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Background and aimsPeripheral nerve block (PNB) is commonly used, but there is a lack of data on its effectiveness and safety in the clinic. Therefore, anesthesiologists have limited insight into how they are faring in terms of both safety and efficacy. Additionally, No PNB registry is recorded in IRAN. Herein, we reveal how a hospital might use information gathered in a hospital registry of PNB outcomes to guide future quality enhancement efforts.MethodThis was an observational, prospective, and unicenter study of all peripheral nerve blocks done in the operating room since December 22, 2022. After studying the data collected by the existing registries worldwide, the anesthesiology research center at Taleghani Hospital developed a questionnaire that incorporated the varying parameters set forth by earlier research and registries. Parameters were documented for each patient.ResultsA total of 105 patients, were accrued from December 22, 2022, to July 23, 2023. The brachial plexus blocks namely axillary, infraclavicular, and popliteal blocks were the most frequently used PNBs, respectively. The indications that generated the greatest demand for PNBs were upper limb fractures, I&D, and amputation, respectively. 82.9% of blocks were conducted while patients were sedated employing systemic administration of sedatives. In this registry, there were no deaths or complications with sequelae. The median duration of hospitalization following admission to the hospital was 3 days. The mean patient satisfaction score was 9.46 out of 10.ConclusionOur analysis demonstrates the effectiveness, safety, and feasibility of peripheral nerve blocks in preoperative anesthesia. It is recommended to continue the registry and conduct additional studies to enhance our understanding of this procedure. more...

The growing global prevalence of diabetes mellitus (DM), along with its associated complications, continues to rise. When clinically detected most DM complications are irreversible. It is therefore crucial to detect and address these complications early and systematically in order to improve patient care and outcomes. The current clinical practice often prioritizes DM complications by addressing one complication while overlooking others that could occur. It is proposed that the commonly targeted cell types including vascular cells, immune cells, glial cells, and fibroblasts that mediate DM complications, might share early responses to diabetes. In addition, the impact of one complication could be influenced by other complications. Recognizing and focusing on the shared early responses among DM complications, and the impacted cellular constituents, will allow to simultaneously address all DM-related complications and limit adverse treatment impacts. This review explores the current understanding of shared pathological signaling mechanisms among DM complications and recognizes new concepts that will benefit from further investigation in both basic and clinical settings. The ultimate goal is to develop more comprehensive treatment strategies, which effectively impact DM complications in multiple organs and improve patient care and outcomes. more...

Key Clinical Message In the context of diabetic ketoacidosis, clinicians should consider uncommon origins of infection, notably infective endocarditis. This is especially crucial when confronted with cases that recur persistently or exhibit resistance to treatment. This is a case of a diabetic patient with diabetic ketoacidosis admitted to our facility. A 35‐year‐old diabetic patient presented with DKA precipitated by mitral valve endocarditis. To our knowledge and according to the literature review, only one case of DKA precipitated by endocarditis has been reported in the past. This report highlights the importance of considering endocarditis as a possible etiology in patients presenting. more...

Background and purpose: Herbal components, particularly sesquiterpenes, are progressively recognized as a crucial resource for developing effective therapeutic agents for breast cancer. In this study, the effect of a sesquiterpene lactone known as 8-O-dihydroxy-11a,13-dihydroeudesma-4(15)-en-12,6a-olide (persianolide- A) was examined in breast cancer cell lines. Experimental approach: MDA-MB-231 and MCF-7 cancer cells were grown in DMEM solution with 10% FBS. Then, an MTT assay was performed to evaluate cell viability. Apoptosis was detected by annexin-PI staining. A caspase 3/7 activity assay kit was used to assess the activity of caspase-3 and caspase-7. Protein expression of Bcl-2, Bax, and p-ERK1/2 was determined by western blotting. Findings/Results: This study showed that the IC50 values of the persianolide-A for MCF-7 and MDA-MB- 468 cells are 34.76 and 54.48 μM, respectively. In addition, persianolide-A showed a significant increase in apoptosis in both MDAMB-231 and MCF-7 breast cancer cell lines. Persianolide-A significantly increased the expression of the pro-apoptotic protein Bax and decreased the expression of the anti-apoptotic protein Bcl-2. Also, presinolide-A treatment led to a substantial increase in caspase activity with a ratio of 3/7 in both MCF- 7 and MDA-MB-231 cancer cells. In addition, the study showed that persianolide-A decreased the expression of p-ERK1/2 protein. Conclusion and implications: The results of this study suggest that persianolide-A, sourced from Artemisia kopetdaghensis, induces cell apoptosis in breast cancer cell types. The molecular mechanisms could be implicated in the modulation of the ERK1/2 signaling pathway. more...