Health Science Reports

Background and Aims Foreign body aspiration (FBA) is common in the pediatric population, typically between 6 months and 4 years. It can be life‐threatening and cause complications such as obstructive bronchitis, recurrent bronchopneumonia, emphysema, and atelectasis. Public awareness and education about risk factors and behaviors to reduce the risk of FBA have been identified as one of the most crucial approaches to prevent the problem or minimize its effects. Methods A study in Majmaah, Saudi Arabia, aimed to evaluate parental practices and awareness about their children's FBA. The study included 462 parents, both Saudi and non‐Saudi, aged 18 and above. The data were collected through an electronic questionnaire in Arabic and English, and analyzed using SPSS software. The study aimed to provide insight into local parents' attitudes and actions toward their children's aspirations. Results A total of 462 parents participated in this study questionnaire, with 367 (79.44%) being mothers and 95 (20.56%) fathers of children. The majority of mothers (67.3%) and fathers (56.8%) indicated that children aged 1–5 years were more prone to swallowing or inhaling foreign objects, while a smaller percentage of mothers (21.8%) and fathers (23.2%) reported this risk for children under 1 year. The Internet emerged as the primary source of information on FBA, with 21% of parents relying on it. However, the findings revealed that (20%) of parents exhibited low levels of knowledge and practices related to FBA. Conclusion The research revealed significant associations between demographic factors and ignorance, including sex and peanut feeding. Educational level changed the way individuals considered the presence of foreign bodies in the airway system and enhanced knowledge of what to do during an emergency as well as confidence in grown‐ups' ability to handle such situations.

Background and Aims Temporary mechanical circulatory support (tMCS) devices play a crucial role in improving survival for patients with hemodynamic instability by providing cardiac assistance, and may serve as either a bridge to recovery or destination therapy. Recently, the PulseCath (iVAC2L and iVAC3L) has been introduced into the broader tMCS landscape. Due to its ease of implantation and low cost, it appears to enhance and complement the spectrum of tMCS devices. This planned scoping review aims to summarize the potential applications and reported side effects of PulseCath, while elucidating its underlying pathophysiological principles and hemodynamic effects, incorporating both preclinical in vivo and clinical published data. Methods We will perform a scoping review in accordance to the JBI methodology and the extension for Scoping Reviews of the PRISMA checklist. We will conduct a comprehensive search of PubMed/MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and Google Scholar (from their inception until February 28, 2025) to identify and retrieve preclinical in vivo and clinical investigations on the implantation of the PulseCath. EndNote X9 and Rayyan softwares will be used to aid article selection. Standardized forms will be employed for subsequent data charting and extraction. The ROBINS‐I and RoB2 tools will be employed to perform a formal assessment of the risk of bias of included studies. Results Included studies will be categorized into two groups: preclinical in vivo and clinical. The clinical studies will be further classified according to implantation strategy, either pre‐emptive or bail‐out. The main findings from the selected studies will be presented through a narrative synthesis. If sufficient homogeneity exists among the studies, the presentation of quantitative data will be conducted. Tables and figures will be used to aid in the illustration of the findings. Conclusion The planned scoping review will systematically examine the existing evidence on the hemodynamic effects, pathophysiology, and potential complications of PulseCath, ultimately seeking to delineate optimal clinical settings for its use. The findings could highlight research gaps in tMCS support and expand the clinical application of PulseCath, thus improving patient outcomes and enhancing clinicians' understanding of this novel device.

Background and Aims A life‐threatening vector‐borne disease, dengue fever (DF), poses significant global public health and economic threats, including Bangladesh. Determining dengue risk factors is crucial for early warning systems to forecast disease epidemics and develop efficient control strategies. To address this, we propose an interpretable tree‐based machine learning (ML) model for dengue early warning systems and outbreak prediction in Bangladesh based on climatic, sociodemographic, and landscape factors. Methods A framework for forecasting DF risk was developed by using high‐performance ML algorithms, namely Random Forests, eXtreme Gradient Boosting (XGBoost), and Light Gradient Boosting Machine (LightGBM), based on sociodemographic, climate, landscape, and dengue surveillance epidemiological data (January 2000 to December 2021). The optimal tree‐based ML model with strong interpretability was created by comparing various ML models using the hyperparameter optimization technique. The feature importance ranking and the most significant dengue driver were found using the SHapley Additive explanation (SHAP) value. Results Our study findings detected a nonlinear effect of climatic parameters on dengue at different thresholds such as mean (27°C), minimum (22°C), maximum temperatures (32°C), and relative humidity (82%). The optimal minimum and maximum temperatures, humidity, rainfall, and wind speed for dengue risk are 25−28°C, 32−34°C, 75%−85%, 10 mm, and 12 m/s, respectively. The LightGBM model accurately forecasts DF and agricultural land, population density, and minimum temperature significantly affecting the dengue outbreak in Bangladesh. Conclusion Our proposed ML model functions as an early warning system, improving comprehension of the factors that precipitate dengue outbreaks and providing a framework for sophisticated analytical techniques in public health.

