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The accuracy of ultrasound findings in predicting the incidence of morbidly adherent placenta has been evaluated previously. In this study, we assessed the sensitivity and specificity of different quantitative findings of color Doppler and grayscale ultrasonography in predicting morbidly adherent placenta.

Background: Sepsis, a severe inflammatory response to infection, is a global health priority due to its high mortality and long-term disability rates. Its pathophysiology involves both inflammation and immune suppression. Managing sepsis requires significant healthcare resources and expenditure, with sepsis being a leading cause of hospital costs. Gut microbiotas play a crucial role in sepsis, and probiotics show promise in managing it by restoring microbial balance. Despite advances, targeted therapies for sepsis remain elusive, necessitating innovative approaches such as probiotic therapy. Method: Fifty-four eligible patients with sepsis will be randomly assigned to either the synbiotic or placebo group. The synbiotic supplement, KidiLact, comprises ten probiotic strains and prebiotic fructooligosaccharides. Participants will receive two sachets daily for 7 days, mixed with sterile water and administered orally or via gavage. Inflammatory factors including interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) will be evaluated. Anthropometric measurements, nutritional assessment, biochemical analysis, and clinical evaluation will be conducted to assess treatment outcomes. Statistical analysis will be performed to compare results between the two groups, employing SPSS version 19 with a significance level of P <.05. Conclusion: This randomized clinical trial aims to evaluate synbiotic supplementation effects on inflammatory markers and clinical outcomes in pediatric sepsis patients in the pediatric intensive care unit (PICU). Probiotics have shown promise in reducing proinflammatory cytokines like IL-6, TNF-α, and CRP, which are vital in the inflammatory response. Synbiotics can enhance gut integrity, preventing pathogen translocation and reducing inflammation. If our expectations regarding the effects of probiotics are correct, we can use them as a cost-effective supplement to improve the condition of pediatric sepsis in hospitals. Trial registration: IRCT,IRCT20230523058266N1 Registered 30 October 2023, https://irct.behdasht.gov.ir/trial/71397. [ABSTRACT FROM AUTHOR]

ObjectiveMethodsResultsConclusionConsidering the anti-inflammatory effects of curcumin and the evidence indicating the role of chronic inflammation in the pathophysiology of fatigue, this meta-analysis aimed to determine the significant effect of curcumin in reducing fatigue.Four main databases, including ISI Web of Knowledge, PubMed, Scopus, and Cochrane Library, were searched from inception to July 2024 to identify randomized controlled trials assessing the effect of curcumin on fatigue scale. Meta-analysis was conducted using Comprehensive Meta-Analysis (CMA) V2 and OpenMeta [Analyst] softwares. The overall estimate of effect size was measured using a random-effects model. To assess the presence of publication bias, funnel plots and Egger's regression test were utilized. The quality of each selected study was assessed using Cochrane Collaboration risk of bias tool. Moreover, the GRADEpro tool was used in order to check the quality of evidence across studies.The meta-analysis of 13 trials, involving 763 subjects, demonstrated a significant decrease in fatigue following curcumin administration (standardized mean difference [SMD] = −1.267 (95% CI: −2.453 to −0.081), p = 0.036). The incidence of fatigue was not affected by curcumin administration. Improvement in fatigue was found to be associated with the time following intervention (≤8 weeks; SMD = −2.156; 95% CI: −3.955 to −0.358; p = 0.019 vs. >8 weeks; SMD = −0.092 (95% CI: −0.663–0.479), p = 0.753) and the health status of the participants. However, the dosage of curcumin did not show a significant correlation with the fatigue score.Curcumin supplementation presents a promising approach for managing fatigue due to its multifaceted mechanisms of action as a phytochemical. [ABSTRACT FROM AUTHOR]

