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Background The Covid-19 pandemic has affected all areas of society, including students. However, medical students have faced many challenges due to direct contact with patients. The present study was conducted with the aim of investigating and comparing the quality of life (QoL), anxiety and mindfulness between Iranian medical and non-medical students during the COVID-19 pandemic. Method Five hundred and six students (both medical and non-medical students) participated in the study from August to October 2022 with a convenience sampling method. The data were collected using an online questionnaire including a demographic form, the QoL Questionnaire (WHOQOL- BREF), the Generalized Anxiety Disorder 7-item survey (GAD‐7) and the Relaxation/Meditation/Mindfulness Tracker t-Persian version survey (RMMt-P). Pearson correlation and independent t-test and multivariate linear regression were used to determine the relationship between the study variables. Results The samples included 272 medical students and 234 non-medical students with a mean age of 21.99 ± 3.46 and 24.17 ± 6.54 years respectively. Most of the medical and non-medical students were female, single and had a bachelor’s degree. The mean scores of medical and non-medical students’ QoL during the COVID-19 pandemic were 57.86 ± 13.26 and 56.75 ± 14.42, respectively which indicates the higher quality of life of medical students. Anxiety and mindfulness predicted 29% of the variance of the QoL in the medical students, while anxiety and mindfulness and having a chronic disease predicted 30% of the variance of the QoL in the non-medical students. No significant difference existed in the QoL and its subscales during the COVID-19 pandemic between medical and non-medical students ( p  > 0.05). There was a significant difference in terms of anxiety ( p  = 0.02) and mindfulness ( p  = 0.03) between medical and non-medical students during the prevalence of COVID-19. Discussion and conclusion The findings of the present study indicated that medical students exhibited lower levels of anxiety and higher levels of mindfulness. Therefore, interventions aimed at reducing anxiety and increasing mindfulness among non-medical students are necessary. It is recommended that preventive approaches and psychological interventions to improve students’ quality of life become an integral part of crisis response during the COVID-19 pandemic. Additionally, reducing anxiety and enhancing mindfulness can improve the quality of education and professional performance of medical students, while also contributing to their mental well-being and effective clinical communication.

Recurrent pregnancy loss is a distinct disorder defined as the loss of at least 2 pregnancies before the 20th wk of gestation. With half of the genome of the embryo belonging to the father, the integrity of the sperm genome is crucial for a successful pregnancy. Semen analysis is recommended for men in such cases to evaluate sperm concentration, morphology, vitality and motility. However, other important sperm parameters such as sperm epigenetics, aneuploidy, Y chromosome microdeletion and chromatin integrity also correlate with successful pregnancy and delivery rate. This article examines the use of different sperm tests and their importance in male partners of women suffering from recurrent pregnancy loss. Key words: DNA fragmentation, Sperm, Y chromosome, Recurrent pregnancy loss.

Abstract Background: It is estimated that in women at reproductive age, the risk of polycystic ovary syndrome (PCOS) is about 5-21%. In PCOS cases with ovulation dysfunction, assisted reproductive techniques (ART) are useful for infertility treatment. Objective: This study aimed to evaluate the ART outcome in infertile PCOS women based on different testosterone levels. Finally, the relationships between testosterone in different levels and reproductive parameters including endocrine status, the response of ovaries, and pregnancy outcomes were assessed. Methods: In this retrospective study, 352 infertile PCOS women were examined. The women were categorised into five groups according to their testosterone levels: A = T < 0.4, B = 0.4 < T > 0.6, C = 0.6 < T > 0.8, D = 0.8 < T > 1.0 and E = T > 1.0 ng/dL. All study cases were in similar hyper-stimulation protocol and finally, hormonal profile and ART outcomes were compared between testosterone levels. P value ≤ 0.05 was statistically significant. Results: In testosterone levels >1.0, the levels of anti-mullerian hormone (AMH) and luteinising hormone (LH) were higher than in other testosterone level groups. AMH (P = 0.05) and LH (P = 0.001) levels showed significant differences. No correlation was present between testosterone levels and ART outcomes, including stimulation duration, endometrial thickness, oocyte numbers, numbers of matured oocytes, number of obtained embryos, fertilisation rate, implantation rate clinical pregnancy and abortion rate. Conclusions: Serum testosterone levels did not show any correlation with pregnancy outcomes in ART cycles of PCOS. However, basal testosterone levels are a good predictor for ovarian reserve and ovarian response. Consequently, we suggest that some prospective studies must be designed to approve the role of testosterone in the prediction of the outcome of pregnancy in ART cycles.

