Reviews on recent clinical trials最新文献

Aim: The aim of this study was to assess the role of seminal Malondialdehyde Acid (MDA) in the diagnosis of male infertility.

Background: Both male and female infertility is increasing all over the world.

Objective: The purpose of this study was to assess the impact of seminal MDA levels on various semen parameters of healthy fertile men and men with infertility, and to know the efficacy of seminal MDA in the diagnosis of male infertility.

Methods: This case-control study was carried out at the Department of Obstetrics and Gynaecology of a tertiary care center in rural Southern India over a period of two years. The study included 90 infertile men (≥21-50 years) having some pathology in semen reports as cases and 90 fertile men (having biological children) with normal semen reports as controls. Biochemical tests for MDA were performed using Human MDA Assay kits on 180 cryopreserved semen samples following the standard protocol. Results of seminal MDA levels were assessed among cases and controls and correlated with different semen parameters.

Results: The mean±SD age for cases was 30.10 ± 4.75 years, and for controls, it was 29.79 ± 5.08 years. Of all the cases, 44 (48.9%) had asthenozoospermia, 22 (24.4%) had oligoasthenozoospermia, 14(15.6%) had oligozoospermia, and 10 (11.1%) had azoospermia. A statistically substantial variance was observed in mean values of MDA (1.03 ± 0.31 mmol/mL vs. 0.60 ± 0.14 mmol/mL; p =0.001) between fertile men and men with abnormal semen reports. A negative association was observed between semen MDA levels with sperm motility, concentration, and normal morphology in 180 participants. The sensitivity of MDA for male infertility prediction was 86.67% at 76.67% specificity, 78.79% positive predictive value, and 78.79% negative predictive value.

Conclusion: MDA has been found to be a promising biomarker for predicting male infertility. However, large sample sizes and prospective cohort studies are required to further confirm its predictive accuracy across various populations.

Background: The HSP90 marker is believed to play a constructive role in facilitating neoplastic transformation mainly via interaction with multiple pro-survival proteins. Welldesigned studies are needed to elucidate the role of HSP90 as a diagnostic marker and therapeutic target in testicular tumors.

Objective: The current study aimed to investigate the expression of HSP90 in various types of testicular cancer and highlight its expression in embryonal testicular cancer.

Material and methods: Immunohistochemical staining for HSP90 in 84 male patients, with nonmetastatic testicular cancer, who underwent orchiectomy from 2000 to 2023, was retrospectively performed at the Laboratory Department of General Hospital of Nikaia in Greece.

Results: A total of 84 males, with a mean age of 36.2 years, who have undergone high-cord radical orchiectomy, were included in this study. Out of the included males, 28.57% had embryonal carcinoma, 23.81% had seminoma, 19.05% had yolk sac tumor, 11.9% had mature teratoma, 9.52% had immature teratoma, and 7.14% had choriocarcinoma. HSP90b was positive in all embryonal carcinoma, seminoma, and choriocarcinoma cases, while it was positive in 75% of the yolk sac tumor, 75% of mature teratoma, and 75% of immature teratoma specimens. HSP90 was found negative in all choriocarcinoma, mature teratoma, and immature teratoma specimens, while it was positive in 25% of yolk sac tumor, 8.33% of embryonal carcinoma, and 10% of seminoma cases. Concerning the expression of HSP90b, a statistically significant relationship was found between excised tumor specimens and normal parenchyma specimens, especially in sac cases (p <0.001). Regarding HSP90a expression, a statistically significant relationship (OR=21.5, p =0.021) was found between excised tumor specimens and normal parenchyma specimens, especially in embryonal carcinoma cases (p <0.001).

Conclusion: HSP90b is highly expressed in the majority of the types of testicular tumors, both in tumor and normal parenchyma specimens, while HSP90a staining is negative in resected specimens. Further well-designed studies are needed to elucidate the role of HSP90 as a diagnostic marker and therapeutic target in testicular tumors.

Background: Maternal position during delivery can affect the physiology of labour and the mechanics of childbirth.

Objective: The study aimed to evaluate the impact of an upright position during the first stage of labour on maternal outcomes.

Methods: This parallel group randomised control trial was conducted from April to June 2020 among 60 women (30 each in the experimental and control groups) admitted to the selected hospital in Punjab, India. Women who entered the active stage of labour naturally with a single live foetus in cephalic presentation, aged 18-45 years, and with normal body mass index were randomly assigned either to the experimental or control group using a concealed envelope method. Women in the experimental group were informed and encouraged to adopt the upright position, while those in the control group received the standard routine care during the first stage of labour. The effectiveness of upright positions during the first stage of labour was assessed in terms of duration of the first, second, and third stages of labour, mode of delivery, and perineal lacerations. Outcome assessors were blinded to the intervention. The differences in the groups were evaluated by mean, median, frequency, percentage, Chi-square, and t-test.

Results: The results of 60 women were analysed. Women in the experimental group experienced a significant reduction in the incidence of instrumental delivery (p =0.005), perineal laceration (p =0.001), and duration of the first stage (p =0.0001) and third stage (p =0.0001) of labour compared to those in the control group. No harm was reported across the study groups.

