Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Curcumin supplementation effect on liver enzymes in patients with nonalcoholic fatty liver disease: a GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials
No full textCONTEXT: Clinical evidence from investigations of the effects of curcumin on liver enzymes in patients with nonalcoholic fatty liver disease (NAFLD) have led to inconsistent results. OBJECTIVE: The aim of this systematic review and meta-analysis was to investigate the overall effects of curcumin and curcumin plus piperine supplementation on liver enzymes such as alanine aminotransferase (ALT), alkaline phosphatase (ALP), and aspartate aminotransferase (AST) in patients with NAFLD. DATA SOURCES: The Scopus, Web of Science, PubMed, and Cochrane Library databases were searched from inception through July 2023, using search terms representing NAFLD and liver enzymes. Articles were screened independently by 2 researchers based on PICOS inclusion criteria. DATA EXTRACTION: The following data were extracted: first author's name, study location, year of publication, mean age, study duration, study design, participants' sex, number of participants in each group, dose of curcumin supplementation, and ALT, ALP, and AST concentrations. Risk of bias was assessed using the Cochrane Collaboration's modified risk-of-bias tool. DATA ANALYSIS: Fixed- or random-effects meta-analysis was performed to estimate the effects of curcumin on liver enzymes, considering heterogeneity across studies. The I2 and Cochran's Q tests were used to assess heterogeneity between studies. RESULTS: Overall, 15 randomized controlled trials comprising 905 participants were eligible for this meta-analysis. Curcumin supplementation significantly reduced ALT (weighted mean difference WMD, -4.10, 95%CI, -7.16 to -1.04) and AST (WMD, -3.27; 95%CI, -5.16 to -1.39), but not ALP (WMD, -0.49; 95%CI, -1.79 to 0.82). Curcumin plus piperine supplementation had no significant effect on ALT (WMD, -3.79; 95%CI, -13.30 to 5.72), and AST (WMD, -1.1; 95%CI, -3.32 to 1.09). CONCLUSIONS: Curcumin supplementation improved AST and ALT levels compared with the control group. However, better-designed randomized controlled trials with larger sample sizes and of higher quality are needed to assess the effects of curcumin on ALP. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42023448231
Comparing the effects of movie-based versus case-based methods among bachelor nursing students: A quasi-experimental study
No full textBackground: It is challenging for educators to select and apply the most effective educational strategies in teaching ethics to undergraduate nursing students. Aim: The study aimed to compare the effect of movies-based and case-based methods, on moral sensitivity and moral courage of nursing students. Methods: This was a quasi-experimental study conducted on 79 nursing students that divided into case- based and Movie-based groups. Data were collected using the standardized Persian versions of Lutzen's moral sensitivity and Sekerka moral courage questionnaires and analysed using SPSS version 16. Results: The case-based and movie-based methods were significantly different only in promoting some sub- scales of moral sensitivity and moral courage (p .05). Conclusions: The case-based method may lead to the improvement of the application aspects of moral sensitivity, and the movie-based method, by engagement of emotions and visual, auditory senses, can improve some aspects of moral courage attitude. Therefore, the simultaneous use of these two methods in teaching ethics to nursing students is recommended. (c) 2024 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies
Patients Survival After Paraquat Poisoning: A Report of Three Cases
No full textBackground: Paraquat poisoning is a common and often fatal herbicide poisoning in society. This study presents a clinical case series of patients who survived after paraquat poisoning. Cases Presentation: This study evaluated patients hospitalized between March 2016 and March 2021 with paraquat (PQ) poisoning who survived. Out of 115 patients with PQ poisoning, three cases of severe toxicity with an average age of 24.33 years are presented here. The urinary sodium dithionate test result was positive in all three surviving patients. All patients arrived at the poisoning emergency center within an hour of ingestion and received gastric lavage and charcoal therapy. They were also treated with corticosteroids, N-acetylcysteine (NAC), vitamins C and E, Curcumin, and Livergel. Hemodialysis was performed for the patients, with one undergoing hemodialysis and hemoperfusion after ingesting 250 mL of PQ 20. After a six-month follow-up, all surviving patients were in good health. Conclusion: Various factors, such as early admission after exposure, prompt gastrointestinal (GI) decontamination, corticosteroids with Curcumin and Livergel, antioxidants, hemodialysis, and hemoperfusion in one case may have contributed to the survival of patients with PQ poisoning in this study. However, individual vulnerability should also be considered a crucial factor requiring further investigation
Investigation of the presence of Candida auris and other Candida species in marine waters
No full textMarine recreational waters harbor various microorganisms that may pose health risks to users. However, fungal contamination, particularly by Candida species, has received limited attention despite evidence of their presence and potential health concerns. This study aimed to assess the microbial quality of water at five popular recreational beaches along the Persian Gulf, with a specific focus on Candida species. Fecal indicator bacteria (FIB), including Escherichia coli and Enterococci, were enumerated in marine water samples. Additionally, the presence of Candida auris and other clinically relevant Candida spp. as well as Meyerozyma guilliermondii was investigated using nested, multiplex, and conventional PCR assays, respectively. FIB were highly prevalent across most of the sampling locations. Additionally, C. albicans, C. tropicalis, C. glabrata, C. krusei, and M. guilliermondii were detected in a few samples. C. albicans specifically found at locations with high FIB concentrations, suggesting an association with anthropogenic activities. However, C. auris was not detected in this study. The presence of Candida spp. in recreational waters suggests a potential public health risk. These findings highlight the importance of further monitoring for fungal contamination to protect public health and guide future water quality management policies
