Biomarkers and optical based biosensors in cardiac disease detection: early and accurate diagnosis.

Rapid and precise detection methods for the early-stage detection of cardiovascular irregularities are crucial to stopping and reducing their development. Cardiovascular diseases (CVDs) are the leading cause of death in the world. Hence, cardiac-related biomarkers are essential for monitoring and managing of process. The necessity for biomarker detection has significantly widened the field of biosensor development. Bio-sensing methods offer rapid detection, low cost, sensitivity, portability, and selectivity in the development of devices for biomarker detection. For the prediction of cardiovascular diseases, some biomarkers can be used, like C-reactive protein (CRP), troponin I or T, creatine kinase (CK-MB), B-type natriuretic peptide (BNP), myoglobin (Mb), suppression of tumorigenicity 2 protein (ST2) and galectin-3 (Gal3). In this review, recent research studies were covered for gaining insight into utilizing optical-based biosensors, including surface plasmon resonance (SPR), photonic crystals (PCs), fluorescence-based techniques, fiber optics, and also Raman spectroscopy biosensors for the ultrasensitive detection of cardiac biomarkers. The main goal of this review is to focus on the improvement of optical biosensors in the future for the diagnosis of heart diseases and to discuss how to enhance their properties for use in medicine. Some main data from each study reviewed are emphasized, including the CVD biomarkers and the response range of the optical-based devices and biosensors.

Cytotoxicity of curcumin against CD44± prostate cancer cells: Roles of miR-383 and miR-708.

Objective: Cancer stem cells (CSCs) remaining in the tumor tissues after applying treatments may cause recurrence or metastasis of prostate cancer (PC). Curcumin has the promising potential to target CSCs. Here, we aim to evaluate the cytotoxic effects of curcumin on the expression of miR-383-5p and miR-708-5p and their target genes in CD44+ CSCs and CD44- non-CSCs isolated from the PC3 prostate cancer cell line. Materials and Methods: We used MTT assay to determine the optimal cytotoxic dose of curcumin on CD44± PC cells. Then, we assessed nuclear morphological changes using DAPi staining. We used Annexin V-FITC/PI to quantify apoptotic cell death. qRT-PCR was also used to detect miRNA and gene expression levels after curcumin treatment. Results: Curcumin significantly enhanced the apoptosis in both CD44- and CD44+ PC cells in a dose-dependent manner (p < 0.05). The cytotoxicity of curcumin against CD44- cells (IC50 40.30±2.32 µM) was found to be greater than that against CD44+ cells (IC50 83.31±2.91 µM). Also, curcumin promoted miR-383-5p and miR-708-5p overexpression while downregulating their target genes LDHA, PRDX3, and RAP1B, LSD1, respectively. Conclusion: Our findings indicate that curcumin, by promoting the expression of tumor suppressors, miR-383-5p and miR-708-5p, and inhibiting their target genes, induced its cytotoxicity against CD44± PC cells. We trust that curcumin could be established as a promising adjuvant therapy to current PC treatment options following more research in clinical settings.

The Effect of Nicotine Patch on Reducing Nausea, Vomiting, and Pain Following Laparoscopic Cholecystectomy: A Randomized Clinical Trial.

Background: The effect of nicotine on nausea, vomiting, and postoperative pain has been investigated in studies on animals and humans. This study aimed to evaluate the effect of nicotine patch on decreasing nausea, vomiting, and pain in laparoscopic cholecystectomy. Methods: The study sample consisted of 100 non-smoking patients undergoing laparoscopic cholecystectomy under general anesthesia in a triple-blind clinical trial. One hour after the start of surgery, patients were randomly assigned to receive 17.5-mg nicotine or placebo patches. The patches located on the right arm were left for 24 hours. The visual analogue scale (VAS) for pain and N/V score for the severity of nausea and vomiting were measured at intervals of 0, 6, 12, and 24 hours. Findings: The results showed there was no statistically significant difference between the groups in terms of pain intensity as well as nausea and vomiting at different time periods after surgery (P>0.05). A total of 36 patients in the nicotine group and 24 patients in the placebo group received meperidine. There was also no statistically significant difference between the two groups in terms of analgesics (P=0.096) and antiemetics (P=0.1). Moreover, the frequency of severe nausea and vomiting during the study in the nicotine group was higher than in the placebo group (4 vs. 1) but this difference was not statistically significant (P>0.05). Conclusion: Receiving a 17.5-mg nicotine patch had a similar effect to receiving placebo in controlling postoperative pain, nausea, and vomiting in non-smokers. Nicotine use had no effect on reducing analgesia.

