Polyvinyl alcohol/citric acid/ß-cyclodextrin/CuONP composite nanofibers as an effective and green absorbent for the simultaneous extraction of three antidepressant drugs in biological fluids prior to GC-FID analysis.

Composite nanofibers, namely, polyvinyl alcohol (PVA), citric acid (CA), ß-cyclodextrin (ß-CD), and copper oxide nanoparticles (PVA/CA/ß-cyclodextrin/CuO NPs), were developed as a novel, green, and efficient adsorbent in the pipette tip-micro-solid-phase extraction method (PT-µSPE), for the simultaneous extraction of three antidepressants drugs namely imipramine (IMP), citalopram (CIT), and clozapine (CLZ) in biological fluids before quantification by gas chromatography (GC-FID). Based on the obtained results from field emission scanning electron microscopy (FE-SEM), energy-dispersive X-ray spectroscopy (EDX), Fourier transform infrared spectroscopy (FT-IR), and X-ray diffraction (XRD), the successful synthesis of composite nanofibers was approved. Due to the presence of ß-cyclodextrins and CuO NPs rich of functional groups on their surface, the nanofibers have high extraction efficiency. Under the optimal conditions, the linear range for imipramine, citalopram, and clozapine was 0.1 to 1000.0 ng mL-1 with a determination coefficient ≥ 0.99. The limits of detection (LODs) were in the range 0.03 to 0.15 ng mL-1. The relative standard deviation was 4.8 to 8.7% (within-day, n = 4) and 5.1 to 9.2% (between-day, n = 3) for 3 consecutive days. In addition, excellent clean-up was achieved which is a great advantage over other sample preparation methods. Finally, the ability of the developed method to extract the target analytes from the biological samples was evaluated.

Dropout of infertility treatments and related factors among infertile couples.

BACKGROUND: Dropout of infertility treatments is a global issue and many factors play role in this phenomenon. It is one of the most challenges in life of infertile couples. The purpose of this study was to determine dropout rate and related factors/reasons in the world and in Iran. METHODS: We will conduct a mixed method study with sequential exploratory design (systematic review, qualitative and quantitative phase). In the first stage a systematic review on dropout rate of infertility treatments and related factors will be done. In second stage (quantitative-qualitative study), a retrospective cohort study will be conducted on infertile couples to determine dropout rate of infertility treatments. The follow-up period to assess the discontinuation of treatment in patients, who have discontinued the treatment, will be considered 6 months after the treatment cessation. Data would be analyzed by descriptive statistics. We want to determine proportion and percentage of discontinuation rate among different groups with different causes of infertility. Then, we also will use Chi-square test to compare discontinuation rates among these groups. In qualitative section of second stage, semi-structured interviews would be performed with infertile female who had the history of infertility treatments failure. In this stage, participants will be selected using purposeful sampling method with maximum variation in terms of age, education, occupation, type of infertility, type of treatments, number of unsuccessful treatment and infertility duration. Data would be analyzed using conventional content analysis. DISCUSSION: Determining dropout rate and its related factors/reasons would be helpful for future studies to plan suitable interventions for supporting infertile couples. It also helps politicians to have a better understanding of infertility and its consequences on infertile couple's life. In today's world, infertility is a common phenomenon due to postponement of childbearing following the older age of marriage, tendency to reach higher educational level, economical problems and etc. Infertility brings many challenges and stresses to the individuals by itself and it is very hard to cope with. The problem gets worse, when it is associated with failure in treatments. Many of infertile couples cannot tolerate this failure and may decide to discontinue treatments before achieving pregnancy for ending many stressors which are associated with treatments. As we know, childbearing and having at least one child has important position in some societies such as Iranian culture; so ending the treatment before achieving optimal result may have some adverse consequences in the families such as divorce, remarriage, family conflicts, et. Absolutely many factors play role in dropout of infertility treatments, and many studies around the world have suggested many factors/reasons in dropout of infertility treatments, but there are still many gaps about this subject, especially among Iranian society. This study would be conducted in three consecutive stages, in the first stage; we will do a complete review of existing studies of the world to find out related factors/reasons of dropout in detail. In second stage, dropout rate of infertile couples (380 couples) after at least one unsuccessful cycle of treatment would be achieved by assessing medical records and telephone interview. Data of the first and second stage will help us to have better vision about the issue of dropout and would be used to construct a semi structured interview for the last stage. And finally in the third stage, reasons of dropout would be asked by an in depth interview from infertile couples. We hope the information from this study will help politicians better understand and plan for dropout of treatment.

