Galen Medical journal
Volume:12 Issue: 1, 2023

The relative darkening of the lower eyelid skin, often linked with dark circles, may make one seem tired and older than the actual age. Considering the recommendations in the sources of Persian medicine regarding Artemisia absinthium L., this clinical trial aimed to investigate the effectiveness of cream prepared from the aqueous extraction of A.absinthium for infra-orbital dark circles removal.

In this double-blind controlled clinical trial, an eye cream is made with 20% of the aqueous extract of A.absinthium in the base of the cream. For standardization based on Artemisinin, the high-performance liquid chromatography (HPLC) method was used. In two drug and placebo groups, 60 patients were equally enrolled in the trial. Erythema and pigmentation were evaluated via Mexameter®.

The cream was standardized, including 1.29±0.02 µg/mg Artemisinin in the product. Finally, 21 and 24 patients in the drug and placebo groups completed the study, respectively. In these groups, the difference in the mean ± standard deviation (SD) delta erythema (DE), delta luminance (DL), erythema, and melanin factors before and after the research were significant (P<0.05). However, the rate of reduction of DE, Erythema, and Melanin and the rise of DL are more significant in the treatment group than in the placebo group. Furthermore, the mean values of DE and DL factors before the research were significantly different in the two groups (P<0.001), but after the investigation did not show a significant difference. The mean value of the Erythema factor in the two groups before (P=0.25) and after (P=0.5) did not show a significant difference. The mean value of Melanin after the research between the two groups showed a significant difference (P=0.01).

The results show that the cream prepared from the herbal composition of Persian medicine improves the infra orbital dark circle around the eyes. 

Excessive inflammatory response is associated with several diseases. Re-cently, there has been an increasing trend for investigation of the acute or short-term effects of whey protein alone or in combination with carbohydrates on inflammato-ry status, especially in athletes. This systematic review aimed to clarify these effects.

PubMed, Scopus, and Web of Science databases were searched from January 1990 to September 2021, without language restriction. Adult studies examining the effects of whey protein alone or together with carbohydrates on interleukin-6, tumor necrosis factor-α, and C-reactive protein levels with a maximum duration of 15 days and with at least one comparison group were included. The quality of studies was determined using the Cochrane risk of bias tool.

Twenty-five studies met the inclusion criteria. Significant reductions in inflammatory markers was observed in seven out of 25 studies (28%). However, one out of 25 studies (4%) re-ported a significant increase in inflammatory status. Among those studies comparing the effects of whey protein alone with non-protein or protein-containing groups, 18.18% (two out of 11) and 10% (one out of ten) of the trials revealed a significant decrease in the markers, respectively. Moreover, of those studies comparing whey protein plus carbohydrate with non-protein or protein-containing groups, 33.33% (two out of six) and 40% (two out of five) of them showed a significant reduction in the inflammatory response, respectively. The quality of the majority of studies (84%) was poor.

It seems that whey protein alone or the combination of it with carbohydrates may not affect the inflammatory markers in the short run (PROSPERO registration number: CRD42021273915).

Previous studies have demonstrated the strong association of inflammatory cytokines and vitamin D (VitD) deficiency and ischemic stroke (IS) pathogenesis. Due to the negative correlation between long non-coding RNA (lncRNA) Malat1 and pro-inflammatory factors we decided to investigate the associations between Malat1 expression with serum interleukin-1β (IL-1β), and VitD levels in IS patients.

In this cross-sectional study, 63 IS patients were included. We used enzyme-linked immunosorbent assays to evaluate the serum levels of VitD and IL-1β. Malat1 expression was evaluated by the real-time polymerase chain reaction test. The associations between Malat1expression with VitD and IL-1β were analysed with linear regression (Stepwise model) and Pearson’s correlation analysis.

The Malat1 expression was inversely correlated with stroke severity (r=-0.25, P=0.043). Stepwise regression analysis showed a significant positive relationship between VitD level and Malat1 expression (Beta=0.28, P=0.02), and also showed a non-significant negative relationship between IL-1β and stroke severity. VitD level showed a positive Pearson correlation with Malat1 (r=0.28, P=0.023) and a negative correlation with IL-1β (r=-0.29, P=0.018) while it could not detect a significantly negative correlation with stroke severity.

For the first time the associations between Malat1 expression with IL-1β and VitD in IS patients was analyzed. We found a significant positive relationship between VitD and Malat1. This correlation needs to be investigated with a larger sample size to achieve a strong and reliable association between VitD and Malat1.[GMJ.2023;12:e2457]

This study aimed to systematically review studies conducted on the application of sonoelastography (SE) to evaluate lumbopelvic muscle stiffness in patients with low back pain (LBP). All relevant articles were retrieved from the available electronic databases, including PubMed, Web of Science, Scopus, EMBASE, Cochrane library, and CINAHL, using the keywords “Sonoelastographyâ€, “Elasticity Imaging Techniqueâ€, “Muscle Stiffnessâ€, “Modulus Elasticityâ€, “Low Back Painâ€. After initial searches, studies that met the inclusion criteria (i.e., published in English and sonoelastography were used to assess lumbopelvic muscle stiffness in both patients with LBP and healthy individuals) were enrolled. Also, any animal research, abstract of the seminar and/or conference, and/or non-English-language article were excluded. The quality of the studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. In total, eight relevant studies were selected for review. Three studies were considered to have excellent quality, and five were considered fair quality using the PEDro scale. All reviewed studies have reported that SE can be considered a non-invasive method for quantifying changes in lumbopelvic muscle stiffness. Muscle stiffness was significantly higher in LBP patients compared to healthy persons, as well as across subgroups of LBP patients in various test postures (PË‚0.05). Only one study was conducted on the reliability of SE in healthy individuals, while another examined the validity of SE imaging. The results of the present systematic review indicated that SE imaging is a reliable and valid tool to identify muscle changes that occur in patients with LBP and evaluate the effects of rehabilitation treatment.

Appendicitis is one of the most common causes of acute abdominal surgeries. The importance of parasitic etiologies in the pathogenesis of appendicitis is not well known in appendectomy specimens on a large scale in southwestern Iran. The current study aimed to retrospectively assess the demographic data and histopathological records of appendicitis in a 28-year period in Fars province, southwestern Iran.

Histopathological records of 13,013 patients who had undergone surgeries for appendicitis at Dr. Ali Shariati Hospital, affiliated with the Fasa University of Medical Sciences from December 1993 to January 2021 were reviewed and data concerning the patients' demographic data and histopathological records were retrieved from each record. More than 6800 archived microscopic glass slides were also reviewed.

From a total of 13,013 histopathological records of surgical excisions of appendicitis that were reviewed over a 28-year period, 8,189 (62.9%) were male and 4,842 (37.1%) were female. Patients' age ranged from 2 to 98 years, with a mean age of 24.68±19.87 years. The most common inflammatory changes were 5,687 (43.7%), 1,228 (9.4%), 670 (5.1%), 522 (4%), and 363 (2.8%) cases of acute appendicitis, suppurative appendicitis, early acute appendicitis, gangrenous appendicitis, and perforated appendicitis respectively. Microscopically, no viral inclusions, fungal elements, and histopathologic findings of bacterial causes were found. Parasitic infections such as helminthiasis were detected in 74 (0.6%) cases aged from 6 to 63. Enterobiasis (Syn. oxyuriasis, pinworm infection) accounted for 73 (98.6%) of the 74 helminthiases, while ascariasis accounted for 1 (1.4%). Out of 74 cases, 29 (39.2%) showed evidence of appendicitis.

The results suggest that although parasitic agents are minor causes of appendicitis, these agents should be kept in mind during differential diagnosis. However, whether every parasitic infection leads to appendicitis is controversial.

