Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Assessment of Mandibular Kinematic Variables using a Motion Analysis System and a Regular Mobile Phone
No full textBACKGROUND: The development of a standard motion capture system is needed since the measurement of temporomandibular disorders is time-consuming and costly using laboratory tools. OBJECTIVE: The current study aimed to investigate the mandibular kinematic variables using a regular mobile phone and the motion analysis system. MATERIAL AND METHODS: In this quasi-laboratory and comparative study, ten healthy individuals participated, and three mobile cameras, nine red markers, and Kinovea software were also used to investigate the mandibular kinematic variables. Nine light reflective markers were used to check the sensitivity, accuracy, and reliability of the proposed system. The motion was analyzed using seven motion analysis infrared cameras and Qualisys Track Manager (QTM) software. Two other raters analyzed the kinematic variables obtained from the mobile to measure intra- and inter-rater reliability. RESULTS: Pearson's correlation coefficient was obtained at 0.98, 0.75, 0.98, and 0.96, showing a high correlation. The accuracy and reliability validation tests showed an average error and an accuracy of 0.156 mm and 95, respectively, with a mobile phone. The Intra Class Correlation coefficient showed a high internal correlation in the mentioned confidence interval (0.98 and 0.81, and 0.96 and 0.97). The intraclass correlation coefficient method also showed 97 inter-raster reliability. CONCLUSION: Mobile phones as a new system can evaluate the kinematic variables of mandibular disorders with appropriate accuracy and reliability
Evaluation of efficacy and safety of generic tacrolimus (Suprotac((R))) compared to reference tacrolimus (Prograf((R))) in kidney transplantation: a phase IV study
No full textTransplant recipients are given an immunosuppressive regimen such as tacrolimus to prevent organ rejection. Suprotac(R) is a generic tacrolimus that is utilized in kidney transplantation regimen in Iran. This post-market study was conducted to evaluate the safety and efficacy of Suprotac(R) in comparison with Prograf(R). In this two-armed, open-label, parallel, active-controlled, and cohort study, de novo kidney transplant recipients aging 18 to 65 years were prescribed Suprotac(R) or Prograf(R) as part of the immunosuppressant protocol. The primary outcome was comparing the mean estimated glomerular filtration rate (eGFR) at month 12. The secondary outcomes were the assessment of patient and graft survival, acute rejections during hospitalization, tacrolimus dose, trough concentration, and Trough Concentration/dose (C/D) ratio, and Adverse Events (AEs) during the study period. A total of 201 patients were enrolled in this study. At discharge, the eGFR was lower in the Suprotac(R) group compared to the Prograf(R) group (51.70 ml/min/1.73m2 and 57.48 ml/min/1.73m2, respectively; p=0.042). However, at month 12, there was no significant difference in mean eGFR between the two groups (58.94 ml/min/1.73m2 and 59.78 ml/min/1.73m2, respectively; p=0.772). Other outcomes, including patient and graft survival, acute rejection during hospitalization, tacrolimus dose, trough concentration, and C/D ratio, and overall incidence of AEs were similar between the two groups (p >0.05). The efficacy and safety profile of the generic tacrolimus were shown to be comparable to the reference tacrolimus at month 12
Effectiveness of Biofeedback with Dilator Therapy for Sexual Function in Women with Primary Vaginismus: Randomized Controlled Trial Study
No full textINTRODUCTION AND HYPOTHESIS: Vaginismus is characterized by the involuntary spasm of the pelvic floor muscles (PFMs) around the outer third of the vagina, leading to difficulties in vaginal penetration. Physical therapists often use biofeedback to help individuals to gain better control over their muscles. This study was aimed at assessing the impact of biofeedback with dilator therapy on sexual function in women with primary vaginismus. METHODS: In this randomized controlled trial study, 32 women with primary vaginismus, aged 18 to 45, were randomly assigned to either the experimental group (n = 16) or the control group (n = 16). The experimental group received both dilator therapy and biofeedback training, whereas the control group only received dilator therapy. Both groups followed a 6-week, twice-a-week session program. The Female Sexual Function Index (FSFI) questionnaire, which includes six dimensions (desire, arousal, lubrication, orgasm, satisfaction, and pain), was administered before and after the 6-week treatment, as well as 1 month after completion. RESULTS: The analysis of variance test showed that the interaction effect of the group and time on the overall score of sexual function (p < 0.001) and the aspects of desire (p < 0.001), arousal (p < 0.001), orgasm (p = 0.028), satisfaction (p < 0.001), and pain (p = 0.003) were significant; however, the interaction between group and time (p = 0.182) was not observed for lubrication. CONCLUSION: Biofeedback therapy combined with dilator therapy and dilator therapy alone are both effective in improving sexual function in women with primary vaginismus. However, women undergoing biofeedback combined with dilator therapy seem to benefit more than those receiving dilators alone
Asian adult sleep medicine fellowship training curriculum: one curriculum, many contexts
