Background and purpose: Renal cell carcinoma (RCC) is one of the most common forms of kidney cancer and presents significant challenges in diagnosis and treatment due to its unique biological and tumour characteristics. Selecting the appropriate surgical approach, whether radical or partial nephrectomy, is crucial for improving patient prognosis and quality of life. This study aimed to investigate the frequency of different RCC subtypes in Babol and to evaluate survival and tumour recurrence among patients who underwent radical or partial nephrectomy. Materials and methods: This historical cohort study included 75 patients. Data on age, sex, type of nephrectomy, RCC subtype, TNM stage, and pathological grade were obtained from pathology records and follow-up telephone interviews with patients. Patients were divided into partial nephrectomy and radical nephrectomy groups, and overall survival and tumour recurrence were compared between the two groups. Results: The mean age of the patients was 59.53 years, and 68% were male. The most common RCC subtype was clear cell RCC (66.7%). Twenty-seven patients (36%) underwent partial nephrectomy. During follow-up, 20 patients (26.7%) died. The mean survival time was 76.0 months in the partial nephrectomy group and 68.9 months in the radical nephrectomy group. Tumour recurrence occurred in 20 patients, with recurrence rates of 7% in the partial nephrectomy group and 37.5% in the radical nephrectomy group. Conclusion: Partial nephrectomy may represent an appropriate treatment option for patients with RCC, particularly those with clear cell RCC, because it preserves renal function, reduces surgical morbidity, and can achieve favourable oncological outcomes when patients with less aggressive tumours are appropriately selected.
Fatemeh Zahra Ranjbar Golafshani1,2 Saeid Mahdavi Omran2,3 Mojtaba Taghizadeh Armaki2,4 Tahereh Shokohi5,6 Firoozeh Kermani2,4 1 MSc in Medical Mycology, Department of Parasitology and Mycology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran 2 Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran 3 Professor, Department of Parasitology and Mycology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran 4 Associate professor, Department of Parasitology and Mycology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran 5 Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran 6 Professor, Department of Parasitology and Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran In the article published in Volume 34, Issue 237 (Mehr 1403), 2024, Figure 2 in the text was corrected.
Background and purpose: After Aspergillus fumigatus, A. flavus is the second most common cause of invasive and non-invasive aspergillosis. Otomycosis is a superficial fungal infection of the external auditory canal, with a worldwide incidence ranging from 9% to 30%. Most cases of otomycosis are caused by Aspergillus species. The aim of the present study was to genotype A. flavus strains isolated from patients with otomycosis in Babol using the Multiple-Locus Variable Number Tandem-Repeat Analysis (MLVA) molecular technique. Materials and methods: In this descriptive cross-sectional study, ear samples were collected by an Ear, Nose and Throat (ENT) specialist using sterile swabs over a five-year period. The samples were then transferred to the mycology laboratory under sterile conditions for direct microscopic examination using 10% KOH and culture on Sabouraud dextrose agar. A total of 40 A. flavus isolates were collected from patients with otomycosis. After DNA extraction, MLVA was performed using four variable number tandem repeat (VNTR) markers for A. flavus (AFLA1, AFLA3, AFLA7, and AFMP3) to determine the genetic diversity and potential relatedness of the clinical isolates by polymerase chain reaction (PCR). Results: Microsatellite typing of the 40 A. flavus isolates identified 40 distinct genotypes (sequence types). The Simpson's index of diversity for the markers ranged from 0.895 to 0.940. No two isolates exhibited 100% genetic similarity. Among the four markers, AFLA1 demonstrated the highest discriminatory power. Conclusion: Microsatellite genotyping revealed considerable genetic diversity among A. flavus isolates obtained from patients with otomycosis. Furthermore, there was no evidence of an association between a specific genotype and the clinical presentation of A. flavus otomycosis.
