Repository of Research and Investigative Information Isfahan University of Medical Sciences
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The niosomal nelarabine as a promising nano combination for retinoblastoma treatment: an in vitro study-experimental research
No full textIntroduction:Retinoblastoma (RB), the most commonly occurring intraocular malignancy among children globally, represents 3 of childhood cancers. In the current study, the authors aim to evaluate the effectiveness of a new formulation of nelarabine (niosomal nelarabine) on RB cancer cells.Methods:Field emission scanning electron microscopy (FE-SEM) and dynamic light scattering (DLS) characterized the physical properties of nelarabine nanoparticles. After cultivation of the Y79 cell line, the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test was performed to determine IC50 of niosomal nelarabine (Nio-Nelarobine) and also the cytotoxicity of Nio-Nelarobine and doxorubicin against Y79 cell line was investigated. The level of apoptosis was assessed by flow cytometry in selected groups. Also, the PTEN/AKT/FOXO1 gene expression level was measured using qRT-PCR.Results:Y79 cell lines were treated with Nio-Nelarobine and doxorubicin. The treatment resulted in a dose-dependent inhibition of Y79 cell viability. However, Nio-Nelarobine showed a higher inhibitory activity with a diameter of about 167 nm. Both Nio-Nelarobine and doxorubicin induced apoptosis in cells, but Nio-Nelarobine treatment resulted in a higher number of apoptotic cells than doxorubicin treatment. The qRT-PCR results showed that the treatment with Nio-Nelarobine and doxorubicin led to an increase in the expression of PTEN and FOXO1 genes, while decreasing the expression of the AKT gene. Furthermore, the statistical significance of these results was higher in the Nio-Nelarobine group than in the doxorubicin group.Conclusions:Nio-Nelarobine may be a functional therapeutic combination for RB treatment. Further experimental and preclinical investigations are necessary to verify this impact in greater detail
Is intranasal dexamethasone effective in reducing sore throat following surgery?
No full textObjectives:Postextubation, individuals may experience the discomfort of a sore throat. Our main aim of the study was to investigate if intranasal dexamethasone is successful in reducing postoperative sore throat occurrence. Materials and Methods:The study involved 96 adult individuals who were scheduled for elective eye surgery at Faiz Medical Center, which is affiliated with Isfahan University, between July 2020 and March 2021. The individuals were assigned by chance to two cohorts of 48 people each, with one cohort getting dexamethasone (IND) through the nose and the other cohort getting normal saline (INS) through the nose right after the endotracheal tube insertion. The presence of symptoms such as aching throat, cough, and hoarseness after surgery was recorded and examined with version 23 of the SPSS software. Results:Upon analysis, it was observed that there were no statistically significant alterations in demographic attributes, tracheal intubation variables, duration of surgery, and postoperative outcomes (P < 0.05). Within the IND cohort, a notable 80.2 decrease in the occurrence of sore throat was noted immediately following the surgical procedure, along with a 34 reduction within the initial 6 hours of hospital stay (P < 0.001). Moreover, dexamethasone also decreased the occurrence of cough and hoarseness by 31.7 and 38.2 during recovery, as well as 19 and 25.4 within the initial 2 h upon admission to the ward (P < 0.001). Conclusion:The current study showcased the preventive impact of dexamethasone intranasally in decreasing the occurrence of sore throat in the early stages of postoperative period. Nevertheless, its efficacy diminished after 6 h. Furthermore, the intranasal application of dexamethasone exhibited the ability to alleviate hoarseness and cough within the first 2 h following surgical intervention
Needs of novice midwives in the management of obstetric emergencies: a qualitative study
