Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Electrochemical biosensors for depression: Diagnosis and therapeutic monitoring
No full textElectrochemical biosensors have revolutionized the detection of biomarkers related to depression and the quantification of antidepressant drugs. These biosensors leverage nanomaterials and advanced assay designs to achieve high sensitivity and selectivity for clinically relevant analytes. Key neurotransmitters implicated in depression, such as serotonin, dopamine, and glutamate, can be accurately measured via biosensors, providing insights into the effects of antidepressant treatments on neurotransmission. Biosensors can also detect biomarkers of inflammation, oxidative stress, and neuronal health that are altered in depression. Real-time biosensing techniques such as fast-scan cyclic voltammetry enable monitoring of dynamic neurotransmitter changes during depressive episodes and pharmacological interventions. Advancements incorporating graphene, gold nanoparticles, and other nanomaterials have enhanced biosensor performance, enabling the detection of low biomarker concentrations. Closed-loop biosensing systems hold promise for precision medicine by automating antidepressant dosage adjustments on the basis of neurotransmitter levels. A wide range of depression biomarkers, including apolipoprotein A4, heat shock protein 70, brain-derived neurotrophic factor, microRNAs, proteins, and combinatorial biomarker panels, have been detected via sophisticated biosensor platforms. Emerging biosensors show selectivity for antidepressant drugs such as serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, and selective serotonin reuptake inhibitors in biological samples. This review emphasizes the transformative potential of electrochemical biosensors in combating depression. By facilitating earlier and more accurate diagnoses, these biosensors can revolutionize patient care and enhance treatment outcomes
Adrenal crisis-induced cardiogenic shock (ACCS): a comprehensive review
No full textAdrenal insufficiency (AI) is a disorder in which inadequate glucocorticoid and mineralocorticoid hormone production leads to a variety of symptoms, including fatigue, weight loss, and nausea. In some patients with unknown AI, adrenal crisis-induced cardiogenic shock (ACCS) can be the first presentation, resulting in a fatal situation. The ACCS may exhibit unresponsiveness to inotropes and fluid therapy; thus, glucocorticoid administration is the primary vital intervention, making early detection of AI essential. Hence, in this study, we review the case reports demonstrating acute cardiomyopathies in the context of AI. The review addresses the suggested underlying mechanisms, including the diminished protective effects of glucocorticoids against catecholamines in AI. We also highlighted some clues to aid physicians in considering AI as a differential diagnosis in critically ill patients presenting cardiogenic shock
Targeting N-Methyl-lysine Histone Demethylase KDM4 in Cancer: Natural Products Inhibitors as a Driving Force for Epigenetic Drug Discovery
No full textKDM4A-F enzymes are a subfamily of histone demethylases containing the Jumonji C domain (JmjC) using Fe(II) and 2-oxoglutarate for their catalytic function. Overexpression or deregulation of KDM4 enzymes is associated with various cancers, altering chromatin structure and causing transcriptional dysfunction. As KDM4 enzymes have been associated with malignancy, they may represent novel targets for developing innovative therapeutic tools to treat different solid and blood tumors. KDM4A is the isozyme most frequently associated with aggressive phenotypes of these tumors. To this aim, industrial and academic medicinal chemistry efforts have identified different KDM4 inhibitors. Industrial and academic efforts in medicinal chemistry have identified numerous KDM4 inhibitors, primarily pan-KDM4 inhibitors, though they often lack selectivity against other Jumonji family members. The pharmacophoric features of the inhibitors frequently include a chelating group capable of coordinating the catalytic iron within the active site of the KDM4 enzyme. Nonetheless, non-chelating compounds have also demonstrated promising inhibitory activity, suggesting potential flexibility in the drug design. Several natural products, containing monovalent or bivalent chelators, have been identified as KDM4 inhibitors, albeit with a micromolar inhibition potency. This highlights the potential for leveraging them as templates for the design and synthesis of new derivatives, exploiting nature's chemical diversity to pursue more potent and selective KDM4 inhibitors
Association between cerebrospinal fluid chitotriosidase level and amyotrophic lateral sclerosis: a systematic review
No full textINTRODUCTION: One of the fatal and debilitating neurodegenerative diseases is amyotrophic lateral sclerosis (ALS). Increasing age is one of the risk factors of ALS. Considering that the elderly population in the world is increasing, it is very important to identify useful and effective diagnostic and treatment methods. The purpose of this systematic review is to determine the relationship between chitotriosidase (CHIT1) level and ALS disorder. CONTENT: Keywords "Amyotrophic Lateral Sclerosis", "Gehrig* Disease", "Charcot Disease", "Guam Disease", ALS, CHIT1 and chitotriosidase were searched in PubMed, Scopus, Web of Science and Science Direct databases without time limit on September 2023. Hundred twenty studies were obtained by searching, and finally, 14 studies were included in this study using the inclusion and exclusion criteria. In all 14 