Repository of Research and Investigative Information Isfahan University of Medical Sciences
Not a member yet
23244 research outputs found
Sort by
The Learning Curve in Urogynecology and Functional Urology: A Systematic Review
No full textIntroduction and HypothesisWhen adopting new methods, surgeons may experience a period of complexity and longer operation times because of their inexperience. This period is known as the "learning curve." This study was aimed at systematically reviewing the current literature on functional urology learning curves.MethodsA comprehensive search was conducted across multiple databases from inception to July 2023 with no language restrictions. All original studies on urogynecological and functional urological procedures, including cross-sectional, cohort, and clinical trials, were eligible for inclusion. Relevant data were extracted, and methodological quality was appraised using standardized Joanna Briggs Institute critical appraisal tools. To quantitatively investigate learning curves, a mixed-effects generalized linear regression analysis was conducted on studies employing cumulative summation methods.ResultsFrom the 7,104 records, 68 studies met the inclusion criteria. The majority of studies were observational and the most common outcome measures were surgical duration, blood loss, and hospital stay. The learning curves varied by procedure type-for incontinence surgeries, 15-80 cases were required; for pelvic organ prolapse surgeries, 18-47 cases; for laparoscopic procedures, 10-105 cases; and for robotic procedures, 5-84 cases. The analysis showed that the number of cases required to surpass the learning curve decreased over time, likely reflecting technological advancements and increased surgical experience.ConclusionThe learning curve for surgical procedures varies significantly. It varies between 5 cases for robotic supratrigonal cystectomy to 75 cases for robot-assisted ventral mesh rectopexy or robotic sacrocolpopexy surgery in 84 cases. These variable learning curves highlight the need for structured training programs and ongoing assessment
Comparative efficacy of lumbar and pelvic support on pain, disability, and motor control in women with postpartum pelvic girdle pain: a three-armed randomized controlled trial
No full textBackground Pregnancy-related posterior pelvic girdle pain (PPGP) is a common cause of back pain and disability in the postpartum period. The objective of this study was to investigate the efficacy of orthotic support on pain, disability, and motor control in women with pregnancy-related PPGP. Methods Eighty-four women with a clinical diagnosis of pregnancy-related PPGP participated in this randomized controlled trial (RCT). Participants were randomly allocated into three groups (with a ratio of 1:1:1): the pelvic support group, the lumbar support group, and the control group (patient-education leaflet). Pain severity, disability, effort during active straight leg raising test (ASLR), maximum isometric muscle force (hip flexion and trunk rotation), and joint position reproduction (JPR) of hip abduction were assessed as study outcomes. These variables were measured at four time points -before the intervention, immediately after the intervention, at the 4-week follow-up (at this time, the intervention period was terminated), and at the 5-week follow-up (one week after discontinuing the interventions)- to evaluate the possible effects of wearing support. Repeated-measures multivariate analysis of variance (MANOVA) was applied to determine the statistical significance between groups. Bonferroni post-hoc correction was used to identify significant differences between groups at different study time points. Results There was a significant interaction effect for group x time for the study outcomes, including pain severity, disability, effort during ASLR, and maximum isometric muscle force between groups (p 0.008). The effect sizes for study outcomes were large, except for the JPR of hip abduction. Conclusions For women with pregnancy-related PPGP, both lumbar and pelvic supports were beneficial for decreasing pain and disability symptoms. Lumbar support showed better results for managing PPGP than pelvic support
Comparison of Vertical Marginal Discrepancy in High and Low Translucent Monolithic Zirconia Crowns in Repeated Firing Cycles
No full textObjective Increase in vertical marginal discrepancy (VMD) during repeated firing cycles and its clinical outcomes is a major concern for high and low translucent monolithic zirconia crowns. The purpose of this in vitro study was to evaluate and compare VMD in high and low translucent monolithic zirconia crowns in repeated firing cycles. Material and Methods To perform this study, 10 monolithic zirconia crowns made by computer-aided design and computer-aided manufacturing method were used in two groups of five with high and low translucency, which were designed on Zimmer tissue-level implant abutment. The crowns in each group were randomly numbered from 1 to 5 and each underwent 1, 3, and 5 firing cycles. After completing each mentioned cycle, the VMD was measured at eight predetermined points on abutment by optical microscope and their average was recorded for each sample. Data analysis was done by SPSS 22 software through repeated-measure analysis of variance, paired t -test, and t -test with a 5 significance threshold. Results A total of 240 measurements were made for the VMD, which, due to the presence of five samples in each translucency group and eight examined points in each sample, was finally summed up to six averages for each translucency group in the mentioned three stages of firing cycles. The averages for the low-translucency group after 1, 3, and 5 firing cycles were 76.86, 85.02, and 90.55 mu m, respectively, and for the high-translucency group after 1, 3, and 5 firing cycles were 80.38, 87.33, and 97.78 mu m, respectively. The average VMD of the samples regardless of the translucency level after 1, 3 and 5 firing cycles was calculated as 78.62, 86.18, and 94.16 mu m, respectively. Conclusion This study found that VMD increased with repeated firing cycles, with no significant difference between high- and low-translucency zirconia crowns. Repeated firings significantly raised VMD, but all values remained within clinically acceptable limits, supporting the suitability of both translucency types for clinical use