Breast cancer is considered one of the leading causes of mortality in the world. Cancer incidence and consequently, drug consumption can strongly influence gene expressions at the transcriptome level. Therefore, the assessment of the candidate biomarkers’ gene expression can accelerate the diagnosis process and increase the chance of treatment and remission. In this regard, the quantitative assessment of Partner and localizer of BRCA2 (PALB2) and BRCA1 Interacting Helicase 1 (BRIP1) genes expression in the breast cancer cell line under the treatment of Tamoxifen (TAM) was executed in this study.

MCF7 cells were cultured as TAM-treated and control groups. RNA extraction and cDNA synthesis were performed based on the instructions of provided kits. qPCR Hi-ROX Master Mix kit was applied to the Quantitative Real-Time Polymerase Chain Reaction (Q-PCR). The outputs of Q-PCR were analyzed by REST statistical software.

Outcomes derived from data analysis of BRIP1 gene expression did not show any significant difference between the gene expression of control and TAM-treated groups. The expression of PALB2 was significantly higher in the TAM-treated group compared to the control group (P<0.05).

Our findings showed a significant alteration between PALB2 gene expression in the TAM-treated breast cancer cell line and the control cell line. The quantitative assessment of mentioned genes as possible markers could be considered a non-invasive method for breast cancer in the processes of prognostic evaluations, screening, and treatment monitoring.

Healthcare workers (HCWs) directly or indirectly involved in the coronavirus disease 2019 (COVID-19) treatment process may experience severe mental consequences of the pandemic. Hence, this study aimed to evaluate the mental health status of HCWs in hospitals affiliated with Shiraz University of Medical Sciences, Iran.

This cross-sectional study was performed on 503 HCWs from five hospitals in Shiraz, including one COVID-19 front-line hospital, two COVID-19 second-line hospitals, and two without COVID-19 wards. Then, to assess the levels of anxiety, depression, insomnia, and post-traumatic stress disorder (PTSD) among HCWs, the Persian versions of the Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), and Global Psychotrauma Screen (GPS) questionnaires were placed, respectively.

The mean age of participants was 33.94±8.26 years, and 252 (50.1%) were females. Anxiety, depression, insomnia, and moderate to high levels of PTSD were observed in 40.4%, 37.8%, 24.5%, and 71% of participants, respectively. A history of mental disorders was associated with all four outcomes (P<0.05). Females gender and living with elderly and/or children were correlated with anxiety and PTSD (P<0.05). Working at COVID-19 front- and second-line hospitals were similarly linked to higher insomnia and PTSD levels (P<0.05). Also, working in COVID-19 wards or non-clinical settings was associated with anxiety and depression (P<0.05).

Most of the HCWs in this study may experience mental difficulties. Some factors may increase their risk of experiencing these difficulties. Hence, in the crisis era, mental health monitoring and identification of groups with predisposing factors are required to provide appropriate care as quickly as feasible.

The prevalence of pre-menopausal female infertility is increasing considerably due to various causes such as environmental pollutants, increased administration of chemotherapeutics and radiation exposure, microbial infections, and genetic/epigenetic alterations. However, the current therapeutical strategies remain unfavorite as the disadvantages are strongly challenging. Icariin (ICI) is a phytoestrogen that exerts some promising properties in order to alleviate female infertility. Therefore, the current literature review aimed to evaluate the conducted studies regarding the beneficial impacts of ICI on the female reproductive system and female fecundity. The findings of the present study revealed that ICI is able to modulate the levels of reproductive hormones as it causes a significant decrement in the levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) while increasing the levels of estrogen and progesterone. Furthermore, the administration of ICI results in a dramatic alteration in the expression of sex steroids’ receptors, particularly in female reproductive tissues. In addition, preserving ovarian follicular reserve, improving the ovarian and uterine histoarchitecture, elongating the estrous cycle duration, and eventually advancing the female fecundity are other major effects of ICI on the female reproductive system. Despite these desired beneficial properties, the current knowledge appears to be insufficient, hence further investigations, particularly on humans, are encouraged. To the best of our knowledge, this review provides a comprehensive information regarding the beneficial effects of Icariin on female infertility for the firs time

Exosomes are a subtype of natural extracellular vesicles that transfer a great number of biomolecules, released by almost all types of cells, and can be specifically taken up by recipient cells in order to maintain homeostasis and induce a proper response to stress or harsh environmental conditions. Since the heart is part of complex systems which involve various cell types, exosome-mediated communication plays a crucial role in the cardiovascular field. Given the extended studies on the molecular mechanisms mediated by exosome cargos, leading to cardiovascular diseases, we focus on the most important data that report the roles of proteins and microRNAs (miRNAs) transferred by exosomes and whether they possess cardiotoxicity or cardioprotection and also the potential of these biomolecules as therapeutic tools or diagnostic biomarkers.

Breast cancer is one of the most common malignancies and the second leading cause of cancer-related death in women. Approximately 75% of all breast cancers are estrogen receptor-positive (ER+ ) and highly responsive to endocrine therapy. MicroRNAs (miRNAs) are short non-coding RNA with a pivotal role in mammal cells by regulating gene expression. Hence, this study aimed to evaluate the miRNAs expression in various breast cancer subtypes.

In this study, after total RNA extraction and cDNA synthesis, expressions of miR-577, miR-505-3p, miR-3682-3p, and miR-4661-5p were investigated in 36 breast cancer samples of ER+ and ER- types and compared with 18 normal adjacent tissues by real-time polymerase chain reaction. Also, diagnostic values of miRNAs were determined based on receiver operating characteristic (ROC) by calculating the area under the curve (AUC).

Downregulation of miR-577 and miR-505-3p were detected in breast cancer samples, significantly in the ER+ subtype compared to ER- subtype (P<0.001). Also, we showed upregulation of miR-3682-3p and miR-4661-5p in breast cancer tissues compared to normal tissues. Compared to the ER+ subtype, the miR-3682-3p expression significantly decreased in the ER- subtype (P<0.001). However, there was no significant difference between ER+ and ER- subtypes in the term of miR-4661-5p (P˃0.05). The ROC analysis demonstrated that miR-577 and miR-505-3p have acceptable diagnostic values, and miR-3682-3p has a relatively proper diagnostic value in diagnosing breast cancer.

Our results revealed that miR-577 and miR-505- 3p could be used as biomarkers for the diagnosis of breast cancer, especially in ER+ subtype.

Liver and heart are two important organs in the human body, whose function strongly affects other organs. On the other hand, these two main organs affect each other due to common metabolic pathways. Therefore, a disorder in any of them can lead to disease in other organs. Today, using the network medicine perspective, these complex connections can be easily mapped and discovered. From the Persian medicine viewpoint, links are formed based on the material causes of diseases, while from the conventional medicine viewpoint, they are mostly formed due to metabolites, genes, and pathways.

In this article, we first investigated the recent articles of conventional medicine that examine the relationship between heart and liver in the important databases. Then, we checked out the sources of Persian medicine and finally, using the RStudio software used in network medicine for text mining, we drew the communication network centered on heart and liver and their mutual causes from the perspective of Persian Medicine.

Examining the network connection between the heart and the liver showed that the definitions based on Persian medicine, which are based on the material causes of diseases, are very compatible with the genes, metabolites and pathways between these two organs.

Understanding these concepts can be helpful in detecting the co-occurrence of diseases of these two organs, as well as predicting the possible occurrence of related diseases between the heart and liver, and ultimately in better treatment.

Evidence of COVID-19 respiratory sequels is restricted and predisposing factors are not well studied more than two years passing pandemic. This study followed COVID-19 patients 12 weeks after discharge from hospital for respiratory sequels.

This was a prospective study on discharged COVID-19 patients in 2021, in Jahrom, Iran. Exposure was COVID-19 clinical features at hospitalization, including symptoms and physical examination and laboratory findings, and primary endpoint was 12-week lung sequel, being evaluated by a chest CT scan. Demographics and previous medical history were considered covariates. SPO2 and CRP 6-week changes were followed as an early tool for prediction of 12-week lung sequel.