Background and Aim Transfusion‐transmissible infections (TTIs) pose a significant threat to patients requiring blood transfusion. The prevalence of TTIs among blood donors reflects the broader burden of infections within populations. Therefore, assessing the prevalence of TTIs among voluntary blood donors is crucial for informing effective prevention and control strategies in the community. Study Design and Methods A cross‐sectional study was conducted from April 2022 to July 2022. Sociodemographic and related data were collected using a pre‐tested structured questionnaire. A venous blood sample (5 mL) was drawn from each blood donor into sterile test tubes, and serum was separated through centrifugation. The serum samples were tested using enzyme‐linked immunosorbent assays (ELISA) to detect hepatitis B Virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis. Data analysis was performed using SPSS version 25 and summarized in tables and figures. Results A total of 538 participants were enrolled in the study, with an overall prevalence of transfusion‐transmissible infections (TTIs) at 7.4% (n = 40). Syphilis exhibited the highest prevalence at 3% (n = 16), followed by HBV at 2% (n = 11). The prevalence of HCV and HIV was 1.3% (n = 7) and 1.1% (n = 6), respectively. Significant factors associated with HBV seroprevalence included the donation site at Debre Berhan [AOR = 24.18, 95% CI: 1.98–295.14, p = 0.01] and the presence of body tattoos [AOR = 19.1, 95% CI: 4.0–89.8, p ≤ 0.01]. Male sex was significantly associated with syphilis infections [AOR = 3.78, 95% CI: 1.23–11.61, p = 0.03]. Conclusions This study highlighted the high prevalence of TTIs among blood donors. To prevent and control the transmission of TTIs within the population, strict donor screening protocols, improved diagnostic methods, and enhanced awareness about infection transmission should be implemented.

Background and Aims The majority of complications arising from the arteriovenous fistula (AVF) site for hemodialysis (HD) can be prevented through the implementation of a daily self‐care plan. This study aimed to assess the knowledge, attitude, and practice (KAP) of hemodialysis patients with end‐stage kidney disease (ESKD) regarding AVF self‐care preoperative, postoperative, and during follow‐up. Methods This prospective cohort study was conducted at a tertiary referral center in Nepal. It included ESKD patients over 18 years with AVF. Patients were interviewed preoperative, postoperative, and at 2, 4, and 6 weeks. KAP was assessed as percentages, and associations were analyzed using the χ² test. Score comparisons over time used the paired t‐test, with p < 0.05 considered significant. Results Among 173 AVF patients, 98.8% had poor knowledge preoperative, while 98.3% had good knowledge postoperative, with significant improvement in the overall score of knowledge (p < 0.001). Initially, 97.1% were motivated towards self‐care, but this dropped to 78.0% by the 6th week. Most patients practiced weight‐bearing prevention, cleaning, and drying, but fewer practiced daily verification of fluid thrill and exercise with malleable balls. Postoperative knowledge acquisition significantly correlated with male sex and higher socioeconomic status. Conclusion Although the majority of patients undergoing HD planned for AVF exhibited a favorable attitude towards fistula care, their knowledge was poor. Knowledge significantly improved with follow‐ups, but motivation for self‐care decreased over time. Patients' practices generally aligned with knowledge scores, emphasizing the importance of regular reminders and periodic evaluations by healthcare workers for practical aspects of AVF care for all ESKD patients undergoing HD.

