Galen Medical Journal
type: channel
description: Galen Medical Journal (GMJ), an esteemed cornerstone of academic inquiry, proudly indexed in prestigious repositories including PubMed and Web of Science. GMJ stands as an intellectual bastion, facilitating the dissemination of scholarly contributions that resonate within the echelons of contemporary medical discourse. With an unwavering commitment to methodological rigor, ethical rectitude, and the promulgation of erudition, GMJ serves as an indispensable conduit for medical luminaries, researchers, and scholars. GMJ's distinctive positioning within the echelons of PubMed and Web of Science bespeaks its elevated stature as a repository of paramount medical scholarship. As an ardent purveyor of knowledge, GMJ orchestrates the convergence of cutting-edge research, incisive analyses, and profound insights, encapsulating the gamut of medical sciences. This is fortified by our unwavering adherence to meticulous peer-review processes, ensuring the veracity and integrity of disseminated information. Scholars worldwide partake in our scholarly tapestry, engaging with a spectrum of erudite perspectives that encompass diverse medical disciplines, thereby fostering a dynamic exchange of ideas and catalyzing the trajectory of medical advancement. We extend a scholarly invitation to explore the realm of GMJ a realm where indexed prominence converges with erudition par excellence. Accompany us in unraveling the intricacies of medical scholarship, propelled by a commitment to academic excellence that resonates through every manuscript, study, and discourse featured within the journal's distinguished pages.
publisher: Salvia Medical Sciences Ltd. incorporation with SalviaPub.
language: en-US
publication name: Galen Medical Journal
issn: 2588-2767
copyright: https://creativecommons.org/licenses/by/4.0/
items: Investigating the Role of Carbohydrates Quantity and Quality in the Incidence of Metabolic Syndrome: A Two-Year Cohort Study
items: Evaluation of The Effect of Acute-normovolemic Hemodilution on Blood Transfusion Rate in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass: A Prospective Randomized and Controlled Trial
items: Evaluation of Hemodialysis Efficacy for Serum and Salivary Clearance of Urea, Creatinine, and Uric Acid in Chronic Kidney Disease Patients
items: Melatoninergic Modulation of Benzene-Induced Pre-Leukemic Alterations in Rats: Effects of Melatonin, Agomelatine, and Luzindole
items: Evaluation of the Predominant Dietary Pattern and Sleep Disorders in Obese Diabetic Patients and Non-diabetic Obese Individuals
items: The Impact of the COVID-19 Pandemic on Medical Faculty's Academic Performance and Well-Being
items: Clinico-pathologic Evaluation of Patients with Hemangioendothelioma: A 10-year Experience from Shiraz, Southern of Iran
items: Targeted Germline Sequencing Identifies Ultra-Rare DDR Variants in High-Risk Prostate Cancer
items: Effect of traditional Chinese medicine external treatment in older patients with nocturia: a meta-analysis
items: Evaluation of Outcomes from Pedicle Screw Fixation Before and After Laminectomy
items: Transformative Approaches to Biomarker Assessment and Clinical Profiles in Pulmonary Hypertension Patients
items: Effects of Botanical Supplementation on Benzene-Induced Hematological, Histopathological, and Molecular Alterations in Rats
items: Facilitators and Barriers to Role Adaptation in Newly Graduated Nurses in Medical-Surgical Units: A Qualitative Content Analysis Study
items: Impact of Trauma System Implementation on Mortality Rate in Alahsa, Saudi Arabia: A Retrospective Comparative Study
items: Preoperative Synbiotic Supplementation and Postoperative Outcomes in Elective GI Surgery: A Double-blinded, Placebo-controlled Trial
items: Comparing the Effect of Subcutaneous and Intradermal Mesotherapy on Pain and Function in Knee Osteoarthritis: A Randomized Clinical Trial
items: The Relationship between Jaundice and Weight Loss after Birth in Neonates Referring to the KOSAR Hospital, Qazvin-Iran
items: A Comparison of the Antibacterial Effects of Moringa Oleifera and Eucalyptus As Intracanal Irrigants on Enterococcus Faecalis: An in Vitro Study
items: Effect of Tamsulosin on Osteopontin Gene Expression in Preventing Ethylene Glycol-Induced Kidney Stone in Male Wistar Rats
items: Reasons for Retraction of Biomedical Articles Written by Eastern Mediterranean and Turkish Authors; A Comprehensive Cross-Sectional Study During 2010-2019
items: Safety and Efficacy of Laser Versus Cryotherapy in the Treatment of Lentigines: A Systematic Review and Meta-analysis of Randomized Controlled Trials
items: Physician-Reported Practices and Innovation Adoption in Acute Kidney Injury Care in Saudi Arabia: A Nationwide Cross-Sectional Survey
items: Comparison of the Antibacterial Effect of Nano-calcium Hydroxide and Nano-chlorhexidine Against Enterococcus Faecalis
items: Surface Topography and Pushout Bond Strength of Glass Fiber Posts with Different Surface Treatments to Root Dentin Following Cementation by Precuring and Co-Curing Methods
items: Awareness of Ovotoxic Cosmetic and Personal Care Products Among Women in KSA
items: Protective Effect of Aqueous Centella asiatica Extract on Ethanol-Induced Gastric Mucosal Injury
items: Safety Profiles of Ionic and Non-Ionic Contrast Agents Used in Percutaneous Coronary Intervention: Analysis of FAERS Data
items: The Statistical Scalpel: Sharpening Clinical Research Through Statistical Literacy in Neurosurgery: A Short Review
items: Cardiac Surgery-Associated Acute Kidney Injury: A Continuum From Pathophysiological Mechanisms to Prevention, Management, and Long-Term Care
items: Comparative Bibliometric Analysis of Herbal Medicine Research in Chinese and Iranian Complementary and Alternative Medicine (CAM) Clinical Trials
items: Scoping Review of Predictors and Risk Factors for Acute Myocardial Infarction in Patients with Chronic Kidney Disease
