Advanced Biomedical Research
Year:2024 | Volume:13 | Issue:January|Papers Count:13

Background: Oculocardiac reflex (OCR) is one of the serious complications following surgical therapeutic procedures for strabismus. Various medications have been tested to prevent or mitigate this complication. We aimed to compare the effect of intravenous atropine and topical tetracaine on the incidence and severity of OCR in strabismus surgery. Materials and Methods: In this triple-blind randomized clinical trial study, 120 patients who were candidates for strabismus surgery were randomly assigned to receive intravenous atropine, topical tetracaine, or artificial tears as the control. The incidence of OCR and its severity along with the changes in hemodynamic conditions were compared across the groups. Results: The incidence rate of OCR in the groups receiving atropine, tetracaine, and the control was found to be 17. 5%, 25. 0%, and 32. 5% in the releasing phase without any difference, respectively (P = 0. 303),however, it was 2. 5%, 7. 5%, and 25. 0%, respectively, in the cutting phase, indicating a lower rate in the group receiving tetracaine (P = 0. 004). Similarly, there was no difference in the severity of OCR across the three study groups in the releasing phase (P = 0. 666),however, in the cutting phase, OCR was revealed to be milder in the group receiving atropine as compared to other groups (P = 0. 033). Prescribing atropine led to higher mean systolic blood pressure and mean arterial pressure during surgery. Conclusion: The injection of atropine can effectively reduce the incidence of OCR during strabismus surgery and reduce its severity if this reflex occurs.

Background: Diabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes mellitus (DM). DPN is the primary risk factor for diabetic foot ulcers that can cause amputation. Although several observational studies have investigated the morphological and biomechanical characteristics of peripheral nerves in DPN, interventional studies regarding the effectiveness of neurodynamic techniques (NDT) in DPN patients are confined to a handful. The effects of NDT on neuropathy severity, nerve conduction parameters, quality of life (QoL), and mechanosensitivity have not been explored yet in this population. Materials and Methods: Forty type 2 DPN (T2DPN) patients, diagnosed based on an electrodiagnosis study, will be recruited into two groups. The experimental group will receive the tibial nerve’s real proximal and distal slider techniques in addition to DPN standard treatment as a basic treatment, and the control group will receive the tibial nerve’s sham proximal and distal slider techniques along with the basic treatment for eight sessions twice a week. Baseline and post-intervention assessments will be based on the Michigan diabetic neuropathy score (MDNS) (primary outcome), tibial nerve conduction parameters, neuropathy-specific quality of life (Neuro QoL) questionnaire, and straight leg raising range of motion (SLR ROM) (secondary outcomes). Results: This study is expected to last approximately seven months, depending on recruitment. The results of the study will be published in a peer-reviewed journal. Conclusions: The present study will evaluate the efficacy of NDT on the primary and secondary outcome measurements in DPN patients.

Background: Due to the importance of sudden sensorineural hearing loss (SSNHL) and the possible role of blood coagulation in its mechanism and the likely therapeutic effect of anticoagulants and also the lack of studies in this field, this study aimed to evaluate the effect of rivaroxaban (RXA) in the treatment of this disease. Materials and Methods: The present double-blind randomized clinical trial study was performed on 34 patients with SSNHL. Patients were randomly divided into two groups. In the first group, in addition to corticosteroid therapy (CST), RXA 10 mg tablets were used daily for 10 days (RXA group), and in the second group, only CST (CST group) treatment was prescribed. Hearing recovery was then assessed and recorded according to the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) criteria. Results: This study showed that the grade of hearing recovery in the RXA group (58. 8%) was higher than the CST group (47. 1%), but this difference was not significant (P value >0. 05). Also, RXA treatment increased the odds of hearing recovery, and this difference was not statistically significant (odd ratio (95% confidence interval)(OR (95% CI): 2. 327 (0. 180–18. 082),P value = 0. 518). In contrast, delay to treatment, more increased PTA (pure tone average (PTA)), and having vertigo reduced the odds of hearing recovery by 0. 138-, 0. 019-, and 0. 069-fold, respectively (P value <0. 05). Conclusion: According to the results of this study, although the percentage of hearing recovery was higher in the RXA group, in general, the results of the two treatments were not significantly different.

