Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Antithrombotic therapy in adults with ectatic coronary artery disease: a systematic review and network meta-analysis
No full textBackgroundMany studies have validated the use of antiplatelet or anticoagulant therapy in coronary artery ectasia (CAE) to reduce major adverse cardiovascular events (MACE); however, it is not completely known which group of these antithrombotic medications is more effective. The purpose of this systematic review and network meta-analysis was to evaluate the efficacy of different anti-thrombotic treatments in adult patients with CAE.MethodsThis systematic review and meta-analysis followed preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines as well as PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses and adhered to a registered predetermined methodology noted in the prospective register of systematic reviews (PROSPERO) protocol. Comprehensive searches were conducted until October 2024. Study selection, data extraction, and risk-of-bias assessments were independently performed by two reviewers. The pairwise meta-analysis compared the odds of MACE among patients receiving different antithrombotic therapies versus no treatment. The network meta-analysis (NMA) combined direct and indirect evidence to compare the efficacy of antithrombotic therapies for MACE.ResultsOur systematic review included 5,039 adult patients suffering from CAE. The odds of MACE were higher in patients with no treatment when compared with those on dual antiplatelet therapy (DAPT) and aspirin monotherapy; although patients on anticoagulation demonstrated a lower incidence of MACE, the difference with the no treatment group did not reach statistical significance. Among various types of interventions in NMA, DAPT was the best in the treatment of CAE.ConclusionsBased on the surface under the cumulative ranking curve (SUCRA) value, DAPT is the most effective treatment in the prevention of MACE for CAE patients, followed by aspirin monotherapy and anticoagulant treatment
Ultrasound-guided seven-gauge vacuum-assisted excision for benign breast lesions: A single expert surgeon experience
No full textBackground: A large percentage of women fear benign breast lesion surgery, and it is a burden to the healthcare system. Ultrasound-guided vacuum-assisted excision (VAE) is as effective as surgery but does not require general anaesthesia, leaves no scars, and improves patient satisfaction. Methods: A retrospective analysis of a prospective cohort research carried out on recorded data of a single breast surgeon. VAE was performed on 611 patients with ACR BIRADS 3 or 4a lesions utilising EnCor Enspire equipment and a 7G probe. The average follow-up time was 30.25 +/- 9.12 months. Results: A total of 772 VAEs were performed on lesions with an average diameter of 18.81 +/- 8.63 mm. Pathology results revealed fibroadenoma in 70.85 of cases and papilloma in 19.43. The overall removal rate was 99.2, and the upgrade rate was <1. Fibroadenoma was significantly more common in younger people, had a larger width, and was located farther away from the nipple than papilloma. Individuals with a lesion size of 13.5 mm or less and an age of 36.5 years or older were more likely to have papilloma than fibroadenoma. The reported issues consisted of temporary localised discomfort and haematoma. There were no serious complications, no hospitalisation or operation as a result of a complication, and no infection or antibiotic use was reported. Conclusion: VAE is a safe and effective alternative to open surgery for those with benign breast lesions. VAE can be utilised for both diagnostic and therapeutic purposes, making it a more cost-effective choice while also increasing patient satisfaction
Introduction of a novel graphene oxide-based nickel nanoflowers for ultrasound-assisted dispersive solid phase extraction of natamycin from dairy products
No full textThis study presented facile ultrasound assisted dispersive solid-phase extraction coupled with high performance liquid chromatography-diode array detector for preconcentration and determination of trace levels of natamycin in dairy products. Highly efficient and selective graphene oxide-based nickel nanoflowers were synthesized and characterized with FE-SEM-EDX, FT-IR, TGA, and XRD techniques. The leading factors including pH, ionic strength, sample volume, the amount of sorbent, and desorption conditions were studied using matrix matched method. Good linearity of 1-750 mu g kg-1 for milk, 1-500 mu g kg-1 for yogurt and cheese were acquired. While 0.30, 0.27, and 0.30 mu g kg-1 as LODs values and 1.00, 0.93, and 0.97 mu g kg-1 as LOQs values were obtained for milk, cheese, and yogurt, respectively. The intra-day precision (n = 7) and the inter-day precision (5 days, n = 3) were achieved <= 4.1 and <= 3.0, respectively, confirming the method's repeatability and reproducibility. High recoveries of 94.0-98.4 and also the satisfactory obtained results indicated high capability of the proposed method for separation and preconcentration of natamycin be applied in dairy products as complex matrixes
A systematic review of traditional and eco-friendly methods for extracting bioactive compounds from Citrus aurantium L. plant
