Introduction: Knee osteoarthritis is a prevalent condition contributing to disability worldwide, primarily treated with non-surgical approaches to alleviate pain and improve function. Transfer energy capacitive and resistive (TECAR) therapy is a non-invasive method gaining attention for managing musculoskeletal conditions, though its efficacy for knee osteoarthritis remains underexplored. Objectives: To compare the effects of TECAR therapy and physiotherapy on symptoms and function in patients with knee osteoarthritis. Patients and Methods: This single blind, randomized clinical trial compared the efficacy of TECAR therapy to standard physiotherapy in treating knee osteoarthritis at Amin hospital's physical therapy clinic (Isfahan university of medical sciences) during 2023-2024. Forty patients with mild to moderate knee osteoarthritis were divided into two groups: one received standard physiotherapy for 10 sessions, and the other underwent six sessions of TECAR therapy. Pain and functional outcomes were assessed using the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline and during follow-ups immediately after the treatment and at one and three months. Results: Both groups showed significant improvements from baseline in VAS and WOMAC scores (P< 0.001). However, TECAR therapy yielded greater reductions in pain and improvements in function, particularly at the three-month follow-up (P < 0.001). The TECAR group also showed significant enhancements in WOMAC pain and stiffness sub-scores, attributed to TECAR's deep tissue heating effect, which facilitates improved circulation and cellular repair (P< 0.001 and P< 0.005, respectively). Conclusion: TECAR therapy was effective for managing knee osteoarthritis, with greater improvements in pain and function than standard physiotherapy. Although limited by sample size and lack of placebo control, these findings support TECAR therapy as a promising non-surgical treatment for knee osteoarthritis.
The mechanistic sequence from hyperandrogenism to tumorigenesis in women with polycystic ovary syndrome (PCOS) encompasses a constellation of structural and functional aberrations spanning the endocrine, metabolic, immunologic, and genetic domains. Chronic hyperandrogenism incites an interconnected cascade through chronic anovulation and unopposed estrogen action, insulin resistance with hyperinsulinemia, low-grade systemic inflammation, oxidative stress, and gut dysbiosis, each playing a synergistic role in promoting oncogenesis. It has been demonstrated that, this syndrome is most strongly associated with an increased risk of endometrial cancer, with a more modest and less consistent association with ovarian and breast cancers. Thyroid cancer risk may also be elevated, particularly in younger women. The underlying mechanisms involve hormonal imbalances, metabolic dysfunction, chronic inflammation, and genetic predisposition. Women with PCOS should be monitored for early signs of these cancers, and management should focus on mitigating risk factors such as obesity, insulin resistance, and chronic anovulation.
Introduction: Colorectal cancer (CRC) is the third most common carcinoma around the world, and oxidative stress may play a role in the occurrence of colorectal cancer. Accordingly, the purpose of the present study was to investigate the association between oxidative balance score (OBS) and the risk of CRC occurrence. Materials and Methods: In this systematic review and meta-analysis article, databases Scopus, PubMed, Web of Science, Cochrane, Embase, and Google Scholar Search Engine were conducted for articles published until November 1, 2025. Data was analyzed using STATA 14. Results: A total of 9 observational studies were examined, and the results revealed that high OBS levels reduced the risk of CRC and colorectal adenoma by 17% and 34%, respectively. Furthermore, high OBS levels in the US (29%), UK (24%), China (6%), case-control studies (9%), and cohort studies (25%) reduced the risk of CRC. Additionally, increased OBS levels in men (32%) and women (22%) reduced the risk of CRC, and high dietary oxidative balance scores (DOBS) and lifestyle oxidative balance scores (LOBS) levels decreased the risk of CRC by up to 23% and 24%, respectively. Conclusion: High OBS levels significantly lowered the risk of CRC occurrence, and high OBS levels in men were more likely to prevent CRC compared with women. Additionally, the difference between the effect of DOBS and LOBS on reducing the risk of CRC was insignificant. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD420251230751) and Research Registry (UIN: reviewregistry2061) websites.