Adipose-derived stem cells-conditioned medium improved osteogenic differentiation of induced pluripotent stem cells when grown on polycaprolactone nanofibers.

Considering that the common osteogenic growth factors cannot be transplanted with stem cells to the patients, many studies are underway to find a replacement for these factors. Recently, it has been determined that mesenchymal stem cell (MSC)-derived conditioned medium (CM) contains effective factors in the bone formation process. In the current study, the synergistic effect of adipose-derived MSC's CM, and polycaprolactone (PCL) scaffold was investigated on the osteogenic differentiation potential of human induced pluripotent stem cells (iPSCs). After scaffold fabrication by electrospinning and characterization by scanning electron microscopy, iPSCs proliferation in the presence of CM, PCL, and both was evaluated using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide. Then, iPSCs osteogenic differentiation was investigated while cultured on tissue culture plate and PCL under CM compared with the osteogenic medium using alizarin red staining, calcium content, alkaline phosphatase activity and gene and protein expression analysis. Proliferation rate of the iPSCs was increased while cultured under CM and its effect was synergistically enhanced by culture on PCL. Evaluation of the osteogenic markers was showed CM alone could induce osteogenic differentiation into the iPSCs and this potential was significantly increased while combined with PCL nanofibrous scaffold. According to the results, it was demonstrated that CM has an osteogenic induction property almost the same of the common osteogenic medium and it can also be used potentially with stem cells when transplant to the patients. CM can also help by prolonging cell survival at the site of the defect as well as accelerating healing process.

Efficient osteogenic differentiation of the dental pulp stem cells on ß-glycerophosphate loaded polycaprolactone/polyethylene oxide blend nanofibers.

Hard tissue lesion treatment in oral and maxillofacial has been challenging because of tissue complexities. This study aimed to investigate novel biopolymeric construct effects on the osteogenic differentiation potential of the dental pulp stem cells (DPSCs) for introducing a cell copolymer bioimplant. A blended polycaprolactone (PCL)-polyethylene oxide (PEO) was fabricated using electrospinning, simultaneously filled by ß-glycerophosphate (ß-GP). After that biocompatibility and release kinetics of the PCL-PEO+ß-GP was evaluated and compared with PCL-PEO and then the osteogenic differentiation potential of the DPSCs was examined while being cultured on the scaffolds and compared with those cultured on the culture plate. The results demonstrated that scaffolds have not any cytotoxicity and ß-GP can release in a long-term manner. Alkaline phosphatase activity and calcium content were significantly increased in DPSCs while being cultured on the PCL-PEO+ß-GP compared with the other groups. Runt-related transcription factor 2, collagen type-I, osteonectin, and osteocalcin (OSC) genes expression was upregulated in DPSCs cultured on the PCL-PEO+ß-GP and was significantly higher than those cultured on the PCL-PEO. Immunocytochemistry result also confirmed the positive effects of PCL-PEO+ß-GP on the osteogenic differentiation of the DPSCs by presenting a higher OSC protein expression. According to the results, incorporation of the ß-GP in PCL-PEO makes a better construct for osteogenic induction into the stem cells and it could be also considered as a great promising candidate for bone, oral, and maxillofacial tissue engineering applications.

Poly (3-hydroxybutyrate-co-3-hydroxyvalerate) improved osteogenic differentiation of the human induced pluripotent stem cells while considered as an artificial extracellular matrix.