Background and purpose: Hydatid cyst is a parasitic disease caused by infection with the tapeworm Echinococcus granulosus. This study presents a rare case of a hydatid cyst located adjacent to the stomach in an elderly patient presenting with peripheral edema and sepsis. Case presentation: An 80-year-old male patient with no known underlying diseases presented to the hospital with a complaint of ankle edema. Initial evaluations resulted in diagnoses of sepsis and acute kidney injury. Abdominal ultrasonography revealed a hydatid cyst located adjacent to the stomach. Initial treatment included broad-spectrum antibiotics (linezolid, meropenem, and clindamycin) administered for seven days, dexamethasone, and supportive measures, including leg elevation and compression stockings. Following infection control (with a reduction in C-reactive protein from +3 to negative) and stabilization of the patient's condition, surgery was performed. Intraoperatively, due to the large size of the cyst (16 cm) and its proximity to the stomach, the cyst contents were first aspirated to minimize the risk of damage to adjacent vital organs, followed by complete excision of the cyst wall. Pathological examination revealed a laminated membrane containing protoscolices, confirming the diagnosis of E. granulosus. Although the patient's critical clinical condition precluded preoperative administration of albendazole, a full course of the drug was initiated postoperatively. The patient recovered uneventfully and was discharged in good condition. Conclusion: This case highlights a rare hydatid cyst located adjacent to the stomach in an elderly patient presenting with peripheral edema, sepsis, and renal dysfunction. Although a definitive causal relationship between these clinical manifestations and the hydatid cyst could not be established, this case underscores the importance of considering atypical presentations of hydatid disease and performing comprehensive diagnostic evaluations in patients with complex clinical findings.
Background and purpose: Neuroinflammation and oxidative stress are major contributors to the pathogenesis and progression of Parkinson's disease (PD). The JNK-cJun-AP1 signaling pathway regulates the transcription of pro-inflammatory genes, cytokines, and neurotoxic mediators, thereby promoting neuronal damage in vulnerable brain regions such as the hippocampus. The present study aimed to evaluate the potential neuroprotective effects of hesperidin (HES), a citrus-derived flavonoid, on the modulation of the JNK-cJun-AP1 pathway and hippocampal inflammatory responses in a reserpine-induced experimental model of PD. Materials and methods: In this controlled experimental study, forty adult male Wistar rats were randomly assigned to five groups: control, vehicle + saline (VR+NS), reserpine + saline (RES+NS), hesperidin + vehicle (HES+VR), and reserpine + hesperidin (RES+HES). Reserpine (0.2 mg/kg, intraperitoneally) was administered for 13 consecutive days to induce parkinsonian-like symptoms. Subsequently, HES (100 mg/kg, orally) was administered for 21 days. At the end of the experimental period, hippocampal concentrations of TNF-α, IL-1β, IL-6, and IL-10 were measured using ELISA. Relative gene expression levels of the JNK, c-Jun, and AP-1 genes were quantified by RT-qPCR. Results: Reserpine significantly elevated hippocampal levels of TNF-α, IL-1β, and IL-6 while reducing IL-10 compared with the control group (P < 0.001). HES treatment reversed these alterations, significantly decreasing IL-1β and IL-6, increasing IL-10, and improving the hippocampal inflammatory profile (P < 0.001). Moreover, JNK, c-Jun, and AP-1 gene expression levels were markedly upregulated in the RES+NS group (P < 0.01), whereas HES administration significantly downregulated their expression (P < 0.05). Conclusion: Hesperidin exerts neuroprotective effects in reserpine-induced PD by modulating the JNK-cJun-AP1 signaling pathway and attenuating hippocampal inflammation, highlighting its potential as a therapeutic agent for PD and other neurodegenerative disorders.
