Long-term systemic effects of metabolic bariatric surgery: A multidisciplinary perspective.

Background: Obesity is a global health crisis with profound implications on various body systems, contributing to a series of comorbidities. Metabolic Bariatric Surgery (MBS) has emerged as an effective treatment option for severe obesity, with significant weight reduction and potential systemic physiological alterations. Objectives: This narrative review aims to provide a comprehensive analysis of the long-term effects of MBS on a wide array of body systems, including the heart, liver, kidneys, reproductive system, skin, lungs, digestive tract, pancreas, and blood, as well as related cancers of these organs. Methods: A systematic search was conducted in academic databases (PubMed, ISI Web of Science, and Scopus) for observational studies and reviews published between July 2000 and December 2023, investigating the association between MBS and the subsequent function of different organ systems. High-quality studies were prioritized to ensure reliable evidence synthesis. Results: MBS has demonstrated favorable outcomes in reducing cardiovascular disease risk, improving cardiac function, and alleviating heart failure symptoms. It has also been associated with improved respiratory function, remission of obstructive sleep apnea, and reduced cancer incidence and mortality. Additionally, MBS has shown benefits in managing gastrointestinal disorders, enhancing glycemic control, and promoting pancreatic beta-cell regeneration in type 2 diabetes mellitus. However, some methods of MBS are associated with a higher risk of cholelithiasis, GERD, and pancreatic exocrine insufficiency. Conclusion: MBS has far-reaching systemic effects beyond weight loss, offering potential long-term benefits for various organ systems and comorbidities associated with obesity. For many patients with severe obesity, the potential benefits of Metabolic and Bariatric Surgery (MBS) can outweigh the associated risks. However, careful evaluation by a qualified healthcare professional is crucial to determine candidacy and ensure a successful outcome. Further research is needed to fully elucidate the long-term impacts and tailor personalized treatment approaches.

A sensitive aptasensor mediated by gold nanoparticles/metal organic framework lattice for detection of Pb2+ ion in marine products.

Herein, an enzyme-free fluorescent aptasensor was introduced for the ultrasensitive quantification of lead (Pb2+) ion as a hazardous pollutant of the environment and foodstuffs. A nanocomposite of zeolitic imidazolate frameworks-8 and gold nanoparticles (ZIF-8@AuNPs) was utilized as an efficient quencher of the fluorescence intensity of carboxyfluorescein (FAM) signal reporter. The establishment of a hybrid structure between attached aptamer on ZIF-8@AuNPs nanocomposite, and its FAM-tagged complementary (CP) strand decreased the fluorescence response. The preferential binding between the aptamer and Pb2+ released CP strands, which retrieved the fluorescence signal. The aptasensor could assess Pb2+ in the linear concentration range of 1 pM-1 nM with a detection limit (LOD) of 0.24 pM. Besides, it could quantify Pb2+ in various samples, including fish, shrimp, tap water, milk, and serum samples. The developed aptasensor with the superiorities of easiness, cost-effectiveness, easy-to-operate, and rapidness is promising for controlling marine foodstuff safety.

Gallocin-derived Engineered Peptides Targeting EGFR and VEGFR in Colorectal Cancer: A Bioinformatic Approach.

BACKGROUND: Colorectal cancer (CRC) treatment using time-saving and cost-effective targeted therapies with high selectivity and low toxicity drugs, is a great challenge. In primary investigations on Gallocin, as a most proposed factor in CRC pathogenesis caused by Streptococcus gallolyticus, it was surprisingly found that this bacteriocin has four α-helix structures and some anti- cancer sequences. OBJECTIVE: The aim of this study was to determine the ability of Gallocin-based anticancer peptides (ACPs) against epidermal growth factor receptor (EGFR) and vascular epidermal growth factor receptor (VEGFR) and the evaluation of their pharmacokinetics properties using bioinformatics approaches. METHODS: Support vector machine algorithm web-based tools were used for predicting ACPs. The physicochemical characteristics and the potential of anti-cancer activity of Gallocin-derived ACPs were determined by in silico tools. The 3D structure of predicted ACPs was modeled using modeling tools. The interactions between predicted ACPs and targets were investigated by molecular docking exercises. Then, the stability of ligand-receptor interactions was determined by molecular dynamic simulation. Finally, ADMET analysis was carried out to check the pharmacokinetic properties and toxicity of ACP. RESULTS: Four amino acid sequences with anti-cancer potential were selected. Through molecular docking, Pep2, and Pep3 gained the best scores, more binding affinity, and strong attachments by the formation of reasonable H-bonds with both EGFR and VEGFR. Molecular simulation confirmed the stability of Pep3- EGFR. According to pharmacokinetic analysis, the ACPs were safe and truthful. CONCLUSION: Designed peptides can be nominated as drugs for CRC treatment. However, different in-vitro and in-vivo assessments are required to approve this claim.

