Journal of Research in Medical Sciences1735-19952837202312101148911489EN20231210<p><strong>Background:</strong> This study aimed to evaluate the severity of alopecia areata (AA) associations with metabolic syndrome, body composition evaluated by bioimpedance techniques, and arterial stiffness based on pulse?wave velocity analysis.</p><p><strong>Materials and Methods:</strong> This cross?sectional study was conducted on patients referred to AA Clinic at Razi Hospital in 2021 and 2022. Patients with AA with the Severity of Alopecia Tool (SALT) score above 20% and receiving no systemic therapy were included. Patient demographic and clinical information, symptoms of metabolic syndrome, and bioimpedance factors were collected, and the relationship between disease severity, metabolic syndrome, and bioimpedance indicators was evaluated.</p><p><strong>Results:</strong> In this study, 59 patients were examined, with 26 (44.07%) being female and 33 (55.93%) being male. The mean age of the patients was 37.42 years (standard deviation [SD] =11.28). The severity of the disease was assessed using the SALT score, with the mean severity in terms of the percentage being 69.83% (SD = 28.57%). In the regression model, SALT score was independently related to the severity of vascular stiffness after adjusting for the effect of other variables (beta = 0.033, 95% CI = 0.009–0.057, P = 0.046). Moreover, SALT score was significantly related to metabolic syndrome after adjusting for the effect of other variables (OR = 1.035, 95% CI = 1.012–1.059, P = 0.002).</p><p><strong> Conclusion:</strong> This study found that AA severity is associated with a higher chance of having metabolic syndrome and arterial stiffness which may lead to cardiovascular diseases in patients with AA, and screening patients regarding cardiometabolic diseases is mandated.<br /><br /></p>http://jrms.mui.ac.ir/index.php/jrms/article/view/11489http://jrms.mui.ac.ir/index.php/jrms/article/download/11489/6296

Journal of Research in Medical Sciences1735-19952837202312101149011490EN20231210<p><strong>Background:</strong> Developmental dysplasia of the hip (DDH) is a common pediatric orthopedic condition. Closed reduction (CR) is the conservative treatment approach with high success rates for DDH. However, avascular necrosis (AVN) is a severe potential complication after this procedure. This study retrospectively assessed the potential risk factors for AVN occurrence after CR and Spica cast immobilization.</p><p><strong>Materials and Methods:</strong> In a retrospective observational study, 71 patients (89 hips) with DDH aged 6–24 months old undergoing CR were enrolled. All patients were followed up for 3 years, and their demographic data, initial Tönnis grade, pre?reduction procedures, abduction angle in the Spica cast, and the AVN presence (based on Bucholz and Ogden classification [3rd–4th class]) were documented. <strong></strong></p><p><strong>Results:</strong> Of 71 patients (89 hips) with a mean age of 12.5 ± 3.9 months, 13 patients (18 hips) developed AVN. The mean age of patients in the AVN and non?AVN groups was 14.3 ± 4.9 and 12.2 ± 3 months (P = 0.07); also, the mean abduction angle in patients with and without AVN was 51.86 ± 3.66 and 58.46 ± 3.91 (P &lt; 0.001) in univariate analysis. The distribution of initial Tönnis grade, and previous conservative procedures, adductor tenotomies during the CR were comparable between the two groups (P &gt; 0.05). We found age 12 months and 54° in abduction angle as the best cutoff values for differentiating AVN patients from non?AVN and the risk of experiencing AVN for patients older than 12 months was odds ratio (OR) =4.22 (P = 0.06) and patients with abduction angle greater than 54 was OR = 34.88 (P &lt; 0.001).</p><p><strong>Conclusion:</strong> In this study, older age at the time of intervention and larger abduction angle in the hip Spica cast were two predictors of experiencing AVN in DDH patients after undergoing CR treatment approach. Performing CR at a younger age and keeping the abduction angle lower than 54° in the hip Spica cast could help to have the best possible prognosis. Level of Evidence: IV, retrospective, observational, cross?sectional study.<br /><br /></p>http://jrms.mui.ac.ir/index.php/jrms/article/view/11490