A growing body of evidence implicates dysbiosis of the oral microbiome as a significant, modifiable risk factor for cardiovascular disease. This dysbiosis, often manifesting as periodontitis, initiates local inflammation and tissue destruction, however its systemic consequences are profound. Key mechanisms linking oral dysbiosis to cardiovascular disease involve the induction of endothelial dysfunction and chronic systemic inflammation. Pathogens and their virulence factors enter the bloodstream through inflamed periodontal tissues, directly impairing endothelial nitric oxide production and bioavailability, promoting vasoconstriction, leukocyte adhesion, and a pro-thrombotic state. Concurrently, microbial components activate innate immune receptors on endothelial and immune cells, triggering sustained release of pro-inflammatory cytokines and acute-phase proteins. The low-grade, systemic inflammation accelerates atherosclerosis by promoting foam cell formation, plaque instability, and vascular remodeling. Epidemiological studies consistently associate periodontitis with increased risks of myocardial infarction, stroke, and atherosclerosis severity, independent of traditional risk factors.
Introduction: Cancer remains a major global health concern, with chemotherapy being a cornerstone of treatment. However, chemotherapy drugs, such as 5-fluorouracil (5-FU), are associated with severe side effects, including intestinal mucositis. Achillea millefolium, a medicinal plant with established anti-inflammatory and antioxidant properties, has been suggested as a potential protective agent against chemotherapy-induced toxicities. Objectives: This study aims to investigate the ameliorative effects of A. millefolium on 5-FU-induced intestinal mucositis. Materials and Methods: A total of 28 male Wistar rats were randomly assigned to four groups (n = 7/group). Group 1 (control) received normal saline by gavage for nine days. Group 2 received a single intraperitoneal injection of 5-FU (150 mg/kg) on day five. Group 3 was administered A. millefolium extract (250 mg/kg, gavage) for nine consecutive days. Group 4 received both A. millefolium extract (250 mg/kg, gavage) and a single intraperitoneal injection of 5-FU. The villus-to-crypt ratio, superoxide dismutase (SOD) activity, and catalase (CAT) levels were evaluated. Results: Our study showed, 5-FU administration led to significant oxidative stress and severe intestinal mucosal damage. Body weight loss was pronounced in the 5-FU/saline group. Co-administration of A. millefolium extract with 5-FU significantly reduced oxidative stress, enhanced SOD activity, and improved the villus-to-crypt ratio compared to the 5-FU group. Conclusion: The findings indicated that A. millefolium possesses protective effects against 5-FU-induced intestinal mucositis. These results suggest its potential role in mitigating chemotherapy-related side effects and enhancing patient outcomes.
Introduction: Pediatric-onset multiple sclerosis (POMS) is a rare but severe form of MS that presents before the age of 18, leading to long-term disability. Despite its clinical significance, the molecular mechanisms driving POMS remain poorly understood. Objectives: This study aims to identify key genes, pathways, and potential therapeutic targets involved in POMS using integrative bioinformatics approaches. Materials and Methods: In this in silico study, gene expression profiles from peripheral blood mononuclear cells of POMS patients and healthy controls were analyzed using the GEO2R platform (GSE203241 dataset). Differentially expressed genes (DEGs) were identified using adjusted P value < 0.05 and a fold change>1.1 or <-1.1. Gene ontology (GO) and pathway enrichment analyses were conducted using BiNGO and Enrichr to explore biological functions and dysregulated pathways. A protein-protein interaction (PPI) network was constructed using STRING (search tool for the retrieval of interacting genes/proteins) and analyzed by Cytoscape with CytoHubba and CytoCluster plugins to identify hub genes and functional modules. Promoter motif analysis was conducted using Tomtom and GoMo to uncover regulatory elements, while DrugBank was utilized to identify potential drug-target interactions. Results: A total of 1101 DEGs were identified, with enrichment in immune response pathways, cytokine signaling, and interferon responses. PPI network analysis revealed 15 hub genes, with MYC, HSP90AA1, JUN, HSPA4, and HIF1A identified by two independent algorithms, highlighting their central role in POMS. CytoCluster analysis uncovered functional modules related to RNA metabolism and vesicle transport. Promoter motif analysis revealed transcription factor binding sites that could influence hub gene expression. Drug-target analysis identified Food and Drug Administration (FDA)-approved and investigational drugs that interact with key hub proteins, offering potential therapeutic candidates. Conclusion: This study provides a comprehensive molecular overview of POMS, identifying critical genes, regulatory elements, and potential drug targets. These findings offer valuable insights into POMS pathogenesis and highlight novel avenues for therapeutic intervention, advancing the prospects for personalized treatment strategies in pediatric MS.
