Case report
Mehrnaz Nazarirad; Nasrin Moazzen; Mojtaba Lotfi
Abstract
Mucopolysaccharidosis is a group of progressive metabolic disease (lysosomal storage) characterized by the deposition of glycosaminoglycans in the body, affecting various organs including the skeletal system, (dysostosis multiplex), viscera (hepatomegaly and splenomegaly), neurological complications, ...
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Mucopolysaccharidosis is a group of progressive metabolic disease (lysosomal storage) characterized by the deposition of glycosaminoglycans in the body, affecting various organs including the skeletal system, (dysostosis multiplex), viscera (hepatomegaly and splenomegaly), neurological complications, eyes (corneal opacity and optic atrophy), and cardiac (thickening and valvular heart disease). The disease can be classified into different types based on the specific enzymatic deficiency. In some types of this disease, treatment is administered weekly through enzyme replacement therapy. Due to the potential for severe reactions and even anaphylaxis during infusion, these medications are prescribed under medical supervision. This article presents a report of an 8-year-old girl diagnosed with Mucopolysaccharidosis type 1 was treated weekly with 2 vials of the enzyme Aldurazyme involving drug allergy to this medication along with a desensitization protocol. The protocol includes more premedication with prednisolone and the use of lower dilutions of the drug, lower infusion rate and gradually increasing the concentration and speed of the drug in addition to the routine administration of the enzyme.
Original article
Mojtaba Yousefi Zoshk; Melika Zamanian; Melika Farshidianfar; Alireza Masoumi; Mohammad Mobin Mirimoghaddam; Elahe Bakhshi; Anoush Azarfar
Abstract
The coronavirus disease 2019 (COVID-19) has affected individuals across all age groups, with a notably high rate of morbidity and mortality. Although most children with COVID-19 exhibit mild symptoms, an increasing proportion are developing a novel multisystem inflammatory syndrome (MIS-C), which shares ...
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The coronavirus disease 2019 (COVID-19) has affected individuals across all age groups, with a notably high rate of morbidity and mortality. Although most children with COVID-19 exhibit mild symptoms, an increasing proportion are developing a novel multisystem inflammatory syndrome (MIS-C), which shares clinical features with Kawasaki disease. MIS-C is a newly recognized hyperinflammatory condition affecting virtually any organ system. The most common symptoms include fever and gastrointestinal disturbances, although neurologic and dermatologic manifestations are well-documented. The clinical presentation of MIS-C overlaps with that of Kawasaki disease, toxic shock syndrome, and other shock syndromes, making accurate diagnosis challenging. Elevated inflammatory markers are frequently observed in MIS-C patients, and abnormalities on echocardiograms or electrocardiograms may be present. Treatment for MIS-C should consider intravenous immunoglobulin, anticoagulation, and corticosteroids. Despite significant cardiovascular involvement in some cases, most patients recover without complications. However, long-term echocardiographic follow-up is essential, as coronary aneurysms have been documented. This narrative review examines the epidemiology, pathophysiology, clinical manifestations, laboratory findings, diagnostic criteria, and treatment strategies for MIS-C to enhance pediatricians' understanding of this emerging syndrome.
Original article
Ali Shamsa
Abstract
Introduction: Magnetic resonance spectroscopy (MRS) is an imaging technique that provides spectroscopic information on the changes in biological markers. Studies suggest that MRS can be valuable in the prognosis of patients with diffuse axonal injury (DAI).Methods: PubMed and Scopus, two major databases, ...
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Introduction: Magnetic resonance spectroscopy (MRS) is an imaging technique that provides spectroscopic information on the changes in biological markers. Studies suggest that MRS can be valuable in the prognosis of patients with diffuse axonal injury (DAI).Methods: PubMed and Scopus, two major databases, were systematically searched in June 2015 using the following search strategy: ((((Magnetic resonance spectroscopy OR MRS OR MR spectroscopy)) AND (Diffuse axonal injury OR DAI)) AND Prognosis). Relevant articles were selected, and the prognostic value of MRS in patients with traumatic DAI was investigated. All necessary information was extracted for data synthesis based on the primary objective of this study.Results: Out of 19 articles found in PubMed and 151 in Scopus, eight documents were selected for data extraction following inclusion/exclusion criteria. The total number of patients included in the selected studies was 197. All selected articles demonstrated that MRS can be used to quantitatively analyze metabolite changes in patients with DAI.Conclusion: Based on the results of the included studies, MRS is a sensitive tool that can help predict the prognosis of patients with DAI.