No full textSTUDY OBJECTIVES: To develop a comprehensive Asian adult sleep medicine fellowship training curriculum to address the significant disparities in sleep medicine training across Asia, guided by the principle of "One Curriculum, Many Contexts," providing a standardized yet adaptable framework for sleep medicine education across the diverse health care landscapes of Asian countries. METHODS: The curriculum development process involved a gap analysis, comprehensive literature review, and expert consensus through a modified RAND/UCLA appropriateness method/Delphi survey. RESULTS: The curriculum offers 2 flexible tracks: a 1-year program (Track A) and a 2-year program (Track B), accommodating varied educational pathways and health care system structures across Asia. Key features of the curriculum include detailed learning outcomes, competency-based educational content, and recommendations for teaching and learning activities. The assessment strategy incorporates summative and formative methods, with standard setting and program evaluation guidelines. The curriculum also provides recommendations for program accreditation, fellow-faculty ratios, and funding considerations. CONCLUSIONS: The Asian adult sleep medicine fellowship training curriculum provides a standardized yet adaptable framework for sleep medicine education across diverse Asian health care landscapes. By emphasizing flexibility and customization while maintaining high training standards, the curriculum aims to bridge the gap in sleep medicine training across Asia, ultimately improving the quality of sleep health care and patient outcomes throughout the region. CITATION: BaHammam AS, Al-Abri MA, Al Oweidat K, et al. Asian adult sleep medicine fellowship training curriculum: one curriculum, many contexts. J Clin Sleep Med. 2025;21(4):627-638
Diffusion Tensor Imaging and Evaluation of Cardiac Ischemic Disorders: A Systematic Review
No full textBACKGROUND: A suitable diagnostic method can be beneficial owing to the high prevalence of myocardial infarction (MI) and structural changes that affect systolic and diastolic performance. In this systematic review, we focused on the possibility of using DTI instead of current methods such as cardiac biopsy, an invasive procedure. METHODS: Articles published in PubMed, Scopus, Embase, and Scholar electronic databases from 2010 to 2023 were reviewed using the determined keywords. The articles included evaluating DTI in patients with MI, compared to standard myocardial structure. Studies that did not examine the association between DTI and cardiac ischemic disorders only considered original articles. Methodological risk was evaluated using QUADAS-2 tool. RESULTS: Sixteen articles were selected from 16855 searched articles and divided into two subgroups: human-based (six studies) and animal-based (ten studies). Among the results obtained from both animal and human-based evaluations: (a) the values of the FA, RD (lambda perpendicular), and AD (lambda parallel) indices in the infarcted region were lower than those in the remote or adjacent areas, and the value of the MD index increased. (b) This trend was also present in both acute and chronic conditions and in the follow-up of patients for the assessment of microstructure remodeling. (c) Confirming the process of change evaluated in preclinical human studies. More studies should be conducted on the effects of factors such as the B-value index and environmental conditions. CONCLUSION: Clarifying the trend of changes in DTI indices for AMI and CMI makes them suitable diagnostic tools in this regard. Meanwhile, the study faced limitations such as low sample size and the risk of bias about "patient selection" index
Strengthening Public Health Systems During an Emerging Respiratory Disease Pandemic: A Realist Review
No full textThe recent outbreak of respiratory diseases such as COVID-19 has highlighted the need to strengthen public health systems to respond effectively to such crises. While previous research has identified various public health interventions for pandemics, there remains a significant gap in understanding which interventions can strengthen public health systems during emerging respiratory pandemics and under what conditions. To address this gap, we conducted a realist review to examine public health interventions during emerging respiratory disease pandemics, focusing on context, mechanisms, and outcomes. We conducted a literature search across PubMed, Scopus, ProQuest, and Web of Science for studies published since 2003. Finally, we analyzed and assessed the quality of 601 articles and analyzed 32 of them. This study emphasizes the importance of understanding the situational, structural, cultural, and environmental contexts that influence public health interventions within the six building blocks of public health systems. We have also identified the mechanisms of these interventions at the individual, organizational, and national levels for successful outcomes, such as improved access to health services, health equity, and effectiveness. This information is important for policymakers and practitioners who can use it to develop evidence-based strategies to strengthen public health systems during emerging respiratory disease pandemics. Our review introduced a new conceptual model to explore the interaction between context, interventions, mechanisms, and outcomes to strengthen public health systems. However, further research is needed to determine the effect of specific contextual factors on public health system interventions during respiratory disease pandemics
Lipid-based nanodelivery systems of curcumin: Recent advances, approaches, and applications
No full textDespite its many beneficial effects, pharmaceutical applications of curcumin (CUR) are limited due to its chemical instability, low solubility/absorption and weak bioavailability. Recent advances in nanotechnology have enabled the development of CUR-loaded nanodelivery systems to tackle those issues. Within many different nanocarriers developed for CUR up to date, lipid-based nanocarriers (LBNs) are among the most extensively studied systems. LBNs such as nanoemulsions, solid lipid carriers, nanostructured phospholipid/surfactant carriers are shown to be potential delivery systems capable of improving the solubility, bioavailability, and chemical stability of CUR. The particle characteristics, stability, bioavailability, and release properties of CUR-loaded LBNs can be tailored via optimizing the formulation and processing parameters. This paper reviews the most recent studies on the development of various CUR-loaded LBNs. Approaches to the improvement of CUR bioavailability and release characteristics of LBNs are discussed. Furthermore, challenges in the development of CUR-loaded LBNs and their potential applications are presented