Introduction: Lophomonas blattarum is an emerging protozoan parasite increasingly identified in patients with unexplained respiratory symptoms. Understanding its prevalence and association with immunological markers such as IgE and eosinophils is crucial for improving diagnostic accuracy in respiratory infections. Objectives: This study aimed to investigate the patterns of L. blattarum in bronchoalveolar lavage (BAL) samples and to assess serum immunoglobulin E (IgE) levels and peripheral eosinophil counts in patients undergoing bronchoscopy. Patients and Methods: This retrospective cross-sectional study examined the clinical and laboratory findings of 140 patients with L. blattarum infection identified in BAL samples who were referred for bronchoscopy at Firouzgar hospital, Tehran, Iran. Bronchoscopies and BAL sampling were performed following standard protocols, and samples were analyzed using direct smear and Giemsa staining. Relevant demographic, clinical, radiological, and laboratory data were collected and analyzed. Results: The mean age of patients was 60.37 +/- 17.86 years, with a majority being female (n=86). Additionally, 82.1% of patients were hospitalized (n=115), indicating notable exposure to environmental risk factors such as cockroaches and damp living conditions. Pneumonia (43.6%) was the most frequent primary diagnosis. Laboratory findings revealed elevated C-reactive protein (CRP) and immunoglobulin E (IgE) levels (174.97 +/- 188.63 IU/mL), suggesting an inflammatory or allergic profile in many patients. Radiologically, ground-glass opacity and consolidation were the most common findings. Conclusion: The results indicated that L. blattarum infection is frequently associated with elevated IgE and eosinophil levels. Increased awareness of its clinical and radiological patterns may enhance early diagnosis and targeted management for affected patients.
Introduction: Parkinson's disease (PD) often coexists with type 2 diabetes mellitus (T2DM), which may worsen disease progression. Metformin, a common diabetes medication, showed potential benefits beyond blood sugar control. Objectives: This study examines metformin's impact on renal function, neurological biomarkers, and clinical outcomes in patients with both PD and T2DM. Patients and Methods: This prospective case-control study involved 50 patients with both T2DM and parkinsonism, recruited from Al-Azhar university hospitals in Assiut, Egypt, between August 2024 and August 2025. Participants were divided equally into two groups; a control group receiving their standard treatment for Parkinsonism and diabetes, and a metformin-treated group receiving metformin alongside their usual therapies. Demographic data and laboratory markers were collected at baseline. Disease assessment employed standardized tools such as the unified Parkinson's Disease Rating Scale (UPDRS) for motor function, Beck Depression Inventory (BDI) for depression severity, Hoehn and Yahr scale for disease staging, Montreal Cognitive Assessment (MoCA) for cognitive evaluation, and Parkinson's Disease Questionnaire-39 (PDQ-39) for quality of life (QOL). All assessments were repeated after a 12-month follow-up to analyze changes relative to baseline. Results: The findings indicated that metformin treatment offers comprehensive benefits by protecting against renal function decline, influencing neurological biomarkers, and supporting multiple clinical domains in PD. It appears to mitigate disease progression, preserve cognitive function, and enhance psychosocial well-being, while having neutral effects on vitamin status and potentially positive, though non-significant, effects on inflammatory markers. Overall, metformin not only prevents typical clinical deterioration but also actively improves motor, cognitive, psychological, and quality-of-life outcomes. Conclusion: Metformin demonstrates promising multifaceted benefits in PD patients with T2DM by not only protecting renal function and preventing clinical deterioration but also actively improving motor, cognitive, psychological, and quality-of-life outcomes across multiple clinical domains, supporting its consideration as an adjunctive therapeutic strategy pending further research.