Background and purpose: Preconception lifestyle is a modifiable factor that may significantly affect pregnancy outcomes. The present study aimed to compare the preconception lifestyle of women with a history of miscarriage with that of women with a history of live birth in Kerman, Iran. Materials and methods: This case-control study was conducted in 2024 and included 50 women with a history of miscarriage (case group) and 100 women with a history of live birth (control group) who attended health centers in Kerman. A multistage cluster random sampling method was used across five regions of the city. Data were collected using a demographic questionnaire and the standardized Lifestyle Questionnaire (LSQ). The validity and reliability of the questionnaire had previously been established. Statistical analyses were performed using SPSS version 22, including the independent t-test, Chi-square test, Mann-Whitney U test, and logistic regression. A P-value of <0.05 was considered statistically significant. Results: The total lifestyle score differed significantly between the two groups (P = 0.002), with women who had a history of live birth achieving higher scores than those with a history of miscarriage. Logistic regression analysis showed that higher scores in physical activity and fitness (OR = 0.84, 95% CI: 0.77-0.92, P< 0.001), weight control and nutrition (OR= 0.83, 95% CI: 0.75-0.91, P< 0.001), and physical health (OR= 0.74, 95% CI: 0.65-0.84, P < 0.001) were associated with reduced odds of miscarriage. No statistically significant differences were observed in demographic characteristics between the two groups (P > 0.05), suggesting that these variables were unlikely to have confounded the findings. Conclusion: Improving lifestyle factors related to physical activity and fitness, weight control and nutrition, and physical health may help reduce the risk of miscarriage
Background and purpose: The use of technology in modern educational systems, including medical education, has become increasingly widespread. Investigating students' attitudes towards educational technology can help to optimise its use, improve teaching methods in line with students' needs and learning styles, and enhance learning outcomes. This study examines the role of educational technology in education from the perspective of basic sciences students at Sari Medical School in the 2024-2025 academic year. Materials and methods: This cross-sectional study was conducted with 280 students using random sampling. The data collection tool was the Persian version of the standard questionnaire “The Role of Educational Technology in Medical Education.” This questionnaire consists of 20 items across four domains assessing the role of educational technology in learning in terms of goals, conditions, resources, and evaluation. Responses were recorded on a five-point Likert scale ranging from “completely ineffective” to “very effective.” The minimum and maximum total scores were 20 and 100, respectively, and the average score for each component ranged from 1 to 5. Data were analysed using IBM SPSS version 26. Results: The overall attitude towards the role of educational technology was positive and relatively high, with a mean total score of 89.63 out of 100 (P< 0.01). At the component level, the highest and lowest mean attitude scores were related to “learning objectives” (3.57) and “learning conditions” (2.79), respectively. The attitude towards “learning resources” had a mean score of 3.35, indicating a positive and significant perception (P< 0.01). In contrast, the mean score for the “evaluation” component was 3.06, which was not statistically significant (P = 0.13). Conclusion: From the students’ perspective, educational technology is relatively effective in supporting learning objectives and providing educational resources; however, it requires further strengthening and improvement in the areas of learning conditions and evaluation.
Background and purpose: Burns affect more than 11 million people worldwide annually, and split-thickness skin grafting remains the standard treatment for deep burns; however, the optimal method for securing skin grafts to the wound bed remains debated. This systematic review was conducted to compare the clinical efficacy of tissue adhesives (fibrin sealants) versus conventional mechanical fixation methods (sutures/staples) for skin graft stabilization in burn patients. Materials and methods: A comprehensive search was conducted using international databases (PubMed, Embase, Scopus, and Web of Science) and national databases (SID, Magiran, and IranDoc) without language or date restrictions. Methodological quality was assessed using the RoB 2 and ROBINS-I tools, and data were synthesized using RevMan 5.4 software to calculate risk ratios (RRs) and mean differences (MDs). Results: Of the 16 eligible studies, seven were excluded due to a high risk of bias, leaving nine studies in the qualitative review and seven studies comprising 545 patients in the meta-analysis. The results showed no significant difference in graft take between the two groups (RR = 1.03; P = 0.19); however, tissue adhesives significantly reduced the need for reoperation (RR = 0.12; P = 0.0001) and postoperative pain intensity (MD = −1.73; P = 0.02). A trend towards reduced hematoma formation and shorter operative time was also observed in the tissue adhesive group compared to mechanical fixation. Conclusion: Fibrin tissue adhesives represent a safe and effective alternative to mechanical fixation for skin graft stabilization in burn patients. Graft take rates and complication rates were comparable between the two methods; however, tissue adhesives significantly reduced postoperative pain and the need for reoperation. Despite higher material costs, the reduction in secondary interventions may offset the overall expenditure. Higher-quality randomized controlled trials are warranted to confirm these findings. (Registration ID (in PROSPERO): CRD420251248124)
