Background and Objective: The therapeutic outcomes of amblyopia after the age range of 8-10 years are poor, and amblyopia in older individuals is resistant to treatment. Repetitive Transcranial Magnetic Stimulation (rTMS), among the efforts intended to modulate cortical excitability in the treatment of psychiatric disorders, has been believed to be associated with a specific disease. This study aimed to determine the effect of rTMS on the treatment of treatment-resistant amblyopia in adult patients.
Methods: This clinical trial was conducted on 16 patients (12 males and 4 females) with unilateral amblyopia, with a mean age of 30±5 years referring to the clinics of Khatam al-Anbia Eye Hospital, Mashhad, Iran, during 2016-17. Patients were randomly selected from those with unilateral amblyopia (refractive, strabismic, or mixed) who had not responded to conventional treatments (patching or penalization). The healthy eye was considered a control. The therapeutic intervention consisted of four rTMS sessions at two-week intervals. Visual acuity and contrast sensitivity were measured and compared three times: Before the intervention, at the first session of intervention, and at the fourth session of intervention.
Results: The mean visual acuity at baseline (0.36±0.19) was not significantly different compared to the first treatment session (0.41±0.1); however, a significant increase was observed compared to the fourth session (0.45±0.23) (P<0.05). The mean contrast sensitivity at baseline (2.02±0.74) was not significantly different compared to the first (1.97±0.63) and the fourth (2.16±0.94) treatment sessions.
Conclusion: In most follow-ups, improvement in contrast was not observed in patients with treatment-resistant amblyopia at older ages using rTMS. Only an improvement in visual acuity was observed in the last follow-up compared to the baseline in the patient group.

Background and Objective: Various surgical techniques, including Open Reduction and Internal Fixation (ORIF), Minimally Invasive Plate Osteosynthesis (MIPO), and External Fixation (EF), have been proposed for the tibial pilon fractures treatment. However, limited comparative data exist regarding the outcomes of these three methods. Despite advancements in surgical procedures, the outcomes have not consistently been excellent, and patients often experience numerous complications. This study aimed to evaluate the outcomes and complications of the tibial pilon fractures treatment in a six-month follow-up.
Methods: This descriptive-analytical prospective cohort study was conducted on 22 patients (18 men and 4 women; mean age=39.4±10.8 years) who presented with tibial pilon fractures at the Fifth Azar Educational-Therapeutic Center in Gorgan, Iran, from April 2020 to March 2022. All 22 eligible patients agreed to participate. Following the necessary treatment determined by the attending physician, patients were examined after six months, and their outcomes were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) ankle score.
Results: The majority of fractures (54.5%) were of closed type. The surgical procedures performed included two-stage EF (40.9%), ORIF (31.8%), expert nailing (13.6%), and MIPO (13.6%), respectively. A total of 72.7% of patients experienced early or late postoperative complications. The most common postoperative complications were osteoarthritis and wound dehiscence, occurring at a rate of 18.2% each. The mean AOFAS score for patients was 82.3±11.2. AOFAS scores were classified as excellent in 4 patients (18.18%), good in 12 patients (54.55%), moderate in 4 patients (18.18%), and poor in 2 patients (9.09%). A statistically significant inverse correlation was observed between the mean surgical time and the AOFAS score (r=−0.661, P=0.001). Furthermore, a statistically significant direct correlation was found between the mean surgical time and the mean length of hospital stay (r=0.571, P=0.006). Surgical time for patients undergoing MIPO (68.3±7.6 minutes) was significantly shorter than that of the other three methods (P<0.05). For open fractures, the frequency of ORIF was significantly higher than that of other procedures (P<0.05). Osteoarthritis was observed as a treatment complication in both expert nailing and two-stage EF interventions. In contrast, non-union and wound dehiscence complications were exclusively observed following ORIF. Superficial infection and mal-union were only observed after two-stage EF, and all instances of deep infection occurred with MIPO.
Conclusion: Two-stage EF and ORIF were the most common surgical techniques employed for patients with tibial pilon fractures. Worse postoperative complications, including non-union and wound dehiscence, commonly occurred in ORIF procedures. However, there was no statistically significant difference in patient-reported outcomes based on the AOFAS self-report questionnaire among the various surgical techniques.