Ameloblastoma is the most common benign odontogenic epithelial tumor, accounting for approximately 11-18% of all odontogenic neoplasms and 1-3% of all oral cysts and tumors. It primarily affects the posterior mandible and usually arises in the third to fifth decades of life. Despite its slow growth, this tumor is locally aggressive and may metastasize or undergo malignant transformation. Histologically, ameloblastoma comprises several variants. The acanthomatous variant, although relatively rare, is characterized by squamous metaplasia and keratin formation within the central stellate reticulum-like cells of the tumor islands. The clinical and radiographic characteristics of ameloblastoma are often nonspecific and may resemble other multilocular radiolucent lesions. Accurate diagnosis necessitates the integration of advanced radiographic imaging, particularly cone-beam computed tomography, along with definitive histopathologic evaluation. We presented a rare case of acanthomatous ameloblastoma affecting both the anterior and posterior regions of the left mandible in a 33-year-old male with a five-year history of jaw expansion and progressive tooth mobility, along with its surgical management. The lesion showed extensive anterior extension, crossing the midline. This case underscores the significance of comprehensive differential diagnosis and histopathological confirmation in managing unusual presentations of ameloblastoma.
Introduction: Oral leukoplakia (OLK) and oral lichen planus (OLP) are recognized as potentially malignant disorders with varying risks of progression to oral squamous cell carcinoma (OSCC). Immunohistochemical (IHC) biomarkers have been extensively studied to identify predictive markers for malignant transformation in these lesions. Objectives: This systematic review synthesizes current evidence on IHC biomarkers associated with malignant progression in OLK and OLP. Materials and Methods: In this systematic review study, a systematic literature search was conducted across databases, including PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar search engine up to April 2025. Studies included were those investigating IHC biomarkers in OLK and OLP with reported malignant transformation outcomes. Results: This systematic review included 10 studies with a total of 549 participants. The most frequently assessed IHC markers were B-cell lymphoma 2 (Bcl-2), p53, Ki-67, Bcl-2-associated X protein (Bax), survivin, mouse double minute 2 homolog (MDM2), and proliferating cell nuclear antigen (PCNA). Bcl-2 was the predominant marker, evaluated in 9 studies, followed by p53 was examined in 7, Ki-67 in 4, and Bax in 3 studies. Less commonly studied markers included survivin, MDM2, PCNA, and p21, each reported in a single study. Conclusion: Although Bcl-2 and p53 emerge as the most significant IHC markers for predicting malignant transformation in oral premalignant lesions due to their roles in apoptosis and tumor suppression, the Ki-67 and Bax biomarkers contribute important information on cell proliferation and apoptotic balance, while markers like survivin, MDM2, PCNA, and p21 are less commonly studied but may have specialized roles. Overall, a panel of these biomarkers, especially Bcl-2 and p53, shows strong potential for improving risk assessment and guiding clinical management of OLK and OLP. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (International Prospective Register of Systematic Reviews) (ID: CRD420251063588) and Research Registry (UIN: reviewregistry2021) websites.
Introduction: Small for gestational age (SGA) births negatively impact neonatal outcomes. Objectives: This study aimed to evaluate the prevalence of SGA, its associated risk factors, maternal complications, biochemical markers, and ultrasound/Doppler findings to identify predictors for the early detection of SGA. Patients and Methods: A cross-sectional study was conducted involving 328 mother-newborn pairs (234 SGA; categorized as 90 mild, 96 moderate, and 48 severe fetal growth restriction [FGR]; 94 controls). Moreover, clinical, biochemical, histological, and immunomorphological variables were analyzed using SPSS version 26. Results: The placental mass and area were lower in cases of FGR compared to controls. Among these, moderate FGR (subgroup II) exhibited the lowest mass (422.4 g) and area (244 cm(2)). Poor maternal nutrition was observed in 75-83.3% of SGA infants, compared to only 5.1% of controls. Additionally, preeclampsia occurred more frequently in moderate (32.3%) and mild FGR (20.0%) than in controls (18.1%) (chi(2) = 9.164, P = 0.002). Besides, logistic regression analysis indicated that acute respiratory infection (ARI) was independently associated with reduced odds of being SGA (adjusted OR = 0.07, P = 0.016), while tumor necrosis factor alpha (TNF-alpha) expression remained a significant independent predictor (adjusted OR = 1.03, P<0.001). Lower estimated fetal weight (EFW), smaller abdominal circumference, and higher umbilical artery pulsatility index (PI) were predictive of SGA status, whereas the uterine artery PI lost significance. Placental growth factor (PlGF) and pregnancy-associated plasma protein A (PAPP-A) levels were lower in SGA infants (84.6 +/- 29.2 pg/mL; 1.54 +/- 0.42 ng/mL) compared to non-SGA infants (125.7 +/- 31.6 pg/mL; 2.49 +/- 0.95 ng/mL). Furthermore, SGA neonates exhibited higher rates of asphyxia (72.6%) and a greater need for resuscitation due to severe FGR (46.8%). Conclusion: Abdominal circumference, EFW, TNF-alpha levels, elevated umbilical artery PI, and low-PlGF are significant predictors of SGA. This finding accentuates the importance of a comprehensive assessment that integrates clinical, biochemical, and sonographic evaluations for early diagnosis and management.
