Journal of Current Biomedical Reports (J Curr Biomed Rep)
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Adjuvant topical dorzolamide or timolol with intravitreal bevacizumab for diabetic macular edema: A double-blind randomized controlled trial
Get PDFDiabetic macular edema (DME) is a leading cause of visual impairment among diabetic patients, primarily managed with intravitreal anti-VEGF agents such as bevacizumab. However, the exploration of adjunctive therapies to enhance treatment outcomes remains an area of ongoing research. This study investigated the effects of adjuvant topical dorzolamide or timolol in combination with intravitreal Bevacizumab (IVB) injections for treating DME. In this study, 34 patients (68 eyes) with bilateral DME were randomized to receive either topical dorzolamide 2% or timolol 0.5% in one eye, along with IVB injections in both eyes. The contralateral eye served as a control, receiving only IVB injections. Central macular thickness (CMT) and visual acuity (VA) were assessed at baseline and one month after the third injection. Results showed statistically significant decreases in CMT for all three groups (dorzolamide, timolol, and control) post-treatment compared to baseline (p < 0.001). Similarly, VA decreased significantly in all groups (p < 0.001). However, there were no statistically significant differences in CMT or VA between the dorzolamide or timolol groups and the control group. Our findings suggest that the addition of topical dorzolamide or timolol to IVB injections does not provide significant additional benefits in reducing CMT or improving VA in DME patients. Further research with larger cohorts and extended follow-up periods is needed to fully elucidate the potential role of adjunctive topical therapy in DME management and to identify patient subgroups that may benefit from this approach
Medical-grade honey as an antimicrobial agent against Helicobacter pylori: A review of current evidence
Get PDFHoney, a natural product of apian biology, has been recognized for its medicinal properties for centuries. The bioactive compounds present in honey, particularly those found in mono-floral varieties, exhibit antimicrobial, anti-inflammatory, and antioxidant activities. These properties have been demonstrated to synergistically interact, allowing honey to effectively combat a range of microorganisms, including multidrug-resistant bacteria. This review focuses on the antimicrobial properties of medical-grade honey, with a specific emphasis on its potential to inhibit the growth and gene expression of Helicobacter pylori, a bacterium responsible for gastric ulcers and gastric cancer
Pre-transplant CMV and EBV seroprevalence in liver transplant candidates in northern Iran
Get PDFViral infections, such as cytomegalovirus (CMV) and Epstein-Barr virus (EBV), contribute to the low survival rates of liver transplant patients. This study aimed to assess the prevalence of CMV and EBV infections in patients awaiting liver transplantation. Utilizing a census sampling approach, this cross-sectional study examined all cases of viral infections from 2016 to 2021 among liver transplant patients referred to Rasht liver transplant center, the North of Iran. The diagnosis of a recent primary viral infection was established by IgM positivity. In total, 34 individuals with a mean age of 48.9±12.2 years were included in the study. Of these, 40 individuals (59.7%) were male. The prevalence of CMV IgM and IgG antibodies among liver transplant candidates was 7.5%, and 97%, respectively. Also, the prevalence of EBV IgM and IgG antibodies was 7.5%, and 97%, respectively. The average serum vitamin D level in CMV IgM-negative patients was 30.7±17.2 compared to 55.1±22.1 in CMV IgM-positive patients (p = 0.011). The prevalence of active CMV and EBV infections in liver transplant patients was found to be 7.5%. These results highlight the necessity for continuous and effective strategies to prevent infection-related complications through prompt diagnosis and treatment, which are crucial for positive liver transplant outcomes
Surveillance of nosocomial infections in kidney and liver transplant recipients in Rasht, Northern Iran
Get PDFSolid organ transplant (SOT) recipients are at heightened risk of hospital-acquired infections (HAIs) due to immunosuppressive therapy and frequent exposure to invasive procedures. HAIs, particularly those caused by multidrug-resistant (MDR) organisms, remain a major source of morbidity, prolonged hospitalization, and mortality in this population. Despite the global significance of this issue, regional data on post-transplant HAIs and antimicrobial resistance in Northern Iran remain limited. This study aimed to investigate the prevalence, microbial etiology, and antibiotic resistance patterns of HAIs among kidney and liver transplant recipients at a tertiary referral hospital in Rasht, Iran. A retrospective cross-sectional study was conducted at Razi Hospital from March, 2018, to February, 2023. Clinical, microbiological, and demographic data were collected for transplant recipients diagnosed with HAIs ≥48 hours after hospital admission. Among 141 transplant recipients, 14 (9.9%) developed confirmed HAIs. urinary tract infections were the most prevalent (57.1%), followed by bloodstream infections (21.4%), ventilator-associated pneumonia (14.3%), and surgical site infections (7.1%). The most frequently isolated organism was Escherichia coli (42.9%), followed by Staphylococcus spp., Acinetobacter spp., Citrobacter spp., and Klebsiella spp. (each 14.3%). Antimicrobial susceptibility testing revealed diverse resistance patterns among the isolated organisms; however, the rates of drug resistance among Gram-negative bacteria was high. This study highlights a moderate prevalence of nosocomial infections among transplant recipients in Northern Iran, with Gram-negative MDR pathogens posing significant therapeutic challenges. These findings emphasize the need for enhanced infection control policies, continuous microbiological surveillance, and locally informed antimicrobial stewardship programs to improve outcomes in transplant populations
