thermometer before and after the intervention. Using SPSS version 26, the data were analyzed. Employing descriptive statistics and the Mann-Whitney U test for group comparisons. The control group shows only a modest decline in body temperature over time, starting at a mean of 38.91±0.53° C and gently decreasing to 38.17±0.50° C by 60 minutes (P=0.145). In contrast, both interventions significantly lowered body temperature in children with fever (P=0.001). WWFI produced a statistically significant reduction in mean body temperature from 38.88±0.42° C at baseline to 36.85±1.32° C at the 60‑minute mark, and the vinegar compresses demonstrated a significant, steep decline from a baseline mean of 39.05±0.54° C to 36.87±0.28° C after 60 minutes. Statistical analysis showed a significant difference in effectiveness between the two interventions (P<0.001), with vinegar compresses being more efficacious. However, WWFI and vinegar compresses are both supportive non-pharmacological interventions among febrile children. But vinegar compresses were more effective than WWFI in reducing body temperature. As a non-pharmacological intervention, vinegar compresses should be involved in the fever management protocol for children, and additional studies with a large sample size and another age group in a different setting are also recommended.

Acute myocardial infarction (AMI) typically presents with retrosternal chest pain exacerbated by exertion and relieved by rest or nitroglycerin. However, this case describes an 81-year-old male who presented with Diarrhea and generalized weakness, an unusual manifestation of AMI. This highlights the importance of recognizing atypical symptoms, particularly in elderly patients with comorbidities, to ensure timely diagnosis and intervention.

Malignant peripheral nerve sheath tumor (MPNST) is a rare and aggressive soft tissue sarcoma, with the epithelioid subtype accounting for less than 5% of cases. Most MPNSTs are associated with neurofibromatosis type 1 (NF1), prior radiation exposure, or occur sporadically. Head and neck involvement is uncommon, especially in large tumors. We report a case of giant sporadic epithelioid MPNST in a 21-year-old male without NF1. The patient presented with a progressively enlarging left head and neck mass over two years. Imaging revealed a heterogeneous lesion with extensive soft tissue, bony, and neural involvement. Histopathology confirmed epithelioid MPNST with high-grade spindle cell sarcoma features, positive for S-100 and p53, and a Ki-67 index of 20%. The patient underwent wide local excision with neurosurgical assistance, preserving major cranial nerves but requiring sacrifice of the facial nerve and jugular vein. Postoperative recovery was uneventful, and no recurrence was observed at six months. This case highlights the diagnostic complexity, aggressive nature, and surgical challenges of giant epithelioid MPNST in the head and neck, underscoring the importance of complete excision with negative margins for improved outcomes.