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Background: Parkinson's disease (PD) is a complex neurodegenerative disorder characterized by dopamine depletion and severe motor impairments. Preladenant, an adenosine A2 receptor antagonist, is an investigational treatment for PD. This systematic review and meta-analysis aimed to critically evaluate the efficacy of Preladenant in improving motor symptoms in patients with PD. Methods: A comprehensive literature search was conducted in PubMed, Embase, and Cochrane Central Register of Controlled Trials from inception to March 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs) comparing Preladenant with placebo in PD patients were included. The primary outcome was the change in daily ON time without troublesome dyskinesia. Secondary outcomes included the change in daily OFF time and adverse events. The risk of bias was assessed using the Cochrane Risk of Bias tool. Results: Four RCTs with a total of 2097 PD patients were included. Pooled analysis showed that Preladenant could generally increase daily ON time (pooled effect 0.15 and 95 % CI: −0.19–0.48) and reduce daily OFF time (pooled effect −0.04 and 95 % CI: −0.43–0.36) compared to placebo, however it was not significant. The included studies had moderate to high heterogeneity. No significant differences in adverse events were observed between Preladenant and placebo. Conclusion: This meta-analysis suggests that Preladenant may improve motor fluctuations in PD patients by increasing ON time and reducing OFF time. However, the high heterogeneity among studies warrants further large-scale, high-quality RCTs to confirm these findings and establish the long-term safety and efficacy of Preladenant in PD management.

IntroductionThis study aimed to investigate the nuanced relationship between spiritual well-being and fear of cancer progression among individuals diagnosed with cancer.MethodsThe study was conducted in 2023 and utilized a predictive cross-sectional survey. A total of 398 cancer patients were recruited using convenience sampling. The Spiritual Well-Being Scale (SWBS) and the Fear of Progression (FOP) scale were used for data collection. Data analysis was performed using SPSS version 26, AMOS, and JASP to assess the reliability of the constructs and the potential relationship between the two main variables.ResultsThe mean age of the participants was 49.14 years (SD = 16.16, 95% CI: 47.55 50.74). All constructs demonstrated strong factorial validity and reliability. Simple linear regression analysis revealed that spiritual well-being significantly predicted fear of cancer progression (R2 = 0.064, F = 27, p

Introduction: Surgical site infection (SSI) constitutes a substantial complication after knee arthroplasty, contributing to notable morbidity. This study aimed to review the existing literature on the incidence and risk factors of SSI following knee arthroplasty. Methods: A systematic search was undertaken across various international electronic databases, including Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex and the Scientific Information Database. The search strategy involved the use of keywords derived from Medical Subject Headings, such as “incidence”, “Surgical wound infection”, “Surgical site infection”, and “Arthroplasty”, covering records from the earliest available up to March 17, 2024. Results: The study incorporated a collective participant group of 1,366,494 knee arthroplasty procedures from twenty-three chosen studies. The pooled incidence rate of SSI after knee arthroplasty was 1.7% (95% confidence interval (CI): 1.1% to 2.6%; I²=99.687%; P

OBJECTIVE During the severe acute respiratory syndrome coronavirus 2 pandemic, could be observed an established use of online information in the field of coronavirus disease worldwide. As a systematic review study, the present investigation aimed to evaluate related studies about digital health/e-health literacy among university students in the coronavirus disease 2019 era. METHODS Three electronic bibliographic databases (PubMed/Medline, Scopus, and Google Scholar) were searched from 2020 until June 2022, and articles were screened according to pre-established inclusion criteria. RESULTS Fifteen studies were included in this systematic review study. All of the studies were cross-sectional in design, and in total, 45,255 students were evaluated. The majority of studies report health literacy scores among university students that are lower compared to reference samples. Students’ health literacy is influenced by different variables (age, gender, socioeconomic background, sources of online information, well-being, and satisfaction with data). CONCLUSION Digital health literacy (DHL) shapes health behaviors and actions. To enhance DHL, multidisciplinary teams from diverse fields can design curricula suitable for students. The internet’s role in DHL is crucial, but it can also spread misleading content. Therefore, professionals should provide clear, evidence-based information and encourage critical data evaluation. Future studies should use robust sampling methods, consider students with limited internet access, and address the unique needs of specific populations, such as those with disabilities and low socioeconomic status.