selected studies, the level of biomarker CHIT1 in the CSF of ALS patients was significantly higher than that of healthy control and disease control groups. But, in 8 studies that included 3 groups, no significant difference was observed between the CHIT1 levels in the two control groups. Six studies have reported the amount of CHIT1 level quantitatively. Among these 6 studies, in 5 studies CHIT1 level in disease control was higher than healthy control (not significant) and in only one study CHIT1 level was higher in healthy control compared to disease control (not significant). SUMMARY AND OUTLOOK: In all 14 studies, a multifold increase in CHIT1 levels has been observed in patients compared to healthy and disease control groups. Therefore, based on the findings of the studies, this study confirms the relationship between CHIT1 increase and ALS disorder
The association of ultra-processed food intake with neurodegenerative disorders: a systematic review and dose-response meta-analysis of large-scale cohorts
No full textOBJECTIVES: Our systematic review and meta-analysis aimed to uncover the relationship between UPFs intake and neurodegenerative disorders, including multiple sclerosis (MS), Parkinson's disease (PD), Alzheimer's disease (AD), cognitive impairment, and dementia. SETTING: A systematic search was conducted using the Scopus, PubMed/MEDLINE, and ISI Web of Science databases without any limitation until June 24, 2023. Relative risk (RR) and 95 confidence interval (CI) were pooled by using a random-effects model, while validated methods examined quality and publication bias via Newcastle-Ottawa Scale, Egger's regression asymmetry, and Begg's rank correlation tests, respectively. RESULTS: Analysis from 28 studies indicated that a higher UPFs intake was significantly related to an enhanced risk of MS (RR = 1.15; 95 CI: 1.00, 1.33; I(2 )= 37.5; p = 0.050; n = 14), PD (RR = 1.56; 95 CI: 1.21, 2.02; I(2 )= 64.1; p = 0.001; n = 15), and cognitive impairment (RR = 1.17; 95 CI: 1.06, 1.30; I(2 )= 74.1; p = 0.003; n = 17), although not AD or dementia. We observed that a 25 g increment in UPFs intake was related to a 4 higher risk of MS (RR = 1.04; 95 CI: 1.01, 1.06; I(2 )= 0.0; p = 0.013; n = 7), but not PD. The non-linear dose-response relationship indicated a positive non-linear association between UPF intake and the risk of MS (P(nonlinearity) = 0.031, P(dose-response )= 0.002). This association was not observed for the risk of PD (P(nonlinearity) = 0.431, P(dose-response )= 0.231). CONCLUSION: These findings indicate that persistent overconsumption of UPFs may have an adverse impact on neurodegenerative conditions, potentially leading to a decline in quality of life and reduced independence as individuals age
Evaluation of the safety and efficacy of biosimilar recombinant growth hormone in children with growth hormone deficiency: non-inferiority, randomized, parallel, multicentric and Phase III trial
No full textOBJECTIVES: This study is designed in order to compare the efficacy and safety of recombinant human growth hormone (rhGH) with the reference brand. METHODS: According to the inclusion criteria, 85 people in 13 Iranian centers were randomly selected to receive biosimilar Somatropin (Somatin(R)) (44 people) and reference Somatropin (Norditropin(R)) (41 people) at a dose of 35 microg/kg/d, seven days/week for 12 months. The primary outcomes included height velocity (HV) was measured during 12 months of treatment. RESULTS: The two intervention groups' Height changes were similar. The mean HV was 10.96 cm/year in the biosimilar group and 10.05 cm/year in the reference groups after 12 months. Estimates of the lower bounds of 95 CI for mean height differences in the biosimilar intervention group compared to the reference intervention group did not exceed the 2 cm margin. Therefore, the non-inferiority of biosimilar intervention compared to the brand product is verified. Common ADRs in both groups were nausea in two patients (2.4), diarrhea in two patients (2.4), increased body temperature in one patient (1.2), and headache in one patient (1.2). CONCLUSIONS: The finding of this study indicated that Somatin(R) and Norditropin(R) have comparable efficacy and safety profiles. CLINICAL TRIAL REGISTRATION: www.IRCT.irIRCT20171122037571N1
Frequency of Pain Intensity and Factors Affecting It after Cesarean Section Using Spinal Anesthesia
No full textBackground: Postoperative pain is an important public health issue that affects the sensory and emotional experiences of patients. This study aimed to understand the impact of pain management on patients. Methods: The present study was a retrospective cross-sectional study conducted on women over 18 years of age who underwent cesarean section with spinal anesthesia in Shahid Beheshti Hospital of Isfahan. Results: In this study, 250 women with a Mean age of 31.75 years and a Mean pain intensity of 8.15 participated. Postoperative pain was more common in people without underlying disease and obese people had more pain. Intravenous pain relievers such as pethidine and diclofenac suppositories temporarily reduced the pain intensity. Conclusion: This study showed that the pain after cesarean section was significantly influenced by the length of the operation, the type of anesthesia, and painkillers, which require strategies to reduce the pain. © 2025 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences
Mental Health in the Workplace from the Perspective of Oncology Nurses in Iran: A Qualitative Descriptive Study