Background and purpose: In recent years, the number of complaints against physicians has increased significantly. Medical complaints include allegations of medical negligence, inadequate communication or information provided by physicians, and premature hospital discharge. Medical negligence may involve malpractice, lack of due care, inadequate professional competence, and violations of administrative or professional regulations. Patient complaints provide an important opportunity to identify weaknesses in healthcare systems. Consequently, examining these complaints may contribute to preventing and reducing medical errors and improving the quality of healthcare services. This study aimed to investigate the main causes of complaints registered with the Medical Council of Ramsar during a 10-year period (2011-2021). Materials and methods: This retrospective descriptive-analytical study reviewed complaint files registered and archived at the Medical Council of Ramsar. Relevant data were extracted and analyzed using appropriate statistical methods. Results: A total of 105 complaints were reviewed. The most common cause of complaints was treatment-related complications or disability (42.9%). The specialty most frequently involved in complaints was dentistry (21.9%), followed by general medicine and infectious diseases (both 17.1%). Hospitals accounted for the highest proportion of complaints (62.8%), whereas pharmacies accounted for the lowest (1.9%). The most common type of negligence was professional negligence resulting in malpractice (42.5%). The mean age of complainants was 43.02 years, while the mean age of physicians was 46.89 years. No statistically significant association was observed between physician gender and the cause of complaint (P> 0.05). However, a significant association was found between the place of service delivery and the cause of complaint (P< 0.05). Conclusion: The gender distribution of doctors and complainants did not differ and could be due to the increase in the number of working women and the fact that women received more services over time, especially cosmetic services. The most common source of complaints was the hospital due to the referral of high-risk individuals and the presence of high-risk practices. Malpractice was the most common cause of complaint, and the most common reason was negligence and then carelessness, which is also confirmed by most other studies. The findings indicate that more effort should be made to train doctors and improve processes.
Background and purpose: Despite substantial efforts to correct biomechanical risk factors such as dynamic knee valgus and hip muscle weakness, the incidence of anterior cruciate ligament (ACL) injuries remains high among athletes. This systematic review aimed to examine the discrepancies between laboratory-based kinematic assessments and real-world ACL injury mechanisms, while also evaluating the role of cognitive factors in injury occurrence. Materials and methods: A comprehensive literature search was conducted across PubMed, Web of Science, PEDro, and Scopus, with Google Scholar searched to identify grey literature. Eligible studies published between January 1, 2010, and January 1, 2025, were identified. Studies investigating landing and cutting biomechanics, systematic video analyses of real ACL injuries, and the effects of cognitive load on movement biomechanics were included. The methodological quality of the 26 eligible studies was assessed using a modified Downs and Black checklist, and the findings were synthesized narratively. Results: Video analyses consistently demonstrated that real-world ACL injuries often occur during defensive and unpredictable situations and are not necessarily associated with severe knee valgus. In contrast, laboratory-based kinematic measures showed only weak correlations with movement patterns observed during competition. Furthermore, introducing cognitive load and decision-making requirements during cutting maneuvers significantly increased knee joint loading, joint torques, and other biomechanical variables associated with ACL injury risk, yet these factors are seldom incorporated into conventional screening protocols. Conclusion: The evidence suggests that laboratory tests conducted under fully predictable conditions may be insufficient for predicting ACL injury risk in the dynamic and complex environment of competitive sport. Rather than being solely the consequence of biomechanical deficits, ACL injury appears to result from the interaction between impaired motor control and cognitive demands encountered during sport-specific tasks. Accordingly, screening and injury prevention programmes should extend beyond technique correction to incorporate cognitive challenges and training under unpredictable conditions, thereby improving their ecological validity and better reflecting the demands of real-game situations.
Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) in which autoreactive immune cells recognize myelin antigens, leading to demyelination and axonal damage. Pro-inflammatory CD4+ T cells reactive to myelin peptides primarily target myelin and oligodendrocytes. Under normal physiological conditions, regulatory CD4+ T (Treg) cells maintain immune homeostasis by suppressing the detrimental effects of inflammatory T cells. However, the number and/or function of Treg cells are reduced in patients with MS, although the underlying mechanisms remain unclear. Many aspects of MS pathogenesis, particularly the mechanisms responsible for the initiation of immune dysregulation, are still poorly understood. For instance, the mechanisms by which the peripheral immune system develops autoreactivity against CNS components remain unknown. This review highlights the emerging role of circulating exosomes in MS, with particular emphasis on their potential involvement in impairing Treg-cell differentiation and function. According to recent findings, exosomes are endosome-derived extracellular vesicles measuring 30-200 nm in diameter that carry specific proteins, lipids, and RNA molecules. They are secreted by a wide variety of cell types and mediate intercellular communication by transferring their molecular cargo to recipient cells. Their ability to interact with nearby and distant cells suggests that they play an important role in signalling between cells within the CNS and the peripheral immune system. In addition to forming myelin sheaths around axons, oligodendrocytes preserve axonal integrity through trophic support mechanisms that are not yet fully understood. Oligodendrocyte-derived exosomes have been shown to promote the differentiation of oligodendrocyte precursor cells into myelin-producing cells, thereby enhancing remyelination following injury. Furthermore, because exosomes are biocompatible and capable of crossing the blood-brain barrier, they represent promising therapeutic vehicles. A better understanding of exosome-dependent pathways in MS may provide new insights into disease pathophysiology and facilitate the development of novel diagnostic and therapeutic strategies. Moreover, exosomes and their molecular cargo have considerable potential as biomarkers for MS.
Abstract: Leptospirosis is a widespread zoonotic infection caused by spirochetes of the genus Leptospira, primarily transmitted through contact with water contaminated by the urine of infected animals. The disease ranges in severity from a mild, self-limiting febrile illness to a severe form, known as Weil's disease, which is characterized by hepatic dysfunction, acute kidney injury, and coagulation abnormalities. Jaundice is a common clinical finding; however, severe hyperbilirubinemia is uncommon and may lead to diagnostic confusion with primary hepatobiliary disorders. Hepatic involvement typically follows a cholestatic pattern, with a disproportionate elevation of serum bilirubin relative to transaminase levels. We report the case of a 52-year-old man who presented with high fever, progressive jaundice, and oliguria after exposure to floodwaters. Physical examination revealed hypotension, tachycardia, conjunctival hyperemia, and tender hepatomegaly. Initial laboratory investigations demonstrated severe hyperbilirubinemia, with a total bilirubin level of 42.3 mg/dL, disproportionately elevated relative to serum transaminase levels (aspartate aminotransferase, 83 IU/L; alanine aminotransferase, 98 IU/L). The patient also had acute kidney injury (serum creatinine, 3.8 mg/dL), thrombocytopenia, and evidence suggestive of hemolysis. Serological tests for viral hepatitis, malaria, and dengue were negative. The diagnosis of severe leptospirosis was confirmed by positive Leptospira IgM serology and the microscopic agglutination test (MAT), with a titre of >1:800. Following treatment with targeted antibiotic therapy, intravenous fluids, vasopressors, platelet transfusions, and supportive care, the patient showed marked clinical and laboratory improvement over the subsequent two weeks. This case highlights that severe hyperbilirubinemia with only mild transaminase elevation can be a rare but clinically important presentation of Weil's disease. Leptospirosis should therefore be included in the differential diagnosis of patients presenting with fever, jaundice, acute kidney injury, and a history of exposure to floodwaters or contaminated water. Early recognition, prompt initiation of appropriate antibiotic therapy, and supportive management are essential to prevent multiorgan failure and improve clinical outcomes.
