International journal of physiology, pathophysiology and pharmacology最新文献

Background: Functional constipation is defined as a delay or difficulty in defecation that lasts two weeks or more which history and physical examination have ruled out its organic causes. In this study, we aimed to evaluate the efficacy of non-pharmacological treatments (dietary changes and increased physical activity) for adult patients with chronic constipation.

Methods: This prospective randomized clinical trial was performed in 2020-2021 on 64 patients with functional constipation with the Iranian Registry of Clinical Trials (IRCT) code IRCT20200601047621N2 (https://en.irct.ir/trial/48798). The demographic data and constipation severity were collected by checklist. The diet was designed by a nutritionist containing 25 to 30 grams of fiber and eight glasses of water or liquids other than tea daily for 12 weeks. The amount of sufficient physical activity was defined as doing half an hour of brisk walking daily to increase the heart rate by 50%. All cases were visited during the study and the constipation severity questionnaire was completed at baseline and after 2, 4, 8 and 12 weeks after the beginning of the study.

Results: Patients had significantly improved defecation frequencies after 12 weeks (P = 0.03 compared to baseline). We also observed that patients had improvements in having a hard stool (P = 0.001 compared to baseline), painful defecation (P = 0.03 compared to baseline), use of a finger to defecate (P = 0.04 compared to baseline), and straining while defecation (P < 0.001 compared to baseline). Patients with age groups 30-40 and 40-50 significantly improved defecation frequencies, painful defecation, and straining while defecating compared to other age groups.

Conclusion: Non-pharmacological treatments could significantly improve functional constipation in patients. Significant improvements were observed in patients between 30-50 years of age.

Industrialization and urbanization have caused a hike in all forms of emissions, many of which have detrimental effects on plants, animals, the environment, and worse still, humans. In a quest for novel products (household, and medical), manufacturing industries work tirelessly worldwide using metals to meet man's needs. However, such metals especially those confined to this research (Hg, Cd, and Pb) are inherently hazardous to not just the environment but human life and existence. Thirty (30) male Wistar rats divided into six groups of five rats each was used for the study. Stock solutions of the heavy metals were prepared and the required dose calculated according to individual weight and administered as such to group 2-5, plantain stem juice (PSJ) was administered to groups 3 to 5 in increasing dose after receiving the HMM (heavy metal mixture) while group six received medium-dose of PSJ used in the study only. Bodyweight of the rats was monitored once in three weeks while the feed and fluid intake were monitored thrice a week. At the end of the ninth week, the animals were weighed and sacrificed. Organs of interest (brain, heart, lungs, and thymus) were harvested and analyzed. Analysis done include Histopathology, hematological, biochemical, and organs/blood metal concentration. The results obtained showed a decline in the weight of animals that received metal mixture only when compared to normal control and PSJ treated groups. This could be traceable to the decline in feed intake of the metal-induced groups. However, no significant effect was observed in the histology of the Thymus and cerebellum even though the presence of a vacuole in the cerebral cortex indicated an anomaly. The histology of the heart and the lungs showed some level of distortion which was ameliorated dose-dependently with the administration of PSJ. Interestingly, after a decrease in the antioxidant level upon administration of metal mixture, a booster effect was observed with an increasing dose of PSJ. In conclusion, the recent findings have demonstrated that treatment with PSJ in HMM induced intoxication has a significant role in protecting the animals from all possible organ toxicity by modulating hemato-biochemical parameters and oxidative stress level.

Background: Bleeding in Dacryocystorhinostomy (DRC) limits the surgeon's sight and access. Tranexamic acid, Remifentanil, and Hydralazine reduce intraoperative blood loss. However, no study has been carried out to compare the efficacy of the latter drugs during DCR surgery.

Methods: Ninety healthy candidates for DCR surgery with chronic Dacryocystitis (aging 20-80) were randomly assigned in groups of 30 to receive low doses of Tranexamic acid (TXA) (10 mg/kg with a maximum dose of 1000 mg), Remifentanil (0.1 µ/kg), or Hydralazine (0.1 mg/kg). All drugs were infused over 15 minutes before the initiation of surgery. The primary outcome was the bleeding volume during the surgery and until 2 hours in recovery. This study was approved by the Iranian Registry of Clinical Trials with the code of IRCT20210614051574N10 (https://en.irct.ir/trial/62759).

