Medicinal, Psychological, and Health Research Journal (MPHRJ)

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 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 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 Introduction: Mechanical prosthetic valve thrombosis is a life threatening complication associated with substantial in hospital mortality, and early prognostic stratification remains clinically challenging. Given the overlap between cardiovascular comorbidities and adverse outcomes, this study aimed to evaluate the prognostic value of the CHA₂DS₂ VASc score for predicting in hospital mortality among hospitalized patients with mechanical prosthetic valve thrombosis.

Material and methods: This hospital based case–control study enrolled 100 patients with mechanical prosthetic valves at Shahid Madani Hospital, Tabriz, between 2017 and 2022. Using census sampling, clinical, echocardiographic, and anticoagulation data were collected, the CHA₂DS₂ VASc score was calculated at admission, and its association with in hospital mortality was analyzed using multivariable statistical models.

Results: Baseline characteristics were comparable between patients with and without thrombosis, indicating a well-balanced study population. The CHA₂DS₂‑VASc score did not differ significantly between thrombotic and non‑thrombotic groups (P = 0.23) and showed no significant association with mortality in either subgroup (P = 0.461 and P = 0.127). ROC analysis demonstrated poor discriminatory performance for prosthetic valve thrombosis.

Conclusion: In patients with mechanical prosthetic valves, the CHA₂DS₂ VASc score demonstrated limited clinical utility for predicting thrombotic events and mortality. Despite its established role in thromboembolic risk stratification for atrial fibrillation, the score failed to effectively discriminate patients at risk for prosthetic valve thrombosis or adverse survival outcomes.

Abstract Background: Acute intracranial hypertension requiring emergency neurosurgical intervention is associated with substantial risks of neurological deterioration, cerebral hypo perfusion, and perioperative mortality. Anesthetic management in this setting is particularly challenging because induction, airway manipulation, ventilation, hemodynamic instability, and anesthetic drug selection may influence intracranial pressure (ICP), cerebral perfusion pressure (CPP), and neurological outcomes. However, evidence regarding the optimal perioperative anesthetic strategy remains heterogeneous.

Objective: This systematic review and meta-analysis aimed to evaluate perioperative anesthetic strategies and their associations with physiological and clinical outcomes in patients undergoing emergency neurosurgery for acute intracranial hypertension.

Methods: A systematic literature search designed to identify clinical studies evaluating anesthetic management during emergency or urgent craniotomy or craniectomy for intracranial hypertension or brain herniation. Relevant outcomes included ICP, CPP, arterial blood pressure, hemodynamic instability, brain swelling, extubation status, neurological outcomes, and mortality. Evidence concerning intravenous and volatile anesthetic techniques, induction strategies, and adjunctive perioperative interventions critically assessed. Risk of bias, clinical, and methodological heterogeneity considered before quantitative synthesis.

Results: Available evidence suggests that perioperative anesthetic management can influence cerebral and systemic physiology, although the certainty of evidence remains limited. Propofol-based anesthesia has been associated with lower ICP and reduced risk of brain swelling compared with volatile anesthetics in broader craniotomy populations, although this benefit not consistently demonstrated in emergency craniotomy subgroups. Contemporary evidence also challenges the historical concern that ketamine invariably increases ICP; systematic reviews have reported no consistent adverse effect on ICP, CPP, or mortality in patients with acute brain injury. Nevertheless, heterogeneity in patient populations, anesthetic regimens, concomitant therapies, and outcome definitions limits definitive comparisons.

Conclusions: Current evidence does not establish a single superior anesthetic regimen for emergency neurosurgery complicated by acute intracranial hypertension. Individualized, physiology-guided management emphasizing preservation of cerebral perfusion and avoidance of secondary physiological insults appears most appropriate.

