Journal of Advances in Medical and Biomedical Research
Volume:31 Issue: 147, Jul-Aug 2023

Very often the patients who undergo laparoscopic surgery suffer from shoulder pain (SP). As a result, different studies have been conducted to mitigate shoulder pain following laparoscopic surgery. This systematic review aims to investigate the efficacy of different interventions in mitigating laparoscopy-induced SP.

In this systematic review, relevant articles were included using ISI, PubMed, MEDLINE, etc., from 2009 to 2020. Medical Subject Headings (Mesh) of Laparoscopic Surgical Procedures, Surgery Laparoscopic, Laparoscopic Assisted, Shoulder Pain, randomized controlled trial, and clinical trial were searched for eligible studies. Random effect model and standardized mean difference (SMD) index were applied to combine the studies and perform a meta-analysis.

A total sample of 11,024 was obtained for 10 selected studies. Results from intraoperative intervention demonstrate that the mean VAS (visual analog scale) scores were 1.46(CI 95%: -0.32, 3.24) and 1.87(CI 95%:0.79, 2.94) in the intervention and control groups, respectively six hours after surgery. The mean VAS scores were 2.06(CI 95%: 0.91, 3.20) and 2.35 (CI 95%: 0.57, 4.13) in the intervention and control groups, respectively, twelve hours after surgery. 24 hours following surgery; the mean VAS scores were 0.96(CI 95%: -0.21, 2.13) and 1.27(CI 95%: 0.33, 2.21) in the intervention and control groups, respectively.

The results of this meta-analysis demonstrate that intraoperative interventions, such as Peritoneal Suction Drainage, injection of Intraperitoneal Hydrocortisone with Bupivacaine, and warm and humidified insufflation carbon dioxide, can reduce the severity of SP in patients with LS. In addition, clinical trials with different interventions are needed to compare the efficacy and find effective interventions for SP management in patients with LS.

 Diabetic neuropathy pain is a common pain condition that has a major negative impact on health-related quality of life. However, despite many studies, it remains difficult to treat neuropathic pain. This study aimed to compare the efficacy of duloxetine with high tone power therapy (HTPT) in diabetic peripheral neuropathic pain.

 The study is a single-centre, phase III clinical trial comparing the effect of HTPT versus treatment with duloxetine in diagnosed diabetic neuropathy patients between October 2019 to December 2020. In the case group, the HTPT was used with a four-second duration for 30 minutes daily. This treatment was continued twice a week for 10 sessions. The control group received duloxetine (30 mg/m2 once a day). The treatment response was assessed based on the VAS score.

 The results showed that in both groups, there was a significant reduction in pain severity. In HTPT group, the average pain decreased from 7.36 to 4.6 and in duloxetine group from 7.7 to 4.8. During 8 measurements after the intervention; decrease in VAS score was higher in HTPT group (5.6) than in duloxetine group (6.5) in the first and fourth times after the intervention (P-Value=0.01). Further analysis demonstrated a positive correlation between pain severity and age so that, the pain also increases with  advancing age.

 The results of the present study showed that both duloxetine and high tone therapies are safe and effective methods for neuropathic pain relief.

In-toeing is the most common gait pattern in children with spastic diplegic cerebral palsy (CP). Kinesio Taping (KT) has been suggested to improve the function and posture of children with CP. No study has yet evaluated the effects of spiral KT on this gait pattern. The objective of this study was to evaluate whether spiral KT could improve in-toeing in children with spastic diplegic CP.

This pre-post designed experimental study was performed on 14 patients with spastic diplegic CP aged between 6 and 10 years at the first level of the Gross Motor Function Classification System. KT was applied spirally with 100% of available tension. Hip, knee, and ankle joint angles in the transverse plane and spatio-temporal parameters including velocity and duration of stride were measured before and immediately after the intervention.

The results showed a significant decrease in hip (p=0.04) and knee (p<0.001) internal rotation, foot adduction, and abduction (p<0.001) in the transverse plane after using KT. Also, significant differences were found for spatio-temporal indices including velocity (p<0.001) and duration of stride (p<0.001).

Spiral KT with 100% of available tension immediately improved the spatio-temporal indices of in-toeing gait pattern in children with spastic diplegic CP. Hence, clinicians can use the applied method to improve the gait pattern in this group of CP children.

 Blood markers and CT-scan results can be useful to the prognosis outcome of traumatic brain injury (TBI). This study aims to evaluate and compare markers and CT-scans during hospitalization regarding death and recovery as the outcomes.

 This longitudinal-observational retrospective study was performed on 133 patients with comatose caused by head trauma from admission to death/discharge in Shohada-E- Tajrish Hospital in Tehran during 2018-2020. The follow-up period lasted 15 days. The patients’ demographic and CT-scans were measured on admission. Blood markers were measured daily. Vital signs and GCS were collected every six hours. These variables were compared in survivor and non-survivor groups.

