Selenium, a trace element present in specific selenoproteins, is essential for thyroid hormone metabolism. Selenium is also an antioxidant with immunosuppressive properties and may help in managing thyroid autoimmune diseases, including Graves’ (GD) hyperthyroidism and Graves’ ophthalmopathy (GO). There were 320 clinical studies related to selenium and thyroid published in English and French between January 1, 2000, and June 1, 2023. Our focus was to identify studies reporting levels of serum selenium in patients with GD and studies that assessed the effect of selenium supplementation on outcomes of GD hyperthyroidism and GO. We also reviewed 20 systematic reviews and meta-analyses of randomized controlled trials that reported selenium levels in GD and the effects of supplementation on GD and GO outcomes. Our review showed that patients with GD had serum selenium levels lower than those of various control patients. In the short-term, a selenium supplement to antithyroid drugs showed benefit for GD hyperthyroidism in most studies, but long-term benefits and positive effects on remission rate were unclear. Some studies did not show benefit. The benefits may depend on baseline selenium deficiency. Two randomized controlled trials showed positive effects of supplementation for mild GO; however, studies about moderate and severe GO are still needed. There is evidence for benefit with short-term selenium supplementation for GD hyperthyroidism, but controlled studies are needed to assess long-term benefits, and benefits in selenium-sufficient areas.

Hashimoto's thyroiditis (HT) is one of the common causes of hypothyroidism. Although various factors are involved in its development, recently the role of oxidative stress in its pathogenesis has been known. The present study aimed to investigate the level of total antioxidant capacity (TAC), catalase (CAT), and salivary superoxide dismutase (SOD) in patients with HT compared with the control group. The present case-control design included patients aged 18-80 years suffering from HT referred to the endocrine clinic. Eligible patients were selected by the available sampling method. Complete unstimulated saliva was collected under a rest state in a comfortable room between 10:00 AM and 12:00 AM and a checklist was used to collect data. The chi-square, t-test, and Mann-Whitney U tests were used for data analysis using SPSS 22 software. The mean age of the participants was 36.55±9.37 years (range: 20-56). The two groups were the same in terms of age and gender (P>0.05). The findings indicated that the difference in the means CAT between the two groups was 22.63 which was strongly and statistically significant (P<0.001). In this study, the level of TAC and SOD in Hashimoto's thyroid patients was decreased and the level of CAT was increased. These initial findings show that oxidative stress can be associated with Hashimoto's thyroid disease or the possibility of developing this disease increase.

Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease that may result in adverse pregnancy outcomes, posing a significant risk to both the mother and the fetus. The major purpose of the current study was to investigate the impact of SLE on the outcomes of pregnancy among women with SLE. This was a retrospective cohort study. Two groups of pregnant women, one with Systemic Lupus Erythematosus (SLE) and one without SLE, were included at the Gynecology and Obstetrics Clinic of Ayatollah Mousavi Hospital in Zanjan, Iran, from 2019 to 2020. Participants from both cohorts completed a checklist of study variables based on their medical records. The data were analyzed using binary logistic regression, chi-square test, analysis of variance, and independent samples t-test with SPSS software version 23. The research involved 400 pregnant women, with the mean age of the SLE and non-SLE groups being 36.68±4.90 and 29.46±6.56 years, respectively. The most prevalent adverse outcome was cesarean section (271 [67.8%]), significantly higher in the SLE group (54.5% vs. 10.0%, P=0.0001). The likelihood of experiencing spontaneous abortion, preterm labor, cesarean section, and LBW was increased by more than 6.5 times (odds ratio, 6.54; 95% CI, 2.22-19.27; P=0.001), 3.6 times (odds ratio, 3.67; 95% CI, 1.47-9.18; P=0.005), 18.9 times (odds ratio, 18.94; 95% CI, 6.46-55.49; P=0.0001), and 3 times (odds ratio, 3.04; 95% CI, 1.09-8.46; P=0.030) in individuals with SLE, respectively. Women with SLE have an increased likelihood of encountering spontaneous abortion, preterm labor, cesarean section, and delivering a low-birth-weight infant.

