Journal of Research in Medical Sciences
Volume:28 Issue: 5, May 2023

Monochorionic diamniotic (MCDA) twin pregnancies are considered high?risk for several reasons, especially the risk of  win?to?twin transfusion syndrome (TTTS). Renal artery Doppler (RAD) is reported as a useful tool for predicting oligohydramnios in singleton pregnancies. We aimed to compare the RAD indices between MCDA twins with and without TTTS.

In this case–control study, all pregnant women aged 18–38 years, with gestational age ? 18 weeks, who were referred to two Prenatal Clinics, Alzahra and Beheshti Educational Hospitals,  ffiliated to Isfahan University of Medical Sciences, Isfahan, Iran, October 2020–March 2022 were enrolled; the women with MCDA twin pregnancies complicated by TTTS (case group, n = 12) and without TTTS (control group, n = 24). For each twin, biometric analysis, fetal weight, and Doppler study of fetal arteries, including RAD, middle cerebral artery (MCA), umbilical artery, and ductus venosus were performed. Peak systolic velocity, Pulsatility index (PI), resistance index (RI), and systole/diastole (S/D) were measured for all arteries.

The donors of the case grouphad a lower mean MCA S/D (4.48 ± 1.89) than the control group (6.48 ± 1.97) (P = 0.01) and higher mean umbilical parameters, including PI, RI, and S/D (P < 0.05). The recipients of the case group had a lower mean renal PI than the control (P = 0.008) and lower mean MCA PI, RI, and S/D (P < 0.05). The donor group had a higher mean umbilical RI and S/D than the recipient twin, while the mean fetal weight of the recipient group was higher (P < 0.05).

Comparing the RAD parameters between the twins with and without TTTS in the present study did not identify significant results, which rejected the primary hypothesis. Among all RAD parameters, the only significant difference observed in the present study was the lower RAD PI in RT, which cannot suggest this measurement as a valuable tool for the prediction of TTTS in MCDA twins. Therefore, the results of the present study failed to show the additional value of RAD, compared with the conventional Doppler examination of fetal arteries. Further studies arerequired to prove this conclusion.

The purpose of this study was to evaluate the effect of threshold inspiratory muscle training (IMT) on the duration of weaning in intensive care unit (ICU)?admitted patients.

This randomized clinical trial enrolled 79 ICU?admitted, mechanically ventilated patients in 2020–2021 in Imam Reza Hospital, Mashhad. Patients were randomly divided into intervention (n = 40) and control (n = 39) groups. The intervention group received threshold IMT and conventional chest physiotherapy, while the control group only received conventional chest physiotherapy once a day. Before and after the end of the intervention, the strength of inspiratory muscles and the duration of weaning were measured in both the groups.

The duration of weaning was shorter in the intervention group (8.4 ± 1.1 days) versus the control group (11.2 ± 0.6 days) (P < 0.001). The rapid shallow breathing index decreased by 46.5% in the intervention group and by 27.3% in the control group after the intervention (both P < 0.001), and the between?group comparison showed a significantly higher  eduction in the intervention group than control group (P < 0.001). Thepatients’ compliance after the intervention compared to the 1st day increased to 16.2 ± 6.6 in the intervention group and 9.6 ± 6.8 in the control group (both P < 0.001), and the between?group comparison showed a significantly higher increase in the intervention group than control group. The maximum inspiratory pressure increased by 13.7 ± 6.1 in the intervention group and by 9.1 ± 6.0 in the control group (P < 0.001). Furthermore, the weaning success was 54% more probable in the intervention group than control group (P < 0.05).

The results of this study showed the positive effect of IMT with threshold IMT trainer on increased strength of respiratory muscles and reduced weaning duration.

Bariatric surgery is an appropriate treatment for obese patients with metabolic syndrome. Adipose tissue is an active endocrine tissue secreting leptin and adiponectin that affect body metabolism. Nowadays, a high incidence of metabolic syndrome with an increased risk of serious diseases has been detected in Shiraz. This study aimed to assess the levels of leptin and adiponectin as well as the  diponectin?to?leptin ratio in three different bariatric surgeries among obese patients in Shiraz. The results will play an important role in physicians’ choice of surgery by distinguishing the effects of these three bariatric surgeries.