Introduction/Objective Floating thrombus of the right heart chambers is an uncommon diagnosis and is systematically associated with pulmonary embolism. The aim of this study is to describe the management and evolution of right intracavitary thrombi (TIC) in pulmonary embolism. Materials and Method This was a prospective cohort that ran for 76 months from March 5, 2017 to July 31, 2023. Patients diagnosed with pulmonary embolism were included. Two population groups were established according to the presence or absence of right intracavitary thrombus on Doppler echocardiography (intracavitary thrombi+ vs. intracavitary thrombi−) permitted to compare the risks factors. Thromboembolic risk factors, including the patient's background and clinical, paraclinical, therapeutic and evolutionary aspects, were reported. A significance level of p < 0.05 was used for data analysis. Results The prevalence of emboli associated with intracavitary thrombi was 2.98%. Arterial hypotension, right ventricular dilatation, and deaths were significantly associated with right chamber thrombi with p = 0.0051 (OR: 4.14; IC 95%: 1.53–11.2); 0.0015 (OR: 4.4; IC 95%: 1.76–10.9); 0.00 (OR: 9.21; IC 95%: 3.69–23.3); 0.0313 (OR: 3.16; IC 95%: 1.10–9.02), respectively. Thrombolysis was performed in 70.58% of patients in the intracavitary thrombi+ group, compared with 11.93% in the intracavitary thrombi− group. The presence of intracavitary thrombi+ was associated with a high mortality rate of 35.29% compared with 9.82% in the intracavitary thrombi− group. Conclusion The discovery of a thrombus of the right heart, although rare, is not exceptional. Their management is the subject of controversy between learned societies. Thrombolysis is the only therapeutic option in this context.

Background and Aims Overweight/obesity is increasing at an alarming rate throughout the world and has now become a global epidemic. According to a recent research report, the burden of obesity is increasing in developing countries; however, no significant reduction has been seen in developed countries over the past few decades. Furthermore, there is limited information about overweight/obesity. The main objective of this study was to assess the prevalence and associated factors of overweight/obesity among reproductive age women. Methods A total of 866 reproductive women participated in the study. The collected data were coded and entered into Epi‐Data version 4.6.0 and exported to STATA version 17 software packages for analysis. Binary logistic regression was used to identify factors associated with overweight/obesity among reproductive age women. Variables with a p‐value < 0.2 in the bivariate analysis was further fitted into multivariate analysis for controlling the possible effect of confounders, and finally the variables that were a p‐value of < 0.05 on the bases of odd ratio (OR) with 95% confidence interval (CI) was considered significantly associated with overweight/obesity and identified based on odds ratio (OR), with 95% confidence interval (CI) and p‐value (p < 0.05). Result The study's response rate was 96% and the overall prevalence of overweight/obesity was 21% [95% CI: 18.00, 24.00]. Being parity [AOR = 3.75, 95% CI: 2.06, 6.81], parity (≥ 2) [AOR = 8.16, 95% CI: 4.63, 14.37], late age at menarche (≥ 14 years) [AOR = 1.65, 95% CI: 1.13, 2.41], and ever used family planning [AOR = 1.50, 95% CI: 1.01, 2.23] were factors significantly associated overweight/obesity. Conclusion In this study, overweight/obesity was high. Late age of menarche, parity, and ever using family planning were factors affecting overweight/obesity in reproductive age women. Healthcare workers should raise awareness among reproductive‐age women about the impacts of overweight/obesity.

Background and Aims Given the recent deadly outbreaks of the Marburg virus (MARV), in early 2023 in Tanzania and Equatorial Guinea, and the most recent one in Rwanda in 2024, there has been renewed attention across Africa on the threat posed by the re‐emergence of MARV as a growing concern for public health. Therefore, it needs to provide a comprehensive overview of the virus and its related infections, encompassing virus classification, historical outbreaks, transmission dynamics, the intricate interface between the virus and its hosts, the methods of diagnosis, core prevention strategies, and current therapeutic options, to better understand the virus and the disease characteristics in responding to future outbreaks. Methods For this review, four scientific online databases, including PubMed, Google Scholar, Scopus, and Web of Science were thoroughly searched for peer‐reviewed journal papers (original, case reports/series, and review studies) published in English language using the following keywords: Filovirus, Marburg virus, Marburg Haemorrhagic Fever, Marburg virus disease, and Marburg virus outbreak. Results MARV shares similarities with its close cousin —the Ebola virus [EBOV]—in terms of viral characteristics and most clinical features. These two viruses are of animal origin and primarily spread to humans through infected bats (both direct and indirect close contact), which serve as the common natural host reservoirs. The potential for interhuman transmission, coupled with the ability to cross borders of endemic regions combined with the absence of a licensed vaccine and effective treatment, have made MARV a significant threat to human health. This virus is clinically characterized by a range of symptoms and organ dysfunctions. The disease is often fatal in a significant proportion of infected individuals. This viral infection is diagnosed by various diagnostic tools, prevented mainly through personal protective measures, and treated usually with clinical management and supportive care. Conclusion The outbreaks of MARV are continuously threaten public health; therefore, the world must be alert and well‐prepared. For MVD, taking precautions along with investing in research and preparedness at regional, national, and global levels is of crucial importance and should be prioritized.