Abstract Osteoporosis is a common bone disease that gradually reduces bone density and increases the risk of fractures. This disease is especially common in postmenopausal women due to a significant decrease in estrogen levels. There are various methods for preventing and treating osteoporosis, including lifestyle changes, proper diet, regular exercise, and the use of various medications. One of the effective drugs in this field is raloxifene tablets. Raloxifene tablets are a nonsteroidal estrogenic drug that acts as a selective agonist-antagonist of estrogen receptors. This drug is designed to mimic the positive effects of estrogen on bones while reducing its negative effects on other tissues such as the breast and uterus. Therefore, raloxifene is used as an important treatment option for postmenopausal women in the management and prevention of osteoporosis. Raloxifene is used to treat breast cancer and infertility associated with oligomenorrhea or secondary amenorrhea. Raloxifene is a new treatment that has recently become available for the prevention of osteoporosis of the spine. It is taken as a single pill daily. In some ways, it works like estrogen, but unlike estrogen, it does not cause vaginal bleeding or increase the risk of breast cancer. In fact, there is evidence that it protects women from developing breast cancer for at least the first three years of treatment. Raloxifene does not help women with menopausal symptoms such as hot flashes, night sweats, and hot flashes.

Abstract Introduction: ST-segment elevation myocardial infarction (STEMI) demands rapid risk stratification, often limited by the availability of complex scores. The Modified Shock Index (MSI), derived from routine vital signs, reflects acute circulatory stress. This study aims to determine the predictive correlation between admission MSI values and the underlying angiographic coronary anatomy, specifically the number and type of involved vessels, thereby assessing MSI’s utility as a simple bedside marker for disease complexity in STEMI patients.

Material and methods: This cross-sectional study analyzed 234 consecutive STEMI patients via census sampling at Shahid Madani Hospital in Tabriz between 2018 and 2019. The core procedure involved calculating the Modified Shock Index (MSI) from vital signs recorded at admission. The study then correlated these pre-treatment MSI values with the detailed coronary anatomy determined by subsequent angiography to assess the extent of vessel involvement.

Results: Patients with high MSI (>0.897) were older (61 vs. 57 years, p = 0.002) and had higher rates of hypertension (p = 0.008), diabetes mellitus (p = 0.002), and dyslipidemia (p = 0.009), along with longer chest pain duration (p = 0.004) and elevated WBC (p = 0.001), troponin (p = 0.002), and creatinine levels (p = 0.001). MSI did not differ by number or type of involved vessels (all p > 0.05) but showed moderate predictive value for MACE (pre‑PPCI AUC = 0.677; post‑PPCI AUC = 0.631; both p < 0.001).

Conclusion: In conclusion, this study demonstrates that the Modified Shock Index is closely associated with patient‑level vulnerability and acute disease severity rather than the anatomical extent or distribution of coronary artery involvement in STEMI.

Abstract Demographic advances and the increasing elderly population have made it necessary to review the professional training and attitudes of future dentists. The present study aimed to investigate the effect of dental students' attitudes towards elderly patients on the satisfaction of these patients with receiving a removable complete denture. The therapist's attitude plays a central role in the formation of the clinical relationship, the manner of communication, the level of attention, and supportive behavior. Factors that can all shape the patient's treatment experience and affect his satisfaction with the treatment. This descriptive-correlation study was conducted with the participation of 150 dental students and 150 elderly patients receiving removable complete dentures at three universities of medical sciences in the country. Data collection tools included a standard questionnaire on attitudes towards the elderly for students and a questionnaire on satisfaction with dentures for patients. Data analysis was performed using descriptive statistical tests, Pearson correlation, multiple regression, and independent t-test. The findings showed that there was a positive and significant relationship between students' general attitude towards the elderly and patients' satisfaction with prosthesis. In particular, the emotional and behavioral components of attitude towards the elderly were stronger predictors of patient satisfaction, while the cognitive component had no significant effect. Finally, the present study, emphasizing the importance of professional attitude in geriatric dentistry, suggests that universities should reform curricula, design attitude-based educational interventions, and strengthen effective clinical experiences.

