Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Severe status epilepticus induced by shunt malfunction: A case report
No full textINTRODUCTION: Focal impaired awareness seizures are a common neurological disorder characterized by abnormal electrical activity in a specific brain region, resulting in impaired consciousness and neurological symptoms. Treatment options for patients may include antiepileptic medications, lifestyle modifications, or, in some cases, surgical intervention aimed at resecting the area of the brain responsible for seizure generation. Shunt malfunction can lead to seizures in cases of hydrocephalus; however, seizures triggered by stimulation of a specific brain area by the shunt catheter post-placement have not been reported. CASE: This case provides a compelling example of a seizure triggered by the stimulation of a foreign body in the ventricle. The patient is a 31-year-old man who suffered seizures due to the proximal catheter remaining in the ventricle. CONCLUSION: In general, accidental events during surgery should be carefully investigated and taken into consideration. And if necessary, timely intervention should be done to eliminate possible complications
Enhancing prostate cancer cells' sensitivity to flutamide by resveratrol: An in-vitro study
No full textBACKGROUND: As the most common cancer in men, and its progression poses a significant challenge. New and effective treatment strategies are needed to improve outcomes for patients with prostate cancer. This study examined if resveratrol, a natural substance, could improve prostate cancer cell lines' response to flutamide, a standard antiandrogenic treatment for untreated prostate cancer, while minimizing adverse effects. METHOD: MTT assay was used to quantify resveratrol and flutamide IC50 values, Annexin-V/PI staining for apoptosis, PI staining for DNA cell cycle, and real-time PCR for BAX, BCL-2, VEGFC, HIF-1alpha, Snail1, E-Cadherin, and KLK3 mRNA levels Scratch-wound, colony-forming, and Hoechst staining analyzed cell migration, proliferation, and nucleus morphology. Spheroid creation in 3D was also considered. All tests used LNCaP, DU145, and PC3 prostate cancer cell lines at various stages. RESULTS: Resveratrol, when combined with flutamide, can reduce malignant cell migration, colony formation, and proliferation and promote apoptosis in prostate cancer cell lines. Even in androgen-unresponsive cell lines (DU145 and PC3), it may benefit flutamide prostate cancer treatment. Apoptosis genes (BAX) were upregulated in LNCaP, DU145, and PC3 cancer cell lines when administered alone or with flutamide. Additionally, flutamide might significantly lower BCL-2 levels in PC3 cells. When combined with flutamide, resveratrol increased apoptosis and altered the expression of genes involved in angiogenesis (VEGFC), epithelial-mesenchymal transition (EMT, Snail1 and E-Cadherin), and prostate cancer biomarker (KLK3) in prostate cancer cell lines. CONCLUSION: Resveratrol reduced the dose of flutamide in the treatment of prostate cancer cell lines (LNCaP, DU145, and PC3) and improved its side effects, as well as increasing the sensitivity of cells to flutamide treatment
The effect of the fenugreek hydrolyzed protein on lipid profile in patients with mild-to-moderate hypercholesterolemia: A confirmatory triple-blind randomized-controlled clinical trial
No full textBACKGROUND: The risk of coronary artery disease in people with high serum cholesterol is more than twice as high as in those with moderate serum cholesterol. Natural medicines, especially herbs, have been the focus of attention for many years because of the desirable and minimal side effects for controlling blood lipids. PURPOSE: The present study aims to investigate the effect of fenugreek hydrolyzed protein (FHP) on lipid profile in patients with mild-to-moderate hypercholesterolemia. METHODS: This study is a confirmatory, triple-blind, two-group parallel, randomized controlled trial, phase 3 conducted on patients aged 18-65 years with mild-to-moderate hypercholesterolemia and low risk for cardiovascular disease. Patients were recruited from a private clinic from May 2021 to June 2021. Sixty patients were randomized with a 1:1 allocation ratio into the FHP group (N = 30) and the placebo group (N = 30). The intervention group was administrated 40 mg/day of FHP for 8 weeks. Patients were examined at baseline and 8 weeks after randomization. The primary outcome was the patient's lipid profile including total cholesterol (TC), high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c), triglyceride (TG), and non-HDL-c. All participants, caregivers, outcome assessors, and analyzers were blind to the type of intervention. RESULTS: In the intervention group, lipid