Journal of Research in Medical Sciences1735-19952837202312101149211492EN20231210<p><strong>Background:</strong> The incidence of gastric cancer is known to be high in the elderly population. Identification of the best perioperative chemotherapy regimen is challenging in patients with resectable gastric cancer. In this study, we aimed to evaluate and compare the outcomes and safety of epirubicin, cisplatin, and 5?fluorouracil (ECF), docetaxel, cisplatin, and 5?fluorouracil (DCF), oxaliplatin plus<br />5?Fluorouracil and leucovorin (FOLFOX), and docetaxel, oxaliplatin, leucovorin, and 5?Fluorouracil (FLOT) chemotherapy regimens to identify the most appropriate treatment option for elderly patients with resectable gastric cancer. Materials and</p><p><strong>Methods:</strong> In this retrospective observational cohort study, data were extracted from the medical archives (2017–2021) of Omid Hospital, which is a tertiary oncology referral hospital in Isfahan, Iran. Patients with resectable gastric cancer, above 60 years of age, who were perioperatively treated with one of the mentioned chemotherapy regimens and met the inclusion criteria, were enrolled in this<br />study. The survival parameters and safety profile of the regimens were evaluated and compared in this population.</p><p><strong>Results:</strong> A total of 63 patients were included in this study. The median follow?up period of the patients was 24 months (range, 7–51 months). The results of survival analysis revealed that the FLOT and DCF regimens were significantly associated with longer overall survival (OS) as compared to the other regimens (median OS: 38 and 33 months, respectively). Based on the results, the progression?free survival was longer in the DCF regimen (median: 24 months) compared to the other regimens; however, only the difference with the ECF regimen (median: 14 months) was significant. The results of Cox regression analysis showed no significant difference in the overall adjusted hazard ratio of mortality between the FLOT and DCF regimens (P = 0.802). The DCF and FOLFOX regimens accounted for<br />the highest and lowest rates of adverse events (e.g., neutropenia and mucositis), respectively.</p><p><strong>Conclusion:</strong> Considering the higher rate of adverse events in the DCF group, besides the significant improvement of OS and the acceptable adverse event profile of patients treated with the FLOT regimen, it can be proposed that this  chemotherapy regimen is the most appropriate treatment option for elderly patients with resectable gastric cancer.<br /><br /></p>http://jrms.mui.ac.ir/index.php/jrms/article/view/11492http://jrms.mui.ac.ir/index.php/jrms/article/download/11492/6299

Journal of Research in Medical Sciences1735-19952837202312101149311493EN20231210<p><strong>Background:</strong> Breast cancer (BC) is the leading cause of cancer death in women. The current study is designed to evaluate the association of lipid profiles, FBS, and body mass index (BMI) with BC recurrence and metastasis.</p><p><strong> Materials and Methods:</strong> This is a case–control study on estrogen receptor?positive BC patients in Isfahan Province, Central Iran, between 2008 and 2020. The control group was patients who had no evidence of recurrence or metastasis at least 1 year after the end of chemotherapy and hormone therapy. The case group was patients with evidence of metastasis or recurrence within 1 year after the end of chemotherapy and hormone therapy. Fasting blood sugar (FBS), total cholesterol (Chol), triglyceride (TG), high?density lipoprotein (HDL), and low?density lipoprotein (LDL) were measured before treatment, after chemotherapy, and after hormone therapy as well as BMI in the case and control groups.</p><p><strong>Results:</strong> There were 108 patients in the case and 119 patients in the control group with a mean age of 50.72 ± 13.26 and 51.91 ± 11.79, respectively. There were no meaningful differences between the case and control groups regarding serum FBS, Chol, TG, HDL, LDL, and BMI.</p><p><strong> Conclusion:</strong> We found no association between serum FBS, lipid profile, and BMI at initial diagnosis and BC recurrence or metastasis.<br />Key words: Breast cancer, fasting blood sugar, metabolic syndrome, recurrence, serum lipid profile</p>http://jrms.mui.ac.ir/index.php/jrms/article/view/11493http://jrms.mui.ac.ir/index.php/jrms/article/download/11493/6300

Journal of Research in Medical Sciences1735-19952837202312101149111491EN20231210<p><strong>Background:</strong> Calcitonin gene?related peptides (CGRP) have been considered a new effective means to prevent and treat migraine. Eptinezumab is a new class of CGRP antagonists that has been ratified for clinical treatment. The purpose of this systematic review was to assess and contrast the therapeutic effect and safety of eptinezumab in the management of migraine in comparison with a placebo.</p><p><strong>Materials and Methods</strong>: We systematically searched PubMed, Embase, Cochrane Library, and the US National Institutes of Health Clinical Trials Registry from the earliest date to February 16, 2023, for randomized controlled trials (RCTs). The mean difference (MD) and risk ratio (RR) were chosen to assess clinical indicators.</p><p><strong>Results:</strong> In total, there were 2, 739 patients in four RCTs, who were ultimately included. Our summarized results showed that eptinezumab had better healing efficacy compared to placebo with respect to monthly migraine days (MD = ?1.56, 95% con?dence interval [CI]: ?2.32, ?0.79, P &lt; 0.001), improving ?75%<br />migraine responder rate (RR = 1.80, 95% CI: 1.40, 2.33, P &lt; 0.001), ?50% migraine responder rate (RR = 1.46, 95% CI: 1.33, 1.61, P &lt; 0.001), and 100% migraine responder rate (RR = 2.41, 95% CI: 1.08, 5.38, P &lt; 0.001). Furthermore, compared with placebo, there was no significant increase for treatment?related adverse events (RR = 1.01, 95% CI 0.94, 1.10, P = 0.71) and serious AEs (RR = 0.93, 95% CI 0.46, 1.90, P = 0.84). It was found that all dosages except for 10 mg had significant efficacy compared with placebo, especially 300 mg (P &lt; 0.001). <strong></strong></p><p><strong>Conclusion:</strong> Eptinezumab has good healing efficacy and insignificant adverse effects in treating migraine, particularly the dosage of 300 mg.<br /><br /></p>http://jrms.mui.ac.ir/index.php/jrms/article/view/11491http://jrms.mui.ac.ir/index.php/jrms/article/download/11491/6298