Cocell polymers can be the best implants for replacing bone defects in patients. The pluripotent stem cells produced from the patient and the nanofibrous polymeric scaffold that can be completely degraded in the body and its produced monomers could be also usable are the best options for this implant. In this study, electrospun poly (3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) nanofibers were fabricated and characterized and then osteogenic differentiation of the human-induced pluripotent stem cells (iPSCs) was investigated while cultured on PHBV scaffold. MTT results showed that cultured iPSCs on PHBV proliferation were increased compared to those cultured on tissue culture polystyrene (TCPS) as the control. Alkaline phosphatase (ALP) activity and calcium content were also significantly increased in iPSCs cultured on PHBV compared to the cultured on TCPS under osteogenic medium. Gene expression evaluation demonstrated that Runx2, collagen type I, ALP, osteonectin, and osteocalcin were upregulated in iPSCs cultured on PHBV scaffold in comparison with those cultured on TCPS for 2 weeks. Western blot analysis have shown that osteocalcin and osteopontin expression as two major osteogenic markers were increased in iPSCs cultured on PHBV scaffold. According to the results, nanofiber-based PHBV has a promising potential to increase osteogenic differentiation of the stem cells and iPSCs-PHBV as a cell-co-polymer construct demonstrated that has a great efficiency for use as a bone tissue engineered bioimplant.

Promoting osteogenic differentiation of human-induced pluripotent stem cells by releasing Wnt/ß-catenin signaling activator from the nanofibers.

Implants that can enhance the stem cells differentiation in the absence of the chemical osteogenic growth factors will attract the great interest of orthopedic scientists. Inorganic polyphosphate (poly-P), as a ubiquitous biological polymer, is one of the factors that can be an alternative for osteogenic growth factors via activating Wnt/ß-catenin signaling. In this study, poly-P was incorporated at the blend of polycaprolactone (PCL)/poly (l-lactic acid) (PLLA) electrospun nanofibers and then osteogenic differentiation potential of human-induced pluripotent stem cells (iPSCs) was investigated by the important bone markers. 3-[4, 5-dimethylthiazol-2-yl]-2, 5 diphenyl tetrazolium bromide (MTT) and scanning electron microscopy results confirmed the biocompatibility of the fabricated nanofibers, while higher proliferation rate of iPSCs was detected in PCL-PLLA(poly-P) group compared with the PCL-PLLA and tissue culture plate groups. Alkaline phosphatase activity, calcium content, and gene expression results demonstrated that osteogenic differentiation of iPSCs was increased when cultured on PCL-PLLA(poly-P) in comparison with other groups. According to the results, PCL-PLLA(poly-P) could be considered as a promising candidate for use as bone implants.

Improved chondrogenic response of mesenchymal stem cells to a polyethersulfone/polyaniline blended nanofibrous scaffold.

Owing to the fact that the cartilage tissue is not able to repair itself, the treatment of the joint damages is very difficult by current methods. Induction of tissue repair requires suitable cell and extracellular matrix. Providing these two parts can only be done using tissue engineering. In the present study, polyethersulfone (PES) and polyaniline (PANI) blend was electrospined for nanofibrous scaffold fabrication. Mesenchymal stem cells were isolated from human adipose tissue (AT-MSCs), and after characterization cultured on the PES-PANI scaffold and culture plate. Electron microscopic and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) colorimetric assays were used for biocompatibility evaluation of the scaffold and the chondrogenic differentiation potential of AT-MSCs were investigated by staining of proteoglycans and gene and protein expression evaluation. Alcian blue staining, real-time reverse-transcriptase polymerase chain reaction and Western blot results showed that chondrogenic differentiation potential of AT-MSCs was significantly increased when grown on PES-PANI nanofibers and was compared to the one grown on a culture plate. According to the results, PES-PANI has a promising potential to be used as a biomedical implant in patients with joints lesion, such as arthritis and osteoarthritis.

Decellularized Wharton's jelly extracellular matrix as a promising scaffold for promoting hepatic differentiation of human induced pluripotent stem cells.

