Repository of Research and Investigative Information Isfahan University of Medical Sciences
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The effect of Zataria multiflora on respiratory symptoms, pulmonary functions, and oxidative stress parameters: a systematic review and meta-analysis
No full textBackground Zataria multiflora (Z. multiflora), also known as Shirazi thyme, is recognized for its medicinal properties, including antioxidant, anti-inflammatory, and immunomodulatory effects. Its longstanding use in traditional medicine for respiratory ailments underscores its significance. Given the widespread prevalence of respiratory disorders and inconclusive outcomes from previous trials, this research aims to conduct a systematic review and meta-analysis to evaluate Z. multiflora's impact on respiratory symptoms, pulmonary function, and oxidative stress markers using available randomized controlled trials (RCTs). Methods In this systematic review and meta-analysis, a comprehensive search of published literature was conducted up to January 2024, encompassing databases such as PubMed, Scopus, Web of Science, and the Cochrane Central for Randomized Clinical Trials. The assessment of the quality of each eligible study was conducted using the Cochrane risk-of-bias tool. The random-effects model was used in the meta-analysis to determine the weighted mean difference (WMD) with 95 confidence intervals (CIs). All statistical analyses were conducted using STATA (version 15). Results A total of 9 studies involving 394 participants were included. The administration of Z. multiflora showed significant effects on cough (WMD: -0.99; 95 CI: -1.66, -0.33; P = 0.003), day wheezing (WMD: -1.18; 95 CI: -1.44, -0.92; P < 0.001), night wheezing (WMD: -0.74; 95 CI: -1.09, -0.37; P < 0.001), chest wheezing (WMD: -1.15; 95 CI: -1.65, -0.64; P < 0.001), forced expiratory volume (WMD: 11.38; 95 CI: 7.40, 15.35; P < 0.001), forced vital capacity (WMD: 16.01; 95 CI: 12.26, 19.75; P < 0.001), and peak expiratory flow (WMD: 8.78; 95 CI: 4.13, 13.43; P < 0.001) compared to the control group. Additionally, Z. multiflora significantly reduced malondialdehyde levels (SMD: -1.54; 95 CI: -2.17, -0.90; P < 0.001) and increased catalase levels (SMD: 0.97; 95 CI: 0.46, 1.46; P < 0.001). Conclusion Z. multiflora shows potential as a complementary treatment for respiratory diseases by improving symptoms, pulmonary functions, and reducing oxidative stress. However, due to the limited number of trials, findings should be interpreted cautiously, and further research is needed
Immunomodulation in Bone Tissue Engineering: Recent Advancements in Scaffold Design and Biological Modifications for Enhanced Regeneration
No full textBone defects, whether caused by trauma, cancer, infectious diseases, or surgery, can significantly impair people's quality of life. Although autografts are the gold standard for treating bone defects, they often fall short in adequately forming bone tissue. The field of bone tissue engineering has made strides in using scaffolds with various biomaterials, stem cells, and growth factors to enhance bone healing. However, some biological structures do not yield satisfactory therapeutic outcomes for new bone formation. Recent studies have shed light on the crucial role of immunomodulation, specifically the interaction between the implanted scaffold and host immune systems, in bone regeneration. Immune cells, particularly macrophages, are pivotal in the inflammatory response, angiogenesis, and osteogenesis. This review delves into the immune system's mechanism toward foreign bodies and the recent advancements in scaffolds' physical and biological properties that foster bone regeneration by modulating macrophage polarization to an anti-inflammatory phenotype and enhancing the osteoimmune microenvironment
The relationship between optical coherence tomography and magnetic resonance imaging measurements in people with multiple sclerosis: A systematic review and meta-analysis
