Background:Patients with hormone-positive breast cancer (BC) who are receiving antihormone medications suffer from complications, including hot flashes, decreased libido, and mood changes due to artificial menopause. Considering the positive effects of melatonin administration on ameliorating hot flashes and depression in postmenopausal women, we aimed to examine the effects of melatonin supplementation on menopausal-related complications in BC patients who were receiving antihormone medications.Materials and Methods:This study was a randomized, placebo-controlled clinical trial conducted in the hematology-oncology clinic of Omid hospital, Isfahan, Iran, during 1-year patients’ recruitment. Adult patients with BC who were being treated with selective estrogen receptor modulator family drugs or aromatase inhibitors while they were complaining of menopausal complications were included. Melatonin (3 mg) or an identical placebo was administered twice a day orally. Several questionnaires, including the Menopause Rating Scale, the Menopause-specific Quality of Life-Intervention and the Female Sexual Function Index, were applied for the evaluation of comparison items.Results:Sixty patients fulfilled the requirements to complete the four-week treatment. There were no significant differences in patients’ baseline clinical characteristics. Supplementation by melatonin was associated with a significant decrease in frequency and severity of hot flashes, and the mean score of menopausal symptoms. The quality of life and sexual function were enhanced by a four-week melatonin treatment.Conclusion:Considering the effect of melatonin on menopausal complications and quality of life during menopause and sexual function scores in people undergoing BC antihormone treatment, melatonin can be considered a potential candidate to include in the treatment regimen of BC patients.

Background:Despite the improved outcomes in acute lymphoblastic leukemia (ALL), drug resistance remains a major challenge. This study provides the first overview of global research trends in pediatric ALL drug resistance, highlighting emerging directions.Materials and Methods:In this bibliometric study, related keywords such as acute lymphoblastic leukemia, pediatric, and drug resistance were searched in the Web of Science (WOS) Core Collection. The retrieved papers were subjected to bibliometric analysis and visualization using Biblioshiny and VOSviewer.Results:A total of 432 original papers and 94 review articles by 2546 researchers from 48 countries were analyzed. The United States contributed 148 articles, which received 9569 citations. Bradford’s law identified nine core sources, with Blood being the most impactful (41 papers and 4900 total citations). “Oncology” was the top WOS category. Pieters was the most influential author, contributing 87 publications in the field. The most frequent keywords highlighted the biological contributors to drug resistance, including altered glucocorticoid response, overexpression of drug-efflux proteins (particularly P-gp), and the critical role of miRNAs and other genetic mediators in leukemic cell drug resistance. Based on the thematic map, the keywords of the motor themes were clofarabine, nelarabine, daunorubicin, vincristine, and microRNA, illustrating the need for further investigation of their clinical applications and the underlying mechanisms of resistance to these agents.Conclusion:Medical researchers have been attracted to different aspects of drug resistance in pediatric ALL. This bibliometric analysis reflects the current state of research on drug resistance in pediatric ALL and draws attention to critical concerns that require further investigation.

Mutations in the SQSTM1 gene have recently been identified as rare causes of progressive childhood neurodegenerative diseases. To date, only 27 cases have been reported, with 11 different mutations affecting SQSTM1. Here, we describe two new cases of progressive childhood-onset cerebellar ataxia with gaze palsy, in whom clinical exome sequencing identified a novel pathogenic variant. The first patient was a 12-year-old boy of Iraqi and Iranian descent, who presented with a 3-year history of recurrent falls, swaying while walking, and difficulties with writing and speech. Physical examination revealed frozen eye movements, gait ataxia, and dysarthria. The second patient was a 9-year-old Iranian boy, who developed involuntary movements, gait instability, and tremor at the age of 8 years. On examination, cerebellar ataxia and dysarthria were observed. In both cases, initial workup was unremarkable, but whole-exome sequencing revealed a novel homozygous pathogenic truncating mutation, SQSTM1 (c.838G>T, p. Glu280Ter). During 2 years of follow-up, the second patient developed gaze palsy. This report highlights the importance of considering SQSTM1 mutations in the differential diagnosis of patients presenting with both cerebellar ataxia and ophthalmological manifestations.