No full textBackgroundMaintaining the health of mothers and neonates depends on the provision of high-quality, timely emergency care by competent health professionals. Obstetric emergencies are among the most challenging moments in a midwife's professional career, especially for novice midwives. Therefore, it is crucial to address the specific needs of novice midwives to ensure they are equipped to effectively and promptly manage such emergencies. The present study was conducted to explore the needs of midwives in the management of obstetric emergencies.MethodsIn this qualitative study, a conventional content analysis approach was employed. The study included a total of 26 participants, comprising 13 novice midwives, 8 experienced midwives, and 5 supervisor midwives. Participants were selected using purposive sampling method with the aim of achieving maximum diversity within the sample. Data collection was performed through in-depth and semi-structured individual interviews, and the process continued until data saturation was reached. Data analysis was conducted simultaneously with data collection, leading to the extraction of the main categories.ResultsTwo main categories were extracted from 26 interviews: (1) Promotion of professional empowerment in the management of obstetric emergencies with five categories, including familiarity with the clinical environment, promotion of professional competence, promotion of professional wisdom, promotion of professional care, and promotion of inter-professional competence; and (2) Promotion of organizational support that involves the two categories of creating a support platform for the healthcare team and strengthening organizational resources.ConclusionThe results of the present study indicated that professional development of individuals and organizational support were the primary needs of novice midwives in managing obstetric emergencies. Based on the findings of this study, it is recommended to develop and implement training-support programs focused on the professional development of midwives in emergency management
Evaluation of the Prevalence of Hypomagnesemia and the Related Risk Factors in Patients Admitted to a Referral Heart Hospital in Isfahan
No full textBackground: Magnesium is one of the most abundant cations in the body and plays a vital role in the function of the cardiovascular system. Hypomagnesemia can cause severe and dangerous cardiovascular complications. Also, since drugs that can lead to hypomagnesemia are commonly prescribed to cardiac patients, we decided to investigate the prevalence of hypomagnesemia in the population of cardiac patients to be aware of the prevalence of this condition as an important risk factor for cardiovascular events. Materials and Methods: This study is a retrospective cross-sectional study of an analytical-observational type with a fundamental-applied approach, in which by recording the information of patients in pre-designed forms, the prevalence of hypomagnesemia in them and also the prevalence of hypomagnesemia separation of different heart diseases and the relationship of hypomagnesemia with age, sex, glomerular filtration rate (GFR), and drugs used have been evaluated. Results: A total of 982 patients were included in the study, of which 636 were men and 346 were women. The average age of the patients in this study was 63 years. Hypomagnesemia was observed in 138 patients (14), and the prevalence of hypomagnesemia in patients with ventricular arrhythmias was 40. It was also observed that only 47 of the patients with hypomagnesemia received magnesium, and the rest were not treated. Conclusion: This study highlights the importance of magnesium status and its relationship with various clinical factors in the studied population. This emphasizes the need to increase attention to hypomagnesemia, especially among vulnerable groups such as women and older adults
MiR-204-5p mediates PERK inhibition to suppress growth and induce apoptosis in ovarian cancer through the eIF2α/ATF-4/CHOP pathway
No full textThe unfolded protein response (UPR) is crucial in maintaining cell survival during stressful conditions, but prolonged ER stress can lead to apoptosis. Based on the evidence acquired, it has been suggested that inhibiting the protein kinase RNA-like ER kinase (PERK) pathway, which constitutes an adaptive branch of UPR, may represent a viable approach for impeding the proliferation of neoplastic cells. This study assesses the influence of PERK inhibition mediated by miR-204-5p on the growth of ovarian cancer cell lines, OVCAR3 and SKOV3. We demonstrated that miR-204-5p significantly downregulated the expression of PERK at the RNA and protein levels. The suppression of PERK, mediated by miR-204-5p, significantly diminished cellular viability and enhanced apoptotic cell death in cells exposed to Tunicamycin (Tm). We ascertained that the inhibition of PERK by miR-204-5p decreased eukaryotic initiation factor 2alpha (eIF2 alpha) phosphorylation. Moreover, activating transcription factor 4 (ATF4) and CCAAT-enhancer-binding homologous protein (CHOP) expression levels were notably elevated in response to miR-204-5p. The expression of Bax and caspase-12 was found to be upregulated, while the expression of Bcl-2 was reduced. This study is the first to demonstrate that silencing the PERK gene through miR-204-5p significantly inhibits cell growth and promotes ER-stress-induced apoptosis in ovarian cancer cells
