Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 63 6 2025 12 31 376 385 Thaer Ali Hussein Department of Medical Laboratory Techniques, Nasiriyah Technical Institute, Southern Technical University, Basra, Iraq. Mohammed H. Flaih Department of Medical Laboratory Techniques, Nasiriyah Technical Institute, Southern Technical University, Basra, Iraq. 2024 10 08 2024 11 26 TIL and pembrolizumab treatments compared for advanced melanoma patient outcomes. The idea was to determine which one was better, the safety of each, and the quality of life of the patients under the treatments. While understanding the safety profile of both drugs, the assumption was that TIL therapy would be a better alternative to pembrolizumab in survival outcomes and quality of life improvements. 120 patients were randomly allocated (TIL n=60; pembrolizumab n=60). Progression-free survival (PFS) and overall survival (OS) were taken as primary endpoints. Secondary endpoints were objective response rate (ORR), quality of life (EORTC QLQ-C15-PAL), and safety (CTCAE v5.0). Median PFS was 8 vs 6 months (HR=0.85, 95% CI: 0.65-1.12; P=0.15). Median OS was 18 vs 17 months (HR=0.92, 95% CI: 0.70-1.21; P=0.21). ORR was similar (36% vs 34%). TIL improved physical functioning, and both arms provided emotional benefit. TIL was associated with higher rates of grade 3-4 toxicities, including neutropenia and cytokine release syndrome. TIL therapy resulted in survival outcomes similar to those with pembrolizumab, with improved quality of life but higher toxicity. https://acta.tums.ac.ir/index.php/acta/article/view/11292 https://acta.tums.ac.ir/index.php/acta/article/download/11292/6003

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 63 6 2025 12 31 371 375 EN Mahshid Shooshtari Department of Obstetrics and Gynecology, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran. Shohre Movahedi Department of Obstetrics and Gynecology, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran . Shima Tavakkolian Department of Obstetrics and Gynecology, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran. Ghazal Roshanzadeh Clinical Research Development Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Midwifery and Reproductive Health, Tehran University of Medical Sciences, Tehran, Iran. Zahra Ghalenoee Department of Obstetrics and Gynecology, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran 2024 06 05 2025 05 05 This study investigates the complications associated with unplanned vaginal birth after cesarean delivery (VBAC) among women in Sistan-Balochistan province, who often delay hospital visits until labor is imminent due to concerns about clinician acceptance. A retrospective case-series study was conducted at Khash and Baharloo hospitals from September 2021 to October 2022. Data on all VBAC deliveries were collected from hospital records with informed consent. Maternal demographics, delivery profiles, and complications were analyzed using SPSS 22 software. The study investigated the safety and complications associated with vaginal birth after cesarean (VBAC) among 120 women, ultimately analyzing data from 114 participants after excluding those who underwent cesarean delivery due to failed trial of labor after cesarean (TOLAC). Out of 114 women who achieved VBAC, there were no maternal deaths. Complications included 5 (4.3%) uterine ruptures and 2 (1.7%) cases of endometritis. Four neonates had an Apgar score< 7 at five minutes, including one intrauterine fetal death (IUFD). Understanding the complications associated with VBAC is essential for developing localized guidelines tailored to individual patient needs. https://acta.tums.ac.ir/index.php/acta/article/view/11123 https://acta.tums.ac.ir/index.php/acta/article/download/11123/6000

