Journal of Research in Medical Sciences1735-19952946202410151158411584EN20241015<p><strong>Background:</strong> This study investigated the effects of humor therapy on the fatigue levels of patients receiving hemodialysis (HD).</p><p><strong>Materials and Methods:</strong> A single?blind, randomized clinical trial of 66 HD patients for 3 weeks was conducted, in which two groups were randomly allocated – humor therapy and control. In the intervention group, humor therapy sessions were conducted twice a<br />week for 3 weeks. As a pre? and postintervention assessment, the Fatigue Symptom Inventory (FSI) was completed.</p><p><strong>Results:</strong> According to the repeated?measures ANOVA test, FSI values exhibited a  significant decline in the humor therapy group and an increase in the control group at the first, second, and third visits (humor therapy vs. control: 30.38 ± 8.75 and 61.80 ± 13.92, P &lt; 0.001; 35.71 ± 10.05 and 69.53 ± 15.32, P &lt; 0.001; and 34.85 ± 9.24 and 70.34 ± 22.26, P &lt; 0.001, respectively) compared with baseline (humor therapy vs.</p><p><strong>control:</strong> 49.26 ± 5.19 and 52.09 ± 11.69, P = 0.204). Conclusion: Findings suggest that humor therapy can effectively reduce fatigue levels in patients presenting with HD.<br /><br /></p>http://jrms.mui.ac.ir/index.php/jrms/article/view/11584http://jrms.mui.ac.ir/index.php/jrms/article/download/11584/6362

Journal of Research in Medical Sciences1735-19952946202410151158611586EN20241015<p><strong>Background:</strong> Primary biliary cholangitis (PBC) can impact both the quality of life and the survival of patients. The study aimed to determine the survival rate and associated variables in patients with PBC.</p><p><strong>Materials and Methods:</strong> This cohort research comprised 65 patients diagnosed with PBC who were admitted to the pathology section between January 2010 and December 2019. Survival was determined by reviewing hospital medical data and following up with the patients. The impact of demographic factors, clinical, laboratory, and histopathological aspects on patient survival time was investigated using Kaplan-Meier survival analysis and Cox<br />regression.</p><p><strong>Results:</strong> The average period of follow?up was 6.25 years with a standard deviation of 3.2 years. In surviving patients, the baseline bilirubin level was 2.83, but in deceased or transplanted patients, it was 8.95 (P = 0.002). The baseline albumin level was 3.99 in surviving patients and 3.66 in deceased or transplanted patients (P = 0.024). The incidence of cirrhosis in those who survived was 1.8%, but in patients who died or underwent a transplant, it was 40%. Out of 65 cases, 3 patients (4.7%) died and 7 (10%) had liver transplants. Survival rates of patients vary based on factors such as jaundice (P = 0.002), weariness (P = 0.03), cirrhosis (P &lt; 0.001), and vitiligo (P = 0.033). There were notable variations in the average Mayo score between the two groups of patients who had liver transplantation and survived, with scores of 7.21 and 5.61, respectively.</p><p><strong>Conclusion:</strong> The study found that aspartate aminotransferase and alanine aminotransferase levels, baseline and final bilirubin, albumin, antinuclear antibody, the presence of cirrhosis, and jaundice significantly influenced patient survival with PBC.<br /><br /></p>http://jrms.mui.ac.ir/index.php/jrms/article/view/11586http://jrms.mui.ac.ir/index.php/jrms/article/download/11586/6364

Journal of Research in Medical Sciences1735-19952946202410151158511585EN20241015<p><strong>Background:</strong> Reducing the frequency of self?monitoring of blood sugar, due to needle phobia, pain, stress, and costs associated with the procedure, can improve patient compliance and quality of life, provided that adequate blood sugar control is maintained. This study aimed to evaluate the effect of low?frequency blood glucose self?monitoring (LFBGSM) on glycosylated hemoglobin (HbA1C) levels among older adults living with type 2 diabetes mellitus (T2DM), treated with or without insulin. <strong></strong></p><p><strong>Materials and Methods:</strong> This randomized controlled trial with a parallel design was conducted on 121 older adults with T2DM in Sabzevar, Iran, between 2018 and 2020. Initially, subjects were stratified based on the type of treatment (with or without insulin) and then randomly assigned to intervention (LFBGSM) and control (no blood glucose self?monitoring [no?BGSM]) groups. HbA1C levels were measured at the<br />beginning of the study and 3 months later for all study groups.</p><p><strong>Results:</strong> The mean age of participants treated with and without insulin was 64.3 ± 9.60 and 64.7 ± 5.01 years, respectively. The ANCOVA test revealed a significant difference in the mean HbA1C levels among the four groups 3 months postintervention (P &lt; 0.001). The HbA1C scores significantly decreased in the LFBGSM groups and increased in the no?BGSM groups at 3 months postintervention (insulin/LFBGSM, insulin/no?BGSM, noninsulin/LFBGSM, and noninsulin/no?BGSM: 7.74 ± 0.76, 8.34 ± 1.53, 7.70 ± 0.75, and 8.14 ± 1.11, respectively) compared to baseline (8.25 ± 0.67, 8.03 ± 0.64, 8.08 ± 0.69, and 7.83 ± 0.74, respectively). The least significant difference post hoc tests showed significant differences between specific groups, emphasizing subtle responses to interventions (P values ranging from 0.001 to 0.929).</p><p><strong>Conclusion:</strong> Findings suggest a significant reduction in HbA1C scores within the LFBGSM groups, while a discernible increase is observed in the no?BGSM groups over the 3 months. These findings  underscore the efficacy of the interventions and emphasize the crucial role of  personalized approaches in optimizing glycemic control for individuals with diabetes.<br /><br /></p>http://jrms.mui.ac.ir/index.php/jrms/article/view/11585http://jrms.mui.ac.ir/index.php/jrms/article/download/11585/6363