Conclusion: This study urges nurses and midwives to recommend the use of upright positions during the first stage of labour to reduce the duration of labour and incidence of perineal laceration among women.

Background: Postpartum hemorrhage (PPH) is one of the three leading causes of maternal mortality. Herbal medicine is one of the well-known methods of treatment in the world.

Objective: This study was conducted to determine and compare the effect of dates, grape seed and dill seed extracts on the PPH rate in women in the fourth stage of labor.

Methods: Two hundred eligible multiparous women visiting the maternity ward in Hamadan for normal delivery participated in this double-blind parallel-group clinical trial. They were randomly divided into four 50-member groups of experiment (3 groups) and control (1 group). The data were collected using a researcher-made questionnaire. In the experimental groups, in addition to routine care and oxytocin administration, the mothers received a capsule containing 15 mg of dill seeds extract or 20 mg of grape seed extract or 5 g of dates extract immediately after the delivery, and then their hemorrhage rates were measured one and two hours after delivery. The control group received routine care, oxytocin, and placebo. Data were analyzed in SPSS 21.

Results: The hemorrhage changes in the placebo group were much less than the intervention groups at 1 and 2 hours after delivery, and the four groups had a significant difference in terms of hemorrhage in both hours (p <0.001). The overall difference between the dates extract group and the placebo and grape seed groups was also statistically significant (p <0.05).

Conclusion: All three extracts of dates, grape seed and dill seeds, especially dates, can be effective in PPH reduction.

Background: Gallstone Disease (GSD) is a multifactorial risk factor for various complications.

Objective: This study aimed to examine the relationship between GSD and Cardiovascular Disease (CVD) through a systematic review and meta-analysis approach.

Methods: A thorough search was conducted across Web of Science, Scopus, MEDLINE/PubMed, Cochrane Library, and Embase databases. Only studies published between 1980 and December 2023 were included. Chi-square, I2, and forest plots were used to assess heterogeneity. Begg's and Egger's tests were used to evaluate publication bias. Statistical significance was considered at p <0.05, and all analyses were performed using Stata 17.

Results: This meta-analysis involved 21 studies and comprised 2,138,282 participants; there has been a significant association found between GSD and an increased risk of CVD (with a relative risk of 1.46, 95% confidence interval: 1.32-1.63, p <0.001). The analysis found no evidence of publication bias based on Begg's test (p =0.085) and Egger's test (p =0.231). Subgroup analysis of the studies showed a higher risk of CVD in studies with a sample size of less than 10,000 participants, conducted in 2016 or later, utilizing a cross-sectional design, in Asian countries; the analysis had a moderate quality score, with a follow-up period of equal to or less than ten years.

Conclusion: There has been a significant association found between GSD and CVD and their incidence is related to each other. Taking proactive steps to implement targeted interventions for individuals with gallstone disease could potentially reduce the risk of cardiovascular disease within this population.

Background: Microbial imbalance is thought to play a role in the pathogenesis of Diverticular Disease (DD).

Objective: We aimed to assess the efficacy of a symbiotic mixture (Prolactis GG Plus®) in the treatment of moderate to severe DD, scored according to the Diverticular Inflammation and Complication Assessment (DICA) classification.

Methods: A retrospective study was conducted enrolling the following patients: at the first diagnosis of DD; in whom DD was diagnosed with colonoscopy and scored according to DICA classification; treated with Prolactis GG Plus® two times/daily for 2 consecutive months; in whom the severity of the abdominal pain was scored with a 10-points visual-analogue scale (VAS) at baseline and the end of follow-up; in whom fecal calprotectin (FC) was assessed at baseline and the end of follow-up as μg/g.

Results: Twenty-four patients were identified (10 males, 14 females; 16 as DICA 2, and 8 as DICA 3). Prolactis GG Plus® decreased the severity of abdominal pain both in DICA 2 (p =0.02) and DICA 3 patients (p =0.01), while FC decreased significantly in DICA 2 (p <0.02) but not in DICA 3 (p =0.123) patients. Acute diverticulitis occurred during the follow-up in two DICA 3 patients but none DICA 2 patients. Add-on therapy was required by eight DICA 2 (50%) and six DICA 3 patients (75%).

Conclusion: In newly diagnosed patients with DD, the symbiotic mixture Prolactis GG Plus® can be a potential treatment for moderate (DICA 2) DD as a single treatment.

