Isfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954384820260220Measurement of psychophysical centers (GSR/HRV) during root canal therapy of teeth with symptomatic irreversible pulpitisMeasurement of psychophysical centers (GSR/HRV) during root canal therapy of teeth with symptomatic irreversible pulpitis201120193331110.48305/jims.v43.i848.2011FASaharShakouie BonabDepartment of Endodontic, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran0000-0002-9712-2412AminSalem MilaniDepartment of Endodontic, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, IranMasoumehZamanluResuscitation and Critical Care Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran0000-0002-6326-8448MasoumehAbbasi-AslDepartment of Endodontic, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran0000-0002-9707-764XNasimHashemiDepartment of Endodontic, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran0009-0009-7233-1339Journal Article20260223Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.Introduction and Objective: Neurophysiological parameters of the autonomic system objectively record parameters related to pain and stress or cardiovascular complications.https://jims.mui.ac.ir/article_33311_b6e16e5df709e3386d7df8c34dccb1d2.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954384820260220Comparison of the outcomes of endoscopic stent placement versus sphincterotomy in bile leakage following laparoscopic cholecystectomyComparison of the outcomes of endoscopic stent placement versus sphincterotomy in bile leakage following laparoscopic cholecystectomy202020243331210.48305/jims.v43.i848.2020FAHosseinNasrabadiStudent Research Committee, Babol University of Medical Sciences, Babol, IranJavadShokryAssociate Professor of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Cancer Research Center, Health Research Institute, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran0000-0003-3242-8522HemmatGholiniaSocial Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran0000-0003-0517-2429Seyyed HasanAbediAssistant Professor of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Rouhani Hospital, Babol University of Medical Sciences, Rouhani, Iran0000-0002-3943-1647Journal Article20260506Introduction: Biliary fistulas may occur after cholecystectomy. Given the lack of studies on endoscopic management of post‑cholecystectomy biliary fistulas in Babol, the aim of this study was to evaluate the different endoscopic techniques used in the endoscopy center of Ayatollah Rouhani Hospital in Babol, the frequency of use of each technique, and the success rate of these methods.<br>Methods: This retrospective study was conducted on 226 patients with bile leakage following laparoscopic cholecystectomy who were referred to Ayatollah Rouhani Hospital in Babol between 2011 and 2021 and underwent ERCP. Demographic characteristics, leak site, the relationship between the site of bile leakage and the endoscopic treatment technique, number of ERCP sessions, type of therapeutic technique (biliary stent placement and sphincterotomy), and the frequency of common bile duct stones were extracted from patients’ records and analyzed.<br>Results: Of the 226 patients included, 95 (42%) were male and 131 (58%) were female. The mean age of patients was 56.28 ± 19.47 years. The most common site of leakage was the common bile duct. Overall, 34.5% of patients had common bile duct stones. There was no significant association between treatment technique, site of leakage, presence of biliary stones, and the number of ERCP sessions.Introduction: Biliary fistulas may occur after cholecystectomy. Given the lack of studies on endoscopic management of post‑cholecystectomy biliary fistulas in Babol, the aim of this study was to evaluate the different endoscopic techniques used in the endoscopy center of Ayatollah Rouhani Hospital in Babol, the frequency of use of each technique, and the success rate of these methods.<br>Methods: This retrospective study was conducted on 226 patients with bile leakage following laparoscopic cholecystectomy who were referred to Ayatollah Rouhani Hospital in Babol between 2011 and 2021 and underwent ERCP. Demographic characteristics, leak site, the relationship between the site of bile leakage and the endoscopic treatment technique, number of ERCP sessions, type of therapeutic technique (biliary stent placement and sphincterotomy), and the frequency of common bile duct stones were extracted from patients’ records and analyzed.<br>Results: Of the 226 patients included, 95 (42%) were male and 131 (58%) were female. The mean age of patients was 56.28 ± 19.47 years. The most common site of leakage was the common bile duct. Overall, 34.5% of patients had common bile duct stones. There was no significant association between treatment technique, site of leakage, presence of biliary stones, and the number of ERCP sessions.https://jims.mui.ac.ir/article_33312_ecc3ebf4a557b4a5f1f8655ccd8897f3.