Background and purpose: Bisphenol A (BPA), an endocrine-disrupting compound, causes hepatotoxicity through oxidative stress and inflammation. Alpha-lipoic acid (α-LA) is a potent antioxidant shown to protect against liver injury induced by various toxic agents. This study aimed to evaluate the protective effect of α-LA against BPA-induced liver damage in mice. Materials and methods: In this experimental study, 28 NMRI mice were randomly assigned to four groups: control, α-LA (100 mg/kg), BPA (300 mg/kg), and BPA + α-LA co-treatment. After 35 days, blood and liver tissue samples were collected. Serum activities of AST and ALT, oxidative stress markers (MDA, SOD, and CAT), and the expression of the Nrf2 and NF-κB genes were evaluated using RT-PCR. Histopathological changes were evaluated by H&E staining. Data were analyzed using SPSS software by one-way ANOVA followed by Tukey's post hoc test. Results: BPA administration significantly increased liver enzyme activities, MDA levels, and NF-κB expression, while decreasing antioxidant enzyme activities and Nrf2 expression. In addition, marked histopathological alterations, including inflammatory cell infiltration and vascular congestion, were observed. Co-treatment with α-LA significantly attenuated these disturbances by reducing hepatic injury markers, improving oxidative stress parameters, upregulating Nrf2 expression, and downregulating NF-κB expression. Conclusion: The findings indicate that α-LA exerts a significant protective effect against BPA-induced hepatotoxicity, possibly by enhancing the antioxidant defence system through activation of the Nrf2 pathway, inhibiting lipid peroxidation, and suppressing the inflammatory response via downregulation of the NF-κB pathway. These findings support the potential of α-LA as a promising therapeutic strategy for preventing chemically induced liver injury. Therefore, α-LA may represent a potential therapeutic agent for protecting against liver injury induced by endocrine-disrupting chemicals.
Background and purpose: Internet addiction among adolescents has become an increasing concern. Given the growing reliance on the internet after the COVID-19 pandemic, this study aimed to examine the relationship between loneliness and internet addiction by investigating the mediating roles of emotion regulation and subjective well-being. Materials and methods: In this correlational study, the statistical population consisted of all female students enrolled in high schools in Districts 4 and 8 of Tehran. Using cluster random sampling, 320 questionnaires were collected, and after excluding incomplete responses, 301 questionnaires were retained for analysis. Data were collected using the Persian versions of Young’s Internet Addiction Test (IAT), the Subjective Well-Being Scale (SWS) developed by Keyes and Magyar-Moe, the Emotion Regulation Questionnaire developed by Gross, and Russell’s UCLA Loneliness Scale. Data analysis was performed using path analysis and confirmatory factor analysis through AMOS-24 and SPSS-26 statistical software. Results: The hypothesised model showed an acceptable fit to the data. Path analysis revealed a significant positive direct association between loneliness and internet addiction (β = 0.57). Furthermore, loneliness was found to contribute to internet addiction both directly and indirectly through impaired emotion regulation (β = 0.071) and decreased subjective well-being (β = 0.483), demonstrating the significant mediating roles of these two variables. Conclusion: The findings of this study indicate that loneliness contributes to adolescents’ internet addiction both directly and indirectly through lower levels of emotion regulation and subjective well-being. Among the examined mediators, subjective well-being demonstrated a stronger mediating effect than emotion regulation, suggesting that adolescents’ overall psychological well-being and quality of social relationships may play an important role in vulnerability to internet addiction. These findings could inform the development of targeted interventions focused on strengthening emotional regulation skills and promoting psychological well-being to reduce internet addiction among adolescents.
