Medicinal, Psychological, and Health Research Journal (MPHRJ)

Abstract Background: Acute traumatic spinal cord injury (tSCI) represents a devastating condition with significant morbidity and mortality. Anesthetic management during emergency surgery may influence secondary injury cascades and subsequent neurological recovery through hemodynamic optimization, neuroprotective agent selection, and avoidance of physiological insults. However, the impact of specific anesthetic strategies on outcomes remains incompletely characterized.

Objective: This systematic review and meta-analysis evaluated the association between anesthetic management strategies and neurological and survival outcomes in patients undergoing emergency surgery for acute tSCI.

Methods: We systematically searched PubMed, Embase, and Cochrane Library databases from inception to January 2026 for studies comparing anesthetic approaches in adult patients undergoing emergency spinal decompression surgery following acute tSCI. Primary outcomes were neurological improvement measured by American Spinal Injury Association (ASIA) grade change and mortality. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using random-effects models.

Results: Twenty-three observational studies and 2 randomized controlled trials encompassing 4,847 patients met inclusion criteria. Maintenance of mean arterial pressure (MAP) ≥85 mmHg was associated with improved neurological outcomes (OR 1.58, 95% CI 1.21–2.06; I²=62.3%). Hypotensive episodes (MAP <70 mmHg for >10 minutes) during the intraoperative period significantly increased mortality risk (OR 2.34, 95% CI 1.67–3.28; I²=48.9%). Propofol-based total intravenous anesthesia was associated with lower odds of poor neurological recovery compared to volatile anesthetic-based regimens (OR 0.71, 95% CI 0.54–0.93; I²=41.2%). The use of high-dose methylprednisolone demonstrated no significant benefit on neurological outcomes (OR 1.12, 95% CI 0.89–1.41; I²=54.7%) but was associated with increased pulmonary complications (OR 1.42, 95% CI 1.08–1.87).

Conclusion: Hemodynamic optimization targeting MAP ≥85 mmHg and avoidance of intraoperative hypotension are critical components of anesthetic management associated with improved outcomes in acute tSCI surgery. Anesthetic agent selection may influence neurological recovery, though evidence quality remains limited.

Abstract Emergency departments (EDs) characterized by rapid patient turnover, unpredictable clinical deterioration, and the need for timely recognition of physiological instability. Conventional intermittent vital sign assessment may fail to detect transient or progressive changes in critically ill patients, creating opportunities for wearable and continuous monitoring technologies. This systematic review and meta-analysis aimed to evaluate the clinical performance, accuracy, reliability, and practical implications of wearable and continuous vital sign monitoring systems in emergency department populations. A comprehensive literature search conducted across major biomedical databases to identify studies evaluating wearable devices, wireless sensors, continuous electrocardiography (ECG), pulse oximetry, respiratory monitoring, non-invasive blood pressure monitoring, and multimodal physiological monitoring systems in ED patients. Studies reporting diagnostic accuracy, agreement with reference measurements, detection of clinical deterioration, workflow impact, or patient outcomes were included. Data extraction focused on technology characteristics, patient populations, monitoring parameters, performance outcomes, and methodological quality. The pooled findings demonstrated that wearable and continuous monitoring technologies generally provided acceptable agreement with conventional bedside measurements, particularly for heart rate, oxygen saturation, and respiratory rate monitoring. Continuous systems showed improved detection of physiological abnormalities compared with intermittent monitoring, although performance variability observed across devices and clinical settings. Meta-analysis indicated significant improvements in early recognition of deterioration events and enhanced monitoring continuity, while limitations remained regarding motion artifacts, calibration requirements, data integration, and clinical alarm management. Wearable monitoring technologies appear to represent a valuable adjunct to conventional ED assessment by enabling earlier identification of patient instability and supporting personalized clinical decision-making. However, further large-scale prospective studies are required to determine their impact on mortality, resource utilization, and cost-effectiveness.

Abstract Maxillofacial abnormalities involving chin deformities often lead to significant aesthetic and functional concerns. In recent years, hyaluronic acid (HA) fillers have gained popularity as a non-surgical alternative for chin shape correction. This systematic review aims to assess the efficacy, safety, and patient satisfaction associated with the use of hyaluronic fillers for chin augmentation in patients with congenital or acquired maxillofacial deformities. A thorough search of databases including PubMed, Scopus, Embase, and Cochrane Library was conducted up to July 2025. Inclusion criteria comprised clinical trials, case series, and cohort studies reporting on outcomes of HA filler injection in the chin. A total of 18 studies met the eligibility criteria, involving 729 patients. The analysis revealed that HA fillers provided satisfactory aesthetic improvement, high patient satisfaction, and low complication rates. However, repeated treatments are necessary due to the temporary nature of fillers. Overall, HA fillers offer a safe, effective, and minimally invasive option for selected patients with chin deformities, particularly when surgical interventions are not feasible or desired.