Abstract Advances in maxillofacial surgery increasingly rely on interdisciplinary approaches that integrate principles from engineering, digital imaging, and design sciences. Architectural methodologies, particularly those related to proportion, structural analysis, parametric modeling, and spatial visualization, offer a powerful conceptual and practical framework for understanding and reconstructing the human face. This article examines how architectural thinking can inform surgical planning, simulation, and outcome evaluation in contemporary maxillofacial practice. Drawing on literature from craniofacial surgery, computational design, and architectural theory, the study analyzes parallels between facial anatomy and built structures, emphasizing load distribution, symmetry, modularity, and hierarchical organization. Three methodological intersections are explored: geometric proportioning based on classical and modern architectural ratios; digital workflows employing three-dimensional scanning, virtual surgical planning, and computer-aided design; and patient-specific reconstruction strategies that mirror adaptive architectural design processes. The discussion highlights the benefits of visual communication tools, iterative modeling, and scenario testing, which allow surgeons to predict functional and aesthetic outcomes with greater accuracy. Ethical and practical limitations are also considered, including the risk of overstandardization and the need to preserve individual anatomical variation and cultural perceptions of facial aesthetics. The article concludes that adopting architectural methodologies does not merely enhance technical precision but also encourages a holistic perspective in which the face is understood as a dynamic, structural, and expressive system shaped by both biological and design principles. Future research should further investigate quantitative metrics for evaluating aesthetic harmony, long-term functional stability, and patient-reported outcomes, while fostering collaboration among surgeons, architects, biomedical engineers, and digital designers to develop standardized yet flexible frameworks capable of addressing diverse clinical conditions and cultural expectations worldwide through longitudinal studies, multicenter trials, and open interdisciplinary data sharing initiatives.

Abstract Introduction: Early detection of lung cancer can be effective in the treatment process. However, it is difficult to detect this cancer in its early stages. Because its symptoms are similar to a respiratory infection.

Material and method: In the current study, the issue investigated by reviewing 42 articles and considering key words such as "radiological images", "diagnosis", "airway tumors", "clinical care", “Systematic Review” in Scopus, Google scholar and PubMed databases.

Findings: Lung cancer treatments are designed to get rid of the cancer in the body or slow its growth. Treatments can eliminate cancer cells, help destroy them, or prevent them from multiplying, or teach your immune system to fight them. Some treatments are also used to reduce symptoms and relieve pain. Your treatment will depend on the type of lung cancer, its location, how far it has spread, and many other factors.

Conclusion: Graphene oxide was prepared using the Hammer method. The structural integrity of the synthesized graphene oxide was verified and confirmed using FT-IR, UV-Vis spectroscopies, and TEM imaging. The different responses of the biosensor Nano sensor to healthy and mutated DNA enabled the detection of lung cancer. Therefore, by relying on nanotechnology, it is possible to detect lung cancer through fast, easy and cost-effective methods.

Abstract Facial reconstruction in plastic and reconstructive surgery represents a unique intersection of art and science, requiring a deep understanding of human aesthetic and anatomical structures. In recent years, the application of architectural concepts such as form, proportion, and harmony has emerged as a guiding framework for designing facial reconstructions. Form refers to the overall shape and three-dimensional volume of facial components, proportion addresses the mathematical relationships between these components, and harmony reflects the visual balance and aesthetic coherence among facial features. Integrating these concepts enhances surgical precision, improves aesthetic outcomes, and produces a more natural and balanced appearance. Research indicates that combining architectural principles with surgical techniques can improve preoperative planning, the selection of appropriate reconstructive methods, and the prediction of final outcomes. Moreover, this approach enables surgeons to correct complex deformities in a manner that respects individual patient characteristics while maintaining visual harmony. This article presents a framework based on form, proportion, and harmony for facial reconstruction and explores its applications in both reconstructive and cosmetic surgery. Findings demonstrate that incorporating architectural concepts not only enhances aesthetic outcomes but also increases patient satisfaction and reduces the need for secondary procedures. The study emphasizes that facial reconstruction surgeons can employ architectural principles as guiding tools for precise and harmonious design, bridging the boundaries between art and science in medicine.