A decade of wild mushroom poisoning: Clinical and laboratory insights from Northern Iran
Get PDFWild mushroom poisoning remains a significant public health concern in regions where foraging is common. Limited long-term data exist for northern Iran, despite its high-risk ecological and cultural context. The present study aims to characterize the clinical and laboratory features of patients hospitalized for mushroom poisoning over a ten-year period in northern Iran. This descriptive cross-sectional study reviewed all cases of confirmed wild mushroom poisoning admitted to the Toxicology Department of Razi Hospital, Rasht, Iran, from March 2012 to March 2022. Data on demographics, medical history, exposure characteristics, clinical manifestations, laboratory findings, and outcomes were collected from hospital records and analyzed using descriptive statistics. A total of 165 patients were included (mean age 44.57 ± 16.02 years; 50.9% male). Housewives (43.0%) and self-employed individuals (29.1%) were the most affected occupational groups. Most patients (60.6%) resided in urban areas. The mean time from ingestion to hospital presentation was 9.01 ± 10.71 hours. Vomiting (90.9%) and nausea (73.3%) were the most frequent symptoms. Laboratory tests showed variable hepatic involvement, with mean AST and ALT levels of 45.72 ± 94.95 U/L and 44.02 ± 93.30 U/L, respectively. The mean length of hospital stay was 1.93 ± 1.45 days. Four patients (2.4%) died, 97.6% recovered and were discharged. Wild mushroom poisoning in northern Iran affects a wide demographic spectrum and is characterized predominantly by early gastrointestinal symptoms. Although most patients recover, the potential for severe hepatotoxicity and mortality underscores the need for preventive education, and careful inpatient monitoring to detect delayed complications
The prevalence of dysplasia and associated factors in patients with atypical melanocytic nevus
Get PDFMelanocytic nevi or moles, are benign proliferations of melanocytes that can appear anywhere on the skin. While most atypical melanocytic nevi are harmless, some may develop dysplastic changes. This cross-sectional study assessed the frequency of dysplasia and related factors in patients with atypical melanocytic nevi. Seventy-one patients clinically suspected of having atypical nevi underwent biopsy. Diagnoses were confirmed by a dermatologist, and histopathological assessments were performed by a pathologist. Demographic and clinical data, including lesion location, were documented. The mean patient age was 42.47 ± 15.27 years; 42 patients were female. Sixty-five cases (91.5%) were confirmed as melanocytic nevi, while 6 cases (8.5%) were non-melanocytic. Dysplasia was found in 2 female patients (3.1%). Lesion distribution was predominantly on the head and face (63.1%), followed by the trunk (26.2%). These findings indicate that most clinically suspected atypical melanocytic nevi are benign, with a low rate of dysplasia in this sample
Cerebral and hemodynamic responses in elderly patients during laparoscopic cholecystectomy: A cross-sectional study
Get PDFLaparoscopic cholecystectomy is among the most frequently performed abdominal surgeries in the elderly population. However, the physiological changes in hemodynamic and cerebral parameters induced by pneumoperitoneum and the head-up (reverse Trendelenburg) position present notable clinical challenges in this age group. This cross-sectional study aimed to evaluate alterations in cerebral oxygenation and hemodynamic status in elderly patients undergoing laparoscopic cholecystectomy. The study was conducted on 50 elderly patients scheduled for laparoscopic cholecystectomy at Razi Hospital, Rasht, between March 20, 2023, and March 19, 2024. Hemodynamic parameters and cerebral oxygen saturation were recorded at baseline (prior to anesthesia induction), 5 and 15 minutes after abdominal gas insufflation, immediately following gas desufflation, and 15 minutes post-desufflation. The mean patient age was 66.9 ± 7.1 years, with 58% being female. Systolic, diastolic, and mean arterial pressures significantly increased following gas insufflation (P < 0.001), whereas heart rate changes were not statistically significant (P = 0.443). End-tidal carbon dioxide (EtCO₂) levels significantly rose during pneumoperitoneum. Cerebral oxygen saturation initially increased after anesthesia induction, declined post-insufflation, and subsequently recovered in the later stages. Peripheral oxygen saturation (SpO₂) remained stable throughout the procedure. The most commonly observed side effects included hypertension (16%), nausea and vomiting (16%), and bradycardia (8%). The findings indicate that anesthesia induction, pneumoperitoneum, and the reverse Trendelenburg position influence both cardiac function and cerebral perfusion in elderly patients. Specifically, carbon dioxide insufflation into the abdominal cavity is associated with elevated hemodynamic parameters, increased EtCO₂, and transient reductions in cerebral oxygenation across both hemispheres