Gout, an inflammatory arthritis form, is renowned for its historical association with affluence. This review delves into its pathophysiology, exploring hyperuricemia, urate crystal formation, and the ensuing inflammatory response. The epidemiology of gout is examined, focusing on its rising prevalence and impact on public health. In this study, progress in gout management is discussed, involving pharmacological interventions, dietary changes, and emerging therapies. Genetic predisposition and triggers like alcohol, temperature, and diet are highlighted in this study. Prevention strategies, including serum urate-lowering therapy and lifestyle modifications, aim to reduce recurrent flares and complications. The inflammatory response in acute gout attacks is elucidated, involving immune cells, cytokines, and the NLRP3 inflammasome. Chronic gout manifestations, such as gouty tophus formation, are explored for their destructive impact on surrounding tissues. Recent advancements in gout treatment, including nanotherapies and novel compounds, are discussed, along with promising urate-lowering drugs. Cutting-edge research on zinc ferrite nanoparticles, dimethyl fumarate, and myricetin/nobiletin hybrids addresses oxidative stress and inflammation in gout. Additionally, the potential therapeutic role of methanolic leaf extract of Euphorbia milii and tip-loaded CLC-Soluplus® MAPs is explored as natural and transdermal alternatives for gout management. The review also covers the development status of new urate-lowering drugs, providing insights into promising candidates and their mechanisms. Patents on gout and recent diagnostic advancements using techniques like laser confocal micro Raman spectrometer, FTIR, and THz-TDS offer a more accurate approach for gout stone analysis, enabling early detection and targeted treatment.

Alzheimer's disease (AD) is a multidimensional, complex condition that affects individuals all over the world. Despite decades of experimental and clinical research that has revealed various processes, many concerns concerning the origin of Alzheimer's disease remain unresolved. Despite the notion that there isn't a complete set of jigsaw pieces, the growing number of public data-sharing initiatives that collect biological, clinical, and lifestyle data from those suffering from Alzheimer's disease has resulted in virtually endless volumes of knowledge about the disorder, far beyond what humans can comprehend. Furthermore, combining Big Data from multi- -omics research gives a chance to investigate the pathophysiological processes underlying the whole biological spectrum of Alzheimer's disease. To improve knowledge on the subject of Alzheimer's disease, Artificial Intelligence (AI) offers a wide variety of approaches for evaluating complex and significant data. The introduction of next-generation sequencing and microarray technologies has resulted in significant growth in genetic data research. When it comes to assessing such complex projects, AI technology beats conventional statistical techniques of data processing. This review focuses on current research and potential challenges for AI in Alzheimer's disease research. This article, in particular, examines how AI may assist healthcare practitioners with patient stratification, estimating an individual's chance of AD conversion, and diagnosing AD using computer-aided diagnostic methodologies. Ultimately, scientists want to develop individualized, efficient medicines.

Different levels of residual drugs can be monitored within a relatively safe range without causing harm to human health if the appropriate dosing methodology is considered and the drug withdrawal period is controlled during poultry and livestock raising. Antimicrobials are factors that can suppress the growth of microorganisms, and antibiotic residues in livestock farming have been considered as a potential cause of antimicrobial resistance in animals and humans. Antimicrobial drug resistance is associated with the capability of a microorganism to survive the inhibitory effects of the antimicrobial components. Antibiotic residue presence in chicken is a human health concern due to its negative effects on consumer health. Neglected aspects related to the application of veterinary drugs may threaten the safety of both humans and animals, as well as their environment. The detection of chemical contaminants is essential to ensure food quality. The most important antibiotic families used in veterinary medicines are β-lactams (penicillins and cephalosporins), tetracyclines, chloramphenicols, macrolides, spectinomycin, lincosamide, sulphonamides, nitrofuranes, nitroimidazoles, trimethoprim, polymyxins, quinolones, and macrocyclics (glycopeptides, ansamycins, and aminoglycosides). Antibiotic residue presence is the main contributor to the development of antibiotic resistance, which is considered a chief concern for both human and animal health worldwide. The incorrect application and misuse of antibiotics carry the risk of the presence of residues in the edible tissues of the chicken, which can cause allergies and toxicity in hypersensitive consumers. The enforcement of the regulation of food safety depends on efficacious monitoring of antimicrobial residues in the foodstuff. In this review, we have explored the rapid detection of drug residues in broilers.

Background: It has been proposed that colchicine may have the potential to prevent cardiovascular and cerebrovascular dysfunctions.

Objective: This study evaluated the impact of colchicine on preventing recurrent stroke in patients with both ischemic stroke (IS) and atrial fibrillation (AF).

Methods: A randomized, double-blinded, placebo-controlled trial was conducted at Golestan Hospital (Ahvaz, Iran) over one year, involving IS patients with AF. Demographic and clinical data were collected from the participants, who were then assigned to either the intervention or placebo groups. The experimental group was administered colchicine at a dosage of 0.05 mg twice daily for one year, while the control group received a placebo at a comparable dosage over the same timeframe.

Results: In one year, 108 patients completed the study. There were 55 patients in the intervention group and 53 patients in the placebo group. During the second trimester of the trial, three patients in the colchicine group and 10 patients in the placebo group experienced recurrent strokes. Gastrointestinal issues were the most commonly reported complications (33 cases) among the two groups, followed by myalgia (8 patients). There were significant differences in the frequency of recurrent stroke and serum levels of C-reactive protein (CRP) between the colchicine and placebo groups (p < 0.05) after intervention.

Conclusion: In this study, colchicine was effective in reducing recurrent stroke and CRP levels in IS patients with AF compared to the control group. Further randomized controlled trials with larger sample sizes and extended durations are recommended to validate the results of this trial.