Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Ramadan fasting among adolescents with type 1 diabetes: a systematic review and meta-analysis
No full textObjectiveThis systematic review and meta-analysis assess the effects of Ramadan fasting in adolescents with type 1 diabetes mellitus (T1DM), on blood sugar factors such as hemoglobin A1C and problems caused by its lack of control such as hypoglycemia and DKA, and metabolic outcomes.MethodsElectronic databases including MEDLINE, Embase, and SINOMED were searched up to February 13, 2024, without language, region, or publication time restrictions. The outcomes were Acute complications, changes in Hemoglobin A1c (HbA1c) and weight changes. Meta-analyses used random-effects models to compute weighted Relative risk (RR) and standard mean differences (SMD). And to check the risk of bias of included studies, the Newcastle-Ottawa scale was used.ResultsNine studies were included, comprising 458 participants, with studies varying in quality from high to low. Meta-analysis showed no significant reduction in HbA1c levels post-Ramadan (SMD: -0.12; 95 CI: -0.38 to 0.14), indicating minimal impact on long-term glycemic control. The incidence of hypoglycemia was notably high (50.79 events per 100 observations), with hyperglycemia and diabetic ketoacidosis (DKA) also reported but less frequently. The variability in complication rates among studies was significant, reflecting the high heterogeneity across the data. Weight changes during Ramadan were minimal and not statistically significant, suggesting fasting's negligible effect on body weight among participants.ConclusionsRamadan fasting among adolescents with T1DM does not significantly alter HbA1c levels, suggesting potential feasibility under careful monitoring and management. However, the high incidence of hypoglycemia underscores the need for vigilant glucose monitoring and tailored adjustments to diabetes management plans during fasting periods
Clinical and psychological factors associated with fear of relapse in people with multiple sclerosis: A cross-sectional study
No full textBackground: Fear of relapse (FoR) is one of the main psychological concerns in people with relapsing-remitting multiple sclerosis (PwRRMS). It has disastrous consequences on treatment adherence, quality of life (QoL), and clinical course. Although the issue is closely linked to psychosocial aspects, it is not widely explored despite its overall impact on managing the condition. The determinants of FoR are vital for the optimization of therapeutic intervention toward ensuring patient welfare. Methods: This cross-sectional study, carried out in Isfahan, Iran, from December 2023 to September 2024, investigated demographic, clinical, and psychological characteristics in PwRRMS. The level of FoR was measured by the Fear of Relapse Scale, and for anxiety, depression, and obsessive-compulsive symptoms, the Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), and the Yale-Brown Obsessive-Compulsive Scale (YBOCS) were used, respectively. Correlation between these factors were analyzed using linear regression. Results: A total of 189 PwRRMS were included. Multivariable linear regression analysis identified significant correlation between the higher annualized relapse rate (ARR) (B = 10.18, standardized 0.14, p-value < 0.05), anxiety (B = 0.32, standardized beta = 0.19, p-value < 0.05), depression (B = 0.63, standardized beta = 0.42, p-value <0.001) and Expanded Disability Status Scale (EDSS) (B = 2.19, standardized beta = 0.11, p-value < 0.05) with the FoR among PwRRMS. On the other hand, other demographic, clinical, and psychological variables, including disease duration, disability, and obsessive behavior, were found to lack a significant correlation with FoR (p-value < 0.05). Conclusion: This study points out that ARR, anxiety, and depression are among the leading independent risk factors of FoR in PwRRMS. Given the great potential for attenuation with focused treatments and psychological consultation, becoming major contributors to the decrease of FoR and, importantly, to improved overall patient well-being, their proper management and clinical follow-up should be considered an important issue in dealing with such patients
Exploring the potential of anticancer peptides as therapeutic agents for cancer treatment
No full textDespite great advances in cancer identification and treatment, malignancies remain the primary cause of high morbidity and mortality worldwide. The drawbacks of conventional chemotherapy, such as severe toxicity, lack of specificity related to actively dividing cells, and resistance, can warrant the urgent need to develop an alternative approach to treat this disease. To overcome the drawbacks, researchers are attempting to deliver drugs to the site of action (targeted delivery) or to identify drugs that specifically target tumor cells. In this regard, highly cationic and amphipathic antimicrobial peptides are attracting the attention of researchers due to their potent anticancer activity, low cost of manufacture, and, most critically, tumor-targeting activity. A growing number of documents have shown that some of the mentioned peptides exhibited a broad spectrum of cytotoxic activity against cancer cells but not normal mammalian cells entitled as anticancer peptides. Due to their solubility, low toxicity, strong tumor penetration, high selectivity, and ability to be used alone or in conjunction with other conventional medications, anticancer peptides have the potential to become very successful cancer treatments in the future. This review provided an overview of the studies concerning anticancer peptide classification, modes of action, and selectivity, and also summarized some of the anticancer peptides developed for targeting different types of malignancies. The role of in silico methods or artificial intelligence in the design and discovery of anticancer peptides was briefly explained. Additionally, the current review addressed challenges in utilizing anticancer peptides for cancer therapy and highlighted peptides currently undergoing clinical trials