Liver tissue engineering as a therapeutic option for restoring of damaged liver function has a special focus on using native decellularized liver matrix, but there are limitations such as the shortage of liver donor. Therefore, an appropriate alternative scaffold is needed to circumvent the donor shortage. This study was designed to evaluate hepatic differentiation of human induced pluripotent stem cells (hiPSCs) in decellularized Wharton's jelly (WJ) matrix as an alternative for native liver matrix. WJ matrices were treated with a series of detergents for decellularization. Then hiPSCs were seeded into decellularized WJ scaffold (DWJS) for hepatic differentiation by a defined induction protocol. The DNA quantitative assay and histological evaluation showed that cellular and nuclear materials were efficiently removed and the composition of extracellular matrix was maintained. In DWJS, hiPSCs-derived hepatocyte-like cells (hiPSCs-Heps) efficiently entered into the differentiation phase (G1) and gradually took a polygonal shape, a typical shape of hepatocytes. The expression of hepatic-associated genes (albumin, TAT, Cytokeratin19, and Cyp7A1), albumin and urea secretion in hiPSCs-Heps cultured into DWJS was significantly higher than those cultured in the culture plates (2D). Altogether, our results suggest that DWJS could provide a proper microenvironment that efficiently promotes hepatic differentiation of hiPSCs.

The anti-cancer effect of amygdalin on human cancer cell lines.

Derived from rosaceous plant seed, amygdalin belongs to aromatic cyanogenic glycoside group, and its anticancer effects have been supported by mounting evidence. In this study, we objected to investigate amygdalin effect on two antiapoptotic genes (Survivin, XIAP) and two lncRNAs (GAS5, MALAT1) in human cancer cells (A549, MCF7, AGS). Employing RT-qPCR analysis, we compared the mRNA levels of the genes related to apoptosis in A549, MCF7, and AGS cancer cells between amygdalin-treated (24, 48 and 72 h) and un-treated groups. RNA was extracted from both cell groups and then cDNAs were synthesized. The changes in the gene expression levels were specified using ΔΔCt method. RT-qPCR analysis has revealed that the expression of Survivin, XIAP, GAS5 and MALAT1 in amygdala-treated cancer cells were significantly different, compared to the un-treated cells. However, these expressions were different depending on the treatment time. According to the results, amygdalin significantly inhibited the expression level of Survivin, and XIAP genes in treated via untreated group. Our findings suggest that amygdalin might have an anticancer effect due to the various gene expressions in A549, MCF7, and AGS human cancer cells, showing it's potential as a natural therapeutic anticancer drug.

Regulatory effects of statins on Akt signaling for prevention of cancers.

Statins, which are primarily used as lipid-lowering drugs, have been found to exhibit anti-tumor effects through modulating and interfering with various signaling pathways. In observational studies, statin use has been associated with a significant reduction in the progression of various cancers, including colon, lung, prostate, pancreas, and esophagus cancer, as well as melanoma and B and T cell lymphoma. The mevalonate pathway, which is affected by statins, plays a crucial role in activating Rho, Ras, and Rab proteins, thereby impacting the proliferation and apoptosis of tumor cells. Statins block this pathway, leading to the inhibition of isoprenoid units, which are critical for the activation of these key proteins, thereby affecting cancer cell behavior. Additionally, statins affect MAPK and Cdk2, which in turn reduce the expression of p21 and p27 cyclin-dependent kinase inhibitors. Akt signaling plays a crucial role in key cancer cell features like proliferation, invasion, and apoptosis by activating multiple effectors in downstream pathways such as FOXO, PTEN, NF-κB, GSK3ß, and mTOR. The PI3K/Akt signaling is necessary for many events in the metastatic pathway and has been implicated in the resistance to cytostatic drugs. The Akt/PTEN axis is currently attracting great interest for its role in carcinogenesis. Statins have been shown to activate the purinergic receptor P2X7 and affect Akt signaling, which may have important anti-cancer effects. Hence, targeting Akt shows promise as an effective approach to cancer prevention and therapy. This review aims to provide a comprehensive discussion on the specific impact of statins through Akt signaling in different types of cancer.