Current and Novel Emerging Medical Therapies for Peripheral Artery Disease: A Literature Review.

Despite the improvements in endovascular techniques during the last decades, there is still an increase in the prevalence of peripheral artery disease (PAD) with limited practical treatment, which timeline impact of any intervention for critical limb ischemia (CLI) is poor. Most common treatments are not suitable for many patients due to their underlying diseases, including aging and diabetes. On the one hand, there are limitations for current therapies due to the contraindications of some individuals, and on the other hand, there are many side effects caused by common medications, for instance, anticoagulants. Therefore, novel treatment strategies like regenerative medicine, cell-based therapies, Nano-therapy, gene therapy, and targeted therapy, besides other traditional drugs combination therapy for PAD, are newly considered promising therapy. Genetic material encoding for specific proteins concludes with a potential future for developed treatments. Novel approaches for therapeutic angiogenesis directly used the angiogenetic factors originating from key biomolecules such as genes, proteins, or cell-based therapy to induce blood vessel formation in adult tissues to initiate the recovery process in the ischemic limb. As PAD is associated with high mortality and morbidity of patients causing disability, considering the limited treatment choices for these patients, developing new treatment strategies to prevent PAD progression and extending life expectancy, and preventing threatening complications is urgently needed. This review aims to introduce the current and the novel strategies for PAD treatment that lead to new challenges for relief the patient's suffered from the disorder.

Mitoprotective effect of mesenchymal stem cells-derived conditioned medium in myocardial reperfusion injury of aged rats: role of SIRT-1/PGC-1α/NRF-2 network.

BACKGROUND: The aged myocardium experiences various forms of stress that cause reduction of its tolerance to injury induced by ischemia/reperfusion (I/R). Developing effective cardioprotective modalities to prevent the amplification of I/R injury during aging is under focus of investigation. Mesenchymal stem cells (MSCs) have the ability to regenerate infarcted myocardium mostly by producing multiple secretory factors. This study aimed to explore the mechanisms of mitoprotection by MSCs-conditioned medium (CM) in myocardial I/R injury of aged rats. METHODS: Male Wistar rats (n = 72, 400-450 g, 22-24 months old) were randomized into groups with/without I/R and/or MSCs-CM treatment. To establish myocardial I/R injury, the method of LAD occlusion and re-opening was employed. MSCs-CM was administered intramyocardially (150 µl) at the onset of reperfusion in recipient group. After 24 h reperfusion, myocardial infarct size, LDH level, mitochondrial functional endpoints, expression of mitochondrial biogenesis-associated genes, and the levels of pro-inflammatory cytokines were evaluated. After 28 days reperfusion, echocardiographic assessment of cardiac function was performed. RESULTS: MSCs-CM treatment improved myocardial function and decreased infarct size and LDH level in aged I/R rats (P < .05 to P < .001). It also decreased mitochondrial ROS formation, enhanced mitochondrial membrane potential and ATP content, upregulated mitochondrial biogenesis-related genes including SIRT-1, PGC-1α, and NRF-2, and lessened TNF-α, IL-1ß, and IL-6 levels (P < .05 to P < .01). CONCLUSIONS: MSCs-CM treatment attenuated myocardial I/R injury in aged rats, in part by improving mitochondrial function and biogenesis and restraining inflammatory reaction. the upregulation of SIRT-1/PGC-1α/NRF-2 profiles is a possible target for the mitoprotective effects of MSCs-CM following I/R injury during aging.

The role of ginseng derivatives against chemotherapy-induced cardiotoxicity: A systematic review of non-clinical studies.

