ImportanceBell palsy (BP) has been reported as an adverse event following the SARS-CoV-2 vaccination, but neither a causative relationship nor a higher prevalence than in the general population has been established.ObjectiveTo compare the incidence of BP in SARS-CoV-2 vaccine recipients vs unvaccinated individuals or placebo recipients.Data SourcesA systematic search of MEDLINE (via PubMed), Web of Science, Scopus, Cochrane Library, and Google Scholar from the inception of the COVID-19 report (December 2019) to August 15, 2022.Study SelectionArticles reporting BP incidence with SARS-CoV-2 vaccination were included.Data Extraction and SynthesisThis study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and was conducted with the random- and fixed-effect models using the Mantel-Haenszel method. The quality of the studies was evaluated by the Newcastle-Ottawa Scale.Main Outcomes and MeasuresThe outcomes of interest were to compare BP incidence among (1) SARS-CoV-2 vaccine recipients, (2) nonrecipients in the placebo or unvaccinated cohorts, (3) different types of SARS-CoV-2 vaccines, and (4) SARS-CoV-2–infected vs SARS-CoV-2–vaccinated individuals.ResultsFifty studies were included, of which 17 entered the quantitative synthesis. Pooling 4 phase 3 randomized clinical trials showed significantly higher BP in recipients of SARS-CoV-2 vaccines (77 525 vaccine recipients vs 66 682 placebo recipients; odds ratio [OR], 3.00; 95% CI, 1.10-8.18; I2 = 0%). There was, however, no significant increase in BP after administration of the messenger RNA SARS-CoV-2 vaccine in pooling 8 observational studies (13 518 026 doses vs 13 510 701 unvaccinated; OR, 0.70; 95% CI, 0.42-1.16; I2 = 94%). No significant difference was found in BP among 22 978 880 first-dose recipients of the Pfizer/BioNTech vaccine compared with 22 978 880 first-dose recipients of the Oxford/AstraZeneca vaccine (OR, 0.97; 95% CI, 0.82-1.15; I2 = 0%). Bell palsy was significantly more common after SARS-CoV-2 infection (n = 2 822 072) than after SARS-CoV-2 vaccinations (n = 37 912 410) (relative risk, 3.23; 95% CI, 1.57-6.62; I2 = 95%).Conclusions and RelevanceThis systematic review and meta-analysis suggests a higher incidence of BP among SARS-CoV-2–vaccinated vs placebo groups. The occurrence of BP did not differ significantly between recipients of the Pfizer/BioNTech vs Oxford/AstraZeneca vaccines. SARS-CoV-2 infection posed a significantly greater risk for BP than SARS-CoV-2 vaccination.

Suicide is the second leading cause of death between the ages of 15 and 29. Most suicides are related to mental illnesses. Suicide is considered a response to predicaments. Due to the growing prevalence of suicide, assessing people's attitudes toward suicide is necessary. Therefore, this study aimed to examine the psychometric properties of the Persian version of the Predicaments Questionnaire (PQ), measuring social attitudes toward suicide.Methods:This psychometrics study evaluated face validity, content validity, temporal stability, internal consistency, and exploratory factor analysis. First, the questionnaire was translated into Persian by the translate-back-translate method. The Persian version was provided to 10 experts in psychiatry for further revision. Two indicators, CVR and CVI, were calculated to evaluate the content validity. To check the face validity, we prepared a form and gave it to 10 people outside the campus to submit their opinions. The results were then given to 10 experts to comment on.Temporal stability was investigated by the test-retest method, reporting Intraclass correlation (ICC). Internal consistency was assessed by reporting Cronbach's alpha and McDonald’s Omega coefficients. Exploratory factor analysis was used to determine the number of dimensions of the questionnaire. In this analysis, χ2, TLI, CFI, RMSEA, and SRMR indices were calculated. All analyses were performed using SPSS software version 22 and R software version 4.Results:A total of 151 students were enrolled with a mean age of 25 (SD=0.32). The Persian PQ was valid in terms of content validity and face validity. Furthermore, it was reliable as Cronbach’s alpha, McDonald’s Omega, and the ICC were 0.94, 0.943, and 0.998, respectively. In addition, the exploratory factor analysis yielded one dimension. Finally, after reviewing the experts’ comments, the final amendments were made, and only question 29 was removed from the final version.Conclusion:Consequently, the Persian version of the PQ is acceptable in terms of content validity, face validity, temporal stability, and internal consistency. This questionnaire can be used in future research on Persian-speaking society.

The RMA for degenerative MR was associated with a functional stenosis and the PAP at rest and at peak exercise discriminated low exercise capacity.

Purpose: Increased left ventricular myocardial mass index (LVMMI) raises mortality risk due to varied cardiovascular complications, the underlying etiology of which revolves around the decreased left ventricular ejection fraction (LVEF), hence heart failure. We hypothesized that increased LVMMI assessed with cardiac computed tomography (CT), along with increased end-diastolic volume index (EDVI) and interventricular septal wall thickness at diastole (IVSd), were associated with chest discomfort in patients with normal coronary arteries. Methods We retrospectively enrolled 130 patients who had undergone coronary CT angiography in our center between 2018 and 2020. Only normal coronary patients without coexisting medical conditions were recruited in groups with and without chest discomfort. We performed propensity-score matching (PSM) to produce matched groups. Using the previous CT data, we calculated LVMMI, EDVI, and IVSd and compared them between the groups. Results After PSM, the LVMMI was significantly higher in the group with chest discomfort both in the total population and in the females, but not in the males (OR=1.04, 95% CI 1.00-1.08, p-value=0.021 and OR=1.11, 95% CI 1.03-1.19, p-value=0.003, for the total population and the females, respectively). EDVI and IVSd were not significantly different between the groups. Moreover, the receiver operator characteristics (ROC) curve analysis showed a significant diagnostic accuracy of LVMMI in the females for chest discomfort (p-value<0.001). Conclusion We proposed that the increased cardiac CT-derived LVMMI within the normal range, is a potential predictor of chest discomfort due to myocardial demand-supply imbalance, at least in females. Further research is required to establish the results.