Acta Medica Iranica

Synergistic Effects of Bavachinin in Combination With Either Ezetimibe or Atorvastatin on Liver Biomarkers: A Randomized Controlled Trial in Hyperlipidemic Rats With NAFLD

2025-12-12T16:39:43+0330

Bavachinin, a flavonoid derived from Psoralea corylifolia, exhibits antioxidant and anti-inflammatory properties and functions as a pan-agonist of PPAR nuclear receptors. This study aimed to evaluate the individual and combined effects of bavachinin with either ezetimibe or atorvastatin on liver function markers and hepatocyte apoptosis in a rat model of diet-induced hyperlipidemia. Thirty-five male Wistar rats were randomly assigned to seven groups: normal control (NC), hyperlipidemic control (HC), bavachinin (BAV), atorvastatin (ATV), ezetimibe (EZI), ATV+BAV, and EZI+BAV. Hyperlipidemia was induced in all groups except NC. Serum levels of AST, ALT, ALP, and IL-10 were measured before and after the 4-week intervention period. Liver tissue was assessed using TUNEL staining. Wilcoxon signed-rank tests showed significant within-group reductions in AST in all intervention groups (P<0.05). ALT significantly decreased in the BAV and ATV+BAV groups. IL-10 levels significantly increased in the EZI, BAV, ATV+BAV, and EZI+BAV groups. Kruskal-Wallis ANOVA revealed significant between-group differences in AST, ALT, and IL-10 levels across all groups (P<0.05). Post hoc Mann-Whitney U tests revealed that both combination groups (ATV+BAV and EZI+BAV) showed significant reductions in AST levels compared with the HC group, and the EZI+BAV group also demonstrated a significant reduction in ALT. IL-10 levels exhibited significant improvements in both combination groups compared with BAV alone. Additionally, TUNEL staining indicated reduced hepatocyte apoptosis in both combination groups as well as in the BAV group relative to the HC group. Bavachinin, in combination with ezetimibe or atorvastatin, demonstrated hepatoprotective and anti-inflammatory effects in a rat model of fatty liver disease. These findings suggest potential therapeutic roles for bavachinin. However, further studies, including complete lipid profiling and oxidative stress markers, are needed.

Evaluation of Cosmetic Outcomes of the Bilateral Reduction Mammoplasty Following the Breast Conserving Surgery and Unilateral Radiotherapy in Patients With Breast Cancer

2025-12-12T16:39:43+0330

Breast asymmetry and deformity are some of the consequences of unilateral breast-conserving surgery in patients with breast cancer, which is also associated with adverse psychological effects. The treatment protocol for these patients may include radiation therapy and surgical procedures, which can affect the cosmetic results in the breast. In this study, 20 patients with breast cancer who underwent reduction mammoplasty surgery after tumor removal were studied. Depending on the location and size of the tumor, it was removed with appropriate margins, and mammoplasty was performed for all patients. After surgery, the patients were referred to a radiotherapist for adjuvant treatment. The breast in which the tumor was located received radiotherapy (case), and the healthy breast was left without adjuvant treatment (control). We evaluated the cosmetic results in these patients 6 months after radiotherapy. The mean age and BMI of the patients were 46.45 years and 26.42 kg/m2, respectively. Thirteen patients were reported to have no comorbidities (65%), and four patients had diabetes (20%). Two of them had hypertension (10%), and one of them had diabetes and hypertension (10%). In seven patients, the tumor was located in the left breast, and the rest in the right. None of these parameters was significantly associated with the cosmetic results of the surgery. Surgical complications were reported in three patients with erythema (15%), in one patient with infection (5%), and in none of the patients without complications (0%). There was no significant difference in the scar score between the control and case groups. Given the negligible association between quantitative cosmetic outcomes in case and control breasts and the similar mammoplasty procedure with the same removal volume on both sides, it seems that different tissue weights need not be removed to achieve symmetry. The Vancouver Scar Score for the case and control sides showed a reduction in scar formation with radiotherapy. However, since the therapeutic dose of radiation is associated with systemic and local complications (erythema, infection, etc.), prophylactic local radiotherapy and brachytherapy could be considered in a risk-benefit study.