Background: Although various treatments are developed against COVID-19 variants, probiotic, and synbiotic adjunct therapy with several benefits such as safety, low cost, and availability could be needed for preventing or treating COVID-19 infection. Objective: The present systematic review aimed to assess the prophylactic efficacy of the probiotic, prebiotic, and synbiotic administration against COVID-19. Methods: The protocol of this systematic review was registered at the PROSPERO (Code number: CRD42023418900). The Scopus, Cochrane Library, Web of Sciences, and PubMed databases were systematically searched to define the clinical trials published up to November 2022 in the English language. The comparison of the incidence of COVID-19 disease and levels of specific antibodies against SARS-cov2 between the intervention and placebo groups were evaluated in this systematic review. Results: According to the five included trials, four indicated the incidence of COVID-19, and no significant differences were observed between the probiotic and placebo groups during 1, 2, or 3 months of follow-up in the mentioned studies. Regarding the antibody assays against SARS-Cov2 including IgM, IgG, or IgA reported by three eligible trials, there were no significant differences between the intervention and control groups. Conclusion: It seems that the administration of single or multi-strain probiotics or synbiotics had no prophylactic effects in different populations such as high-risk staff exposed to COVID-19, elderly nursing home residents, healthy adults, and household contact with COVID-19 patients during 1-to-3- months of intervention. [ABSTRACT FROM AUTHOR]

Background: ADHD is widely recognized as the most prevalent neurodevelopmental disorder in children. Recently, the potential role of gut microbiota as an etiological factor in ADHD has gained attention. This systematic review aims to investigate the potential impact of probiotic supplements on alleviating ADHD symptoms and influencing behavior. Methods: PubMed, Web of Science, Cochrane Library, and SCOPUS were searched from inception to May 2023. Only randomized controlled trials that have suitable data of the effects of probiotics/synbiotics on children with ADHD were enrolled. The risk of bias of the included studies was assessed by Cochrane Collaboration risk of bias tool. Results: Five related randomized controlled trial were evaluated in the current review. Types of interventions ranged from single/multi strain probiotics to synbiotic. The duration of intervention in all of the studies were 2 to 3 months. The assessed outcomes were very diverse and different tools were used to report the symptoms in children. Among those which used Conners' Parent Rating Scale, a decrease in the total score occurred in the probiotic group, compared to the placebo group. An improvement in both intervention and control groups was seen in one study which used ADHD-Rating Scale. Conclusion: In summary, the combined findings from the reviewed studies suggest that probiotic supplements might potentially serve as a complementary intervention for ADHD. However, given the small number of studies, limited sample sizes, and the diversity of probiotic strains, further research is needed to clarify the effects of probiotics in children with ADHD. The observed tolerability of probiotics is noteworthy as none of the studies report adverse effects. [ABSTRACT FROM AUTHOR]

Context: Coronavirus disease 2019 (COVID‑19) has been revealed as a severe illness with a wide‑ranging cardiac manifestation and has a worldwide burden on the health‑care system. Aims: Our aim in this study is to assess the impact of mild COVID‑19 infection on cardiac function in patients without previous structural heart disease. Settings and Design: We evaluated 100 outpatients with a history of mild COVID‑19 infection without needing hospitalization within 3 weeks to 3 months after recovery from the acute phase of the illness between August 2020 and July 2021. Subjects and Methods: The patients were compared with 105 healthy participants without a history of COVID‑19 as the control group. All participants underwent comprehensive transthoracic echocardiography. Statistical Analysis Used: Data were analyzed using IBM SPSS statistics 23. For all tests, P < 0.05 was defined as statistically significant. Results: COVID‑19 patients had higher global longitudinal strain (P = 0.001), systolic pulmonary artery pressure (P = 0.008), RV E’ (P = 0.049), and RV A’ (P = 0.003), while had lower septal tissue velocities (P = 0.01) and left ventricular ejection fraction (EF) (LVEF) (P = 0.03). Abnormal EF (LVEF <55%) was noted in 19% of the COVID‑19 patients and 8.6% of the control group (P = 0.03). Moderate or more diastolic dysfunction was noted in 10 COVID‑19 patients but only in one participant in the control group (P = 0.005). Conclusions: Mild COVID‑19 infection can result in cardiac functional and structural changes, even in patients without known previous structural heart disease. Echocardiography can be a useful modality for risk assessment and follow‑up in patients with COVID‑19. [ABSTRACT FROM AUTHOR]

