European Journal of Medical and Health Sciences

Orthopedic War-Related Injuries in Gaza: In-Depth Insights from within the Strip

2025-01-14T13:52:53+01:00

Gaza has been under continuous attack for over a year, resulting in widespread destruction and a severe humanitarian crisis. The bombings have caused mass casualties and devastating injuries, with buildings collapsing and overwhelming the healthcare system. Attacks on hospitals, arrests of medical staff, and severe shortages of medical supplies have hindered the delivery of life-saving treatments, forcing hospitals to provide only basic care. Due to a lack of specialized staff and equipment, treatment delays and infection risks have increased, and emergency measures such as amputations are often used. This review highlights the critical medical situation in Gaza, focusing on the challenges faced by medical staff, the impact of war-related injuries, and the broader health consequences caused by infrastructure damage and limited access to healthcare.

Association of First-Trimester Low PAPP-A Levels (<0.2 MoM) with Maternal and Fetal Outcomes

2025-01-14T13:53:05+01:00

Background and Aim: First-trimester screening is routinely performed globally to detect chromosomal abnormalities using non-invasive methods such as nuchal translucency (NT) measurements, pregnancy-associated plasma protein A (PAPP-A), and β-human chorionic gonadotropin (β-hCG). Recent studies have highlighted that low PAPP-A levels may be associated with adverse pregnancy outcomes, including pre-eclampsia, intrauterine growth restriction (IUGR), and pre-term delivery. Generally, low PAPP-A is defined as below 0.4 multiples of the median (MoM) or under the 5^th percentile. However, extremely low PAPP-A, defined as levels below 0.2 MoM or under the 1st percentile, significantly increases the risk of adverse outcomes. This category has received less attention in research. Our study aims to investigate the correlation between PAPP-A levels below 0.2 MoM and adverse pregnancy outcomes.

Materials and Methods: A retrospective cross-sectional study was conducted on 10,256 pregnant women who underwent first-trimester screening at Imam Khomeini Hospital in Ahvaz between January 2010 and April 2024. PAPP-A and β-hCG levels were measured, and factors such as maternal age, weight, parity, and abortion history were assessed. Data were obtained using the Fetal Medicine Foundation (FMF) software and medical records. Statistical analysis was performed using SPSS version 26.

Results: Out of 10,256 pregnancies, 6,040 (6.4%) had PAPP-A levels below the 5th percentile, while 45 women had PAPP-A levels below 0.2 MoM. The average age of these women was 30.4 ± 4.812 years. Among those with PAPP-A < 0.2 MoM, 2.2% had trisomy 21, 6.7% had IUGR, 26.7% experienced gestational hypertension, and 15.6% developed pre-eclampsia. Trisomies 13 and 18 were not observed in the study population.

Conclusions: Pregnant women with PAPP-A levels below 0.2 MoM showed increased incidences of trisomy 21, pre-eclampsia, gestational hypertension, and IUGR. Although low PAPP-A appears to contribute to both maternal and fetal complications, it cannot be used independently to predict adverse pregnancy outcomes. Further large-scale studies are required to better understand the implications of extremely low PAPP-A on pregnancy outcomes.

Effectiveness of Exercise Therapy for Patients with Prostate Cancer Focusing on High-intensity Interval Training: A Narrative Review

2025-01-03T13:51:29+01:00

Prostate cancer (PC) is the most frequently diagnosed cancer in men, and the population of survivors continues to increase. Although PC has a slower progression rate and a relatively favorable prognosis compared to other cancers, new strategies are needed to enhance outcomes after diagnosis and treatment. The effectiveness of exercise therapy in the prevention and treatment of PC is well documented. The significance of exercise for patients with PC includes prevention of disease progression, maintenance of physical fitness, and enhancement of muscle strength before surgery, as well as during chemotherapy and radiotherapy, all of which contribute to improving prognosis after treatment. High-intensity interval training (HIIT) is a well-established training protocol for long-distance runners that has also been applied to cardiovascular and metabolic diseases as a relatively novel and promising approach. HIIT, which involves high-intensity aerobic exercise, is known to enhance cardiorespiratory fitness, cardiac function, and insulin resistance to a greater extent than moderate-intensity training. Recent studies have demonstrated that HIIT effectively improves cancer cell growth inhibition and decreases prostate-specific antigen levels in both localized PC under active surveillance and metastatic castrate-resistant PC. However, the HIIT protocol should be tailored to each patient's condition and physical fitness level upon implementation. If accumulating evidence confirms the ability of HIIT to enhance physical fitness and suppress PC growth, the benefits to patients with PC would be substantial, and expected to be widespread.