Abstract Introduction: Cancer patients receiving chemotherapy are particularly vulnerable to COVID 19–associated thrombotic complications. The coexistence of SARS CoV 2 infection, malignancy related hypercoagulability, and treatment induced immunosuppression may adversely affect mechanical thrombectomy outcomes. Understanding this interaction is essential for optimizing acute stroke management and improving neurological and survival outcomes in this high risk population.

Material and methods: Following ethical approval, data were prospectively collected at Imam Reza Hospital using standardized forms. Demographic characteristics, comorbidities, cancer type, laboratory findings, thrombotic sites, anticoagulant use, ICU course, and clinical outcomes were systematically recorded for eligible cancer patients with COVID‑19. Statistical analyses were conducted to evaluate associations between clinical variables and patient outcomes.

Results: Critically ill cancer patients with concurrent COVID‑19 exhibited marked inflammatory and hypercoagulable profiles, with frequent multisite thrombosis, predominantly pulmonary and cerebral. Clinical outcomes were poor, characterized by prolonged ICU stays, high mechanical ventilation use, and substantial mortality. Active chemotherapy was associated with significantly reduced overall survival, underscoring its prognostic relevance in this high‑risk population.

Conclusion: the findings of this study support the concept that COVID 19 and malignancy act synergistically to create a uniquely severe thromboinflammatory state with profound clinical consequences. The combination of systemic inflammation, diffuse thrombosis, prolonged critical illness, and reduced survival—particularly among patients receiving chemotherapy—highlights the need for heightened vigilance, early identification of thrombotic complications, and tailored management strategies in this population.

Abstract Introduction: Maintaining hemodynamic stability during orthopedic surgery is crucial to reducing perioperative complications. Dexmedetomidine, an α2-adrenergic agonist, has been increasingly utilized for its sedative, analgesic, and sympatholytic properties. This systematic review evaluates the preventive effects of dexmedetomidine on intraoperative and postoperative hemodynamic stability in orthopedic surgery patients.

Materials and Methods: A systematic review was conducted following PRISMA guidelines. Databases including PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched for randomized controlled trials and observational studies investigating dexmedetomidine’s impact on hemodynamic parameters. Data extraction included study design, patient demographics, dexmedetomidine dosing, intraoperative mean arterial pressure (MAP), heart rate (HR), and postoperative hemodynamic stability. Meta-analysis was performed where applicable.

Results: Dexmedetomidine significantly reduced intraoperative MAP fluctuations and heart rate variability compared to controls (p < 0.001). Postoperative hypertension (8.73% vs. 21.35%; p = 0.014) and tachycardia (10.24% vs. 26.57%; p = 0.008) were also lower in the dexmedetomidine group. Mild bradycardia was observed more frequently but was not clinically significant.

Conclusion: Dexmedetomidine enhances perioperative hemodynamic stability in orthopedic surgery, reducing intraoperative fluctuations and postoperative cardiovascular events. It remains a valuable anesthetic adjunct with an acceptable safety profile. Future research should focus on optimal dosing strategies.

Abstract Introduction: Rapid molecular diagnostic techniques have emerged as critical tools for optimizing targeted antimicrobial therapy in critically ill ICU patients with multidrug‑resistant bacterial infections. By enabling early pathogen identification and resistance detection, these methods support timely therapeutic decision‑making, improve clinical outcomes, and strengthen antimicrobial stewardship in high‑risk critical care settings.

Material and methods: This systematic review synthesized evidence from major international databases using a comprehensive, unrestricted search strategy to evaluate rapid molecular diagnostics and their clinical impact on targeted antimicrobial therapy in critically ill patients.

Results: Across included studies, PCR‑based molecular diagnostics predominated, reflecting their clinical feasibility in ICU settings. Rapid molecular testing significantly shortened time to targeted therapy, reduced empirical broad‑spectrum antibiotic use, and improved ICU length of stay. Stewardship decisions were frequently optimized through de‑escalation, targeted escalation, or antibiotic discontinuation, collectively supporting more precise and evidence‑based antimicrobial management.