Evaluating Viola Odorata for Prevention of Mechanical Ventilation-Related Complications: The First Double Blind Randomized Clinical Trial

2025-12-12T16:39:43+0330

Endotracheal intubation is a life-saving procedure performed to protect the airway. However, it may lead to significant complications such as edema, granuloma, and strictures. A unified approach for preventing these complications remains elusive. This study aims to compare the efficacy of Pulmicort plus salbutamol (S-P) versus Viola Odorata extract combined with salbutamol (S-V) in preventing intubation-related complications. This study aims to assess the use of Pulmicort combined with salbutamol versus Viola Odorata extract combined with salbutamol for the prevention of intubation-related complications. This randomized clinical trial was conducted on 63 patients under mechanical ventilation due to trauma from 2018 to 2020. Patients were randomly assigned to receive either 2.5 mg of salbutamol via nebulizer every six hours, plus two puffs of 0.5 mg Pulmicort spray, or 10 cc of Viola Odorata syrup twice daily. Ultrasonographic assessments of air leak, tracheal air column diameter, and tracheal wall thickness were performed at baseline and at the time of weaning. The two groups were similar in terms of age and gender distribution (P>0.05). Comparison of baseline and final measurements of tracheal air column diameter, tracheal wall thickness, and air leak revealed a significant increase in both groups (P<0.001). Post-weaning assessments revealed no significant differences between the S-P and S-V groups in any parameters (P>0.05), except for a higher tracheal air diameter in the S-P group (P=0.004). This study found that Viola Odorata extract led to promising outcomes in preventing mechanical ventilation-related complications. Comparisons with Pulmicort revealed no significant differences. These findings, achieved through ultrasonographic evaluations, suggest that Viola Odorata may be a viable alternative for preventing intubation-related complications.

Determining the Safety and Effectiveness of ENDOR Oral Combination Drug in the Treatment of Patients With COVID-19: A Randomized Controlled Trial

2025-12-12T16:39:44+0330

The novel coronavirus caused by SARS-CoV-2 is still a public health concern as it can have dire consequences. Anti-inflammatory drugs are promising. Therefore, this study aimed to determine the safety and effectiveness of the ENDOR oral combination drug in the treatment of patients with COVID-19. This double-blinded, randomized controlled trial was conducted at the Imam Khomeini Hospital complex in Tehran, Iran. All COVID-19 patients who were admitted to the Imam Khomeini hospital complex from April 2022 to April 2023 and who were 18-75-Year-Old signed the consent form to participate in this study, were not pregnant, and did not need mechanical ventilation at admission. In this study of 200 patients (50% in the Endor group and 50% in the placebo group), 56.8% were male, and the mean age was 65.02±14.94. There were no statistically significant differences observed between the Endor and control groups across time for temperature (P=.075), WBC (P=.095), CRP (P=.108), sodium (P=.323), or calcium (P=.352). The slope of the decrease in ESR and the body temperature, as well as the slope of the increase in oxygen saturation in the Endor group, was higher than in the control group. Statistically significant differences between the Endor and control groups over time for respiratory rate (P=.003), oxygen saturation (P<.001), and potassium (P=.031) were observed. The decreasing slope of the respiratory rate in the Endor group was significantly higher than in the control group. ENDOR with anti-inflammatory features helps COVID-19 hospitalized patients recover faster by improving oxygen saturation, lowering fever, and decreasing respiratory rate.

Exploring Hemodynamic Alterations: The Impact of Post-Induction and Pre-Intubation Urinary Catheterization in General Anesthesia: A Randomized Controlled Trial

2025-12-12T16:39:44+0330

General anesthesia with endotracheal intubation is essential for major surgical procedures; however, the associated laryngoscopy and intubation elicit significant hemodynamic responses, posing risks particularly in susceptible patients. Although noxious stimuli are traditionally deferred until after securing the airway, modern anesthetic techniques and depth monitoring may allow for safe pre-intubation interventions that improve operating room efficiency. This study aimed to evaluate whether urinary catheterization, a minor but potentially painful procedure, performed after anesthetic induction and prior to intubation, induces significant hemodynamic alterations. In this prospective, single-blind, randomized controlled trial, 60 adult patients undergoing elective open abdominal surgery were randomly assigned to either an intervention group (catheterization after induction and before intubation) or a control group (no catheterization). Hemodynamic variables—systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR)—and bispectral index (BIS) were recorded at five predefined time points: before induction, after induction, before and after catheterization, and post-intubation. No significant intergroup differences were observed in HR, DBP, MAP, or BIS at any time point except after intubation. Post-intubation, the control group demonstrated significantly higher SBP and MAP compared to the intervention group (SBP: 130.9±11.8 vs. 122.5±10.4 mmHg, P=0.027; MAP: 99.2±8.3 vs. 91.7±8.1 mmHg, P=0.032). BIS values remained within the target range (40-60) in both groups, indicating consistent anesthetic depth. Urinary catheterization performed after induction and before intubation does not cause significant hemodynamic instability or alter the depth of consciousness. This finding supports the safe incorporation of minor procedural steps prior to airway instrumentation, potentially enhancing intraoperative workflow without compromising patient safety. Validation in broader patient populations is warranted.

