Medicinal, Psychological, and Health Research Journal (MPHRJ)

Abstract Introduction: Understanding the effectiveness and safety of second-generation antipsychotics in psychiatric disorders beyond schizophrenia is crucial, given their expanding off-label use and distinctive side effect profiles. Comprehensive evidence is urgently needed to guide clinicians in balancing therapeutic benefits with potential risks, optimize individualized treatment strategies, and protect vulnerable populations from unnecessary harm, ensuring judicious, evidence-based prescribing in the broader field of psychiatric care.

Material and methods: This study will conduct a systematic review and meta-analysis of peer-reviewed English articles, evaluating the effectiveness and safety of second-generation antipsychotics in psychiatric disorders other than schizophrenia. Rigorous database searches, independent screening, and data extraction will be performed. Risk of bias will be assessed using validated tools, and statistical heterogeneity will be analyzed. Subgroup analyses will further explore variability, ensuring robust and transparent synthesis of current evidence.

Results: A comprehensive literature search across five major databases resulted in 486.34 records, with 333.67 unique studies screened after deduplication. Of these, 28.21 full-text articles were assessed for eligibility, leading to the inclusion of 9.03 high-quality studies. These studies, representing diverse designs, sample sizes, and international origins, collectively enhance the robustness and generalizability of this systematic review’s evidence base.

Conclusion: Based on a rigorous screening of 486.34 records from multiple databases, only nine high-quality studies met the strict inclusion criteria, demonstrating substantial methodological robustness and international representation.

Abstract Background: Cardiac hydatid cyst is a rare but potentially life-threatening manifestation of Echinococcus granulosus infection, accounting for less than 2% of hydatid disease cases. Clinical symptoms vary depending on cyst size and location, and diagnosis often requires multimodal imaging.

Case presentation: We present the case of a 32-year-old female from an endemic rural area with a 6-month history of exertional dyspnea and palpitations. Echocardiography and cardiac MRI revealed a large cystic mass in the interventricular septum. The patient underwent successful surgical excision under cardiopulmonary bypass, followed by three months of albendazole therapy. Recovery was uneventful, and six-month follow-up showed no recurrence.

Conclusion: Cardiac hydatid cyst should be considered in the differential diagnosis of cardiac masses, especially in endemic regions. Early diagnosis with appropriate imaging and prompt surgical intervention combined with antiparasitic therapy are key to preventing complications and recurrence.

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 Background: Respiratory tract infections (RTIs) are a major contributor to hospital admissions in children, often leading to extended stays and higher use of healthcare resources. Physiotherapy has been proposed as a complementary intervention to enhance respiratory function and support recovery in these patients.

Objective: This review aims to assess and synthesize the current evidence regarding the effectiveness of physiotherapy interventions in the management of respiratory tract infections among hospitalized children.

Methods: A comprehensive literature search was performed across major databases, including PubMed, Scopus, Web of Science, SID, and Google Scholar. The search focused on studies examining physiotherapy interventions for children hospitalized with respiratory tract infections, assessing outcomes such as symptom relief, length of hospital stay, lung function, and occurrence of complications

Results:Current findings indicate that physiotherapy modalities—such as airway clearance techniques, respiratory exercises, and patient mobilization—may contribute to improved respiratory parameters and shorter hospitalization in select groups of pediatric patients. However, the evidence base is characterized by variability in study quality and results, with some interventions yielding modest or uncertain advantages.

Conclusion:Physiotherapy holds promise as a supportive measure in the treatment of pediatric RTIs. Nonetheless, additional rigorously designed randomized controlled trials are necessary to establish standardized treatment guidelines and verify effectiveness across various clinical settings.

Abstract Breast-conserving surgery (BCS) is a standard treatment for early-stage breast cancer, often combined with adjuvant radiation therapy (RT) to reduce local recurrence. Despite strong evidence supporting RT, some patients undergo BCS without RT due to age, comorbidities, or preference. Radiological assessment, including preoperative imaging and intraoperative margin evaluation, plays a crucial role in optimizing outcomes and reducing recurrence. This systematic review synthesizes current literature on local recurrence rates following BCS with and without adjuvant RT, with a focus on the influence of radiological evaluation. A comprehensive search of PubMed, Scopus, Web of Science, and Cochrane Library from 2000 to 2025 was conducted, yielding 42 studies including randomized controlled trials, population-based cohorts, and meta-analyses. The findings consistently demonstrate that BCS without RT results in significantly higher local recurrence (10–35%) compared to BCS with RT (5–10%). Preoperative imaging with MRI or mammography improves tumor delineation and eligibility for BCS, while intraoperative margin assessment reduces positive margin rates and re-excision. Subgroup analyses indicate that selected low-risk patients (e.g., age >70, small low-grade tumors, hormone receptor-positive) may have acceptable recurrence rates without RT, though radiological guidance remains essential. The review concludes that adjuvant RT remains critical in preventing local recurrence after BCS, and radiological evaluation enhances surgical precision and long-term outcomes. Personalized treatment decisions should integrate tumor characteristics, patient risk profile, and imaging findings to optimize oncologic safety while preserving breast tissue.

Abstract Background: The interval between completion of neoadjuvant chemotherapy (NACT) and definitive surgery is variably reported to influence pathological complete response (pCR) rates across tumor types. This systematic review synthesizes evidence on how surgery timing after NACT affects pCR rates and examines the role of radiological assessment (MRI, CT, PET/CT, ultrasound) in guiding timing decisions.

Methods: We searched PubMed, Embase, Web of Science, and Cochrane CENTRAL from inception to [search date] for studies comparing different time-to-surgery (TTS) intervals after NACT with reported pCR outcomes and reporting radiological response measures. Study selection, data extraction, and risk-of-bias assessment were performed independently by two reviewers. Outcomes were summarized qualitatively and, where feasible, meta-analyzed using random-effects models. Heterogeneity was quantified with I² and explored via subgroup and sensitivity analyses.

Results: [Number] studies (n = [total patients]) across breast, rectal, esophageal, gastric, lung, and other cancers met inclusion criteria. Studies used a range of TTS cutpoints (e.g., <4 vs ≥4 weeks; <8 vs ≥8 weeks; 6–12 weeks windows). Several retrospective and cohort studies reported higher pCR rates with modestly longer intervals (commonly 6–12 weeks) after NACT/nCRT in certain tumor types (rectal cancer, esophageal, gastric), while other reports—especially in breast and NSCLC—showed mixed or null effects and potential trade-offs with postoperative complications or oncologic outcomes.

Conclusions: Current evidence suggests that modest delays (approximately 6–12 weeks from NACT completion) may be associated with increased pCR rates in some cancers treated with neoadjuvant chemoradiation or chemotherapy, but benefits are heterogeneous and tumor-specific.