Testosterone extends its impact beyond sexual function, playing a crucial role in shaping overall male health, including aspects such as muscle mass, bone density, mood regulation, and energy levels. Lipoic acid, a cofactor for specific enzymes, particularly dehydrogenases involved in cellular energy production, has been studied for its impact on testosterone. This comprehensive review systematically scoured PubMed and Scopus databases using the keywords “lipoic acid” and “testosterone.” It encompassed all relevant English papers published from November 1971 to the present, including full texts and abstracts, along with research elucidating the biochemical mechanisms linking lipoic acid to testosterone. In summary, lipoic acid consistently restores testosterone levels, offering promise as an intervention in testicular health, especially in cases of testicular toxicity caused by various harmful agents. Its mechanisms encompass nitric oxide enhancement, fortification of testicular antioxidants, elevation of luteinizing hormone, enhancement of steroidogenesis, and the maintenance of energy production. These mechanisms underscore the therapeutic potential of lipoic acid for testicular health.

Background: Type 1 diabetes (T1D) results in autoreactive T cells chronically destroying pancreatic islets. This often results in irreplaceable loss of insulin-producing beta cells. To reverse course, a combinatorial strategy of employing glucose-responsive insulin restoration coupled with inhibiting autoreactive immune responses is required. Methods: Non-obese diabetic mice received a single intraperitoneal implantation of a novel biomaterial co-seeded with insulin-producing islets and T regulatory cells (Tregs). Controls included biomaterial seeded solely with islets, or biomaterial only groups. Mice were interrogated for changes in inflammation and diabetes progression via blood glucose monitoring, multiplex serum cytokine profiling, flow cytometry and immunohistochemistry assessments. Results: Islet and Tregs co-seeded biomaterial recipients had increased longevity, insulin secretion, and normoglycemia through 180 days post-implantation compared to controls. Serum profile revealed reduced TNFα, IFNγ, IL-1β and increased IL-10, insulin, C-Peptide, PP and PPY in recipients receiving co-seeded biomaterial. Evaluation of the resected co-seeded biomaterial revealed reduced infiltrating autoreactive CD8 + and CD4 + T cells concomitant with sustained presence of Foxp3 + Tregs; further analysis revealed that the few infiltrated resident effector CD4+ or CD8+ T cells were anergic, as measured by low levels of IFNγ and Granzyme-B upon stimulation when compared to controls. Interestingly, studies also revealed increased Tregs in the pancreas. However, there was no restoration of the pancreas beta cell compartment, suggesting normoglycemia and production of insulin levels were largely supported by the implanted co-seeded biomaterial. Conclusion These studies show the efficacy of a combinatorial approach seeding Tregs with pancreatic islets in a novel self-assembling organoid for reversing T1D.

The radial artery is currently the main vascular access site for cardiac catheterization. Radial artery occlusion (RAO), although a relatively silent complication, raises concerns because of its potential impact on future procedures. This pilot randomized controlled trial compared the efficacy and safety of two anticoagulation regimens—subcutaneous enoxaparin and oral rivaroxaban—in resolving symptomatic ultrasound-confirmed RAO in 40 patients (median age 55 years [interquartile range, 48-64], including 26 female patients [70.3%]) who underwent diagnostic cardiac catheterization without requiring dual antiplatelet therapy. Thirty-seven patients completed the 28-day ultrasound-based follow-up, demonstrating comparable complete or partial resolution rates between rivaroxaban (16 of 20 patients [80.0%]) and enoxaparin (14 of 17 patients [82.3%]), with an odds ratio of 0.85 (95% confidence interval: 0.16 to 4.50). No major bleeding events occurred during the 28-day follow-up period. While rivaroxaban shows potential in resolving RAO, larger studies are necessary to validate these findings and evaluate the long-term outcomes.

AIM: To identify various risk factors that may play a significant role in the development of congenital nasolacrimal duct obstruction(CNLDO).METHODS: This observational case-control study included a case group of 122 children less than two years of age with CNLDO who underwent probing and irrigation treatment at the ophthalmology department of Imam Khomeini Hospital in Ahvaz, Iran, from June 2022 to June 2024. A control group of 122 age-matched children without CNLDO was also included for comparison. Data was collected from the children's medical records. RESULTS:The study found a significant correlation between the occurrence of CNLDO and several maternal factors, such as preeclampsia, the use of levothyroxine, hypothyroidism, having more than three pregnancies(gravidity >3), natural pregnancy, and gestational diabetes mellitus. Additionally, in children, factors, such as oxygen therapy, anemia, reflux, jaundice, and a family history of CNLDO in first-degree relatives were associated with CNLDO, and maternal preeclampsia and hypothyroidism were found to significantly increase the risk of developing CNLDO in children.CONCLUSION: Given that CNLDO affects both premature and full-term children, the present findings may potentially facilitate the early identification of children and infants at risk of nasolacrimal duct obstruction, thereby preventing the onset of chronic dacryocystitis.

