AIM: To identify various risk factors that may play a significant role in the development of congenital nasolacrimal duct obstruction(CNLDO).METHODS: This observational case-control study included a case group of 122 children less than two years of age with CNLDO who underwent probing and irrigation treatment at the ophthalmology department of Imam Khomeini Hospital in Ahvaz, Iran, from June 2022 to June 2024. A control group of 122 age-matched children without CNLDO was also included for comparison. Data was collected from the children's medical records. RESULTS:The study found a significant correlation between the occurrence of CNLDO and several maternal factors, such as preeclampsia, the use of levothyroxine, hypothyroidism, having more than three pregnancies(gravidity >3), natural pregnancy, and gestational diabetes mellitus. Additionally, in children, factors, such as oxygen therapy, anemia, reflux, jaundice, and a family history of CNLDO in first-degree relatives were associated with CNLDO, and maternal preeclampsia and hypothyroidism were found to significantly increase the risk of developing CNLDO in children.CONCLUSION: Given that CNLDO affects both premature and full-term children, the present findings may potentially facilitate the early identification of children and infants at risk of nasolacrimal duct obstruction, thereby preventing the onset of chronic dacryocystitis.

Background: Fine needle aspiration (FNA) is a widely utilized technique for assessing thyroid nodules; however, its inherent non-diagnostic rate poses diagnostic challenges. The present study aimed to evaluate and compare the diagnostic efficacy of FNA, core needle biopsy (CNB), and their combined application in the assessment of thyroid nodules. Methods: A total of 56 nodules from 50 patients was analyzed using both FNA and simultaneous CNB. The ultrasound characteristics were categorized according to the American College of Radiology Thyroid Imaging Reporting and Data Systems classification system. The study compared the sensitivity, specificity, and accuracy of FNA, CNB, and the combination of the two techniques. Results: The concordance between FNA and CNB was notably high, with a kappa coefficient of 0.837. The sensitivity for detecting thyroid malignancy was found to be 25.0% for FNA, 66.7% for CNB, and 83.3% for the combined FNA/CNB approach, with corresponding specificities of 84.6%, 97.4%, and 97.4%. The accuracy of the FNA/CNB combination was the highest at 94.1%. Conclusions The findings of this study indicate that both CNB and the FNA/CNB combination offer greater diagnostic accuracy for thyroid malignancy compared to FNA alone, with no significant complications reported. Integrating CNB with FNA findings may enhance management strategies and treatment outcomes for patients with thyroid nodules.

Objectives: This study aimed to investigate the role of time preferences in compliance with coronavirus disease 2019 (COVID-19) preventive behaviors in an adult population of Iran. Methods: A web-based questionnaire was utilized to conduct a cross-sectional survey of 672 Iranian adults. The parameters of time preferences were estimated using a quasi-hyperbolic discounting model, and the relationship between COVID-19 preventive behaviors and time preferences was examined using a probit regression model. Results: A significant association was observed between the preventive behaviors of COVID-19 and the levels of patience and present-biased preferences among the study participants. Individuals who exhibited low levels of patience were found to be 12.8 percentage points less inclined to follow preventive behaviors compared to those with high levels of patience. The likelihood of having good preventive behaviors of COVID-19 was found to decrease by 14.3 percentage points among individuals with a present bias as opposed to those with a bias toward future. Conclusions Patience and present-biased preferences are important determinants of adopting preventive behaviors against COVID-19. These behavioral characteristics should be considered in the design of control and prevention programs. Considering people’s discounting behavior and time (in)consistency in their preferences in the design of COVID-19 policy interventions can provide valuable insights for developing tailored public health policy interventions.

Background and Objectives: This study aimed to evaluate Mal de Debarquement syndrome (MdDS) in high-risk pilots using the Istanbul MdDS Symptom Questionnaire (IMdDSSQ) and investigate the effect of flight time. Subjects and Methods: The IMdDSSQ was administered to 150 healthy pilots, ≥18 years (37.47±11.14 years), on active duty, using a Google Forms link. The responses to the questionnaire were assessed based on flight time (<4 h and >4 h) and age group, for all subfactors. Results: For the MdDS diagnosis subfactor of the questionnaire, 32.1% of males and 66.7% of females reported a suspicion of MdDS after flights <4 h. As flight time increased, the number of participants reporting suspected MdDS increased in both sexes. There was a significant difference between short and long flights for all subfactors of the questionnaire across all age groups and sex comparisons (p<0.05). Conclusions As flight time and age increased, the severity of the symptoms of MdDS increased for all subfactors. With advancing age, dizziness and the severity of intolerance to visual motion increase in long flights compared to short flights, and the quality-of-life decreases. The quality-of-life of female pilots was lower than that of male pilots.