No full textBackground:The workplace and the context in which oncology nurses work are unique due to the complex and dynamic nature of cancer care. Nurses who care for cancer patients are exposed to varying degrees of psychological pressure. The present study was conducted to explore oncology nurses' perceptions regarding mental health in the workplace.Materials and Methods:This study was conducted in 2018-2019. The participants were recruited through purposive sampling from eight educational specialty cancer treatment centers in Iran. Data were collected through individual semistructured interviews and analyzed using the conventional qualitative content analysis method. The Consolidated criteria for Reporting Qualitative research (COREQ) checklist was used to document the report of the study.Results:The extracted concepts were classified into three main categories and 17 subcategories. The main categories included attention to nurses' occupational stress-provoking factors, attention to emotional/psychological responses in the workplace, and healthy mental atmosphere in the workplace.Conclusions:The findings indicate that oncology nurses need to be supported to enhance their mental health in the workplace. The findings of this study could help policymakers and nurse managers to understand the importance of improving the mental health of nurses in cancer care. In this regard, it is essential to make the necessary plans and scientific decisions to design and provide strategies to alleviate workplace problems and improve nurses' mental health
Enhancing stone expulsion: The efficacy of combined medical therapy with tamsulosin and dexamethasone in renal colic patients
No full textBackground:Ureteral stones are a common aspect of daily urologic practice, affecting 10-15 of people worldwide over their lifetime. This study aimed to assess the efficacy of combined medical expulsive therapy (MET) with intravenous dexamethasone and oral tamsulosin compared to tamsulosin alone in the frequency and duration of distal ureteral stone expulsion.Materials and Methods:This prospective, double-blind, randomized controlled trial with 1:1 balanced randomization was conducted from September 2022 to March 2023 at Al-Zahra Hospital, a tertiary care facility affiliated with Isfahan University of Medical Sciences. Of 213 patients admitted to our center with acute renal colic, 134 had distal ureteral stones and were assessed. Among them, 105 patients were eligible and included in the trial and were randomly assigned into the intervention group (n = 52) and control group (n = 53). Data from four patients in the case group were omitted from the analysis due to the drop-out from the study.Results:Mean initial stone size was 6.5 +/- 1.2 mm in the intervention, and 6.3 +/- 1.0 mm in the control groups, which was not statistically significant (P = 0.488). Gender was comparable between both groups (P = 0.196), whereas the distribution of BMI (27.2 +/- 4.0 vs. 29.8 +/- 3.9 kg/m2, P = 0.001) and age (41.5 +/- 12.9 vs. 47.9 +/- 16.2 years, P = 0.031) was not in balance. In total, 43 patients had expelled the stone by the end of the 2 weeks, resulting in an overall expulsion rate of 42.5. Specifically, 28 (58.3) patients in the intervention group and 15 (28.3) patients in the control group had expelled the stone, a difference that was statistically significant (P = 0.002). The time to stone expulsion did not exhibit a significant difference between the intervention and control groups (9.8 vs. 5.4 days, respectively). However, it is noteworthy that the variability in the time to stone expulsion in the tamsulosin + dexamethasone group was considerably smaller than that in the control group, as indicated by the smaller standard deviation in the former (1.0 vs. 3.8 days, respectively).Conclusion:Adding dexamethasone to standard MET with tamsulosin for distal ureterolithiasis appears to increase the stone expulsion rate, although it did not significantly shorten the expulsion time
Development of health promotion model in patient with severe traumatic brain injuries: A mixed-method study protocol
No full textBACKGROUND:Patients with severe traumatic brain injury with some degree of long-term physical and cognitive disabilities are transferred from the hospital to home. So this study was conducted to the development a health promotion model in patient with severe traumatic brain injuries. MATERIALS AND METHODS:This exploratory, mixed-methods, qualitative-quantitative study consists of 4 phases will be conducted in Isfahan University of Medical Sciences in 2023-2024. In The first phase, a literature review will be carried out to extract the patient need for care in postdischarge in many other countries. The second phase involves a directional content analysis of healthcare providers and caregivers of patients with severe-TBI to identify the needs of care of patients at home. In this phase, purposeful sampling will be used to collect data through semistructured interviews. In the third phase, the postdischarge care program will be designed based on the results of the first and second phases. In this phase, the classic Delphi method will be used to evaluate the final version of the program's initial draft and determine the program priorities and experts' consensus. In the last phase, the designed program will be implemented through a quasi-experimental study in two groups (before and after intervention), and the effectiveness of the intervention will be evaluated. DISCUSSION:Using of care plan based on patient needs in postdischarge and improving the quality of life in patients with severe brain damage, taking into account the cultural, social, and religious context of Iran, will provide the possibility of effective home care for these patients