Novelty in Biomedicine

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder associated with increased cardiovascular morbidity and mortality. This study investigated the association between RA inflammatory markers, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and various cardiac function parameters.

Materials and Methods: A cross-sectional study involved 71 patients diagnosed with RA at Imam Hossein Hospital in Tehran, Iran. Cardiac function parameters, including left ventricular end-diastolic diameter (LVDD), left ventricular end-systolic diameter (LVDS), left ventricular ejection fraction (EF), E/A ratio, septal e' velocity, left atrial (LA) area, and LA size, were assessed using echocardiography. The correlation between RA inflammatory markers and cardiac function parameters was analyzed using Pearson correlation coefficients. Multiple linear regression models were employed to further explore these associations. Statistical analyses were performed using SPSS Statistics version 26.

Results: Among the cardiac function parameters assessed, only LA size significantly correlated with RA inflammatory markers (ESR-CRP) (p = 0.034). However, LVDD, LVDS, EF, and E/A ratios did not exhibit significant correlations. Septal e' velocity notably showed a weak positive correlation with inflammatory markers.

Conclusion: Our findings suggest a potential link between systemic inflammation in RA and cardiac remodeling, particularly affecting LA size. This highlights the importance of monitoring cardiac function parameters, especially LA size, in RA patients to identify individuals at higher risk of cardiovascular complications. Further research is warranted to elucidate this association's underlying mechanisms and clinical implications.

Background: Non-invasive detection of renal cell carcinoma (RCC) recurrence is a major challenge that could radically affect patient survival. To date, there are no approved biomarkers for inclusion in the monitoring and follow-up of RCC; therefore, assessment of treatment response is lacking.

Materials and Methods: A Cross-sectional study was carried out on biopsy-proven renal cell carcinoma patients scheduled for nephrectomy at Hayatabad Medical Complex (HMC) Hospital, Peshawar, Pakistan, between September 2022 and January 2024.

Results: A total of 160 samples were included in the study. Eighty samples were obtained from biopsy-proven non-metastatic renal cell carcinoma patients, of which 40 were collected pre-nephrectomy, 40 were collected post-nephrectomy from the same patients, and 80 samples were collected from age and gender-matched healthy individuals. Total plasma glycosaminoglycans (GAGs) levels were analyzed through a manual enzyme-linked immunosorbent assay using a non-competitive sandwich technique. Quantitative variables were summarized as means and standard deviation, while qualitative variables were summarized as frequency and percentage. A paired t-test was performed to check whether the difference between the mean plasma GAG levels in pre-nephrectomy and post-nephrectomy groups was significant.

Conclusion: The results revealed that post-nephrectomy GAG levels have significantly decreased compared to pre-nephrectomy levels (P<0.001). Plasma glycosaminoglycan levels could be promising markers for monitoring renal cell carcinoma patients post-nephrectomy.

Background: We decided to compare the effects of sertraline and escitalopram in the treatment of major depressive disorder in hemodialysis patients.

Materials and Methods: In this single-blind randomized clinical trial, 100 patients with End-Stage Renal Disease (ESRD) undergoing hemodialysis with a Beck Depression Inventory (BDI) score greater than 15 who were not using medication for depression were included in the study. Then randomly assigned to two groups: (one receiving sertraline and one receiving escitalopram). Both groups were monitored using the Beck questionnaire at the end of the first, second, and third months. Additionally, side effects, treatment compliance, and mortality were compared between the two groups.

Results: In total, 100 patients with ESRD were included in the study (48 in the sertraline treatment group and 52 in the escitalopram treatment group). The results indicate that in both treatment groups, depression rates significantly decreased over time with medication (P<0.001). Comparing the depression scores over time revealed that the effect of sertraline and escitalopram in reducing depression was not significantly different. However, the depression score in the sertraline group was slightly lower than that in the escitalopram group, although this difference was not statistically significant. Side effects, treatment compliance, and mortality were comparable between the two groups.

Conclusion: In general, both sertraline and escitalopram significantly reduced the score of depression in patients, but sertraline in reducing the depression score was greater than that of escitalopram, although this difference was not significant.

Background: Tinea versicolor is a common cutaneous fungal infection of the skin caused by a part of the resident flora of skin known as Malassezia species. This infection is recognized by pigmentation disturbance in the form of lesions and superficial scaling in the skin.