Results: Thirty patients (mean age ± SD: 50.48±13.4) were investigated. Mean blood loss volume was lower in Remifentanil and Hydralazine groups compared with the TXA group (P<0.05); there was no significant difference (P>0.05) in bleeding volume between Remifentanil and Hydralazine groups (Tranexamic acid group: 146.83±91 ml, Remifentanil group: 77.6±52.1 ml, Hydralazine group: 80.0±48.7 ml, 95% confidence interval, P<0.05).

Conclusion: Our results show that Remifentanil and Hydralazine are more effective than Tranexamic acid in bleeding control.

Background: Magnetic resonance imaging (MRI) has a pivotal role in diagnosing breast lesions. Here we aimed to compare the diagnostic values of Abbreviated and Full Breast MRI for breast lesions.

Methods: This is a cross-sectional study performed in 2017-2021 on 80 women with breast lesions. Using the available MRI analysis software, the necessary sequences for the Abbreviated MRI were extracted from standard breast MRI protocol. First, a Full Breast MRI was examined by a radiologist giving Breast imaging-reporting and data system (BI-RADS). Then, from this Full Breast MRI, the necessary sequences for Abbreviated Breast MRI were prepared. The second expert radiologist read them in this field and BIRADS was reported. The data relating to each patient were recorded in the patient-specific profile and then the pathology results were followed for each patient.

Results: Modified breast MRI had 84% sensitivity and 58.18% specificity, while full Breast MRI had 100% sensitivity and 38.18% specificity. Comparing the results of pathology (benign or malignant) for breast tumors and BIRADS reported by modified breast MRI indicated that these results were similar in 53 cases (66.3%) and different in 27 patients (33.8%). On the other hand, similar assessments for Full Breast MRI and pathology reports showed that the results were the same in 46 patients (57.5%) and different in 34 patients (42.5%).

Conclusion: Abbreviated breast MRI has lower sensitivity and higher specificity than full breast MRI.

Introduction: Kyphosis treatment aims to prevent curve progression and deformity correction. This study aimed to evaluate the long-term beneficial effects of Kyphologic brace treatments in patients with Scheuermann kyphosis.

Methods: This retrospective case series study was performed on patients with Scheuermann kyphosis treated with a Kyphologic brace from 2013-2020. Demographic data, including age, gender, and duration of treatments, were extracted. Mean kyphosis angles before, one month and 1 year after treatments were collected. Patients were followed for at least 18 months after treatments. The location of kyphosis apex was also noted and classified into the following groups: upper thoracic, mid thoracic, lower thoracic, and thoracolumbar.

Results: 48 patients with Scheuermann kyphosis enrolled in the present study. The mean age of the patients was 12.95 ± 1.4 years. The average follow-up time in this study was 23.02 ± 11.8 months. The mean kyphosis angle before treatments was 63.66 ± 9.51°, which decreased significantly after one month (to 43.33 ± 8.7°) and after 1 year (to 37.6 ± 9.4°) of treatments with Kyphologic brace compared to before treatments (P < 0.001). The most common location of kyphosis apex was in mid-thoracic with 77% frequency.

Conclusions: In this study, we showed that using a Kyphologic brace was associated with a significant reduction in kyphosis angle in patients. Our results emphasized the effectiveness of this brace in patients with Scheuermann kyphosis.

Objectives: The complications of normal vaginal delivery (NVD) are one of the issues that researchers have been discussing today and various ways to reduce these outcomes have been presented. In this study, we aimed to compare the effect of Transcutaneous Electrical Nerve Stimulation (TENS), the aromatherapy of Lavandula and physiologic delivery without medication on NVD outcomes.

Methods: This randomized clinical trial was conducted on 150 women that were candidates of NVD. The information related had been registered in the Iranian clinical trial registration system with the code IRCT20210501051151N1 (https://www.irct.ir/trial/56014). Patients were divided into three groups of Lavandula, TENS, and physiologic delivery. Postpartum pain, maternal and neonatal outcomes, and labor duration were compared in groups.

Results: Labor pain was significantly less in TENS and Lavandula than in the physiologic group, respectively (P<0.001). There was no significant difference between the groups in terms of labor duration and maternal and fetal outcomes.

Conclusion: The use of TENS and Lavandula aromatherapy are useful methods for reducing pain in patients undergoing NVD, but using TENS method is better than Lavandula method, and on the other hand, there are no differences between groups as maternal and neonatal complications.