Mechanisms of apoptosis-related non-coding RNAs in ovarian cancer: a narrative review
No full textOvarian cancer remains a major challenge in oncology due to its complex biology and late-stage diagnosis. Recent advances in molecular biology have highlighted the crucial role of non-coding RNAs (ncRNAs) in regulating apoptosis and cancer progression. NcRNAs, including microRNAs, long non-coding RNAs, and circular RNAs, have emerged as significant players in the molecular networks governing ovarian cancer. Despite these insights, the precise mechanisms by which ncRNAs influence ovarian cancer pathology are not fully understood. This complexity, combined with the heterogeneity of the disease and the development of treatment resistance, poses substantial obstacles to effective therapeutic development. Additionally, the lack of reliable early detection methods further complicates treatment strategies. This manuscript reviews the current state of research on ncRNAs in ovarian cancer, discusses the challenges in translating these findings into clinical applications, and outlines potential future directions. Emphasis is placed on the need for integrated approaches to unravel the intricate roles of ncRNAs, improve early detection, and develop personalized treatment strategies to address the diverse and evolving nature of ovarian cancer. While these findings provide valuable insights, it is crucial to recognize that many results are based on preclinical studies and require further validation to establish their clinical applicability
Isfahan Artificial Intelligence Event 2023: Reflux Detection Competition
No full textBackground:Gastroesophageal reflux disease (GERD) is a prevalent digestive disorder that impacts millions of individuals globally. Multichannel intraluminal impedance-pH (MII-pH) monitoring represents a novel technique and currently stands as the gold standard for diagnosing GERD. Accurately characterizing reflux events from MII data are crucial for GERD diagnosis. Despite the initial introduction of clinical literature toward software advancements several years ago, the reliable extraction of reflux events from MII data continues to pose a significant challenge. Achieving success necessitates the seamless collaboration of two key components: a reflux definition criteria protocol established by gastrointestinal experts and a comprehensive analysis of MII data for reflux detection.Method:In an endeavor to address this challenge, our team assembled a dataset comprising 201 MII episodes. We meticulously crafted precise reflux episode definition criteria, establishing the gold standard and labels for MII data.Result:A variety of signal-analyzing methods should be explored. The first Isfahan Artificial Intelligence Competition in 2023 featured formal assessments of alternative methodologies across six distinct domains, including MII data evaluations.Discussion:This article outlines the datasets provided to participants and offers an overview of the competition results
Egg consumption, sleep, and mental health status among women with type II diabetes
No full textTo evaluate if egg consumption is associated with sleep quality and psychological health (depression, anxiety, and stress) in women with type 2 diabetes. A cross-sectional study was conducted on women with type 2 diabetes (n = 230). Weight, height, waist circumference (WC), and blood pressure were measured. A Food Frequency Questionnaire (FFQ) was used to obtain dietary intake data and estimate total egg consumption, which was presented in tertiles. The Pittsburgh Sleep Quality Index (PSQI) and Depression, Anxiety, and Stress Scale (DASS-21) were used to evaluate sleep and mental health outcomes, respectively. Dietary intake of carbohydrates, sodium, saturated fatty acids, and cholesterol was greater in the highest tertile of egg consumption (P < 0.05). Dietary intake of fat, monounsaturated, and polyunsaturated fatty acids was lower in the highest tertile of egg consumption (P < 0.05). WC was greater in the highest tertile of egg consumption in the crude model (p = 0.03), however, there was no evidence of this association in the adjusted model. There was no evidence of an association between egg consumption and the odds of poor psychological health or sleep quality in unadjusted or adjusted models. There was no association between egg consumption and poor sleep or mental disorders. Future studies are needed to confirm these findings and to identify the mechanism of action
β-lactoglobulin amyloid fibrils: Architecture, preparation, characterization, and
No full textCompared to native protein monomers, (3-lactoglobulin amyloid fibrils ((3-LAFs) produced through strong acidic and high thermal conditions possess unique nutritional, technological, and physicochemical attributes, but there is yet inadequate comprehensive information about the architecture, preparation, and characterization for their wide consumption. In this review, we summarize recent progress in the generation, characterization, and application of (3-LAFs. A holistic viewpoint is adopted to provide an in-depth, critical, and readable document useful to a broad community in chemistry, food, material science, medical, and environmental sciences. (3-LAFs, as emulsifying and gelling agents, possess tremendous potential in bioactive/drug delivery, tissue engineering, food packaging, antioxidant/antibacterial/antiviral materials, environmental applications, etc. In this review, we set: (i) to highlight structural, physicochemical, and techno-functional properties of (3-LAFs alongside the critical factors in the protein fibrillation process, (ii) to tabulate a large number of characterization techniques to understand various properties of (3-LAFs, (iii) to consolidate the most important and up-to-date information from the field of (3-LAF applications (like chemistry, food, material science, medical, environmental, etc.); and to reflect these progresses in one, comprehensive study, (iv) and finally, to broadly reflect on the difficulties with application of (3-LAFs