Hospitalization and cost trends during Iranian health system reforms over two decades: a time series analysis
No full textBackgroundHealth Sector Reform (HSR) in Iran was implemented in two phases, in 2005 and 2014, financed through a governmental health insurance model managed by the Iranian Health Insurance Organization (IHIO). This study mainly aimed to evaluate the outcomes of HSR by analyzing trends in hospitalization rates and associated expenditures among the insured population covered by the IHIO over the past 20 years as well as forecasting for future based on the observed time series trend.MethodsThis observational longitudinal study assessed key indicators, including hospitalization rates, average per capita inpatient costs, and the inflation rate of inpatient expenditures, from 2001 to 2021, for populations covered by both rural and non-rural insurance funds of the IHIO. Data were analyzed across three distinct periods: pre-HSR, between the two HSR phases, and post-second-phase implementation. Time series analyses were conducted using autoregressive integrated moving average (ARIMA) and exponential smoothing models to forecast trends through 2027.ResultsProjections suggest that by 2027, the hospitalization rate for citizens covered by both rural and non-rural funds will likely reach 101 per 1,000 insured individuals. Over the study period, per capita hospitalization costs remained stable across both funds with no significant differences. However, the mean annual increase in per capita hospitalization costs is expected to continue rising between 2021 and 2027, reaching 54.90 in non-rural funds and 48.67 in rural funds.ConclusionsHSR appears to have achieved health equity in hospitalization rates between rural and urban populations. While per capita inpatient costs have shown parity between rural and non-rural funds
The Effect of Pre-emptive Dose of Dexamethasone on Pain, Nausea, Frequency of Vomiting, and Postoperative Restlessness in Patients Undergoing Septorhinoplasty: A Randomized Control Clinical Trial Study
No full textBackground:This study was conducted with the aim of determining the effect of pre-emptive dose of dexamethasone on pain, nausea, frequency of vomiting, and restlessness after septorhinoplasty. Materials and Methods:In this clinical trial study, 70 patients' candidates for septorhinoplasty were divided into two groups of 35 and before induction of anesthesia, 0.1 mg/kg of dexamethasone was injected intravenously in the first group and the same volume of normal saline in the second group. Postoperative nausea severity and frequency of vomiting, pain intensity, patient restlessness, painkiller, and antinausea medication usage up to 24 hours after surgery were evaluated and compared in two groups. Results:There was a significant difference between the two groups in the mean of pain intensity at the time of recovery (0.031). Also, 6 hours (P = 0.016), 12 hours (P=<0.001), 18 hours (P = 0.013), and 24 (P = 0.009) hours after the operation, the control group had higher pain intensity. In recovery, 9 (28.1) of the dexamethasone group and 22 (66.7) of the control group had restlessness (P = 0.002). Severity of nausea from PACU until 24 hours after surgery showed that the dexamethasone group had less nausea at the PACU (P < 0.001); three subjects from this group have vomited and seven subjects from the control group vomited after surgery, and differences were not significant (P = 0.3). Conclusion:Intravenous dexamethasone 0.1 mg/kg before induction of anesthesia reduced the intensity of pain, nausea, restlessness, and the need for painkillers and antinausea drugs, without causing serious hemodynamic disorders. It seems that the use of this drug with the mentioned dose in septorinoplasty patients is associated with a reduction in postoperative complications
Investigating the Effectiveness of Mindfulness Education on the Happiness of Women with Premenstrual Syndrome (PMS) Using Social Media: An Educational Study
No full textAim Numerous studies have investigated the effectiveness of mindfulness meditation education on the improvement of physical and mental conditions in women. However, there is limited information about the effects of mindfulness counseling on happiness.Background Premenstrual Syndrome (PMS) causes not only physical problems in women but also mental problems, such as reduced levels of happiness.Objectives This study aimed to determine the effectiveness of the mindfulness meditation approach on the happiness of women with underlying premenstrual syndrome (PMS).Methods The sample size was estimated by power of 90, confidence interval of 95, delta 1= 6.07and delta 2 = 5.11, mu 1= 23.05, mu 2=19.01, Z1- beta= 1.28, Z1- alpha/2 =1.96 and alpha = 0.05, the total number of the