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 63 6 2025 12 31 365 370 Mohammad Reza Golbadinejad Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran. AND Department of Internal Medicine, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran. Manizheh Yousefi Moghadam Zardoshtr@medsab.ir.ac Behnaz Souizi School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran Roghayeh Zardosht Department of Operative Room, Iranian Research Center on Healthy Aging, School of Paramedical, Sabzevar University of Medical Sciences, Sabzevar, Iran. 2025 09 07 2025 10 18 Effective pain relief supports both the mother and fetus against many stressors associated with labor pain, which can have adverse effects on both. This study was conducted to determine Apgar scores and neonatal dysrhythmia in painless delivery compared with natural childbirth. The current study was conducted as a cross-sectional investigation of 213 hospital records of pregnant women (2020-2022) who underwent natural childbirth and painless delivery using a combination of two drugs: 25 µg of fentanyl and 25 mg of pethidine. Data were extracted from both groups using a checklist that included maternal age, infant sex, gravidity, parity, gestational age, birth weight, duration of labor, number of previous cesarean sections, mode of delivery, neonatal Apgar score, and dysrhythmia. In this study, 49.3% delivered painlessly, whereas 50.7% experienced natural childbirth. The mean Apgar score for infants born to mothers who underwent natural childbirth was 9.81±0.53, whereas that for infants born to mothers who experienced painless delivery was 9.93±0.53. Despite the higher Apgar scores in infants delivered using painless methods, this increase was not statistically significant. No cases of dysrhythmia were observed in either group. Based on the results of the present study, it can be concluded that there were no significant differences in neonatal outcomes, specifically Apgar scores and dysrhythmia, between the two groups. Therefore, it can be stated that painless delivery may be the preferred method of childbirth for pregnant women who have a fear of labor pain. https://acta.tums.ac.ir/index.php/acta/article/view/11792 https://acta.tums.ac.ir/index.php/acta/article/download/11792/5999

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 63 6 2025 12 31 359 364 Atie Safaee Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Ali Bagherpour Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. AND Department of Oral and Maxillofacial Radiology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. Mohammad Ashoori Private Practice, Mashhad, Iran. Zahra Jamali Paghaleh Department of Oral and Maxillofacial Radiology, School of Dentistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. 2025 01 08 2025 07 07 The hyoid bone, with its unique morphology, offers a valuable alternative for gender determination in cases where traditional indicators like the pelvis and skull are compromised. This study aimed to investigate the relationship between gender and hyoid bone dimensions using CT scan images. This retrospective study analyzed 120 neck CT scans to investigate the relationship between gender and hyoid bone dimensions. RadiAnt DICOM Viewer software was used for evaluation. Measurements included width, length, and proximal and distal widths of the greater horns of the hyoid bones on both sides. Statistical analysis employed a range of techniques, including independent t-tests, paired t-tests, Spearman's rank correlation, and discriminant analysis, with a significance level of 0.05. This retrospective study analyzed 120 neck CT scans from 60 women (mean age 48.92±13.53 years) and 60 men (mean age 53.97±17.05 years). In examining the dimensions of the hyoid bone, all variables except the distal width of the greater horn on both sides (RDD, LDD) were found to have statistically significant differences between the two sexes. The classification of individuals by sex was correctly determined in 85% of cases using discriminant function analysis. Stepwise analysis identified hyoid body length and width as the most significant predictors, demonstrating 81.7% and 85% accuracy in classifying men and women, respectively. In our study population, measurements of body length and width at the hyoid bone proved highly reliable indicators of sex differentiation. https://acta.tums.ac.ir/index.php/acta/article/view/11472 https://acta.tums.ac.ir/index.php/acta/article/download/11472/5998