profile improved through a significant reduction in TC (P < 0.001), LDL-c (P = 0.043), and non-HDL-c (P < 0.001), but no significant changes were observed in the TG level. The mean difference of these variables was -10.07 mg/dl 95 %CI:30.84; 10.70, -8.93 mg/dl 95 %CI:27.07; 9.21, and -10.37 mg/dl 95 %CI:32.26; 11.52 for TC, LDL-c, and non-HDL-c, respectively. FHP successfully decreased LDL-c level by 7 %. There was no significant change in any component of the lipid profile in the comparison group. FHP was well tolerated with only 1 patient experiencing gastrointestinal adverse manifestations. CONCLUSION: These findings suggest that FHP administration can improve the lipid profile of patients with mild-to-moderate hypercholesterolemia. Considering the low adverse effects of FHP and patients' high tolerance, it can be considered in the management of these patients, who fall into the low-risk cardiovascular disease category, adjuvant to the main therapies. REGISTRATION CODE: IRCT20210125050 142N1
Comparison of clinicodemographic characteristics in patients with selective serotonin reuptake inhibitors poisoning: A cross-sectional study
No full textBACKGROUND: Our objective of this study was to evaluate patients of Selective Serotonin Reuptake Inhibitors (SSRIs) overdose and compare the toxicological effects of citalopram overdose with other SSRIs in adult poisoning cases. METHODS: This cross-sectional study focused on acute, known-type SSRI ingestions. Demographic and toxicological data were collected on the patients. The outcomes analyzed were length of hospital stay, coma, seizures, electrocardiographic abnormalities, abnormal heart examination, and the presence of serotonin syndrome. RESULTS: There were a total of 199 cases, with 165 (82.9) being women. The majority of cases (n = 76, 38.2) were attributed to citalopram, followed by sertraline (n = 67, 33.7), fluoxetine (n = 33, 16.6), fluvoxamine (n = 10, 5), escitalopram (n = 6, 3), paroxetine (n = 1, 0.5), and mixed (n = 6, 3). The most common symptoms were nausea and vomiting (n = 96, 48.2). Most patients (58.3) were conscious, with only 7 patients (3.5) experiencing seizures. Among those with seizures, six patients had taken citalopram, with 50 of them ingesting 400 mg of citalopram. Tachycardia was observed in 62 (31.2) patients, while no QT interval prolongation, PR interval changes, or arrhythmias were reported. Serotonin toxicity was noted in only 6 patients (3), with 4 of them being poisoned with citalopram. The incidence of seizures with citalopram was significantly higher than with other SSRIs (odds ratio (OR) = 10.457; 1.6-2.88, P = 0.008), while nausea and vomiting were significantly more common in poisoning cases involving other SSRIs (OR = 0.51; 0.2-0.9, P = 0.02). There were no reported deaths. CONCLUSION: Ingesting SSRIs results in minimal toxicity. However, seizures are more likely to occur with citalopram compared to other SSRIs
Innovative applications of MXenes in dialysis: enhancing filtration efficiency
No full textMXenes, a family of two-dimensional transition metal carbides and nitrides, exhibit exceptional properties such as high electrical conductivity, large surface area, and chemical versatility, making them ideal candidates for various dialysis applications. One prominent application of MXenes lies in the efficient removal of toxic metals and harmful dyes from wastewater. Their unique structure allows for rapid adsorption and selective separation, significantly improving purification processes. MXenes show great promise in the therapeutic management of acute kidney injury, where their biocompatibility and ability to facilitate toxin removal can mitigate damage to renal tissues. In hemodialysis, MXenes can enhance membrane performance through improved permeability and selectivity, leading to more effective clearance of waste products. Despite the potential of MXene-based composites in dialysis applications, several challenges loom large on the horizon. The stability of MXenes in physiological environments is a critical concern, as they can undergo oxidation or degradation, which may compromise their functionality over time. The scalability of synthesis processes remains a significant barrier; producing high-quality MXene materials in sufficient quantities for clinical use is not yet fully realized. Moreover, ensuring biocompatibility is paramount, as any adverse reactions could lead to inflammation or other complications in patients. The integration of MXenes into existing dialysis systems requires meticulous engineering to maintain optimal filtration properties while avoiding clogging or fouling. The future of MXenes and their composites in dialysis presents a promising horizon, teeming with potential innovations. The