Meta- analysis
Nahid Maleki; Elahe Akbari; Hamid Heidarian; Sanam Borji
Abstract
Background:Premenstrual disorder (PMS) is perhaps the most widely recognized issues among women of reproductive age. The utilization of natural therapies or complementary medicine has grown in recent years, especially among women. PurposeThis study aimed to determine the efficacy of saffron on the treatment ...
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Background:Premenstrual disorder (PMS) is perhaps the most widely recognized issues among women of reproductive age. The utilization of natural therapies or complementary medicine has grown in recent years, especially among women. PurposeThis study aimed to determine the efficacy of saffron on the treatment of PMS. MethodElectronic searching of Medline, PubMed, Scopus, Cochrane, Embase, Web of science, SID and Google Scholar was performed up to Jan 2024. Inclusion criteria consist of both English and Persian, published, clinical trials using saffron as medical for treatment of PMS. In the long run Five CTs met the inclusion criteria. The quality of these trials was evaluated by two researchers who carried out the data extraction, using Oxford Center for Evidence Based Medicine checklist. A total of three RCTs were ultimately included in a meta-analysis. Statistical analysis were performed by Comprehensive Meta-analysis (CMA) Version 2.ResultsQualitative analysis revealed that 8-12 week of treatment with saffron could be effective in reducing the symptoms and severity of PMS and it might cause fewer side effects than chemical medicines. Three studies were included in the quantitative analysis, which resulted in a mean difference of 0.63 with 95% confidence interval (CI) (1.18-0.07), implying that the effects of saffron on PMS were statistically significant (p=0.03).ConclusionAlthough saffron has a positive effect on PMS but interpretation of results is limited because of methodological flaws of the included studies so further trials are still needed to confirm the current findings.
Original article
Nazanin-Zeinab Hajmolarezaee; Mohammadhossein Taherynejad; Hassan Mehrad-Majd; Ali Moradi; Yalda Ravanshad; Amirreza Rostami; Salman Farsi; Sara Movahed; Sahar Ravanshad
Abstract
BackgroundLow back pain is a common reason for disability in patients younger than 45 years old who visit physicians. Although there are many attitudes toward treating back pain, there is no commonly accepted approach. This study compared various attitudes toward the examination, diagnosis, and treatment ...
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BackgroundLow back pain is a common reason for disability in patients younger than 45 years old who visit physicians. Although there are many attitudes toward treating back pain, there is no commonly accepted approach. This study compared various attitudes toward the examination, diagnosis, and treatment of chronic low back pain among neurologists, neurosurgeons, and orthopedic surgeons. MethodsIn this cross-sectional study, a checklist including four main aspects of history taking, clinical and para-clinical tests, and treatment of chronic low back pain was designed to be completed by 45 specialists (orthopedic surgeons, neurosurgeons, and neurologists). Results Straight Leg Raising (SLR) was the most frequent test during the examination process. The high priorities among the para-clinics were MRI, lumbosacral graph, EMG-NCV, serology lab test, and CT scan, respectively. A significant difference was found in requesting lumbosacral graph among specialties. Moreover, the priorities for nonsurgical treatment were NSAIDs, nonpharmaceutical treatment, muscle relaxants, gabapentin, and corticosteroids, respectively. ConclusionHistory taking, physical examination, diagnostic approaches, and treatments were significantly different among the different specialties. The results revealed the need for consensus on common and well-established guidelines for a clinical approach to chronic low back pain.
Original article
Sepideh Fattahi; Solmaz Hasani; Masood Mohebi; Negar Morovvat-Dar; Farid Qoorchi; Moheb Seraj; Ghazale Taghavi
Abstract
Parathyroidectomy for patients with primary hyperparathyroidism (PHPT) has been found to improve bone mineral densitometry (BMD). In this prospective cohort study on the patients with PHPT referred to the Endocrine Clinic of our tertiary center between 2017 and 2018 and divided into two groups of a surgery ...