Understanding the PPP Syndrome: A Rare Combination of Pancreatitis, Panniculitis, and Polyarthritis
No full textPancreatitis, panniculitis, and polyarthritis (PPP) syndrome is a rare but serious disease that can be deadly. Its symptoms come on suddenly and unexpectedly. This disease is identified by erythematous bullous skin lesions and arthritis caused by pancreatic dysfunction. A 25-year-old man had an abdominal trauma with no past medical history. A CT scan showed pancreatic inflammation, peripancreatic edema, and mild fluid in the head of the pancreas without any collection and collection of blood in the retroperitoneum. The patient came back to the hospital 2 weeks later with a fever, abdominal pain, tender joints, redness, warmth in arms and legs, and rash on the skin. In addition, their amylase and lipase levels were increased. Based on the symptoms, the patient was referred to a rheumatologist and diagnosed with PPP syndrome with concomitant pancreatitis, panniculitis, and polyarthritis. Despite being prescribed corticosteroids and broad-spectrum antibiotics, the patient passed away. The exact pathophysiology of the additional abdominal symptoms has not yet been determined. However, some researchers have suggested that this disorder may be due to the entry of pancreatic lipase enzymes into the bloodstream. Pancreatic enzymes damage adipose tissue in the lower extremities and cause panniculitis (subcutaneous adipose tissue inflammation). The symptoms of arthritis may vary depending on the clinical case as different joints are affected and the number and symmetry of joints involved may differ. Therefore, PPP syndrome is sporadic and not easily diagnosed
The Effect of Pulsed Electromagnetic Field Therapy on Fatigue, Depression, and Quality of Life in Multiple Sclerosis: A Systematic Review of Randomized Clinical Trials
No full textBackground: Multiple sclerosis (MS) is a debilitating neurodegenerative condition characterized by various symptoms, particularly fatigue, which can significantly impact mental health and quality of life. Evidence regarding the efficacy of pulsed electromagnetic field (PEMF) therapy in managing certain symptoms of MS remains controversial. Objectives: This systematic review aimed to evaluate randomized clinical trials (RCTs) assessing the effects of PEMF therapy on fatigue, depression, and quality of life in individuals with MS. Methods: The electronic databases PubMed, Scopus, and Web of Science were searched for arucles published between 1990 and 2023 using the keywords magnetic field therapy and MS. Two independent reviewers conducted the processes of screening. data extraction, and quality assessment. Fatigue was analyzed as the primary outcome, while depression and quality of life were considered secondary outcomes. Results: The search yielded 1,768 articles, of which & met the inclusion criteria for this review. A total of 372 participants were analyzed, 267 (71.7) of whom were women. The intervention duration ranged from 3 to 12 weeks. Fatigue levels were reported in all included studies, while depression and quality of life were assessed in three studies. Conclusions: Compared to placebo, beneficial effects of PEMF therapy on fatigue severity were observed in only two studies, while the remaining studies showed no significant differences between groups. Furthermore, quality of life improved in only one study, and depression scores were comparable between groups at the end of all three studies. Additional trials with longer intervention durations, larger sample sizes, advanced technological devices, and objective assessment tools needed to resolve this controversy
The adaptation of clinical practice guideline recommendations regarding family-centered collaborative care of people living with schizophrenia, major depressive disorder, and bipolar mood disorder in the Iranian context: using the resource toolkit for guideline adaptation
No full textIntroductionChronic mental diseases are enduring and recurring, and need constant care and a collaborative approach for management. Based on clinical guidelines, family interventions can improve the quality of care for individuals with chronic mental diseases.ObjectiveSpecifically, the study examined family involvement in the care of people suffering from schizophrenia, major depressive disorder, and bipolar mood disorder by adapting international clinical guidelines.MethodsThe resource toolkit for guideline adaptation was selected as the adaptation process. Seven databases were searched for international clinical guidelines. Independent reviewers utilized the Appraisal of guidelines for research and evaluation II tools to assess guidelines that met the inclusion and quality criteria. The recommendations from the guidelines were combined with those from the systematic review and qualitative research, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and COnsolidated criteria for REporting Qualitative research checklists. Rephrased recommendations with redundant or overlapping content were excluded from the Iranian context due to the cultural, religious and belief changes of the people, as well as the lack of necessary facilities. Translations of the selected recommendations were made into Persian, along with modified recommendations.ResultsA total of 573 