Background: The current study intends to assess the impact of oral selenium intake on anti-Tg antibody in individuals with autoimmune hypothyroidism. Methods: In this double-blinded randomized controlled trial, two groups of 72 autoimmune hypothyroid patients were randomly assigned; One group received levothyroxine (LT4) and oral selenium and the other group was given placebo with LT4. Anti-Tg antibody, free T4, anti-TPO antibody, and TSH were identified in both groups before the treatment and also 3 months after treatment and analysis of data was done by SPSS software. Results: After the intervention, the average amount of anti-Tg antibody decreased in both of the groups, and this decrease was noticeably greater in the intervention group (P = 0.03). In the intervention group, the TSH level decreased after the intervention (p < 0.05), and the free T4 level increased after the intervention (p < 0.05); the changes in these two variables were statistically significant. Conclusion: Consumption of selenium, compared to placebo, in patients with autoimmune hypothyroidism drastically reduces the level of anti-Tg antibody, and it significantly increases the free T4 level. Also, there is a greater decrease in the level of TSH compared to the control group. [ABSTRACT FROM AUTHOR]

Objective: Asthma is a common disease and curcumin has modest effect in inflammatory disorders. This study investigated the efficacy of nano-curcumin on asthma. Materials and Methods: In this double-blinded randomized clinical trial, 60 patients with non-atopic bronchial asthma were randomly stratified in two groups of intervention (N=30) and control (N=30) groups. Apart from their standard treatment, the intervention group received 40 mg nano-curcumin (soft gel) three times daily while the control group received placebo. During the 60-day study, patients were assessed using spirometry to measure Forced expiratory volume in first second (FEV1). Asthma control test (ACT) was completed every 30 days and asthma quality of life questionnaire (AQLQ) was completed at the first and end of the study. Results: Totally, 31 patients (51.7%) were male and the mean age was 51.45±12.58 years. FEV1 was improved but there was no significant difference between intervention and control groups. ACT and AQLQ domains scores significantly improved. However, it was not statistically different between control and intervention groups. Conclusion: Nano-curcumin at administered dosage had no additive effect on the standard treatment in asthmatic patients. [ABSTRACT FROM AUTHOR]

Objective: Body hair removal plays an important role in beauty standards, particularly for women. Finding a method that is easy to use, cheap, and can be done without supervision can significantly affect long-term hair reduction and reduce the side effects of hair removal. The present study investigated the impact of a containing 20% broad bean (Vicia faba) extract cream on axillary hair removal. Materials and Methods: Twenty-five female volunteers were randomly divided into A (right axillary intervention - left axillary placebo) and B (right axillary placebo - left axillary intervention). Depending on the group, each person used a cream containing 20% broad bean extract) "The extract made from the seeds and pods of broad beans.") on one side and a placebo on the other twice a day for three months. Volunteers shaved their axillary hairs three days before each visit and took pictures of both sides on the day of the visit with a trichoscope (to check the diameter and thickness of the hairs). Results: We found a decrease in thickness on the intervention group (the axilla where a cream containing broad bean extract was applied); however, this difference was not significant between the intervention side and the placebo. In terms of the number of hairs, the difference between the two groups was significant only in the second month despite the decrease on the intervention side. Evaluation based on the personal judgment of the volunteers showed that there was a substantial difference in terms of the number of hairs (p=0.012) and thinning of hair (p=0.02). Conclusion: Our findings showed that 20% broad bean extract cream could potentially reduce axillary hair growth. [ABSTRACT FROM AUTHOR]