Introduction: Susceptibility weighted imaging can be used to study intracranial venous blood arteries based on the paramagnetic sensitivity of blood discharged by oxygen (SWI). Significant hypotensive drainage channels have been discovered in the ischemic tissue of the brain, which have been recognized by SWI. The compliance or non-compliance between the variation in venous drainage of ischemic brain tissue by SWI and diffusion limitation.

Material and methods: This cross-sectional study was conducted in 2019 on 20 patients (15 men and 5 females) who were assigned to the Ghaem Hospital MRI Institute in Rasht, Iran.

Results: Infarction has been detected in a total of 20 vascular regions. The caliber of the sulcal and intramedullary veins, on the other hand, was increased in 80 percent and 65 percent of the infarcted regions, respectively. In 45 percent of the vascular regions, a match between SWI and diffusion-weighted magnetic resonance imaging (DWI) was detected, mismatch was detected in two; follow-up revealed infarct progression.

Conclusions: Significant data on critically perfused cerebral cortex with possibility of infarction growth was focused on in elevated SWI investigations, contributing to SWI as a worthy MR implies that could be attached as complementary protocols to neuroimaging techniques for acute ischemia, according to the findings of this study.

Lisfranc complex injuries are a spectrum of midfoot and tarsometatarsal (TMT) joint trauma, more frequent in men and in the third decade of life. Depending on the severity of the trauma can range from purely ligamentous injuries, in low-energy trauma, to bone fracture-dislocations in high-energy trauma. A quick and careful diagnosis is crucial to optimize management and treatment, reducing complications and improving functional outcomes in the middle and long-term. Up to 20% of Lisfranc fractures are unnoticed or diagnosed late, above all low-energy trauma, mistaken for simple midfoot sprains. Therefore serious complications such as post-traumatic osteoarthritis and foot deformities are not uncommon. Clinically presenting with evident swelling of the midfoot and pain, often associated with joint instability of the midfoot. Plantar region ecchymosis is highly peculiar. First level of examination is X-Ray performed in 3 projections. CT scan is useful to detect nondisplaced fractures and minimal bone sub-dislocation. MRI is the gold standard for ligament injuries. The major current controversies in literature concern the management and treatment. In stable lesions and in those without dislocation, conservative treatment with immobilization and no weight-bearing is indicated for a period of 6 weeks. Displaced injuries have worse outcomes and require surgical treatment with the two main objectives of anatomical reduction and stability of the first three cuneiform-metatarsal joints. Different surgical procedures have been proposed from closed reduction and percutaneous surgery with K-wire or external fixation (EF), to open reduction and internal fixation (ORIF) with transarticular screw (TAS), to primary arthrodesis (PA) with dorsal plate (DP), up to a combination of these last 2 techniques. There is no superiority of one technique over the other, but what determines the post-operative outcomes is rather the anatomical reduction. However, the severity of the injury and a quick diagnosis are the main determinant of the biomechanical and functional long-term outcomes.

Intrahepatic cholestasis of pregnancy (ICP) has an increased predisposition to occur in the third trimester of pregnancy and has a varied population incidence rates due to genetic influences. Owing to the adverse and unpredictable fetal outcomes, it poses a serious therapeutic challenge to the clinician. A rise in the incidence of iatrogenic prematurity has been observed, raising concerns over the perinatal outcomes. Excess bile acids and altered placental transport mechanisms have been strongly implicated in the pathogenesis of ICP and its complications. The exact etiology is not known; yet major underlying risk factors that are thought to contribute to the disease process include genetic, environmental, hormonal, and immunological. Newer molecular processes acting at the placental level, apart from specific histopathological changes, have assumed significance in recent times. In this review, we attempt to highlight the recent understanding of the mechanisms that operate in the placenta in patients with obstetric cholestasis that lead to poor fetal outcomes, through various studies published in the literature. Despite these additions to the existing knowledge on the etiopathogenesis of obstetric cholestasis and its possible placental origin, further studies are needed to validate the newer concepts.

COVID-19 vaccination is proven useful for primary prevention against COVID-19. Classically, two doses of vaccine are required. After complete vaccination, there might be a decline in immunity level. When there is a new emerging variant and a possible decline of immunity in general people after standard mass vaccination, many scientists propose ideas for the additional third dose vaccination. The effectiveness of the third vaccine still unknown, therefore any studies on its effectiveness are interesting. Additionally, there are also many new ideas for using a new type of COVID-19 crossing to the previous completely vaccinated one. In this study, the authors use a clinical model technique for estimating of response to the additional third dose of COVID-19 vaccine based on different complete standard vaccination background.