Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Sodium-Glucose Cotransporter 2 Inhibitors and Pulmonary Hypertension: A Systematic Review
No full textPulmonary hypertension (PH) is a chronic disease characterized by elevated pulmonary arterial pressure, often leading to right ventricular failure. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are potential therapies for PH due to their cardiovascular effects. In this systematic review, we aim to assess the safety and efficacy of SGLT2 inhibitors in improving pulmonary hemodynamics and cardiac parameters in patients with PH. A systematic review search until November 2024 was conducted across 8 databases. Six studies involving 462 participants were included, comprising 3 randomized controlled trials, 2 observational studies, and 1 cohort study. SGLT2 inhibitors, particularly dapagliflozin and empagliflozin, significantly reduced pulmonary arterial pressure in most studies. Cardiac indices, such as left ventricular diastolic and systolic diameters, E/e', and left ventricular ejection fraction, also improved. However, one randomized controlled trial reported no significant improvement in the hemodynamic outcomes. SGLT2 inhibitors are assumed to be promising in the management of PH through cardiac and hemodynamic improvements. Further research is needed to elucidate their efficacy and the underlying mechanisms
Determining the normal range of the dimensions and volume of the pituitary gland of children using a 3D magnetic resonance imaging (MRI) protocol in Imam Hossein Hospital of Isfahan in 2021 to 2024
No full textBACKGROUND: Understanding the morphological changes and dimensions of the pituitary gland is crucial for accurate diagnosis and personalized treatment in pediatric patients. Advanced imaging techniques, such as 3D magnetic resonance imaging (MRI), enhance our ability to address knowledge gaps and improve clinical practices in pediatric endocrinology. This study aims to determine normative pituitary gland dimensions and volumes in pediatric patients at Imam Hossein Hospital in Isfahan using advanced 3D MRI protocols. METHODS: Conducted as a prospective cross-sectional study, this research focused on children under 15 years without specific conditions. A total of 412 participants were selected through simple random sampling, and data were analyzed using SPSS version 20 to rigorously assess measurements and extract insights beneficial for pediatric endocrinology. RESULTS: The study included participants aged 0 to 15 years, with a higher representation of boys (63.83) compared to girls (36.17). Significant differences were observed in height and volume based on gender and age group. Scatterplots illustrated variations in the pituitary gland's volume, width, height, and anterior-posterior diameter according to age and gender. CONCLUSION: This research provides valuable insights into pediatric endocrinology, facilitating accurate diagnosis and treatment of pituitary disorders in children
Galbanic acid delays the development of seizures by modulating the expression of TNFalpha, IL1beta, and TLR4 genes and reducing hippocampal nitrite levels and may be useful in the treatment of epilepsy
No full textINTRODUCTION AND OBJECTIVE: Epilepsy is one of the most common chronic brain disorders worldwide. This study aimed to determine the effect of Galbanic acid on seizures. MATERIALS AND METHODS: In this study, 40 NMRI mice were used and divided into 4 groups. The control group received 10 mg/kg normal saline. Three groups received Galbanic acid at doses of 10, 20, and 40 mg/kg. The positive control group received diazepam with a dose of 10 mg/kg. All injections were made intraperitoneally for one week. Seizures were induced in all mice by injection of 90 mg/kg Pentylenetetrazole (PTZ). Then the latency of seizure onset in each of the experimental groups was recorded. After anesthesia with Ketamine 100 mg/kg and Xylazine 10 mg/kg, blood samples were taken and after decapitation, the hippocampus was isolated and the expression of alphaTNF-, IL1beta, and TLR4 genes in this region was measured. RESULTS: Galbanic acid increased the delay in seizure onset, decreased brain and serum nitrite levels, and decreased the expression of alphaTNF-, IL1beta, and TLR4 genes in brain tissue compared to the control group (P < 0.01, p < 0.001). CONCLUSION: Galbanic acid reduced nitrite and the expression of alphaTNF-, IL1beta, and TLR4, leading to a decrease in neuroinflammation and, as a result, a delay in seizure onset in mice
Exploring the oxidative mechanism of methotrexate on catalase enzyme: an in vitro study
No full textMethotrexate (MTX) is a well-known anti-metabolite agent recognized for its oxidative effects, particularly in the liver where the enzyme catalase is abundant. This research aimed to clarify the impact of MTX on the behavior of liver catalase. The cytotoxicity of HepG2 cells was assessed across various concentrations of MTX. Following that, the examination focused on the generation of reactive oxygen species (ROS) and the activity of catalase. Furthermore, the kinetic activity of bovine liver catalase (BLC) was examined in the presence of MTX. Finally, the interaction between MTX and the enzyme's protein structure was investigated using docking and dynamic light scattering (DLS) methods. The results indicated a significant decrease in catalase activity and a significant increase in ROS production in HepG2 cells treated with MTX. Although the activity of BLC remained unaffected by MTX directly, molecular docking and DLS techniques revealed MTX binding to BLC, inhibiting its tetramerization. The oxidative effects of MTX were associated with elevated ROS levels in cellular processes, leading to excessive catalase activity and subsequent suicide inactivation. Furthermore, MTX influenced the protein structure of catalase