 Death occurred for 78 patients (58.64%). Tachycardia (OR=60.1, P=0.003), SDH (OR=39.3, P<0.001), ICH (OR=9.91, P<0.001), SAH (OR=13.6, P<0.001) had a significant relationship to death on multivariate logistic regression. The mean TT, PT, INR, GCS, PR, and systolic and diastolic blood pressure at the beginning of hospitalization were significantly different in the surviving and non-surviving groups. GCS, Cr, BUN, PTT, PT, INR, FBS, and PH had separate lines with spacing without overlap in the two groups in the graphs during hospitalization.

 Based on the results, the factors such as age, tachycardia, and some CT-scan findings (SAH, ICH, and SDH), as well as high coagulation profile (INR, PTT) and low GCS on admission, were important variables to the prognosis of TBI patients. During hospitalization, high values of BUN, PR, Cr, FBS, PT, and INR and low values of GCS, RR, and PH were associated with a worthwhile outcome. In addition, high changes in BUN, GCS, RR, PR, and BP during hospitalization should be considered a worthwhile prognosis.

 The diameter of the internal jugular vein changes with variations in intrathoracic pressure during inhalation and exhalation and this difference increases during hypovolemia. One of the causes of increased intrathoracic pressure in patients under mechanical ventilation is the tidal volume, which can affect the diameter of the internal jugular vein. On this basis, the present study was designed to investigate the effect of tidal volume on the internal jugular collapsibility index.

 In this clinical trial, 30 hypovolemic patients under mechanical ventilation were studied and three tidal volumes of 8, 10, and 12 cc/kg were applied to the patients. Subsequently, patients received fluid therapy and the measurements were repeated. Finally, the internal jugular vein diameters and the indices before and after the fluid therapy were measured in the three mentioned tidal volumes. A repeated measures t- test was used to compare the data.

 The means of the internal jugular collapsibility index in the three tidal volumes of 8, 10, and 12 cc/kg were 27.78 ±8.87, 28.11±10.24, and 29.67±11.72(p=0.577) respectively before fluid therapy. These values were 27.78±8.87, 28.11±10.24, and 29.67±11.72 (p= 0.288) respectively, after fluid therapy.

 The results of this study showed that the internal jugular collapsibility index does not correlate with the tidal volume in hypovolemic patients and after fluid therapy.

 Genetic modifications in the adiponectin receptor 2 (AdipoR2) gene can affect phenotypes associated with insulin resistance and diabetes. The purpose of this study was to evaluate the possible role of genetic modifications in the AdipoR2 gene, to determine the frequency of genotypes and polymorphism alleles of this gene at rs11061971 (+219 A>T), and to investigate its correlation with type 2 diabetes (T2D) and its related metabolic profile.

 In this case-control study, the single-nucleotide polymorphism (SNP) of AdipoR2 in 116 T2D patients and 102 controls was evaluated using RFLP PCR and FOK 1 enzyme. Fasting blood sugar, cholesterol, triglyceride, insulin, HDL-C, LDL-C and HbA1c were also measured and their correlation with the studied genetic modifications was assessed. The collected data were analyzed using Chi-square test and Hardy-Weinberg equation.

 There was a significant association in AT and TT genotypes in rs11061971 (+219 A>T) with T2D. However, no significant difference was observed in the frequency of alleles between the case and control groups. In addition, in LDL-C and total cholesterol in the control group, there was a significant difference between AA and TT genotypes as well as with AA and AT genotypes. However, no correlation was found between the other studied serum parameters and the genotype of individuals in the rs1106197171 polymorphism.

 It can be concluded that rs11061971 (+219 A>T) polymorphism is associated with T2D incidence. The findings suggest that AT and TT genotypes in this gene compared to AA genotype increase the risk of diabetes.

 COVID-19, caused by SARS-CoV-2, can lead to a wide range of clinical severities in infected individuals. Among the observed manifestations, pulmonary fibrosis stands out, characterized by chronic inflammation and collagen buildup in the interalveolar space. Numerous studies have indicated that proinflammatory cytokines may contribute to this condition. The cytokine storm, a critical phase in the deterioration of COVID-19 patients, plays a significant role in this process. The main objective of this study was to determine the levels of IL-10, IL-20, and MMP7 in COVID-19-infected people.

 During the period between November-2022 to March-2023, a case-control study with 200 participants was carried out at Al-Ramadi Hospitals in Anbar province, Iraq. A total of 100 individuals diagnosed with COVID-19 and 100 healthy controls (HCs) took part in the study. Serum concentrations of interleukins, including IL-10, IL-20, and MMP7, were assessed using enzyme-linked immunosorbent assays (ELISA).