Aims The question of how to choose the right type of exercise to lower blood pressure and cardiovascular risk factors in people worldwide with high blood pressure is not yet fully understood. Thus, the aim of this study was to investigate the effects of various exercise training on blood pressure and cardiovascular risk factors among young and middle‐aged adults with prehypertension or hypertension. Design Systematic review and network meta‐analysis. Methods We searched five electronic databases to identify randomized controlled trials that compare exercise training versus a sedentary or sham control group in young and middle‐aged adults with prehypertension or hypertension. Review Manager 5.3, Stata15.0, and R4.2.1 software estimated the efficacy of exercise training modalities. Results We included 19 eligible articles with 1590 participants to assess five exercise trainings. Our findings indicated that low‐middle intensity aerobic exercise (mean difference (MD) = −8.08, 95% confidence interval (CI) = −13.58, −2.58) was superior to all exercise strategies (high‐intensity aerobic exercise: MD = −6.53, 95% CI = −12.51, −0.56; high‐intensity resistance exercise: MD = −4.95, 95% CI = −11.07, 1.17; low‐middle‐intensity resistance exercise: MD = −3.49, 95% CI = −12.36, 5.39) compared with control group in lowering systolic blood pressure. Compared with the control strategy, high‐intensity resistance exercise (MD = −4.75, 95% CI = −8.00, −1.50), high‐intensity aerobic exercise (MD = −4.27, 95% CI = −7.08, −1.45) could lower diastolic blood pressure. The effects of different exercise patterns on cardiovascular risk factors, the results indicated that only low‐middle‐intensity aerobic exercise significantly improved body mass index (MD = −0.55, 95% CI = −7.08, −1.45), total cholesterol (MD = −19.07, 95% CI = −36.42, −1.72), triglycerides (MD = −14.32, 95% CI = −23.16, −5.48), high‐density lipoprotein (MD = 2.29, 95% CI = 0.85, 3.73), and low‐density lipoprotein (MD = −13.90, 95% CI = −22.18, −5.63). In addition, no intervention affects heart rate. Conclusion Compared with other types of exercise, aerobic exercise can significantly improve systolic blood pressure, while high‐intensity resistance or aerobic exercise may significantly improve diastolic blood pressure. In addition, AE‐LM is effective in the reduction of risk factors that are contributors to the development of cardiovascular disease. Therefore, this study provides strong evidence to support the selection of appropriate exercise modalities for hypertensive patients.

Background and Aim Antiretroviral therapy (ART) has reduced human immunodeficiency virus (HIV)/AIDS to a manageable chronic condition even though no cure exists. Despite ART control, latent HIV infection results in failed memory CD4 T‐cell responses, immune overactivation, inflammation, oxidative stress, genomic instability, deoxyribonucleic acid (DNA) damage, and premature CD4 T‐cell ageing. Overproduction of reactive oxygen species during oxidative stress can cause mitochondrial DNA damage, cancer, neurodegenerative and cardiovascular diseases, and premature aging in people living with HIV (PLWH). This review outlines current knowledge in oxidative stress among PLWH. Methods Google Scholar, Scopus, PubMed, and Science Direct were searched for literature conforming with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines from studies published from January 2013 to December 2023. A total of 75 studies from 22 countries were identified, with 52 studies carried out in human participants, 17 studies in cell lines, and 6 studies in animal models to assess oxidative stress levels. Results An increased oxidative stress with no changes in antioxidant levels was reported in HIV‐positive smokers, and those on substance abuse. Long‐term ART usage showed high levels of oxidative protein products and low levels of antioxidants when compared to short‐term ART usage. The use of supplements such as N‐acetylcysteine, selenium, and silibinin in animal models and cell lines showed increased cell viability, reduced reactive oxygen species, and increased antioxidant levels, which are promising therapeutic interventions that should be studied in PLWH to further help improve their disease outcomes. Conclusions Identifying extracts from natural and synthetic products with antioxidant effects will improve the general well‐being of PLWH.

