Irish Journal of Medical Science最新文献

Background: Hyperemesis Gravidarum (HG) in pregnancy is a severe form of nausea and vomiting resulting in dehydration, weight loss and declining mental health. Research on the clinical characteristics and management of HG in Ireland is limited.

Aim: To describe a cohort of women with HG attending an Irish Maternity Hospital.

Methods: A retrospective chart review of 198 women referred for HG management in an urban stand-alone maternity hospital in Dublin between 2020-2023. Data included medical and obstetric history, management, symptoms and birth outcomes.

Results: Most (64.8%) were multiparous, with 77% reporting previous HG. The majority (76.3%) presented in the first trimester. PUQE scores indicated mild (3.4%), moderate (48.3%), or severe (48.3%) nausea and vomiting, and 72.1% rated their wellbeing 5 or lower (on a scale of 0-10). Mean weight loss from pre-pregnancy to first presentation was-2.64kg (SD 3.9), with 39% losing >5%. Dehydration (61.3%) and ketonuria (42.8%) were common. Mean duration of HG care was 11.04 (SD 8.4) weeks. Nearly half (49.5%) trialled 3-4 medications, with 87.9% prescribed Doxylamine/Pyridoxine and/or Prochlorperazine. Hospital resource use was high; 76% required day ward management, 78% attended A&E, and 36.9% needed overnight admission, at least once. Among 187 live births, 55.2% were male, 70% were vaginal deliveries, 9.1% were small for gestational age (<10^thcentile) and 13.4% were large for gestational age (>90^thcentile).

Conclusion: HG significantly impacts maternal health and places demands on hospital resources. While birthweight centiles were generally normal, HG's potential long-term effects on child health warrant further investigation.

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality in the world, with most cases being diagnosed in an advanced stage of the disease. Small non-coding microRNAs (miRNAs), which play a crucial role in regulating gene expression, have emerged as potential diagnostic, prognostic, and therapeutic targets for HCC. This systematic review aims to review the current evidence on the diagnostic and prognostic significance of miRNAs in HCC METHODS: A comprehensive literature search by using PubMed, Scopus, Web of Science, and Google Scholar was conducted, considering papers published between January 2013 and June 2025. The review followed PRISMA 2020. The studies that fit the criteria were human studies and focused on the effects of miRNAs on the diagnosis, prognosis, or response to treatment of HCC. Data extraction was performed independently by 2 reviewers, and the quality of included studies was assessed with use of the Newcastle-Ottawa Scale. Narrative synthesis was performed, and sensitivity, specificity, and AUC measurements were extracted as appropriate.

Findings: Out of 1,572 articles, 300 studies met the criteria for inclusion. The analysis looked at over 120 different miRNAs from biological samples like blood, serum, tissue, and plasma. Although many miRNAs, such as miR-21, miR-122, and miR-199a, show significant promise for diagnosis and prognosis, their application in clinical settings necessitates thorough validation in extensive, multicentre studies. A few miRNAs showed good diagnostic accuracy (AUC & gt; 0.85) and had links to tumor stage, metastasis, and how long patients lived. Still, differing sample types and detection methods made the meta-analysis difficult.

Conclusion: miRNAs show potential as non-invasive markers for early detection and prognosis of HCC. This review emphasises the potential of miRNAs as non-invasive indicators for the diagnosis and prognosis of HCC. Nonetheless, the variability across studies and the absence of methodological consistency restrict their prompt application in clinical settings. It is crucial to validate findings through extensive, multicentre studies and to integrate them with traditional diagnostic methods to guarantee their relevance in clinical practice. Future research should focus on confirming miRNA panels and integrating them into current diagnostic methods.

Background: Contamination of cough syrups not produced under sterile conditions is dangerous for users and can affect product quality.

Methods: The bacterial quality was investigated in 15 cough syrup samples collected from Punjab, India (validity: January-June 2024). This was confirmed when contamination was measured via membrane filtration (0.45 μm pores) and microbes were grown on Tryptone Soya Agar, mannitol salt agar, Xylose Lysine Deoxycholate Agar and Eosin Methylene Blue Agar. The number of isolates (CFU/mL) was determined, and the isolates were identified using Gram staining, biochemical tests, and 16S-rRNA gene sequencing.