Conclusion: The proportion of cases in which no change in therapy was made following molecular testing likely reflects scenarios where empirical management was already appropriate. Rather than diminishing the value of molecular diagnostics, this finding reinforces their role in validating clinical judgment and providing reassurance regarding therapeutic adequacy.

Abstract Background: Conscientiousness, one of the Big Five personality traits, is consistently linked to better health outcomes and longevity. It is thought to influence behavior through enhanced self-regulation, adherence to medical recommendations, and lower stress reactivity. Hair cortisol concentration (HCC) has emerged as a reliable biomarker for chronic physiological stress. However, the relationship between conscientiousness, HCC, and health behaviors remains underexplored, particularly in older adults.

Objective: This study aims to investigate how conscientiousness relates to health behaviors and chronic stress, as measured by HCC, in older men and women. It also explores potential sex differences in these associations.

Methods: A cross-sectional sample of 350 older adults (aged 65–85) was recruited. Participants completed standardized assessments of personality traits, including conscientiousness, and reported on health-related behaviors (diet, physical activity, smoking, alcohol use, and medication adherence). Hair samples were collected and analyzed for cortisol concentration using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Statistical analyses included regression modeling and interaction terms for sex.

Results: Higher levels of conscientiousness were significantly associated with healthier behaviors and lower HCC. These associations remained robust after controlling for age, education, and socioeconomic status. Furthermore, the inverse relationship between conscientiousness and HCC was stronger in women, suggesting possible sex-related moderating effects.

Conclusion: Findings support the role of conscientiousness as a protective factor against chronic stress and unhealthy behaviors in aging populations. Interventions that enhance conscientiousness-related traits may improve stress regulation and health outcomes, particularly among older women.

Abstract Abstract

This article explores a cross-disciplinary framework linking architectural design principles with facial surgery, arguing that both fields address structure, aesthetics, function, and human perception through comparable logics. Architecture organizes space through proportion, symmetry, load distribution, and material behavior; facial surgery similarly reshapes bone and soft tissue to restore balance, stability, and expression. Drawing on architectural theories of form, modularity, and structural hierarchy, the paper proposes an analytical model for understanding the face as a dynamic, inhabitable structure rather than a static surface. Concepts such as scale, rhythm, tectonics, and contextual integration are translated into surgical planning tools that support more predictable functional and aesthetic outcomes. The study synthesizes literature from architecture, craniofacial surgery, biomechanics, and visual psychology, and illustrates how architectural thinking can enhance preoperative analysis, three-dimensional modeling, and patient-specific design. Conversely, insights from facial surgery—particularly adaptability, biological constraints, and healing processes—are shown to offer architecture valuable perspectives on responsive design and human-centered construction. By framing facial surgery as a form of micro-architecture and architecture as a macro-expression of embodied form, the article highlights shared epistemologies that transcend disciplinary boundaries. This integrative approach encourages collaboration between architects and surgeons, promotes innovative educational models, and opens new research pathways in digital simulation, biomimetic design, and aesthetic evaluation. Ultimately, the paper argues that understanding faces and buildings through a unified structural and perceptual lens can lead to more ethical, functional, and aesthetically coherent interventions in both the built environment and the human body. Such a perspective reframes professional responsibility, emphasizing long-term impact, interdisciplinary literacy, and the careful alignment of technique, meaning, and lived experience within complex social, cultural, and ethical contexts across contemporary practice globally today.

Abstract Introduction: Pelvic fractures are severe injuries commonly resulting from high-energy trauma, such as motor vehicle accidents and falls. These fractures can be complicated by missed diagnoses, particularly when patients are admitted to non-orthopedic wards. This study aimed to assess the incidence of undiagnosed pelvic fractures in trauma patients treated in non-orthopedic settings at Tabriz University of Medical Sciences.