Statins affect the bone metabolism. Considering the role of nitric oxide (NO) in many physiological processes, this study assessed the effects of atorvastatin (ATOR) and NO on the mandible and skull bone density (BD) in ovariectomized rats. This study evaluated 48 female Sprague-Dawley rats in 6 groups (n=8). Groups 1 and 2 underwent sham surgery. Group 1 (sham) did not receive any medication, but group 2 (sham/ATOR) received atorvastatin. Groups 3 to 6 underwent ovariectomy. Group 3 (OVX) did not receive any medication, group 4 (OVX/ATOR) received atorvastatin, group 5 (OVX/L-NAME) received L-NG-nitro arginine methyl ester (L-NAME), and group 6 (OVX/ATOR/L-NAME) received both atorvastatin and L-NAME. Atorvastatin (40 mg/kg) was gavaged and L-NAME (3 mg/kg) was administered intraperitoneally for 4 weeks. All rats underwent lateral cephalometry before and after the interventions, and BD was measured at 2 points in the mandible and skull before and after the intervention by a digital densitometer. Data were analyzed by t-test, ANOVA, and Sidak test (alpha=0.05). The change in BD was 26.5±10.17 in the mandible and 22.17±9.45 in the skull in OVX group. These values were 25.63±5.55 and 28±8.59 in OVX/ATR, 1.5±7.78 and -1.88±4.39 in OVX/L-NAME, and 6.63±7.37 and 4.33±6.35 in OVX/ATOR/L-NAME, respectively. OVX/ATOR showed no significant difference (P=1), but OVX/L-NAME (P<0.001) and OVX/ATOR/L-NAME (P<0.001) groups showed significant differences with OVX group. The present findings indicated that atorvastatin had no significant effect on BD, but administration of L-NAME prevented osteoporosis in ovariectomized rats.

In liver cirrhosis, there is low T3 syndrome associated with a decrease in total triiodothyronine (T3) and free T3 concentrations and cirrhotic cardiomyopathy (CCM) with chronotropic incompetence. Thus, we aimed to investigate the effects of eliminating T3 and thyroxine (T4) deficiencies on cardiac chronotropic dysfunction. Bile duct ligation (BDL) was used to induce cirrhosis in male Wistar rats. The chronotropic responses were studied through the Power Lab system in sham/saline, sham/T3T4, BDL/saline, and BDL/T3T4 groups. The serum T3 and T4, and T3 resin uptake (T3RU) levels were assessed. The atrial T3 receptor expression was investigated through a real-time polymerase chain reaction (Real-time PCR). The chronotropic responses were decreased in the BDL/saline group and raised in the BDL/T3T4 group. The serum T3 levels decreased in the BDL/saline group compared to sham group, but increased in the BDL/T3T4 group compared to the BDL/saline group. The serum T4 level increased in the BDL/saline and decreased in the BDL/T3T4 group. The serum T3RU level decreased in the BDL/saline and increased in the BDL/T3T4 group. The T3 receptor expression in atria increased in the BDL/saline group, nonetheless, it did not change in the BDL/T3T4 group compared to the sham/saline and the BDL/saline groups. T3T4 treatment did not increase the chronotropic response in the control group but the treatment improved the chronotropic hyporesponsiveness, and serum T4 and T3 RU abnormalities in cirrhosis, however, it is not related to the atrial T3 receptor expression.

The pretest-posttest control group design is one of the most widely used quantitative experimental design models for evaluating the efficacy of programs, treatments, and interventions. Despite the prevalence and utility of this research design, best practices for data analytical procedures are not clearly defined. Invalid results decrease the chance of generalization. Given that Iranian Journals are interested in publishing pretest-posttest control group design studies, it is important to denote the accuracy of them. The aim of the current study is to explore the correct procedure for using ANCOVA in pretest-posttest control group designs to mitigate the potential limitations of this approach. This study explores the use of ANCOVA in pretest-posttest control group design. It has been done by analyzing data from experimental studies published in five Iranian journals indexed in PubMed or Scopus between 2011 and 2018. The results indicate that among the 280 published experimental studies in these journals, 53 papers (18.9 percent) used ANCOVA as the statistical test in pretest-posttest studies. The power of the test represents the probability of detecting differences between the groups being compared when such differences exist. Our analysis concludes that ANCOVA, which runs a multiple linear regression, is a suitable method for comparing and examining pretest-posttest study designs. Implications of this study have potential utility for researchers employing the use of pretest-posttest control group designs in various fields in and outside of Iran.