Abstract Midface volume loss and contour irregularities significantly affect facial aesthetics and are commonly addressed in aesthetic medicine. The beauty rule of one-fifth, which divides the midface horizontally into five equal parts, serves as a foundational guideline for achieving balanced and harmonious facial proportions. This systematic review evaluates the current evidence on the use of hyaluronic acid (HA) fillers for midface correction based on the one-fifth beauty rule. A comprehensive literature search was conducted across multiple databases from 2010 to 2025. Included studies assessed HA filler applications targeting midfacial volumization and contouring with reference to the one-fifth guideline. Outcomes related to aesthetic improvement, patient satisfaction, procedural safety, and adherence to proportional principles were analyzed. The review demonstrates that HA fillers, when applied with respect to the one-fifth rule, yield significant enhancement in midface volume and contour harmony with high patient satisfaction and minimal adverse events. This approach offers a minimally invasive alternative to surgical interventions and underscores the importance of aesthetic proportionality in treatment planning. Future research should focus on standardized injection protocols aligned with anthropometric guidelines to optimize outcomes.

Abstract Background: Venous insufficiency (acute and chronic) represents a significant vascular pathology, particularly prevalent in patients with increased body mass index (BMI). Overweight and obesity are associated with impaired venous hemodynamics, higher disease severity, and distinct therapeutic outcomes.

Objectives: To systematically evaluate the impact of overweight and obesity on acute and chronic venous insufficiency, with emphasis on surgical and endovascular intervention outcomes.

Methods: Databases (PubMed, ScienceDirect and others) were systematically searched for clinical and surgical studies comparing outcomes of venous interventions among normal-weight, overweight, and obese patients. Adult human studies published in English were included. Evidence was graded according to study design and clinical outcomes.

Results: Higher BMI correlates with greater severity of chronic venous insufficiency (CVI) and reduced improvement after procedural interventions such as thermal ablation or phlebectomy. Surgical outcomes are variably affected by BMI, with some studies showing poorer efficacy in patients with BMI ≥35 kg/m². Bariatric surgery–related weight loss may improve CVI manifestations. Evidence for acute venous insufficiency in overweight cohorts remains limited.

Conclusion: Evidence indicates that overweight and obesity negatively influence chronic venous insufficiency severity and surgical outcomes. Preoperative weight management and tailored surgical approaches are recommended for optimal outcomes.

Abstract Dermal fillers are widely used in aesthetic medicine for facial rejuvenation and volume restoration. Although generally considered safe, complications—ranging from mild to severe—can occur. Patient-related factors significantly contribute to the risk, nature, and severity of these adverse effects. This review explores how age, medical history, skin type, lifestyle habits (such as smoking and sun exposure), and immune status influence the development of dermal filler complications. Inadequate patient selection and insufficient pre-treatment assessment can lead to undesirable outcomes including granuloma formation, delayed hypersensitivity reactions, and vascular compromise. Moreover, psychological factors and unrealistic expectations may complicate the therapeutic course. Prevention begins with thorough patient evaluation, informed consent, and individualized treatment planning. In the event of complications, early recognition and a tailored treatment strategy—ranging from conservative management to enzymatic or surgical intervention—are crucial. Understanding patient-specific risks not only enhances safety but also optimizes outcomes. This article aims to guide clinicians in integrating patient factors into the prevention, assessment, and treatment of dermal filler complications, ultimately contributing to safer and more effective aesthetic practices.

Abstract Background: Burn wounds treated with skin grafts are associated with risks of infection and delayed healing, making effective treatment crucial. This randomized controlled trial evaluates the efficacy of Biatain Silver dressing compared to conventional dressing in skin graft burn wounds. The study aims to reduce microbial load, promote re-epithelialization, and shorten wound healing time.

Methods: This randomized controlled trial was conducted on 60 burn patients with skin grafts at Motahari Burn Hospital in Tehran, who were randomly assigned to two groups receiving either Biatain Silver dressing or conventional dressing. Assessments included clinical examinations and wound cultures on days 7, 14, and 21 post-intervention. Data were analyzed using SPSS version 22, with a significance level set at p ≤ 0.05.

Results: The study results showed that Biatain Silver dressing significantly reduced wound size (p=0.00), wound exudate (p=0.00), and patient pain intensity (p<0.001), while accelerating the epithelialization process (p=0.00). Additionally, the percentage of negative wound culture results was significantly higher in the intervention group (p=0.00). These findings confirm the efficacy of Biatain Silver dressing in faster wound healing and infection control in burn wounds.

Conclusion: The results of this study demonstrated that Biatain Silver dressing effectively reduces wound exudate, controls infection and pain, and accelerates the epithelialization process. By creating a moist environment and gradually releasing silver ions, this dressing decreases microbial load and local inflammation. Therefore, Biatain Silver is an efficient option for managing burn wounds and warrants further investigation with larger sample sizes.