Materials and Methods: A retrospective, cross-sectional analysis was conducted on trauma patients with pelvic fractures admitted to non-orthopedic wards from January 2020 to December 2024. Patient demographics, injury mechanisms, fracture types, and missed diagnoses were reviewed from medical records. Data were analyzed using descriptive and inferential statistics.

Results: A total of 300 patients were included, with a mean age of 46.35 years. The majority were male (60.67%), and the primary injury mechanism was motor vehicle accidents (50.33%). Pelvic ring disruptions (42.33%) were the most common fracture type. The incidence of missed fractures was 34%, with pelvic ring disruptions being the most frequently missed (10.33%).

Conclusion: Missed pelvic fractures represent a significant challenge in trauma care, particularly in non-orthopedic wards. The findings highlight the need for comprehensive diagnostic protocols, including early orthopedic consultation and advanced imaging, to reduce the risk of undiagnosed fractures and improve patient outcomes.

Abstract Introduction: Obese postmenopausal women undergoing thoracic surgery represent a high‑risk population due to the combined effects of hormonal deprivation, metabolic dysfunction, and reduced cardiopulmonary reserve. These factors significantly increase postoperative complications, ICU admission rates, and mortality, underscoring the need for tailored perioperative and critical care strategies in this vulnerable group.

Material and methods: This retrospective cross sectional study reviewed medical records of postmenopausal women admitted to the intensive care units of Imam Reza Hospital over a five year period. Clinical, demographic, and outcome data were collected using predefined criteria, and statistical analyses were performed with SPSS to evaluate associations between obesity, ICU outcomes, and mortality.

Results: Obese postmenopausal women admitted to the ICU after thoracic surgery exhibited significantly worse clinical outcomes compared with non obese patients. Obesity was associated with higher disease severity, increased need for mechanical ventilation and vasopressor support, longer ICU and hospital stays, and elevated ICU and 28 day mortality rates. These findings highlight obesity as a major determinant of postoperative morbidity and short term mortality in critically ill postmenopausal women.

Conclusion: In conclusion, our study demonstrates that obesity markedly deteriorates short term clinical outcomes among postmenopausal women admitted to the ICU following thoracic surgery. The data reveal higher disease severity, prolonged intensive care utilization, increased organ failure, and substantially greater mortality rates compared with non obese patients.

Abstract Introduction: Postoperative infections are a significant complication following surgical fixation of upper limb fractures, leading to increased morbidity, prolonged hospitalization, and potential implant failure. Early and accurate diagnosis is crucial for optimizing patient outcomes, yet distinguishing between normal postoperative inflammatory responses and infection remains challenging. This study aimed to evaluate the diagnostic utility of inflammatory markers, including C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count, in detecting postoperative infections.

Material and Methods: This prospective cohort study included patients undergoing upper limb fracture surgery. Inflammatory markers were measured at postoperative days (POD) 3 and 7. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) analysis, with sensitivity, specificity, and area under the curve (AUC) calculated.

Results: CRP and PCT demonstrated the highest diagnostic accuracy for detecting infections. At POD 3, CRP (AUC = 0.863) and PCT (AUC = 0.893) significantly differentiated infected from non-infected patients (p < 0.001). ESR and WBC count showed moderate diagnostic accuracy. Serial CRP and PCT measurements improved infection detection.

Conclusion: CRP and PCT are the most reliable markers for early detection of postoperative infections in upper limb fracture surgery. Incorporating these biomarkers into routine postoperative monitoring can improve early diagnosis and patient outcomes.

