Background: Diseases related to the brain and nervous system lead to various complications in patients. One of these diseases is bipolar disorder (BD). Bipolar disorder is a multifaceted disorder that is influenced by various factors, including environment and genetics. Objectives: For this reason, this study was conducted with the aim of bioinformatically determining gene biomarkers in BD using biomarker study methods. Methods: The methodology began by identifying candidate genes through the triangulation of evidence from animal models, in vitro cell cultures, and in silico predictions. Subsequently, high-throughput gene expression data for these candidates were systematically retrieved from public bioinformatics databases. A crucial data processing step involved rigorous standardization: Expression values from case cohorts were precisely normalized against those from healthy controls. This normalization was essential to mitigate batch effects and ensure that observed differences were reliably attributable to the disease state. This allowed for the robust investigation of the primary research hypotheses. Results: The core of the analysis involved assessing the topological importance of these genes within the inferred biological networks. Utilizing five complementary network centrality criteria—namely degree, closeness, radius, betweenness, and most neighboring—a highly conserved set of essential genes was successfully isolated. Crucially, four specific genes: CI3RN, BDNF, PPARGC1A, and TP53, exhibited the highest degree of recurrence and centrality when evaluated across the entirety of the five distinct network analysis methods. Conclusions: These findings offer a clear and data-driven mandate to suggest and prioritize complementary validation studies at both the fundamental laboratory/molecular level and the translational clinical level, focusing on their efficacy as refined diagnostic biomarkers for BD.

Background: Aluminum chloride (AlCl3) exposure is implicated in Alzheimer's disease (AD) pathogenesis, inducing cognitive deficits, oxidative stress, and neuroinflammation. Pyroptosis, an inflammatory form of cell death driven by the NLRP3 inflammasome, is a critical link between these pathologies. Objectives: This study investigated the combined efficacy of melatonin (MEL), an antioxidant and anti-inflammatory agent, and methylphenidate (MPH), a cognitive enhancer, against AlCl3-induced neurotoxicity. Methods: Male BALB/c mice were divided into six groups (n = 6): Control, sham (MEL 10 mg/kg + MPH 10 mg/kg), AlCl3 (300 mg/kg), and AlCl3-treated groups with MEL, MPH, or their combination. After 15 days of treatment, cognitive function was assessed via a passive avoidance test. Hippocampal tissues were analyzed for oxidative stress markers [reactive oxygen species (ROS) and myeloperoxidase (MPO)] and key pyroptosis proteins [NLRP3, cleaved caspase-1, gasdermin D (GSDMD)] using biochemical assays. Results: The AlCl3 administration significantly induced cognitive impairment in the passive avoidance test, increased ROS production and MPO activity, and upregulated hippocampal levels of NLRP3, cleaved caspase-1, and GSDMD. While MEL and MPH monotherapies showed modest benefits, their combination produced the most robust effects. The combined treatment significantly reduced oxidative stress markers and markedly suppressed the expression of all measured pyroptosis-related proteins compared to the AlCl3 group. Conclusions: The combination of MEL and MPH demonstrates a superior protective effect against AlCl3-induced neurotoxicity compared to either drug alone. The therapeutic mechanism appears to involve the synergistic inhibition of the NLRP3/caspase-1/GSDMD pyroptosis pathway and the mitigation of MPO-mediated oxidative stress, presenting a novel combinatorial strategy for alleviating neuroinflammation in AD-like pathology.