Totally, 383 participants (17 had sequels) with mean age of 57.43±18.03 years old (50.13% male) completed 12-week study follow-ups. Ninety-one (23.8%) subjects had an ICU admission history. SPO2% in 6th week was statistically significantly associated with a higher rate of 12-week sequelae (p<0.001). Also, patients having CT scan scores between 40% to 50% (p=0.012) and higher than 50% (p=0.040) had higher chance of experiencing lung sequelae than patients with CT scan score of below 40%, as well as having ICU admission history and lower SPO2% at 6th week of discharge. There was a statistically significant increasing trend of SPO2% (P<0.001) and a statistically significant decreasing trend of CRP levels (P<0.001), overall. SPO2% increase after 6 weeks was lower in participants with lung sequels than fully improved ones (P=0.002) and as well as total 12-week change in SPO2% (P=0.001). CRP changes in none of evaluated periods were different among study groups (P>0.05).

Our results were in favor of closely following SPO2 levels after patient discharge, while CRP assessment seems not helpful based on our results.

Cardiovascular disorders remain the leading cause of death around the world. Heart transplan-tation is considered the only therapeutic choice defined as the gold standard strategy to manage end-stage heart failure. Nevertheless, the remaining postoperative complications compromise both the survival rate and quality of life in heart transplantation recipients. The present study aimed to review the current findings concerning the main early complications after heart trans-plantation, reliable predictors, diagnostic approaches, novel surgical techniques, and manage-ment strategies. The results demonstrated that significant advances in immunosuppressive phar-maceuticals, determining appropriate policies for donor acceptance, pre- and post-operative treatment/care, selection of the most compatible donor with the recipient, and the suggestion of novel diagnostic and surgical techniques over the past decade had dropped the mortality and morbidity rates early after transplantation. However, marrhythmia, atrial flutter, atrial fibrilla-tion, deep sternal wound infection along with other sites infections, low cardiac output syn-drome, acute graft dysfunction, pericardial effusion, constrictive pericarditis, and acute cellular rejection could be considered as the major early complications following heart transplanta-tions that pivotally require further investigations.

Parents of children with intelligence and motor problems, including Down syndrome have to spend more time babysitting resulting in less intimacy with their mates. Solution-focused brief therapy is one of the treatments presented in the field of marital intimacy. This study aimed to investigate the effectiveness of solution-focused counseling on marital intimacy in mothers of children with Down syndrome.

In this randomized clinical trial study, 72 couples were selected among members of the Asemannili Society (Isfahan-Iran) from 19/01/2021 to 20/04/2021. The control group received an educational pamphlet for four sessions (without homework) every other week while the intervention group attended eight 90-minute online counseling programs once a week. Bagarozi Marital Intimacy Questionnaire was completed at baseline, after intervention (8th week), and follow-up period (12th week) by the women and their spouses.

The mean scores of marital intimacy between the two groups at baseline (online: 313.23 ± 70.86, pamphlet: 315.92 ± 41.45) compared to the 12th week (online: 370.13 ± 44.63, pamphlet: 332.42 ± 30.39) were significantly different. The analysis of the variance test with repeated observations showed that the effect of group, and time on the total score of marital intimacy and its other dimensions, were significant (P<0.05) for women.

Both online and pamphlet counseling can improve marital intimacy in mothers of children with Down syndrome, but online counseling appears to be more effective. Thus, this method is recommended for improving the marital intimacy of these women.

Sleep disorder is a common problem during pregnancy and a large percentage of pregnant women (especially in the third trimester of pregnancy) experience changes in their natural sleep pattern. Considering the fact that sleep disorder can cause many complications before, during and after childbirth, it is necessary to achieve good sleep quality during pregnancy. Therefore, the present research investigated the effect of mindfulness interventions on the quality of sleep among pregnant mothers in the second and third trimesters of pregnancy.

The present randomized clinical trial study used pre-education-post-education design in Sabzevar Health Center from 2019 to 2020 on all pregnant women referred for receiving prenatal care. A sample of 98 women who met the inclusion criteria were divided into intervention (n=50) and control groups (n=48). The sleep quality and depression anxiety and stress -21 (DASS-21) questionnaires, were completed by two groups at pre-test, post-test, and one month after the educational intervention. The intervention group received 6 sessions (1 hour and 30 minutes) of mindfulness lessons during 2 months, while the control group received routine pregnancy care and a mindfulness session was performed after completion of the post-education. Data was analyzed by SPSS software (version 20) and descriptive and repeated measures analysis were used.

Mindfulness interventions were effective in changing the sleep quality of pregnant mothers (P<0.05). Also, the mean scores of anxiety, stress and depression questionnaires of pregnant mothers, as confounding variables on sleep quality, was significantly changed during different stages of the study (P<0.05).

Mindfulness training significantly increased the sleep quality of pregnant mothers. Therefore, mindfulness interventions can be used as effective interventions in improving psychological wellbeing during pregnancy and also reducing the anxiety and stress of pregnant women.

Kelussia odoratissima (KO) and Angelica sinensis (AS) have been used in their indigenous traditional medicine, for various diseases. This study was conducted to evaluate the volatile oil composition of KO leaves (KVL) and AS root (AVR) and biological activity of essential oils (EOs) and hydroalcoholic extracts of both plants using two different transgenic zebrafish (Danio rerio) models.

Both EOs were isolated by hydrodistillation and analysed by GC and GC/MS. For viability tests, larvae were treated with different concentrations of extracts to determine an appropriate starting concentration. Hydroalcoholic extracts and EOs have been tested in a dose-dependent manner for their biological activity using tissue-specific transgenic zebrafish Tg(fli-1: EGFP) and Tg (ins: GFP-NTR) embryos and larvae. One-way ANOVA was used to compare the mean of pBC area and intersegmental vessels (ISVs) outgrowth between the treatment groups.

Eleven compounds were in common to both oils, comprising 51.3% of KVL and 61.7% of AVR, of which 39.3% in KVL and 37.6% in AVR were phthalide structures. Results revealed that both EOs blocked ISVs formation in the Tg (fli-1: EGFP) embryos increased to 10% of the control value, while both hydroalcoholic extracts did not show any anti-angiogenesis effects in these embryos. In addition, AVR has been shown to significantly induce PBC regeneration following ablation in the Tg (ins: GFP-NTR), but its regenerative activity was lower than that of 5′-N-ethylcarboxamidoadenosine (NECA) as a positive control. Taken together, the anti-angiogenesis activity of both EOs could be attributed to the phthalide structures while for the PBC regenerative activity, other compounds including β-Thujaplicinol, exclusively existing in AVR, might be effective.

Although the genera, organs, and origin of these plants are different, their similar chemical composition and biological activities make them valuable resources for further investigation in basic medical and pharmaceutical science.

In reproductive biology, testicular organoids can be used to treat infertility and to study testicular development and spermatogonial stem cells (SSCs) differentiation. Generating organoid from primary cells is challenging. In this study, testicular organoids were created using human primary testicular cells and evaluated the apoptotic gene expression and hormone secretion profiles of the organoids.

Primary human testicular cells were isolated using 2-step enzymatic digestion from three brain-dead donors. Immunocytochemistry and flow cytometry analyses were performed to confirm human SSCs. Isolated cells were cultured in three experimental groups: control group (2 dimensional (2D)), group 1 (organoid culture after 2D culture), and group 2 (organoid culture immediately after enzymatic digestion). Testicular organoids were cultured in DMEM/F-12 media supplemented with follicle-stimulating hormone (FSH) and fetal bovine serum (FBS) for four weeks. After 24 hours and four weeks of culture, reverse transcription quantitative real-time PCR (RT-qPCR) was used to investigate the relative expression of apoptotic genes (caspase 3, 9, Bax, and Bcl-2). At 24 hours, two weeks, and four weeks after culture, enzyme-linked immunoassay (ELISA) was used to determine the testosterone and inhibin B concentrations. Light microscopy and toluidine blue staining were also used for morphological analysis.