Abstract Temple volumization has become an integral component of facial rejuvenation, aiming to restore youthful contours and address age-related soft tissue loss. Despite the increasing use of dermal fillers in the temporal region, variability exists regarding filler type, injection depth, technique, and clinical outcomes. This systematic review and meta-analysis aimed to evaluate the efficacy, safety, and patient satisfaction associated with temple filler injections. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Cochrane Library databases from January 2000 to December 2025. Studies reporting on outcomes of hyaluronic acid (HA), poly-L-lactic acid (PLLA), and calcium hydroxylapatite (CaHA) in temple rejuvenation were included. Data extraction focused on injection technique, depth, volume, longevity of effect, adverse events, and patient-reported satisfaction. A total of 66 studies encompassing 3,214 patients met inclusion criteria. Meta-analytic pooling demonstrated significant improvement in temporal volume restoration with HA, PLLA, and CaHA, with standardized mean differences (SMD) of 1.12 (95% CI: 0.85–1.39), 1.05 (95% CI: 0.77–1.32), and 0.98 (95% CI: 0.70–1.26), respectively. Complication rates were low, predominantly mild bruising and transient edema, with no serious adverse events reported. Patient satisfaction scores were consistently high, with pooled satisfaction rates exceeding 90% across all filler types. Comparative analysis suggested slightly longer-lasting results with PLLA and CaHA compared to HA. The findings underscore that temple filler injections are effective, safe, and yield high patient satisfaction when performed with proper technique and depth awareness. Limitations include heterogeneity in study designs, follow-up duration, and reporting standards. Future research should focus on standardized injection protocols, long-term outcomes, and comparative studies between filler types. Overall, this meta-analysis provides evidence-based guidance for clinicians to optimize temple rejuvenation strategies and enhance patient-centered outcomes.

Abstract Introduction: Early detection of cancer can significantly increase the likelihood of successful treatment, and imaging tests can have a significant impact on cancer diagnosis. Early cancer treatments are simpler and cheaper than advanced treatments.

Material and method: In the current study, the issue investigated by reviewing 43 articles and considering key words such as "Radiology", "Radio Oncology", "Thoracic", "Pelvic Cancers", and “Systematic Review” in Scopus, Google scholar and PubMed databases.

Results: It should be noted that X-rays can cause changes in DNA, which can lead to cancer in the decades or years to come, but this risk is very small. Therefore, the World Health Organization (WHO) has classified X-rays as a probable carcinogen, although the benefits of X-rays outweigh their negative consequences. According to estimates, 0.4% of cancers in the United States are caused by CT scans could increase with the increase in the use of CT scans. On average, at least 62 million CT scans were performed in the United States in 2007.

Conclusion: Early detection helps doctors detect abnormalities in cancer-prone tissues that may develop into malignant cancers and prevent their spread by using cancer treatments.

Abstract Spinal cord injury (SCI) results in extensive neural tissue damage and significant functional deficits, representing a major challenge in neuroscience and rehabilitation medicine. Despite advances in therapeutic strategies, effective neuronal regeneration and functional recovery remain limited. Fibrin-based hydrogels have recently attracted considerable attention as biocompatible and tunable scaffolds, providing a supportive environment for neuronal protection, attenuation of inflammatory responses, and facilitation of axonal regeneration. This study presents the first comprehensive systematic review and meta-analysis evaluating the effects of fibrin hydrogels on neural repair following SCI in both animal models and human studies. A comprehensive search conducted in PubMed, Scopus, Web of Science, and Embase up to December 2025, selecting controlled studies with extractable quantitative data. Study quality assessed using standardized tools, including SYRCLE and the Cochrane Risk of Bias tool. Meta-analysis results demonstrated that fibrin hydrogel treatment significantly improved motor function (assessed via BBB and BMS scores), enhanced axonal regeneration, and reduced lesion cavity size (p < 0.01). Subgroup analysis indicated that combining fibrin hydrogels with stem cells or neurotrophic factors further amplified therapeutic outcomes. Although clinical data remain limited, preclinical findings are promising and support the potential of fibrin-based hydrogels as a key component in future SCI treatment strategies. Remaining challenges, such as optimizing degradation rates, controlling bioactive factor release, and standardizing hydrogel design for clinical applications, discussed. Overall, fibrin-based hydrogels offer a versatile platform for promoting neural protection and regeneration after SCI, highlighting their translational potential.

Abstract Introduction: One-anastomosis gastric bypass (OAGB) with a 150 cm biliopancreatic limb is increasingly used as a bariatric surgery option, offering effective weight loss and metabolic benefits. However, micronutrient deficiencies are common following this procedure due to altered gastrointestinal physiology. This study aims to evaluate changes in key micronutrient levels during the first three months after OAGB.