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 63 6 2025 12 31 352 358 Saba Rezazadeh Student Research Committee, Arak University of Medical Sciences, Arak, Iran. Amirabbas Faridpour Student Research Committee, Arak University of Medical Sciences, Arak, Iran Fakhreddin Shariatmadari Department of Pediatric Nourology, Clinical Research Development Center of Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran. Yazdan Ghandi Department of Pediatric Cardiology, Clinical Research Development Center of Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran. Seyed Mojtaba Hashemi Departement of Pediatric Gastroenterology, Clinical Research Development Center of Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran. Parsa Yousefichaijan Department of Pediatric Nephrology, Clinical Research Development Center of Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran. 2024 10 09 2024 12 31 Migraine headaches are a significant concern for both parents and primary care providers due to their frequency and impact on the child's quality of life. Studies in the adult population have shown that migraines are linked to cardiovascular disease. This study aimed to compare blood pressure in children with and without Migraine. In this case-control study, we evaluated blood pressure in patients with Migraine and a control group. Blood pressure was evaluated during three clinic visits. Systolic, diastolic, pulse, and mean arterial blood pressure were compared between the two groups, and the association between blood pressure and Migraine was evaluated using the odds ratio. The mean systolic and diastolic pressures, pulse pressure, and mean arterial pressure were not significantly different between the two groups (P>0.05). Twenty-three children with Migraine had abnormal blood pressure, and the adjusted odds ratio was 1.32 (95% CI: 0.68-2.57). There was no significant relationship between prehypertension, stage 1 hypertension, and stage 2 hypertension and Migraine in children (P>0.05). The prevalence of prehypertension in children with bilateral Migraine was higher compared to unilateral Migraine, although this difference was not statistically significant (P>0.05). Our results did not confirm blood pressure as an etiological factor in children with Migraine. These findings suggest that further research is needed to explore the relationship between Migraine and blood pressure in pediatric populations. https://acta.tums.ac.ir/index.php/acta/article/view/11297 https://acta.tums.ac.ir/index.php/acta/article/download/11297/5997

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 63 6 2025 12 31 345 351 Peyman Kouhi Habibi Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Pegah Mirzapour Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Sanam Mahmoudi Tazehkandi Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Zeinab Hassanzadeh Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Mohammadreza Salehi Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Infectious Diseases Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Abbas Boosiraz Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Seyed Ali Dehghan Manshadi Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Bahareh Hasanpour Shahid Beheshti University of Medical Sciences, Tehran, Iran. SeyedAhmad SeyedAlinaghi Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Shayesteh Jahanfar Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States. 2025 07 26 2025 09 20 According to data from the WHO and CDC, Toxoplasma gondii is found worldwide, with a higher prevalence in regions with warm, humid climates; the highest reported rates in the general population reach 90%. The prevalence of cytomegalovirus infection among the general population of Iran has been estimated at 5.2%. According to the existence of insufficient data on the seroprevalence of Cytomegalovirus (CMV) infections in Tehran and the Center for Behavioral Diseases of human immunodeficiency virus (HIV)+ and toxoplasmosis among the people of Imam Khomeini Hospital, as well as the grave and fatal complications that threaten these infections, to identification, prevention and timely treatment of People Living with HIV (PLWH), general knowledge of its prevalence in our country is essential. This project was a cross-sectional study of PLWH referred to the Behavioral Diseases Counseling Center of Imam Khomeini Hospital in Tehran in 2018. A number was assigned to each patient who visited this year, and 348 were selected from this group. Anti-Cytomegalovirus Immunoglobulin G (IgG Anti CMV), and Anti-Toxoplasmosis Immunoglobulin G (IgG Anti-Toxoplasmosis) levels in serum were measured alongside demographic information, HIV transmission routes, disease duration, cluster of differentiation 4 (CD4) count, viral load, and Hepatitis B Virus and Hepatitis C Virus status of participants. The collected data were entered into IBM SPSS Statistics software version 25. The data were extracted from the patients' files to support the research aim. The seroprevalence of cytomegalovirus and toxoplasmosis was 99.4% and 41.7%, respectively. Due to cytomegalovirus's high prevalence, it has been impossible to investigate the impact of influential factors, and the efforts have been ineffective. A statisticlopment Unit, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Seyed Ali Dehghan Manshadi Department of Infectious Disease, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Saeed Reza Jamali Siahkali Department of Infectious Disease, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran Mostafa Mohammadi Department of Anesthesiology and Critical Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Banafsheh Moradmand Badie Australasian Bone Marrow Transplant Recipient Registry (ABMTRR), Sydney, Australia Tahereh Sajadifard Department of Infectious Disease, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Ensiyeh Rahimi Department of Infectious Disease, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2022 06 28 2023 08 15 Despite the improvement in COVID-19 therapeutic management the mortality of mechanically ventilated COVID-19 patients remains high. In this study, we determined the risk factors of death in these cases. This cross-sectional study evaluated clinical and paraclinical features of mechanically ventilated COVID-19 patients at the time of hospital admission until death or discharge from hospital between April and September in 2021 in three COVID-19 referral hospitals. The patients were divided into survivors and non-survivors and then the characteristics were compared. One hundred twenty-five patients (60% male, mean age 62±15.18, range 17 to 97 years old) were recruited to the study. 51(40%) survived and 74 (60%) didn’t survive. At the time of hospital admission, the vital signs were not significantly different between the survivors and non-survivors, although diarrhea was not reported in non-survivors, but reported in 9.5% of survivors (P=0.02). The mean age of non-survivors was higher (65.1±14.17 vs 56.9±15.41, P=0.003). The intubation time since the patients were admitted was not significantly different between the two groups (3.38±2.88 days vs 4.16±3.42 days, P=0.34). The mean of serum LDH and D-dimer at the time of ICU admission were significantly higher in the non-survivors (863±449 vs 613±326, P=0.01; 4081±3342 vs 542±634, P=0.009; respectively). However, the mean CRP was not significantly different between the two groups (76±66.4, 54±84.3; P=0.1). Mean APACHE-II score was higher in the non-survivors than the survivors (15 vs 13; P=0.01). Use of remdesivir, interferon beta-1a, and low dose corticosteroids were significantly higher in the survivors group (P=0.009, P=0.001, P=0.000). Success of weaning and ICU discharge among mechanically ventilated COVID-19 patients are probably higher in younger patients with lower D-dimmer and LDH that received remdesivir, interferon beta-1a and low dose corticosteroids, while the intubation time did not seem to play a role on patients' outcome. https://acta.tums.ac.ir/index.php/acta/article/view/10224 https://acta.tums.ac.ir/index.php/acta/article/download/10224/5810