No full textCitrus aurantium L. (C. aurantium), commonly known as bitter orange, is a rich source of bioactive compounds (BCs), including flavonoids, alkaloids, essential oils, and phenolic compounds. The various studies emphasize on the extraction of BCs from C. aurantium L. by-products, such as peels, seeds, and leaves, using both traditional and innovative eco-friendly techniques. These compounds exhibit various pharmacological properties such as antioxidant, anti-inflammatory, antimicrobial, and anti-obesity effects, making them highly valuable in traditional medicine, pharmaceuticals, cosmetics, and food industries. The extraction of these BCs is a crucial process, with conventional methods like maceration, Soxhlet extraction, and steam distillation being widely used. However, these methods often present challenges such as long extraction times, high solvent use, and potential degradation of heat-sensitive compounds. To address these limitations, green extraction techniques such as ultrasound-assisted extraction (UAE), microwave-assisted extraction (MAE), supercritical fluid extraction (SFE), and enzyme-assisted extraction (EAE) have gained prominence. These techniques offer increased efficiency, reduced environmental impact, and improved preservation of BCs. Despite their advantages, comprehensive comparisons between conventional and green methods for extracting compounds from C. aurantium are limited. This systematic review critically evaluates and compares both conventional and green extraction techniques for C. aurantium L., analyzing their efficiency, practicality, and sustainability. By synthesizing existing research, this review highlights the strengths and limitations of each method, providing valuable insights for optimizing extraction processes. The review also identifies gaps in current research and suggests future directions, including the need for standardized comparisons of extraction techniques and further exploration of environmentally friendly methods to enhance the industrial application and sustainability of C. aurantium L. BCs extraction
GLP-1-based therapies for type 2 diabetes: from single, dual and triple agonists to endogenous GLP-1 production and L-cell differentiation
No full textGlucagon-like peptide-1 (GLP-1) is an incretin peptide hormone mainly secreted by enteroendocrine intestinal L-cells. GLP-1 is also secreted by alpha-cells of the pancreas and the central nervous system (CNS). GLP-1 secretion is stimulated by nutrient intake and exerts its effects on glucose homeostasis by stimulating insulin secretion, gastric emptying confiding the food intake, and beta-cell proliferation. The insulinotropic effects of GLP-1, and the reduction of its effects in type 2 diabetes mellitus (T2DM), have made GLP-1 an attractive option for the treatment of T2DM. Furthermore, GLP-1-based medications such as GLP-1 receptor agonists and dipeptidyl peptidase-4 inhibitors, have been shown to improve diabetes control in preclinical and clinical trials with human subjects. Importantly, increasing the endogenous production of GLP-1 by different mechanisms or by increasing the number of intestinal L-cells that tend to produce this hormone may be another effective therapeutic approach to managing T2DM. Herein, we briefly describe therapeutic agents/compounds that enhance GLP-1 function. Then, we will discuss the approaches that can increase the endogenous production of GLP-1 through various stimuli. Finally, we introduce the potential of L-cell differentiation as an attractive future therapeutic approach to increase GLP-1 production as an attractive therapeutic alternative for T2DM
Efficacy of a Metal Artifact Reduction Algorithm in CBCT Images of Teeth With Ceramic Brackets With/Without Coated Archwires: An In Vitro Study
No full textObjective This study aimed to assess the efficacy of a metal artifact reduction (MAR) algorithm for cone-beam computed tomography (CBCT) scans of teeth with ceramic brackets with/without coated archwires. Material and Methods In this in vitro study, 10 ceramic brackets were bonded to maxillary anterior teeth from the second premolar of one side to the second premolar of the other side on a dry human skull. CBCT scans (85 kVp, 8 mA, 14.5 s) were taken twice in the presence and absence of coated nickel-titanium (NiTi) archwires. The skull was placed in a water container for soft tissue simulation during scanning. The images were reconstructed with and without the MAR algorithm, and imported to ImageJ software in DICOM format to calculate the contrast-to-noise ratio (CNR) at 15-, 20-, and 25-mm distances from the tooth center. Data were analyzed by independent t-test, ANOVA, and Bonferroni test (alpha = 0.05). Results Application of the MAR algorithm had no significant effect on the CNR in the presence or absence of archwire (p > 0.05). Significant differences were found in the CNR according to tooth type and distance from the tooth center, such that the CNR significantly increased in farther distances (p < 0.05). Conclusions Within the limitations of this in vitro study, the results showed that the application of the MAR algorithm had no significant efficacy in improving the quality of CBCT scans of teeth with ceramic brackets with/without coated archwire
Anti-leishmanial effect of the hydroalcoholic extract of the leaves, roots and seeds of Arctium lappa