Background: Pain and discomfort in the lower back and cervical regions are common symptoms of many musculoskeletal and non-musculoskeletal diseases, and these conditions have a high prevalence in society. Such problems can significantly affect patients' quality of life, including their sexual function (SF). Objectives: This study aimed to determine and compare the status of SF in patients with cervical and lumbar discopathy (LD) and healthy individuals. Methods: This case-control study was conducted in Ilam city in 2025. The study population comprised individuals with LD (48), cervical discopathy (CD) (48), and healthy controls (48), aged 18 - 60 years. Data were collected using questionnaires on personal characteristics, the Female Sexual Function Index (FSFI), the Brief Sexual Function Inventory (BSFI) for men, and the Visual Analog Scale (VAS) for pain intensity. Data analysis was performed using SPSS version 18, with descriptive and inferential statistical tests. Results: Among women, the mean ± SD SF score in the CD group was 27.81 ± 3.82, in the LD group was 22.31 ± 5.89, and in the control group was 30.26 ± 2.76. Among men, the mean ± SD SF score was 26.80 ± 5.83 in the CD group, 24.60 ± 4.57 in the LD group, and 36.29 ± 1.98 in the control group. Statistically significant differences were observed in the overall SF scores (P < 0.001) and all dimensions (P < 0.05) among the three groups in both men and women. Conclusions: Given that SF scores were lower in patients with cervical and lumbar disc disorders than in healthy individuals, it is recommended to implement appropriate interventions to improve SF in these patients. Furthermore, consultation with a midwife or gynecologist should be included in the treatment process to enhance patients' sexual health.

Background: Identifying key brain regions implicated in Parkinson’s disease (PD) can enhance both diagnostic accuracy and our understanding of disease mechanisms. Objectives: This study aims to compare three machine learning methods — least absolute shrinkage and selection operator (LASSO), random forest (RF), and recursive feature elimination (RFE) — for selecting influential regions of interest (ROIs) from functional magnetic resonance imaging (fMRI) data to distinguish PD patients from healthy controls. Methods: This retrospective analysis used fMRI data from 15 patients with PD and 15 matched healthy controls, sourced from an open-access database. Three machine learning approaches were applied to identify significant ROIs associated with PD. The selected ROIs were subsequently evaluated using logistic regression models, assessing classification performance through area under the curve (AUC), sensitivity, and specificity. A comparative analysis of model performance was conducted using DeLong’s test. Results: The LASSO identified 9 ROIs, RF selected 10, and RFE identified 4 key ROIs. Logistic regression models constructed with these ROIs yielded AUC values of 0.96, 0.94, and 0.88 for LASSO, RF, and RFE, respectively. Both sensitivity and specificity were highest for LASSO (0.92 for both). DeLong’s test revealed statistically significant differences among the methods (P < 0.001), with LASSO outperforming RF and RFE. Conclusions: This study demonstrates that LASSO, RFE, and RF machine learning techniques are promising for identifying key brain regions, showing preliminary alignment with clinical observations. Focusing on patients with PD, it highlights regions associated with executive function, memory, motor skills, and sensory processing. Early detection of abnormal connectivity in these areas may potentially inform exploratory preventive strategies for PD.

Background: Trauma is a common cause of mortality and disability in humans, occurring in various parts of the body. Objectives: Given the importance of patients with rheumatoid arthritis (RA), this study was conducted with the aim of determining the clinical characteristics and outcomes of spinal and orthopedic traumas in patients with RA. Methods: In this study, patients admitted to Imam Khomeini Hospital from the beginning of 2022 to the end of 2024 due to spinal cord injury and/or orthopedic trauma were enrolled. To collect data, researchers, by studying other published articles, designed a researcher-made checklist. This checklist contained patients’ demographic information as well as questions regarding spinal cord injuries, orthopedic injuries, and common injuries, which were completed as yes/no responses. Quantitative data analysis was performed using descriptive and inferential statistical tests, entered into SPSS 16 software. Results: According to the findings, out of 155 patients with RA, 36 patients were hospitalized due to SCI, 91 patients due to orthopedic trauma, and 28 patients due to orthopedic and SCI trauma. According to the findings, a significant relationship was observed between the type of trauma and the mortality status of the patients. In such a way that in patients with RA who were hospitalized due to orthopedic and SCI, the mortality rate was higher than in other patients. There was also a correlation between infection and VAP in patients with mortality, and the mortality rate in patients with infection and VAP was higher than in other patients. Conclusions: Given that the mortality rate in patients with both orthopedic trauma and spinal cord trauma is higher than in other patients, it is essential that these patients be given higher priority.