Journal of Research in Medical Sciences1735-19952946202410151158711587EN20241015<p><strong>Background:</strong> There have not been any clear studies on the use of mesenchymal stem cells (MSCs) to treat osteoarthritis (OA) in the knee.</p><p><strong> Materials and Methods:</strong> This study investigates the effects of different MSC dosages on pain alleviation in individuals with OA in the knee by conducting a meta?analysis of existing randomized controlled trials. Electronic resources such as Google Scholar,<br />PubMed, Cochrane Library, and Web of Science were searched up until June 2023. Treatment effect sizes were computed using the knee osteoarthritis outcome score (KOOS), the Western Ontario and McMaster Universities Osteoarthritis Index  WOMAC), and the Knee Society Score (KSS). Random or fixed effect models were applied to aggregate the data. We performed a subgroup analysis according to dosage level. The heterogeneity of the research was investigated using the Chi?square test and the I2 index.</p><p><strong>Results:</strong> The meta?analysis included 26 studies with a total sample size of 739 patients. A significant reduction in pain was observed 1 year and 2 years following the injection of MSCs into the injured joint, as indicated by the Visual Analogue Scale, WOMAC, KOOS, and KSS indexes (P &lt; 0.05). Patients on MSCs reported much reduced pain after 1 and 2 years compared to the control group (P &lt; 0.05). Subgroup and meta?regression analyses revealed no statistically significant variations in the effectiveness of MSC dosage (P &lt; 0.05). The studies did not report any adverse effects.</p><p><strong>Conclusion:</strong> Different dosages of MSCs had the same pain?relieving effects<br />on patients with OA in the knee. MSC injections were safe and beneficial in such cases.<br /><br /></p>http://jrms.mui.ac.ir/index.php/jrms/article/view/11587http://jrms.mui.ac.ir/index.php/jrms/article/download/11587/6365

Journal of Research in Medical Sciences1735-19952946202410151158211582EN20241015<p><strong>Background:</strong> The objective of the study was to systematically evaluate the efficacy and safety of semaglutide in overweight or obese adults with or without type 2 diabetes.</p><p><strong> Materials and Methods:</strong> The study, registered with PROSPERO (CRD42023450979), was designed as a systematic review and meta?analysis. Using a combination of subject matter and free words, a comprehensive search of Embase, PubMed, and Cochrane Library databases was performed to identify randomized controlled trials of semaglutide in overweight or obese adults with or without Type 2 diabetes mellitus from January 1, 2020, to July 14, 2023. The primary outcomes were the changes in body weight and adverse drug reaction (ADR). Random or fixed effects models were used in meta?analysis, pooling data as relative risks (RRs) or mean difference (MD) with 95% confidence intervals (CIs). Cochrane Collaboration’s Risk of Bias tool was used to assess quality. Meta?analysis was performed using RevMan 5.3.</p><p><strong> Results:</strong> A total of 2490 publications were retrieved. Fifteen publications were finally included, totaling 6984 overweight or obese adult patients. Meta?analysis showed that compared with the control group, the semaglutide group was reduced more significantly in body weight (MD = ?7.49, 95% CI [?9.92, ?5.07], P &lt; 0.001),<br />body mass index (MD = ?3.35, 95% CI [?4.79, ?1.92], P &lt; 0.001), waist circumference (MD = ?7.26, 95% CI [?9.94, ?4.58], P &lt; 0.001), as well as glycosylated hemoglobin (RR = ?0.66, 95% CI [?1.07, ?0.25], P = 0.002), fasting blood glucose values (RR = ?4.81, 95% CI [?7.03, ?2.60], P &lt; 0.001), and systolic blood pressure (RR = ?3.37, 95% CI [?5.32, ?1.42], P &lt; 0.001), and the proportion of patients who lost &gt; 5%, 10%, 15%, and 20% of their overall body weight, respectively (RR = 3.19, 95% CI [1.89, 5.36], P &lt; 0.001), (RR = 4.74, 95% CI [2.78, 8.11], P &lt; 0.001), (RR = 6.17, 95% CI [3.88, 9.82], P &lt; 0.001), and (RR = 9.14, 95% CI [6.05, 13.80], P &lt; 0.001) were also superior to the control group. Regarding safety, the incidence of total ADR in the semaglutide group was close to the placebo group. Still, gastrointestinal adverse effects such as nausea, vomiting, abdominal pain, and diarrhea were higher than those in the control group.</p><p><strong>Conclusion:</strong> Semaglutide can effectively lose weight in overweight or obese adults with or without diabetes, potentially providing cardiovascular benefits; however, gastrointestinal adverse should be closely monitored.<br /><br /></p>http://jrms.mui.ac.ir/index.php/jrms/article/view/11582http://jrms.mui.ac.ir/index.php/jrms/article/download/11582/6360

Journal of Research in Medical Sciences1735-19952946202410151158311583EN20241015---http://jrms.mui.ac.ir/index.php/jrms/article/view/11583http://jrms.mui.ac.ir/index.php/jrms/article/download/11583/6361