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 7 2023 12 24 439 442 Helena Azimi Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Amir Hosein Jafarian Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Behroouz Davachi Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Elaheh Zandieh Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Fatemeh Shirzadeh Department of Nursing, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Zohreh Yousefi Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2021 04 25 2023 01 27 Choriocarcinoma usually occurs in the uterine body. Non-gestational choriocarcinoma is an extremely rare malignant tumor with a poor prognosis and is difficult to distinguish from gestational choriocarcinoma. In this case report, we describe a case of pure non-gestational choriocarcinoma. A 35-year-old woman was referred to our academic hospital with a pathology report of non-gestational choriocarcinoma of right ovarian cystectomy. Since the diagnosis did not coordinate with the patient's symptoms, PCR amplifying, and genomic DNA were performed. Finally, the diagnosis of pure non-gestational choriocarcinoma was confirmed. In follow-up, lung and brain metastasis was determined. Brain radiotherapy and BEP regimen chemotherapy were prescribed. However, the response was not appropriate, so she is currently undergoing palliative chemotherapy. Stage IV primary pure ovarian choriocarcinoma is a very aggressive tumor. Regardless of the nature of the tumor, the response to the treatment may not be good. Indeed the treatment of each case should be individualized. https://acta.tums.ac.ir/index.php/acta/article/view/9348 https://acta.tums.ac.ir/index.php/acta/article/download/9348/5819

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 7 2023 12 24 419 423 EN Parvaneh Karimzadeh Department of Pediatric Neurology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Reza Shiari Department of Pediatric Rheumatology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Masoud Hassanvand Amouzadeh Neuroscience Research Center, Qom University of Medical Sciences, Qom, Iran Samane Rahimi Department of Pediatrics, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Shaghayegh Sadat Esmail Nejad Department of Pediatrics, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Seyed Mohammad Hashem Montazeri Student Research Committee, School of Medicine, Qom University of Medical Sciences, Qom, Iran Mohammad Hossein Arjmandnia Department of Pediatrics, Hazrat-e-Fatemeh Masoumeh Hospital, Qom University of Medical Sciences, Qom, Iran