Novelty in Biomedicine

Background: Legg-Calvé-Perthes disease (LCPD) presents in childhood with idiopathic avascular necrosis of the femoral head(s), which can lead to disability and the need for corrective surgery at an early age. Bisphosphonates are a group of drugs that prevent osteoclastic bone resorption and may be helpful in the treatment of LCPD. So far, no trial has been conducted to investigate the effect of monthly intravenous pamidronate in the treatment of LCPD in children. Therefore, we assessed this issue in this study.

Materials and Methods: This study was conducted as a clinical trial on children with LCPD who were referred to Mofid Children's Hospital (Iran-Tehran) during 2022 and 2023. Pamidronate was injected monthly and intravenously at a dose of 1 mg/kg/dose. Both groups were the same in terms of the type of treatment received (except pamidronate), the number of visits, and other follow-up parameters. The study was conducted for one year. The significance level was considered less than 0.05.

Results: Forty-seven patients were included in the study. Twenty-one (60%) were in the pamidronate group, and 26 (40%) were in the control group. The mean age in the intervention group was 6.19 ± 1.69 years, and it was 6.15 ± 1.85 years in the control group (P-value=0.944). There was no statistically significant difference in children's gender (P-value = 0.731). Patients with pamidronate had a better overall score than the control group. The overall score in the pamidronate group was 2.37 more than the control group, but this difference was not statistically significant (P value=0.753). The scores of pain, lameness, walking, distance, squat, cross leg, and range of motion (ROM) in the pamidronate group were not significantly different from the control group (P value>0.05).

Conclusion: Pamidronate can improve the clinical results of children with Legg-Calve-Perthes disease, and it is recommended that this drug be used along with the usual treatments for these patients.

Background: Chronic Kidney Disease (CKD) patients often face complex health challenges, including cardiovascular and pulmonary issues. Smoking is a recognized risk factor for these conditions, but its specific impact on CKD patients remains less understood.

Materials and Methods: In this cross-sectional study, we investigated the relationship between smoking habits and cardiopulmonary health among CKD patients. We examined baseline characteristics, including demographics, medical history, and biochemical markers, in a cohort of CKD patients. Cardiopulmonary parameters were assessed during exercise testing, including oxygen consumption, ventilation rates, ventilation-perfusion matching markers, and oxygen saturation levels.

Results: Our findings revealed no statistically significant differences in cardiopulmonary parameters between smokers and non-smokers within the CKD patient population. This suggests that the relationship between smoking and exercise capacity in CKD patients is complex and influenced by multiple factors. Our analysis of demographics, comorbidities, and medication history provided critical context for interpreting these results.

Conclusion: This study contributes to our understanding of the intricate relationship between smoking habits and cardiopulmonary health in CKD patients. While smoking is recognized as a risk factor, its specific impact on exercise capacity within this population may be influenced by individual variables. Further research is needed to explore these relationships in larger and more diverse cohorts. These findings underscore the importance of considering multiple variables when assessing the impact of smoking on the health of CKD patients.

Background: Retinopathy of prematurity (ROP) is one of the common complications in premature neonates. ROP examination is one of the most important examinations for premature babies, which is associated with pain and can be very annoying. This study aimed to compare the effectiveness of pharmacological and non-pharmacological methods in reducing the pain of ROP examination.

Materials and Methods: This study was conducted as a double-blind, randomized control trial on 300 ROP examinations of patients who were hospitalized in the NICU department of Mahdieh Hospital in Tehran. The neonates were randomly selected into three groups, and ketamine 2mg/kg nasally, fentanyl two µg/kg nasally10minutes before an examination, and acetaminophen 2drop/kg orally 30 minutes before each examination were given to each neonate as two pharmacological groups. In the non-pharmacological group, infants received saddling-pacifier oral sucrose 25% 0.5cc 2 minutes before examination. Pain was assessed based on PIPP (premature infant pain index).

Results: The amount of pain after using oral sucrose was significantly lower than the ketamine-acetaminophen (P-value=0.011) and fentanyl-acetaminophen (P-value=0.027) groups, but there was not a statistically significant difference between the two groups of ketamine-acetaminophen and fentanyl-acetaminophen (P-value=0.953). The hypoxia was more prevalent in the ketamine-acetaminophen group (18.8%), and the least hypoxia occurred in the oral sucrose treatment group (7%) (P-value=0.028).

Conclusion: It is concluded that the effect of non-pharmacological drugs is greater than pharmacological drugs in reducing the pain of neonates during ROP examination. The effect of oral sucrose in reducing pain was more significant than ketamine-acetaminophen and fentanyl-acetaminophen. However, there was no significant difference between the two groups of ketamine-acetaminophen and fentanyl-acetaminophen.

Background: Rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality, attributed in part to myocardial dysfunction. Global longitudinal strain (GLS) measured by speckle-tracking echocardiography is a sensitive marker of myocardial function. This study aimed to investigate the association between RA serology markers, including rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies, and GLS in RA patients.

Materials and Methods: This one-year cross-sectional study was conducted at Imam Hossein Hospital in Tehran, Iran, focusing on patients diagnosed with RA. Rheumatoid arthritis serology markers, including RF and anti-CCP antibodies, were assessed. GLS was measured using speckle-tracking echocardiography. The association between RA serology markers and GLS categories was analyzed using chi-square tests with IBM SPSS Statistics version 26.

