Background and aims: Home quarantine and physical distancing at the time of coronavirus disease 2019 (COVID‐19) had a severe effect on the mental health of the populations. Resilience has been reported previously to be a protective factor against anxiety, stress, and depression. This study evaluates the prevalence and severity of depression, anxiety, stress, and perceived stress and their relation with resilience associated with the COVID‐19 pandemic among a sample of the general population in Southern Iran.Methods: In this cross‐sectional web‐based survey, from April 12 to May 13, 2020, stress, anxiety, depression, perceived stress, and resilience were measured using the Persian version of Depression Anxiety and Stress Scale (DASS‐21), Perceived Stress Scale (PSS‐14), and Connor‐Davidson Resilience Scale (CD‐RISC). Statistical analyses were carried out using the IBM Statistical Package for Social Sciences. Mean ± standard deviation (SD) and frequencies were used to describe demographic data. Independent sample t‐test, Spearman correlation, and the Pearson correlation coefficient were performed to examine anxiety, depression, stress, and resilience.Results: Among a total of 538 participants, the overall prevalence of moderate‐to‐extremely severe depression, anxiety, and stress was found to be 26.1%, 33.2%, and 5.8%, respectively. The overall median PSS and resilience score were 30 and 70, respectively. There was a significant association between higher age and perceived stress. Male and high income were related to higher resilience scores. Perceived stress positively correlates with resilience, whereas depression significantly correlates with anxiety and stress. Individuals with underlying disease demonstrated significantly higher scores for depression and anxiety. Also, perceived stress had a significant but weak, positive correlation with age and the number of quarantine days.Conclusion: The occurring COVID‐19 pandemic could be the culprit of psychological distress, anxiety, and depression of large population quantities. Our results showed a subordinate overall resilience in the general Iranian population during the COVID‐19 pandemic.

Introduction: Congenital heart disease (CHD), the lethal congenital anomaly in newborns, is multifactorial, with environmental and genetic factors contributing to its occurrence. Although some studies on the prevalence of CHD have been conducted throughout the country, this large‐scale study aims to provide information on the prevalence of various types of CHDs in newborns according to the echocardiography findings.Patients and Methods: Over 3 years, 8145 neonates with suspected CHD who underwent echocardiography by a trained pediatric cardiologist were included in this multicenter, cross‐sectional observational study. CHD was categorized into two major groups; cyanotic and acyanotic heart disease. The SPSS version 22 software was used to analyze the data with a significance level set at 0.05.Results: Of 8145 neonates who were referred to our centers with CHD symptoms, 6307 were indicated for echocardiography. The mean age of the studied population was 8.5 ± 9.3 days and the male‐to‐female ratio was 2.6, especially in the arterial septal defect (ASD), ventricular septal defect (VSD), and patent ductus arteriosus (PDA) groups. 77.2% of patients had acyanotic heart disease (100 in 1000 neonates) with ASD as the most common one and 9% were diagnosed with cyanotic heart disease (11 in 1000 neonates) with transposition of the great arteries as the most common form and the aortopulmonary window was the rarest form.Conclusion: This large prospective, multicenter screening study reported arterial septal defect (85%) and patents with ductus arteriosus (32%) as the most frequent type of CHD. Moreover, the prevalence of male patients was significantly higher. This information would be helpful for health policy makers, stakeholders, and general practitioners in regions where there are no trained pediatric cardiologist fellowships and limited access to echocardiography devices for better management of CHD.