Catechin-Induced changes in PODXL, DNMTs, and miRNA expression in Nalm6 cells: an integrated in silico and in vitro approach.

BACKGROUND: This study explored the impact of predicted miRNAs on DNA methyltransferases (DNMTs) and the PODXL gene in Nalm6 cells, revealing the significance of these miRNAs in acute lymphocytic leukemia (ALL). METHODS: A comprehensive approach was adopted, integrating bioinformatic analyses encompassing protein structure prediction, molecular docking, dynamics, and ADMET profiling, in conjunction with evaluations of gene and miRNA expression patterns. This methodology was employed to elucidate the therapeutic potential of catechin compounds in modulating the activity of DNA methyltransferases (DNMTs) and the PODXL gene. RESULTS: The findings from our investigation indicate that catechins possess the capability to inhibit DNMT enzymes. This inhibitory effect is associated with the upregulation of microRNAs miR-200c and miR-548 and a concurrent downregulation of PODXL gene expression. These molecular interactions culminate in an augmented apoptotic response within ALL (Nalm6) cells. CONCLUSION: The study posits that catechins may represent a viable therapeutic avenue for inducing apoptosis in ALL cells. This is achieved through the modulation of epigenetic mechanisms and alterations in gene expression profiles, highlighting the potential of catechins as agents for cancer therapy.

Malnutrition elevates delirium and ICU stay among critically ill older adult COVID-19 patients.

Background and aim: Malnutrition among intensive care unit (ICU) patients is associated with a higher risk of mortality and prolonged hospitalization. However, the influence of malnutrition on severe outcomes of ICU patients with coronavirus disease 2019 (COVID-19) is unclear. By evaluating the effect of malnutrition on the outcomes of COVID-19 in the ICU in older adult patients, this study will contribute to new knowledge of assessing the nutritional status and recovery of these patients. Methods: In the current single center prospective study, 310 critically ill COVID-19 patients with an age range of ≥65 years were recruited. Data on demographic characteristics, laboratory parameters, comorbidities, medications, and types of mechanical ventilation were collected in the first 24 h of ICU admission. Malnutrition was defined based on the two-step approach of the Global Leadership Initiative on Malnutrition (GLIM) scale at baseline. During the 45 days after the baseline, we collected data on delirium incidence, mortality, invasive mechanical ventilation (IMV) requirement, length of ICU and hospital admission, and re-hospitalization. Results: In this study, the prevalence of malnutrition was 63.4% among critically ill COVID-19 patients. During the 45-day follow-up, 190 (61.3%) COVID-19 deaths were recorded among the baseline 310 patients. After controlling for potential confounders, malnutrition was associated with an increased risk of delirium so malnourished COVID-19 patients had a significantly 35% higher risk of delirium than those without malnutrition (HR: 1.35, 95% CI: 1.01-1.83). Such a significant association was not for COVID-19 mortality and IMV requirement. In addition, malnutrition was associated with a significantly 84% greater odds of prolonged ICU admission (OR: 1.84, 95% CI: 1.09-3.10). No significant association was seen between malnutrition and re-hospitalization and also prolonged hospital admission. Conclusion: Malnutrition was associated with an increased risk of delirium and prolonged ICU admission among critically ill older adult COVID-19 patients. Prevention, diagnosis, and treatment of malnutrition could be a key component in improving outcomes in these patients.