RT-qPCR results revealed that pro-apoptotic (caspase 3, 9, Bax) gene expression levels were highest in group 2 after 24 h and four weeks of culture. In contrast, the expression level of Bcl-2 (anti-apoptotic) was lower in group 2 compared to other groups. The hormone secretion levels decreased in a time-dependent manner during the cultivation. According to morphological evaluations, testicular organoids are compact, spherical structures with two to three elongated cells organized along their border.

Our findings revealed that the testicular organoid culture system maintained hormonal secretory abilities, demonstrating the function of Sertoli and Leydig cells in the absence of testis-specific environments.

Many hospitals globally have valuable experiences in preparing for man-agement and responding to infectious epidemics. Identifying and analyzing these expe-riences can provide comprehensive and practical data for decision-making and effec-tive performance. This study aimed to conduct a scoping review and content analysis of the best practices of hospital (private or public) management in epidemic conditions.

This research is a scoping review and content analy-sis, conducted in 2021. Data was collected by searching different databases, includ-ing Pubmed, Scopus, Web of Sciences, ProQuest, websites, search engines, and pub-lic reports without time limits. Content analysis was performed for data analysis.

We retrieved 8842 records from databases and other sources. Finally, 24 studies from 12 countries were selected for analysis. Most studies belonged to the United States (9 cas-es), and most subjects were on Coronavirus disease 2019 (Covid-19) (19 studies). We clas-sified the results into two major categories of in-hospital executive readiness and logistic readiness. Executive readiness included 11 main categories (physical structure, resource man-agement, exposure reduction, patients and caregivers’ management, corpse management, dis-infection, staff support, patient admission, instructions and guidelines, tele- communication, and education) and 26 sub-categories. Logistic readiness consisted of three major categories (leadership/team making, communication, and using capabilities) and five sub-categories.

Healthcare managers can use the identified categories and dimen-sions of managerial readiness and responsiveness as an action plan during an in-fectious disease epidemic.

Researchers and clinicians need to be aware of procedures that are more adaptable to new and different environments in premature infants; therefore, it is important to conduct a comprehensive review of the effect of aromatherapy on apnea attacks and oxygen saturation (SpO2) in premature newborns. In this review, databases such as PubMed, Scopus, Web of Science, and Cochrane Library were systematically searched without language and time limitations up to November 1, 2022. Initially, 153 studies were founded, and after duplicate removal, title as well as full-text review, seven studies were enrolled in the final analysis. Studies indicated that aromatherapy with Rosa damascena, vanilla, and breast milk odors could significantly reduce apneas in preterm infants and improve SpO2 levels. Hence, aromatherapy could consider as an effective adjuvant treatment for the reduction of apnea attacks among preterm infants.

The applications of nanotechnology have greatly increased in the recent years. Nanotechnology can be used for diagnosis and treatment of many conditions in medicine and dentistry. The aim of this paper is assessment the cytotoxicity of silver nanoparticles (AGNPs) synthesized employing Lactobacillus acidophilus against human oral squamous cell carcinoma (OSCC) cell line.

In this in vitro, experimental study, AgNPs were biologically synthesized by using L. acidophilus, and characterized by dynamic light scattering (DLS), scanning electron microscopy (SEM), transmission electron microscopy (TEM), ultraviolet-visible (UV-V) spectroscopy and Fourier-transform infrared (FTIR) spectroscopy. The methyl thiazolyl tetrazolium (MTT) test was performed to assess the cytotoxic effects of AgNPs in 3.125, 6.25, 12.5, 25, 50, and 100 μg/mL concentrations within 24 hours.

Synthesis of AgNPs was confirmed by visual perception of dark brown color variation (from achromatic) and maximum UV-V absorption at 428 nm. TEM and SEM indicated the spherical form of AgNPs with a median size of 397 nm. FTIR spectroscopy showed the presence of functional groups from the cells involved in the reduction process. The MTT assay indicated that the biosynthesized nanoparticles made a decrease of cell livability in a concentration dependent method.

AgNPs produced by Lactobacillus acidophilus have the potential to inhibit OSCC cell line.

Providing comprehensive nursing care and ensuring patient satisfaction are essential health performance indicators worldwide. Despite some efforts to improve patient satisfaction with nursing care, the approach in developing countries, including Ethiopia, remains insufficient. This study aimed to assess the level of adult patient satisfaction and identify the factors affecting satisfaction.

This cross-sectional study included 407 participants selected using a simple randomization technique. The samples were distributed using proportional allocation to each selected adult inpatient department. The participants were interviewed using a modified structured Amharic version of the Newcastle Satisfaction with Nursing Scale. Bivariate and multivariable logistic regression analyses were also performed.

The overall level of patient satisfaction with nursing care services was 54.3%. Respondents without formal education (P=0.010), male sex (P=0.041), free service consumers (P<0.001), and health insurance users (P<0.001) were significantly associated with satisfaction with nursing care. In addition, previously hospitalized patients (P=0.001), governmental workers (P<0.001), and patients admitted to the medical ward (P=0.010) were associated with patient dissatisfaction with nursing care services.

This study revealed that adult patient satisfaction with nursing care services is low. A previous admission history, higher education level, paying cash for services, and private and governmental workers were significant predisposing factors for dissatisfaction with nursing care. On the other hand, patients without formal education, free-service consumers, and male sex were significant predictors of satisfaction with nursing care services. Therefore, hospital administrators are encouraged to focus on patients’ needs and expectations.

Globally, acute myocardial infarction (AMI) is the leading cause of death. Early and precise di-agnosis is essential for medical care to enhance prognoses and reduce mortality. The diagnosis of AMI relies primarily on conventional circulating biomarkers. However, these markers have many drawbacks. Non-coding RNAs (ncRNAs) form a significant fraction of the transcriptome and have been shown to be essential for many biological processes, including the pathogenesis of the disease. ncRNAs can be utilized as biomarkers due to their important role in the disease’s development. The current manuscript describes recent progress on the role of ncRNAs as new AMI biomarkers.

Phacoemulsification is the main method of cataract surgery in developed countries. Due to the importance of appropriate analgesia and the immobility of the participants throughout the procedure, the study aimed to assess the impact of intranasal ketamine vs. intranasal fentanyl on the quality of sedation and analgesia in phacoemulsification surgery.

This double-blinded study was carried out on participants who underwent cataract surgery in Faiz Hospital, Isfahan, Iran. Eighty subjects were randomly assigned to two groups of 40 receiving ketamine at a dosage of 1.5 mg/kg intranasally (Intranasal Ketamine (INK) group) or fentanyl at 1.5 μg/kg nasally (Intranasal Fentanyl (INF) group). The drugs were administered through the nasal passage 15 minutes before the operation. The primary outcomes were a difference in the quality of sedation and pain relief between groups during the procedure and recovery unit. Secondary outcomes were cardiovascular parameters, side effects, the need for sedative rescues, and changes in vital signs.

During the study, 25 patients (62.5%) in the INK cohort and 19 patients (47.5%) in the INF cohort had no pain. In the INK group, 22 (55%) and in the INF group 20 (50.0%) patients achieved optimal sedation (Ramsay sedation score 4). There was no discernible disparity observed between the two cohorts in terms of the quality of sedation (P=0.071), receipt of rescue dosage of propofol (P=0.601), hemodynamic parameters (P>0.05), and side effects during treatment Operation (P=0.542) and in recovery (P=0.104), patient (P=0.098) and surgeon (P=0.120) satisfaction, operative time (P=0.082), and duration of stay in recovery (P=0.110).

Although INK was more effective than INF in reducing pain and achieving optimal sedation in cataract surgery, it was not significantly superior to INF.