Association Between Circulating Levels of Magnesium and Metabolic Syndrome: A Systematic Review and Meta-Analysis of Observational Studies with GRADE Assessment
No full textContext Evidence on the associations between circulating magnesium (Mg) levels and metabolic syndrome (MetS) is inconclusive.Objective In this meta-analysis we examined the relationship between Mg concentrations and MetS.Data sources Observational studies were searched through the PubMed, EmBase, ISI Web of Science, and Scopus databases and Google Scholar, without time or language limitations, up to January 2024.Data extraction Eligible studies were epidemiological investigations that reported relative risks or odds ratios ORs of MetS in relation to serum, plasma, or blood Mg levels. The certainty of each meta-analysis was assessed by use of the grading of recommendations, assessment, development, and evaluation (GRADE) approach.Data analysis A total of 11 studies (9 cross-sectional and 2 case-control) were eligible to be included. Pooling estimates of these studies (with 14 188 individuals and 4724 cases with MetS) revealed that compared to individuals with the lowest level of Mg concentration, those with the highest Mg concentration had 46% significantly lower odds of MetS (OR = 0.54; 95% CI: 0.34-0.86). Each 0.5-mg/dL increase in the level of circulating Mg was related to an 11% reduction in the odds of contracting MetS (OR = 0.89; 95% CI: 0.83-0.96). Nonlinear analysis showed a U-shaped curve; the lowest likelihood of MetS was seen at a circulating Mg concentration of 2.5 mg/dL. Certainty of the evidence was high.Conclusions In this meta-analysis of epidemiologic studies we documented that circulating Mg levels were inversely associated with MetS. Additional prospective studies are needed to provide more solid evidence for the optimal range of circulating Mg concentrations with respect to prevention of MetS.Systematic Review Registration PROSPERO registration No. CRD42024535236
Cortical Areas Involved in Subjective Visual Vertical Perception: A Systematic Review
No full textBackground and Aim: The information related to brain oscillation, head rotation and head orientation relative to gravity is obtained from the vestibular system. An important reference for upright posture and navigation is gravity-based vertical perception. Many studies have been conducted for the determination of cortical areas involved in Subjective Visual Vertical (SVV) perception in healthy people or patients with brain injuries. Their results have indicated an extensive and bilateral cortical area involved in SVV perception. The purpose of this review study is to investigate these cortical areas and their functional role. Recent Findings: Neuroimaging studies in patients with brain injuries showed that multiple cortical areas have arole in SVV perception. These areas mainly include the occipital cortex, frontal cortex, posterior temporoparietal, temporo-occipital, parieto-occipital, superior temporal gyrus, inferior parietal lobe in temporoparietal junction, posterior insula, cuneus, lingual gyrus, precuneus, ventral dentate nucleus, cerebellum, and brainstem. Conclusion: The cortical areas involved in SVV perception are a part of the vestibular system, which is distributed bilaterally. These areas have a multi-sensory processing task and play a role in processing of cognitive and motor sensory information
Investigating the effect of a herbal cream containing rose essence in an animal model of eczema
No full textObjective: Eczema, a common inflammatory skin condition characterized by itching and dermatitis, can significantly impact the quality of life. While conventional treatments exist, there is interest in exploring natural alternatives. This study investigates the efficacy of a rosehip extract-based cream in mitigating eczema symptoms in a mouse model. Materials and Methods: Thirty-five mice were divided into five groups: control, dinitrochlorobenzene (DNCB)-induced eczema (model group), and treatment groups receiving placebo, betamethasone cream (positive control), or rosehip extract cream. Following topical treatment for four weeks, the animals were euthanized, and their skin was evaluated for inflammation, moisture, and thickness. Histopathological analysis was performed using hematoxylin and eosin (H&E) staining. Results: Compared to the control group, DNCB treatment significantly increased inflammation, erythema (redness), dryness, and epidermal thickness. Notably, topical application of the rosehip extract cream significantly reduced these eczema-associated parameters, demonstrating efficacy comparable to the positive control (betamethasone cream). Conclusion: This study suggests that a topical cream formulated with rosehip extract may be a promising therapeutic strategy for alleviating eczema symptoms. The anti-inflammatory and potentially regenerative properties of rose extract warrant further investigation for the development of natural eczema treatments
Microwave-assisted tailoring of bredigite nanoparticles with strontium for superior bioactivity and bone regeneration applications
