Journal of Research in Medical Sciences1735-19953166202605201174411744EN20260519<p><strong>Background:</strong> Systemic sclerosis (SSc) is a relatively uncommon connective tissue disorder, commonly manifesting as interstitial lung disease (ILD) and affecting both the lung parenchyma and the modification of the space between endothelium and epithelium. Imagingmodalities like computed tomography (CT) scans are essential for diagnosing and revealing specific abnormal findings (ILD patterns) in SSc, such as reticulation and Ground?glass opacity (GGO). To enhance diagnostic precision and minimize human error, we leverage deep learning (DL) techniques.</p><p><strong> Materials and Methods:</strong> In our study, we collected and annotated a new public dataset from 22 individuals, encompassing 2190 lung CT scan slices. After preprocessing and exclusion of slices without abnormalities, 1777 slices from 17 patients were used for model training and validation, and 413 slices from five patients were reserved for independent testing. We use a specialized U?net model to segment these patterns, categorizing them into reticulation or GGO, and employ an automated algorithm to outline lung areas in each CT slice. The model’s objective is to quantify the patient’s lung involvement in SSc by calculating the total identified GGO and reticulation areas across all slices and normalizing this by the total lung surface area.</p><p><strong> Results:</strong> The U?net model shows promising results in segmenting both reticulation and a combination of GGO and reticulation, as indicated by Dice coefficients of 87.22% and 86.20%, respectively. Furthermore, the automated algorithm effectively outlines the lung region in each slice, enabling accurate measurement of lung involvement in SSc patients.</p><p><strong>Conclusion:</strong> In conclusion, using DL using the U?Net model and an automated algorithm has shown promising results in accurately segmenting and quantifying lung involvement in Scleroderma patients using CT scans.<br /><br /></p>http://jrms.mui.ac.ir/index.php/jrms/article/view/11744http://jrms.mui.ac.ir/index.php/jrms/article/download/11744/6516

Journal of Research in Medical Sciences1735-19953166202605201174611746EN20260520<p><strong>Background:</strong> Sepsis remains a leading cause of morbidity and mortality among critically ill patients. Fluid resuscitation is essential, but conventional protocols often lack  ndividualized assessment of tissue perfusion, risking underresuscitation or fluid overload. The peripheral perfusion index (PPI), derived from pulse oximetry, offers a practical,  oninvasive way to dynamically guide fluid therapy and may improve outcomes. The objective of the study was to evaluate whether PPI?guided targeted fluid therapy improves clinical and microvascular outcomes in septic intensive care unit patients compared with conventional fluid therapy.</p><p><strong>Materials and Methods:</strong> In a prospective, randomized trial, 60 septic adults were assigned to standard fluid therapy or PPI?guided resuscitation. The primary outcome was microvascular perfusion improvement within 72 h. The secondary outcomes included 7?day mortality, acute kidney injury (AKI), fluid balance, lactate clearance, and renal biomarkers (including cystatin C).</p><p><strong>Results:</strong> PPI?guided therapy significantly improved microvascular perfusion (P = 0.001) and reduced cystatin C levels by day 7 (P = 0.0001), suggesting renal protection. Although there were fewer deaths at 7 days and less AKI in the intervention group, these differences did not reach statistical significance. Trends favored lactate clearance and more favorable fluid balance with PPI guidance.</p><p><strong> Conclusion:</strong> PPI?guided fluid therapy is a feasible, low?cost approach to individualized resuscitation in septic patients, associated with short?term improvements in microvascular perfusion and renal biomarkers. The observed physiological benefits warrant confirmation in larger multicenter trials to determine any impact on long?term clinical outcomes.<br /><br /></p>http://jrms.mui.ac.ir/index.php/jrms/article/view/11746http://jrms.mui.ac.ir/index.php/jrms/article/download/11746/6517