Materials and Methods: This prospective observational study included 25 patients who underwent OAGB with a 150 cm biliopancreatic limb. Blood samples were collected at three time points: preoperatively, 1 month postoperatively, and 3 months postoperatively. Serum levels of iron, ferritin, vitamin B12, folate, calcium, vitamin D, and fat-soluble vitamins (A, D, E, K) were measured. Statistical analysis was performed using repeated measures ANOVA and Friedman’s test to assess changes in micronutrient levels over time.

Results: The study found significant decreases in ferritin, vitamin B12, calcium, and fat-soluble vitamins (A, E, and K) from baseline to 3 months post-surgery (p < 0.05 for all). Ferritin and vitamin B12 levels declined sharply, indicating potential iron and vitamin B12 deficiencies, while vitamin D and calcium levels also decreased, raising concerns about bone health. Fat-soluble vitamin levels decreased significantly, pointing to malabsorption of these vitamins.

Conclusion: Significant micronutrient deficiencies, particularly in iron, vitamin B12, calcium, and fat-soluble vitamins, were observed within the first three months after OAGB. These findings highlight the need for careful monitoring and tailored supplementation to prevent nutritional deficiencies and associated complications in the early postoperative period.

Abstract Introduction: Opioids such as fentanyl and remifentanil are commonly used for anesthesia induction and maintenance, each with distinct pharmacokinetic and pharmacodynamic properties. This study aimed to compare their effects on hemodynamic stability, intraoperative excitability, neuromuscular blockade requirement, postoperative nausea, and recovery characteristics.

Materials and Methods: This prospective, randomized clinical trial included 400 patients, equally divided into fentanyl (n=200) and remifentanil (n=200) groups. Baseline characteristics, intraoperative hemodynamics, anesthesia recovery parameters, and postoperative complications were recorded. Data were analyzed using appropriate statistical tests, with P < 0.05 considered statistically significant.

Results: The remifentanil group exhibited significantly lower heart rate and blood pressure at all measured time points post-induction (P < 0.05). Intraoperative excitability and neuromuscular blocker requirement were higher in the remifentanil group (P = 0.014, P = 0.009). Postoperative nausea and antiemetic use were significantly higher in the fentanyl group (P = 0.041, P = 0.038). The remifentanil group had faster induction, earlier respiratory recovery, and shorter awakening time (P < 0.05).

Conclusion: Remifentanil ensures faster recovery with reduced postoperative nausea but causes greater hemodynamic suppression and intraoperative excitability. These findings support tailored opioid selection based on surgical needs and patient-specific factors.

Abstract Persistent HPV infection drives carcinogenesis via E6/E7 targeting p53 and Rb inactivation; loss of the p16 gatekeeper amplifies cellular susceptibility to HPV integration, rapidly accelerating progression toward invasive disease, defining critical targets for therapeutic precision and risk stratification. This narrative review rigorously synthesized literature from PubMed, Scopus, and other databases using combined MeSH terms and keywords like “cervical cancer” AND “HPV” AND “p16 expression,” filtering for English-language, full-text articles indexed before January 2026, explicitly excluding editorials and non-human studies via initial screening followed by full-text assessment focused solely on molecular pathogenesis linking viral oncogenesis to host cell cycle control in precursor lesions. High-risk HPV infection drives cervical carcinogenesis through E6 and E7 oncogenes, which degrade p53 and inactivate Rb, leading to uncontrolled proliferation reflected by compensatory p16 overexpression, a robust biomarker for high-grade disease. Viral integration is a critical step, often disrupting host genes like CDKN2A while locking in high E6/E7 expression, creating genomic instability. Clinically, p16 status helps triage positive HPV tests to identify high-risk lesions; while CDK4/6 inhibitors offer therapeutic avenues, primary vaccination remains the definitive strategy by eliminating the initiating oncogenic stimulus.