Medicinal, Psychological, and Health Research Journal (MPHRJ)

Abstract Introduction: The comparative effectiveness of DMARDs in psoriatic arthritis is of paramount clinical importance, given the disease’s heterogeneity and the expanding range of therapeutic options. Evaluating and synthesizing evidence across multiple agents helps guide personalized, evidence-based treatment decisions, supports optimal therapeutic sequencing, and informs treat-to-target strategies.

Material and methods: This systematic review and meta-analysis rigorously evaluated the comparative efficacy and safety of DMARDs in psoriatic arthritis by comprehensively searching multiple databases for RCTs and observational studies. Methodological quality and risk of bias were assessed using validated tools, with data independently extracted by reviewers. Statistical heterogeneity was quantified and explored through subgroup analyses, applying random-effects models when appropriate to ensure robust, generalizable conclusions for clinical decision-making.

Results: This systematic review included eight studies selected from 1,243 identified records, assessing the comparative effectiveness and safety of csDMARDs, bDMARDs, and tsDMARDs in psoriatic arthritis. Pooled efficacy outcomes showed superior ACR and PASI responses with bDMARDs and tsDMARDs compared to csDMARDs. Adverse event rates were highest with tsDMARDs, particularly for serious events, while csDMARDs had higher withdrawal rates. Findings underscore differences in therapeutic profiles across DMARD classes.

Conclusion: Based on this systematic review, biologic DMARDs demonstrated superior efficacy in ACR and PASI response rates compared to conventional and targeted synthetic DMARDs, with an acceptable safety profile. Targeted synthetic DMARDs showed intermediate efficacy but higher rates of serious adverse events. Conventional DMARDs were less effective overall. These findings support the preferential use of biologic agents in moderate-to-severe disease, safety factors.

Abstract prognostic factor that may influence treatment strategies and outcomes. Identifying hematologic and biochemical markers associated with CNS infiltration could aid in early risk assessment.

Materials and Methods: This retrospective cross-sectional study was conducted on 87 children diagnosed with acute leukemia at Bou Ali Hospital in Ardabil between 2018 and 2022. Patients were categorized based on the presence or absence of CNS involvement, confirmed via cerebrospinal fluid analysis. Baseline laboratory parameters, including white blood cell (WBC) count, hemoglobin (Hb), platelet count (Plt), and lactate dehydrogenase (LDH), were compared between groups. Statistical analysis was performed using SPSS v26, with a significance threshold of p < 0.05.

Results: Among 87 patients, 14 had CNS involvement. Although mean WBC was higher and Hb and Plt levels were lower in the CNS-involved group, none of the differences were statistically significant (p > 0.05). LDH levels were nearly identical between groups.

Conclusion: No significant association was found between routine laboratory parameters and CNS involvement in pediatric leukemia. However, observed trends suggest potential predictive value, warranting further investigation in larger, prospective studies.

Abstract Introduction: Leukemia is the most common childhood malignancy, often associated with various thoracic complications. Chest radiography serves as an essential diagnostic tool for identifying respiratory manifestations and guiding clinical management in pediatric leukemia patients.

Materials and Methods: This descriptive-analytical cross-sectional study evaluated 56 pediatric leukemia patients hospitalized at Bouali Hospital in Ardabil, Iran, over a five-year period (2018–2023). Data regarding age, sex, leukemia subtype, respiratory symptoms, and chest X-ray findings were extracted from medical records and analyzed using SPSS version 25.

Results: Of the patients, 83.9% were diagnosed with acute lymphoblastic leukemia (ALL) and 16.1% with acute myeloid leukemia (AML). Abnormal chest radiographic findings were identified in 62.5% of patients, with pulmonary opacities (23.2%), peribronchial thickening (14.3%), pleural effusion (14.3%), and mediastinal mass (8.9%) being the most common. No statistically significant difference was found between leukemia subtypes regarding overall radiographic abnormalities (P > 0.05).

Conclusion: Chest radiographic abnormalities are frequent in pediatric leukemia, regardless of subtype. Routine imaging is crucial for early detection of thoracic complications, even in asymptomatic cases.

Abstract Introduction: Familial Mediterranean Fever (FMF) is a hereditary autoinflammatory disorder commonly associated with MEFV gene mutations. While arthritis is a well-documented manifestation, axial involvement such as sacroiliitis remains rare and poorly understood. This study aimed to assess the relationship between MEFV mutation subtypes and sacroiliitis in FMF patients.

Materials and Methods: A cross-sectional study was conducted on 115 genetically confirmed FMF patients at Bu-Ali Hospital in Ardabil. Demographic, clinical, and genetic data were collected, including family history, parental consanguinity, and MEFV mutation subtypes. Sacroiliitis was evaluated based on clinical and imaging findings. Statistical analysis was performed using chi-square and t-tests with a significance level of P < 0.05.

Results: Only one patient (0.87%) was diagnosed with sacroiliitis. This patient had a compound heterozygous mutation (R202Q-M694V), positive family history, and parental consanguinity. Sacroiliitis was significantly associated with family history of FMF (P = 0.04), but not with other demographic or genetic variables.

Conclusion: Although sacroiliitis was rare, its association with family history and specific MEFV mutations may suggest a genetic predisposition. Further large-scale studies are recommended to clarify the role of MEFV genotypes in axial involvement in FMF.