Introduction: Behcet's disease (BD) is a systemic vasculitis that can affect the gastrointestinal system. Case Presentation: This report discusses a 41-year-old woman with a history of bariatric surgery who later developed gastrointestinal symptoms and arthralgia consistent with BD. Diagnosing BD is challenging because there are no specific diagnostic tests; instead, diagnosis is based on the constellation of clinical signs and symptoms such as recurrent oral and genital ulcers, uveitis, and multisystem involvement, which can overlap with other diseases. It remains unclear whether surgical procedures influence the onset or progression of the disease. Conclusions: The relationship between surgical interventions and the onset of BD requires further investigation. This case underscores the importance of considering BD in the differential diagnosis of post-surgical GI symptoms and highlights the role of tailored immunosuppressive therapy in achieving resolution of GI ulceration or arthralgia. Future studies must clarify the interplay between surgical procedures and immune-mediated diseases like BD.

Background: Addiction, particularly to synthetic stimulants like mephedrone, poses significant challenges for both treatment and societal health. Mephedrone, a cathinone derivative, is increasingly misused and has been shown to affect brain function. While the neurotoxic effects of mephedrone are well-documented in adolescents, limited research exists on its effects during pregnancy, particularly on cerebellar development in offspring. Objectives: This study examines the effect of mephedrone exposure during gestation on the morphometrical parameters of the cerebellum in Balb/C mouse offspring. Methods: In this experimental study, 10 one-day-old male mouse pups were divided into a control and an experimental group, whose mothers received daily subcutaneous mephedrone injections (50 mg/kg) from days 5 to 18 of pregnancy. Cerebellar tissue from the pups was processed and stained with cresyl violet, and cerebellar layers and cell characteristics were assessed using histological methods. Results: A significant reduction was observed in the thickness of the outer granular, molecular, Purkinje, and inner granular layers compared to the control group (P < 0.05). However, no significant differences were observed in white matter (WM) thickness, cell counts, or Purkinje cell morphology, including their area, perimeter, or diameters. Conclusions: Exposure to mephedrone during pregnancy resulted in altered cerebellar development in mouse pups, specifically reducing the thickness of cerebellar layers.

Background: While the incidental detection of idiopathic intracranial hypertension (IIH) imaging findings is common during brain MRIs, the existing literature dedicated to the neuroimaging relevance remains limited. Objectives: This study aims to determine the prevalence and clinical significance of incidental MRI indicators suggestive of raised intracranial hypertension in outpatients undergoing brain imaging, with a particular focus on their association with papilledema. Methods: This prospective cohort study was conducted at an academic hospital's radiology department between 2020 and 2022. A total of 178 adult patients referred for outpatient brain MRI participated in the study. MRIs were conducted with established protocols and criteria utilized for identifying IIH radiographic signs. Ocular fundoscopy was performed as part of the examination protocol. A comparison was then made between imaging findings in two groups of patients with and without papilledema. Results: The MRI assessments revealed that 73.5% of patients (n = 131) exhibited at least one indication of IIH, with 4.24% showing at least four signs. The prevalence of papilledema varied, ranging from 2.8% in cases with at least one MRI sign of IIH to 40.0% in those displaying at least four signs. Papilledema demonstrated a significant correlation with prominent Meckel caves and optic nerve tortuosity. Conversely, other imaging findings exhibited negligible associations. A notable correlation was identified between the presence of papilledema and the quantity of IIH indicators detected in brain MRIs. Notably, when three or more MRI features associated with IIH were present, a statistically significant correlation with papilledema emerged. Conclusions: The MRI results in this study frequently revealed indications of IIH, whereas occurrences of papilledema were infrequent. In cases where there are no alarming symptoms or the presence of papilledema, invasive procedures may not be deemed necessary for patients incidentally diagnosed with IIH.