Caregiving consequences in cancer family caregivers: a narrative review of qualitative studies.

Background: Cancer is a significant public health issue, causing various challenges for individuals affected by it. As cancer progresses, patients often become dependent on others for support. Family caregivers and members play a crucial role in the recovery and rehabilitation of these patients. However, caregivers themselves face numerous challenges throughout the course of their family member's illness. Exploring the experiences of family caregivers can inform long-term planning and supportive interventions to address their caregiving difficulties. This study reviews previous literature on caregiving outcomes. Method: This study presents a narrative review of qualitative studies, analyzing a total of 23 articles. The results were extracted and organized into subcategories. After revision by the research team, main categories were identified. These categories encompass both positive and negative outcomes of caregiving. Results: The findings of this review demonstrate that caring for a family member with cancer has significant implications for caregivers. These implications include: (A) Positive outcomes of caregiving (such as achieving self-management and balance, promoting kinship intimacy, finding meaning and purpose, and experiencing spiritual growth) and (B) Negative outcomes of caregiving (including care-related physical exhaustion, disruption of personal life plans, psycho-emotional consequences, and socio-economic burden). Conclusion: The results of this study highlight the challenges faced by family caregivers and emphasize the importance of addressing their needs within the healthcare system. By providing support and attention to their well-being, caregivers can enhance their resilience and adaptability in managing caregiving difficulties.

Machine Learning Approaches to Identify Affected Brain Regions in Movement Disorders Using MRI Data: A Systematic Review and Diagnostic Meta-analysis.

BACKGROUND: Movement disorders such as Parkinson's disease are associated with structural and functional changes in specific brain regions. Advanced magnetic resonance imaging (MRI) techniques combined with machine learning (ML) are promising tools for identifying imaging biomarkers and patterns associated with these disorders. PURPOSE/HYPOTHESIS: We aimed to systematically identify the brain regions most commonly affected in movement disorders using ML approaches applied to structural and functional MRI data. We searched the PubMed and Scopus databases using relevant keywords up to June 2023 for studies that used ML approaches to detect brain regions associated with movement disorders using MRI data. STUDY TYPE: A systematic review and diagnostic meta-analysis. POPULATION/SUBJECTS: Sixty-seven studies with 6,285 patients were included. FIELD STRENGTH/SEQUENCE: Studies utilizing 1.5T or 3T MR scanners and the acquisition of diffusion tensor imaging (DTI), structural MRI (sMRI), functional MRI (fMRI), or a combination of these were included. ASSESSMENT: The authors independently assessed the study quality using the CLAIM and QUADAS-2 criteria and extracted data on diagnostic accuracy measures. STATISTICAL TESTS: Sensitivity, specificity, accuracy, and area under the curve were pooled using random-effects models. Q statistics and the I2 index were used to evaluate heterogeneity, and Begg's funnel plot was used to identify publication bias. RESULTS: sMRI showed the highest sensitivity (93%) and mixed modalities had the highest specificity (90%) for detecting regional abnormalities. sMRI had a 94% sensitivity for identifying subcortical changes. The support vector machine (93%) and logistic regression (91%) models exhibited high diagnostic accuracies. DATA CONCLUSION: The combination of advanced MR neuroimaging techniques and ML is a promising approach for identifying brain biomarkers and affected regions in movement disorders with subcortical structures frequently implicated. Structural MRI, in particular, showed strong performance. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 2.

Application of "Partnership Care Model" in chronically ill adults and children: A systematic review and dose-response meta-analysis of randomized controlled trials.