Background and purpose: The human gut microbiome is a complex and dynamic ecosystem composed of bacteria, viruses, fungi, and archaea that plays a fundamental role in metabolism, immune regulation, and colonization resistance. Although the bacterial component has been extensively investigated over the past two decades, the viral component, particularly the gut phageome, remains comparatively understudied. Emerging evidence suggests that bacteriophages regulate microbial communities, facilitate horizontal gene transfer, modulate metabolic functions, and influence host-microbe interactions, thereby contributing to both health and disease. This narrative review aimed to provide a comprehensive overview of the role of the gut phageome in microbiome regulation and its implications for human health. Materials and methods: A narrative review was conducted through a systematic search of studies published between 2000 and 2025 in PubMed, Scopus, Web of Science, and Google Scholar. Eligible studies were reviewed and categorized based on the roles of bacteriophages in shaping gut microbial composition, contributing to dysbiosis and disease, and their therapeutic potential, particularly in phage therapy. Results: Gut bacteriophages influence intestinal ecology through their lytic and lysogenic life cycles, horizontal gene transfer, modulation of bacterial fitness, and carriage of auxiliary metabolic genes. These mechanisms may affect short-chain fatty acid production, bile acid metabolism, immune signaling, intestinal barrier integrity, and resistance to pathogenic colonization. Alterations in the gut phageome have been associated with inflammatory bowel disease, enteric infections, obesity, and type 2 diabetes. However, most available evidence remains observational or preclinical, and causal relationships have yet to be firmly established. Conclusion: The gut phageome is an active and influential component of the intestinal microbiome that may contribute to microbial homeostasis, immune regulation, and disease pathogenesis. Translating these findings into precision microbiome-based therapies will require well-designed randomized controlled clinical trials, standardized viromics methodologies, and rigorous evaluation of the safety and efficacy of phage-based interventions.
Vaccines are widely regarded as one of the greatest achievements of modern medicine. By substantially reducing the burden of infectious diseases, they have dramatically improved global public health and life expectancy. Vaccination has successfully controlled or eliminated many life-threatening diseases, including smallpox, plague, poliomyelitis, and tetanus. However, effective vaccines remain unavailable for several diseases in which protection depends predominantly on cell-mediated immunity rather than humoral immune responses. Third-generation vaccines, also known as DNA vaccines, represent a major advance in vaccine technology because they are capable of inducing robust cellular immune responses and offer several advantages over conventional vaccine platforms. Nevertheless, no DNA vaccine has yet been approved for the prevention of human infectious diseases. One of the major limitations is the presence of prokaryotic sequences within conventional plasmid DNA vectors. These bacterial elements are required during plasmid construction and propagation but serve no functional purpose once the vector is delivered into human cells. Moreover, they raise safety concerns, including the potential spread of antibiotic resistance genes. Fortunately, advances in molecular biotechnology have led to the development of next-generation DNA vectors designed to overcome these limitations. This review summarizes these emerging vector platforms and the mechanisms by which they function. Replacing conventional plasmid vectors with these next-generation systems may facilitate the development of effective DNA vaccines against diseases that require strong cell-mediated immunity, such as leishmaniasis. Furthermore, these advanced plasmid platforms have the potential to enhance not only DNA vaccine efficacy but also other applications of molecular medicine, including gene therapy, genome editing, and immunotherapy.