Background: Upper limb dysfunction in stroke reflects layered impairments — from impaired motor execution to maladaptive plasticity and disrupted white matter architecture. Unlike the more resilient recovery of lower limbs, fine motor restoration remains limited. Although electromyographic (EMG) biofeedback is clinically validated, its influence on central structural substrates of motor recovery remains poorly understood. Objectives: This exploratory feasibility study examined EMG biofeedback as a potential neuromodulatory input influencing white matter architecture, assessed with diffusion tensor imaging (DTI). The findings are hypothesis-generating and provide preliminary indications rather than definitive evidence of structural change. Methods: Twelve individuals (aged 50 - 70) with ischemic stroke (6 - 22 months post-onset) and upper limb spasticity [Modified Ashworth Scale (MAS) ≥ 3] underwent an 8-week EMG biofeedback intervention targeting distal extensor activation. In this single-arm, exploratory assessment, functional outcomes were measured using the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), MAS, and Barthel Index. Microstructural plasticity was assessed via DTI, with extraction of fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) across motor pathways. Due to the limited sample size and exploratory nature of the study, we employed both frequentist and Bayesian methods to assess pre-post changes and brain-behavior associations, allowing for prior-informed estimation and improved uncertainty characterization. Results: Motor performance showed improvement (FMA-UE: +12.4; P < 0.01), accompanied by increases in EMG tension amplitudes (P < 0.001), consistent with enhanced motor unit activation. The DTI analyses indicated a marginal FA increase in the corticospinal tract [CST, P = 0.05; posterior mean: 0.045 (CI: 0.0039 - 0.0877)] and an RD increase in the internal capsule [P < 0.01; posterior mean: 0.027 (CI: -0.0034 - 0.0584)], which appeared to correlate with motor gains. By contrast, functional independence measured by the Barthel Index showed no clear improvements in this cohort. Conclusions: The current preliminary findings suggest that EMG biofeedback may modulate motor function and corticospinal microstructure in stroke. Observed clinical, electrophysiological, and imaging trends warrant cautious interpretation given the pilot design. Larger, controlled studies are required to validate efficacy and clarify underlying neuroplastic mechanisms.

Background: In children, risk factors for delirium include anesthetics such as sevoflurane, surgeries such as dentistry and ENT, autism, and ADHD. Objectives: The present study was conducted to determine the rate of delirium in children and adolescents hospitalized for surgery. Methods: In this cross-sectional study, 75 children and adolescents hospitalized for surgery were evaluated for delirium. The instrument used was the Cornell Assessment of Pediatric Delirium (CAPD), which has 2 sections and 4 questions in each section. The Kernel tool was scored by an anesthesiologist once per shift and every 12 hours until the patient was discharged. In all cases, ethical codes were observed in the research. Data analysis was performed in SPSS 16 software. Results: Results showed a total of 75 patients were studied, of which 56% were in the adolescent age range and female gender, 84% had surgery duration less than 45 minutes, and 53.3% were hospitalized due to non-emergency surgeries. The incidence of delirium in patients was 11 (14.7%), which in Table 1 showed that there is a relationship between delirium and gender (P = 0.003), type of inpatient ward (P = 0.02), surgery duration (P = 0.02), coexisting disease (P = 0.000), and type of surgery (P = 0.006). Also, out of 86 patients studied, 11 patients had delirium and 64 patients did not. It was also related to gender 0.04 [4.16 (1.00 - 17.8)], type of inpatient ward 0.02 [0.27 (0.073 - 1.06)], surgery duration 0.04 [4.00 (0.95 - 16.79)], and type of surgery 0.006 [0.088 (0.011 - 0.73)]. Conclusions: Although the incidence of delirium was low in this study, it is necessary to identify factors affecting the occurrence of delirium and to implement interventions to prevent delirium in patients undergoing surgery.