Cardiovascular diseases (CVDs) are considered the most prevalent noncommunicable disease and the leading cause of death worldwide. A plethora of evidence has revealed that microRNAs (miRNAs) could control the inhibition or progression of CVDs by regulating pivotal cell pro-cesses ranging from metabolism and homeostasis to programmed cell death (PCD). Pyroptosis and ferroptosis are two major types of nonapoptotic PCDs involved in the pathogenesis of heart failure. However, no study has discussed the crosstalk between miRNAs and these two types of PCDs in the CVDs. The current review demonstrated that different types of miRNAs can regu-late both ferroptosis and pyroptosis and thereby affect CVDs progression and inhibition. Alto-gether, the discussed content encourages further studies to confirm that mentioned pathways are suitable to be considered as novel therapeutic approaches against CVDs.

While new studies are being published on the prehospital continuous positive airway pressure (CPAP) application in patients with respiratory failure with conflicting results, previous meta-analyses are showing the benefits of CPAP in the prehospital transfer of patients with respiratory distress. Before the clinical application of high-level evidence, updated pooled estimates are needed based on the growing literature. This study aimed to compare prehospital CPAP with the usual standard oxygen therapy of respiratory failure patients.

PRISMA guidelines served as the framework for this updated review study. It is an extension of a prior systematic review. We conducted comprehensive searches across several databases, including PubMed, Web of Science, Embase, and Scopus, focusing on randomized trials that juxtaposed pre-hospital CPAP application against standard care. Our primary interest was to assess the in-hospital mortality risks, and we employed random effect models to aggregate risk ratios from the selected studies.

Four articles were gathered based on the review of the updated literature (2013 to November 2022) in conjunction with the research incorporated in the preceding meta-analysis with a total number of 747 patients receiving prehospital CPAP with 101 events of in-hospital mortality. In the standard treatment control groups, there were 713 patients and 115 deaths occurred. Pooled mortality risk comparison between the group of prehospital CPAP and standard care patients had no statistically significant difference (P=0.16). There was no heterogenicity. A regression between the year of the studies and the effect size showed increased RR in new studies (P=0.017).

Still more randomized trials are needed with higher sample sizes to conclude the lifesaving efficacy of the out-of-hospital CPAP.

While there are multiple guidelines for the management of bleeding complications and hematoma if being treated with antithrombotic and anticoagulant drugs, these risks are not yet stratified for procedures with regional anesthesia.

This study was an umbrella review of systematic studies and meta-analysis based on PRISMA guidelines in databases of Scopus, PubMed, Medline, Cochrane Library, and Web of Science databases. Due to heterogeneity in evaluated outcomes and methods of studies, only the qualitative evidence synthesis was performed. AMSTAR checklist was used to assess the risk of bias in included systematic reviews.

After an extensive search of relevant studies, 971 primary cases were identified. Following a thorough screening process, 5 systematic reviews were selected. The evidence suggests that head and neck punctures generally do not result in bleeding complications, except for rare cases of hematoma associated with Infraclavicular brachial plexus block. A deep cervical plexus block is not recommended. Interscalene blocks have varying findings, with some studies reporting hematoma incidence and spinal injury, while others consider them low risk. Supraclavicular brachial plexus block might be associated with hemothorax and infraclavicular blocks are not favored by reviews. Axillary brachial plexus blocks have a minor incidence of hematoma. Abdomen blocks, TAP blocks, ilioinguinal blocks, and rectus sheath blocks carry a higher risk of hematoma. Pectoral nerve (PECS) blocks have a relatively high risk, while paravertebral and intercostal blocks are considered high risk, but further research is needed regarding paravertebral blocks.

The available evidence from systematic reviews and studies suggests varying levels of risk for different blocks and procedures that should be considered before decision-making.

Surgical or medical treatment for type B or descending aortic dissections with difficult presentation or stable hemodynamics is debatable. This study aimed to review the type B aortic dissection therapy to assess safety and effectiveness.

Online databases of PubMed, Science Direct, Web of Science, Cochrane, and Scopus were searched for relevant systematic reviews, guidelines, and meta-analysis studies on the management of type B aortic dissection, up to July 2023. The conclusions were qualitatively synthesized.

Best medical therapy (BMT], thoracic aortic endovascular repair (TEVAR), and open surgeries (OS) were management approaches. Hemodynamics classify type B aortic dissection as complex or simple. Both examples reveal decreased in-hospital all-cause mortality with TAVR than OS. Guidelines recommend TEVAR for difficult situations and OS if it fails. Complication analyses favour TEVAR, however left subclavian artery coverage without revascularization increases stroke risk. Studies show Type B aortic dissection is simpler than TEVAR and BMT. Acute or subacute presentation did not affect reintervention rates between treatments. TEVAR had a greater early stroke risk than BMT but a decreased long-term aortic-related and all-cause mortality. The best data showed no differences in in-hospital mortality or early re-intervention between regimens. BMT reduced early stroke but increased late all-cause death.

In conclusion, addressing Type B aortic dissection is complicated, depending on presentation and hemodynamics. TEVAR is best for difficult patients, however BMT and OS also work. TEVAR may reduce in-hospital mortality but increase early stroke risk.

In addition to biochemical gradients and transcriptional networks, cell be-haviour is controlled by endogenous bioelectrical signals resulting from the action of ion channels and pumps. Cells are regulated not only by their own membrane resting potential (Vmem) but also by the Vmem of neighbouring cells, establishing networks through electrical synapses known as gap junctions. V mem is the primary factor in producing a polarity that can regulate cell assimilation of various substances. This article aimed to examine how cell polarity can change and how variations in cell polarity may lead to clinical demonstrations.

Using Cochrane Central, PubMed, Scopus, Web of Sci-ence (WOS), and Embase, a comprehensive qualitative literature review was con-ducted from February 1, 2018, to February 1, 2023, to identify studies addressing bio-electric, cell polarity, and electroceuticals in patients with foot and ankle problems.

Out of 1,281 publications, 27 were included. One study investigated bioelectric wound-healing. Twenty-five studies examined bioelectric nerve cell growth, whereas one study evaluated bioelectricity-induced cellular differentiation in the treatment of arteriopathies.

The author of this systematic review support addressing the predisposing fac-tors and healing impediments for a disease, thereby enhancing the healing process and re-ducing the likelihood of recurrence or parallel conditions. This method of treatment has pro-vided a summary of evidence indicating that cell polarity could be addressed for the treat-ment and prevention of most if not all, foot and ankle problems. However, owing to the limitations of V mem and bioelectricity measurement and the direct or indirect involvement of genetics and chemical gradients, further studies are required to confirm these results.

Transfer energy capacitive and resistive (TECAR) therapy (TT) is a newly developed deep heating therapy that can generate heat within tissues through high-frequency wave stimulation. Compared to conventional physiotherapy methods, the application of TT especially in sports rehabilitation is becoming more popular. This study aimed to investigate the comparative effect of TT and therapeutic ultrasound (US) on hamstring muscle shortness. Additionally, the effects of TT with static stretching (SS) were compared with US combined with SS.

Totally, 39 male athletes with hamstring shortness were randomly assigned into three groups: A, B, and C. Group A received 15 minutes of TT plus SS, while Group B received 15 minutes of US with SS, and Group C only performed SS. Hamstring flexibility was measured by active knee extension (AKE), passive knee extension (PKE), and the sit and Reach (SR) tests before the intervention, and following the first, and third treatment sessions.

The range of motion of the AKE and PKE, and displacement range in the SR test improved significantly after the first and third sessions in all three groups (P<0.0001). The improvement of the three flexibility indices in the TT group was greater than in the other two groups.

The present study showed that TT could increase the flexibility of hamstring muscles more than US therapy. However, TT in combination with SS had a similar effect to SS alone.