Non-caloric artificial sweeteners: A mini-review of current perspectives on health benefits and potential risks
Get PDFNon-caloric artificial sweeteners (NAS) have gained widespread use in food, beverages, and pharmaceuticals due to their intense sweetness and minimal caloric contribution. Initially introduced as sugar substitutes for weight management and glycemic control, their safety profiles have come under renewed scrutiny. This mini-review summarizes current evidence on the health benefits and potential risks associated with NAS. Clinical trials support their short-term benefits, including modest reductions in body weight, improved glycemic indices, and dental health advantages due to their non-cariogenic properties. Additionally, certain NAS exhibit antimicrobial and antioxidant activities, although these may also disrupt beneficial gut microbiota. Notably, some epidemiological studies have paradoxically linked NAS consumption with weight gain, metabolic disturbances, and cardiovascular risk. Alterations in gut microbiota, neuroendocrine signaling, and taste perception are proposed mechanisms for these effects. Emerging data also raise concerns about carcinogenic and genotoxic potential, particularly for aspartame and acesulfame-K, although findings remain inconsistent across studies. Regulatory agencies maintain acceptable daily intake limits based on toxicological assessments; however, individual susceptibility, cumulative exposure, and long-term outcomes warrant further investigation. Overall, NAS offer useful alternatives to sugar but should be consumed with awareness of potential systemic and microbiome-mediated risks. Ongoing research, particularly well-designed longitudinal human studies, is essential to inform future dietary recommendations and regulatory policies
Sub-minimal inhibitory concentrations of fluoroquinolones in the environment: A trigger for the emergence of drug-resistant bacteria
Get PDFFluoroquinolones represent a significant class of antimicrobial agents. These compounds are effective in the treatment of various enteric infections in veterinary medicine. The primary bacterial targets of quinolones are topoisomerase IV and DNA gyrase, enzymes essential for DNA replication and repair. A major public health concern is the potential transmission of fluoroquinolone-resistant bacteria from livestock to humans. The development of antimicrobial resistance in both animals and humans is interconnected. Multiple observational studies and randomized trials have established an association between the use of antibiotics in food animals and the emergence of antimicrobial-resistant bacteria. Fluoroquinolones induce DNA damage, leading to DNA strand breaks that activate the SOS response and various DNA repair pathways. The SOS system, a key component of the DNA repair machinery, plays a critical role in cell cycle regulation. Activation of this system initiates a cascade of signals within bacteria, resulting in enhanced pathogenicity. Through these signaling pathways, bacteria have evolved diverse mechanisms such as pathogenicity islands, biofilm formation, and toxin production. The presence of residual fluoroquinolones in livestock environments and animal production systems following veterinary use is associated with increased bacterial virulence. This review focuses on the impact of fluoroquinolone exposure at sub-minimal inhibitory concentrations on bacterial virulence and pathogenicity
The frequency of nosocomial infection and environmental contamination in the burn center
No full textNosocomial infections result in a high rate of morbidity and mortality globally. The present study investigated patterns of bacterial contamination in the hospital environment and hospital-acquired infections in hospitalized burn patients.This cross-sectional study was conducted on 212 hospital environmental samples and 673 clinical samples of hospitalized burn patients in Velayat Hospital, Rasht, Iran, from 2018 to 2021. Demographical data and clinical characteristics of burn patients were recorded and analyzed. The data of reported infections were recorded to find the infection pattern. All data was performed using SPSS version 22, and the significant level was set at 0.05. Among 212 environmental samples, 94.8% were from hospital surfaces, with the ICU being the most sampled area (36.8%). Fungal infections were most prevalent (65.5%), followed by Staphylococcus spp. (19.8%). Analysis of 673 burn patients showed a predominantly male population (74.5%), with a mean age of 39.50 years and an average burn severity of 39.57%. Patients typically developed infections 3.91 days post-admission, with an average hospital stay of 12.07 days. The mortality rate was high at 50.3%. Pseudomonas aeruginosa (P. aeruginosa) was the most common pathogen in patients (34.9%), followed by Klebsiella spp. (12.3%), with 46.9% of isolates remaining unidentified. The study illustrated the urgent need for improved infection control strategies, enhanced environmental monitoring, and better diagnostic capabilities to reduce the high rates of nosocomial infections and improve patient outcomes in burn centers