Background and Aims Many studies investigated the prevalence and severity of depression and anxiety among dentists. This systematic review aimed to determine: (i) the prevalence and severity of depression and anxiety symptoms, (ii) the prevalence rates of depression and anxiety before and during the COVID‐19 pandemic, and (iii) gender difference in prevalence of depression and anxiety among dentists. Methods Eligible articles on depression and anxiety in dentists were systematically searched for in PubMed and Scopus databases from September 2023 to October 2023 according to the Preferred Reporting Items for Systematic Review and Meta‐Analysis protocol. We assessed the methodological quality of the studies using the Newcastle–Ottawa Quality Assessment checklist adapted for cross‐sectional studies. Statistical heterogeneity across the studies was evaluated using Cochran's Q test and I² statistic. The prevalence rates of depression and anxiety were calculated using the random‐effect model with the Restricted Maximum‐Likelihood estimator. Of 3762 searched articles, 33 articles were analyzed. Results The prevalence rates of depression and anxiety symptoms among dentists were 42% and 44%, respectively. The prevalence rates of mild, moderate, and severe or extremely severe depression were 20%, 18%, and 8%, respectively. For mild, moderate, and severe or extremely severe anxiety, the respective prevalence rates were 21%, 18%, and 11%. We did not find evidence to suggest differences in depression or anxiety prevalence rates between the periods before and during COVID‐19. In comparison with men, women showed approximately 27% higher risk of experiencing depression and 24% higher risk of experiencing anxiety. Conclusion Equally high levels of depression and anxiety in dentists were found both before and during the COVID‐19 pandemic, with a significant percentage of moderate to severe depression and anxiety. Female dentists reported a higher prevalence of depression and anxiety symptoms than their male colleagues.

Background and Aim The sural neurovascular flap has been effectively used to reconstruct complex tibial and soft tissue defects caused by severe trauma, promoting successful wound repair and healing. Proactive management is essential in minimizing postoperative complications and achieving optimal outcomes. This study evaluates the efficacy and long‐term outcomes of sural neurovascular flap applications in distal lower limb wound reconstruction. Methods Our institution's ethics committee approved this retrospective study numbered YJ202457 involving 47 participants. Informed consent was obtained from all subjects. Data collected included demographic details, injury mechanisms and sites, mode and size of soft tissue defects, complications, cosmetic outcomes, and functional outcomes of the lower limb and ankle. All flaps were performed by a single surgeon, with follow‐up from January 2012 to February 2018. Result The study observed minor complications, primarily superficial necrosis. Over 95% (45) of flaps survived, and less than 5% (2) required reoperations due to superficial necrosis. Patient satisfaction was high, with over 50% (24) achieving excellent cosmetic results and over 40% (20) good cosmetic results. The study recorded improved Functional Recovery and Quality of life. Conclusion Sural neurovascular flap applications show significant promise in reconstructing distal lower limb wounds. Our findings highlight the procedure's efficacy, demonstrated by high patient satisfaction, excellent cosmetic outcomes, and favorable functional results. Critical factors for success include meticulous patient selection, thorough debridement, and careful planning to mitigate risks and optimize outcomes. The patients with diabetes and hypertension were not included to minimize factors that could interfere with the study's results.

Background Depression and cardiovascular disease (CVD) by the end of 2030 will be among the major causes of disability worldwide. Meanwhile, medication adherence is an important factor in predicting clinical outcomes in patients with CVD. Further, lack of medication compliance is affected by depression. Thus, this study aimed to explore the relationship between depression and medication adherence among older patients with CVD. Materials and Methods The search was done across eight databases of PubMed/MEDLINE, Google Scholar, Embase, Scopus, APA Psycinfo, CINAHL/ebsco, ProQuest, and Web of Science. For the selection of included studies, there were no constraints regarding publication language. All studies available in each of the databases were searched up to December 9, 2021. Risk of bias assessment was done based on the Joanna Briggs Institute scale. The final result was estimated using a random effects model. The data were analyzed by CMA 2 software. Results Seven studies and 10,153 elderly suffering from CVD were identified. Most included studies had reported an inverse association between depression and medication adherence. There was a small effect between depression and medication adherence among these older patients (combined odds ratio 0.603, 95% confidence interval 0.252–1.442). Thus, having depression would reduce medication adherence by 40%. Conclusion Depression has a considerable effect on medication adherence among older patients with CVD. Thus, it is suggested that considering the importance of depression and lack of medication adherence in increasing the negative outcomes of this disease in these patients, primary studies be conducted in this regard to achieve conclusive results in subsequent systematic reviews and meta‐analyses.