Evaluating the Role of Vitamin D3 in Modulating Insulin Resistance and Glycemic Control Among Type 2 Diabetic Nephropathy Patients

2025-12-12T16:39:44+0330

Type 2 diabetes mellitus (T2DM) is a major global health concern, often complicated by diabetic nephropathy (DN), a leading cause of end-stage renal disease. Vitamin D3 has been implicated in various metabolic and inflammatory processes, potentially influencing insulin sensitivity and renal outcomes. However, the exact relationship between vitamin D3 levels, glycemic control, and insulin resistance in T2DM patients with different stages of DN remains unclear. This study aims to evaluate serum vitamin D3 levels in T2DM patients with varying degrees of albuminuria and to assess their correlation with markers of insulin resistance and glycemic control, compared with healthy controls. A case-control study was conducted involving 180 T2DM patients—divided into normoalbuminuria (n=60), microalbuminuria (n=60), and macroalbuminuria (n=60) groups—and 60 healthy controls. Glycemic Profile (Fasting blood glucose [FBS], HbA1c, fasting insulin), lipid profile (total cholesterol, triglycerides, LDL, HDL, VLDL), renal function markers (urea, creatinine, albumin-to-creatinine ratio [ACR], glomerular filtration rate [GFR]), calcium, and vitamin D3 levels were measured. Insulin resistance was assessed using the HOMA-IR index. Serum vitamin D3 levels were significantly lower in all T2DM subgroups than in controls (P<0.001), with the lowest levels observed in the macroalbuminuria group. A significant positive correlation was observed between vitamin D3 and FBS only in the microalbuminuria group (r= +0.437, P=0.016). No significant associations were found between vitamin D3 and HOMA-IR or other glycemic parameters across the groups. Markers of renal dysfunction, including serum creatinine, urea, and ACR, were significantly elevated with increasing severity of albuminuria. Vitamin D deficiency is prevalent in T2DM patients with nephropathy, especially those with advanced renal impairment. While no strong associations were found between vitamin D3 and insulin resistance, a positive correlation with FBS in early-stage nephropathy suggests a potential role for vitamin D in glycemic regulation during the progression of DN. Further longitudinal studies are warranted to explore the therapeutic implications of vitamin D supplementation in T2DM patients at risk of nephropathy.

A Right fibular Artery Variation: Case Report

2025-12-12T16:39:44+0330

The fibular artery originates distal to the popliteus muscle and descends along the inferior tibiofibular syndesmosis. A key feature of this artery is its primary perforating branch. Knowledge of the anatomy and variations of this branch is essential for surgeons to achieve optimal surgical outcomes. Variations in the posterior tibial artery (PTA) and fibular artery (FA) are frequently seen in cadaveric dissections and imaging studies. These variations are important for evaluating arteriograms and performing procedures such as vascular grafting, angioplasty, and embolectomy. Our study found that the fibular artery pierced the interosseous membrane 8 cm proximal to the lateral malleolus, continuing as the dorsalis pedis artery. Recognizing these variants is crucial for assessing peripheral arterial disease and planning revascularization

Bukhtishu Family and the Commencement of a New Era in the Islamic Golden Age

2025-12-12T16:39:44+0330

Bukhtishu were a family of Iranian physicians who provided medical services to the Abbasid Caliphate's court for six generations, from the eighth to the eleventh centuries. Their place of origin was The Academy of Gondishapur, which was located in the southwestern region of Iran. This article examines the family's history and their significant contributions to the Islamic Golden Age.