No full textBackground: Several studies show that optical coherence tomography (OCT) metrics e with cognition, disability, and brain structure in people with multiple sclerosis (PwMS). This review the correlation between OCT parameters and magnetic resonance imaging (MRI) measurements in PwMS. Methods: A comprehensive search of PubMed/MEDLINE, Embase, Scopus, and Web of Science was performed, including studies published in English up to November 29, 2024 to identify studies reporting quantitative data on the correlation between baseline OCT parameters and MRI measurements in PwMS. The meta-analysis was performed using R software version 4.4.0. Results: From 4931 studies, 68 studies on 6168 PwMS (67.4 female) were included. The most significant correlations were found between peripapillary retinal nerve fiber layer (pRNFL) thickness and lower T1 lesion volume r = -0.42 (95 CI: -0.52 to -0.31, p-value <0.001, I-2 = 24 ), greater thalamic volume r = 0.39 (95 CI: 0.17 to 0.61, p-value <0.001, I-2 = 81 ), and lower T2 lesion volume r = -0.37 (95 CI: -0.54 to -0.21, p-value <0.001, I-2 = 85 ), respectively. Additionally, lower macular ganglion cell-inner plexiform layer (mGCIPL) thickness showed the most significant correlations with positive and lower thalamic volume r = 0.37 (95 CI: 0.1 to 0.64, p-value = 0.008, I-2 = 88 ), and positive and lower grey matter volume (GMV) 0.33 (95 CI: 0.15 to 0.52, p-value <0.001, I-2 = 81 ), respectively. Conclusion: pRNFL and mGCIPL thickness are correlated with MRI measurements, suggesting that OCT can serve as a non-invasive, cost-effective, and complementary tool to MRI for enhancing the exploring of brain structural changes in PwMS
Deep learning for age estimation from panoramic radiographs: A systematic review and meta-analysis
No full textIntroduction: Panoramic radiographs are widely used for age estimation in clinical and forensic domains. Conventionally, age estimation uses humans assessing tooth development and deducing the expected age from that. Deep learning may improve or substitute this traditional approach and allow age estimation at scale in routine settings. The objective of this systematic review was to assess the performance of deep learning for age estimation on panoramic radiographs. Data: Studies using deep learning for age estimation (index test), reporting their performance metrically against a reference test (human expert assessment or the actually known age) were included. Sources: PubMed, Google Scholar, Embase, Scopus, ArXiv, medRxiv, and IEEE databases were searched on 24th July 2023, and the search was updated in June 2024. Study selection: Out of 2,441 studies, 42 were selected for inclusion. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Meta-analysis was restricted to studies (n = 9) that reported the error of the model against the reference test in years. Results: Thirteen studies demonstrated a low risk of bias, while the majority showed unclear or high risk of bias. Accuracy for classifying individuals into age brackets emerged as the most common metric, with accuracy spanning from 27 to 100 . Pooled mean absolute error was 1.75 (95 CI: 0.96 - 2.55) years Conclusion: The performance of deep learning for age estimation from panoramics varied significantly between studies. The mean absolute error, at 1.75 years, however, indicates the promises of deep learning for this purpose. Clinical significance: This systematic review and meta-analysis demonstrated the potential of deep learning as an adjunct diagnostic tool for age estimation, showing that, in mean, the absolute error of deep learning was only 1.75 years. However, several methodological limitations identified herein necessitate further investigation before widespread clinical implementation can be considered
Ultra-processed foods and risk of declined renal function: a dose-response meta-analysis of 786,216 participants
No full textObjectives Earlier investigations have documented an association between elevated consumption of Ultra-Processed Foods (UPFs) and adverse renal outcomes. To explore this relationship further, we executed a comprehensive dose-response meta-analysis to examine the link between UPFs intake and the risk of declined renal function. Setting. A systematic search was completed utilizing the ISI Web of Science, Scopus, Embase as well as PubMed/MEDLINE databases (without any restrictions), up until September 5, 2024. Effect sizes of declined renal function were recalculated by applying a random effects model. The GRADE tool was adopted to assess the certainty of the evidence, while study quality and potential publication bias were examined via validated methods such as the Newcastle-Ottawa Scale, Egger's regression asymmetry and Begg's rank correlation test. Results Thirty-three studies (comprising 786,216 participants) were incorporated in the quantitative analysis. The results demonstrated that a greater UPFs intake was significantly associated with an enhanced risk of declined renal function (RR = 1.16; 95 CI: 1.09, 1.23; I-2 = 68.8; p < 0.001; n = 37). Additionally, we observed that each 1-serving-per-day increase in UPFs consumption was associated to a 5 greater risk of reduced renal function (RR = 1.05; 95 CI: 1.02, 1.09; I-2 = 80.9; p = 0.013; n = 9). A positive, linear association between UPF intake and the risk of declined renal function (P-nonlinearity = 0.107, Pdose-response < 0.001) was further displayed in the non-linear dose-response analysis. Conclusion Greater exposure to UPFs is positively associated with the risk of declined renal function. The information emphasizes the importance of considering UPFs in the prevention and management of adverse renal outcomes