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954384820260220Comparison of Initial MRI Characteristics of the Optic Nerve and Brain in Patients with Optic Neuritis with Different Diagnoses in One-Year Follow-UpComparison of Initial MRI Characteristics of the Optic Nerve and Brain in Patients with Optic Neuritis with Different Diagnoses in One-Year Follow-Up202520333331310.48305/jims.v43.i848.2025FASomayehHaji AhmadiAssociate Professor of Radiology, Department of Radiology, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-8654-4548ShahrbanooZolfaghariDepartment of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0009-0005-4721-3649FeloraFerdosiProfessor of Retina & Vitreous, Department of Ophthalmology, School of Medicine, Eye Research Center, Feiz Hospital, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-3685-0846AlirezaDehghaniProfessor of Retina & Vitreous, Department of Ophthalmology, School of Medicine, Eye Research Center, Feiz Hospital, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-6313-0262VahidShaygannejadProfessor of Neurology, Department of Neurology, School of Medicine, Neurosciences Research Center, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-9732-4153AzinShayganfarAssociate Professor of Radiology, Department of Radiology, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-9367-268XJournal Article20241223Background: This study investigates and compares the initial MRI characteristics of the optic nerve and brain in patients with optic neuritis across different diagnoses during a one-year follow-up.<br>Methods: In this cross-sectional study, 30 patients with acute optic neuritis from 2022 to 2024 were examined. Visual acuity was assessed using a Snellen chart, and relative afferent pupillary defect and color vision testing were conducted within 48 hours. The DWI sequence was analyzed for the apparent diffusion coefficient (ADC) of optic nerve lesions. Patients were monitored for one year post-attack, with clinical examinations, paraclinical tests (AQP4 and MOG antibody evaluation), and follow-up MRI performed.<br>Findings: Right optic nerve involvement was observed in 63% of cases, with less than half the nerve length affected in 63% of those cases. MRI findings of the brain revealed that 18.5% were normal, 7.4% were unclear, 59.3% had spatial dissemination lesions, and 14.8% had lesions disseminated in both space and time. One-year follow-up imaging showed that 63% of patients were diagnosed with multiple sclerosis (MS), 33.3% with clinically isolated syndrome (CIS), and 3.7% with neuromyelitis optica (NMO).<br>Conclusion: While the correlation between the initial MRI pattern and visual recovery remains unclear, the presence and number of brain lesions during the initial manifestations of optic neuritis may help predict the development of MS.Background: This study investigates and compares the initial MRI characteristics of the optic nerve and brain in patients with optic neuritis across different diagnoses during a one-year follow-up.<br>Methods: In this cross-sectional study, 30 patients with acute optic neuritis from 2022 to 2024 were examined. Visual acuity was assessed using a Snellen chart, and relative afferent pupillary defect and color vision testing were conducted within 48 hours. The DWI sequence was analyzed for the apparent diffusion coefficient (ADC) of optic nerve lesions. Patients were monitored for one year post-attack, with clinical examinations, paraclinical tests (AQP4 and MOG antibody evaluation), and follow-up MRI performed.<br>Findings: Right optic nerve involvement was observed in 63% of cases, with less than half the nerve length affected in 63% of those cases. MRI findings of the brain revealed that 18.5% were normal, 7.4% were unclear, 59.3% had spatial dissemination lesions, and 14.8% had lesions disseminated in both space and time. One-year follow-up imaging showed that 63% of patients were diagnosed with multiple sclerosis (MS), 33.3% with clinically isolated syndrome (CIS), and 3.7% with neuromyelitis optica (NMO).<br>Conclusion: While the correlation between the initial MRI pattern and visual recovery remains unclear, the presence and number of brain lesions during the initial manifestations of optic neuritis may help predict the development of MS.https://jims.mui.ac.ir/article_33313_1e4cb2e03f2f23188afd6326c1ccd15b.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954384820260220Assessment of Knee Injuries in Individuals with a History of Femoral Fracture: A 3-Year Retrospective StudyAssessment of Knee Injuries in Individuals with a History of Femoral Fracture: A 3-Year Retrospective Study203420393331410.48305/jims.v43.i848.2034FARezaNoktehsanjAssistant Professor of Surgery of the Knee, Department of Surgery, School of Medicine, Fatemi Hospital, Ardabil University of Medical Sciences, Ardabil, Iran0000-0001-9008-4487KeyvanAminiAssistant Professor of Emergency Medicine, Department of Surgery, School of Medicine, Fatemi Hospital, Ardabil University of Medical Sciences, Ardabil, Iran0000-0002-6518-0052AzizKamranProfessor of Health Education and Promotion, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran0000-0001-6065-4397ParyaMahboubiDepartment of Surgery, School of Medicine, Fatemi Hospital, Ardabil University of Medical Sciences, Ardabil, IranJournal Article20250103Background: This study aimed to assess knee injuries in individuals with a history of femoral fractures (proximal, shaft, or combined) and to investigate potential risk factors such as gender, fracture type, underlying medical conditions, and surgical history.