Ischemic stroke is a leading cause of morbidity and mortality worldwide, necessitating advancements in early diagnosis and treatment modalities. This review aims to provide an overview of recent advances in the early diagnosis and treatment of ischemic stroke, highlighting the importance of the potential impact on patient outcomes. Recent advancements have focused on various aspects of stroke care, including imaging techniques, laboratory testing, telemedicine and mobile technology, intravenous thrombolysis, mechanical thrombectomy, and collaborative systems. Advances in imaging techniques have played a pivotal role in the early diagnosis of ischemic stroke. Computed tomography perfusion imaging, advanced magnetic resonance imaging (MRI) techniques, multimodal imaging, and automated image processing tools have greatly improved the ability to assess the extent of ischemic injury. Laboratory testing has seen significant progress in identifying biomarkers associated with ischemic stroke. High-sensitivity cardiac troponin assays have improved our understanding of the cardiac component of stroke. Additionally, biomarkers such as S100B, glial fibrillary acidic protein, and neuron-specific enolase have shown promise in assessing stroke severity and prognosis. Mobile applications and wearable devices facilitate stroke symptom recognition, risk assessment, and prompt medical attention. The development of tenecteplase, a modified form of tissue plasminogen activator, has enhanced clot-dissolving efficacy. Collaborative systems, including regional stroke systems of care and telestroke networks, have optimized communication and coordination among healthcare providers. Interoperable electronic health records streamline information exchange and facilitate prompt decision-making. Mobile communication technologies enhance real-time collaboration, involving all stakeholders in stroke care. Future directions focus on artificial intelligence and machine learning algorithms for stroke diagnosis and risk assessment. Wearable devices and remote monitoring may enable continuous monitoring of stroke-related indicators. Overall, advances in early diagnosis and treatment of ischemic stroke can enhance stroke care, reduce treatment delays, and improve patient outcomes.

Co-occurring mental health disorders (MHDs) and alcohol use disorders (AUDs) challenge healthcare professionals. The complexity of these conditions can hinder accurate diagnosis and effective treatment. Therefore, it is crucial for healthcare professionals to be aware of the po-tential for co-occurring disorders and to provide appropriate care. Evidence-based interventions in nursing are critical in managing these disorders and improving patient outcomes. Nurses must be trained in these interventions to provide optimal care for patients with co-occurring disorders. Patients should be encouraged to disclose any substance use or mental health issues to ensure they receive the best care possible. This review provides a comprehensive overview of nursing interventions for managing MHDs and AUDs. Nursing care is pivotal in managing these disorders, and interventions can significantly improve patient outcomes. By unifying the style and using clear, concise, and appropriate language for a scientific audience, this review aims to clarify the importance of nursing interventions in managing co-occurring MHDs and AUDs.

Traumatic subarachnoid hemorrhage (tSAH) is a critical condition that requires comprehensive management to optimize patient outcomes. Nursing care plays a key role in the overall management of patients with tSAH via various aspects of care, including neurological assessment, monitoring, intervention, and education. In this review, we aim to evaluate the significant contributions of nursing care in managing patients with tSAH. Nurses perform initial neurological assessments, including the glasgow coma scale, pupil reactivity, vital signs, and sensory-motor evaluations. These assessments provide valuable information for early identification of deteriorating neurological status and prompt intervention. Additionally, nurses closely monitor intracranial pressure (ICP), cerebral perfusion pressure, and other hemodynamic parameters, assisting in the prevention and timely detection of secondary brain injury. For example, some strategies to manage ICP include elevating the head of the bed, maintaining adequate oxygenation and ventilation, administering proper medications, and ensuring fluid and electrolyte balance. Also, through careful monitoring, early recognition, and appropriate preventive measures, nursing care could prevent complications, including infections, deep vein thrombosis, and pressure ulcers. Furthermore, nursing care extends beyond physical management and encompasses psychosocial support for patients and their families. Nurses establish therapeutic relationships, providing emotional support, education, and counseling to alleviate anxiety, address concerns, and facilitate coping mechanisms. Education regarding medication management, lifestyle modifications, and the importance of regular follow-up enhances patient compliance and promotes long-term recovery.

Over the past few decades, significant progress has been made in the management of hu-man epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) due to the de-velopment of targeted therapies. However, HER2-positive BC is an aggressive subtype, posing significant challenges, including treatment resistance and disease recurrence. Cur-rent standard treatment options for HER2-positive BC include combinations of chemother-apy drugs, targeted therapies such as trastuzumab and pertuzumab, and hormone therapies. However, some important limitations of these treatments, such as resistance and adverse effects, are reported. Also, we showed emerging therapeutic options, such as novel chemo-therapy agents, antibody-drug conjugates, and immune checkpoint inhibitors, and discussed their mechanisms of action, potential benefits, and potential future directions in the field.

Overweight and obesity are the most critical risk factors for chronic diseases. The quality of dietary fatty acids as one of the factors affecting fat accumulation has received little attention. This study investigates the association between dietary linoleic acid (LA) and alpha-linolenic acid (ALA) with body fat indices in a sample of healthy Iranian adults.

In this cohort-based cross-sectional study, 3,195 individuals aged 20 to 60 who participated in the Shiraz University of Medical Science Employees Health Cohort study were included. Dietary intake was assessed using a validated 118-item Food Frequency Questionnaire (FFQ), and body composition was assessed by the bioelectrical impedance analysis method. Multiple linear regression adjusted for relevant confounders was used to determine the associations.

Mean dietary intake of LA was 14.20 ± 7.01 mg/day for men and 13.90 ± 6.71 mg/day for women. Additionally, the daily intake of ALA was 0.18 ± 0.18 mg/day in men and 0.17 ± 0.19 mg/day in women. Dietary intake of ALA for men had an inversely significant association with body fat mass (BFM) (β: -0.585, 95% CI: -1.137, -0.032, P=0.038), percentage of body fat (PBF) (β: -0.537, 95% CI: -0.945, -0.129, P=0.010), Visceral Fat Area (VFA) (β: -2.998, 95% CI: -5.695, -0.302, P=0.029), and Waist to Hip Ratio (WHR) (β: -0.689, 95% CI: -1.339, -0.040, P=0.038).

Higher dietary ALA intake was associated with lower BFM, BFP, VAF, and WHR in men. The present study confirms that ALA intake should be considered a preventive treatment to improve body composition. However, further research is recommended in this regard.

Aeromonas hydrophila is a pathogenic bacterium responsible for various infections in humans and animals. Bacterial exoproteases are considered an important determinant in the pathogenicity of A. hydrophila. Serine protease and metalloprotease, that are regulated by the bacterial Quorum sensing (QS) system are important virulent factors in the pathogenicity of A. hydrophila. Anti-QS potential of curcumin has been reported, previously. In this work, we characterized the effect of curcumin on the expression of the metalloprotease and serine protease genes in A. hydrophila.

The minimum inhibitory concentration (MIC) of curcumin was measured by the agar macro-dilution method and a sub-inhibitory concentration (1/2 MIC) was used in subsequent experiments. The expression level of the metalloprotease and serine protease genes among the treated and control bacteria was evaluated using quantitative PCR (qPCR) assay. Bacterial proteolytic activity was also measured by skim milk agar plate assay.

MIC of curcumin for bacterial strain was 1024 μg/ml curcumin, and at 512 µg/mL (1/2 MIC) it remarkably attenuated the expression of the metalloprotease and serine protease genes up to 66 and 77%, respectively. Also, the proteolytic activity of A. hydrophila was considerably reduced by curcumin.

Due to the promising inhibitory effect on bacterial proteolysis, curcumin could be considered an anti-virulence agent against A. hydrophila.

Delirium and dementia are considered to be the most significant postoperative neurocognitive complications in patients undergoing cardiac surgery, particularly those aged 60 years and older, which reduces the post-surgery quality of life, prolongs hospitalization, increases costs, and ele-vated the rates of mortality. Nevertheless, the etiology, risk factors, and predictive biomarkers, have not been well elucidated particularly, in patients with unmanifested underline cognitive im-pairments. The present study aimed to review the findings on the etiology, factors increasing the risk of incidence, and predictive biomarkers of postoperative delirium and dementia after cardiac surgery, and to describe the suggested pharmacological and non-pharmacological interventions.