Background and Objective: Prostate cancer is one of the most common malignancies worldwide. Docetaxel (DTX) is proposed as a well-known compound for prostate tumor chemotherapy, and its function is based on inhibiting microtubule depolymerization, disrupting microtubule balance, and consequently delaying cell cycle progression. Complications of DTX include hypersensitivity reactions, red blood cell aggregation, neutropenia, neurological problems, such as paralysis, fluid retention, bronchospasm, refractory hypotension, ADRS, respiratory impairment, cardiac dysfunction, ventricular tachycardia, cystoid macular edema, optic nerve damage, conjunctivitis, and keratopathy. This study aimed to determine the effect of curcumin on DTX-induced apoptosis in the DU145 (prostate) cell line using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.
Methods: This descriptive analytical study was conducted on the DU145 (prostate) cell line, purchased from the National Genetic Resources Cell Bank, at the Cell Culture Laboratory of the F aculty of Pharmacy, Mazandaran University of Medical Sciences. Cells were passaged for exposure to the desired drugs. Groups included curcumin at concentrations of 2, 4, 6, 8, and 10 µg/mL and DTX at a concentration of 4.46 µg/mL. Cells were incubated in triplicate for 24 hours. For the MTT assay, the culture rate was 10⁴ cells per well. Apoptosis testing was designed for four groups (DTX at a concentration of 4.46 µM, curcumin at a concentration of 2 µM combined with DTX at an optimal concentration, curcumin at a concentration of 10 µM combined with DTX at an optimal concentration, and curcumin at a concentration of 10 µM alone), with the culture rate of 5×10⁵ cells per well in 6-well plates. After cell exposure, MTT and apoptosis determination assays were performed.
Results: DTX reduced the viability of DU145 (prostate) cells by approximately 50% (P<0.05). Groups treated with curcumin combined with DTX showed a dose-dependent decrease in cytotoxicity and an increase in the viability of DU145 (prostate) cells (P<0.05). Additionally, curcumin was able to reduce apoptosis in DU145 (prostate) cells by 90%.
Conclusion: Curcumin increases cell viability and reduces apoptosis in DU145 (prostate) cells.

Background and Objective: Docetaxel is an effective chemotherapy drug for treating lung cancer, but its side effects and cytotoxicity limit its use. Natural compounds like carvacrol and thymol, known for their anti-cancer and anti-inflammatory properties, have gained attention as adjunct agents to reduce toxicity and enhance the efficacy of chemotherapy drugs. This study aimed to investigate the impact of carvacrol and thymol on cell viability and function in A549 cancer cells exposed to docetaxel.
Methods: This experimental study was conducted on the epithelial cell line derived from lung cancer tissue (A549), obtained from the Pasteur Institute of Iran at the Faculty of Pharmacy, Mazandaran University of Medical Sciences in the year 1042. In this research, A549 cells were pre-treated with various concentrations of carvacrol and thymol (5, 10, 20, 40, 80, 100, and 200 µg/mL) along with a cytotoxic dose of docetaxel (8.92 µg/mL) over a period of 48 hours. Cytotoxicity was assessed using the MTT assay. Additionally, the levels of reactive oxygen species (ROS) in cells were measured using the DA-DCFH reagent, and malondialdehyde (MDA) levels were determined using the thiobarbituric acid (TBA) reagent.
Results: Carvacrol and thymol significantly reduced the cytotoxic effects of docetaxel at concentrations ranging from 5 to 200 µg/mL (P<0.05). The evaluation of cytotoxicity indicated that at a concentration of 200 µg/mL, carvacrol and thymol exhibited a more pronounced enhancing effect (98.11±1.64%) compared to the concentration of 5 µg/mL (54.64±2.03%). Furthermore, these compounds significantly mitigated the oxidative stress induced by docetaxel by decreasing the production of reactive oxygen species (ROS) and malondialdehyde (MDA) (P<0.05). Specifically, at the concentration of 200 µg/mL, the levels of ROS and MDA were (13.57±0.09%) and (0.55±0.003%), respectively, in contrast to the levels at 5 µg/mL, which were (20.50±0.59%) and (0.98±0.01%). This demonstrates a notable inhibitory effect on the growth of cancer cells by carvacrol and thymol.
Conclusion: Carvacrol and thymol demonstrate high potential as compounds to improve cell function and reduce the cytotoxicity induced by docetaxel in A549 cancer cells. These findings suggest the potential enhancement of chemotherapy regimens for cancer treatment.

Background and Objective: Fear of childbirth is a common problem during pregnancy. Previous studies have shown that pregnancy outcomes and experiences can significantly vary across various ethnic groups. This study aimed to determine the prevalence of fear of childbirth among pregnant mothers of various ethnicities referring to comprehensive health service centers in Gorgan, Iran.
Methods: This descriptive-analytical study was conducted on 341 pregnant women of Fars, Turkmen, and Sistani/Baluch ethnicities using a random sampling method at comprehensive health service centers in Gorgan during 2023. Data collection instruments consisted of a demographic and pregnancy characteristics form and the Childbirth Fear Questionnaire (CFQ; Zar and Wijma).
Results: The mean fear of childbirth score in pregnant women was determined to be 69.88±20.19 (severe fear). Among all studied groups, mild fear (21 individuals), moderate fear (100 individuals), severe fear (147 individuals), and clinical fear (73 individuals) were identified in 6.2%, 29.3%, 43.1%, and 21.4% of the pregnant women, respectively. The combined prevalence of severe and clinical fear of childbirth among pregnant women of Sistani/Baluch, Turkmen, and Fars ethnicities was determined to be 73%, 73.3%, and 52.2%, respectively, and this difference was statistically significant (P<0.05). A statistically significant relationship was observed among the variables of age, gestational period, and the level of satisfaction with prenatal care received at comprehensive health service centers (P<0.05).
Conclusion: Severe and clinical fear of childbirth is more prevalent among pregnant women of Sistani/Baluch and Turkmen ethnicities compared to the Fars ethnicity.