Aims: Although chemotherapy agents are used to treating cancers, they have serious side effects, like their harmful effects on the cardiovascular system, limiting the clinical use of these chemotherapy agents. This study aimed to systematically investigate the potential role of ginseng derivatives in the prevention of chemotherapy-induced cardiac toxicity. Methods: This systematic review was performed according to PRISMA guidelines strategy in databases till August 2022. First, identify studies related to using search terms in titles and abstracts. After studying and screening 209 articles, 16 articles were selected in this study according to our inclusion and exclusion criteria. Results: According to the findings of this study, ginseng derivatives showed significant changes in biochemical, histological, and heart weight loss, as well as a reduction in mortality, which occurred in the groups treated with chemotherapy agents compared to the control groups. Co-administration of ginseng derivatives with chemotherapy agents inhibited or reversed these changes to near-moderate levels. The protective effects of ginseng derivatives can be due to their anti-inflammatory, anti-oxidant, and anti-apoptotic action. Conclusion: This systematic review shows evidence that concomitant administration of ginseng derivatives improves chemotherapy-induced cardiac toxicity. However, for better conclusions about the practical mechanisms of ginseng derivatives in reducing the cardiac toxic effects of chemotherapy agents and evaluating the efficacy and safety of the compound simultaneously, it is necessary to design comprehensive studies.

Sudden development of the upper and lower limb ischemia as the first manifestation of COVID-19 infection.

Introduction and importance: Atherosclerosis is the most common cause of peripheral vascular disease, and common predisposing causes are inflammation and diabetes. It is over two year that the COVID-19 pandemic has impacted the world and costed millions of lives. Case presentation: The patient was a case of COVID-19 infection presenting as acute arterial occlusion in the upper and lower limb. Clinical discussion: Hyper coagulopathy is one of the COVID-19 outcomes that may develop PAD following the involvement of vascular endothelium in the cytokine storm phase. Endothelial damage following COVID-19, especially in those with underlying diseases such as diabetes mellitus or inflammatory diseases with vascular involvement, can cause acute vascular events. Conclusion: Patients with inflammatory diseases and diabetes are prone to the uncommon symptoms of COVID-19 and more vulnerable to peripheral vascular occlusion, especially when the underlying disease remains uncontrolled, so anticoagulation with therapeutic doses is recommended for their treatment. Inflammation as a predisposing factor for PAD should be controlled using plasmapheresis or anti-inflammatory drugs depending on the patient's condition.

Comparing the Efficacy and Side Effects of Intravenous Ibuprofen and Acetaminophen in Pain Control Following Laparoscopic Cholecystectomy.

BACKGROUND: The importance of using effective postoperative analgesia is widely accepted. Systemic opioids are the gold standard for reducing severe pain after surgery, but the side effects have limited the use of adequate doses. We aimed to evaluate the effect of adding intravenous acetaminophen and intravenous ibuprofen to fentanyl on patient-controlled analgesia. METHODS: In this randomized clinical trial study in Ardabil city hospital at 2019, 90 patients undergoing elective laparoscopic cholecystectomy were randomly divided into three groups. The control group (n=30) received normal saline, the acetaminophen group (n=30) received 1g intravenous acetaminophen, and the ibuprofen group (n=30) received 800 mg intravenous ibuprofen. All patients received a pain control by intravenous pump containing fentanyl (15µ/ml). The drugs were injected intravenously after surgery. Shoulder and abdominal pain scores, sedation rate, nausea and vomiting, satisfaction, and the doses of fentanyl and meperidine were recorded in SPSS software within 24 h after surgery. RESULTS: The mean abdominal pain scores in ibuprofen (3.02) and acetaminophen (2.89) groups were not significantly different (P=0.719) but were significantly lower than in the control group (5.10) (P<0.001). The severity of shoulder pain, nausea and vomiting, sedation, and fentanyl intake were not significantly different in the ibuprofen and acetaminophen groups but were significantly lower than in the control group. CONCLUSION: The use of both intravenous acetaminophen and ibuprofen in pain control after surgery can reduce the need for opioid use. Acetaminophen can also be a suitable alternative for postoperative pain control in patients that are unable to use NSAIDs.

Exploring The Interactions of a Natural Gamma-Oryzanol with Human Serum Albumin: Surface Plasmon Resonance, Fluorescence, and Molecular Modeling Studies.