Background and Objectives: Virtual reality (VR) applications change the perception of reality, resulting in a feeling of being in a natural environment. The occurrence of cybersickness (CS) when using VR applications is a well-documented side effect, and the Simulator Sickness Questionnaire (SSQ) has been used to assess CS. Considering the speed of VR technology development, CS will likely become a frequently researched and discussed topics in the near future. Therefore, the aim of this study was to conduct a Turkish validity and reliability study and introduce the SSQ to Turkish medical literature. Materials and Methods: A total of 160 healthy individuals (80 females and 80 males) aged >18 years (28.4±7.2 years) were included in our study. The SSQ was provided to the participants through Google Forms before and after the VR provocation experience and within the scope of the test and retest protocol. Results: The reliability and internal consistency of the questionnaire were observed at a high level (Cronbach’s alpha=0.854, Spearman-Brown coefficient r=0.871). Factor analysis was performed and the questionnaire was divided into three subfactors, consistent with the original questionnaire. In the responses obtained from the participants before and after VR provocation, statistically significant differences were observed in 13 of the 16 items in the questionnaire that are related to VR provocation (p<0.05). Statistically, the differences in fatigue, dizziness, and vertigo were greater in females than in males (p<0.05). Conclusions The Turkish version of the SSQ is an effective tool for measuring the side effects in VR environments. The inclusion of the SSQ in the Turkish literature enables the inclusion of non-English-speaking participants in research, especially for disciplines that consider peripheral and central vestibular disorders.

Background: Advancements in surgery, chemotherapy, and radiotherapy have improved survivalfor brain tumor patients, increasing the risk of second primary tumors (SPTs) among long-term survivors. This study examines the types and risks of SPTs in brain tumor patients presenting at a tertiary care hospital. Methods: This single-center, retrospective study explored occurrences of SPTs following prima-ry brain tumors and occurrences of brain tumors as SPTs following primary extra neural tumors. A total of 41 patients were included and analyzed presenting with histologically confirmed SPTs between 1st January 2000 and 31st December 2020. Results: The study included 41 patients with SPTs, primarily female (65.9%). Of these, 20 pa-tients (48.7%) developed SPTs after a primary brain tumor, while 21 patients (51.2%) developed brain tumors as SPTs after extra-neural tumors. Among patients who developed SPTs after brain tumors (n=20), meningioma (n=8, 40.0%) and pituitary adenoma (n=6, 30.0%) were the most prevalent first primary tumors (FPTs) while breast tumors predominated as SPTs (n=4, 20.0%). Survival analysis indicated younger mean age (44.5 years) for patients marked alive, compared to those marked deceased (57.0 years) and those with unknown outcomes (63.0 years). Conclusion Based on this retrospective analysis, the median age at diagnosis was 44.5 years,with a considerable number of patients (36.6%) having uncertain outcomes at follow-up due to incomplete records. These findings highlight the need for improved follow-up data management to better assess long-term survival in patients with SPTs following brain tumors.

Breast cancer is one of the most common causes of death all over the world. Therapeutic options applied to the patients include surgery, chemotherapy, and radiotherapy.However, far advanced disease often leads to chemoresistance and toxicity. Innovative therapies are needed to address these challenges. Melatonin has the potential to prevent and treat cancer, as it has been revealed in numerous clinical studies. Melatonin is a nontoxic agent that is mostly produced in the pineal gland, inducing various mechanisms of action such as the induction of apoptosis, antiangiogenic, antiproliferative, and metastasis-inhibitory effects. Therefore, melatonin increases therapeutic sensitivity when combined with conventional medication in breast cancer. Melatonin (3-20 mg/day) may reduce breast cancer cell growth in preclinical studies and enhance chemotherapy efficacy. Small human trials suggest potential benefits, but larger studies are needed. Higher doses (≥20 mg/day) are sometimes used alongside chemotherapy. This manuscript reviews research that has demonstrated the antitumor properties of melatonin, thereby focusing on its actions on angiogenesis, apoptosis, metastasis, and antiproliferative properties. We also discuss recent advances in the understanding of the actions of melatonin on epigenetic mechanisms (especially DNA methylation) and telomere length. The data in this review were obtained from journal articles up to May 2024.Regarding the study, Google Scholar and ScienceDirect were used as engines to search for open access. We searched the ISI, Pubmed and Scopus as valid external databases, and as internal databases, ISC and Iran medex. By finding mean keywords such as ‘breast cancer’, ‘estrogen’, ‘melatonin’, ‘cell death’, ‘cell proliferation’, ‘telomerase’ and ‘DNA methylation’, we reached to the formula with maximum collectivity in searching, then equivalent terms were found by Mesh database. The review also covers recent clinical investigations of melatonin in breast cancer.