Breast cancer (BC) is the major cause of cancer-related death in women. Some studies have indicated the cytotoxic effects of vanadyl oxide sulfate (VOSO4). This study aimed to evaluate the anti-cancer effect of VOSO4 in the treatment of MCF-7 cell lines.

The MCF-7 cell line was treated with different concentrations of VOSO4 for 24 and 48 hours. Cell death was measured using the MTT assay. The cell apoptosis rate was measured using Annexin V/Propidium Iodide assay through flow cytometry. Also, the expression levels of p53, P21, Caspase8, superoxide dismutase type 1 (SOD1), Sod2, and Bcl2 mRNAs were assessed, and Western blotting was performed for Sod1 protein.

The results showed that the half-maximal inhibitory concentration (IC50) for VOSO4 was 25 and 20 μg/ml for 24 and 48 hours, respectively. Indeed, VOSO4 has dose-dependent cytotoxic effects on the MCF-7. Also, after exposure to VOSO4 for 24 hours, cell apoptosis reached 52% compared with untreated cells. Moreover, after 24 hours of exposure to VOSO4 with IC50 concentration, the expression of p53, P21, Caspase8, Sod1, and Sod2 mRNAs increased (P<0.05), and the expression of Bcl2 mRNA was decreased (P<0.05). Also, the Western blotting revealed Sod1 protein level markedly increased following exposure to VOSO4 (P<0.05).

Our results demonstrated that VOSO4 has an apoptotic and cytotoxic effect on BC cells. Therefore, it could be considered a complementary agent for the medical treatment of patients with BC.

Recent advances in artificial intelligence (AI) have shown great promise in the diagnosis, prediction, treatment plans, and monitoring the progression of neurodegenerative disorders. AI algorithms can analyze large amounts of data from various sources, including medical images, quantifiable proteins in urine, blood, and cerebrospinal fluid (CSF), genetic information, clinical records, Electroencephalography (EEG) signals, driving behaviors, etc. Alzheimer's disease as one of the most common neurodegenerative disorders. This study specifically explores the possible application of AI in the diagnosis, prediction, monitoring of disease progression, classifying, finding new biomarkers and drugs, and personalizing treatment plans of AD.

Mizaj is a fundamental concept in traditional Persian medicine (TPM) that explains the physiological and psychological traits of human beings. This study aimed to investigate the association between the ABO/Rh blood groups and the Mizaj.

This cross-sectional study was conducted on 18-60 years old individuals who visited the Iranian Blood Transfusion Organization, Shiraz Branch. We used Mojahedi’s Mizaj questionnaire to determine the Mizaj of the participants. The participants’ blood group and Rh were determined based on the antibodies against types A, B, and Rh antigens of their blood.

We assessed 308 individuals consisting of 174 (56.49%) male and 134 (43.51%) female. The results of our study showed a significant relationship between the AB blood group and the cold Mizaj in both simple and compound Mizaj categories (P=0.012, P=0.014, respectively). Logistic regression analysis revealed that people with the AB blood group were 2.88 times more likely to have cold Mizaj than people with the O blood group (OR=2.88, 95% CI: 1.16 to 7.15). In addition, those with the A blood group were found to be 54% less likely to have a dry Mizaj than those with the O blood group (OR=0.46, 95% CI: 0.23 to 0.92). There was no significant association between the participants’ Mizaj and their Rh blood group (P>0.05).

It seems that there was a significant relation between the AB blood group and cold Mizaj, as well as the A blood group and dry Mizaj. However, further studies are recommended with controlling the probable confounding factors.

Tuberculosis (TB) treatment through Directly Observed Therapy (DOT) has an alternative form of video surveillance therapy (VOT) that utilizes the technological capabilities of smartphones to provide patients with low-cost access to doctors without impacting their work and personal life. We aimed to assess TB patients’ drug compliance, perceptions, and feasibility towards smartphone-based video direct observed therapy (VDOT) in Jeddah, KSA.

We conducted a prospective non-randomized interventional study. We delivered smartphone-based VDOT among previously unstudied patients to monitor adherence to the treatment regimen. The expected total number of VDOT sessions was1200. We conducted post-intervention interviews to assess acceptability and satisfaction.

In this study, we included 20 participants, 16 of whom were males, with a mean age of 34.3 (±12.5) years. No side effects to the treatments were identified in all participants. The adherence rate for the total period was 93% and 99.5%, measured by the first and second methods, respectively. Most participants were satisfied with the VDOT experience, the time spent on sessions, and the approach’s privacy.

This study provides promising results for the feasibility and effectiveness of smartphone-based VDOT for TB treatment to increase adherence which was indicated by a high compliance rate, acceptability, and high satisfaction level.

Social anxiety disorder (SAD), known as social phobia, is considered a prevalent psychiatric disorder characterized by a constant fear of social positions. Frequently, social phobia occurs with other mental disorders including depression and substance abuse conditions. Although SAD is considered one of the most common types of mental disorders, proper management may be compromised in recurrent psychiatric comorbidity due to clinicians’ focus on secondary complications. Moreover, despite the description of social phobia as a polygenic and complex condition, few altered genetic and epigenetic factors are identified as causative agents. Over the past decades, several studies have suggested polymorphisms in serotonergic and dopaminergic-related genes as the etiology of social phobia. Serotonin, on the other hand, as a necessary neurotransmitter in the central nervous system (CNS), is involved in a variety of disease processes including social phobia. Nevertheless, the exact mechanism of serotonin-dependent development of the disease and the efficacy of suggested pharmacotherapies are not fully understood. The current study aimed to review the serotonin-dependent mechanisms by which SAD develops and discuss the current suggested strategies that are based on serotonin metabolism.

Takotsubo cardiomyopathy accounts for 1% of acute coronary syndrome presentations and has been increasingly recognized.1 Reverse Takotsubo cardiomyopathy, a variant form of Takotsubo cardiomyopathy has been described which presents with hyperdynamic function of the apical segments and hypokinesis of the basal or mid-ventricular segments, is the rarest type of acute stress cardiomyopathy, with mid-ventricular akinesia and preservation of apical and basal contractility.2

Case Report:

We report the rare case of an elderly lady admitted to our intensive care unit (ICU) with acute respiratory failure due to exacerbation of chronic obstructive lung disease and heart failure. Echocardiography revealed reverse Takotsubo cardiomyopathy. Cardiac catheterization showed nonobstructive coronary artery disease. The wall motion abnormalities resolved in 2 weeks. The case is unique in that she had an identical presentation one year earlier after she had entered the same dusty room! 

This case demonstrates that reverse Takotsubo cardiomyopathy with identical wall motion abnormalities can recur in a patient when re-exposed to similar stressful situation. Early recognition and appropriate management can prevent catastrophic outcomes.

Schizophrenia (SZ) is a severe psychiatric disorder associated with a dysregulation of the immune system. Immune-related genes and environmental factors including stress, food, infections, and microbiota, alter the immune system’s homeostasis and play a role in SZ pathogenesis. The most distinctive feature in the pathophysiology of the disease is a shift in the T helper 1(Th1)/Th2 balance toward Th2 dominance in the immune system. Also, microglial and Th17 cell activation cause inflammatory responses in the central nervous system (CNS). Antibodies play a role in the pathophysiology of SZ and give more evidence of a link between humoral immune reactivity and the disease. Accordingly, an imbalance in cytokine activities and neuroinflammation has been considered the main contributor to the pathogenesis of the SZ. Overall, the deregulation of the immune system caused by genetic, environmental, and neurochemical effects may all play a role in the etiology of SZ. This review summarized the etiological factors for SZ and discussed the role of immune responses and their interaction with genetic and environmental factors in SZ pathogenesis.

