Declaration of interests: The authors declare that they have no conflict of interests. Authors' contribution: All the authors had substantial contributions to the conception of the work. Drafting of the work was done by NS and NR; the remaining authors did critical revision. All approved the final draft and agree to be accountable for all aspects of the work.

Background and Aim Due to the high social and economic burden and also mortality and morbidity caused by coronavirus disease 2019 (COVID‐19) in the past few years, researchers have aimed at finding solutions to suppressing the severity of infection. Recently, selective serotonin and serotonin‐norepinephrine reuptake inhibitors (SSRI/SNRI) have been investigated as an adjuvant treatment for COVID‐19. The aim of the current study was to investigate the impact of SSRI/SNRIs on outcomes of COVID‐19 patients. Methods In this systematic review and meta‐analysis, a comprehensive search strategy consisting of relevant words was performed by two researchers in PubMed, Scopus and EMBASE libraries. Studies reporting the effect of SSRI and/or SNRI use in COVID‐19 patients' outcome were included. Hospitalization, mortality, hospitalization event, and length of hospital stay were considered as main outcomes of this study. Analysis was carried out using Comprehensive Meta‐Analysis (CMA‐version 2) and final data were reported as odds ratio (OR) and 95% confidence interval (CI). Results Our search led to the final selection of 9 articles including 15,287 patients. The effect of fluvoxamine, fluoxetine, and the overall effect of SSRI/SNRI use on mortality of COVID‐19 patients were investigated in 3, 2, and 7 articles, respectively. The results of our analyses showed that these medications could significantly decrease mortality of COVID‐19 patients (OR and 95% [CI]: 0.595 [0.467–0.758], 0.620 [0.469–0.821], and 0.596 [0.437–0.813]). The effect of SSRI/SNRIs on hospitalization events of COVID‐19 patients was not significant (OR: 0.240% and 95% CI: 0.041–1.4). Also, length of hospital stay was longer in patients who administrated SSRIs. Conclusion According to this study's results, SSRI/SNRIs may be effective in reducing mortality of COVID‐19 patients, suggesting the superiority of fluvoxamine to fluoxetine. The safety profile and affordable cost of SSRI/SNRIs for a short‐term use may be other reasons to propose them as beneficial medications in preventing mortality in COVID‐19.

Introduction Intracranial aneurysms have a high prevalence in human population. It also has a heavy burden of disease and high mortality rate in the case of rupture. Convolutional neural network(CNN) is a type of deep learning architecture which has been proven powerful to detect intracranial aneurysms. Methods Four databases were searched using artificial intelligence, intracranial aneurysms, and synonyms to find eligible studies. Articles which had applied CNN for detection of intracranial aneurisms were included in this review. Sensitivity and specificity of the models and human readers regarding modality, size, and location of aneurysms were sought to be extracted. Random model was the preferred model for analyses using CMA 2 to determine pooled sensitivity and specificity. Results Overall, 20 studies were used in this review. Deep learning models could detect intracranial aneurysms with a sensitivity of 90/6% (CI: 87/2–93/2%) and specificity of 94/6% (CI: 0/914–0/966). CTA was the most sensitive modality (92.0%(CI:85/2–95/8%)). Overall sensitivity of the models for aneurysms more than 3 mm was above 98% (98%-100%) and 74.6 for aneurysms less than 3 mm. With the aid of AI, the clinicians’ sensitivity increased to 12/8% and interrater agreement to 0/193. Conclusion CNN models had an acceptable sensitivity for detection of intracranial aneurysms, surpassing human readers in some fields. The logical approach for application of deep learning models would be its use as a highly capable assistant. In essence, deep learning models are a groundbreaking technology that can assist clinicians and allow them to diagnose intracranial aneurysms more accurately.

Introduction As one of the major causes of acute ischemic stroke, intracranial arterial stenosis necessitates an intervention that ranges from medical treatment to balloon angioplasty and stenting. Self-expandable stents (SES) and balloon-mounted stents (BMS) are two types of stents and their comparative efficacy and safety for intracranial stenosis are not well established. Methods Studies that investigate balloon-mounted stenting for intracranial stenosis were extracted from PubMed, Scopus, and Cochrane library. We sought to gather data on the success rate, change in mean arterial stenosis, and complications such as minor and major stroke and death (MMD), symptomatic intracranial hemorrhage, myocardial infarction, all-cause mortality, and in-stent re-stenosis. Results 3049 patients from 35 studies were included in this study. 20 studies investigated BMS alone and others compared BMS with SES. BMS was significantly more effective in reducing the degree of stenosis compared to SES (Difference in mean −5.953, CI 95% −7.727 to −4.179), had less complications compared to SES such as MMD (8.5% vs. 11.2%) and less in-stent re-stenosis (18.6% vs. 19.6%), but patients with SES experienced a lower rate of all-cause mortality(1.7% vs. 4.1%). Conclusion Intracranial stenting with BMS is more effective in reducing the degree of stenosis and has lower rates of complications when compared to SES.