Journal of Research in Medical Sciences1735-19953166202605201174711747EN20260520<p><strong>Background:</strong> Transurethral resection of the prostate (TURP) is the standard treatment for benign prostatic hyperplasia (BPH). The incidence of postoperative urethral stricture (US) and urinary incontinence remains clinically important, and their predictors are not fully established. This study aimed to determine the incidence of these complications and identify associated risk factors.</p><p><strong> Materials and Methods:</strong> This retrospective cohort study was conducted at Al?Zahra  ospital, Isfahan, Iran, between 2020 and 2023. A total of 110 male patients with BPH who  nderwent TURP and completed 6 months of postoperative follow?up were included. Baseline variables (age, prostate volume, and operative duration) were extracted from medical records. Complications were assessed at 6 months, specifically the occurrence of US, urinary incontinence, and the composite outcome defined as either stricture or  incontinence. An independent samples t?test compared mean values between groups, and logistic regression was used to identify predictors.</p><p><strong>Results:</strong> The mean age of patients was 68.2 ± 11.6 years, the mean prostate volume was 38.9 ± 10.3 mL, and the mean operative duration was 96.8 ± 17.4 min. The incidence of US was 9.1% (18.2 cases per 100 person?years), urinary incontinence 6.4% (12.7 cases per 100 person?years), and the composite outcome 15.5% (30.9 cases per 100 person?years). Patients with US had slightly lower age and smaller prostate volume but longer operative duration; none of these differences were statistically significant. Patients with urinary incontinence were significantly older (78.1 ± 9.4 vs. 67.5 ± 11.4 years, P = 0.018). Logistic regression confirmed age as an independent predictor of incontinence (odds ratio = 1.095, 95% confidence interval: 1.011–1.186, P = 0.025). No significant predictors were identified for stricture or the composite outcome.</p><p><strong> Conclusion:</strong> The incidence of US and urinary incontinence after TURP was modest, with age emerging as a significant predictor of incontinence. Elderly patients undergoing TURP should be counseled about the increased risk of postoperative incontinence, and perioperative strategies may be needed to mitigate this risk.<br /><br /></p>http://jrms.mui.ac.ir/index.php/jrms/article/view/11747http://jrms.mui.ac.ir/index.php/jrms/article/download/11747/6518

Journal of Research in Medical Sciences1735-19953166202605201174211742EN20260519Linear psoriasis (LP) is an unusual form of psoriasis with an unidentified prevalence and is characterized by psoriatic papules and plaques in a Blaschko linear distribution. Based on clinical features, this disorder is divided into two types: isolated LP and superimposed<br />LP. Previous studies have suggested that LP presenting linear appearances is closely related to the Kobner phenomenon (KP) caused by external provocation, including trauma, skin incision, drugs, infections, and striae distensae. Pathogenesis of LP is mainly attributed to the concept of genetic mosaicism but not completely illustrated until now. In this review, we summarize its epidemiological characteristics, clinicopathological features, diagnosis/differential diagnosis, corresponding therapies, focus on the possible pathogenesis of LP, and explore the relationship between LP and KP.<br /><br />http://jrms.mui.ac.ir/index.php/jrms/article/view/11742http://jrms.mui.ac.ir/index.php/jrms/article/download/11742/6514

Journal of Research in Medical Sciences1735-19953166202605201174311743EN20260519<p><strong>Background:</strong> Numerous epidemiological studies have identified a positive correlation between increased physical activity and raised levels of serum 25?hydroxyvitamin D (25(OH)D). However, it remains uncertain whether this correlation implies a  ause?and?effect relationship. The aim of this systematic review and meta?analysis was to analyze the effects of physical activity on serum 25(OH)D concentrations in humans.</p><p><strong>Materials and Methods:</strong> Interventional studies examining the effect of physical activity on serum 25(OH) D and published before July 2025 were detected by searching online databases, including PubMed, Embase, Scopus, and Web of Sciences, using a combination of suitable keywords. The heterogeneity among the included trials was evaluated using I2 statistics. Data were pooled using a random?effects model, and the weighted mean difference (WMD) was considered as the overall effect size.</p><p><strong> Results:</strong> Thirty eligible studies were included in the final analysis. Pooling effect sizes from studies demonstrated a significant increase in serum 25(OH)D levels following physical activity (WMD = 4.08 nmol/L; 95% confidence interval [CI]: 2.05, 6.11). Moreover, in subgroup analysis, the outdoor setting of the intervention resulted in a large and statistically significant difference in the serum Vitamin D levels, compared to the control groups (WMD: 17.23 nmol/L, 95% CI: 14.54, 19.92). However, the indoor setting of the physical activity intervention had a negligible effect on the serum Vitamin D levels (WMD: 0.37 nmol/L, 95% CI: ?0.38, 1.14), compared to the control groups.</p><p><strong> Conclusion:</strong> These results propose that prescribing outdoor physical activity may be an effective clinical strategy for improving Vitamin D levels, primarily mediated through sunlight exposure.</p>http://jrms.mui.ac.ir/index.php/jrms/article/view/11743http://jrms.mui.ac.ir/index.php/jrms/article/download/11743/6515