Diabetic nephropathy (DN) is one of the most common kidney diseases, but its exact pathophysiology remains unknown. Toll-like receptors (TLRs) are innate immune receptors that recognize pathogen- and danger-associated molecular patterns, which can result in an inflammatory response. TLR4, TLR2, TLR5, TLR7, TLR8, TLR9, and TLR11 are essential in the pathogenesis of DN, according to recent evidence collected from both in vivo and in vitro studies. Studies have shown that TLR2 and TLR4 expression is higher in patients with renal failure and nephrotic diabetes. They also play critical roles in podocyte injury and inflammation caused by high glucose. TLR2 and TLR4 may be helpful therapeutic targets to prevent or delay DN in patients with type 2 diabetes mellitus. Additionally, TLR7 may contribute to kidney damage in type 1 diabetes mellitus, whereas downregulation of TLR9 expression inhibits inflammation and apoptosis pathways associated with DN.

BackgroundDepression is a state of low mood and aversion to activity, which affects a person’s thoughts, behavior, motivation, feelings, and sense of wellbeing. Pharmacologic therapies are still the best effective treatment of depression. Still, most antidepressant drugs have low efficacy and delayed onset of therapeutic action, have different side effects, and even exacerbate depression. Such conditions make it possible to look for alternatives. Consequently, we decided to summarize the impact of flavonoids on depression in this review.MethodsWe searched scientific databases such as SCOPUS, PubMed, and Google Scholar to find relevant studies until July 2022.ResultsA wide variety of natural components have been shown to alleviate depression, one of which is flavonoids. Due to the growing tendency to use natural antidepressant drugs, scientific studies are increasingly being conducted on flavonoids. This study aims to review the latest scientific researches that indicate the antidepressant potential of flavonoids. Various mechanisms include neurotransmitter system modulation and dopaminergic, noradrenergic, and serotonergic pathways regulation in the central nervous system. Different compounds of flavonoids have antidepressant properties in vivo or in vitro experiments or clinical trials and can be used as alternative and complementary treatments for depression. In general, it was observed that there were no severe side effects.ConclusionOur study proves the antidepressant potential of flavonoids, and considering the limited side effects, they can be used as complementary medicine for depressed patients.

Abstract Background and aims The current systematic review aimed to elucidate the effects of lipid variability on microvascular complication risk in diabetic patients. The lipid components studied were as follows: High-density lipoprotein (HDL), High-density lipoprotein (LDL), Triglyceride (TG), Total Cholesterol (TC), and Remnant Cholesterol (RC). Method We carried out a systematic search in multiple databases, including PubMed, Web of Science, and SCOPUS, up to October 2nd, 2023. After omitting the duplicates, we screened the title and abstract of the studies. Next, we retrieved and reviewed the full text of the remaining articles and included the ones that met our inclusion criteria in the study. Result In this research, we examined seven studies, comprising six cohort studies and one cross-sectional study. This research was conducted in Hong Kong, China, Japan, Taiwan, Finland, and Italy. The publication years of these articles ranged from 2012 to 2022, and the duration of each study ranged from 5 to 14.3 years. The study group consisted of patients with type 2 diabetes aged between 45 and 84 years, with a diabetes history of 7 to 12 years. These studies have demonstrated that higher levels of LDL, HDL, and TG variability can have adverse effects on microvascular complications, especially nephropathy and neuropathic complications. TG and LDL variability were associated with the development of albuminuria and GFR decline. Additionally, reducing HDL levels showed a protective effect against microalbuminuria. However, other studies did not reveal an apparent relationship between lipid variations and microvascular complications, such as retinopathy. Current research lacks geographic and demographic diversity. Increased HDL, TG, and RC variability have been associated with several microvascular difficulties. Still, the pathogenic mechanism is not entirely known, and understanding how lipid variability affects microvascular disorders may lead to novel treatments. Furthermore, the current body of this research is restricted in its coverage. This field's lack of thorough investigations required a more extensive study and comprehensive effort. Conclusion The relationship between lipid variation (LDL, HDL, and TG) (adverse effects) on microvascular complications, especially nephropathy and neuropathic (and maybe not retinopathy), is proven. Physicians and health policymakers should be highly vigilant to lipid variation in a general population.

Introduction: Considering the importance of delirium disorder in burn patients and its complications, the present systematic review and meta-analysis aimed to determine the prevalence of delirium and its related factors in burn patients. Methods: A comprehensive, systematic search was performed in different international electronic databases, such as Scopus, PubMed, and Web of Science, as well as Persian electronic databases such as Iranmedex, and Scientific Information Database (SID) using keywords extracted from Medical Subject Headings such as "Prevalence", "Delirium", and "Burns" from the earliest to the 17th of July, 2023. Results: In total, 2,710 burn patients participated in ten original studies. Among the participants, 64.6% were male. In the ten studies, the reported pooled prevalence of delirium among burn patients was 20.5% (95% CI: 10.9% to 35.0%; I2=96.889%; P