No full textObjective: Zoonotic cutaneous leishmaniasis is a common including endemic infectious disease in many parts of the world and Iran. Due to Arctium lappa wide therapeutic applications, the anti-leishmanial effect of the hydroalcoholic extract of its leaves (L), roots (R) and seeds (S) has been investigated in this research. Materials and Methods: The leaves, seeds and roots of the greater burdock plant were extracted. In the in vitro phase, its cytotoxic and anti-leishmanial effects on promastigote and amastigote forms of Leishmania major(L.major) were investigated. In the in vivo stage, the leishmaniasis mouse model was dosed with concentrations of 50, 100, and 200 mg/kg and the liver and spleen parasite burden was checked. Results: The results of this research in the in vitro phase showed that the antileishmanial effect of the hydroalcoholic extract of leaves, roots and seeds on the promastigote and amastigote forms of L. major has a significant relationship with the increase in the concentration of the extract (for all p <= 0.001). Also, exposure time and interaction effect of concentration and exposure time were significant. In the in vivo phase the significant effect of the increase in concentration (L: p <= 0.001, R: p=0.02, S: p=0.03), exposure time (L: p <= 0.001, R: p <= 0.001, S: p <= 0.01) and the interaction effect of these two factors (L: p=0.002, R: p <= 0.001, S: p <= 0.001) on reducing the size of the wound was shown. Conclusion: The investigation established that hydroalcoholic extract of the leaves, roots, and seeds of the greater burdock in high concentration exhibited beneficial inhibitory effects on the leishmanial lesions
Antibiotic resistance and virulence patterns of O25 and O16 serogroups in uropathogenic Escherichia coli
No full textObjectiveThis study investigates antibiotic resistance patterns, virulence factors, and phylogenetic groups of O25 and O16 serogroups in uropathogenic Escherichia coli (UPEC) isolates from kidney transplant recipients (KTPs) and non-KTPs. The presence of serogroups O25 and O16, resistance genes (e.g., blaCTX-M, blaTEM), and virulence factors (e.g., fimH, PAI) were determined using PCR. Phylogenetic groups were identified via quadruplex PCR, and genetic diversity was assessed using ERIC-PCR.ResultsA total of 111 E. coli isolates were examined in the present study. The O-serotyping results indicated that 18 and 3.6 of isolates were positive for O25 and O16 serogroup, respectively. In serogroup O25, the highest resistance rates were observed for nalidixic acid and cotrimoxazole, whereas in serogroup O16, the highest resistance rates were against cotrimoxazole and ampicillin-sulbactam. ESBL production was identified in 30 of O25 and 25 of O16 isolates. O25 isolates belonged to phylogenetic group B2, whereas O16 isolates were grouped in B1. ERIC-PCR revealed significant genetic diversity among isolates. The O25 serogroup is prevalent and closely associated with high antibiotic resistance and virulence, suggesting its critical role in UTI pathogenesis in transplant patients. These findings underscore the importance of monitoring resistance patterns and developing targeted therapeutic and preventive strategies for managing UPEC infections
A rare but serious case of subdural hematoma following transsphenoidal surgery for a pituitary adenoma
No full textTranssphenoidal endoscopy is a prevalently performed surgical procedure aimed at removing pituitary lesions. This procedure can lead to various complications, including CSF leakage, tension pneumocephalus, and hypernatremia following the removal of a pituitary adenoma. In this particular case, we present a patient with a pituitary adenoma who unexpectedly got a spontaneous subdural hematoma (ASDH), nine days after undergoing transsphenoidal surgery, despite having a minor CSF leak. We speculate that this complication was linked to severe hypernatremia and a sudden decrease in consciousness level, necessitating immediate surgical intervention for hematoma removal. this case represents the first reported instance of ASDH associated with severe hypernatremia and negligible CSF leakage
Evaluation of the diagnostic value of image processing algorithms and artificial intelligence in diagnosing and locating venous sinus thrombosis compared to 3D, MRV, T2WI sequences
No full textBackground: Dural sinus thrombosis (DST) is a severe condition that should be diagnosed with magnetic resonance imaging (MRI) and treated as soon as possible. We aimed to assess the diagnostic value of image processing algorithms and artificial intelligence in diagnosing and locating venous sinus thrombosis. Methods: This is an analytic-descriptive, retrospective cross-sectional study performed from 2020-2022 on medical records of patients suspected of cerebral vein thrombosis who underwent 3DMRV and T2WI sequences imaging. T2WI coronal and sagittal images of patients were obtained from Kashani Hospital PACS system. In smartening the diagnosis of cerebral venous thrombosis, the areas marked in sagittal, coronal T2 images, and the patient MRV 3D image were used for the presence of venous sinus thrombosis to teach the intelligent algorithm. In the first stage, images of 100 standard sagittal and coronal MRI samples from the brain's venous sinuses were entered into the PYTHON software for software training. In the thrombosis evaluation stage (test), the patient's sagittal and coronal T2 images were given to the algorithm, and the algorithm intelligently segments the areas suspected of thrombosis. Then we evaluated the patient's MRV 3D image to confirm the result. Using this training, the program should identify the thrombosis area in the patient's MRV 3D image with appropriate accuracy. Results: The accuracy of artificial intelligence in diagnosing superior sagittal thrombosis was 99.1, and its accuracy for the right sigmoid sinus, left sigmoid sinus, and right and left transverse sinus were 75.8, 73.6, 71.5, and 70.4 respectively. Conclusion: We showed that artificial intelligence has high accuracy rates in image processing algorithms and artificial intelligence in diagnosing different areas of venous sinus thrombosis. This data could have critical importance in clinical practice