Introduction: Uterine cervical cancer remains a major public health concern worldwide, ranking as the fourth most common cancer among women. Despite advances in prevention and treatment, significant disparities in incidence and mortality persist, largely reflecting underlying socioeconomic inequalities. The human development index (HDI), a composite measure of life expectancy, education, and per capita income, offers a critical lens for examining these disparities on a global scale. Objectives: This ecological study aimed to investigate the patterns of cervical cancer incidence and mortality across countries stratified by HDI in 2022, highlighting the persistent influence of socioeconomic development on disease burden. Materials and Methods: This ecological study utilized data from the International Agency for Research on Cancer (IARC) and the Global Cancer Observatory (GLOBOCAN) project for the year 2022. Incidence and mortality statistics for uterine cervical cancer were extracted for countries worldwide and stratified according to the HDI categories. Comparative analyses were then performed to evaluate differences in uterine cancer incidence and mortality across varying HDI levels. Results: The results showed that countries classified as very high HDI demonstrated the most favorable outcomes in the context of uterine cervical cancer, displaying the smallest proportions of both newly diagnosed cases and resultant mortality. Conversely, as the HDI categorization shifts downwards, transitioning from the designation of high to medium, and subsequently to low, a corresponding and gradual escalation becomes evident in the rates of both the incidence of new cervical cancer diagnoses and the rates of mortality stemming from this particular disease. Conclusion: In conclusion, the significant socioeconomic disparities identified in uterine cervical cancer incidence and mortality underscore the urgent need for targeted interventions in lower HDI countries. Addressing these inequities through improved access to prevention, screening, and treatment is essential to reduce the disproportionate burden and promote global health equity in cervical cancer outcomes.
Introduction: Diabetic peripheral polyneuropathy is a common complication of type 2 diabetes characterized by nerve damage and neuropathic symptoms. Magnesium deficiency has been implicated in the pathogenesis of diabetic neuropathy, as magnesium plays a critical role in nerve function, glucose metabolism, and inflammation modulation. Objectives: This study aims to evaluate the therapeutic impact of oral magnesium citrate supplementation on neuropathic symptoms in diabetic patients. Patients and Methods: This randomized, double-blind, clinical trial was conducted on 60 adult patients with type 2 diabetes and clinically confirmed peripheral neuropathy, referred to Loghman Hakim hospital in Tehran, Iran, between July 2023 and August 2024. Patients were assigned to two equal groups of 30 patients. The control received a placebo, and the magnesium group received 300 mg of magnesium citrate daily for 8 weeks. Data on demographics, diabetes management, clinical status, and informed written consent were collected at baseline. Neuropathy was assessed using the validated neuropathy disability score (NDS) at baseline, 1 month, and 2 months, and was compared within and between groups. Results: The results demonstrate that although changes in the NDS between the magnesium-treated and control groups were comparable at baseline vs 1-month follow-up (significant mean difference [SMD] = 0.36, confidence interval [CI]:-1.17-0.91) and showed minor non-significant changes in one month vs 2-months (SMD = 0.97, CI: 0.32-1.60), the magnesium group experienced significant improvements in neuropathy symptoms over the two-month follow-up compared to baseline (SMD = 0.61, CI:-0.08-1.28). Concussion: The results suggest that magnesium treatment leads to significant improvement in neuropathy symptoms over a two-month follow-up. These findings support the neuroprotective role of magnesium, which is believed to reduce nerve damage and inflammation, improve nerve function, and potentially slow neuropathic progression. This finding highlights magnesium's promise as an effective adjunctive therapy for managing neuropathy, particularly in diabetic patients.