The serum adiponectin and leptin levels were measured using enzyme?linked immunosorbent assay. Blood glucose, lipid profile, weight, and liver enzyme level were measured before and 7 months after surgery.

This clinical trial was conducted on 81 obese patients who underwent sleeve gastrectomy (SG), Roux?en?Y gastric bypass (RYGB), and single anastomosis sleeve ileal (SASI) bypass surgeries. The results revealed a decrease in fasting blood sugar and triglyceride (TG) levels 7 months after the surgeries. In addition, decrease of body mass index (BMI) was more significantly in the SASI group (12.8 ± 3 4.95) compared to the Roux?en?Y gastric group (8.56 ± 4.61) (P = 0.026). Besides, a more significant improvement in liver function was observed in SG (P < 0.05). Furthermore, the results revealed a significant difference among the three groups regarding the increase in the adiponectin level (P = 0.039). Decrease in the leptin level and increase in the adiponectin level were more significant after the RYGB surgery compared to the SG group (P < 0.05).

The three bariatric surgeries were effective in increasing theadiponectin level and decreasing the leptin levels. The surgeries also changed the metabolic risk factors including TGs, high?density lipoprotein, fasting blood glucose, and BMI.

Diabetic kidney disease has substantial burden and limited therapeutic options. An inadequate understanding of the complex gene regulatory circuits underlying this disorder contributes to the insufficiency of current treatment strategies. MicroRNAs (miRNAs) play a crucial role as regulators of functionally related gene networks. Previously, mmu-mir-802-5p was identified as the sole dysregulated miRNA in both the kidney cortex and medulla of diabetic mice. This study aims to investigate the role of miR-802-5p in diabetic kidney disease.

The validated and predicted targets of miR-802-5p were identified using miRTarBase and TargetScan databases, respectively. The functional role of this miRNA was inferred using gene ontology enrichment analysis. The expression of miR-802-5p and its selected targets were assessed by  PCR. The expression of the angiotensin receptor (Agtr1a) was measured by ELISA.

miR-802-5p exhibited dysregulation in both the kidney cortex and medulla of diabetic mice, with two- and four-fold over- xpressions, respectively. Functional enrichment analysis of the validated and predicted targets of miR-802-5p revealed its involvement in the reninangiotensin pathway, inflammation, and kidney development.  ifferential expression was observed in the Pten transcript and Agtr1a protein among the examined gene targets.

These findings suggest that miR-802-5p is a critical regulatorof diabetic nephropathy in the cortex and medulla compartments, contributing to disease pathogenesis through the reninangiotensinaxis and inflammatory pathways.

Currently, the anticancer effects of metformin on different types of lung cancer have been frequently studied. However, the  elationship between metformin and prognosis in nondiabetic patients with lung cancer remains controversial. To systematically evaluate the efficacy of metformin adjunctive therapy as the treatment for nondiabetic patients with advanced non?small cell lung cancer (NSCLC) to provide an evidence?based reference for clinical medication.

The literatures related to Phase II or III randomized controlled trials (RCTs) of metformin adjunctive therapy in nondiabetic patients with advanced NSCLC, including EMBASE, PubMed, the Cochrane Library, and Scopus database, were retrieved by computer, and the search time ranged from January 2017 to August 2022. The risk of bias assessment tool recommended by Cochrane Systematic Evaluator Manual 5.1.0 was used to evaluate the quality of the RCTs included. Rev Man 5.3 software and STATA15.0 were used for meta?analysis.

A total of 8 studies were included (925 patients). Meta?analysis results showed that there were no significant differences inrogression?free survival (PFS) (hazard ratio [HR] = 0.95, 95% confidence interval [CI]: 0.66–1.36, P = 0.77), overall survival (OS) (HR = 0.89, 95% CI: 0.61–1.30, P = 0.55, n =7), objective response rate (ORR) (odds ratio [OR] = 1.37, 95% CI: 0.76–2.46, P = 0.30), and 1?year PFS rate (OR = 0.87, 95% CI: 0.39–1.94, P = 0.73, n = 3). Sensitivity analysis showed that PFS and OS indexes were stable.

Metformin adjunctive therapy can improve the DCR of nondiabetic patients with advanced NSCLC. In addition, the patients cannot obtain a prolonged PFS, OS, 1?year PFS rate, and higher ORR rate.