AimsThe aetiology of peripartum cardiomyopathy (PPCM) is still not clear, and it is unknown who would recover from PPCM. In this meta-analysis, for the first time, we aimed to explore the prognostic value of potential baseline factors that may help predict recovery in patients with PPCM. Methods A systematic approach following the Meta-analysis of Observational Studies in Epidemiology guideline was taken by using appropriate keywords in PubMed, Scopus, and Embase databases. Studies that had compared different clinical and paraclinical markers at the time of diagnosis related to cardiovascular function between recovered and non-recovered patients with PPCM were included. To find potential predictors of recovery, the odds ratio (OR) was calculated for different parameters using the random-effects model. Results Eighteen cohort studies including 1047 patients with PPCM were enrolled. Six markers out of the 11 potentially eligible markers were associated with PPCM recovery. Baseline echocardiographic parameters [left ventricular ejection fraction (LVEF) (OR = 4.84 [2.53; 9.26]), left ventricular end-diastolic diameter (OR = 3.67 [2.58; 5.23]), left ventricular end-systolic diameter (OR = 3.99 [2.27; 7.02]), and fractional shortening (OR = 6.14 [1.81; 20.85])] were strong predictors of PPCM recovery. Systolic blood pressure (OR = 2.16 [1.38; 3.38]) and diastolic blood pressure (OR = 2.06 [1.07; 3.96]) at diagnosis were also associated with recovery. Conclusions Patients with PPCM who have a higher baseline LVEF, lower left ventricular diameters, and higher blood pressure levels have a greater chance to recover from PPCM.

No abstract

Background: Infertility can lead to major bio-psychological disorders. Coping strategies help individuals adapt to unpredictable conditions in a systematic way. The present study aimed to determine the perceived stress of couples undergoing treatment for infertility, as well as their coping strategies and correlation between the studied variables and gender.Methods: This was a cross-sectional study conducted on 140 infertile couples undergoing infertility treatment at the Infertility Center of Yazd, Yazd City, Iran. The relevant data were collected by Perceived Stress Scale and Billings and Moos's Coping Responses Inventory. Then, the obtained data were analyzed by descriptive statistics (relative frequency percentage, mean and standard deviation), Pearson correlation coefficient and regression analysis in SPSS. Results:The obtained results suggest that the mean score of perceived stress is higher in women. Moreover, women more frequently use problem-focused mechanisms, while men more frequently use emotion-focused mechanisms. In both men and women, a positive significant relationship exist between positive perceived stress and coping mechanisms; the former predicted the latter. While, the mean scores for avoidant and behavioral coping mechanisms were higher in men, the mean scores for cognitive coping mechanisms were higher in women (P<0.05). However, women achieved higher scores for both problem-focused and emotion-focused strategies.Conclusion: there is a significant and positive correlation between perceived stress and coping mechanisms in both sexes. In addition, stress predicts the kind of coping strategies in these people. On the whole, psychiatric approach and counseling may enhance the mental health of infertile couples and increase the chance of success in this costly treatment.

Objectives: Those men who have long been suffering from infertility and failed to get any treatment experience higher levels of depression, are less satisfied with their sex lives, and are far less healthy. Sexual dysfunction is a problem among infertile couples that can affect marital relationship and satisfaction. This study aimed to examine male infertility and its influence on women's sexual behaviors. Methods:This study is a cross-sectional study in which people attending a Fertility Center in Yazd between 1 September 2013 and 10 March 2014 were included via convenience sampling. The subjects were women with infertile husbands without associated physical and mental diseases such as sexual function disorder, diabetes, cardiovascular and psychotic or mood disorder, or non-consumption of certain drugs and women with fertile husbands who were matched for age, education, and occupation. The data were gathered using three questionnaires: the Hurlbert Index of Sexual Assertiveness, Sexual Dysfunctional Beliefs Questionnaire (SDBQ), and Couple Burnout Measure (CBM). The results were then compared between the groups. Results:The findings showed that the mean two subscales of emotional burnout (P=0.01) and psychological burnout (P=0.001) from the CBM were statistically significant in both the groups of women. There were differences between the mean scores of two groups in SDBQ subcategories with respect to sexual self-thought (P=0.002) and sexual dysfunctional beliefs (P=0.04). Sexual assertiveness in women with fertile husbands was higher than in the other one. Sexual burnout and SDBQ subcategories were higher in women with infertile husbands than in women with fertile husbands.Discussion: Male infertility may be associated with sexual disorders in the partner. Attention to psychological need and rehabilitation in infertile couples may be helping them to increase mental health and quality of life in these people.