With the rising attention towards improving the quality of life and mental health, sleep hygiene and sleep quality have recently been the main topics of numerous studies. Quality of sleep not only affects our physical status but also plays a pivotal role in our psychological and emotional states. Sleep deprivation can increase the risk of cardiovascular and metabolic diseases along with the risk of impaired concentration and consequent road injury and accidents. As technology has become a main figure in our daily lives, technological advances have paid a great interest in improving the quality of sleep by enhancing the detection of sleep-related disorders and sleep abnormalities, particularly in the setting of smart homes and the Internet of Things (IoT). Smartphone applications, portable wearable gadgets, and devices along with more sophisticated and precise algorithms are now endeavoring to help us improve our quality of sleep and subsequently our quality of life. Hence, this review aims to illustrate a vivid picture of recent advancements in smart homes and their related technologies for improving sleep quality.

Trigeminal neuralgia has an incidence of 4-13 per 100000 people per year. The incidence of this disease increases in the elderly, and it is known to cause severe shock-like pain. Pharmacological therapy is the first-line treatment of trigeminal neuralgia. If pharmacological therapy fails, then different procedures are available. Pulse-dose radiofrequency is one such procedure. In this study, we evaluated Pulse dose radiofrequency's efficacy as a method in which pulse amplitude and width are considered essential variables. This research was conducted as a cross-sectional study on trigeminal neuralgia patients referred to the pain clinic of Amir A’lam Hospital in 2020. Conservative therapy has failed; therefore, the clinician decided to use pulse dose radiofrequency to reduce their pain. Among the 29 patients registered during this period, 15 (51.8%) were women and 14 (48.3%) were men. The mean (±SD) age of the patient was 57.07(±14.26) years. The tow route was interrupted in 7 (24.1%) patients. A significant difference was observed between the pain scores before and after the operation (P<0.001). Pulse-dose radiofrequency is a safe and effective therapy for treating trigeminal neuralgia and can be considered a new way to develop the pulse radiofrequency method.

Hemodynamic changes is of great concern during awake intubation, particularly in patients with underlying medical conditions. As heterogeneities exist in regard to the best anesthesia drugs and techniques, herein, we aimed to investigate the effects of Lidocaine 10% spray compared to trans tracheal glossopharyngeal nerve block in hemodynamic stability in patients undergoing awake intubation. A total of 62 patients were included in this randomized clinical trial. Using a longitudinal interventional design, hemodynamic measures were statistically compared before intubation, one minute after intubation, and five minutes after intubation. The first group underwent topical anesthesia with Lidocaine 10% sprayed on the base of tongue and tonsillar pillar while the second group underwent trans tracheal and glossopharyngeal nerve block with simultaneous injection of Lidocaine 2%. Our results indicated that all hemodynamic parameters except for the pulse rate in both groups were significantly reduced after the intubation, which indicates the effectiveness of the interventions. However, the reduction in SBP, DBP, and MAP was significantly lower in the nerve block group compared to the Lidocaine spray group. Regarding the pulse rate, despite the significant decrease in the group of patients undergoing nerve block, those undergoing anesthesia with Lidocaine spray experienced a significant increase in the heart rate in the first minute after the operation. Finally, our research provides substantiation that employing a glossopharyngeal nerve block and trans tracheal block constitutes an efficacious method for local anesthetic during conscious intubation and can be a promising technique.

Stroke has many different symptoms, isolated hand weakness is the rarest one. Even less common are concomitant radial nerve lesions and ischemic stroke that leads to isolated hand weakness. We report a patient with sudden onset of right wrist drop mimicking radial nerve palsy, found to be due to a acute cerebral infarct and radial nerve palsy in the same time. A well-taken history of the patient's illness and thorough clinical examination can differentiate stroke from peripheral neuropathy as the cause of hand weakness. Modern neuroradiological methods such as brain MSCT or MRI can quickly and reliably indicate the etiology of a neurological disease. In every patient who presents with isolated arm weakness, and for whom we are not sure whether it is a lesion of the central or peripheral nervous system, cerebral infarction must be included as a critical differential diagnosis because it can divert attention from sometimes harmful thrombolytic therapy.