<br>Methods: A retrospective study was conducted with 143 patients who had experienced various types of femoral fractures, including proximal femur, femoral shaft, and combined fractures. Data on comorbidities, including diabetes, hypertension, thyroid disorders, and skeletal diseases, were collected. Knee injuries were analyzed based on injury side (right or left) and surgical history (single or multiple surgeries). Logistic regression analysis was used to examine the associations between these factors and knee injury occurrence.<br>Findings: No significant differences were found in knee injuries related to gender (P=0.70), fracture type (P=0.50), comorbidities (P=0.30), or surgical history (P=0.25). The side of injury showed a borderline result (P=0.051) but remained non-significant. Further analysis revealed no significant association between age, gender, hospital stay length, surgical history, injury side, or comorbidities and knee injuries (p-value > 0.05).<br>Conclusion: The study suggests that factors like gender, fracture type, comorbidities, and surgical history do not significantly impact knee injury occurrence in individuals with femoral fractures. Further research is necessary to identify additional potential risk factors for knee injuries in this group.Background: This study aimed to assess knee injuries in individuals with a history of femoral fractures (proximal, shaft, or combined) and to investigate potential risk factors such as gender, fracture type, underlying medical conditions, and surgical history.<br>Methods: A retrospective study was conducted with 143 patients who had experienced various types of femoral fractures, including proximal femur, femoral shaft, and combined fractures. Data on comorbidities, including diabetes, hypertension, thyroid disorders, and skeletal diseases, were collected. Knee injuries were analyzed based on injury side (right or left) and surgical history (single or multiple surgeries). Logistic regression analysis was used to examine the associations between these factors and knee injury occurrence.<br>Findings: No significant differences were found in knee injuries related to gender (P=0.70), fracture type (P=0.50), comorbidities (P=0.30), or surgical history (P=0.25). The side of injury showed a borderline result (P=0.051) but remained non-significant. Further analysis revealed no significant association between age, gender, hospital stay length, surgical history, injury side, or comorbidities and knee injuries (p-value > 0.05).<br>Conclusion: The study suggests that factors like gender, fracture type, comorbidities, and surgical history do not significantly impact knee injury occurrence in individuals with femoral fractures. Further research is necessary to identify additional potential risk factors for knee injuries in this group.https://jims.mui.ac.ir/article_33314_6fca7a9b9ac98ccc83aebb9fa27a2149.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954384820260220Association of the host genetic factors with influenza A H1N1 severity in an Iranian populationAssociation of the host genetic factors with influenza A H1N1 severity in an Iranian population204020463331510.48305/jims.v43.i848.2040FASanaEybpooshAssociate Professor, Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran0000-0002-2304-8352VahidehMazaheriPhysician, Influenza and Respiratory Viruses Dept., Pasteur Institute of Iran, Tehran, IranParvanehMehrbodAssociate Professor, Autophagy Research Center, Shiraz University of Medical Sciences, Shiraz, Associate Professor, Influenza and Respiratory Viruses Dept., Pasteur Institute of Iran, Tehran, Iran0000-0002-8391-9228Journal Article20250318Introduction <br>Variation in host genetic factors may play a role in immune response and severity of influenza. This study investigated the association of host genetic factors with the severity of influenza A H1N1 in an Iranian population.<br>Methods<br>Nasopharyngeal swab samples from 97 patients were evaluated by PCR(+) test. Single nucleotide polymorphisms in the studied genes were studied with iPLEX platform. The association of host genetic variants with influenza severity was assessed by logistic regression analysis.<br>Findings<br>Participants with severe influenza had a higher mean age than those with mild influenza, but this was not significant (P=0.3764). In mild influenza group, mean BMI levels were slightly higher (mean difference=3.8 kg/m2), although it was not significant (Pt-test=0.1098). Logistic regression analysis showed that the presence of G/A genotype at rs1800629, rs1800871, rs1801274, rs361525 and rs8070740 increased the risk of severe H1N1 influenza infection compared to G/G genotype. This association was significant only for rs1800629 (P=0.097) and rs1801274 (P=0.062) (at 0.1 level). This association was similar for A/A genotypes with a lower magnitude. The effect of other genotypes on severity of H1N1 influenza infection was not statistically significant.