An Unusual Presentation of Bladder Carcinoma in a Visceral Hernia: A Case Report and Literature Review
No full textIntroduction: Bladder carcinoma (BC) is the most prevalent malignancy of the urinary system. These cancers are primarily seen in adults > 60 years old and mostly present with microscopic or frank hematuria or obstruction of the urinary system. However, these rare cancers can be found in hernias. Case Presentation: This report discusses a rare, localized bladder urothelial carcinoma (UC) manifestation. The patient had presented with lower abdominal pain several times. However, no accurate diagnosis was made due to the unspecified pain features. After being referred to a radiologic evaluation with ultrasonography, a bladder hernia was detected entering the abdominal wall, and it contained an unusual mass. Further evaluations revealed the malignant feature of the tumor. The abdominal wall hernia was replaced, and a TURP procedure was performed. The resulting sample showed UC without the involvement of the muscle layer. Conclusion: One of the most common malignancies of the urogenital and reproductive systems in male patients is BCs. They are most commonly seen in men older than 60 years old with a history of smoking. The prevalent manifestations of cancer are microscopic or macroscopic hematuria, urinary obstruction, and abdominal pain. A rare but previously reported bladder cancer location is within inguinal or abdominal hernias. The diagnosis of this cancer is not always straightforward, and delays can result in the spread of malignancy and the transition of the patient's clinical condition to a poorer prognosis
Unseen threats: Microplastic presence in waterpipe tobacco
No full textMicroplastics (MPs) are a ubiquitous form of waste and an emerging public health concern. MPs have been detected in various environmental matrixes, vegetables, and foods, but no data currently exists for tobacco samples. This research aimed to evaluate the concentration and characteristics of MPs in fresh tobaccos (fruit-flavored and regular) and their post-consumption waterpipe tobacco wastes (PWTWs). Our findings showed that the mean +/- SD concentration of MPs particles in fresh flavored tobacco was 4.64 +/- 1.59 items/g, whereas it was 0.79 +/- 0.12 items/g in regular samples (p < 0.05). In the case of PWTW of flavored tobacco, the MPs concentration was 0.82 +/- 0.07 items/g, while no particle was found in the PWTW of regular samples (p < 0.05). The most dominant size of MPs in fruit-flavored tobacco was 10-50 mu m, while particles < 50 mu m (250-500 mu m) were the most frequent particles in fresh regular tobacco. Fibers were the most common shape among MP particles detected in both tobacco samples, with white/transparent and black being the predominant colors across all samples. The SEM-EDS (scanning electron microscope and energy-dispersive X-ray spectroscopy) analysis revealed that carbon and oxygen (C and O) were the primary elements detected in MPs present in waterpipe tobacco, confirming that these particles are plastic in nature. To better understand the implications of these findings, further research is needed to assess additional MP characteristics, such as polymer type. Moreover, investigating the potential toxicity of these MPs is crucial for understanding their effects on smokers' health
Impact of COVID-19 vaccination on lower urinary tract (LUTS) in benign prostatic hyperplasia (BPH) patients
No full textPurpose: Benign prostatic hyperplasia (BPH) is a common condition in men that can impact quality of life, especially in older age. BPH is nonmalignant prostate enlargement associated with lower urinary tract symptoms (LUTS). Various factors like aging, hormonal imbalance, and inflammation contribute to BPH, with androgen dysregulation playing a key role. The coronavirus disease 2019 (COVID-19) pandemic raised concerns about vaccine side effects, particularly in BPH patients experiencing LUTS. Research is ongoing to understand the impact of COVID-19 vaccination on LUTS in BPH patients. Materials and Methods: This prospective longitudinal study conducted at Sina Hospital in Tehran, Iran, from September 2022 to March 2023 enrolled 106 BPH patients receiving COVID-19 vaccines. Ultrasonography, total and free prostate specific antigen (PSA) test, and urine analysis were performed, and International Prostate Symptom Score questionnaires were completed before the vaccination. Vaccines included Oxford University/ AstraZeneca, Sinopharm, or Sputnik-V, with booster doses administered per manufacturer protocol. Three months post-booster shot, patients were re-evaluated with the same questionnaire. Data was analyzed using SPSS software. Results: Out of 3,591 individuals receiving COVID-19 vaccine,106 were eligible for analysis. The mean +/- standard deviation age on vaccination day was 65.4 +/- 11.74 years. Individuals receiving COVID-19 vaccines found no significant changes in PSA levels or prostate volume post-vaccination. Among urinary symptoms, urgency, dysuria, frequency, and hematuria rates increased significantly (p-value<0.05). Other symptoms showed no statistical differences. Conclusion: Our findings elucidate that urgency, dysuria, frequency, and hematuria may be exacerbated after COVID-19 vaccination in BPH patients