Materials and Methods: This study was conducted on 350 students between the ages of 18-25 years who lived in a school dormitory and were suspected of clinical diagnosis of Tinea versicolor. The Scotch tape method was used to take samples from the infected skin of students, and methylene blue staining was used to prepare smears.

Results: After mycological examinations, among the 350 suspected students, 30 cases tested positive for Tinea versicolor, including 17 males and 13 females. 43.3% (n: 13) of patients had hypopigmentation followed by hyperpigmentation (33.3%, n:10) and erythematous (23.3%, n:7).

Conclusion: This study demonstrated a significant prevalence of Tinea versicolor among the students located in the dormitories, with a higher rate among male students. Different infection periods and lesions were observed in the cases, but no severe lesion was seen.

Background: Obesity is a prevalent health issue associated with an increased risk of cardiovascular diseases. While obesity's link to various cardiovascular conditions is well-documented, its specific impact on global longitudinal strain (GLS) requires further investigation. This study aims to explore the relationship between obesity and GLS in an adult population.

Materials and Methods: This cross-sectional study included 91 adult participants, categorized into obese (n=59) and non-obese (n=32) groups based on body mass index (BMI). GLS was measured using speckle-tracking echocardiography. Chi-square tests and odds ratios (OR) were used to assess the association between obesity and abnormal GLS.

Results: Among the non-obese group, 25.0% had abnormal GLS compared to 20.3% in the obese group. The chi-square test indicated no significant difference in the prevalence of abnormal GLS between the groups (p = 0.60). The odds ratio for abnormal GLS in obese versus non-obese participants was 1.3 (95% CI: 0.4-3.6), indicating no significant association.

Conclusion: The study found no significant association between obesity and abnormal GLS, suggesting that BMI alone may not be a reliable predictor of subclinical myocardial dysfunction. These findings highlight the need for a comprehensive approach to cardiovascular risk assessment that includes multiple factors beyond BMI.

Background: Hypertension is a leading risk factor for cardiovascular diseases, significantly contributing to global morbidity and mortality. Understanding the determinants of hypertension is crucial for effective prevention and management. This study investigates the relationships between demographic and physiological factors and hypertension status in a cohort of adults.

Materials and Methods: A cross-sectional study was conducted with 105 adult participants, comprising 47 hypertensive and 58 non-hypertensive individuals. Data on age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, and fasting blood sugar (FBS) were collected. Statistical analyses included summary statistics, Pearson correlation coefficients, and logistic regression to identify significant predictors of hypertension.

Results: There were significant differences between hypertensive and non-hypertensive groups regarding SBP, DBP, and BMI. Hypertensive individuals had higher mean SBP (141.4 ± 10.5 mmHg) and DBP (86.4 ± 8.0 mmHg) compared to non-hypertensive individuals (118.1 ± 11.5 mmHg and 72.2 ± 6.8 mmHg, respectively; p < 0.001 for both). BMI was also significantly higher in the hypertensive group (36.8 ± 11.8 kg/m² vs. 32.6 ± 9.8 kg/m²; p < 0.001). Age and BMI positively correlated with both SBP and DBP, while HDL showed a significant negative correlation with DBP. Logistic regression analysis identified age (OR = 1.07, 95% CI: 1.05-1.09, p = 0.02), BMI (OR = 1.06, 95% CI: 1.01-1.15, p = 0.01), and LDL (OR = 1.04, 95% CI: 1.00-1.02, p = 0.04) as significant predictors of hypertension.

Conclusion: This study reinforces the significant roles of age, BMI, and LDL cholesterol in the risk of hypertension. These findings highlight the importance of targeting these modifiable risk factors through effective interventions to reduce the prevalence and impact of hypertension. Future research should explore the mechanisms linking these predictors to hypertension to develop comprehensive prevention and management strategies.

Background: Osteoporosis is a significant concern, especially for individuals undergoing renal transplantation, as it disrupts bone health and increases the risk of fractures. Interventions for osteoporosis aim to address bone-related challenges in patients with renal transplantation, yet concerns persist regarding both efficacy and potential adverse events.