Background and purpose: Magnetic resonance imaging (MRI) is one of the most widely used noninvasive diagnostic imaging modalities in clinical practice. However, its relatively low intrinsic contrast often necessitates the use of contrast agents to improve image quality and diagnostic accuracy. Gadolinium-based contrast agents (GBCAs) are commonly used for this purpose; however, the development of new agents with improved efficacy and safety remains an important research goal. This study aimed to synthesize, characterize, and evaluate novel gadolinium complexes derived from amino tricarboxylic acid ligands as potential MRI contrast agents. Materials and methods: In this experimental study, three amino tricarboxylic acid ligands (2, 4, and 7) were synthesized and subsequently complexed with Gd³⁺ ions to generate the corresponding gadolinium complexes, designated as 2-Gd, 4-Gd, and 7-Gd. Structural characterization was performed using nuclear magnetic resonance (NMR) spectroscopy, infrared (IR) spectroscopy, mass spectrometry, and elemental analysis. The physicochemical and biological properties of the complexes were evaluated using in vitro cytotoxicity assays, T₁ and T₂ relaxation measurements, biodistribution studies, and in vivo MRI experiments. Results: Among the synthesized complexes, 4-Gd and 7-Gd exhibited favorable relaxometric properties, with longitudinal relaxivity (R₁) values of 6.11 ± 0.73 and 6.32 ± 1.21 mM⁻¹s⁻¹, respectively. These values were comparable to those of the clinically used contrast agent Gd-DOTA (5.95 ± 0.86 mM⁻¹s⁻¹). Furthermore, both complexes demonstrated low cytotoxicity and biodistribution patterns similar to those of Gd-DOTA, indicating good biocompatibility. Conclusion: The findings suggest that 4-Gd and 7-Gd possess promising physicochemical and biological characteristics, supporting their potential application as effective MRI contrast agents and warranting further preclinical investigation
Despite the widespread availability of effective vaccines, measles remains one of the most contagious viral infections and continues to pose a significant public health challenge worldwide. Pneumonia is the most common and severe respiratory complication of measles, whereas pneumomediastinum and subcutaneous emphysema are rare manifestations. Early recognition of these uncommon complications is essential, as timely management may reduce disease-related morbidity and mortality. We report the case of a 7-year-old unvaccinated boy who presented with fever, severe respiratory distress, and cervical subcutaneous emphysema as the initial manifestation of illness. Notably, this unusual presentation preceded the development of the classic clinical features of measles, including the characteristic skin rash and conjunctivitis. Chest radiography and computed tomography revealed extensive subcutaneous emphysema extending into the upper thoracic region, without radiological evidence of pneumonia. Given his history of close contact with confirmed measles cases, supportive care, vitamin A supplementation, and empirical antibiotic therapy were initiated. The patient's clinical condition improved steadily, and no surgical intervention was required. The diagnosis of measles was subsequently confirmed by polymerase chain reaction (PCR) and serological testing. After six days of hospitalization, he was discharged in good general condition with marked clinical improvement and near-complete resolution of the subcutaneous emphysema. Subcutaneous emphysema may represent a rare but clinically important manifestation of measles, even in the absence of radiologically apparent pneumonia. This case highlights the possibility that such an atypical presentation can occur early in the course of the disease. Clinicians should be aware of this rare complication, particularly in unvaccinated children and during measles outbreaks, as early recognition and appropriate management may help prevent adverse outcomes.
Background and purpose: This service could not be searched because you are not connected to the Internet. Please connect and try again. Materials and methods: In this experimental study, 72 male Wistar rats were divided into 12 groups (seven burn wound groups and five surgical wound groups). The healing process was evaluated by measuring wound area on days 3, 7, 14, and 21, together with qualitative histopathological evaluation using haematoxylin and eosin (H&E) staining on days 7 and 21 post-injury. Results: In the burn wound model, no significant differences were observed on day 3; however, differences between the treatment groups became highly significant from day 7 onwards. By day 21, the Arnebia euchroma (2% and 5%) and nano-formulation (2% and 5%) treatment groups achieved complete wound healing, whereas the silver sulfadiazine group demonstrated the lowest efficacy. In the surgical wound model, all groups achieved complete healing by day 21, with the 2% nano-formulation group exhibiting the fastest healing rate. However, histopathological evaluation performed on day 21 revealed that the silver sulfadiazine, mupirocin, and 5% Arnebia euchroma groups exhibited greater collagen density and more organised collagen fibre orientation, indicating superior tissue quality, whereas tissue in the 2% nano-formulation group appeared less mature. Conclusion: The efficacy of wound treatment depends on the wound type. Both the nano-formulation and the herbal ointment demonstrated superior efficacy in the treatment of burn wounds. In surgical wounds, a trade-off was observed between the rate of healing and the quality of the regenerated tissue, suggesting that faster healing does not necessarily lead to superior tissue regeneration.