Results: A total of 71 patients were included in the study, with a mean age of 52.31 years. Among the RA patients, 28 individuals (71.8%) with negative RA serology exhibited abnormal GLS values, while 11 (28.2%) had normal GLS values. Conversely, all 21 (100%) RA patients with positive serology showed abnormal GLS values. Statistical analysis revealed no significant association between RA serology markers and GLS category (χ2 = 0.313, P>0.05).

Conclusion: In this study, RA serology markers, including RF and anti-CCP antibodies, were not significantly associated with GLS abnormalities in RA patients. Further research is needed to elucidate other factors contributing to myocardial dysfunction in RA.

Background: Probiotic administration can be an effective treatment against intestinal inflammation. This study aimed to assess the potential effects of spores isolated from probiotic strains Bacillus subtilis natto and Bacillus coagulans Hammer on inflammation induced by lipopolysaccharide (LPS) in human colon epithelial cells in vitro.

Materials and Methods: The viability of HT-29 cells treated with spores derived from B. subtilis natto and B. coagulans Hammer (MOI 10, 100, 1000), as well as LPS (10 µg/ml) was assessed. The anti-inflammatory effects of spores were examined on HT-29 cells that were pre-stimulated with LPS. The expression level of IL-6 and TLR4 genes in HT-29 cells was quantified after 24 h using RT-qPCR.

Results: There was no significant reduction in the viability of HT-29 cells after exposure to LPS and various MOIs of probiotic spores. Stimulation of HT-29 cells with LPS significantly increased the expression level of IL-6 and TLR4 in comparison to control (P < 0.0001). Spores isolated from both probiotic strains, B. subtilis natto and B. coagulans Hammer, caused a significant reduction in the gene expression of IL-6 and TLR4 in HT-29 cells compared to LPS control (P < 0.0001).

Conclusion: The findings of this study suggest that probiotics-derived spores may exert anti-inflammatory effects through interference with the LPS signaling pathway in colon cancer HT-29 cell line.

Background: Insulin-secreting tumors are the most common hormone-producing neoplasm of the gastrointestinal tract. Only 10 percent of overall cases of insulinoma have malignant variants, which have a poor prognosis.

Cases Report: The present study reports an unusual case of pancreatic neuroendocrine tumor associated with hypoglycemia and liver metastasis as the initial presentation followed a rapidly progressive clinical course. A few cases of malignant insulinoma were reported with favorable responses in the literature. This research presents a patient with resistant malignant insulinoma who could not undergo an operation and received treatment with somatostatin analogs (S.S.A.), Peptide Receptor Radionuclide Therapy (PRRT), and other supportive care that was inappropriate.

Conclusion: Early diagnosis and extensive treatment are auspicious for improving the prognosis of malignant insulinoma, and proper treatment with medications would increase the quality of life of patients. Nevertheless, unfortunately, late patient referrals, socioeconomic conditions, and being infected with Covid-19 disease resulted in death.

Background: Rabies is an acute and fatal zoonotic viral disease that affects warm-blooded mammals. This disease is usually transmitted between humans and other animals through bites, scratches, or saliva from infected animals. Depending on the mortality rate of rabies, people sometimes experience mental stress after biting or contact. This condition is called mental stress toward rabies (Rabies Hysteria).

Cases Report: In this study, we referred to seven cases of rabies hysteria, which were referred to the WHO Collaborating Center for Reference and Research on Rabies of Pasteur Institute of Iran.

Conclusion: Studies have shown that the level of low awareness and the wrong attitude toward the disease aggravates medical hysteria. The health system should evaluate social knowledge and attitude.

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the greatest pandemic in the world. This virus involves the respiratory system, causes pulmonary dysfunction, and causes coronavirus disease (COVID-19). Pulmonary dysfunction due to COVID-19 may be asymptomatic, mild, moderate, and severe/critical. COVID-19 may involve other organs, and its sequelae may be persistent for a long time. The pulmonary function test is a method for evaluating the lungs in people. In this study, we reviewed the results of pulmonary function test (PFT) in patients with a history of COVID-19 involvement based on previous studies.

Materials and Methods: The present review was conducted in 2024 using the keywords COVID-19, pulmonary function test, recovery, and pulmonary involvement in English. Eligible articles (articles containing the mentioned keywords) published during the years 2019 to 2023 were searched in Scopus, Pubmed, Wiley, and Google Scholar international databases. Relevant articles were identified, and after review, the most important and valuable points were presented.

Results: PTF should not be done during COVID-19 involvement because it increases the rate of disease transmission. Small airway dysfunction, restrictive ventilatory dysfunction, and pulmonary diffusion impairment patterns are the most common findings in the PFTs of patients with a history of COVID-19. PFT improves gradually after the recovery of pulmonary involvement of COVID-19 for two years, even in patients with severe or critical forms of COVID-19.

Conclusion: In this review, we summarized the results of studies about pulmonary function tests after COVID-19 involvement in survivors. Small airway dysfunction, restrictive ventilatory dysfunction, and pulmonary diffusion impairment are the most common findings in the PFT of survivors of COVID-19. These patterns are more prevalent among patients with severe or critical forms of COVID-19, and they are associated with the risk factors of COVID-19 severity, such as age, underlying disease, and pulmonary disorders. Forced vital capacity and diffusion capacity of lungs for carbon monoxide decreased in patients with COVID-19, and forced expiratory volume in 1 second (FEV1)/FVC and residual volume (RV) increased in these patients and they were associated with COVID-19 severity. The pulmonary involvement of COVID-19 recovers over time, and after two years, patients return to their baseline PFTs.