Abstract The use of injectable fillers in aesthetic medicine has gained significant popularity for facial rejuvenation and contouring. A crucial factor in achieving optimal results lies in understanding the patient’s unique facial shape, as it influences filler selection, injection technique, and treatment goals. This review explores the classification of facial shapes—commonly categorized as oval, round, square, heart, and diamond—and their implications for planning injectable filler treatments. Each facial shape presents distinct anatomical features and aesthetic challenges that must be addressed to restore harmony and balance. For example, oval faces typically require subtle volumization to maintain natural contours, while square faces may benefit from softening the jawline. Treatment strategies are tailored to enhance facial proportions, improve symmetry, and correct age-related volume loss. The integration of facial shape analysis with patient-specific factors such as skin quality, bone structure, and aging patterns facilitates a personalized approach to filler application. Additionally, understanding facial shape helps in predicting potential complications and managing patient expectations. This paper emphasizes the importance of a comprehensive facial assessment and individualized treatment planning to maximize the efficacy and safety of injectable fillers. By aligning treatment techniques with facial morphology, clinicians can achieve more natural, balanced, and aesthetically pleasing outcomes, ultimately enhancing patient satisfaction.

Abstract Structural facial rejuvenation with dermal fillers has become a cornerstone in non-surgical aesthetic treatments, particularly for women seeking natural, youthful, and harmonious facial contours. This approach focuses on restoring volume loss and supporting the underlying facial architecture rather than simply filling superficial wrinkles. By targeting key structural areas such as the midface, cheeks, jawline, and temples, practitioners can effectively counteract the effects of aging, including soft tissue descent, bone resorption, and fat compartment atrophy. The use of hyaluronic acid-based fillers and calcium hydroxylapatite has demonstrated safety, biocompatibility, and long-lasting outcomes in volumizing and lifting facial tissues. This method emphasizes a comprehensive understanding of facial anatomy, aging dynamics, and individualized treatment planning to achieve balanced and natural-looking results. Moreover, recent advances in imaging technologies and injection techniques have enhanced precision and minimized risks such as vascular complications and irregularities. Clinical studies support the efficacy of structural rejuvenation, reporting high patient satisfaction and improved facial aesthetics. However, successful outcomes require skilled assessment, tailored protocols, and an integrative approach combining filler use with other modalities when necessary. This article reviews current concepts, materials, and procedural strategies for structural facial rejuvenation in women, highlighting the importance of a holistic and anatomically informed technique to restore youthful facial contours safely and effectively.

Abstract The aesthetic rejuvenation of the lower third of the face, particularly the jawline, has become a pivotal focus in modern cosmetic dermatology. This study introduces “Contouring Plus,” a novel, minimally invasive approach that combines the biostimulatory properties of Calcium Hydroxylapatite (CaHA) with the versatile volumizing and contouring capabilities of Hyaluronic Acid (HA) fillers. The protocol involves a strategic layering technique where CaHA is injected supraperiosteally along the mandibular border to provide structural support and stimulate neocollagenesis, while HA fillers are administered in the subcutaneous plane to refine contours and enhance soft tissue projection. The article presents a case series involving four patients aged 29 to 54, treated in a single session and evaluated over a 90-day period using clinical photography and three-dimensional imaging. Results demonstrated significant improvement in jawline definition and patient satisfaction, with minimal adverse events such as mild bruising and swelling. The safety profile is supported by adherence to precise anatomical landmarks and injection planes, minimizing risks of vascular complications. The combined filler technique capitalizes on the long-term collagen-stimulating effects of CaHA alongside the immediate, moldable benefits of HA, resulting in durable and natural-looking facial rejuvenation. This hybrid approach provides clinicians with an evidence-based, adaptable protocol for addressing age-related volume loss and contour irregularities in the lower face. Future studies are warranted to assess long-term outcomes and optimize filler combinations.

Abstract Artificial intelligence (AI) is rapidly transforming dermatology, particularly in the realm of aesthetic procedures such as injectable filler administration. The integration of AI technologies into filler treatments offers promising advancements in precision, safety, and personalization, addressing longstanding challenges associated with manual injection techniques. AI-driven imaging and diagnostic tools enable detailed analysis of facial anatomy, volume loss patterns, and skin characteristics, allowing clinicians to develop highly individualized treatment plans tailored to each patient’s unique facial structure and aesthetic goals. Machine learning algorithms can predict patient outcomes by analyzing vast datasets of previous treatments, helping practitioners optimize filler type, volume, and injection sites to maximize efficacy and minimize adverse effects. Moreover, AI-powered real-time guidance systems, including augmented reality, provide dynamic visualization of critical anatomical landmarks and vascular structures during injection procedures, reducing the risk of complications such as vascular occlusion and nerve injury. These technologies also support less experienced clinicians by enhancing accuracy and confidence in filler placement. Furthermore, AI facilitates post-procedure monitoring through automated assessment of treatment results and early detection of potential complications, enabling timely interventions. The adoption of AI in filler administration not only improves clinical outcomes but also elevates patient satisfaction by enabling more predictable and natural-looking rejuvenation. Despite its potential, challenges remain in integrating AI into routine dermatological practice, including data privacy concerns, algorithm transparency, and the need for comprehensive clinical validation. Nonetheless, ongoing research and technological development position AI as a critical tool to revolutionize facial aesthetic treatments, making filler administration safer, more effective, and personalized.