Background and Aims In this study, we investigated the effects of Z. multiflora on clinical presentation, pulmonary function, and inflammatory and oxidative parameters in patients with pulmonary disorders. Methods PubMed, Embase, Web of Science, Scopus, and Cochrane Library databases were searched to identify trials that assessed the effects of Z. multiflora in patients with different pulmonary diseases. A random‐effects model was then applied to estimate the weighted mean differences (WMDs) with 95% confidence intervals (CIs) of the outcomes considered in this meta‐analysis. Additional analyses were performed. Results Eight articles were included in this meta‐analysis. Z. multiflora supplementation was associated with a significant increase in forced vital capacity (15.17%, 95% CI: 11.01–19.33), forced expiratory volume in 1 s (9.22%, 95% CI: 1.73–16.70), peak expiratory flow (8.68%, 95% CI: 5.94–11.42), catalase (0.05 U/mL, 95% CI: 0.01–0.10), thiol (0.02 μmol/mL, 95% CI: 0.01–0.03), interleukin‐10 (0.38 pg/mL, 95% CI: 0.34–0.42) and interferon‐gamma (0.74 pg/mL, 95% CI: 0.56–0.91). Besides, there were significant decreases in chest wheeze (−1.24, 95% CI: −1.48 to 1.01), malondialdehyde (−2.63 nmol/mL, 95% CI: −3.86 to −1.39), and tumor necrosis factor‐alpha levels (−1.45 pg/mL, 95% CI: −2.01 to −0.89). However, there were no significant changes in mid‐maximum expiratory flow and superoxide dismutase levels. Conclusions The current meta‐analysis underscores the effects of Z. multiflora in improving the clinical manifestations of patients with pulmonary disease, as well as its anti‐inflammatory, immunomodulatory, and antioxidant effects. However, more trials with larger samples and longer observation durations are needed to strengthen the evidence for widespread supplementation of Z. multiflora.

Background and Aim Human giardiasis poses a significant public health challenge globally, particularly in resource‐limited countries due to poor personal hygiene, environmental sanitation, and unsafe water. It affects approximately 300 million people globally every year, and children are the most at‐risk population. This scoping review assesses the burden, transmission dynamics, and public health implications of human giardiasis in Ghana. Methods A comprehensive search strategy across PubMed, African Journals Online, Science Direct, Scopus and Web of Science databases using key terms “Giardia duodenalis,” “Giardia intestinalis,” and “Giardiasis.” Published articles on Human giardiasis in Ghana between 2004 and 2024 on epidemiology, prevalence, diagnostic methods, and target populations were extracted. Results Seventeen studies conducted in Ghana met the inclusion criteria and were included in this review. The prevalence of Giardia duodenalis in Ghana varies significantly across studies and settings, with rates ranging from 0.7% to 59.6%, with children being the most affected. However, studies conducted in Ghana since 2020 indicate a lower prevalence, with rates between 0.7% and 13.0%. Regional studies indicate varied prevalence: 0.7%–13.0%, 2.3%–59.6%, and 5.9% in the Southern, Middle, and Northern belts, respectively. Conclusion The prevalence of human giardiasis in Ghana is relatively low. However, targeted public health interventions are necessary to maintain the progress achieved, in addition to improvements in sanitation and hygiene practices.

Background and Aims Stroke remains a leading cause of mortality and long‐term disability worldwide, presenting a significant global health challenge. Effective early prediction models are essential for reducing its impact. This study introduces a novel ensemble method for predicting stroke using two datasets: a primary dataset collected from a hospital, containing medical histories and clinical parameters, and a secondary dataset. Methods We applied several preprocessing techniques, including outlier detection, data normalization, k‐means clustering, and missing value detection, to refine the datasets. A novel ensemble classifier was developed, combining AdaBoost, Gradient Boosting Machine (GBM), Multilayer Perceptron (MLP), and Random Forest (RF) algorithms to enhance predictive accuracy. Additionally, Explainable Artificial Intelligence (XAI) techniques such as SHAP and LIME were integrated to elucidate key features influencing stroke prediction. Results The proposed ensemble classifier achieved an accuracy of 95% for the secondary dataset and 80.36% for the primary dataset. Comparative analysis with other machine learning models highlighted the superior performance of the ensemble approach. The integration of XAI further provided insights into the critical indicators influencing stroke classification, improving model interpretability and decision‐making. Conclusion Our study demonstrates that the novel ensemble classifier, supported by effective preprocessing and XAI techniques, is a powerful tool for stroke prediction. The high accuracy rates achieved validate its effectiveness and potential for practical clinical application. Future work will focus on incorporating deep learning techniques and medical imaging to further improve classification accuracy and model performance.