BACKGROUND: "Partnership Care Model (PCM)", which is the first partnership conceptual framework founded on the Iranian culture to control chronic diseases, has been recently used in different fields of nursing research with no levels of valid evidence to support its application. Therefore, this systematic review and meta-analysis sought to clarify the impacts of interventions developed based on PCM on quality of life (QoL), sleep quality, anxiety, and depression among adults and children with chronic diseases. METHODS: International data sources (e.g., PubMed, Web of Science, Scopus) and national databases (e.g., SID, MagIran, IranDoc, IRCT) were searched from 2001 to September 23, 2023, to find Randomized Controlled Trials (RCTs) on PCM-driven interventions for the experimental groups versus no intervention or standard care groups. The studies' methodological quality and evidence quality were rated utilizing the Cochrane risk of bias instruction and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Data were pooled by a random-effects approach employing STATA (vers. 11.2). RESULT: Eighteen RCTs, reported in 22 publications, were qualified. The PCM compared to the standard care significantly improved the QoL among both adults (10 effect sizes [ESs], mean difference [MD]: 3.17, P < 0.001) and children (4 ESs, MD: 4.45, P < 0.001). Likewise, the intervention enhanced adults' sleep quality (3 ESs, MD: 7.15, P < 0.001). The anxiety of adults and children was also significantly lower in the PCM group (4 ESs, MD: -4.52, P = 0.001; 2 ESs, MD: -4.04, P < 0.001, respectively). However, regarding depression, a significant effect of PCM was found only among children (3 ESs, MD: -7.99, P = 0.011). The methodological quality of the studies and the evidence quality were undesirable. CONCLUSION: The PCM had a promising influence on the caring of adults and children suffering from chronic diseases. However, additional high-quality RCTs are needed to generate a higher quality of evidence concerning the clinical benefits of the PCM. PROSPERO NO: CRD42021253790.

MRI findings in movement disorders and associated sleep disturbances.

BACKGROUND: One of the most useful tools for identifying sleep disturbances is neuroimaging, especially magnetic resonance imaging (MRI). This review research was to look at the role of MRI findings in movement disorders and sleep disturbances. METHODS: This review collects all MRI data on movement disorders and sleep disruptions. Between 2000 and 2022, PubMed and Google Scholar were utilized to find original English publications and reviews. According to the inclusion and exclusion criteria, around 100 publications were included. We only looked at research that explored MRI modality together with movement problems, sleep disorders, and brain area involvement. Most of the information focuses on movement irregularities and sleep interruptions. RESULTS: Movement disorders such as Parkinson's disease (PD), Huntington's disease (HD), neuromuscular diseases, rapid eye movement (REM) sleep behavior movement disorder (RBD), cerebellar movement disorders, and brainstem movement disorders are assessed using MRI-based neuroimaging techniques. Some of the brain areas were associated with disorders in movement abnormalities and related sleep disturbances. This review found that many people with mobility disorders also have sleep problems. Some brain areas' malfunctions may cause motor and sleep issues. CONCLUSION: Neuroimaging helps us understand the sleep difficulties associated with movement disorders by examining the structural and functional implications of movement disorders and sleep disturbances.

Effects of family-based dignity intervention and expressive writing on anticipatory grief in family caregivers of patients with cancer: a randomized controlled trial.

Family caregivers of dying cancer patients may suffer from grief experiences and bereavement complications. Previous studies have proposed some psycho-emotional interventions for the management of these complications. However, little attention has been given to family-based dignity intervention and expressive writing. This study was conducted to examine the effects of family-based dignity intervention and expressive writing, combined and alone, on anticipatory grief in family caregivers of dying cancer patients. This was a randomized controlled trial, in which 200 family caregivers of dying cancer patients were randomly assigned to four intervention groups: family-based dignity intervention (n = 50), expressive writing intervention (n = 50), combined family-based single dignity intervention and expressive writing (n = 50), and control group (n = 50). In three times (baseline, 1 week, and 2 weeks after the interventions), anticipatory grief was assessed by a 13-item anticipatory grief scale (AGS). Finally, we found a significant reducing effect of family-based dignity intervention on AGS (-8.12 ± 1.53 vs. -1.57 ± 1.52, P = 0.01) and its subscales including behavioral (-5.92 ± 0.97 vs. -2.17 ± 0.96, P = 0.04) and emotional (-2.38 ± 0.78 vs. 0.68 ± 0.77, P = 0.03) subscales compared to the control group. However, no significant effect was seen for expressive writing intervention and combined interventions of expressive writing and family-based dignity intervention. In conclusion, family-based dignity intervention may be a safe intervention for relieving anticipatory grief among family caregivers of dying cancer patients. Additional clinical trials are needed to confirm our findings. Registration number: IRCT20210111050010N1. Trial registration date:2021-02-06.