Easy and fast synthesis of MnCo-LDH yolk-shell spheres porous composites applied electrospinning nanofibers highly effective for extracting triazole fungicides.

Today, the wide utilization of triazole fungicides due to environmental damage and its side effects has raised global concern. Thus, in this investigation, polyacrylonitrile/MnCo-layered double hydroxides nanofiber was synthesized and applied as an effective and novel adsorbent at thin-film solid-phase micro-extraction technique for the quick and concurrent extraction of five triazole fungicides in fruit and vegetable samples before quantitative analysis by high-performance liquid chromatography-ultraviolet. The incorporation of MnCo-layered double hydroxides with porous structure and abundant functional groups in a polymer medium improves the extraction efficiency of nanofibers owing to hydrogen bonding and π-π interactions formed between analytes and synthesized nano-adsorbent. Various important elements that affect the extraction efficiency of the intended analytes were optimized using a time-variable approach. Under the optimum conditions, the limit of detection and quantification range from 0.1 to 0.15 and 0.3-0.5 ng mL-1, respectively.

The Relationship between Perfectionism and Sexual Function: A Systematic Review.

Objective: Perfectaionism is a common personality trait that can affect various aspects of life, especially sexual relationships. The purpose of this systematic review was to summarize the existing evidence for the relationship between perfectionism and sexual function in studies conducted in Iran and the world. Method : A comprehensive search of databases such as Scopus, PubMed, Cochrane, Science Direct, ProQuest, PsychINFO, IranPsych, Irandoc, SID, and Google Scholar search engine was performed until December 2021 without a time limit. To find studies, we searched for the keywords perfectionism and sexual function in both Persian and English and combined these words with the AND operator. Studies that scored above 15 according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria were included. Data analysis was performed qualitatively. Results: From the total of 878 articles found in databases, six articles met the inclusion criteria and had moderate quality. Reviewing studies corroborated that, notwithstanding the positive association between general/sexual perfectionism and sexual desire, specific dimensions such as socially prescribed perfectionism, partner-prescribed, and socially prescribed sexual perfectionism, have the utmost unfavorable effect on female sexual function, which means that a higher level of perfectionism ultimately decreases the rate of sexual function in women. In addition, studies suggested that by increasing sexual anxiety and distress levels, perfectionism deteriorates sexual function. Conclusion: Perfectionism may cause a variety of problems regarding sexual function. However, to clarify the precise role of each dimension of perfectionism on different areas of sexual function, more research must be conducted in this area in various communities and on age groups other than females of reproductive ages.

Development of electrospun nanofibers based on Poly (vinyl alcohol) for thin film solid-phase microextraction of antidepressant drugs in biological samples.

Today, antidepressants are widely used and it is important to determine their trace amounts due to harmful consequences. Here, a new nano sorbent was reported for the simultaneous extraction and determination of three types of antidepressant drugs (Clomipramine (CLO), Clozapine (CLZ), and Trimipramine (TRP) by the thin-film solid-phase micro-extraction (TFME-µSPE) method followed by the Gas Chromatography-flame ionization detector (GC-FID) analysis. So, the compound poly (vinyl alcohol) (PVA)/citric acid(CA)/ß-cyclodextrin/Bi2S3@g-C3N4 nano sorbent was constructed by electrospinning technique. Then, nano sorbent was studied to optimize the many parameters impacting the extraction performance. Electrospun nanofiber has a large surface area, high porosity, and homogeneous morphology with a uniform bead-free structure. In optimal conditions, the limits of detection and quantification were calculated to be 0.15-0.03 ng mL-1 and 0.5-0.1 ng mL-1, respectively. The dynamic linear range (DLR) was in the range of 0.1 to 1000 ng mL-1 for CLO and CLZ, and 0.5 to 1000 ng mL-1 for TRP with correlation coefficients (R2) of 0.999. The relative standard deviations (RSDs) were achieved in the range of 4.9-6.8% (intra-day, n = 4) and 5.4-7.9% (inter-day, n = 3) in the period of 3 days. Finally, the capability of the method was evaluated to simultaneously measure trace amounts of antidepressants aqueous sample with desirable extraction efficiency (78 to 95%).