 The current study revealed significant differences in IL-10 and IL-20 concentrations among the groups being compared with a P-value of <0.01. Notably, the COVID-19 group had significantly more MMP7 than the control group or the group of individuals who had recovered from the disease. This outcome raises the possibility that MMP7 could act as an independent indicator of COVID-19 infection.

 Patients with COVID-19 disease had IL-10, IL-20, and MMP-7 levels that were noticeably higher than those found in healthy controls.

 Regarding the high prevalence of sepsis, it is important to discover methods to control this condition. Valuable effect of vitamin C in vasopressin synthesis is demonstrated, moreover, its antioxidant effect reduces vascular infiltration. Therefore, the beneficial effects of vitamin C in prognosis of the patients who have been admitted to Vali-e- Asr hospital in Zanjan, Iran with the diagnosis of sepsis have been evaluated.

 This cross sectional study was planned on patients with sepsis who have been admitted to the infectious ward of Vali-e-Asr hospital in Zanjan. Patients with sepsis above 18 years old from June to March 2020 have been included in this study. Data of patients whom have received intravenous vitamin C, 25 mg/kg/24h for 4 days, and patients without reception vitamin C was collected from their files. Their demographic, clinical and para clinical information were collected, then the information was analyzed.

 54 patients (26 received vitamin C and 28 did not receive vitamin C) were enrolled in this study. Considering that the two groups were matched from the beginning of the study, no statistically significant difference was found between the two groups of patients in demographic characteristics. Furthermore, there were no significant differences in the sepsis induced complications, e.g. laboratory findings, mean days of hospitalization in ICU and SOFA score.

 Our findings demonstrated that no clear statistically significant difference was found between the two groups of control and vitamin C received groups; nonetheless for precise conclusion more studies with larger groups are required.

 Trace element levels are important for sperm function. On the other hand, oxidative stress is one of the most important causes of DNA damage. This study aimed to evaluate the relationship between cadmium (Cd), nickel (Ni), and manganese (Mn) trace elements and also oxidative stress in infertile men.

 This case-control study was carried out on 50 oligozoospermic, 50 asthenozoospermic, and 50 normozoospermic men. All individuals were subjected to semen analysis. Cadmium, nickel, manganese, total antioxidant capacity (TAC), and total oxidant status (TOS) were detected using the manual assays. Superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were analyzed using the ELISA.

 The findings revealed that there was a significant increase in TOS index in the patient groups compared to the normozoospermic group (p = 0.045, p = 0.038 respectively); however, these changes were downward for the TAC factor. The levels of SOD and GPx activities were significantly reduced in the patient groups compared to the normozoospermic group (p = 0.015, p = 0.020 respectively). Also, Cd and Ni levels were significantly elevated and had a negative association with TAC in the patient groups compared to the normozoospermic group. However, the results of Mn level showed a significantly lower value and a positive association with the TAC index.

 Mn as a component of SOD enzyme is necessary for normal sperm functions. In contrast, high levels of Cd and Ni are toxic for human sperm and negatively correlated with TAC and sperm parameters.

 Rheumatoid arthritis (RA) is a systemic autoimmune disease that causes joint deterioration. Over the past decade, the primary approach to treat RA has relied on biological medications. Despite confirming the effectiveness of this therapy, patients have shown significant diversity in their clinical responses to treatment. This variability can be attributed to various genetic polymorphisms that influence the response to biological drugs. This study was conducted to investigate whether TNFRSF1B (rs1061622), PADI4 (rs1748033), and miRNA 499 (rs3746444) gene polymorphisms are associated with susceptibility and responsiveness to TNF-α inhibitors in RA patients.

 100 RA patients (50 responders and 50 non-responders) and 100 apparently healthy subjects as the control group were studied. Genotyping of the polymorphisms was carried out using real-time polymerase chain reaction (PCR) with the TaqMan allelic discrimination assay.

 The frequency of TG (P0.039) and GG genotypes of TNFRSF1B (rs1061622) were higher in RA patients than in the control group. At the alleles level the mutant G allele was significantly more frequent among patients than control group (P=0.018). For PADI4 (rs1748033), the mutant C allele was more frequent among patients than controls (P=0.041). Sub-dividing of patients into responders and non-responders revealed that the mutant homozygous CC genotype of PADI4 (rs1748033) was significantly more frequent in non-responders than responders patients (P=0.046). AG genotype (P=0.016) and G allele (P=0.036) of miRNA 499a (rs3746444) were more frequent in non-responders than responders.

 Variant genotypes of TNFRII (Rs1061622) and PADI4 (rs1748033), may be associated with an increased risk of RA while PADI4 (rs1748033) and miRNA-499a (rs3746444) polymorphism may be associated with non-response to infliximab.