What Features Predict Poorer Outcomes in Micropapillary Thyroid Carcinoma? A Retrospective Cohort Study
No full textOBJECTIVE: Micropapillary thyroid carcinoma (MPTC), a variant of papillary thyroid carcinoma sized /=7 mm) (odds ratio OR, 3.196; P value = .001) and multifocality (OR, 2.431; P value = .004). Age (OR, 0.973; P value = .048) and background Hashimoto thyroiditis (OR, 0.439; P value = .014) were found as protective factors. Excellent response to therapy was observed in 48.4% of patients, whereas structural and biochemical incomplete responses were found to be 11.2% and 7.5%. Recurrence was detected in 14 (8.18%) patients. CONCLUSION: MPTC generally has a good prognosis and responds well to the treatment. Larger tumors (>/=7 mm), younger age (<40 years), multifocality, and absence of Hashimoto thyroiditis correlate with a higher American Thyroid Association risk and poorer outcomes
Recent advances in the clinical management of intoxication by five heavy metals: Mercury, lead, chromium, cadmium and arsenic
No full textMetals have been used for many centuries, but their nutritional and toxic effects have been investigated since the last century. The common toxic heavy metals (THM) include mercury, lead, chromium cadmium, and arsenic. As human exposure to THM increasingly causes systemic and organ complications, it seems required to review the recent advances of treatment of the toxic metals. Despite the current knowledge of the hazards of heavy metals, there is still high incidents of their poisonings particularly in developing countries. In this review, after an introduction, we briefly describe the routes of exposure, clinical features and prognosis of each metal poisoning. Then, review the different treatments for each metal with particular attention to recent advances in the treatment of both acute and chronic poisonings. The main antidotes for all THM are still chelating agents, but new agents were developed over the past decades and have been used successfully for the THM poisonings. Dimercaptosuccinic acid (DMSA) known as succimer has been prescribed as a safe oral chelator in lead poisoning. Similarly, dimercapto-propanesulfonic acid (DMPS) has also revealed fewer side effects than the old chelating agents. The two are currently gaining increased acceptance among clinical toxicologists. However, there is no specific antidote for mercury poisoning. Dimercaprol is almost no longer used as an antidote of choice in the treatment of chronic THM poisoning. Comparison of clinical management of intoxication by the five heavy metals reveals similar treatment strategies. On the other hand, some of them require specific interventions to reduce the toxicity. Because of drawbacks in the application of commonly known chelating agents, treatment with bioactive compounds which have antioxidant and anti-inflammatory properties has been the subject of much interest in recent research. However, despite the promising results observed in experimental animals, clinical trials on their clinical therapeutic benefits have not been yet successful and need further studies to determine their efficacy and safety in humans. Development of less toxic chelating agents are still under investigations. Moreover, the development of orally administrable chelating agents for home health care would likely be of great interest for future research
Intraocular drug delivery systems for Diabetic retinopathy: Current and future prospective
No full textIn pharmaceutical research and development, novel drug delivery systems represent a significant advancement aimed at enhancing the efficacy of therapeutic agents through innovative delivery mechanisms. The primary objective of these systems is to transport therapeutic compounds to specific target sites, such as tumors and afflicted tissues, with the dual purpose of mitigating side effects and toxicity associated with the drugs while concurrently augmenting therapeutic effectiveness. Numerous innovative drug delivery strategies have been scrutinized for their applicability in the context of targeted ocular drug delivery. Diverse novel carriers, including but not limited to implants, hydrogels, metal nanoparticles, Nano-liposomes, micelles, solid lipid nanoparticles (SLN), emulsions, and biodegradable nanoparticles, have been harnessed to facilitate the controlled release of pharmaceutical agents to the retina and vitreous. These carriers offer distinct advantages, such as enhanced intraocular drug delivery, precise control over drug release kinetics, heightened stability, and superior entrapment efficiency. This comprehensive review seeks to elucidate the current strides made in the realm of carriers and their contemporary applications in treating diabetic retinopathy (DR). Furthermore, it underscores these carriers' pivotal role in achieving efficacious intraocular drug delivery. Additionally, this article explores the various administration routes, potential future advancements, and the multifaceted challenges confronting the domain of novel carriers in treating DR. In conclusion, novel formulations are introduced to surmount the challenges associated with intraocular drug delivery