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Parathyroidectomy for patients with primary hyperparathyroidism (PHPT) has been found to improve bone mineral densitometry (BMD). In this prospective cohort study on the patients with PHPT referred to the Endocrine Clinic of our tertiary center between 2017 and 2018 and divided into two groups of a surgery group (SG) and a non-surgery group (NSG). The BMD, the serum levels of calcium, phosphorus, creatinine, 25(OH) D, albumin, and Parathyroid hormone changes were analyzed at baseline and two years of follow-up. 30 patients were included in the study; 20 patients in SG and 10 patients in the NSG In the SG, the levels of 25(OH) D and phosphorus increased significantly after 2 years (p<0.001). The amount of calcium and PTH also decreased (p<0.001). Moreover, the changes in the parameters after two years in the NSG were not statistically significant. In the SG, the T-score and Z-score significantly increased compared to pre-operative values in the area of lumbar vertebrae (p<0.01)). In the distal region of the radius, the T-score increased significantly (p<0.05) and the Z-score increase was at the border of significance (p=0.048). The parameters had a non-significant increase in the femoral neck. Our study demonstrated that parathyroidectomy for patients with primary hyperparathyroidism enhances the BMD of the lumbar vertebrae and the distal radius and a clear improvement and the biochemical parameters reached the normal level.
Review
Seyed Mohammad Javadzadeh; Mehdi Barati; Amirali Ghahremani; Hasan Namdar Ahmadabad
Abstract
Dendritic cells (DCs) are pivotal in the field of cancer immunotherapy due to their unique ability to initiate and modulate robust immune responses. Therefore, they represent a promising strategy for cancer vaccine development. Nonetheless, the efficacy of DC vaccines is hampered by the immunosuppressive ...
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Dendritic cells (DCs) are pivotal in the field of cancer immunotherapy due to their unique ability to initiate and modulate robust immune responses. Therefore, they represent a promising strategy for cancer vaccine development. Nonetheless, the efficacy of DC vaccines is hampered by the immunosuppressive microenvironment that is frequently present in tumors, which poses significant challenges to their effectiveness. Recent research has focused on two primary approaches to enhance DC vaccine outcomes. The first strategy involves the synergistic use of DC vaccines along with immune checkpoint inhibitors, traditional chemotherapy, or monospecific/bispecific antibodies to bolster immune activation. The second strategy emphasizes the identification and selection of tumor antigens that are not only specific and immunogenic but also manifest safety and stability characteristics. Among these, personalized neoantigens, specific antigens that arise from the tumor microenvironment, have garnered particular attention in clinical trials and have emerged as ideal candidates for DC vaccine targeting. This literature review comprehensively discusses these challenges and strategically explores the pathways to develop effective and safe neoantigen-based DC vaccines for cancer immunotherapy.
Original article
Roohallah Yousefi
Abstract
The flowering plant Ammi visnaga from the Apiaceae family is rich in secondary metabolites with established traditional benefits and promising therapeutic applications. Notable compounds include γ-pyrones (e.g., khellin and visnagin), coumarins, flavonols, isoflavones, and essential oils. These ...
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The flowering plant Ammi visnaga from the Apiaceae family is rich in secondary metabolites with established traditional benefits and promising therapeutic applications. Notable compounds include γ-pyrones (e.g., khellin and visnagin), coumarins, flavonols, isoflavones, and essential oils. These metabolites exhibit diverse pharmacological effects such as anti-inflammatory, antitumor, antimicrobial, antiviral, anti-diabetic, anticoagulant, antioxidant, and neuroprotective activities. γ-Pyrones are particularly prominent in A. visnaga and have been linked to treatments for respiratory and cardiovascular conditions. Flavonols like quercetin, kaempferol, and rhamnetin contribute to its antioxidant and anti-inflammatory profile, while isoflavones like genistein and daidzein possess phytoestrogenic properties, potentially reducing cancer risk and alleviating menopausal symptoms. The essential oils of A. visnaga are enriched with bioactive components like linalool and thymol, which provide aromatherapeutic benefits and antimicrobial properties. The study's comprehensive analysis of the physicochemical properties, pharmacokinetics, and pharmacological effects of these metabolites using databases like PubChem and SwissADME highlights their potential for pharmaceutical and cosmeceutical applications. It is an in silico study. The high bioavailability of certain compounds suggests their suitability for oral formulations, and their potential to cross the blood-brain barrier may offer neuropharmacological opportunities. However, the presence of Pgp substrates and CYP inhibitors requires careful consideration to avoid drug interactions. The essential oils' antifungal and antibacterial properties indicate natural alternatives to synthetic treatments. The findings emphasize the importance of further research into the formulation of A. visnaga-derived natural medicines and the development of sustainable, economically viable synthesis methods.