Background and Aims Diverse HPV 16 variants have been known to vary in geographic distribution and oncogenic potential. On this point, the nucleotide changes of the E6 gene were studied to find lineages of HPV 16 in normal, premalignant, and malignant stages of uterine cervical samples. Methods In this study, 120 HPV 16‐infected samples were investigated using PCR and sequencing. Results In our samples, three lineages A, C, and D were found and lineage D was predominant (79.2%) followed by lineages A (20%) and C (0.8%). Concerning the association between histopathological stages and lineages, no statistically important differences were found. Conclusion Our finding revealed that two lineages A and D were circulating, with the dominancy of lineage, in Tehran, Iran. This finding emphasizes the geographic diversity of distinct HPV 16 (sub)lineages is different in the world.

Introduction Nurses play a vital role in healthcare systems, directly influencing patient care quality and outcomes. This study aims to identify and analyze strategies for improving nursing performance in Iran through a systematic review and meta‐synthesis, following PRISMA 2020 guidelines. Methods Data were collected from four electronic databases: Web of Science, Scopus, PubMed, and Embase. Qualitative studies and mixed methods focused on nursing performance in Iranian healthcare contexts were included. Data management and theme development were facilitated using MAXQDA qualitative analysis software. Findings Thirty‐seven studies were included, identifying 10 key themes for improving nursing performance: leadership, organizational culture, self‐efficacy, mental health support, continuous education, technological integration, working conditions, performance evaluation, recruitment and retention, and service quality improvement. Conclusions A holistic approach, including leadership development, supportive work environments, continuous education, and technology integration, is essential for enhancing nursing performance and healthcare outcomes in Iran.

Background and Aims Intralesional immunotherapy is an upcoming method of wart treatment with fewer side effects and this study aims to assess and compare the efficacy of intralesional MMR vaccine and vitamin D3 in the treatment of nongenital warts. Methods A comparative prospective study was done with a total of 61 patients divided into two groups. Thirty‐one patients were treated with intralesional MMR, while 30 patients received intralesional vitamin D3. In both groups, a maximum of five sessions were carried out every 3 weeks and follow‐up was done for 3 months. χ², Fisher's exact, and multivariate analyses assessed variable relationships. Results In the MMR group, 80.6% of patients achieved complete response, 6.5% had excellent response, 9.7% showed good response, and 3.2% had no response. Similarly, in the vitamin D3 group, 73.4% achieved complete response, 20.0% had excellent response, 3.3% showed good response and 3.3% had no response. The difference in response rates between the two groups was statistically insignificant. One patient (4.0%) in the MMR group and three patients (13.6%) in the vitamin D3 group experienced recurrence within 3 months of follow‐up, but this difference was not statistically significant. Both treatments were well tolerated. Pain was universal, while swelling (60%), hyperpigmentation (30%), and pruritus (16.7%) were more common with vitamin D3. In logistic regression analysis, pain duration was significantly higher in the Vitamin D group compared to the MMR group (p < 0.001). Fever (MMR) and hypervitaminosis D3‐related fatigue (vitamin D3) were rare. No severe adverse events occurred. Conclusions Both intralesional MMR and vitamin D3 showed positive response and were well tolerated and comfortable modalities for the treatment of warts. However, recurrence rate and side effects were higher with Vitamin D3 than MMR. Clinicaltrials.gov: NCT04428359.

Background and Aims Maternal and neonatal mortality remain critical global health challenges, particularly in low‐resource settings where preventable deaths occur due to inadequate access to timely care. This article explores the potential of Artificial Intelligence (AI) to enhance maternal and child healthcare by improving early risk identification, diagnosis, treatment recommendations, and postpartum monitoring. Methods It explores the use of AI in identifying pregnancy‐related risks, recommending treatments, predicting adverse outcomes, and monitoring postpartum and neonatal care. Various AI models, including supervised machine learning, Large Language Models (LLMs), and Small/Medium Language Models (SLMs/MLMs), are discussed in terms of their feasibility into resource‐limited healthcare systems. Results AI has demonstrated significant potential in identifying pregnancy‐related risks, recommending treatments, predicting adverse outcomes, and supporting postpartum and neonatal care. While AI‐driven solutions can optimize healthcare decision‐making and resource allocation, challenges such as data availability, integration into clinical workflows, and ethical considerations must be addressed for widespread adoption. Conclusion AI offers promising solutions to reduce maternal and neonatal mortality by enhancing risk detection and clinical decision‐making. However, its real‐world implementation requires overcoming barriers related to data quality, infrastructure, and equitable deployment. Future efforts should focus on data standardization, AI model optimization for resource‐limited settings, and ethical considerations in clinical integration.