Fish Protein Hydrolysate from Sulfated Polysaccharides Extraction Residue of Tuna Processing By-Products with Bioactive and Functional Properties.

The ethanol-induced precipitation after enzymatic hydrolysis commonly used for sulfated polysaccharide extraction from marine resources wastes a large amount of proteins. Here, possible extraction of fish protein hydrolysates (FPH) from the ethanol residue of sulfated polysaccharide precipitation from head, bone, and skin of skipjack tuna is investigated. Antioxidant, antibacterial, angiotensin I-converting enzyme (ACE) inhibitory activities and functional properties of the recovered FPHs are also evaluated. A degree of hydrolysis of 40.93, 38.13, and 37.23 is achieved for FPH from head, bone, and skin, respectively. FPH from the head presents the highest antioxidant and ACE inhibitory activity as well as foam/emulsion capacity among all the FPHs. The FPHs are all able to inhibit three Gram-positive bacteria and three Gram-negative bacteria to varying degrees and have a water solubility >65%. Altogether, the results demonstrate great potential for recovery of bioactive/functional peptides from the residue of sulfated polysaccharide extraction process enabling efficient biorefining of aquatic resources.

Ultrasonic-assisted enzymatic extraction of sulfated polysaccharide from Skipjack tuna by-products.

The effect of ultrasound pretreatment on extraction efficiency of sulfate polysaccharides (SPs) using alcalase from different by-products of Skipjack tuna including head, bone and skin was evaluated. Structural, functional, antioxidant and antibacterial properties of the recovered SPs using the ultrasound-enzyme and enzymatic method were also investigated. Ultrasound pretreatment significantly increased the extraction yield of SPs from all the three by-products compared with the conventional enzymatic method. All extracted SPs showed high antioxidant potential in terms of ABTS, DPPH and ferrous chelating activities where the ultrasound treatment enhanced antioxidant activities of the SPs. The SPs exerted strong inhibiting activity against various Gram-positive and Gram-negative bacteria. The ultrasound treatment remarkably increased antibacterial activity of the SPs against L. monocytogenes but its effect on other bacteria was dependent on the source of the SPs. Altogether, the results suggest that ultrasound pretreatment during enzymatic extraction of SPs from tuna by-products can be a promising approach to improve extraction yield but also bioactivity of the extracted polysaccharides.

Erectile dysfunction from mechanisms to medicines with a focus on the application of topical Minoxidil.

INTRODUCTION: Erectile dysfunction (ED), for multifactorial reasons, is one of the biggest current quandaries among men worldwide and results in other complications such as reduced quality of life of the patient and his sexual partner, impotence, and psychiatric problems. OBJECTIVES: Understanding of disease etiology, penile anatomy, erectile physiology, therapeutic mechanisms, and effective molecular pathways all play key roles in determining a therapeutic approach. This project is based on the study of topical minoxidil's effectiveness in treating ED. METHODS: To perform a comprehensive overview of the subject, we performed a triple-keyword combination search to assess recent studies of ED. RESULTS: The most common formulation used in these studies was 2% minoxidil solution. Except for cases studied in paralytic patients, topical treatment with minoxidil appears to elicit a mild erectile response; however, this finding is insufficient to confirm the effectiveness of this topical treatment. CONCLUSIONS: Although evidence to confirm the therapeutic properties of minoxidil in ED is limited, combination therapy and the use of modern formulations of minoxidil are promising options for treating ED in the future.

A systematic review, meta-analysis, and network analysis of diagnostic microRNAs in glaucoma.