Introduction: Burn injuries represent a significant global health burden, with infection-related complications being a leading cause of morbidity and mortality in affected patients. Objectives: This study aimed to characterize wound culture patterns, bacterial isolate distribution, and mortalityassociated factors among burn patients admitted to Taleghani hospital in Ahvaz, Iran. Materials and Methods: This retrospective cross-sectional study analyzed burn patients referred to Taleghani hospital in Ahvaz, Iran. Data were collected retrospectively from hospital clinical documents, focusing on demographic characteristics, clinical parameters, and microbiological findings from wound cultures. Results: The study identified Pseudomonas species, particularly Pseudomonas aeruginosa, as the most prevalent pathogens in burn patients, alongside Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus strains vancomycin-resistant Staphylococcus aureus [VRSA]). Polymicrobial infections involving P. aeruginosa with E. coli or K. pneumoniae were common, reflecting complex wound ecologies. Mortality analysis revealed a prevalence of 54.5% of deaths and significant associations with male gender, extensive burn surface area, and higher burn grades, while age showed no prognostic relevance. Pathogen-specific outcomes highlighted exclusive fatality linkages for Acinetobacter (particularly co-infections with Klebsiella or MRSA) and polymicrobial P. aeruginosa infections, whereas MSSA and Proteus correlated strongly with recovery. Conclusion: This study highlights the critical relationship between microbial ecology, antimicrobial resistance, and clinical outcomes in burn care, identifying P. aeruginosa as the predominant pathogen, often coexisting with K. pneumoniae or E. coli in fatal polymicrobial infections. Mortality risks correlated strongly with male gender, extensive burn surface area, and higher burn grades, but not age. Acinetobacter species (particularly in co-infections with Klebsiella or MRSA) and polymicrobial Pseudomonas aeruginosa infections were exclusively linked to mortality, contrasting with favorable outcomes for MSSA and Proteus monoinfections.
Introduction: Locally advanced laryngeal squamous cell carcinoma often requires aggressive treatment. Total laryngectomy followed by radiotherapy remains a standard approach for achieving local control and improving survival when organ preservation is not feasible. Objectives: To evaluate the morbidity and mortality outcomes of patients with locally advanced laryngeal cancer (LC) managed with total laryngectomy followed by postoperative radiotherapy (TLPR) at a tertiary hospital in Egypt. Patients and Methods: This retrospective study included patients with a pathological diagnosis of T3 or T4 locally advanced LC treated with TLPR between 2017 and 2021, with a follow-up period of 33 months. Clinical and demographic variables, including age, gender, smoking status, tumor sub-site, TNM (tumor, node, metastasis) classification, clinical staging, pathological features, treatment modality, preoperative tracheostomy, postoperative fistula, and associated comorbidities, were collected and analyzed for their relationship to prognosis. Results: A total of 84 patients were included in the study, with a mean age of 52.93 years (range: 26-82 years) and a male-to-female ratio of 68% to 32%. Among the patients, 45.2% achieved complete response, 28.5% had partial response, 16.8% experienced stable disease, and 9.5% showed disease progression. Frequent relapse occurred in 22 patients. The mean overall survival was 57.29 +/- 62.14 weeks (range: 8-242 weeks), while the mean progression-free survival was 26.81 +/- 40.92 weeks (range: 6-225 weeks). Conclusion: Postoperative radiotherapy following total laryngectomy is an effective strategy for achieving better disease control and long-term survival in patients with locally advanced laryngeal squamous cell carcinoma.