Results: The presence of genetic variation among organisms was also evaluated. Only one out of 15 samples (6.66%) had levels higher than allowed, three others (20%) were near the limit, and the rest (73.33%) were below the United States Pharmacopeia (USP) limit ( 10³ CFU/mL) for bacterial contamination. Staphylococci sp. were present in syrups C, D, L, and O according to biochemical testing. The results for syrup C showed that Staphylococcus aureus (GenBank: PV137763) was above the level required by the USP. Genetic diversity analysis revealed six main haplotypes, with a high haplotype diversity (Hd= 0.8667) and nucleotide diversity (Pi = 0.09097), suggesting that the population is either expanding or undergoing purifying selection.

Conclusion: The majority of syrups were of good quality; however, there were contaminated samples, which raised doubts about how they were produced. It is recommended that good manufacturing practices be strictly enforced. Larger and ongoing quality control studies should be conducted to evaluate product safety.

Background: Dexmedetomidine (Dex) is known for extending the time of action and enhancing the analgesic efficacy of local anesthetics. However, its effects on surgical wound healing have not been comprehensively investigated.

Aim: This study aims to thoroughly examine the effects of subcutaneously administered Dex on wound healing in rats.

Methods: 32 rats in total were randomly distributed into four groups: Control, 3 ml Saline (Group I), 5 μg/kg Dex (Group II), 30 μg/kg Dex (Group III), and 60 μg/kg Dex (Group IV). After the procedure, samples were collected from the surgical wound site on the 7th day. Several wound-healing-related parameters were measured, including arginase, collagen type I, hydroxyproline, Xaa-Pro dipeptidase/prolidase, transforming growth factor-β (TGF-β1), and basic fibroblast growth factor (bFGF). Additionally, the immunoreactivity of proliferating cell nuclear antigen (PCNA) and vascular endothelial growth factor (VEGF) proteins was assessed to evaluate connective tissue cell proliferation and blood vessel development in the dermis.

Results: Hydroxyproline (ng/ml) levels were significantly higher in Groups II, III, and IV compared to Group I. Statistically significant differences were also observed between the groups for Arginase (ng/ml), Collagen Type I (ng/ml), TGF-β1 (ng/L), and bFGF (ng/L) values. PCNA immunoreactivity was significantly higher in the 30 μg/kg group than in other groups. VEGF immunoreactivity was significantly higher in the 5 μg/kg group.

Conclusion: The subcutaneous administration of Dex did not negatively impact wound healing in rats. Histological and biochemical findings showed that doses of 5 and 30 μg/kg promoted the fastest wound closure and supported homogeneous tissue formation. These results suggest that dexmedetomidine has therapeutic potential in wound healing.

Background: White noise may reduce pain levels in newborns.

Aims: Examine the effect of white noise on pain levels in newborns.

Methods: The studies included in this meta-analysis were identified through a comprehensive search of databases including Web of Science, PubMed, EBSCO host, Google Scholar, and the National Thesis Center of the Turkish Council of Higher Education. Following an evaluation of the studies, 14 eligible studies were included in the analysis. The quality of the included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools, tailored to each study design. Data synthesis was conducted using Comprehensive Meta-Analysis (CMA) version 2. The findings were structured through a combination of meta-analytic and narrative synthesis approaches.

Results: This meta-analysis found that the use of white noise during painful procedures significantly reduced pain levels in newborns (SMD: -1.026, 95% CI: -1.443 to -0.610; Z = -4.828, p = 0.000). Subgroup analyses revealed that specific sounds, including those from the Colic album by Orhan Osman (e.g., "Colic," "Don't Let Your Baby Cry," "Don't Let Your Baby Cry Pt-3"), as well as intrauterine-like sounds such as hair dryers and vacuum cleaners and recordings of heartbeat sounds, were significantly more effective than other types of white noise.

Conclusions: The findings of this meta-analysis indicate that white noise is an effective intervention strategy for reducing pain levels in newborns. It is recommended that healthcare professionals incorporate white noise, which is a simple, low-cost, effective, and safe non-pharmacological method, into their clinical practice to alleviate neonatal pain.