Does supplementation with pine bark extract improve cardiometabolic risk factors? A systematic review and meta-analysis
No full textBackground Supplementation with pine bark extract (PBE) may improve risk factors associated with cardiometabolic syndrome (CMS). The effects of PBE supplementation on cardiometabolic risk factors were evaluated in this systematic review and meta-analysis of randomized controlled trials (RCTs). Methods A comprehensive search of various databases was performed to identify relevant RCTs published up to September 2024. A random-effects model was employed for the meta-analysis, which included 27 RCTs with 1,685 participants. Results The findings indicated that PBE supplementation significantly reduced systolic blood pressure (SBP) (weighted mean difference (WMD): -2.26 mmHg, 95 confidence interval (CI): -3.73, -0.79; P = 0.003), diastolic blood pressure (DBP) (WMD: -2.62 mmHg, 95 CI: -3.71, -1.53; P < 0.001), fasting blood sugar (FBS) (WMD: -6.25 mg/dL, 95 CI: -9.97, -2.53; P = 0.001), hemoglobin A1c (HbA1c) (WMD: -0.32, 95 CI: -0.54, -0.11; P = 0.003), body weight (WMD: -1.37 kg, 95 CI: -1.86, -0.88; P < 0.001), and low-density lipoprotein (LDL) cholesterol (WMD: -5.07 mg/dL, 95 CI: -9.21, -0.94; P = 0.016) in the PBE-treated group compared to their untreated counterparts. However, no significant impact of PBE was observed on waist-to-hip ratio (WHR), body mass index (BMI), waist circumference (WC), or serum levels of insulin, high-density lipoprotein (HDL) cholesterol, triglycerides (TG), and total cholesterol (TC). Conclusions Supplementation with PBE may ameliorate specific cardiometabolic risk factors, as indicated by reductions in body weight, DBP, SBP, FBS, LDL, and HbA1c levels. This approach can be regarded as an adjunct therapeutic strategy for CMS management. Further high-quality trials with larger sample sizes and longer durations are required to validate these findings
Evaluation of factors influencing return to work in STEMI patients: A case-control study
No full textThis study aimed to evaluate return to work (RTW) across different job groups, identify predictors of successful RTW, and investigate reasons for RTW failure. This case-control study, conducted in 2022, included 164 male patients who had ST elevation myocardial infarction (STEMI) in 2016 to 2017 and were registered in the 5-year ST Elevation Myocardial Infarction Cohort in Isfahan, Iran. Patients were divided into RTW (n = 82) and RTW failure (n = 82) groups, frequency-matched for education, marital status, and comorbidities. Baseline data were extracted from the cohort database, and occupational factors were gathered via telephone contact. Statistical analysis was performed using chi-square tests, t tests, and multivariate logistic regression to identify significant predictors of RTW, with P < .05 considered statistically significant. Data from 164 patients aged 18 to 65 with STEMI showed that those who returned to work had a mean age of 49.05 years, compared to 53.04 years for those who did not (P = .001). Factors associated with increased RTW included younger age (odds ratios OR: 0.86; 95% confidence intervals: 0.77-0.95), shorter hospitalization (OR: 0.63; 0.44-0.91), and lower first systolic blood pressure (OR: 0.97; 0.94-0.99). Most patients (49.39%, n = 59) returned within 1 month. Common RTW failure reasons were personal decisions (36.58%, n = 30), retirement (25.61%, n = 21), and choosing lighter jobs (25.61%, n = 21). No significant relationship was found between job groups of the International Standard Classification of Occupations and RTW (P = .581). Our study identifies key factors influencing RTW after STEMI, including age, history of myocardial infarction, hospitalization duration, treatment methods, and initial systolic blood pressure. The most common barrier to RTW was patient unwillingness. A comprehensive approach that integrates primary prevention, personalized rehabilitation, and financial and social support is recommended to improve RTW outcomes