recommendations from 17 books, 10 national documents, 16 guidelines, 27 articles, and 31 English and Persian theses were identified. After the initial review (referred to as RAND/UCLA Appropriateness Method 1), 467 recommendations received an appropriate score, 106 had an uncertain score, and none of them received an inappropriate score. After merging the recommendations, they received 433 good grades and 98 uncertain grades. After the face-to-face meeting of the research team, 7 were merged due to similarity, and 91 recommendations were made in a hybrid panel of experts (RAND/UCLA Appropriateness Method 2). Finally, 524 recommendations were identified that applied to the psychiatric medical centers in Iran. The examined and revised recommendations suggest healthcare professional interventions for family involvement in the care of patients with schizophrenia, major depressive disorder, and bipolar mood disorder referred to medical centers in Iran. The adapted recommendations emphasize the need for family-centered collaborative care ( interventions which satisfy the needs of patients with chronic mental diseases and their caregivers, considering their preferences and capabilities
Caring Challenges of Family Caregivers of Cancer Patients in the COVID-19 Pandemic: A Qualitative Study
No full textBackground:Caregivers of cancer patients experience significant challenges that affect their physical, psychological, and social well-being. This qualitative study aims to explore the specific challenges faced by caregivers of cancer patients during the COVID-19 pandemic.Materials and Methods:The present study is a conventional qualitative study based on the Graneheim method for content analysis. Data were collected through semi-structured individual interviews with 11 family caregivers of cancer patients in Isfahan, Iran.Results:The challenges faced by family caregivers of cancer patients are classified into three main categories: 1) caregiver burnout which includes, "non-cooperation of the patient with the caregiver," "funding the costs of care and treatment," "lack of support for the family caregiver by the family and society," and "lack of knowledge and proper care skills." 2) Health threats to the family caregiver which include, "imbalance of self-care versus patient care," "disruption of a healthy lifestyle," and "occurrence of psychophysical symptoms caused by stress in caregivers." 3) Work-family-care conflicts which include: "conflict between patient care and family" and "conflict between patient care and work."Conclusions:This study provides additional insights into the personal and societal challenges faced by family caregivers of cancer patients during the COVID-19 pandemic. Based on our findings, health policymakers can take concrete steps to address these challenges and enhance the support for family caregivers, who play a crucial role in public health
The Effect of Vitamin D Deficiency on Liver Transplant Recipients
No full textLiver disease, which leads to end-stage organ dysfunction, is becoming one of the top causes of death worldwide. Many molecular and cellular pathways affect liver transplant such as tissue maintenance or rejection. Low 25-dihydroxyvitamin D levels are linked to numerous chronic disorders, including end-stage liver disease. We conducted a thorough search of five major academic databases (ScienceDirect, PubMed, Medline, Google Scholar, and Scopus) for articles published by November 4, 2023. The research was carried out utilizing the seven processes delineated in the Cochrane Handbook. The search for studies involved the use of different keywords, including "Vitamin D," "deficiency," and "liver transplantation." This study analyzed 14 papers that examined Vitamin D levels after liver donation (among the liver's recipients). The research's findings revealed that patients with normal Vitamin D levels had a greater rate of recovery after surgery, a stronger immune system, and a lower severity of the risk of transplant rejection than those with Vitamin D deficiency. In general, Vitamin D supplementation before or after liver transplantation can reduce the risk of infection and increase the survival rate in these patients without any toxic effects at standard doses
Gustatory dysfunction in multiple sclerosis: a systematic review and meta-analysis
No full textGustatory dysfunction is an often overlooked symptom in people with multiple sclerosis (PwMS), potentially leading to poor appetite, malnutrition, weight loss, and decreased quality of life. This systematic review and meta-analysis aimed to assess the pooled prevalence of gustatory dysfunction in PwMS and compare their gustatory test scores with healthy controls. An online database search of PubMed, Embase, Scopus, and Web of Science was conducted on 2024 June 29. Observational studies reporting gustatory dysfunction or gustatory test scores in PwMS were included. Pooled prevalence rates were calculated using a random-effects model, with subgroup analyses based on the type of gustatory test used. Standardized mean differences (SMD) were calculated for comparisons between PwMS and healthy controls. A total of 9 studies encompassing 1385 PwMS were included. The pooled prevalence of gustatory dysfunction among PwMS was 16.4 (95 confidence intervals 95% CI: 8.7% to 24.1%, I-2 = 90%, P < 0.01). Subgroup analysis showed a prevalence of 18.8% (95% CI: 10.5% to 27.2%, I-2 = 0%) in 4 studies using the Taste Strip Test (TST), while 3 non-TST studies using liquid tastants or self-reports reported a prevalence of 20.2% (95% CI: 7.2% to 33.3%, I-2 = 86%). PwMS had significantly lower gustatory test scores compared to healthy controls (SMD: -0.93, 95% CI: -1.20 to -0.65, I-2 = 0%, P = 0.48). Gustatory dysfunction affects a notable proportion of PwMS, with prevalence rates varying by assessment method. Future studies should assess the possible causes of gustatory dysfunction in PwMS using validated gustatory assessment scales