Background:Cataracts are a leading cause of visual impairment worldwide, necessitating effective non-surgical preventative strategies. This study is the first to evaluate the morphological and histopathological effects of Zataria multiflora Boiss essential oil (ZE) on selenite-induced cataracts in rats.Materials and Methods:Seventy-two male Sprague–Dawley rat pups were randomly assigned to six groups: control (C), vehicle control (VC), ZE control (ZC), selenite (S), selenite plus vehicle (SV), and selenite plus ZE (SE). Cataracts were induced by a single subcutaneous injection of sodium selenite (30 μmol/kg) on postnatal day 8. ZE (500 μL/kg, diluted 1:1 with olive oil) was administered orally twice weekly for 5 weeks. Cataract severity was graded weekly by using Hiraoka’s scale (0–6) by a blinded ophthalmologist. Histopathological changes were qualitatively assessed via hematoxylin and eosin staining. Statistical analysis employed the Kruskal–Wallis test with Dunn’s post-hoc test.Results:No cataracts developed in the control groups (mean grade: 0). The S and SV groups developed severe cataracts (mean grade: 5.14 ± 0.64). ZE treatment significantly reduced cataract severity in the SE group (mean grade: 2.07 ± 0.59; P < 0.05 vs. S and SV). Histopathology showed that ZE preserved lens architecture and markedly reduced degenerative changes compared with S and SV.Conclusion:This study provides the first morphological and histological evidence that ZE can prevent or delay cataract formation by preserving lens structure and function in a selenite-induced rat model. ZE demonstrates promising potential as a natural therapeutic agent for cataract prevention.

Background:Laparoscopic cholecystectomy is the standard surgical procedure in symptomatic gallstones. Laparoscopy is a minimally invasive surgical method. The aim of the present study was to investigate the effect of dexamethasone (DX) administration on postoperative pain management following laparoscopic cholecystectomy.Materials and Methods:165 patients with laparoscopic cholecystectomy surgery were studied in this double-blind clinical trial. They were randomly divided into three groups: A) DX1 (Intravenous DX): Injection of 0.1 mg/kg DX intravenously, B) DX2 (Local DX): Injection of 0.1 mg/kg of DX, diluted with normal saline, injection volume of 10 mL, injection into the bed of the removed gallbladder through a laparoscopic 10 mm subxiphoid trocar, and C) Control: Injection of placebo, the volume and injection site are similar to group B. The amount of postoperative pain in patients was recorded using the Visual Analogue Scale score in 5 times (15 minutes, 30 minutes, 1 hour, 6 hours, and 12 hours after entering the recovery room).Results:In terms of postoperative pain, there was a statistically significant difference between the studied groups so that the amount of postoperative pain 6 hours and 12 hours after surgery in the intravenous DX group was lower than that in the local DX and placebo groups (P = 0.001).Conclusions:The results of this study showed that the administration of intravenous DX has a better effect than the administration of local DX in pain management after laparoscopic cholecystectomy.

Background:High-throughput data generation is developing in the cancer area and offers a better opportunity of understanding molecular pathways involved in the progression of tumors. Meta-analysis of gene expression based on data integration makes it possible to determine changes in gene expression with more accuracy. This approach and downstream analysis were utilized for colorectal cancer to identify promising biomarkers and drug targets.Materials and Methods:First, a systematic search was performed in the Gene Expression Omnibus (GEO) database. Meta-analysis was used to obtain differentially expressed (DE) genes from the NetworkAnalyst database. Moreover, microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and transcription factors (TFs) enriched with DE genes were determined by the Enrichr database. The integrated DE genes-miRNAs-lncRNAs-TFs network was constructed and analyzed using Cytoscape software. Then, the downstream analyses of hub genes were performed.Results:The primary candidate genes, HNF4A, FLI1, MITF, E2F4, SPI1, FOXA2, VDR, and SMAD3, which are overlapped nodes with the highest degree, betweenness, and closeness centrality parameters in the top 30 nodes were selected. Also, the hsa-miR-26b-5p, hsa-miR-16-5p, hsa-miR-124-3p, and hsa-miR-92a-3p were introduced as key non-coding RNAs with the highest degree and betweenness centralities. For the determination of the clinical significance of hub genes, the mutation, differential expression, and survival analysis were assayed. Also, the drugs related to candidate hub genes were determined. The functional analysis revealed pathways significantly related to cancer progression.Conclusion:Employing systems biology approaches with holistic insight can identify essential genes and their regulation as possibilities for further experimental testing.

Tracheal stenosis may follow a period of tracheal intubation. Postintubation tracheal stenosis is caused by either cuff-induced ischemic damage, injury after formation of a tracheostomy, or a combination of the two. Management may require tracheal dilation via rigid bronchoscopy. This can either be performed under general anesthesia using neuromuscular blocking drugs or under deep sedation using regional blocks. We describe a case of tracheal stenosis in a patient who had sustained extensive burns 4 months previously. Because of resource limitations in our healthcare setting, we successfully dilated her tracheal stenosis under deep sedation and translaryngeal anesthesia, avoiding general anesthesia and neuromuscular blocking agents.