Background: Nephropathic cystinosis (NC) is an uncommon autosomal recessive disease with abnormality in lysosomal storage that appearances in patients with mutations in the CTNS gene encoding a lysosomal transporter cystinosin. Disrupted function of this transporter is followed by accumulation of cysteine crystals in cells of many various organs. This study aimed to investigate the mutations of the CTNS gene in 20 Iranian patients suffering from NC. Materials and Methods: Twenty Iranian cystinosis patients referring to Imam Hossein Hospital of Isfahan were employed in this case-series study. After extraction of genomic DNA, the promoter and entire coding regions of CTNS were analysed using sanger sequencing in all patients. Gap–Polymerase Chain Reaction was used to detect 57 kb deletion in the CTNS gene. In silico study was performed to analyse variants. Results: The large deletion was not seen in any NC patients. Molecular analysis which conducted to screen the CTNS gene of patients, identified eight different mutations, including two new mutations, c. 971_972insC and c. 956_956delA, which have not been reported before, and c. 681G>A mutation, which was identified as a frequently founded mutation in the Middle East and was observed in 35% of patients. In this study, five other mutations including c. 1015G>A, c. 922G>A, c. 323_323delA, c. 433C>T, and c. 18_21delGACT were also observed, which have been reported in previous studies. Conclusion: The mutational spectrum in the Iranian patients is the same as previously reported mutations except that two new mutations were found. The present findings will present suggestions for regular molecular diagnosis of cystinosis in Iran.

Background: This study assessed the effect of combined application of hydrofluoric (HF) acid and phosphoric acid (PA) and active irrigation (AI) with a microbrush on shear bond strength (SBS) of lithium disilicate (LDS) ceramics to enamel. Materials and Methods: This in vitro study was conducted on 40 extracted teeth that received enamel preparation with a #12 cylindrical bur. Forty IPS e. max LT rods (3mm diameter, 6mm height) were fabricated and randomly assigned to four groups (n = 10) for surface treatment with 5% HF (group 1), 5% HF and AI with a microbrush for 20 seconds (group 2), 5% HF and 32% PA (group 3), and 5% HF and 32% PA plus AI with a microbrush for 20 seconds (group 4). Silane and Choice 2 cement were used for bonding rods to enamel. The SBS was measured by a universal testing machine. Data were analyzed by two-way analysis of variance (ANOVA), Bonferroni, and Chi-square tests (alpha = 0. 05). Results: Group 4 had the highest SBS, and group 1 had the lowest SBS (P < 0. 05). Group 2 had a significantly higher SBS than group 1, and group 4 had a significantly higher SBS than group 3. AI with a microbrush significantly increased the SBS (P < 0. 05), but the application of PA caused no significant change in SBS (P > 0. 05). The interaction effect of PA and AI on SBS was not significant (P > 0. 05). Conclusion: The application of PA in addition to 5% HF acid caused no significant change in the SBS of LDS ceramic to enamel. However, AI with a microbrush significantly increased the SBS.