Interindividual variability in diabetic patients' response to opium poppy: an overview of impressive factors.

Diabetic patients always seek alternative treatments to lower their blood glucose level efficiently, because antidiabetic drugs produce adverse effects and many patients experience reduced response after a treatment period. Opium poppy (Papaver somniferum) is frequently consumed by diabetic patients for reduction of blood glucose level. Scientific studies found controversial results in the investigation of the blood glucose-lowering effects of opium poppy. In this regard, we explored the antidiabetic effect of opium poppy more closely. The antidiabetic or antihyperglycemic effect of P. somniferum alkaloids were reviewed. Next, opioid receptors and their role in diabetes were explored. In the final part origins of interindividual variabilities in opioid receptors and metabolizing enzymes' functions including genetic and epigenetic factors were reviewed.

The effect of occupational stress on marital satisfaction and mental health in Iranian nurses.

BACKGROUND: Work and family life are the two basic components of the individuals' life and each one affects the other. OBJECTIVE: This study aimed to investigate the relationship between occupational stress, mental health and marital satisfaction among Iranian nurses. METHODS: A cross-sectional study was conducted on 200 randomly selected nurses. The 35 items hospital stress scale, Enrich Marital Satisfaction questionnaire and Scl-25 mental health questionnaire were used. Descriptive statistics, Pearson correlation coefficient, independent sample t-test and analysis of variance and regression analysis were used. RESULTS: Inverse correlations were observed between the scores of job stress and mental health (r = -0.468, p = 0.001) and marital satisfaction (r = -0.517, p = 0.001). More than 0.74% of variation in marital satisfaction is explained by the components of occupational stress. CONCLUSION: The results revealed that occupational stress plays a decisive role in nurses' marital satisfaction and mental health. Due to the destructive effects of occupational stress on the people's mental health, interpersonal relationships and on their efficacy in their job, establishment of some counseling services for nurses to be used by them periodically or by need, can help them to manage their stress level and better management of their family life problems. Moreover, in-service courses or workshops on stress management may help nurses to possess appropriate knowledge and skills on stress management.

Effects of Quiet Mind Training on Alpha Power Suppression and Fine Motor Skill Acquisition.

The aim of the present study was to investigate the effect of Quiet Mind Training (QMT) on Alpha power suppression and fine motor skill acquisition among novice dart players. 30 novice dart players were randomly assigned either to a QMT or a control condition. Playing skills and Alpha power suppression were assessed at four time-points: at baseline, retention test 1, under pressure conditions, at retention test 2. Over time, Alpha power suppression increased and radial errors decreased but more so in the QMT condition than in the control condition. In contrast to the control condition, darts performance and Alpha power suppression in the QMT condition were also stable under pressure conditions. Results indicated that QMT successfully suppressed Alpha power and improved implicit learning skills.

Effects of Quiet Mind Training on Alpha Power Suppression and Fine Motor Skill Acquisition.

The aim of the present study was to investigate the effect of Quiet Mind Training (QMT) on Alpha power suppression and fine motor skill acquisition among novice dart players. 30 novice dart players were randomly assigned either to a QMT or a control condition. Playing skills and Alpha power suppression were assessed at four time-points: at baseline, retention test 1, under pressure conditions, at retention test 2. Over time, Alpha power suppression increased and radial errors decreased but more so in the QMT condition than in the control condition. In contrast to the control condition, darts performance and Alpha power suppression in the QMT condition were also stable under pressure conditions. Results indicated that QMT successfully suppressed Alpha power and improved implicit learning skills.

Cardiac injury following blunt chest trauma: diagnosis, management, and uncertainty.