γ-oryzanol (ORY) is the vital bioactive compound, which is a mixture of ferulic acid ester and plant sterols. In the present work, the binding of ORY to human serum albumin (HSA) was investigated at the molecular level using fluorescence spectroscopy and surface plasmon resonance (SPR) as well as molecular modeling studies. Based on the fluorescence data analysis, ORY can form a non-fluorescent complex with HSA and induce static quenching of the emission intensity of HSA. Also, the high value of K SV (34.69 × 104 M-1) confirmed a high sensitivity of HSA toward ORY. The real-time monitoring of the binding of ORY to HSA was carried out using the SPR technique. The small K D value (1.23 × 10-6 M) calculated by SPR analysis indicated a high affinity of ORY toward HSA. The molecular modeling studies confirmed that ORY has only one binding site on HSA and binds HSA in a cavity between subdomain IIA and IIIA.

Therapeutic potentials of resveratrol in combination with radiotherapy and chemotherapy during glioblastoma treatment: a mechanistic review.

Glioblastoma, WHO grade IV astrocytoma, is the most aggressive type of brain tumors. These cancerous cells have a rapid growth rate, tendency to penetrate vital brain structures, molecular heterogeneity, etc. and this cancer is associated with a poor prognosis and low survival rate. Due to the resistance of glioblastoma cells to conventional therapeutic modalities (such as radiation therapy and chemotherapy) as well as the adverse effects of these modalities, the researchers have attempted to discover an appropriate alternative or adjuvant treatment for glioblastoma. Resveratrol, as an herbal and natural polyphenolic compound, has anti-tumoral property and has shown to be effective in GBM treatment. Resveratrol exerts its anti-tumoral effect through various mechanisms such as regulation of cell cycle progression and cell proliferation, autophagy, oxidant system, apoptosis pathways, and so on. Resveratrol in combination with radiation therapy and chemotherapy has also been used. In the present study, we summarized the current findings on therapeutic potentials of resveratrol in glioblastoma radiotherapy and chemotherapy.

MicroRNA-22 in female malignancies: Focusing on breast, cervical, and ovarian cancers.

MicroRNAs (miRNAs), a novelty-defined class of regulatory genes, have revolutionized principles of classical bimolecular. These RNAs regulate the expression of a gene through inhibition of translational initiation or targeting mRNAs for degradation. MiRNAs act in several biological operations, including proliferation, differentiation, and cell death, and their expression is often abnormal in human diseases such as cancer. In recent years, miR-22 has attracted much attention from researchers. Its expression is downregulated in female malignancies such as breast, cervical, and ovarian cancers, exhibiting that miR-22 plays a tumor-suppressive function in these cancers. Also, different reports exist about the involvement of miR-22 in non-tumor diseases. In the present review, we report the results of performed studies on the potential roles of miR-22 in female malignancies with a focus on breast, cervical, and ovarian cancers. Also, we summary its predicted target genes in various cancers. In conclusion, it is effective for researchers to understand the role of miR-22 in different cellular operations.

Comparison of Intraperitoneal Bupivacaine and Intravenous Ketorolac for Postoperative Pain Management Following Laparoscopic Cholecystectomy.

Background: Postoperative pain following laparoscopic cholecystectomy (LC) arises from incision sites and residual intraperitoneal CO2 gas. Opioids as a class of pain-relieving drugs are broadly used to control pain after LC; however, these drugs can cause various side effects. Objectives: The purpose of this study was to compare the efficacy of intraperitoneal injection of bupivacaine with that of intravenous ketorolac in managing postoperative pain in patients who had undergone LC. Methods: This randomized, double-blind clinical trial was carried out on patients who had undergone LC. Ninety patients who had undergone elective LC were randomly divided into 3 groups (n = 30 for each group). Group A received 40 mL of 0.25% bupivacaine solution intraperitoneally at the end of the operation; group B received 30 mg of ketorolac intravenously 30 minutes before surgery and every 8 hours after surgery, and patients in group C received normal saline intraperitoneally and intravenous injection. The patients were postoperatively assessed for Visual Analog Scale (VAS) scores, postoperative opioid consumption, shoulder pain, side effects (sedation, nausea, and vomiting), and satisfaction. The data were analyzed using SPSS. P values < 0.05 were considered significant. Results: The intraperitoneal injection of bupivacaine and intravenous injection of ketorolac were significantly effective in reducing postoperative abdominal pain, shoulder pain, and incidence of nausea and vomiting compared to the placebo group (P < 0.001). Although intraperitoneal bupivacaine and intravenous ketorolac had no significant difference in pain relief compared with each other, patients in both bupivacaine and ketorolac groups were significantly more satisfied with their analgesia compared to the control group (P < 0.001). Conclusions: Intraperitoneal injection of bupivacaine and intravenous injection of ketorolac both are safe and effective methods to control pain, nausea, and vomiting after LC.