Background: To determine the superiority of the combination of endoscopic retrograde cholangiopancreatography (ERCP) and digital single-operator cholangioscopy (DSOC) in the same sitting over the individual modality alone in patients with indeterminate biliary strictures. Materials and Methods: A randomized study enrolled 60 adult patients with biliary strictures who were randomized into two groups: ERCP + DSOC and ERCP/DSOC. Histopathologic or cytologic assessment was performed in terms of benign, indeterminate, or malignant nature of the strictures. Procedural adverse events were documented. Accuracy in terms of sensitivity (Sn), specificity (Sp), and predictive value [positive (PPV) and negative (NPV)] were noted. Results: As per final diagnosis, in ERCP/DSOC group, there were 12 (40%) benign cases and 18 (60%) malignant cases, and in group ERCP + DSOC, there were 8 (26. 67%) benign cases and 22 (73. 33%) malignant cases. ERCP/DSOC labeled 16 (53. 33%) patients as benign, 8 (26. 67%) as malignant, and 6 (20%) as indeterminate, while ERCP + DSOC labeled 8 (26. 67%) as benign, 17 (56. 67%) as malignant, and 5 (16. 67%) as indeterminate. The Sn, Sp, PPV, and NPV of ERCP/DSOC were 44. 4%, 75%, 100%, and 56. 25%, and for ERCP + DSOC was 77. 27%, 62. 50%, 100%, and 62. 5%, respectively (P = 0. 033). Side effects were statistically similar in both the groups (P > 0. 05). Conclusion: To conclude, the combination of ERCP with DSOC is safe and effective with higher diagnostic sensitivity (77. 27%) in comparison to standard ERCP or DSOC alone (44. 4%) for the diagnosis of biliary strictures.

Yolk sac tumors make up 14% to 20% of all malignant ovarian germ cell tumors. Serum alpha-fetoprotein (AFP) levels are elevated in a significant number of patients and are useful for monitoring the response to treatment and for post-treatment surveillance. Surgery is required for diagnosis, staging, and treatment. The first case is a 12-year-old girl presented with abdominal pain. The ultrasonography (US) showed a huge pelvic tumor. AFP level was high (1000 mg/ml). Right salpingo-oophorectomy and pelvic lymphadenectomy were done. Histopathology reported yolk sac tumor of ovary. She received 3 courses of bleomycin, etoposide, cisplatin (BEP). The second case is a 25-year-old G1AB1 presented with pelvic pain and distension. The US showed a huge pelvic tumor in the right abdominopelvic region. AFP level was high (1000 mg/ml). Right salpingo-oophorectomy, omentectomy, and appendectomy were done. Histopathology reported yolk sac tumor of ovary. The patient received four cycles of BEP protocol; AFP level decreased to 10 mg/ml after the four cycles of chemotherapy. The third case is a 21-year-old girl presented with abdominal pain. The US showed a huge pelvic tumor in the right adnexa. AFP level was high (8700 mg/ml). Right salpingo-oophorectomy and pelvic lymphadenectomy were done. Yolk sac tumor is rare in children and it could be cured usually. In this study, we described three patients with ovarian yolk sac tumors and their fertility preservation treatments.These cases has reminded that in young age with high AFP levels and rapidly growing ovarian mass, diagnosis of the yolk sac tumor has to be kept in mind.

Artificial intelligence talks about modeling intelligent behavior through a computer with the least human involvement. Drug repositioning techniques based on artificial intelligence accelerate the research process and decrease the cost of experimental studies. Dysregulation of fibroblast growth factor (FGF) receptors as the tyrosine kinase family of receptors plays a vital role in a wide range of malignancies. Because of their functional significance, they were considered promising drug targets for the therapy of various cancers. This review has summarized small molecules capable of inhibiting FGF receptors that progressed using artificial intelligence and repositioning drugs examined in clinical trials associated with cancer therapy. This review is based on a literature search in PubMed, Web of Science, Scopus EMBASE, and Google Scholar databases to gather the necessary information in each chapter by employing keywords like artificial intelligence, computational drug design, drug repositioning, and FGF receptor inhibitors. To achieve this goal, a spacious literature review of human studies in these fields—published over the last 20 decades—was performed. According to published reports, nonselective FGF receptor inhibitors can be used for cancer management, and multitarget kinase inhibitors are the first drug class approved due to more advanced clinical studies. For example, AZD4547 and BGJ398 are gradually entering the consumption cycle and are good options as combined treatments. Artificial intelligence and drug repositioning methods can help preselect suitable drug targets more successfully for future inhibition of carcinogenicity.