 Obesity is a major public health problem whose prevalence has constantly increased worldwide. Obesity is a risk factor for several diseases such as type 2 diabetes, fatty liver disease, hyperlipidemia, cardiovascular diseases, and cancer, all of which reduce the quality of life and life expectancy. This study investigated anti-adipogenic effects of Eryngium billardierei (Ery) extract.

 The nontoxic concentration of Ery extract was estimated via the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazoliu bromide (MTT) assay. The differentiation of mouse-derived 3T3-L1 preadipocytes into mature adipocytes was induced in the presence or absence of Ery extract. Then, the accumulation of lipid droplets was identified by Oil Red O staining. Triacylglycerol level and glycerol-3phosphate dehydrogenase (GPDH) activity were also measured.

 The MTT assay showed that 3 mg/mL of the Ery extract can be a nontoxic dose for other analyses. Oil Red O staining demonstrated a reduction of lipid droplets in the extract-treated adipocyte 3T3-L1 compared to the non-treated group. A significant decrease of triacylglycerol level in the treated 3T3-L1 adipocyte (0.32±0.03 mgTG/mg protein) compared with the nontreated group (0.78±0.05 mgTG/mg protein) (P<0.01), and a significant decrease of glycerol-3-phosphate dehydrogenase (GPDH) activity in the 3T3-L1adipocyte treated (15.3±2.1 U/ml) compared to the non-treated group (30.2±3.9 U/ml) (P<0.05) confirmed the inhibitory action of Ery extract on adipocyte differentiation.

 Ery extract, as a safe herbal extract, has anti-adipogenic activity and merits more investigation as a candidate for developing an anti-obesity drug or supplement.

 Cisplatin as a chemotherapy drug causes liver damage by increasing inflammation. Hepatoprotective agents with antioxidant properties can be useful for preventing this complication. Capparis spinosa, as a natural antioxidant source, can help to eliminate these productions. The purpose of this study was to determine the effect of two different doses of hydroalcoholic extract of Capparis seed on cisplatin-induced liver damages in rats.

 Forty male rats were divided into five groups (the control group, Cis (cisplatin) group, 200 C/S (Capparis spinosa), Cis + 50 C/S, and Cis + 100 C/S). Biochemical and histopathological evaluations were made. At the end of the study, all animals were euthanized with a CO2 gradient. Statistical analyses were performed through Graph Pad Prism Statistics software 9.1.2. The level of significance was set at p < 0.05.

 Liver function tests, antioxidant and inflammatory markers and histopathological changes were evaluated. Significant changes in the pathology results were noticeable. Central vein, portal vein and bile duct diameter, thickness of the hepatic artery wall, and hepatic sinusoids were significantly increased in the Cis and 200 C/S-fed groups, compared to the controls, and also changes in favor of improvement were evident in the treatment groups, especially in the Cis + 100 C/S group compared to the Cis and 200 C/S groups.

 Based on pathology results, treatment with C. spinosa seed extract may be helpful in preventing cisplatin hepatotoxicity.

 Myocardial infarction (MI) is one of the highest leading causes of death worldwide. Many biomarkers are universally accepted in clinical practice as crucial diagnostic biomarkers in acute MI. The current study aims to introduce new sensitivity biomarkers to aid the diagnosis and to facilitate faster decision-making in the emergency department.

 A total of 50 patients, diagnosed with acute myocardial infarction, in Nasiriyah Heart Center, and 30 age-matched healthy individuals were studied. Serum Cardiac Troponin I (cTnI), Myoglobin (MYO), Creatine kinase (CK-MB), Procalcitonin (PCT), Heart-type fatty acid binding protein (H-FABP), Lipoprotein-associated phospholipase A2 (Lp-PLA2), High sensitive C reactive protein (hsCRP), were determined by electro-chemiluminescence immunoassay. Blood sugar and serum total cholesterol, triglycerides, LDL, VLDL, and HDL were determined by using Cobas C311 photometric assays. Serum IL-6 was assayed by electro-chemiluminescence immunoassay, while, IL-9, IL-1β, and TNF-α were assayed by ELISA.

 In comparison with healthy control, patients with acute MI showed significant elevation of the serum levels of cTnI, CK-MB, MYO, CRP, H- FABP, PCT, TNF-α, IL-1β, IL-9, and IL-6.

 The present study suggests that, in addition to cTnI, CK-MB, and MYO, many other mediators such as CRP, H-FABP, PCT, and cytokines are sensitive to the diagnosis of MI. Furthermore, using human monoclonal antibodies that selectively neutralize cytokines may provide additional insight into cytokines-targeted therapies.