Topical Tranexamic Acid versus Phenylephrine-lidocaine for the Treatment of Anterior Epistaxis in Patients Taking Aspirin or Clopidogrel; a Randomized Clinical Trial.

INTRODUCTION: Epistaxis is one of the most prevalent complaints in the emergency department (ED), especially in patients who take antiplatelet agents. This study aimed to compare the effect of topical use of tranexamic acid (TXA) with phenylephrine-lidocaine anterior nasal packing (PANP) in controlling epistaxis of patients who take aspirin or clopidogrel. METHODS: This prospective, double-blind, parallel-group, randomized clinical trial was conducted to compare the effect of topical use of intravenous (IV) TXA compared with PANP on controlling anterior epistaxis in patients who take aspirin or clopidogrel. RESULTS: One hundred patients with the mean age of 59.24 ± 7.75 (45 - 75) years were studied (52% male). Two groups were similar in terms of age (p=0.81) and sex (p=0.23) distribution, diabetes mellitus (p=0.54), and hypertension (p = 0.037). The mean time to stop bleeding was 6.70 ± 2.35 minutes in the TXA group and 11.50±3.64 minutes in the PANP group (p=0.002). Bleeding recurrence occurred in 3 (6%) cases of the TXA group and 10 (20%) cases of the PANP group (p =0.03). Time to discharge from ED in the TXA group was significantly lower than the PANP group (p<0.001). The absolute risk reduction (ARR), relative risk reduction, and number needed to harm of treatment with TXA for anterior nasal bleeding were 14.00% (95%CI: 1.11 - 26.89), 17.50% (95%CI: 0.60 - 37.27), and 7.14 (95%CI: 3.71 -90.43), respectively. CONCLUSION: Topical TXA is an appropriate treatment option in bleeding cessation, and reducing re-bleeding and duration of hospital stay in patients with epistaxis who take antiplatelet agents.

Urinary Tract Bleeding as a Rare Manifestation of Uterine Artery Pseudoaneurysm.

Pseudoaneurysm of the uterine artery is a rare condition, which usually occurs after a traumatic birth, cesarean section, dilatation and curettage, and hysterectomy. This case is a 28-year-old female patient that presented with the chief complaint of severe urinary tract bleeding and hypovolemic shock. This patient underwent cesarean section 2 months before the first presentation. After the primary examination, the patient was sent to the hybrid operation room with the primary diagnosis of uterine artery pseudoaneurysm and coil embolization was done for treating the pseudoaneurysm. Considering continued bleeding, open surgery was performed and the internal iliac artery was ligated.

A case of hydatid cyst in biceps femoris.

INTRODUCTION: Hydatid cysts primarily involve the liver and lung, but could be presented in any site of the body including the muscles which is very rare. PRESENTATION OF CASE: We report a 50-year-old woman with hydatid cyst in biceps femoris presenting as growing painful mass. There was also a small cyst in the liver. The cyst was completely excised and patient was treated with albendazole 15 mg/kg daily before and after surgery. The patient was symptom free during the three months follow-up. DISCUSSION: Hydatid cyst should be considered as differential diagnosis of any growing mass or cyst in the body in the endemic areas.

Management of celiac trunk and superior mesenteric artery synchronous aneurysms as an extremely rare manifestation of Wegener granulomatosis.

Large-vessel aneurysm is an extremely rare complication of Wegener granulomatosis. We report a case of Wegener granulomatosis in a 49-year-old woman with large synchronous aneurysms of the celiac trunk (54 mm) and superior mesenteric artery (42 mm) who presented with abdominal pain. Because of the large diameter of the aneurysms and their proximity to each other, a combination of endovascular and hybrid repair was used for management. After surgical debranching and endovascular repair, the patient was discharged in good general condition. We concluded that abdominal pain in Wegener granulomatosis can be a rare manifestation of a large visceral aneurysm.