Due to the evolving nature of injuries caused by high-speed motor vehicle accidents, the incidence rate of blunt chest trauma is continuously increasing. Blunt cardiac injury (BCI) is a potentially lethal entity as a result of trauma to the chest. Due to its indistinct clinical presentation and heterogeneous definition, BCI might be missed during the initial survey of trauma patients in the acute care setting. Additionally, unnecessary operation in hemodynamically stable patients in whom the extent of cardiac injury has not been thoroughly evaluated might result in adverse clinical outcome. Due to ongoing advances in the diagnostic modalities and minimally invasive procedures in the acute care and trauma setting, patients with blunt trauma to the chest, who are also suspected of having a BCI, can be monitored with more confidence and managed accordingly as the clinical scenario evolves. While low-yield diagnostics such as chest X ray, electrocardiogram, and a bedside ultrasonography are still routinely performed in patients with suspected BCI, high-yield modalities such as computed tomography, highly sensitive cardiac biomarkers, and transesophageal echocardiography are all a next step in the management approach. In either case, the clinical judgment of the medical team plays a pivotal role in transition to the next step with adequate resuscitation remaining an inevitable part.

Intrathoracic gastric fistula after bariatric surgery: a systematic review and pooled analysis.

Even in the hands of highly experienced bariatric surgeons, perioperative complications are inevitable. Of these, leaks and fistulas are amongst the scariest complications. Intrathoracic gastric fistulas (ITGF) can be associated with serious morbidity, mostly when cases are misdiagnosed or detected with delay. This is a systematic review of the literature to investigate the clinical and surgical outcomes of morbidly obese adult patients with a confirmed diagnosis of ITGF following bariatric surgery. A pooled analysis of 25 articles, encompassing 76 patients with post-bariatric ITGF, showed that the clinical outcome depends on the initial presentation, timing of the diagnosis in relation to symptom onset, and prompt and effective treatment. Any septic or unstable patient must undergo urgent surgical intervention, while stable patients might tolerate a step-up approach and watchful waiting for nonsurgical treatment. Among those who undergo surgery, treatment failure and the mortality rate are substantially high. Contingent upon a prompt management strategy, patients with postbariatric ITGF can generally have a favorable outcome in the long term.

The effect of oral melatonin supplementation on MT-ATP6 gene expression and IVF outcomes in Iranian infertile couples: a nonrandomized controlled trial.

This study aims to evaluate the effect of melatonin supplementation on the outcomes of in vitro fertilization (IVF) and mitochondrial adenosine triphosphate production (MT-ATP6) gene expression in Iranian infertile couples. A single-blind nonrandomized controlled trial was conducted, recruiting 90 infertile couples who underwent IVF at an infertility center in Tehran, Iran. Patients who were assigned to the intervention group received melatonin as a supplementation to the standard controlled ovarian stimulation (COS). The control group received a COS protocol only. Primary outcome was the mRNA level of the MT-ATP6 gene in cumulus cells of ovarian follicles. Secondary outcomes were the mean number of mature oocytes retrieved, the embryo quality, and biochemical and clinical pregnancy rates. The mRNA level of the MT-ATP6 gene in cumulus cells between intervention and control groups was not statistically different (0.931 vs.1; P Ëƒ 0.05). The mean number of poor-quality embryos was significantly lower in the intervention group than that in the control group (0.27 vs. 0.80; P = 0.028). The biochemical and clinical pregnancy rates were higher in the intervention group (24% vs. 14%, P = 0.089, and 14% vs. 7%, P = 0.302, respectively); however, the difference was not significant. Melatonin supplementation did not increase the odds of clinical pregnancy and the number of mature oocytes retrieved, but significantly reduced the number of low-quality embryos. More extensive studies focusing on the level of MT-ATP6 gene expression in the oocyte or blastomere cells may further elucidate the effect of supplementation with melatonin in infertile couples who have poor clinical outcomes. Trial registration: Current Controlled Trials: IRCT2015042912307N4.