Background: Advancements in surgery, chemotherapy, and radiotherapy have improved survivalfor brain tumor patients, increasing the risk of second primary tumors (SPTs) among long-term survivors. This study examines the types and risks of SPTs in brain tumor patients presenting at a tertiary care hospital. Methods: This single-center, retrospective study explored occurrences of SPTs following prima-ry brain tumors and occurrences of brain tumors as SPTs following primary extra neural tumors. A total of 41 patients were included and analyzed presenting with histologically confirmed SPTs between 1st January 2000 and 31st December 2020. Results: The study included 41 patients with SPTs, primarily female (65.9%). Of these, 20 pa-tients (48.7%) developed SPTs after a primary brain tumor, while 21 patients (51.2%) developed brain tumors as SPTs after extra-neural tumors. Among patients who developed SPTs after brain tumors (n=20), meningioma (n=8, 40.0%) and pituitary adenoma (n=6, 30.0%) were the most prevalent first primary tumors (FPTs) while breast tumors predominated as SPTs (n=4, 20.0%). Survival analysis indicated younger mean age (44.5 years) for patients marked alive, compared to those marked deceased (57.0 years) and those with unknown outcomes (63.0 years). Conclusion Based on this retrospective analysis, the median age at diagnosis was 44.5 years,with a considerable number of patients (36.6%) having uncertain outcomes at follow-up due to incomplete records. These findings highlight the need for improved follow-up data management to better assess long-term survival in patients with SPTs following brain tumors.

Breast cancer is one of the most common causes of death all over the world. Therapeutic options applied to the patients include surgery, chemotherapy, and radiotherapy.However, far advanced disease often leads to chemoresistance and toxicity. Innovative therapies are needed to address these challenges. Melatonin has the potential to prevent and treat cancer, as it has been revealed in numerous clinical studies. Melatonin is a nontoxic agent that is mostly produced in the pineal gland, inducing various mechanisms of action such as the induction of apoptosis, antiangiogenic, antiproliferative, and metastasis-inhibitory effects. Therefore, melatonin increases therapeutic sensitivity when combined with conventional medication in breast cancer. Melatonin (3-20 mg/day) may reduce breast cancer cell growth in preclinical studies and enhance chemotherapy efficacy. Small human trials suggest potential benefits, but larger studies are needed. Higher doses (≥20 mg/day) are sometimes used alongside chemotherapy. This manuscript reviews research that has demonstrated the antitumor properties of melatonin, thereby focusing on its actions on angiogenesis, apoptosis, metastasis, and antiproliferative properties. We also discuss recent advances in the understanding of the actions of melatonin on epigenetic mechanisms (especially DNA methylation) and telomere length. The data in this review were obtained from journal articles up to May 2024.Regarding the study, Google Scholar and ScienceDirect were used as engines to search for open access. We searched the ISI, Pubmed and Scopus as valid external databases, and as internal databases, ISC and Iran medex. By finding mean keywords such as ‘breast cancer’, ‘estrogen’, ‘melatonin’, ‘cell death’, ‘cell proliferation’, ‘telomerase’ and ‘DNA methylation’, we reached to the formula with maximum collectivity in searching, then equivalent terms were found by Mesh database. The review also covers recent clinical investigations of melatonin in breast cancer.

Background/Aims: The irregular Z-line, defined as a segment of columnar mucosa less than 1 cm in the distal esophagus, is often biopsied despite guidelines advising against it due to a low risk of progression to esophageal adenocarcinoma (EAC). However, the clinical significance of an irregular Z-line remains unclear. This meta-analysis examines the prevalence of Barrett’s esophagus, dysplasia, and EAC in patients with an irregular Z-line. Methods: We searched Medline, Embase, and Scopus databases up to October 2023 for studies on the prevalence of Barrett’s esophagus, dysplasia, and EAC in these patients. A random-effects model was used for meta-analysis, and heterogeneity was assessed using I2 statistics. Results: Nine studies involving 17,637 patients were analyzed. Among those with an irregular Z-line, the prevalence of intestinal metaplasia was 29.4%. In patients with intestinal metaplasia, dysplasia was found in 6.2%, low-grade dysplasia in 5.9%, high-grade dysplasia in 1.6%, and EAC in 1.5%. These rates were higher compared to those without intestinal metaplasia. Conclusions Patients with an irregular Z-line and intestinal metaplasia may be at higher risk and could benefit from endoscopic surveillance. Further studies are needed to determine the necessity of biopsying irregular Z-lines.

Clinical guidelines typically endorse conventional therapies such as 5-aminosalicylic acid (5-ASA) as the mainstay of ulcerative colitis management. However, the degree of adoption and application of guideline recommendations by physicians within Asia remains unclear. This study aims to understand the prescribing patterns of 5-ASA and implementation of current guideline recommendations across Asian clinical practice. A physician survey was conducted among inflammatory bowel disease specialists in 8 Asian territories to understand practices and preferences in ulcerative colitis management, focusing on the use of 5-ASA and concordance with guideline recommendations. Survey findings were validated by country experts in diverse healthcare settings. Subgroup analyses stratified data by income levels and treatment reimbursement status. Ninety-eight valid responses were received from inflammatory bowel disease specialists or gastroenterologists among 8 economic entities. Significant differences were found in clinical practices and treatment preferences for ulcerative colitis management among different income-level and government-subsidy groups. Survey results are summarized in 8 findings that illustrate trends in 5-ASA use and guideline implementation across Asian territories. This study emphasizes socioeconomic factors that impact the adoption of guideline recommendations in real-world practice. Our findings indicate an eclectic approach to guideline implementation across Asia, based on resource availability and feasibility of treatment goals.