Background: Despite the high prevalence of head and neck cancers in Iran, no studies have been conducted to investigate the relationship between vitamin D levels and these cancers. Many Iranians suffer from vitamin D deficiency, which underscores the importance of conducting these studies in Iran. Objectives: This study aims at investigating the relationship between vitamin D levels and laryngeal cancer. Methods: This 1: 1 matched case-control study included 216 patients in Mashhad, Iran, who had not consumed vitamin D supplements for 3-months before study onset. Participants were grouped in 2 categories; the case group, which consisted of patients with laryngeal cancer whose squamous cell carcinoma was confirmed pathologically for the first time (new cases), and the control group, which consisted of individuals who did not have any cancer at the time of the study, confirmed by indirect laryngoscopy, and were identical to the patient group in terms of other risk factors for laryngeal cancer (smoking and alcohol abuse). First, the relevant checklist (including age, occupation, consumption of tobacco, alcohol use, etc., history of contact with mustard gas, wood, stone, metal, and cement industry, as well as history of reflux in the individual and cancer in relatives) was completed for all case and control group members. After taking blood samples, they were evaluated for serum levels of vitamin D3. Data were analyzed using chi-square, Mann-Whitney U or independent sample t-tests. Logistic regression was also used to determine the relation between vitamin D level and laryngeal cancer. Results: Mean age, sex and risk factors of laryngeal cancer were not significantly different between the two groups. Vitamin D level was significantly lower in patients with laryngeal cancer compared to control group (16.02 ± 3.62 ng/mL vs 25.19 ± 3.40 (P< 0.001)). Logistic regression analysis showed that vitamin D level is independently related to laryngeal cancer and has a protective effect on this neoplasm (OR= 0.54, 95%CI: 0.46 - 0.63, P < 0.001). Conclusions: A lower vitamin D level may be related to laryngeal cancer. However, the role of vitamin D deficiency as a risk factor for head and neck cancers and whether the treatment of this condition could prevent the incidence of such cancers is a matter of future investigations. [ABSTRACT FROM AUTHOR]

Introduction: The rate of olfactory loss related to COVID-19 was reported between 4-89 percent. There is no approved treatment for patients who experience anosmia after the mentioned infection. This systematic review aimed to assess the therapeutic effects of corticosteroids on anosmia in COVID-19 patients. Materials and Methods: Databases including PubMed, ISI Web of Sciences, Scopus, and Cochrane Library. Databases were searched up to September 2022 to find out randomized controlled trials that assessed the effect of corticosteroids on post-COVID anosmia/hyposmia. Only studies published in the English language were entered in this review. Results: Among the six relevant trials with a total population of 712, one study administered the combination therapy of both systemic and nasal corticosteroids, while others used intranasal corticosteroids. No significant difference was observed between the intervention (IG) and control (CG) groups in terms of duration of improvement from anosmia (mean difference:-1.799). The pooled effect of self-rating olfactory scores was assessed at 2 weeks and at the end point of the studies which revealed no significant effect in favor of the IG (pooled effect in 2 weeks: 0.739; in the endpoint: 1.32). The objective evaluation with different tools indicated that IG obtained higher scores at the endpoint of treatment. The pooled results showed that the number of patients who recovered from anosmia is higher in IG compared to CG (Odds Ratio: 1.719). Conclusion: It appears that the duration of corticosteroid therapy more than two weeks may be a considerable effect on the recovery of smell dysfunction in COVID-19 patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Coronavirus disease 2019 (COVID-19) may lead to myocardial damage and arrhythmia. Patients with ECG changes have shown an increased risk of mortality. OBJECTIVE: We aimed to study the changes in the electrocardiogram, which may be of great significance for risk stratification of COVID-19-positive patients. METHODS: A retrospective study was conducted to compare electrocardiogram changes and disease severity markers in COVID-19-positive patients admitted to a referral hospital between February 20 and March 20, 2020. RESULTS: Our study consisted of 201 cases, including 123 males and 78 females. Ages ranged between 16 and 97 years old. Fifty-two (25.9%) cases had a history of ICU admission. Multivariate logistic regression analysis showed that a low O2 saturation level (OR = 0.920, 95% CI 0.868–0.976, p=0.005), several lab tests, ECG changes (OR = 46.84, 95% CI 3.876–566.287, p = .002) and Age (OR = 1.03, 95% CI 1.000–1.065, p = .048) were the independent risk factors for predicting mortality rate. In addition, we utilized multivariate logistic regression analysis, demonstrating that LBBB (OR = 4.601, 95% CI: 1.357–15.600, p=0.014) is the only ECG risk factor associated with morbidity in elderly patients with ECG changes. CONCLUSIONS: ECG changes are strong indicators of high mortality rates in elderly COVID-19 patients. ECG interpretations should therefore be used for risk stratification and predicting the need for ICU admission. [ABSTRACT FROM AUTHOR]