Dietary Magnesium Intake in Relation to Depression in Adults: A GRADE-Assessed Systematic Review and Dose-Response Meta-analysis of Epidemiologic Studies
No full textCONTEXT: The relation of magnesium (Mg) intake with depression was previously investigated by meta-analyses. However, due to limited data, a dose-response analysis was not performed. OBJECTIVE: Considering the recently published articles, a systematic review and dose-response meta-analysis was conducted to summarize the relation of dietary Mg intake with depression in adults. DATA SOURCES: Medline (PubMed), ISI Web of Science, Scopus, and Google Scholar were comprehensively searched up to August 2023. DATA EXTRACTION: Observational studies that reported the relation of dietary Mg intake and depression in adults were included and their data were extracted. DATA ANALYSIS: A total of 63 214 participants from 10 cross-sectional and 3 cohort studies were included in the current study. Pooling 15 effect sizes from 12 studies (including 50 275 participants) revealed that individuals with the highest Mg intake had a 34 lower risk of depression, compared with those with the lowest Mg intake (RR: 0.66; 95 CI: 0.57, 0.78). Moreover, the linear dose-response analysis revealed that each 100-mg/d increment in Mg intake was associated with a 7 reduced risk of depression (RR: 0.93; 95 CI: 0.90, 0.96). Additionally, based on nonlinear dose-response analysis, increasing Mg intake from 170 to 370 mg/d was associated with a reduced risk of depression. Analyses were also conducted on 9 studies (49 558 participants) with representative populations, and similar results were found in the meta-analysis (RR: 0.71; 95 CI: 0.61, 0.83) and linear (RR: 0.93; 95 CI: 0.90, 0.96) and nonlinear dose-response analysis. CONCLUSION: The current study shows an inverse dose-dependent association between dietary Mg intakes and risk of depression in both a general and representative population of adults in a dose-response manner. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42024506570
The concentration of potentially toxic elements (PTEs) in honey: Global systematic review and meta-analysis and risk assessment
No full textThe papers were searched in databases including PubMed, Scopus, Web of science, Embase, Science Direct until 21 September 2023 and meta-analysis of concentration of PTEs in honey was performed using random effects model based on country subgroups. The non-carcinogenic risk and carcinogenic risk were calculated by Target Hazard Quotient (THQ) and Cancer Risk (CR), respectively. The sort of PTEs in honey based on pooled concentration was Cu (1.10E + 02 microg/kg) > Ni (1.80E + 01 microg/kg) > Pb (2.60E + 00 microg/kg) > Hg (1.50E + 00 microg/kg) > Cd (5.10E-01 microg/kg) > As (4.80E-01 microg/kg). The concentration of PTEs in the countries of Ethiopia (As), Jordan (Cd and Pb), Thailand (Ni), Brazil (Cu and MeHg) was observed to be higher than other countries. The non-carcinogenic risk was less than 1, hence, the consumption of honey does not have non-carcinogenic risk. Except children in Nigeria, CR due to iAs in honey was acceptable for the both adults and children in the other countries, Therefore, the consumption of honey does not have carcinogenic risk
Cardiac Function in Pediatric Patients with MIS-C Using Speckle Tracking and Conventional Echocardiography: A Longitudinal, Single-Center Study
No full textCardiovascular involvement in Multisystem Inflammatory Syndrome in Children (MIS-C), a potential consequence of coronavirus disease-2019 (COVID-19), is common. Conventional transthoracic echocardiography (TTE) provides primary data on the function of the left and right ventricles, while Speckle Tracking Echocardiography (STE) is more sensitive. This study aims to assess longitudinal cardiac function using STE in these patients. This longitudinal study was conducted from late 2021 to early 2022 at Imam Hossein Children's Hospital, Isfahan. Cardiac function was assessed by STE at the time of diagnosis and again two months later. Demographics, clinical characteristics, ECG interpretations, imaging studies, and serum cardiac marker levels were collected. Thirty-five pediatric patients with a mean age of 5.1 years (range: 4 months to 17 years) were included and prospectively followed. Twenty-nine of them, comprising 14 males (48.3) and 15 females (51.7), underwent STE and were compared with 29 healthy age- and sex-matched children. Factors related to adverse events included reduced myocardial function, enlarged left atrium or ventricle, and mitral regurgitation (MR). Patients with comorbidities affecting strain measurements were excluded from the strain analyses. A significant difference was observed between the groups in regional strains in the basal and apical septal and middle lateral regions. Global strain rate (GLS) and strain rates were not significantly different but were still lower than the control group. Twenty percent of patients had abnormal GLS but normal left ventricular ejection fraction (LVEF). All patients exhibited reduced segmental myocardial strain in at least one segment. Four out of 26 recovered patients without comorbidities had abnormal GLS at follow-up, despite normal LVEF. STE proves more useful than conventional echocardiography in patients with MIS-C, revealing subclinical cardiac injury in the acute and post-acute phases