An unusual pathology of a nasal tip mass in a 28-year-old female
No full textThe nose is a frequently affected site for skin cancers, thus it should always be considered when addressing pathologies of the external apex nasi. This case report presents a 28-year-old woman with an atypical nasal tip mass, characterized as a keratinous cyst demonstrating a multinucleated giant cell reaction and calcification. The mass, which had gradually enlarged over 3 years, was successfully removed using an open rhinoplasty technique. Preoperative imaging studies, including ultrasound, noncontrast CT, and MRI, revealed specific characteristics of the mass, aiding in diagnosis and surgical planning. The study underscores the need for increased awareness about nasal tip deformities caused by keratinous cysts, emphasizing the need for comprehensive diagnostic and therapeutic strategies to improve patient outcomes
The Effect of Foot Reflexology on the Sexual Function of Lactating Women: A Randomized Clinical Trial
No full textBACKGROUND: Sexual health is an essential part of women's lives at different ages. Pregnancy, childbirth, and breastfeeding can affect women's sexual function by inducing biological, psychological, and social changes. Due to the prevalence of sexual dysfunction in lactating women and the effects of reflexology therapies on it, this study was conducted to investigate the effect of foot reflexology on the sexual function of lactating women. MATERIALS AND METHODS: This randomized clinical trial was conducted in selected health centers of Isfahan in 2022 on 64 lactating women (32 women in each group of intervention and control). The samples were selected using the convenience sampling method and were randomly divided into two groups with a random number table. Each participant in the intervention group received 10 sessions of foot reflexology, and each session lasted for 50 minutes (25 minutes for each foot) and was held every three days. The female sexual function index (FSFI) questionnaire was completed before the intervention and four weeks after the end of it. The control group received routine care and completed the questionnaire before the intervention and 9 weeks later. Data were analyzed using SPSS version 20 and independent/paired t-tests. RESULTS: Data analysis showed that the subjects of the two groups were homogeneous in demographic and fertility characteristics at the beginning of the study. The total mean score of sexual function in the intervention group was 20.36 +/- 4.16 before the intervention and 28.05 +/- 2.89 after the intervention. In the control group, this score was 20.51 +/- 3.75 before the intervention and 20.54 +/- 3.71 nine weeks after it. A comparison of the total mean score of sexual function and dimensions showed a significant difference between the two groups four weeks after the intervention (p <0.001). In the intervention group, significant changes were observed in the total mean score of sexual function and its dimensions four weeks after the intervention compared to before the intervention. However, in the control group, there were no significant changes in this score and its dimensions nine weeks later compared to before the intervention. CONCLUSION: Based on the results of this study, lactating women in the two groups did not have a desirable sexual function before the intervention. However, foot reflexology in the present study could effectively improve the sexual function of women in the reflexology group. Therefore, it is recommended to employ foot reflexology therapy in health centers to help lactating women restore their sexual function
NRF-mediated autophagy and UPR: Exploring new avenues to overcome cancer chemo-resistance
No full textThe development of chemo-resistance remains a significant hurdle in effective cancer therapy. NRF1 and NRF2, key regulators of redox homeostasis, play crucial roles in the cellular response to oxidative stress, with implications for both tumor growth and resistance to chemotherapy. This study delves into the dualistic role of NRF2, exploring its protective functions in normal cells and its paradoxical support of tumor survival and drug resistance in cancerous cells. We investigate the interplay between the PERK/NRF signaling pathway, ER stress, autophagy, and the unfolded protein response, offering a mechanistic perspective on how these processes contribute to chemoresistance. Our findings suggest that targeting NRF signaling pathways may offer new avenues for overcoming resistance to chemotherapeutic agents, highlighting the importance of a nuanced approach to redox regulation in cancer treatment. This research provides a molecular basis for the development of NRF-targeted therapies, potentially enhancing the efficacy of existing cancer treatments and offering hope for more effective management of resistant tumors