Glaucoma is a chronic neurodegenerative process of the optic nerve that is the leading cause of blindness worldwide, and early diagnosis of the disease could greatly affect patients' prognoses. The pathophysiology of glaucoma is complicated by a combination of genetic and epigenetic factors. Deciphering the early diagnostic biomarkers in glaucoma could attenuate the disease's global burden and help us understand the exact mechanisms involved in glaucoma. The microRNAs are members of a larger family of non-coding RNAs that play an essential role in the epigenetic basis of glaucoma. A systematic study and meta-analysis of diagnostic microRNAs in glaucoma, jointly with network analysis of target genes, were carried out on published papers assessing differentially expressed microRNAs in human subjects. In total, 321 articles were found, and, after screening, six studies were eligible for further analysis. 52 differentially expressed microRNAs were found, of which 28 and 24 were up-regulated and down-regulated, respectively. Only 12 microRNAs were qualified for meta-analysis, with overall sensitivity and specificity of 80% and 74%, respectively. Then, using network analysis, it became apparent that the VEGF-A, AKT1, CXCL12, and HRAS genes were the most important targets for the microRNAs. Perturbations in WNT signaling, protein transport, and extracellular matrix organization pathways were discovered to be important in the etiology of glaucoma using the community detection approach. This study tries to uncover the promising microRNAs and their target genes that govern the epigenetics of glaucoma.

Exploring family caregiver challenges in caring for patients with COVID-19 in intensive care units.

Background: Families of individuals hospitalized in an intensive care unit (ICU) with severe illnesses, such as COVID-19, are experiencing a range of physical and emotional stressors. Identifying the challenges faced by family members and providing support to loved ones battling life-threatening diseases can lead to improved treatment and care for the said family members in a healthcare setting. Aim: The current study was conducted to explore and understand the experiences of family caregivers caring for their loved ones battling COVID-19 in an ICU. Methods: This descriptive qualitative study was conducted from January 2021 to February 2022, based on the experiences of 12 family caregivers of patients with COVID-19 hospitalized in the ICU. Data collection was conducted through purposeful sampling using semi-structured interviews. MAXQDA10 software was used for data management, and conventional content analysis was used for qualitative data analysis. Results: The present study conducted interviews with caregivers to understand their experiences while caring for a loved one in an ICU. Three main themes emerged from the analysis of these interviews: hardship of care trajectory, pre-loss mourning, and contributing factors in resolving family health crises. The first theme, the hardship of care trajectories, encompasses categories such as immersion in the unknown, lack of care facilities, negligence in care, neglect of families by healthcare providers, self-ignorance, and perceived stigma. The second these was pre-loss mourning that included some categories such as emotional and psychological turmoil, witnessing the exhaustion of loved ones, separation suffering, the fearing of loss, anticipatory grief, blame related to the disease causative agents, and perceived helplessness and despair. The third theme was contributing factors in resolving family health crises that included categories of the critical role of family caregivers in health engagement, the role of healthcare professionals in health engagement, and the role of interpersonal factors in health engagement. A total of 80 subcategories were also obtained based on the experiences of the family caregivers. Conclusion: This study's findings indicate that families can play an important role in resolving their loved ones' health problems in life-threatening situations such as the COVID-19 pandemic. Moreover, healthcare providers must recognize and prioritize family-based care and trust the families' ability to effectively manage health crises. Healthcare providers should also be attentive to the needs of both the patient and their family members.

Application of Orem's theory-based caring programs among chronically ill adults: A systematic review and dose-response meta-analysis.

AIM: This study aimed to clarify the value of caring programs developed according to Orem's Self-Care Deficit Nursing Theory regarding quality of life and self-care as the primary outcomes and self-efficacy, anxiety, depression, and stress as the secondary outcomes among individuals aged 18-70 years with chronic diseases. BACKGROUND: Chronically ill patients need to receive appropriate self-care training, counseling, and support. In this regard, the use of caring programs developed based on theories is highly suggested. Orem's Nursing Theory is the most well-known theory that provides a structure to involve patients in their self-care activities. INTRODUCTION: Orem's Nursing Theory has been increasingly applied to guide practice for patients with chronic health conditions. However, recent trials have reported conflicting findings on the value of its application. METHODS: Eight information sources (e.g., Web of Science Core Collection, PubMed, and Scopus) and the International Clinical Trials Registry Platform were searched up to 30 March 2022. RESULTS: A total of 46 studies and 11 study register entries were eligible. Orem's theory-based interventions significantly improved the quality of life, self-care, and self-efficacy as well as significantly reduced anxiety and depression. However, the value of the interventions on stress was uncertain, as performing the meta-analysis was not possible. DISCUSSION: Orem's Nursing Theory can help nurses in different fields to dynamically and carefully evaluate patients' self-care ability and implement appropriate nursing measures tailored to their needs, interests, and problems. Considering the inconsistent evidence to support the empirical adequacy of this theory, high-quality reviews are essential. CONCLUSION: Orem's theory-based programs had a favorable effect on taking care of adults with chronic diseases. IMPLICATIONS: This study augments the previous reviews related to the applicability of Orem's Nursing Theory. Considering the undesirable evidence quality and the high between-study heterogeneity, further well-designed trials are required to draw an evidence-based conclusion.