subjects was 112 respondents (56 in intervention and 56 in the control groups). One hundred twelve participants who had PMS in one interventional-educational study were randomly selected from the health centers in Isfahan. The samples were divided into two groups: intervention and control groups. The intervention group received eight 60-minute sessions of mindfulness education using Google Meet. They taught meditation in a sitting position for 1-10 minutes by using sounds and thoughts as the center of attention, applying the attention technique with a focus on body movements while breathing, and doing yoga and relaxing the muscles to relieve stress. The control group received no intervention. The data were collected using the demographic characteristics questionnaire and the Oxford Happiness questionnaire three times (before, immediately, and one month after the intervention). SPSS 23, chi-square, independent t-test, and repeated measure ANOVA were used to analyze the data.Results There was a significant increase in the mean score of happiness in the intervention group immediately and one month after the intervention (P=0.0001).Conclusion It was found that mindfulness education was effective on the level of happiness in women with PMS; therefore, this intervention can be used to improve the level of happiness in women with PMS
Quality of Life After Laser Vision Correction: A Systematic Review and Meta-Analysis
No full textPurpose: To analyze patients' quality of life (QOL) after laser vision correction (LVC) from a worldwide literature review.Methods: Studies of prospective or cross-sectional design which evaluated QOL in patients after LVC and compared that to preoperative values or a matched group of emmetropes were included. The Web of Science, PubMed, Scopus, and ProQuest were searched for relevant articles published until February 2024. The fixed- or random-effects models were used to estimate the weighted mean difference (WMD) for postoperative QOL changes. Meta-regression was conducted for adjusting the effects of potential confounders.Results: A total of 11 peer-reviewed articles (1753 patients) were included in the study. LVC improved QOL of patients at one (SMD = 0.38, 95 CI: 0.15, 0.60), three (SMD = 1.03, 95 CI: 0.55, 1.50), and six months after surgery (SMD = 0.71, 95 CI: 0.30, 1.11). In meta-regression analysis, QOL improvement was lower in older patients compared to younger ones (beta = -0.06, 95 CI: -0.11, -0.01). Also, no statistically significant difference was noted while comparing QOL in post-laser refractive surgery patients and emmetropes (SMD = -0.44, 95 CI: -0.95, 0.07).Conclusion: Patients undergoing LVC experience significant improvements in QOL, particularly in younger subjects, and achieve comparable QOL to individuals with emmetropia
The Role of Predictive Anxiety, Depression, Cognitive Function, and Confidence in Balance for Participation, Level of Disability, and Duration of Physical Activity in Community-Dwelling Elderly Individuals
No full textBackground and Objective: Aging can be described as a gradual decline in physical and mental abilities, accompanied by an increased susceptibility to illnesses and disabilities. This global phenomenon is escalating rapidly. Accurate prediction of future consequences based on identified factors is crucial for clinicians and researchers, particularly in progressive states such as aging. Thus, this study aims to investigate some of the most prevalent psycho-cognitive factors that may influence elderly individuals' participation levels, disability status, and duration of physical activity. Methods and Materials: In this correlational study, 150 subjects (87 males and 63 females) were selected through a simple non-probability sampling method from community-dwelling older adults in Tehran. Social participation, level of disability, and physical activity duration were evaluated using the CCIQ, the MHAQ, and a qualitative questionnaire, respectively. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) and the Geriatric Depression Scale-15 (GDS-15), respectively. Cognitive function and balance were examined with the Montreal Cognitive Assessment (MoCA) and the Fullerton Advanced Balance (FAB) scale, respectively. Results: The multiple regression models showed that FAB alone accounted for 13.5-61.9 of the variance in all three outcomes. MoCA, GDS-15 and educational level were the second most significant predictorsof participation disability and physical activity time respectively. Conclusion: These results suggest that treatments that target balance, cognitive, and depression states and improve manual function may be particularly important for improving participation, disability state, and physical activity time in community-dwelling older adults