Introduction: Chronic obstructive pulmonary disease (COPD) is a heterogeneous respiratory condition characterized by chronic inflammation and exacerbations. Inhaled corticosteroids (ICS) are commonly prescribed to reduce exacerbation risk, yet their efficacy varies among patients. Emerging evidence suggests that blood eosinophil count may serve as a biomarker to predict ICS responsiveness in COPD patients. Objectives: This study investigates the relationship between serum eosinophil counts and the effectiveness of ICS in reducing COPD exacerbation rates. Patients and Methods: This prospective cohort study enrolled 430 COPD patients from two major pulmonology centers in Tehran, Iran, between May 2021 and November 2022. After obtaining written informed consent, demographic data and spirometry measurements were collected to classify COPD severity according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Venous blood samples were analyzed for eosinophil counts, categorizing patients into groups with counts below or above 300 cells/mu L. Participants were followed for six months to record clinical outcomes, including mortality, hospitalizations, and outpatient visits related to COPD exacerbations. The study's primary focus was to assess the impact of ICS on exacerbation rates stratified by eosinophil levels, aiming to evaluate eosinophil count as a biomarker for treatment responsiveness and to inform personalized COPD management. Results: In a population of COPD patients who underwent ICS, the results indicated that patients with eosinophil counts higher than 300 cells/mu L, compared to those with lower counts, demonstrated significantly fewer hospitalization rates (unadjusted B:-0.52 and adjusted B:-0.55). Similarly, the relationship between elevated eosinophil counts and outpatient visit frequency showed significant negative associations (unadjusted B:-1.82 and adjusted B: 1.88). However, in terms of six-month outcomes (recovery versus death), no statistically significant differences were observed between the two groups. Conclusion: These findings suggest that blood eosinophil counts >= 300 cells/mu L are associated with a pronounced reduction in severe COPD exacerbations among patients treated with ICS. This supports the use of eosinophil levels as a practical biomarker to guide ICS therapy, enabling more targeted, personalized treatment strategies that optimize clinical outcomes in COPD management.
Introduction: This study aims to assess the effectiveness and safety of infliximab in hospitalized patients with severe COVID-19. Patients and Methods: This double blind, randomized controlled trial was conducted on 48 patients with COVID-19 at Hajar hospital in Shahrekord, Iran, from December 2020 to June 2021, to evaluate the efficacy and safety of infliximab in hospitalized patients with severe COVID-19. Eligible adults with confirmed severe COVID-19 were randomized to receive a single intravenous dose of infliximab (4 mg/kg) plus standard care (infliximab-treated group n = 24), or the control group (n = 24) received standard care alone. Data on demographics, clinical signs, radiologic findings, laboratory markers, and clinical outcomes were systematically collected at admission and during hospitalization. The primary outcomes included comparison of duration of hospital stay, mortality rate, mechanical ventilation requirement, and laboratory parameters between the two groups. Results: The results indicate that infliximab treatment in patients was associated with better clinical outcomes, including reduced hospital stay, lower mortality rates, decreased need for mechanical ventilation, and experiencing of better oxygen saturation. Laboratory parameters showed that the infliximab group experienced improved immune cell profiles marked by increased lymphocytes and decreased neutrophils and white blood cells. Additionally, inflammatory and coagulation markers such as D-dimer, lactate dehydrogenase (LDH), and C-reactive protein (CRP) were more effectively reduced in the infliximab-treated group, reflecting better control of inflammation; however, infliximab treatment indicated no significant difference in platelet levels between groups. Conclusion: Infliximab treatment in COVID-19 patients is associated with improved clinical outcomes, highlighting its potential as an effective immunomodulatory therapy.
Introduction: Breast cancer is a heterogeneous disease influenced by genetic, hormonal, and molecular factors. Among these, BReast CAncer gene 1 (BRCA1) protein alterations play a critical role in hereditary breast cancers and may also have implications in sporadic cases. Objectives: This study aims to analyze the immunohistochemical expression of BRCA1 protein and its association with clinicopathological predictors. Materials and Methods: This cross-sectional study analyzed 100 paraffin-embedded tissue blocks from female breast cancer patients treated at educational and therapeutic hospitals in Isfahan, Iran, between March 2018 and April 2023. Tissue sections underwent immunohistochemical staining to evaluate BRCA1 protein expression. Patient data, including demographic information (age and family history of breast cancer), tumor characteristics (size, grade, and lymph node involvement), hormonal receptor status (estrogen receptor [ER], progesterone receptor [PR], human epidermal growth factor receptor 2 [HER2]) and Ki67 expression were extracted from archived medical records and staining results. Statistical tests were used to assess the correlation between clinicopathological factors and BRCA1 alteration status. Results: This study identified several clinico-pathological factors significantly associated with BRCA1 alteration status. Advanced tumor grades and lymph node involvement were strongly linked to BRCA1 mutations, with grade II and III tumors showing substantial increases in likelihood compared to grade I. Initially, hormone receptor-negative status also correlated with altered BRCA1. However, after adjusting for confounders, only tumor grade and lymph node involvement remained as independent predictors. Specifically, grade II and III tumors demonstrated significantly elevated odds, while lymph node involvement showed a strong association. Although negative ER still showed an increased likelihood, it did not reach statistical significance in the adjusted analysis, and neither PR nor HER2 status retained predictive value. Conclusion: The study findings suggest strong relationships between BRCA1 alterations and advanced disease characteristics, particularly the nodal metastasis, hormone receptor negativity, and higher tumor grade. The magnitude of association for tumor grade and nodal metastasis progression highlights their potential clinical relevance in BRCA1-related oncogenesis as independent predictors.