Effects of Topical Application and Oral Intake of Rosa damascena on Acute Pain in Adults: A Systematic Review and Meta-analysis.

Objectives: To conduct a systematic review and meta-analysis of available studies regarding the effects of the traditional herb Rosa damascena (as topical application and oral intake) on the severity of acute pain in adults. Methods: A systematic search was performed on the following databases: Cochrane Central Register of Controlled Trials, PubMed, Scopus, Web of Science Core Collection, Embase, Cumulative Index to Nursing and Allied Health Literature, Scientific Information Database, and Magiran from inception to 20 March 2021. We included parallel-group and cross-over randomized controlled trials that compared the effects of any products containing R damascena in oral and topical administration forms to placebo, non-treatment, or conventional treatment. Two researchers independently performed the document screening and selection, data extraction, and risk of bias assessment. A random-effect model was used to pool the data. Results: From a total of 11 studies that met the inclusion criteria, four studies administered R damascena through topical application and seven by oral intake. Nine studies recruited only females. Ten studies had parallel-group design, while one adopted cross-over design. The oral intake of Rdamascena reduced pain severity non-significantly (standardized mean difference (SMD) = -0.55, 95% CI: -1.27-0.17; p =0.132). However, the topical application of this treatment had no pain-alleviating effect (SMD = 0.10, 95% CI: -0.75-0.96; p =0.814). One study reported mild allergic rhinitis as an adverse effect of the treatment. Risk of bias assessment revealed that three of the eleven studies had good methodological quality, six had fair quality, and two were of poor quality. Conclusions: This systematic review and meta-analysis suggests that the oral intake of R damascena may have a non-significant alleviating effect on acute pain severity in adults. However, its topical application has not shown pain-alleviating effect. More robust randomized controlled trials are needed for accurate estimation of the effects of oral and topical use of R damascena on the severity of different types of acute pain in adults.

Prostaglandins as a Topical Therapy for Erectile Dysfunction: A Comprehensive Review.

INTRODUCTION: Erectile dysfunction (ED) is a substantial cause of dissatisfaction among many men. This discontentment has led to the emergence of various drug treatment options for this problem. OBJECTIVES: Unfortunately, due to various interactions, contraindications, and side effects, systemic therapies such as phosphodiesterase-5 inhibitors (including sildenafil, tadalafil, vardenafil, avanafil, etc.) are not welcomed in many patients. These problems have led researchers to look for other ways to reduce these complications. METHODS: This article holistically reviews the efficacy of topical prostaglandins and their role in treating ED. We sought to provide a comprehensive overview of recent findings on the current topic by using the extensive literature search to identify the latest scientific reports on the topic. RESULTS: In this regard, topical and transdermal treatments can be suitable alternatives. In diverse studies, prostaglandins, remarkably PGE1 (also known as alprostadil), have been suggested to be an acceptable candidate for topical treatment. CONCLUSION: Numerous formulations of PGE1 have been used to treat patients so far. Still, in general, with the evolution of classical formulation methods toward modern techniques (such as using nanocarriers and skin permeability enhancers), the probability of treatment success also increases. Hamzehnejadi M, Tavakoli MR, Homayoun F et al. Prostaglandins as a Topical Therapy for Erectile Dysfunction: A Comprehensive Review. Sex Med Rev 2022;10:764-781.