Background and Aims Electronic prescribing holds significant potential for improving healthcare quality and efficiency. However, its success relies on healthcare professionals' acceptance and use. This study investigated the factors influencing e‐prescribing adoption among physicians and pharmacists in Iran, where its use has been mandated since December 2021. Methods A cross‐sectional study was conducted in 2024 using a structured questionnaire to gather data from 189 physicians and pharmacists in Kerman, Iran. The data collection tool was a structured questionnaire divided into two sections: demographic information and research variables. The questionnaire measured key constructs based on the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT). Data were analyzed using SPSS 25.0 and MPLUS 8.3.2 software. Results A total of 171 individuals participated in our survey. The updated measurement model confirmed the presence of convergent and discriminant validity, as well as reliability and fit. Analysis of the structural model indicated that, at the 95% confidence level, perceived ease of use positively influences perceived usefulness, which in turn enhances trust in the e‐prescribing system. Additionally, technology self‐efficacy has a positive impact on attitudes toward using e‐prescribing. Conclusions This study presents valuable insights into the factors influencing the adoption of e‐prescribing within the Iranian healthcare context. The findings carry significant implications for policymakers, system developers, and healthcare administrators aiming to enhance the implementation of e‐prescribing and promote its widespread adoption. Furthermore, this study contributes to the broader discourse on health information technology adoption by emphasizing the critical importance of contextual factors in technology acceptance research.

Background and Aims The recommended dosing regimens for oral misoprostol in labor induction include 25 μg every 2 h and 50 μg every 4 h. However, there is no specific protocol for these regimens at Shahid Akbarabadi Hospital. This study aimed to assess the safety and effectiveness of the two dosing protocols for labor induction in women with premature rupture of membranes (PROM) and establish a tailored protocol to minimize maternal and neonatal complications. Methods This randomized controlled trial was conducted at Shahid Akbarabadi Hospital from 2021 to 2023, including pregnant women with term singleton pregnancies and confirmed PROM. Participants were randomly assigned to receive either 25 μg of oral misoprostol every 2 h (up to 12 doses) or 50 μg every 4 h (up to 6 doses). The primary outcome was the mode of delivery. Secondary outcomes included induction‐to‐delivery time, uterine tachysystole, postpartum hemorrhage, and neonatal complications. Statistical analysis was performed using chi‐square and t‐tests for comparisons between groups. Results A total of 400 women were enrolled, with 200 in each group. The mean induction‐to‐delivery interval was significantly shorter in the 50 μg group (p = 0.001). Uterine tachysystole and postpartum hemorrhage due to atonia were more frequent in the 25 μg group (p < 0.05). The rates of cesarean and instrumental deliveries did not differ significantly between groups. The mean ± SD age was 27.1 ± 5.27 years in the 25 μg group and 26.8 ± 5.11 years in the 50 μg group (p = 0.639). Conclusion Both dosing regimens of oral misoprostol were effective for labor induction, but the 50 μg dose was associated with a shorter induction‐to‐delivery time. The findings suggest that adjusting the misoprostol dosage may reduce complications. Clinical Trial Registration Code: IRCT20221123056587N1.

Objectives This study aims to determine the prevalence of risk factors among patients with spontaneous intracerebral hemorrhage in Syrian society. Methods This study is a retrospective cross‐sectional study, patients' data were collected from four hospitals. Cross‐tabulation tables and the χ² test were used to show the relationship between gender/age and the prevalence of risk factors, demonstrate statistical significance, and calculate p value. Results From a total of 194 patients included in the study, there were 123 males, accounting for 63.4% of the patients, while there were 71 females, accounting for 36.6%. The most common risk factor among intracerebral hemorrhage patients was hypertension at 44.8% of the total patients, followed by antithrombotic use at 25.8%, smoking at 19.1%, diabetes at 15.5%, and hematological diseases making up 9.3% of the patients, whereas in age groups under 10 years, various hematological diseases were the most prevalent risk factors at 42.5%, followed by prematurity at 27.5%, and hyaline membrane disease at 15%. The study showed no statistically significant differences in the distribution of risk factors between males and females except for smoking. However, the results revealed a significant difference in the distribution of risk factors according to age for Smoking, hypertension, antithrombotic use, diabetes, arteriovenous malformation, hyaline membrane disease, hematological diseases, and prematurity (p < 0.05). Conclusion The study showed that hypertension and antithrombotic use are the most important risk factors for intracerebral hemorrhage, so controlling arterial pressure and periodic tests such as platelet count/PT/PTT are gold roles in preventing intracerebral hemorrhage.