Background: Non-pharmacologic prophylactic methods for chronic migraine have been developed, including the promising non-invasive techniques of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS). This study aimed to compare the efficacy of rTMS and tDCS on pain intensity, the impact of headaches on daily life, anxiety, and depression in migraine headaches patients. Materials and Methods: This randomized clinical trial was conducted on 72 patients with migraine headaches, randomly allocated to the rTMS and tDCS groups. Participants received 3 and 12 sessions of stimulation over the left dorsolateral prefrontal cortex (DLPFC), respectively. Follow-up measurements, including pain intensity, anxiety, depression, and impact on daily life, were performed one month after the last sessions. Analyses were done by IBM SPSS statistics version 26 software. Results: Of 72 patients enrolled in the study, 19 were male (8 in the rTMS group and 11 in the tDCS group). There was no significant difference in baseline characteristics between groups. During the follow-up visit, both groups showed a decrease in anxiety levels (P values = 0. 005 and 0. 015), while only the rTMS group displayed a significant improvement in depression (P value = 0. 01). However, no statistically significant difference was found among the groups regarding changes in pain intensity, anxiety, and the impact of headaches on daily life (P values >0. 05). Conclusion: Our findings suggest that both rTMS and tDCS may be effective in reducing pain intensity and improving the impact of headaches on daily life and anxiety in patients with chronic migraine. However, significant improvement in depression was only observed in the rTMS group patients.

Background: Analyzing co-occurrence is an effective way to monitor the overview of topic spreading. The present study aimed to conduct a co-occurrence analysis of scientific publications related to COVID-19, emphasizing Global Health Governance (GHG). Materials and Methods: This applied research with an analytical approach was carried out on all the scientific publications related to COVID-19, emphasizing GHG (51056 records), extracted from PubMed Central on 26/01/2022. The research population consisted of all the scientific publications related to COVID-19, emphasizing GHG (51056 records), extracted from PubMed Central on 26/01/2022. The data were analyzed using BibExcel, UCINET, Excel, and SPSS software, and Spearman’s test was used to confirm correlations. Results: The co-word network of the thematic area of COVID-19 includes 226 nodes and 7292 edges. COVID-19 and the pandemic formed the most co-word pairs with 2224 connections. The COVID-19* mental health and COVID-19* anxiety, with 1019 and 925 connections, are ranked next, respectively. The term COVID-19 is ranked first with a centrality index of 225. The keywords of pandemic and public health are ranked second and third with the centrality index of 217 and 206, respectively. Conclusion: The global approach of studies related to COVID-19 is more inclined to the epidemiological and public health fields. Assuming the GHG, detailed and comprehensive planning should be performed to strengthen these studies and pave the way for international cooperation, determining research requisites, and developing applied research studies.

Background: This study investigated the clinical outcomes at the minimum and maximum levels of hematocrit (HCT) during cardiopulmonary bypass (CPB) in low-risk patients undergoing coronary artery bypass graft (CABG) surgery. Materials and Methods: In this cross-sectional study, 85 patients who underwent CABG with an ejection fraction of greater than 35% were selected. Based on the HCT range during CPB, patients were divided into two groups: minimum HCT: HCT = 16–18% and maximum HCT: HCT = 25–27%. Then the operation outcomes, amount of drainage, and transfusion were recorded and compared between these groups. Results: In the middle tube 8 h after surgery and left tube 24 h after surgery, the amount of drainage in the minimum HCT group with mean of 71. 00 ± 130. 9 and 60. 65 ± 71. 23, respectively, was significantly lower than the maximum HCT group with mean of 101. 5 ± 246. 50 and 123. 76 ± 93. 17, respectively (P value < 0. 05). The incidence of cognitive disorders in the maximum HCT group was significantly higher than in the minimum HCT group (11. 1% vs. 0%, P value = 0. 041). Also, the mean transfusion of packed red blood cell (PRBC) and fresh frozen plasm (FFP) during CPB in the maximum HCT group, with mean of 346. 7 ± 86. 22 and 396. 1 ± 21. 05, respectively, were significantly higher than the minimum HCT group with mean of 178. 8 ± 80. 91 and 136. 8 ± 46. 77, respectively (P value < 0. 05). After CPB, there was no significant difference in transfusion products (P value > 0. 05). Conclusion: According to the results of this study, patients undergoing CABG surgery with maximum HCT level versus minimum HCT level during CPB, need more packed cells and fresh frozen plasma products transfusion, which will be associated with the complication of cognitive impairment.