Background:Imaging continues to have a crucial role in evaluating patients with shoulder pain, helping to make treatment choices. Magnetic resonance arthrography (MRA), rather than magnetic resonance imaging (MRI), is now routinely used to diagnose shoulder injuries. Against the gold standard investigation of arthroscopy, the study aimed to determine the accuracy of MRA in the evaluation of shoulder injuries.Materials and Methods:From June 2017 to May 2019, a cross-sectional study was conducted in a tertiary care health setup in North India. A total of 50 individuals were enrolled for diagnostic imaging with rotator cuff (RC) pathology. Patients were assessed using an MRA and their clinical history. In comparison with the gold standard for arthroscopy, the sensitivity (Sn), positive predictive value (PPV), and diagnostic accuracy (DA) of MRA for diagnosing shoulder injuries were evaluated. A P value under 0.05 was taken to be statistically significant.Results:The mean ± standard deviation (SD) age of the patients was 37.32 ± 12.78 years. There were seven women and 43 (86%) men. The different lesions were superior labral anterior–posterior (SLAP) tear (24 (48%)), Bankart lesions (19 (38%)), anterior labral periosteal sleeve avulsion (ALSPA) (4 (8%)), partial articular supraspinatus tendon avulsion (PASTA) lesion (2 (4%)), and Buford lesions (1 (2%)). The Sn, PPV, and DA of MRA were 98%, 100%, and 98%, respectively, for identifying the shoulder injury.Conclusion:It was concluded that MRA was reasonably accurate at diagnosing shoulder injuries. MRA demonstrated an excellent 98% Sn in identifying shoulder injuries and missed only one case of shoulder injury, suggesting that it can be an advantageous imaging tool for recognizing and evaluating shoulder injuries for immediate diagnosis and management.

Background:Terrible triad of elbow injury (TTI) has great potential for joint instability with a relatively poor prognosis. Different surgical methods have been introduced for radial head fractures. In this study, we aimed to evaluate the results of treatment of radial head fractures with open reduction and internal fixation (ORIF) and resection in TTI patients when radius head replacement was not attainable.Materials and Methods:In this retrospective study, 48 patients with TTI who underwent radial head fracture surgery with ORIF (n = 33) or resection (n = 15) were included. During follow-up, patients were evaluated for elbow range of motion (ROM), pain score, complications, need for reoperation, and Mayo Elbow Performance Score (MEPS). ORIF and resection groups were followed for 49.47 ± 28.58 and 52.79 ± 23.57 months, respectively.Results:Compared to the resection group, the ORIF group had significantly better ROM in extension and pronation and lower supination, although, when compared with a subgroup of mason type III fractures, the resection group had substantially better ROM in extension, pronation, and supination and better MEPS. The resection group had lower rates of pain score, instability, arthritis, heterotopic ossification, and need for reoperation compared to ORIF and its subgroup; however, the difference was not significant.Conclusion:Compared to resection of radial head fractures in TTI, ORIF had significantly better ROM overall, but resection efficacy was better than ORIF when comparing the Mason type III fractures.

The anticancer action of biogenic Ag-Cu nanoparticles (NPs) using Eryngium billardieri against PC-3 and LNCaP cell lines in prostate malignancy was investigated. XRD, FTIR, EDAX, FESEM, and TEM were used to illustrate the Ag-Cu NPs. The PC-3 and LNCaP cell lines were used to test the anticancer ability of Ag-Cu NPs. The cytotoxicity was assessed by MMT and flow cytometry. Apoptotic and metastatic-promoting gene expressions were evaluated by real-time PCR. ROS generation was measured. NPs are spherical and their average size was 12 ± 9.7 nanometers. The EDAX result indicated the presence of Ag, Cu, and C. The XRD results revealed the NPs' crystalline structure. The results demonstrated a remarkable antiproliferative effect of the nanoparticles, with IC50 values of 15.43 μg/mL for PC-3 and 7.64 μg/mL for LNCaP. The Ag-Cu NPs exhibited a tendency to trigger apoptosis. This was confirmed by analyzing apoptosis-related gene expression. The apoptotic influence of Ag-Cu NPs was suggested to be critical when compared to the control and extract-treated groups by the up-regulation of Bcl2-related X (Bax), caspase3, and caspase9, and the down-regulation of Bcl2. Furthermore, Annexin V-FITC/propidium iodide presented a 23.15% and 22.3% apoptotic ratio of PC-3 and LNCaP cells, respectively. Vascular endothelial growth factor (VEGF), and metalloproteinases (MMPs) down-regulation showed that Ag-Cu NPs were hostile to metastasis. Also, ROS generation was estimated at 1261 and 1366 RFU in LNCaP and PC-3 cells treated with green-synthesized Ag-Cu NPs, respectively. The study suggested E. billardieri synthesized Ag-Cu as a potential candidate in prostate cancer therapeutic management.