Materials and Methods: We searched PubMed/MEDLINE, EMBASE, and the Cochrane CENTRAL databases until December 15, 2023, seeking studies that evaluated the efficacy and adverse events of osteoporosis medications in patients with renal transplantation. The Cochrane tool was utilized to assess the quality of the studies. The statistical analysis was performed using Comprehensive Meta-Analysis software, version 3.0.

Results: We enrolled 594 participants from 7 randomized controlled trials. Combining trial results reveals that using anti-osteoporotic agents (Ibandronate, Risedronate, and Pamidronate) reduces the risk of vertebral fractures compared to the placebo. However, the reduction was not statistically significant (OR: 0.49, CI 95%: 0.20-1.22). Additionally, lumbar spine, femoral neck, and total hip BMD showed no significant differences between anti-osteoporotic agents (Denosumab, Zoledronic acid, Ibandronate, Risedronate, and Pamidronate) and placebo. Moreover, there were no significant differences in adverse events between the interventions and placebo.

Conclusion: The study suggests that anti-osteoporotic agents in renal transplantation patients may be associated with a non-significant lower risk of vertebral fractures compared to a placebo. Findings also indicate no significant differences in adverse events between interventions and placebos. Caution is advised in interpreting these results due to the absence of statistically significant differences, emphasizing the need for further research to enhance our understanding of efficacy and safety in renal transplantation.

Background: Various fumigant products containing aluminium  phosphide, known as rice pills, are widely used to kill insects in many parts of Iran, including the northern provinces. Poisoning with zinc phosphide as a rat poison also has the same side effects as aluminium  phosphide. This poisoning has no specific antidote, and the treatment is auxiliary, and one of the effective auxiliary treatments is L-carnitine. This review study aimed to determine the prevalence of aluminium  phosphide poisoning and treatment with intravenous L-carnitine.

Materials and Methods: This study was a narrative review conducted in 2023. Search keywords aluminium  phosphide, zinc phosphide, intravenous L-carnitine, and poisoning in Persian and English languages in databases including Magiran, PubMed, Wiley, Science Direct, web of Sciences, SID, Scopus, and Google Scholar were done from 1970 to 2022. Relevant articles were identified, and the most important and valuable points were presented after review.

Results: According to the findings of most studies, aluminium  phosphide pills had the most adverse effects as toxic substances.

Conclusion: Due to the prevalence of its consumption among young people with low education levels, there was a need for physicians to treat these patients as quickly as possible accurately. It is also necessary to raise awareness about its potentially dangerous side effects and to monitor closely the distribution of this poisonous pill in its distribution centers. Moreover, the quick start of supportive treatment with antioxidants and L-carnitine can help in this poisoning that does not have a specific antidote. Very effective and useful.

Background: Pyogenic brain abscess is a severe neurological infection associated with significant morbidity and mortality. Despite advances in diagnostic techniques, neurosurgical procedures, and antimicrobial therapy, managing pyogenic brain abscesses remains challenging. This article reviews the current understanding of the epidemiology, pathogenesis, diagnosis, and treatment of pyogenic brain abscesses, highlighting the importance of a multidisciplinary approach to improve patient outcomes.

Materials and Methods: A comprehensive literature review was conducted using PubMed, Scopus, and Google Scholar databases. The search terms included "pyogenic brain abscess," "epidemiology," "pathogenesis," "diagnosis," "treatment," "antibiotic therapy," and "prognosis." Relevant articles published in English between 2010 and 2023 were selected, focusing on the most recent advances and evidence-based recommendations for managing pyogenic brain abscesses.

Results: Pyogenic brain abscess is a life-threatening condition that requires prompt diagnosis and treatment. A multidisciplinary approach involving neurosurgeons, infectious disease specialists, and radiologists is necessary to manage pyogenic brain abscesses successfully.

Conclusion: Early recognition, appropriate antibiotic therapy, and timely neurosurgical intervention are essential for improving patient outcomes and minimizing neurological sequelae. Antibiotic therapy and surgical approach should be tailored to the individual patient, considering factors such as the suspected pathogens, immune status, and the primary source of infection. Long-term follow-up is crucial, as recurrence and neurological sequelae are common among survivors. Continued research is needed to improve our understanding of this complex condition and develop more effective treatment strategies.