Introduction: Pain experienced during the insertion of a catheter into the arteriovenous fistula (AVF) and restless legs syndrome (RLS) are prevalent issues among Hemodialysis (HD) patients. The primary objective of this systematic review and meta-analysis was to consolidate the findings from randomized clinical trial (RCT) studies examining the impact of aromatherapy with lavender on the pain associated with AVF catheter insertion and RLS in HD patients. Methods: A systematic search was conducted on PubMed, Web of Science, Scopus, Cochrane, Embase, ClinicalTrials.gov, and Google Scholar search engine from inception to August 1, 2022, using keywords extracted from Medical Subject Headings, such as “Aromatherapy”, “Lavender”, “Arteriovenous fistula”, “Pain”, “Restless legs syndrome”, and “Hemodialysis”. Results: Finally, eleven articles were included in this systematic review and meta-analysis. The results showed that aromatherapy reduced the average pain of catheter insertion in AVF compared to the control group (Standard Mean Difference: -1.60, 95% Confidence Interval: -2.32 to -0.87, Z=4.32, I2:90.3%, P

Introduction: In the absence of timely treatment, the risk of rupture in patients with ectopic pregnancy (EP) increases, which is associated with extensive bleeding, complicated surgery, and maternal death. This study aimed to investigate the prevalence of rupture and its related factors among EP cases. Methods: A comprehensive, systematic search was conducted in electronic databases, such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as "Ectopic pregnancies", "Extrauterine pregnancies", and "Ruptured ectopic pregnancy" from the earliest to the 13th of December 2022. The CMA program, version 3, was utilized for analysis. The overall effect size was calculated using the sample size and the frequency of rupture in each of the studies. Heterogeneity was measured using the I2 statistics. Results: A total of 5,269 women with EP participated in 17 studies. The pooled prevalence of rupture was 56.4% (95%CI: 44.9% to 67.2%; I2=98.09%; P

Due to the growth of the elderly population, age-related neurological disorders are an increasing problem. Aging begins very gradually and later leads to several neurological issues such as lower neurotransmitter levels, oxidative stress, neuronal inflammation, and continual neuronal loss. These changes might contribute to brain disorders such as Alzheimer’s disease (AD), dementia or mild cognitive impairment, and epilepsy and glioma, and can also aggravate these disorders if they were previously present. Momordica charantia (bitter gourd), a member of the Cucurbitaceae family, is a good source of carbohydrates, proteins, vitamins, and minerals. It is used for diabetes and known for its hypoglycemic and antioxidant effects. In this review, we discuss the pharmaceutical effects of M. charantia on age-related neurological disorders. We searched several databases, including PubMed and Google Scholar, using MeSH terms. We searched articles published up until 2022 regardless of publication language. M. charantia is rich in luteolin, which increases acetylcholine in neurons by binding to enzymes in acetylcholine metabolism pathways, including butyrylcholinesterase and acetylcholinesterase. This binding inhibits the hyperphosphorylation of tau protein by restraining its kinase enzyme. Furthermore, this substance can lower serum cholesterol and has multi-target activity in AD and memory loss. M. charantia can also improve memory by decreasing tau protein and it also has potent antioxidant activity and anti-inflammatory effects. This review highlights that M. charantia has effects on many age-related neurological disorders, and can be a cost-effective supplement with minimal side effects.

Background: Early colorectal cancer (CRC) diagnosis can drastically reduce CRC-related morbidity and mortality. In this regard, increasing attention is now being directed to DNA-based tests, especially the evaluation of methylation levels, to prioritize high-risk suspected persons for colonoscopy examination. Therefore, we aimed to assess the accuracy of MGMT gene promoter methylation levels in peripheral blood mononuclear cells (PBMCs) for distinguishing CRC patients from healthy people. Materials and Methods: For this study, a total of seventy individuals with CRC and 75 healthy individuals from Iran were included. The methylation level of MGMT in the DNA isolated from PBMCs was evaluated using the methylation quantification endonuclease-resistant DNA technique. To assess the diagnostic capability of the MGMT promoter methylation level, a receiver operating characteristic (ROC) curve was generated. Results: The mean promoter methylation level of MGMT in the CRC and control groups was, respectively, 27.83 ± 22.80 vs. 12.36 ± 14.48. The average percentage of methylation of the MGMT promoter between the CRC and control groups was significantly different (P < 0.001). Also, the MGMT promoter was more hypermethylated in female patients than in males. ROC analyses indicated that the diagnostic power of the MGMT promoter methylation level for CRC was 0.754, with a sensitivity of 81.43% and a specificity of 75.71%, indicating a good biomarker for CRC diagnosis. Conclusion: Methylation evaluation of MGMT in PBMCs could be utilized as a diagnostic biomarker with high accuracy for prioritizing suspected CRC patients before colonoscopy.