Heart failure (HF), a worldwide epidemic with significant morbidity and mortality risks, is frequently secondary to cardiovascular disorders and probably is the common final way to survive patients. Almost 25% of hospitalized patients with acute HF are expected to be readmitted within 30 days post-discharge, and the rates of rehospitalization increase to almost one-third at 60 days and 60 percent within one year of discharge. Although care planning for patients with heart failure is complex, multidisciplinary, and resource-dependent, optimal self-care management along with appropriate educational intervention and follow-up strategy could be able to reduce readmissions, decline the duration of hospitalization, increase life expectancy, decrease the rates of mortality, and reduce costs of healthcare services for patients with HF. However, there are contradictions in previous reports about the efficacy of self-care, mainly due to patients’ non-adherence to self-care behaviors. Therefore, the current study aimed to review the investigations on the effectiveness of self-care of HF patients in reducing hospital readmissions and increasing quality of life, and discuss novel approaches for predischarge educational interventions and postdischarge follow-up strategies.

The purpose of this study was to assess the prognostic value of the monocyte-to-high-density lipoprotein ratio (MHR) as a marker of inflammation in patients diagnosed with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).

This retrospective cross-sectional study was conducted on patients with a diagnosis of STEMI who underwent PCI between March 2021 and March 2022 at Madani Training and Research Hospital in Tabriz, Iran. Data regarding clinical and demographic properties, and laboratory parameters were obtained from medical records. Patients were categorized into two groups according to the median of admission MHR.

The study population consisted of 652 patients, 378 males (58%), and 275 females (42%), with a median age of 68 years (interquartile range: 57-77). Results showed that groups with higher MHR (&gt;15.59) had higher rates of in-hospital mortality and higher major adverse cardiovascular events (MACEs) in comparison with the group featuring lower MHR (&lt;15.59). Receiver operating characteristic (ROC) curves demonstrated that MHR could predict in-hospital mortality with a 75.7% sensitivity and 53.5% specificity, as well as predict MACE with 60.2% sensitivity and 59.7% specificity. Multivariate analyses indicated that MHR is an independent predictor of both in-hospital mortality (OR 1.05, 95% CI 1.02-1.08, P=0.002) and MACE (OR 1.05, 95% CI 1.02-1.08, P&lt;0.001).

This research indicated that the rise in MHR was independently associated with a higher risk of MACE and in-hospital mortality in STEMI patients undergoing primary PCI.

Thymoquinone (TQ) has some beneficial roles in bone repair. Local administration of the drugs by loading them into a scaffold leads to releasing higher concentrations of a drug in the appropriate position. This study was conducted to evaluate the effects of the local administration of TQ loaded in an alginate scaffold on bone regeneration in rabbit mandibular defect.

In this experimental study, male rabbits with mandible defect were divided into 3 groups that received either alginate containing 50µM TQ, alginate or remained untreated. Then each group was subdivided into 2 groups that followed for 4 and 8 weeks (n=5). The radiological opacity, histopathology, and histomorphometrical analysis were done and data were analyzed by ANOVA and Tukey.

Radiological examination indicated that the presence of TQ had no significant effect on the turbidity of the images (P=0.595). TQ treatment significantly increased the bone area after 4 (P=0.011, P=0.0021, respectively) and 8 weeks (8w P=0.019, P<0.001, respectively) compared to alginate-treated and control defects. TQ also elevated the number of osteocytes (4wP<0.001, P=0.001 and 8w P<0.001, P<0.001, respectively) and osteoblasts (P<0.001, P<0.001, respectively) compared to the group receiving alginate and control. However, at 8 weeks, the number of osteoblasts was statistically similar in all the groups. In this week, although the average number of osteoblasts in the defects treated with TQ was significantly higher than the control group (P=0.01), it was similar to the group that received alginate.

It seems that alginate containing TQ has positive effects on bone healing. TQ can be suggested as a good additive to improve bone healing and accelerate bone repair.

Calcifying epithelial odontogenic tumor (CEOT) and ameloblastoma are types of odontogenic tumors accounting for 1%, and 10% of all the odontogenic tumors. While sharing same odontogenic origin, these tumors are found to exhibit distinct clinicopathological features. In the present study, we present the third hybrid CEOT/Ameloblastoma tumor ever reported. The current CEOT/Amelobastoma is occurred after a previously operated CEOT in the same area. The patient was refered with distict clinical features of swelling and paresthesia. In the radiographic examination, a unilocular lesion with mixed internal structure and ambiguous periphery was seen which exhibited buccal and lingual cortical expansion, thining, and perforation as well as inferior alveolar canal perforation. The histopathology results suggested a CEOT/Ameloblastoma lesion. After the tumor removal, the patient was set up for further follow-ups and maxillofacial prosthesis.

Multiple studies have investigated the serum concentrations of calcium (Ca) and magnesium (Mg) in preeclampsia, but the results have been contradictory. The objective of this systematic review and meta-analysis was to examine the association between serum calcium and magnesium levels in patients with preeclampsia and those in the healthy pregnancies.

A comprehensive search was conducted in various online databases, including PubMed/Medline, Scopus, Embase, Web of Sciences, and Cochrane library to identify relevant studies on Ca and Mg levels in preeclampsia up to July 2023. Inter-study heterogeneity across the included studies was assessed using the chi-square test and I2 statistic. Pooled effect size (ES) was calculated as weighted mean differences (WMDs) with corresponding 95% confidence intervals (CI).

A total of 76 articles (comprising 92 studies) were included, with a combined sample size of 10,482 participants (preeclampsia: n=3,991; controls: n=6,491). The random-effects model revealed significantly lower levels of calcium (WMD=-0.807 mg/dL, 95% CI: -0.983, -0.632, P<0.01) and magnesium (WMD=-0.215, 95% CI: -0.338, -0.092, P<0.01) in women with pre-eclampsia compared to the control group. However, the overall pooled WMD for calcium and magnesium levels did not significantly change when individual studies were excluded one by one.

This meta-analysis demonstrates that the circulating levels of calcium and magnesium in patients with preeclampsia are significantly lower than those in the control group.

Multiple sclerosis (MS) affects the central nervous system and creates plaques by demyelination of neurons. Several studies have investigated the effect of selective serotonin reuptake inhibitors (SSRIs) on MS clinical courses. The current meta-analysis was conducted to determine the effect of SSRIs on neurological and depressive symptoms of MS disease based on a systematic review and meta-analysis of randomized controlled trials.

We searched the PubMed/Medline, Scopus, EMBASE, Google scholar, Web of Science, and Cochrane Library until June 2023. The effects of SSRI were assessed through indictors such as symbol digit modalities test (SDMT), expanded disability status scale (EDSS), modified fatigue impact scale (MFIS), and Beck’s depression inventory/psychiatric (BDI).

Considering the inclusion criteria, seven articles (including eight trials) were included in this review. The meta-analysis results demonstrated that SSRIs treatments did not have significant effects on indicators of neurological and depressive symptoms, such as SDMT (Weighted Mean Difference (WMD)=-0.87; 95% CI, -7.74, 5.99, P=0.35; I2=0.0%), EDSS (WMD=-0.05; 95% CI, -0.24, 0.14, P=0.62; I2=0.0%), MFIS (WMD=5.29; 95% CI, -18.10, 28.68, P=0.21; I2=0.0%), and BDI (WMD=-0.47; 95% CI, -2.61, 1.67, P=0.67; I2=32.05%) in patients with MS compared with controls.

This study shows that the consumption of SSRIs in MS patients compared to the control group does not bring about a significant change in the indices related to neurological and depressive symptoms. Further meta-analyses are required in order to provide stronger evidence in the future.

Artificial Intelligence (AI) is rapidly transforming various aspects of healthcare, including the field of diagnostics and treatment of diseases. This review article aimed to provide an in-depth analysis of the impact of AI, especially, radiomics in the diagnosis of neuro-oncology diseases. Indeed, it is a multidimensional task that requires the integration of clinical assessment, neuroimaging techniques, and emerging technologies like AI and radiomics. The advancements in these fields have the potential to revolutionize the accuracy, efficiency, and personalized approach to diagnosing neuro-oncology diseases, leading to improved patient outcomes and enhanced overall neurologic care. However, AI has some limitations, and ethical challenges should be addressed via future research.