Dear Editor,

Domestic violence (DV) in the form of marital rape refers to any act between spouses involving unwanted intercourse or sexual penetration that is forced, threatened, or occurs when the victim is incapacitated (e.g., asleep or intoxicated). It is a devastating and often overlooked category of DV that profoundly affects the victim, violating the fundamental principles of trust and intimacy in a relationship. Unfortunately, many victims of marital rape suffer in silence due to fear of societal stigma or being doubted, as well as the incorrect belief that consent is automatic within marriage. As a result, the psychological and emotional scars are long-lasting and seriously impact the victim’s self-esteem and mental well-being. Marital rape is often hidden by cultural taboos and confusion surrounding the concept of consent within marriage. Over time, many legal systems have incorrectly assumed that marriage automatically equals consent to sexual activity. This misunderstanding not only overlooks the problem of marital rape within legal frameworks but also keeps this form of DV hidden from public view. This lack of awareness minimizes the pain experienced by victims and reinforces a culture of silence, enabling marital rape to persist unchecked.

Introduction: The transition of parents to the empty nest (EN) stage, in which children leave the nest, is often accompanied by profound psychological and interpersonal adjustments. Therefore, it is critical to examine the impact of this stage on parents’ emotional divorce, changes in marital dynamic, physical intimacy, and personal well-being. This review also explores strategies for couples to cope with the challenges of the EN stage. Methods: Peer-reviewed articles, psychological and sociological research, and other relevant texts published from 2013 to 2025 from indexing sites such as Iran Medex, PubMed, and Google Scholar, as well as additional texts from Elsevier journals and WHO publications, were reviewed. Special weight was put on the Iranian society, where cultural norms influenced family dynamics. Results: The main findings indicated that the EN stage could either lead to emotional divorce or presented an opportunity for personal growth, depending on the couple's adaptive capacity or coping skills for this transition. Effective strategies such as enhancing open communication, identifying new shared goals, seeking professional counseling, and being aware of cultural influences on marriage could help improve well-being and strengthen family relationships. Conclusion: The rational of this research was to bring to light proactive approaches for couple's EN stage challenges, which may well be conquered and marital bonds strengthened. Educating professionals, and policymakers about key factors influencing marital instability during the transition to and navigation of the EN phase, as well as providing couples with recommendations to promote strong and lasting relationships are rewarding.

Background: Laparoscopic cholecystectomy (LC), a common abdominal operation, is associated with significant morbidity, particularly bile duct injury. Artificial intelligence (AI) can enable real-time monitoring, assist decision-making, increase safety, and improve patient outcomes. This study systematically reviews AI applications in LC, evaluating different models and their performance. Methods: A systematic review was conducted in accordance with the PRISMA guidelines. A comprehensive literature search was conducted using PubMed and ScienceDirect databases for studies published between 2014 and 2024. All studies assessing AI applications in LC were included. Data extraction focused on the study aims, types of AI tools, datasets, anatomical recognition capabilities, and accuracy metrics. Results: The search yielded 413 citations; a final list of 43 citations was compiled after applying the inclusion and exclusion criteria. Different datasets and developed AI tools were used in LC. AI tools were utilised in risk-scoring models for complication identification and outcome prediction, as well as for recognising anatomical landmarks during LC and subdividing the procedure into subtasks. Conclusion: AI integration in LC is promising for improving intraoperative guidance, enhancing surgical education, and supporting decision-making processes. Future large-scale studies are warranted to validate the role of AI in improving patient safety and outcomes in LC.

Enhancing Health-Related Quality of Life (HRQOL) for infectious diseases like malaria requires a shift from a disease-focused to a patient-centered model of care. By implementing an integrated framework that addresses clinical, psychological, and socioeconomic dimensions of the illness simultaneously, healthcare professionals can improve patient well-being significantly. It is crucial that national primary health care systems and malaria control programs formally adopt HRQOL metrics as key performance indicators. Future research should prioritize evaluating these intervention strategies to establish a robust evidence base for holistic patient care

As our understanding of the human body andmind deepens, we are discovering the significantrole that psychological and emotional factors playin the onset and progression of serious illnessessuch as cancer. This intricate interplay is oftentriggered by chronic distress, including extremestress, sorrow, pain, and ongoing resentment.Chronic stressful events, such as life adversities,work pressures, financial difficulties, and ongoingrelational conflicts can trigger a series of biological reactions. Resentment, defined as a feeling ofindignant displeasure or persistent hostility towards perceived wrongs, insults, or injuries, cancontribute to this complex emotional environment. Exposure to violence can also play a role increating an atmosphere conducive to tumor development and progression (1-3).

Patients undergoing hemodialysis often face physical, emotional, and psychological challenges that can downgrade their quality of life. However, their spiritual needs are frequently overlooked. On the other hand, spiritual care can improve mental health in these patients, reduce distress, and enhance resilience. By integrating spiritual care into routine care, it is possible to improve treatment outcomes and overall well-being of patients, and support their comprehensive recovery. This article presents the authors’ views on the importance of spiritual care for patients undergoing hemodialysis, drawing on the available evidence.