Effect of Autologous Platelet-Rich Plasma (PRP) on Endometrial Thickness of Wistar Rats Under Antagonist Protocol in In Vitro Fertilization

2024-12-29T13:51:03+01:00

Introduction:The advancement of Assisted Reproductive Technology (ART) has significantly improved fertility outcomes, particularly through In Vitro Fertilization (IVF). One critical factor influencing IVF success is the health and receptivity of the endometrium. This study aimed to evaluate the effect of Autologous Platelet-Rich Plasma (PRP) on endometrial thickness in Wistar rats subjected to an antagonist protocol during IVF.

Methods:This experimental study used a randomized post-test only con- trolled group design involving 40 Wistar rats, divided into two groups: the treatment group (administered PRP) and the control group (no PRP admin- istration). Endometrial thickness was measured using histomorphometry, and the results were analyzed using the Mann-Whitney test.

Result: A total of 40 rats were included in the study. PRP administration significantly increased endometrial thickness in rats subjected to the IVF antagonist protocol compared to the control group (p < 0.001). The mean endometrial thickness in the treatment group was 335.5 ± 32.2 μm, while in the control group, it was 228.5 ± 42.7 μm.

Conclusion:Autologous Platelet-Rich Plasma (PRP) significantly increases endometrial thickness in Wistar rats under the IVF antagonist protocol, suggesting its potential in enhancing IVF success. This finding has important implications for the field of reproductive medicine.

Preoperative Findings of Ascites, Liver Involvement, and Pleural Effusion Can Predict Surgical Outcomes in Patients with Advanced Epithelial Ovarian Cancer

2025-01-03T13:55:35+01:00

Background: Advanced epithelial ovarian cancer has a poor prognosis, where the likelihood of suboptimal debulking surgery (PDS) is a primary cause of postoperative complications and delays in chemotherapy. Accurate diagnosis and efficient management are crucial for improving clinical outcomes in patients. This study aims to evaluate the predictive value of preoperative findings of ascites, liver involvement, and pleural effusion on surgical outcomes in patients with advanced ovarian cancer, as well as to provide additional insights into prognostic factors that may influence treatment strategies.

Methods: This diagnostic study was conducted at Prof. Dr. I.G.N.G. Ngoerah Hospital from January 2018 to December 2021. A total of 40 patients with advanced ovarian cancer were included in this study, with research variables including findings of ascites, liver involvement, and pleural effusion. Data were collected through medical records and comprehensive preoperative examinations.

Results: Among the total patients, 22 had ascites, 3 showed liver involve- ment, and 15 experienced pleural effusion. Diagnostic tests revealed a sensitivity and specificity of liver involvement for suboptimal PDS of 90.62% and 72.5%, respectively, with a positive predictive value of 100%. In contrast, findings of ascites and pleural effusion had low accuracy, at 45% and 62.5%, respectively, in predicting PDS outcomes. These results indicate that liver involvement is a more reliable indicator for predicting suboptimal PDS outcomes than ascites and pleural effusion.

Conclusion: Liver involvement is a good predictor of suboptimal PDS outcomes, showing potential to assist in preoperative management decisions. Meanwhile, ascites and pleural effusion findings are inconsistent in predict- ing surgical outcomes. This study highlights the importance of thoroughly evaluating these factors before surgical intervention. These findings can aid in the selection of more appropriate preoperative management for patients with advanced ovarian cancer and provide a basis for further research in this area.