<br>Conclusion<br>In a sample of Iranian adult population, an association was observed between different SNPs and susceptibility to severe A/H1N1 influenza infection. The rs8070740 allele affected both susceptibility and severity of A/H1N1 infection in the Iranian population. Influenza pathogenicity is influenced by a multigene set of host and pathogen.Introduction <br>Variation in host genetic factors may play a role in immune response and severity of influenza. This study investigated the association of host genetic factors with the severity of influenza A H1N1 in an Iranian population.<br>Methods<br>Nasopharyngeal swab samples from 97 patients were evaluated by PCR(+) test. Single nucleotide polymorphisms in the studied genes were studied with iPLEX platform. The association of host genetic variants with influenza severity was assessed by logistic regression analysis.<br>Findings<br>Participants with severe influenza had a higher mean age than those with mild influenza, but this was not significant (P=0.3764). In mild influenza group, mean BMI levels were slightly higher (mean difference=3.8 kg/m2), although it was not significant (Pt-test=0.1098). Logistic regression analysis showed that the presence of G/A genotype at rs1800629, rs1800871, rs1801274, rs361525 and rs8070740 increased the risk of severe H1N1 influenza infection compared to G/G genotype. This association was significant only for rs1800629 (P=0.097) and rs1801274 (P=0.062) (at 0.1 level). This association was similar for A/A genotypes with a lower magnitude. The effect of other genotypes on severity of H1N1 influenza infection was not statistically significant.<br>Conclusion<br>In a sample of Iranian adult population, an association was observed between different SNPs and susceptibility to severe A/H1N1 influenza infection. The rs8070740 allele affected both susceptibility and severity of A/H1N1 infection in the Iranian population. Influenza pathogenicity is influenced by a multigene set of host and pathogen.https://jims.mui.ac.ir/article_33315_2ad8c5f5cf1914eef5cb64d16d685a73.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954384820260220Diagnostic Accuracy of Ultrasonography Combined with the S.T.O.N.E. Criteria in Patients Suspected of Acute Ureteral StoneDiagnostic Accuracy of Ultrasonography Combined with the S.T.O.N.E. Criteria in Patients Suspected of Acute Ureteral Stone204720533331610.48305/jims.v43.i848.2047FADorsaHaeriMedical Student, School of Medicine, Iran University of Medical Sciences, Tehran, Iran0009-0005-1315-5970Mohammad RezaSafaviProfessor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-8975-7661MohamadaliFahimiAssistant Professor, Department of Emergency Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranMohamad HassanBarzegariAssistant Professor, Department of Emergency Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranJavadMozaffariAssistant Professor, Department of Emergency Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran0000-0002-8903-7138FaribaSabetiResident of Emergency Medicine, Department of Emergency Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran0009-0002-4460-8256Journal Article20250426Background:<br>Renal colic is a common emergency department presentation, typically evaluated by CT scan. This study assesses the diagnostic value of combining bedside ultrasound with the STONE score as a safer alternative for suspected ureteral stones.<br>Methods:<br>In this prospective study, 176 patients with renal colic symptoms were stratified by STONE scores into low-, moderate-, and high-risk groups. Bedside ultrasound findings were compared against CT results. Statistical analysis included sensitivity, specificity, and ROC curve evaluation.<br>Results:<br>Ureteral stones were confirmed by CT in 101 patients (57.4%). Hydronephrosis was present in 78.2% of stone-positive versus 17.3% of stone-negative patients. Ultrasound showed 75%/89.2% (sensitivity/specificity) in low-risk, 74%/56.3% in moderate-risk, and 83%/42.9% in high-risk groups. The AUC was 0.78 for ultrasound alone versus 0.75 for the combined model.<br>Conclusion:<br>The ultrasound-STONE score combination reliably screens for ureteral stones in low/moderate-risk patients, potentially reducing unnecessary CT scans. CT remains preferred for high-risk cases due to ultrasound's limited specificity in this group.Background:<br>Renal colic is a common emergency department presentation, typically evaluated by CT scan. This study assesses the diagnostic value of combining bedside ultrasound with the STONE score as a safer alternative for suspected ureteral stones.<br>Methods:<br>In this prospective study, 176 patients with renal colic symptoms were stratified by STONE scores into low-, moderate-, and high-risk groups. Bedside ultrasound findings were compared against CT results. Statistical analysis included sensitivity, specificity, and ROC curve evaluation.