Background: This study aimed to evaluate the effectiveness of emotional schema therapy on psychological distress, severity and frequency of symptoms in women with irritable bowel syndrome (IBS). Materials and Methods: This semi-experimental two-group three-stage (pre and post-test and two-month follow-up) study was done on 30 women of 18-50 years old with IBS. They were randomly assigned to two groups (experimental and control). Psychological distress and Bowel symptoms severity and frequency in the three stages were measured. The emotional schema therapy group was treated for 8 sessions and the control group remained on the waiting list. Results: The mean score of pre-test, post-test and follow-up of emotional therapy schema group in psychological distress were 21. 23 ± 8. 18, 16. 08 ± 6. 05 and 14. 69 ± 4. 05,in symptom intensity 7. 46 ± 1. 98, 5. 23 ± 1. 30 and 6. 46 ± 1. 33 and in symptom frequency 7. 46 ± 1. 98, 6. 08 ± 1. 66 and 7. 54 ± 2. 18 respectively. In the control group, there was no difference between the scores of different tests,in the pre-test, post-test and follow-up, the scores of psychological distress were 20. 23 ± 5. 39, 20. 08 ± 5. 59, and 20. 38 ± 4. 75, in the symptoms severity 7. 69 ± 1. 49, 7. 62 ± 1. 33, and 7. 69 ± 1. 80, and in the symptoms frequency 6. 92 ± 2. 75, 6. 54 ± 2. 40 and 6. 62 ± 2. 63 respectively. In the control group, there was no difference between the scores in different tests. In the pre-test, post-test and follow-up, in psychological distress, the scores were 20. 23 ± 5. 39, 20. 08 ± 5. 59, and 20. 38 ± 4. 75 in the symptom severity 7. 69 ± 1. 49, 7. 62 ± 1. 33, and 7. 69. ±1. 80 and in the symptoms frequency 6. 92 ± 2. 75, 6. 54 ± 2. 40 and 6. 92 ± 2. 75 respectively (P < 0. 05). Conclusion: Emotional schema therapy can be used as a complementary psychological treatment to reduce psychological distress and severity and frequency of symptoms in women with IBS.

Background: The present study aimed at comparing the hemodynamic responses to laryngoscopy and initiation of intubation with either direct or video-assisted laryngoscopy. Materials and Methods: This double-blind clinical trial was performed on 90 pregnant women candidates for cesarean section under general anesthesia. The participants were divided into two groups. In the first group, intubation was performed using direct Macintosh laryngoscope (MCL group). The second group underwent intubation using the GlideScope video laryngoscope (GSL group). Then, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), the percentage of the saturation of peripheral oxygen (SpO2), the time-to-intubation (TTI), and the number of intubation attempts were recorded. Results: SBP, DBP, and MAP in the MCL group were significantly higher than GSL group 1, 3, and 5 min after laryngoscopy (P < 0. 05). HR in the MCL group with the mean of 118. 44 ± 15. 53 bpm was significantly higher than that the GSL group with the mean of 110. 11 ± 16. 68 bpm only 3 min after laryngoscopy (P = 0. 016). The TTI in the MCL group was significantly longer than that of the GSL group (12. 80 ± 1. 86 vs. 10. 15 ± 2. 61,P = 0. 001). The frequency of the first intubation attempt in the GSL group with 91. 1% was significantly higher than that the MCL group with 84. 4% (P = 0. 003). Conclusion: It seems that the GSL technique is a better choice to conduct laryngoscopy with more success in intubation and a higher stability of the patients’ hemodynamic status.