Background: Fine needle aspiration (FNA) is a widely utilized technique for assessing thyroid nodules; however, its inherent non-diagnostic rate poses diagnostic challenges. The present study aimed to evaluate and compare the diagnostic efficacy of FNA, core needle biopsy (CNB), and their combined application in the assessment of thyroid nodules. Methods: A total of 56 nodules from 50 patients was analyzed using both FNA and simultaneous CNB. The ultrasound characteristics were categorized according to the American College of Radiology Thyroid Imaging Reporting and Data Systems classification system. The study compared the sensitivity, specificity, and accuracy of FNA, CNB, and the combination of the two techniques. Results: The concordance between FNA and CNB was notably high, with a kappa coefficient of 0.837. The sensitivity for detecting thyroid malignancy was found to be 25.0% for FNA, 66.7% for CNB, and 83.3% for the combined FNA/CNB approach, with corresponding specificities of 84.6%, 97.4%, and 97.4%. The accuracy of the FNA/CNB combination was the highest at 94.1%. Conclusions The findings of this study indicate that both CNB and the FNA/CNB combination offer greater diagnostic accuracy for thyroid malignancy compared to FNA alone, with no significant complications reported. Integrating CNB with FNA findings may enhance management strategies and treatment outcomes for patients with thyroid nodules.

Objectives: This study aimed to investigate the role of time preferences in compliance with coronavirus disease 2019 (COVID-19) preventive behaviors in an adult population of Iran. Methods: A web-based questionnaire was utilized to conduct a cross-sectional survey of 672 Iranian adults. The parameters of time preferences were estimated using a quasi-hyperbolic discounting model, and the relationship between COVID-19 preventive behaviors and time preferences was examined using a probit regression model. Results: A significant association was observed between the preventive behaviors of COVID-19 and the levels of patience and present-biased preferences among the study participants. Individuals who exhibited low levels of patience were found to be 12.8 percentage points less inclined to follow preventive behaviors compared to those with high levels of patience. The likelihood of having good preventive behaviors of COVID-19 was found to decrease by 14.3 percentage points among individuals with a present bias as opposed to those with a bias toward future. Conclusions Patience and present-biased preferences are important determinants of adopting preventive behaviors against COVID-19. These behavioral characteristics should be considered in the design of control and prevention programs. Considering people’s discounting behavior and time (in)consistency in their preferences in the design of COVID-19 policy interventions can provide valuable insights for developing tailored public health policy interventions.

Purpose: To determine the effect of lower eyelid blepharoplasty (LEB) surgery on corneal biomechanical parameters before and 4 months after the procedure. Methods: In this prospective longitudinal study, corneal biomechanical parameters measured by Corneal Visualization Scheimpflug Technology device were evaluated before and 4 months after LEB surgery. Results: The study included 19 eyelids of the right eyes of 19 patients who underwent LEB, with a mean age of 49.0 ± 10.1 years (range, 37–72 years). Four months after the procedure, significant increases were observed in the first applanation time (p = 0.007), second applanation time (p < 0.001), highest concavity time (p = 0.004), intraocular pressure (p = 0.009), and biomechanical-compensated intraocular pressure (p = 0.007). In addition, the absolute value of highest concavity delta arc length and stress-strain index showed a significant decrease after the LEB (p = 0.021 and p = 0.037, respectively). Other corneal biomechanical parameters did not show significant differences following the LEB procedure (p < 0.05). Conclusions The resection and repositioning of the fat pockets in LEB lead to biomechanical changes of the cornea in the direction of increasing corneal stiffness.