<br>Results:<br>Ureteral stones were confirmed by CT in 101 patients (57.4%). Hydronephrosis was present in 78.2% of stone-positive versus 17.3% of stone-negative patients. Ultrasound showed 75%/89.2% (sensitivity/specificity) in low-risk, 74%/56.3% in moderate-risk, and 83%/42.9% in high-risk groups. The AUC was 0.78 for ultrasound alone versus 0.75 for the combined model.<br>Conclusion:<br>The ultrasound-STONE score combination reliably screens for ureteral stones in low/moderate-risk patients, potentially reducing unnecessary CT scans. CT remains preferred for high-risk cases due to ultrasound's limited specificity in this group.https://jims.mui.ac.ir/article_33316_bb1a58619514c1c544f8972fac9f5717.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954384820260220Report of a case of pecan (Peganum harmala) poisoning: Evaluation of neurological symptoms and treatment.Report of a case of pecan (Peganum harmala) poisoning: Evaluation of neurological symptoms and treatment.205420583331710.48305/jims.v43.i848.2054FAKhadijehSaravaniAssociate Professor of Clinical Toxicology, Department of Community Medicine, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran0000-0002-2295-9402AmirhoseinKamravaStudent in General Medicine, Student Research Committee, Zabol University of Medical Sciences, Zabol, Iran0009-0004-7062-174XJavadPoursamimiAssistant Professor of Clinical Immunology, Department of Immunology, Faculty of Medicine, Zabol University of Medical Sciences, Zabol, Iran0000-0002-8726-4425Journal Article20250301Introduction<br>The use of herbal medicines in traditional Iranian medicine has recently gained public interest as an alternative to conventional modern medicine. However, neglecting the proper guidelines for these herbal treatments can result in serious issues, including severe poisoning. This article explores a case of poisoning induced by the oral consumption of Peganum harmala.<br>Methods<br>A 32-year-old woman experiencing symptoms such as nausea, vomiting, auditory and visual hallucinations, ataxia, and a distorted perception of time and space was transferred to the emergency room at Amir-al-momenin Hospital in Zabol. The medical team examined her, and diagnostic tests, along with a CT scan, were conducted.<br>Findings<br>The results from the patient's laboratory tests and CT scan were normal. The patient's medical history was reliable, and the clinical symptoms indicated poisoning from peganum. These symptoms were consistent with the effects of the alkaloids found in peganum, such as harmine and harmaline, which are known inhibitors of monoamine oxidase and acetylcholinesterase.<br>The patient was treated with diazepam and metoclopramide, and intravenous fluids were administered. The symptoms completely resolved after 24 hours, and the patient was discharged without any complications.<br>Conclusion<br>Consuming pecans improperly (orally) can lead to poisoning. This study highlights the critical importance of timely recognition of poisoning by medical teams, particularly regarding their accuracy and vigilance in managing patients with neuropsychiatric symptoms. Additionally, it emphasizes the need for education about the risks associated with the self-administration of herbal medicines.Introduction<br>The use of herbal medicines in traditional Iranian medicine has recently gained public interest as an alternative to conventional modern medicine. However, neglecting the proper guidelines for these herbal treatments can result in serious issues, including severe poisoning. This article explores a case of poisoning induced by the oral consumption of Peganum harmala.<br>Methods<br>A 32-year-old woman experiencing symptoms such as nausea, vomiting, auditory and visual hallucinations, ataxia, and a distorted perception of time and space was transferred to the emergency room at Amir-al-momenin Hospital in Zabol. The medical team examined her, and diagnostic tests, along with a CT scan, were conducted.<br>Findings<br>The results from the patient's laboratory tests and CT scan were normal. The patient's medical history was reliable, and the clinical symptoms indicated poisoning from peganum. These symptoms were consistent with the effects of the alkaloids found in peganum, such as harmine and harmaline, which are known inhibitors of monoamine oxidase and acetylcholinesterase.<br>The patient was treated with diazepam and metoclopramide, and intravenous fluids were administered. The symptoms completely resolved after 24 hours, and the patient was discharged without any complications.<br>Conclusion<br>Consuming pecans improperly (orally) can lead to poisoning. This study highlights the critical importance of timely recognition of poisoning by medical teams, particularly regarding their accuracy and vigilance in managing patients with neuropsychiatric symptoms. Additionally, it emphasizes the need for education about the risks associated with the self-administration of herbal medicines.https://jims.mui.ac.ir/article_33317_83a46649c8bf2b58bfc892041bd2b0e9.pdf