Varicocele is characterized by the abnormal dilation of veins within the testicular pampiniform plexus, contributing to inflammation, pain, and infertility in males. The precise roles of vascular endothelial growth factor receptors (VEGFRs), B-cell lymphoma 2 (BCL-2), and BCL-2-associated X-protein (BAX) in the pathology of varicocele still need to be clarified. This study sought to investigate the protein expression levels of VEGFR1, VEGFR2, VEGFR3, BCL-2, and BAX in varicose and healthy vessels from patients diagnosed with varicocele. Tissue samples were collected from 20 varicose veins and 20 healthy vessels from patients diagnosed with varicocele. Western blotting was utilized to quantify VEGFR1, VEGFR2, VEGFR3, BCL-2, and BAX protein levels. Analysis revealed a statistically significant increase in VEGFR3 protein expression within varicose veins compared to healthy vessels (p = .0473), while no significant differences were observed in the levels of VEGFR1 and VEGFR2 between the two groups. Concerning apoptotic signaling proteins, no significant differences were noted in the individual expression levels of BAX and BCL-2; however, the BAX/BCL-2 ratio was approximately 1.29 in varicose vessels. This ratio, exceeding 1.0, may suggest a pro-apoptotic shift in varicose veins and indicates a potential involvement of apoptosis in the pathology of varicocele. These findings suggest that VEGFR3 may play a pivotal role in the pathogenesis of varicocele and could contribute to vascular alterations associated with this condition. Furthermore, the elevated BAX/BCL-2 ratio implies a pro-apoptotic environment within varicose veins, thereby implicating apoptosis as a possible mechanism in the development of varicocele. Further exploration of VEGFR3-related signaling pathways and apoptotic markers may yield valuable insights for identifying therapeutic targets in managing varicocele.

Background: Asherman’s syndrome (AS) is a rare reproductive abnormality, resulting in endometrial collapse due to aggressive or recurrent endometritis and/or curettage. Objective: We aimed to assess the effectiveness of using platelet-rich plasma (PRP) to lower the recurrence rate of intrauterine adhesions (IUAs) following postlysis hysteroscopy. Materials and Methods: In a nonrandomized controlled study, women aged 20-45 years with AS diagnosed by sonohysterography, 3D sonography, hysteroscopy, or uterosalpingography between May 2018 and September 2018 were included. Patients (n = 30) were divided into case and control groups. Following hysteroscopic adhesiolysis, a Foley catheter was placed into the uterine cavity in all women. After two days, the catheter was removed, and 1-mL PRP was injected into the uterine cavity of women in the PRP (case) group, while the control received no PRP. All controls and subjects underwent diagnostic hysteroscopy 8-10 weeks following the intervention to assess the IUAs according to the American Society for Reproductive Medicine scoring system. Result: Our results did not reveal any significant difference in the menstrual pattern of either the control or test groups before or after treatment (p = 0.2). Moreover, the IUA stage in both studied groups before and after treatment was similar (p = 0.2). The duration of menstrual bleeding in both studied groups before and after treatment was also similar. Conclusion: PRP cannot decrease the menstrual pattern or development of postsurgical IUAs, as evaluated by follow-up hysteroscopy. Key words: Asherman’s syndrome, Platelet-rich plasma, Pregnancy rate.

Background Diazinon (DZN), a widely used agricultural pesticide, causes toxic effects on the reproductive system, leading to oxidative stress and impaired follicular development. Objectives Due to its established antioxidant and anti-inflammatory properties, this experimental study aims to evaluate the potential protective effects of pistachio pericarp essential oil (PPEO) in mitigating DZN-induced ovarian damage in mice, with a focus on preserving ovarian structure and function. Methods Forty-eight female NMRI mice (10–12 weeks old) were randomly divided into six groups ( n  = 8 per group), receiving different treatments for 28 days. The control group was given a standard diet, while experimental groups received 30 mg/kg/day DZN, DZN combined with 5% or 10% PPEO, or 10% PPEO alone. The ovaries were processed for histomorphometric analysis on every fifth ovarian section, classifying follicles into primordial, primary, secondary, and antral stages. Follicular volume was estimated using the Cavalieri method, and follicle diameters were measured using specialized software. Results Ovary, cortex, and medulla volumes were significantly lower in the DZN group than those of the control group, and the decrease in all follicular stages (otoogonia, primordial, primary, secondary, and antral) was marked. On the other hand, the 10% PPEO group indicates statistically significant ovarian weight (1.9 ± 0.14 mg) and volumes. More importantly, co-administration of PPEO, especially at a 10% dose, exerted marked corrective effects against the DZN-induced loss in follicular counts by improving both follicular survival and ovarian structure. Conclusion DZN disrupts ovarian function by inducing oxidative stress and damaging follicular development. PPEO offers productive protection against DZN by enhancing antioxidant defenses and successfully maintaining ovarian structure and folliculogenesis.