A Systematic Review of Spectroscopic Techniques for Detecting Milk Adulteration
No full textMilk adulteration is a crucial worldwide concern that endangers food safety and public health, as it involves the deliberate tampering with milk by adding foreign substances or removing essential nutrients, often to boost profits or hinder microbial growth. Traditional detection methods frequently lack the sensitivity and speed required to identify adulterants within milk's complex matrix. This systematic review critically examines the application of spectroscopic techniques for detecting milk adulteration, focusing on Nuclear Magnetic Resonance (NMR), Infrared (IR) Spectroscopy, Raman Spectroscopy, Ultraviolet-Visible (UV-Vis) Spectroscopy, Mass Spectrometry, Laser-Based Techniques, Dielectric Spectroscopy, and X-Ray Spectroscopy. Each technique's principles, advantages, limitations, and specific applications in identifying adulterants, such as water, urea, melamine, added sugars, fats, preservatives, and heavy metals are discussed. The review highlights how these methods offer rapid, non-destructive, and sensitive analysis, enhancing the ability to detect adulterants at molecular levels. Despite advancements, challenges persist, including the complexity and natural variability of milk composition, high costs of advanced equipment, need for specialized expertise, and lack of standardized protocols. Future directions emphasize developing portable and cost-effective spectroscopic devices, integrating artificial intelligence and machine learning for advanced data analysis, and fostering international collaboration to establish standardized methodologies and comprehensive spectral databases. By addressing these challenges, spectroscopic techniques can be more widely implemented, ultimately safeguarding public health, ensuring the integrity of dairy products, and maintaining consumer trust in the global food supply chain
Dimethyl Fumarate for Pediatric-Onset Multiple Sclerosis: A Systematic Review
No full textBACKGROUND: Dimethyl fumarate (DMF) is an oral disease-modifying therapy (DMT) being used for adult patients with multiple sclerosis (MS) with acceptable safety and efficacy profile. The use of DMF for pediatric-onset multiple sclerosis (POMS) is being considered especially for patients who prefer a self-administered oral DMT. To systematically review the experience with DMF in POMS regarding the safety and efficacy profile. METHODS: This systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three different databases were searched (PubMed, Scopus, and Web of Science) to find relevant articles until the end of May 15, 2024. Data were screened and extracted by two independent authors. RESULTS: From 344 studies, six studies with 316 patients were included in the systematic review. DMF had an acceptable effect on reducing relapses and magnetic resonance imaging activity. Gastrointestinal discomfort and facial flushing were the most reported adverse events related to the use of DMF in patients with POMS. CONCLUSIONS: DMF could be considered for patients with POMS both as first-line and switching therapy. Despite a recent tendency toward high-efficacy DMTs for POMS, DMF remains a good option for certain cases
Cervical extraosseous Ewing's sarcoma: A case report
No full textEwing's sarcoma itself is an uncommon disease. But its occurrence as a primary extraosseous cervical lesion is extremely rare. Considering the rarity of the manifestation of this disease in the form of a soft tissue mass in the neck, and the occurrence with nonspecific initial symptoms, this study introduces a patient whose only initial symptom was neck pain. The patient was a 23-year-old man who had been suffering from neck pain for ten days. Due to neck pain and 1 episode of urinary incontinence, the patient was hospitalized and examined. In the first 6 hours after admission, the patient experienced weakness of the upper limbs. A round lesion was seen in the alignment of the second vertebra with dimensions of 7 x 6 cm. Due to the progression of clinical symptoms, especially in the upper limbs, emergency surgery was planned for the patient. The diagnosis was Ewing's carcinoma. Tumoral cells were seen in diffuse form in small size with large nuclei, hyperchromatic and high N/C with large areas of necrosis. In conclusion, the urgency of surgical intervention in extraosseous Ewing sarcoma cannot be overstated, and it is essential for healthcare providers to remain vigilant in recognizing the signs of this aggressive disease to facilitate timely and effective treatment