development of hybrid materials that utilize MXenes alongside other nanomaterials can lead to multifunctional systems, capable of addressing multiple challenges faced in dialysis treatments. Advancements in fabrication techniques may allow for tailored porosity, enabling customized dialysis solutions for individual patients. Research into surface modifications and composites can enhance their stability and functionality, potentially overcoming current limitations. The purpose of this review is to provide a comprehensive understanding of the current landscape of MXenes in dialysis, highlighting their applications, challenges, and future directions. This review explores the diverse applications of MXenes in the field of dialysis, focusing on their roles in the removal of toxic metals and dyes, therapy for acute kidney injury, and hemodialysis enhancement
Predicting lymph node metastasis in thyroid cancer: systematic review and meta-analysis on the CT/MRI-based radiomics and deep learning models
No full textBACKGROUND: Thyroid cancer, a common endocrine malignancy, has seen increasing incidence, making lymph node metastasis (LNM) a critical factor for recurrence and survival. Radiomics and deep learning (DL) advancements offer the potential for improved LNM prediction using CT and MRI, though challenges in diagnostic accuracy remain. METHODS: A systematic review and meta-analysis were conducted per established guidelines, with searches across PubMed, Scopus, Web of Science, and Embase up to February 15, 2024. Studies developing CT/MRI-based radiomics and/or DL models for preoperative LNM assessment in thyroid cancer patients were included. Data were extracted and analyzed using R software. RESULTS: Sixteen studies were analyzed. In internal validation sets, sensitivity was 81.1 (95 CI: 75.6 -85.6 ) and specificity 76.4 (95 CI: 68.4 -82.9 ). Training sets showed a sensitivity of 84.4 (95 CI: 81.5 -87 ) and a specificity of 84.7 (95 CI: 74.4 -91.4 ). The pooled AUC was 86 for internal validation and 87 for training. Handcrafted radiomics had a sensitivity of 79.4 and specificity of 69.2 , while DL models showed 80.8 sensitivity and 78.7 specificity. Subgroup analysis revealed that models for papillary thyroid cancer (PTC) had a pooled specificity of 76.3 , while those including other or unspecified cancers showed 68.3 specificity. Despite heterogeneity, significant differences (p = 0.037) were noted between models with and without clinical data. CONCLUSION: Radiomics and DL models show promising potential for detecting LNM in thyroid cancer, particularly in PTC. However, study heterogeneity underscores the need for further research to optimize these imaging tools
Human microbiome in post-acute COVID-19 syndrome (PACS)
No full textThe global COVID-19 pandemic, which began in 2019, is still ongoing. SARS-CoV-2, also known as the severe acute respiratory syndrome coronavirus 2, is the causative agent. Diarrhea, nausea, and vomiting are common GI symptoms observed in a significant number of COVID-19 patients. Additionally, the respiratory and GI tracts express high level of transmembrane protease serine 2 (TMPRSS2) and angiotensin-converting enzyme-2 (ACE2), making them primary sites for human microbiota and targets for SARS-CoV-2 infection. A growing body of research indicates that individuals with COVID-19 and post-acute COVID-19 syndrome (PACS) exhibit considerable alterations in their microbiome. In various human disorders, including diabetes, obesity, cancer, ulcerative colitis, Crohn's disease, and several viral infections, the microbiota play a significant immunomodulatory role. In this review, we investigate the potential therapeutic implications of the interactions between host microbiota and COVID-19. Microbiota-derived metabolites and components serve as primary mediators of microbiota-host interactions, influencing host immunity. We discuss the various mechanisms through which these metabolites or components produced by the microbiota impact the host's immune response to SARS-CoV-2 infection. Additionally, we address confounding factors in microbiome studies. Finally, we examine and discuss about a range of potential microbiota-based prophylactic measures and treatments for COVID-19 and PACS, as well as their effects on clinical outcomes and disease severity
New horizons for promising influences of sulforaphane in the management of metabolic syndrome: a mechanistic review