No full textBiomaterials with exceptional biofunctionality are increasingly in demand. This study aimed to enhance the biofunctionality of bredigite, a well-established bioceramic, by substituting strontium (Sr) into its structure, owing to the ability of Sr to promote bone regeneration, stimulate osteoblast differentiation, and increase alkaline phosphatase (ALP) activity. Bredigite and Sr-substituted bredigite nanoparticles were synthesized via a microwave-assisted method. The results demonstrated that Sr substitution altered the nanocrystal morphology and increased crystallite size. Pure bredigite (Br-0S), 5 Sr-substituted bredigite (Br-5S), and 10 Srsubstituted bredigite (Br-10S) exhibited cuboidal, irregular, and spherical shapes, respectively. The crystallite size increased from 40 nm for Br-0S to 60 nm and 90 nm for Br-5S and Br-10S, respectively. Sr substitution significantly improved the bioactivity of bredigite by accelerating apatite formation and increasing its amount. The MTT assay confirmed the good viability and proliferation of MG-63 osteoblast-like cells on Sr-substituted bredigite specimens. Cell adhesion studies demonstrated strong adhesion and proliferation on Sr-substituted specimens. ALP activity assays revealed higher ALP levels with increasing Sr content, facilitating osteogenic differentiation. These findings highlight two synergistic effects of Sr substitution in bredigite: enhanced bioactivity and increased ALP activity, both of which are critical for osteogenic differentiation and bone regeneration. Sr-substituted bredigite nanoparticles show significant promise for addressing challenges in bone tissue engineering, offering enhanced bioactivity and osteogenic potential for improved bone regeneration therapies
Investigating the Trend of Mortality, Life Expectancy and Excessive Death with Emphasis on the Role of the COVID-19 Pandemic Period in the Isfahan Province: A Cross-sectional Study of Join Point Regression Analysis 2011-2021
No full textBackground: Comparing the trends of mortality rates provides valuable insight for policy discussions and promotes awareness of health issues. This study aimed to investigate the changes in mortality rate and life expectancy from 2011to 2021 and the effect of COVID-19 period on these indices. Methods: We investigated the data of all-cause deaths between 2011 and 2021 by age group, sex and year using Excel spreadsheets from the National Organization for Civil Registration (NOCR), via collected the census method. Joinpoint regression was used to calculate the trend of mortality rate during the study period. Results: During the study period, there were 262,708 deaths, of which 148,919 were men (56.68). The trend of mortality rate in both sexes has been increasing. Life expectancy in men and women decreased from 76.71 and 80.82 in 2011 to 74.43 and 77.53 in 2021, respectively. From 2018 to 2021, there was a significant increase in standardized mortality rate in men (APC= 14.74; 95 CI = 5.73; 28.65) and women (APC= 14.29; 95 CI = 4.67; 28.97). However, from 2011 to 2018, we observed a yearly 2.65 decreasing trend in men which was statistically significant (APC =-2.95, 95 CI =-7.67,-0.84). In women, no significant trend was seen. Conclusion: With the emergence of the COVID-19 epidemic in 2019, the trend of mortality rate and life expectancy changed completely, with additional deaths and decreasing life expectancy. Therefore, prevention, control and treatment of epidemic diseases should be a serious concern of policy makers
Manifestation of leech infestation as severe hematemesis and melena in a 29-year-old man: A case report and review of the literature
No full textBackgroundLeeches are rarely the cause of foreign bodies in the airways and digestive tracts of adults. Most of the cases reported about the presence of leech as a foreign body in the respiratory and digestive tracts have been reported in children. We report a rare case of manifestation of leech infestation in a 29-year-old man.Methods and resultsWe report the case who presented with hemoptysis and melena. The patient underwent an endoscopy, which revealed a leech in the lower end of the esophagus. In order to better investigate and understand the different dimensions of conflict with leeches, we investigated the cases reported in adults.ConclusionLeech contamination is one of the rare causes of gastrointestinal bleeding, especially in adults, which is due to non-compliance with health recommendations to drink safe drinking water or swim in ponds/or river water. A detailed history and clinical examination of the patient are essential for the diagnosis of leech bite in adult patients who live in or travel to tropical regions
Antifungal activity of polyphenolic compounds against fluconazole-susceptible and -resistant Candida species
No full textBackground and Objectives: The rapid emergence of resistant fungi is occurring worldwide, and this crisis has been attributed to the lack of new antifungal drug development. This issue emphasizes the need for innovation in finding novel antifungals. There is an increasing interest in using the natural products of plants with high biological activity as alternatives to synthetic drugs. This study aimed to evaluate the possible applicability of polyphenols as alternative antifungal drugs to treat resistant Candida infections. Materials and Methods: A panel of fluconazole-resistant (n=14) and fluconazole-susceptible (n=26) clinical Candida isolates was obtained from the reference culture collection. The determination of the minimum inhibitory concentrations (MICs) of fluconazole, tannic acid, rosmarinic acid, gallic acid, chlorogenic acid, caffeic, ferulic, and p-coumaric was carried out following the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: The MIC values of 40 Candida species isolates ranged from 0.25 to >64 mu g/mL for polyphenolic compounds. The highest inhibitory effect against Candida species was observed with tannic acid, followed by fluconazole. Non-albicans Candida groups were more sensitive to tannic acid compared to C. albicans isolates. Significant differences were observed in the MICs of fluconazole and tannic acid against non-albicans Candida isolates. Conclusion: The increasing antifungal resistance highlights the importance of evaluating new drugs that are more robust against resistance. This study suggests that tannic acid could be considered a novel antifungal agent for managing fungal infections, including multidrug-resistant non-albicans Candida infections