Background: It is estimated that in women at reproductive age, the risk of polycystic ovary syndrome (PCOS) is about 5–21%. In PCOS cases with ovulation dysfunction, assisted reproductive techniques (ART) are useful for infertility treatment. Objective: This study aimed to evaluate the ART outcome in infertile PCOS women based on different testosterone levels. Finally, the relationships between testosterone in different levels and reproductive parameters including endocrine status, the response of ovaries, and pregnancy outcomes were assessed. Methods: In this retrospective study, 352 infertile PCOS women were examined. The women were categorised into five groups according to their testosterone levels: A = T < 0.4, B = 0.4 < T > 0.6, C = 0.6 < T > 0.8, D = 0.8 < T > 1.0 and E = T > 1.0 ng/dL. All study cases were in similar hyper-stimulation protocol and finally, hormonal profile and ART outcomes were compared between testosterone levels. P value ≤ 0.05 was statistically significant. Results: In testosterone levels >1.0, the levels of anti-mullerian hormone (AMH) and luteinising hormone (LH) were higher than in other testosterone level groups. AMH (P = 0.05) and LH (P = 0.001) levels showed significant differences. No correlation was present between testosterone levels and ART outcomes, including stimulation duration, endometrial thickness, oocyte numbers, numbers of matured oocytes, number of obtained embryos, fertilisation rate, implantation rate clinical pregnancy and abortion rate. Conclusions: Serum testosterone levels did not show any correlation with pregnancy outcomes in ART cycles of PCOS. However, basal testosterone levels are a good predictor for ovarian reserve and ovarian response. Consequently, we suggest that some prospective studies must be designed to approve the role of testosterone in the prediction of the outcome of pregnancy in ART cycles.

Background Spontaneous Coronary Artery Dissection (SCAD) is an acute coronary event of uncertain origin. SCAD occurs when the coronary artery wall dissects non-traumatically and non-atherosclerotically, leading to the formation of an intramural hematoma or intimal tear, ultimately compressing and restricting the true lumen, or even occluding it. The management of SCAD remains controversial despite modern imaging techniques. In addition to supportive drug therapy, percutaneous coronary intervention (PCI) is another option that can be used as an effective treatment modality. Case presentation We describe A 50-year-old male with SCAD presented to the hospital emergency department complaining of chest pain. Coronary angiography incidentally showed spiral dissection from the proximal to distal right coronary artery (RCA). Three overlapping coroflex stents were deployed from the distal to the proximal RCA. Conclusions To stabilize the coronary artery in Acute Coronary Syndrome (ACS) patients due to SCAD, prompt interventions such as stenting and angioplasty are needed. However, it is necessary to pay attention to the clinical condition of patients and quick diagnosis for the recovery of patients and reduction of complications.

This narrative review explains the history of anaphylactic or hypersensitivity reactions, their connection to the cardiovascular system, and Kounis syndrome, which is linked to hypersensitivity. Additional subjects discussed include immunoglobulin E and serum tryptase, common pathways of allergic and nonallergic cardiovascular events, current perspectives on Kounis syndrome, allergic myocardial infarction, allergic angina, and the impact of COVID-19 and its vaccination on Kounis syndrome. Kounis syndrome is a distinct kind of acute vascular disease that affects the coronary, cerebral, mesenteric, peripheral, and venous systems. Kounis syndrome is currently used to describe coronary symptoms linked to disorders involving mast cell activation and inflammatory cell interactions, such as those involving T-lymphocytes and macrophages, which further induce allergic, hypersensitive, anaphylactic, or anaphylactic insults. Platelet activating factor, histamine, neutral proteases like tryptase and chymase, arachidonic acid products, and a range of cytokines and chemokines released during the activation process are among the inflammatory mediators that cause it. Proinflammatory cytokines are primarily produced by mast cells in COVID-19 infections. Mast cell-derived proteases and eosinophil-associated mediators are also more prevalent in the lung tissues and sera of COVID-19 patients. As a modern global threat to civilization, COVID-19 is linked to chemical patterns that can activate mast cells; therefore, allergic stimuli are usually the reason. Virus-associated molecular patterns can activate mast cells, but allergic triggers are typically the cause. By activating SARS-CoV-2 and other toll-like receptors, a variety of proinflammatory mediators, including IL-6 and IL-1β, are released, potentially contributing to the pathology of COVID-19.

The prevalence of cancer, especially in industrial countries, is a major problem for health and treatment systems. Cancer can affect the quality of life of all family members and has many negative effects on the community. Despite many advances in cancer treatment, this disease is still a major worldwide problem. There is strong evidence that dietary habits are effective in protecting against cancer and even helping in the disease treatment progress. Nuts with various biologically‐active compounds, such as vitamins, phytosterols, isoflavones, flavonoids, and polyphenols have been reported to possess anticarcinogenic properties. Accordingly, this review provides an insight into the association between nut consumption and the prevention of some cancers. We considered the cancers related to the urogenital and genital tract, gastrointestinal tract, as well as women‐related cancers. Both cell culture examinations and experimental animal studies alongside observational epidemiological studies demonstrated that regular consumption of a nut‐enriched diet is able to reduce the risk of these cancers. Key points Nuts can potentially inhibit the development and progression of some cancer types. Nuts contain biologically active compounds with anticarcinogenic properties such as folate, phytosterols, saponins, phytic acid, isoflavones, ellagic acid, α‐tocopherol, quercetin, and resveratrol. Evidence suggests that consuming nuts may reduce the risk of cancer and cancer‐related mortality. These findings support dietary recommendations to increase nut consumption to reduce cancer‐related risk and mortality.