Introduction: COVID-19 infection (SARS-CoV-2) is associated with high morbidity and mortality rates, and worse outcomes have been reported for various morbidities. The impact of pre-existing hypothyroidism on COVID-19 outcomes is unclear. Objectives: This study aimed to evaluate the frequency of treated hypothyroidism and its effect on disease complications in COVID-19 patients in Razi hospital of Ahvaz. Patients and Methods: This cross-sectional study was conducted on patients with a laboratory and computed tomography (CT) confirmed COVID-19 diagnosis between August 2021 and December 2021 in Razi hospital in Ahvaz. The medical records of all patients were reviewed, and patient's characteristics and outcomes related to COVID-19, including severe disease, hospitalization in intensive care unit (ICU), need for mechanical or invasive ventilation, and all-cause mortality, was collected. The presence of hypothyroidism was identified based on the patient's medical history in the medical record. Results: Of 850 patients with COVID-19 positive, 59 patients (6.9%) had pre-existing hypothyroidism and received thyroid hormone replacement therapy. Hypothyroidism was not associated with increased risk of ICU admission (odds ratio [OR]: 0.447; 95% CI: 0.216-0.925, P = 0.030), severe disease (OR: 1.237; 95% CI: 0.6882.223, P = 0.447) mechanical ventilation (OR: 1.785; 95% CI: 0.894-3.562; P = 0.064) and death (OR: 0.997; 95% CI: 0.478-2.080; P = 0.993). Conclusion: Our study showed that underlying hypothyroidism does not lead to worse outcomes and complications in patients with COVID-19. It suggests that hypothyroidism is not associated with a worse prognosis and should not be considered among the comorbidities that indicate a risk factor for COVID-19 severity and its complication.
Introduction: Cervical cancer is a significant health issue globally, with human papillomavirus (HPV) being a primary causative factor. In Iraq, the prevalence and specific risk factors for cervical cancer remain under-explored, necessitating studies that assess genetic and biochemical markers like C-type lectin domain family four-member M (CLEC4M) and glutathione (GSH). Objectives: This study was conducted to evaluate serum CLEC4M and GSH Levels in newly diagnosed cervical neoplasm patients in Iraq with the aim of their accuracy evaluation in the diagnosis of this cancer. Patients and Methods: The case-control study enrolled a total of 70 individuals, comprising 35 recently diagnosed cervical cancer patients and an equal number of 35 healthy female participants who served as the control group. Blood samples were collected from both the patient and control groups to facilitate biochemical analyses. The levels of serum CLEC4M were quantified using the enzyme-linked immunosorbent assay (ELISA) method, while the concentration of GSH was determined using a spectrophotometer. The receiver operating characteristic (ROC) curve analysis was employed to evaluate the sensitivity and specificity of CLEC4M and GSH as biomarkers in diagnosing cervical cancer. Results: The results indicated that CLEC4M levels were significantly elevated in cervical cancer patients compared to healthy controls; in contrast, GSH levels were significantly lower in the cancer group (P<0.05). The ROC curve analysis revealed that CLEC4M exhibited a sensitivity of 71.4% and a specificity of 68.6%, reflecting moderate diagnostic performance for cervical cancer diagnosis; in comparison, GSH demonstrated superior diagnostic capability with a sensitivity of 80% and an exceptional specificity of 97.1%. Conclusion: This study demonstrates significant differences in biomarker levels associated with cervical cancer, with elevated CLEC4M and decreased GSH levels observed in patients compared to healthy controls. The ROC curve analysis indicates that while CLEC4M has moderate diagnostic performance, GSH shows superior sensitivity and specificity, suggesting its potential as a valuable biomarker for enhancing cervical cancer diagnosis.