Background and Aims: Melasma is a common dermatologic disorder characterized by symmetrical hyperpigmented lesions on the face. Although various therapeutic options are available for melasma, its treatment remains challenging. The present study evaluated the safety and efficacy of intradermal microinjection of tranexamic acid (TA) plus ascorbic acid in treating melasma lesions compared with TA and placebo.Methods: From September 2019 to May 2020, 24 patients with symmetrical melasma were enrolled in a prospective, double‐blind, split‐face, randomized controlled clinical trial. Each patient received 50 mg/ml TA and 50 mg/ml ascorbic acid for one side of the face (A) and 50 mg/ml TA and placebo for the other side (B) every 2 weeks for 12 weeks. The Melasma Area and Severity Index (MASI) score, Physician Global Assessment, and pain were measured at baseline and at 4, 8, 12, and 24 weeks. Statistical analysis was done using SPSS software version 16, and data were reported as mean ± standard deviation or median and interquartile range. χ² and Fisher's exact tests were used to test differences between the groups.Results: Both groups experienced a significant decrease in MASI scores compared with the baseline. The MASI score was significantly less in the intervention group than the placebo group at the 8th and 12th weeks. However, burning pain was significantly more prominent in the intervention group.Conclusion: Intradermal injection of ascorbic acid combined with TA can be beneficial in treating melasma. Currently, there are numerous treatment modalities for melasma. However, the results still vary, and satisfactory outcomes are yet to be reached.

Background and Aim: Vitiligo is an autoimmune skin disorder characterized by circumscribed depigmented macules and patches caused by the loss of functional melanocytes. Although there is no definitive treatment for vitiligo, several treatment options have been associated with relative satisfactory outcomes. The purpose of this study was to compare the efficacy of micro‐needling in conjunction with topical 5‐fluorouracil (5‐FU) versus topical tacrolimus ointment in treating vitiligo patches.Patients and Methods: This study included nineteen participants, each of whom received both treatments on two randomly selected vitiligo patches of approximately the same size and location. On one patch, a combination of weekly micro‐needling and topical application of 5‐FU solution was used every other day, while on the other, 0.1% tacrolimus topical ointment was applied twice daily. The G‐score was used to compare treatment outcomes after 3 months.Results: The median duration of the disease in our population was 7 years. Six patients (32%) in the micro‐needling plus topical 5‐FU treated group showed a moderate to excellent response, indicating a significant improvement between both treatments (p‐value = 0.019). In contrast, all other patches treated with topical tacrolimus showed poor improvement. Lower extremity and trunk responded more to treatment with micro‐needling plus topical 5‐FU than upper extremity and acral areas. Moreover, none of those who have had the disease for more than ten years have responded to treatment. Mild erythema, pinpoint bleeding, and irritation were detected only in the micro‐needling treated group.Conclusion: The current study showed that using micro‐needling in conjunction with 5‐FU could treat vitiligo patients more efficiently than tacrolimus monotherapy. Despite showing moderate to excellent improvement in patches treated with micro‐needling and 5‐FU, this well‐tolerated office‐based modality still requires additional research.

Post‐acne scarring is the most common permanent consequence of acne vulgaris. Subcision is an intervention in which a needle or blunt cannula is inserted under the scar and moved back and forth to cut fibrotic strands and form new connective tissue, thereby elevating the atrophic scars. In this study, we reviewed the efficacy and adverse effects of different subcision techniques alone or in combination with other modalities to manage acne scars. The terms (subcision), (subcision AND acne scar), and (subcision AND scar) were searched in PubMed and Google Scholar. We included all available reports on clinical trials written in English and published before June 2022. A total of 16 relevant articles were identified after reviewing the abstracts and full texts. Four articles compared blunt cannula‐based subcision as a modified technique with needle‐based subcision as a conventional method, while the others investigated the combination of subcision with other modalities. According to our findings, subcision is a safe and effective method for treating atrophic acne scars. Needle‐based subcision and cannula‐based subcision offer comparable efficacy, with the latter causing fewer side effects and inducing greater patient satisfaction. Combining subcision with the application of autologous tissues (platelet gel) or artificial materials (hyaluronic acid gels and threads) as fillers can improve outcomes and prevent the re‐depressing of scars, as can its combination with frequent suctioning. Combinations with microneedling or fractionated microneedle radiofrequency have also been safe and effective. We conclude that modifications of the subcision procedure lessen its side effects, and combination therapies improve its efficacy.