Diabetic foot ulcers (DFUs) are one of the most serious and common complications that, if not treated properly, can lead to potential damage and even amputation. The aim of this systematic review and meta-analysis was to assess the drug-resistant Candida species in DFU. PubMed, Web of Science, Scopus and Google Scholar databases were systematically searched for eligible articles up to 22 June 2024. All articles on Candida diabetic foot infections that reported data on drug resistance were included in the study. In addition to general information, data on the type and number of fungi and the percentage of resistance to each drug were collected for analysis. A total of 238 studies were screened and finally, 16 articles were selected and analysed. Candida albicans was the most frequently isolated species in DFUs, followed by Candida tropicalis and Candida parapsilosis. For antifungal agents, the highest resistance was reported to Nystatin (32.48%, p-value = 0.30), Itraconazole (19.46%, p-value = 0.001) and Fluconazole (16.4%, p-value = 0.001). Miconazole (1.18%, p-value = 0.54) and Caspofungin (4.69%, p-value = 0.01) had the lowest resistance rates. For all drugs, resistance was higher in C. albicans than in non-albicans. This study found that antifungal drug resistance in Candida species is high in patients with DFUs, especially to itraconazole and fluconazole. Caspofungin, micafungin and voriconazole were more effective. Antifungal treatment in these patients should prioritize agents with lower resistance rates to improve outcomes and reduce the risk of treatment failure.
Protocol Registration: PROSPERO—CRD42024567133.
This study aimed to assess the association between lipid accumulation product (LAP) index, a novel index combining waist circumference (WC) and triglyceride levels, and anthropometric indices, metabolic factors and hepatic function markers in obese subjects with non-alcoholic fatty liver disease (NAFLD).
Cross-sectional study.
Specialised and subspecialised outpatient clinics of Tabriz University of Medical Sciences.
Overall, 232 adult patients with obesity and ultrasound-proven NAFLD were included in the present study.
Anthropometric measurements (body weight, height and waist and hip circumferences) were measured, and serum levels of glucose, lipid profile, ferritin and liver enzymes were assessed subsequent to an overnight fasting.
Mild and Moderate NAFLD were found in 43.5% and 48.2% of the participants, respectively. LAP index markedly increased with higher grades of steatosis, showing values of 63.72±22.26, 84.57±44.96 and 112.14±56.97 for healthy, grade I and grade II groups, respectively (p
In conclusion, the LAP index was not only associated with anthropometric indices, metabolic parameters and hepatic function markers, but also increased in line with higher grades of liver steatosis in NAFLD.
Longitudinal studies provide insights into the outcomes of medical training curriculum. However, few educational cohort studies have been conducted in Iran. This study aims first to evaluate the impact of the current curriculum on medical students' medium- and long-term academic and career outcomes and, second, to identify medical students' characteristics and how they change through the doctor of medicine programme.
This protocol outlines a multi-phase, prospective cohort study that will take place in Mashhad, Iran. The study will implement the Kirkpatrick model, investigating medical students' knowledge, skills, behaviour and professionalism development over 10 years. Approximately 1000 medical students will be recruited through peer invitations and social networks. Data will be collected through baseline and follow-up questionnaires, academic performance records and comprehensive test scores throughout the Doctor of Medicine (MD) programme.
The data from the questionnaires will be reported using a Likert scale. Quantitative data will be described using means and SD, while qualitative variables will be presented as frequencies and percentages. We will evaluate the relationship between quantitative variables using correlation coefficients and the relationship between qualitative variables via the 2 or Fisher exact test. All tests will be two-sided, with a significance level set as p
All participants will complete written informed consent before data collection. All students can withdraw from the study at any time with no consequences. Results of this study will be presented at relevant conferences and will be submitted for publication in peer-reviewed journals. This study was approved by the Ethics Committee of Mashhad University of Medical Sciences.
IR.MUMS.REC.1400.311.
Osteoporosis is a skeletal condition with decreased bone mass and structural deterioration, increasing fracture vulnerability. Several studies have found a correlation between prostate cancer in men and an increased risk of osteoporosis. This study aims to determine the prevalence of osteoporosis in patients with prostate cancer.
The primary objective of this study will be to estimate the prevalence of osteoporosis in prostate cancer survivor patients. An extensive search will be conducted on PubMed, Scopus, Embase, Web of Science, CINAHL and ProQuest databases to ensure comprehensive coverage. The search will encompass the timeframe from 1 January 1994 to 24 September 2024. Furthermore, we will not impose any limitations on the language or geographical location of the published studies. In order to assess the potential bias in the included studies, the Joanna Briggs Institute critical appraisal checklist for prevalence studies will be employed. The analysis of data will be performed using STATA V.17. The prevalence of osteoporosis or osteopenia will be calculated for each study by dividing the number of participants with these conditions by the total number of patients diagnosed with prostate cancer. A subgroup analysis will examine prevalence regarding geographical location, age groups, ethnicity, definitions and measurements of osteoporosis or osteopenia, risk of bias in the included studies, type and duration of androgen deprivation therapy, and site of osteoporosis diagnosis. We will employ multiple methods to detect publication bias, including funnel plot analysis, Begg’s and Egger’s tests, and the Trim and Fill method. If we have enough data, we will conduct a sensitivity analysis using the leave-one-out-remove method.
No ethical approval or patient consent is required as this study synthesises only published aggregate data. Results will be disseminated via a peer-reviewed publication.
CRD42024600884.