No full textThe disorder known as metabolic syndrome (MetS) represents a substantial threat to society since it is linked to a higher risk of heart disease, diabetes, stroke, and other health issues. Although there is no known cure for metabolic syndrome, lifestyle changes in diet and physical activity can help. Sulforaphane (SFN), a compound in cruciferous vegetables, has been recognized as a promising treatment for addressing metabolic syndrome. The information was compiled after a thorough search of four databases, PubMed, Scopus, Web of Sciences, and Google Scholar. This analysis includes 86 studies that include clinical and nonclinical SFN investigations in diseases connected to metabolic syndrome. Research has shown that sulforaphane is a prospective treatment option for obesity, type 2 diabetes mellitus (T2-DM), and associated metabolic disorders due to its capacity to regulate fatty acid production and glucose management. Many molecular processes have been investigated, including activating nuclear factor erythroid 2-related factor 2(Nrf2), activating nuclear factor erythroid 2(NF-E2), reducing reactive oxygen species, and upregulating insulin receptor substrate 1(IRS-1) and other suggested mechanisms. The current review established many facts in favor of SFN's prospective benefits in metabolic syndrome. More studies in this field involving human studies are necessary to determine whether SFN may effectively treat metabolic syndrome
Crocin Improves Cognitive Impairment in LPS-treated Rats through Anti-Apoptotic, Anti-Inflammatory, and Antioxidant Activities
No full textBrain inflammation and oxidative stress play critical roles in neuronal apoptosis and memory dysfunction in Alzheimer's disease. Crocin, a natural carotenoid in the stigma of saffron, possesses radical scavenging, anti-inflammatory, and anti-apoptotic properties. This study investigates the protective impact of crocin on neuronal apoptosis, oxidative stress, neuroinflammation, and memory deficits induced by lipopolysaccharide (LPS) in rats. Male Wistar rats received 100 mg/kg of crocin for 12 days, with LPS (1 mg/kg, ip) injected on days 8-12. Spatial learning and memory were evaluated in the Morris water maze two hours after LPS injection. Gene expression of nuclear factor kappa B (NF-kappaB), tumor necrosis factor-alpha (TNF-alpha), caspase 3, and lipid peroxidation was assessed in hippocampal homogenates at the end of the behavioral test. Histopathological changes in the hippocampus and cerebral cortex were evaluated using H&E staining. The results indicated that LPS administration caused spatial learning and memory dysfunction (P = 0.001, P < 0.01) accompanied by upregulation of Nfkb, Tnfalpha, and Casp3 mRNA expression (P < 0.0001), increased TNF-alpha (P < 0.01) and lipid peroxidation level (P < 0.01), decreased total thiol concentration (P < 0.05), tissue damage and neuronal loss in the hippocampus (P < 0.0001). Furthermore, crocin treatment at a dosage of 100 mg/kg attenuated learning and memory impairments (P = 0.001, P < 0.01), downregulated Nfkb, Tnfalpha, and Casp3 mRNA expression (P < 0.0001), decreased TNF-alpha level (P < 0.01) and lipid peroxidation (P < 0.05) and increased total thiol level (P < 0.05) in the hippocampus. Crocin also ameliorated LPS-induced pathological changes and neuronal loss in the hippocampus (P < 0.001) and cerebral cortex (P < 0.01). In conclusion, the neuroprotective effects of crocin against LPS-induced histopathological and behavioral changes could be attributed to its anti-apoptotic, anti-inflammatory, and radical-scavenging activities in the rat brain
The potential protective effects and mechanisms of fasting on neurodegenerative disorders: A narrative review
No full textThis study aimed to review the potential neuroprotective effects and underlying mechanisms of fasting in neurodegenerative disorders by synthesizing the existing literature. Research indicates that fasting may induce substantial modifications in both brain structure and function through diverse metabolic and cellular pathways. Preclinical studies utilizing animal models have elucidated several key mechanisms mediating these effects. The other significant proposed mechanism involves the modulation of gut microbiota during fasting periods. The intestinal microbiome functions as a crucial intermediary in the complex interplay between feeding patterns, circadian rhythms, and immune responses. These microbiome alterations may subsequently exert considerable influence on central nervous system functionality. Moreover, by reducing glucose availability, fasting has been shown to enhance the survival and resistance of healthy cells to adjuvant treatments in central nervous system tumors. Fasting presents a promising non-pharmacological intervention for neurodegenerative disorders, potentially offering both preventive and therapeutic benefits. However, the current evidence base remains preliminary, warranting extensive further investigation to validate these initial findings and establish robust clinical protocols for both efficacy and safety