items: Pediatric Dental Management for Children With Special Health Care Needs and Disabilities
items: The Role of Preventive Pediatrics Dentistry in Oral Health: A Review of Evidence-Based Strategies
items: Systematic Review and Meta-Analysis of Shear Bond Strength after Photodynamic Therapy Versus Conventional Methods for Orthodontic Bracket Bonding
items: Diagnostic Performance and Radio–Pathologic Correlation of Image-Guided Biopsy in Head and Neck Lesions: A Systematic Review
items: Intravascular Imaging–Guided Percutaneous Coronary Intervention: A Critical Appraisal of Evidence and Clinical Practice
items: Synthesizing Evidence on Adverse Events of Perioperative Clonidine: An Umbrella Review
items: Maternal Psychological Distress and Repeated Implantation Failure: A Mini Review
items: The Role of Surface-Modified Titanium Scaffolds and Implants in Tissue Engineering for Bone Healing in Maxillofacial and Reconstructive Surgery
items: Student Self-Assessment and Faculty Evaluation in Dental Education: A Cross-Sectional Study
items: The Importance of Periodic Electrocardiograms in Individuals with Metabolic Disorders: A Policy Brief
items: Novel Antithrombotics in Geriatric PCI for STEMI: Balancing Ischemic Protection with Bleeding Risk
items: Focused Echocardiography to Guide Management in Acute Decompensated Heart Failure: From Rapid Phenotyping to Therapeutic Precision
items: Severe Gastroparesis-like Syndrome Following Single-dose Liraglutide Administration: A Case Report

Investigating the Role of Carbohydrates Quantity and Quality in the Incidence of Metabolic Syndrome: A Two-Year Cohort Study
type: item
description: Background: Metabolic syndrome (MetS) defines as a cluster of risk factors and is a global public health problem. Quality and quantity of carbohydrates (CHOs) intake plays a crucial role in the development of MetS. This study aimed to investigate the role of CHOs quantity and quality in relation to MetS. Materials and Methods: This prospective cohort study was conducted among healthy adults aged 18–65 years in Kerdabad, Isfahan, Iran. Participants (n=1904) were selected through a census-based sampling method. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (FFQ). CHOs quantity and quality were evaluated using measures such as dietary glycemic index (DGI), dietary glycemic load (DGL), and fiber intake. MetS was defined by established clinical criteria ATPΙΙΙ and assessed annually over a two-year follow-up. Anthropometric measurements, blood pressure, and fasting blood samples were collected at baseline and yearly to monitor metabolic parameters. Statistical analyses included multivariate logistic regression models adjusting for potential confounders including age, sex, energy intake, physical activity, socioeconomic factors, and BMI. Results: Among 1904 participants (45% male; mean age: 39.6 ± 10.2 years; mean BMI: 27.1 ± 4.9 kg/m²), in fully adjusted models, none of the dietary CHOs quantity or quality indices were significantly associated with MetS during the two-year follow-up. Conclusion: quantity and quality of CHOs not significantly associated with MetS after adjusting for confounders. Although some trends indicated potential metabolic effects, these were not statistically significant. Further long-term research with more detailed dietary assessments is needed to clarify these relationships.
creator: Melika Fallah
creator: Azadeh Aminianfar
creator: Awat Feizi
creator: Peyman Adibi
creator: Hamid Reza Roohafza
creator: Alireza Ani
creator: Leila Azadbakht
creator: Ahmad Esmaillzadeh
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-01-30
publication date: 2026-01-30
volume: 15
starting page: e3984
ending page: e3984
doi: 10.31661/gmj.v15i.3984

Evaluation of The Effect of Acute-normovolemic Hemodilution on Blood Transfusion Rate in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass: A Prospective Randomized and Controlled Trial
type: item
description: Background: Perioperative use of allogeneic blood products is associated with increased mortality, morbidity, and postcardic therapy. The effectiveness of blood preservation strategies such as acute isovolemic hemodilution (ANH) has been demonstrated with varying degrees of success. This study presents an analysis of the effects of isovolemic hemodilution on blood transfusion in patients undergoing cardiopulmonary bypass. Material and Methods: We tested the efficacy of ANH in reducing cardiac morbidity during anesthesia prior to cardiopulmonary bypass using a randomized trial. They were divided into two groups: ANH (88 patients) and standard control (88 patients), both selected as CS. The ANH group aimed to achieve a hematocrit level of 28% by performing full blood exchange with colloids. Patients underwent myocardial protection procedures, including cold blood cardioplegia and anesthesia preconditioning. Outcomes were evaluated by measuring cardiac enzymes, including serum troponin I and creatinine phosphokinase. Changes in demand for cardiovascular and cerebrovascular drugs were also taken into account. Results: Intraoperative fluid balance (crystalloids, colloids, and urine), postoperative fluid balance (crystalloids plus colloids, urine, and chest tube fluid), and RBC concentrate were not statistically different between the two groups (P>0.05). However, the results showed that the hematocrit level was more stable in the ANH group than in the control group. Conclusion: Preoperative ANH provides better hematocrit stability and better cardio protection in patients receiving a myocardial perfusion pump; but does not affect water and urine treatment.
creator: Ali Jabbari
creator: Shabnam Tabasi
creator: Marjan Kazemi Nia
creator: Mansour Deylami
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-06-09
publication date: 2026-06-09
volume: 15
starting page: e3740
ending page: e3740
doi: 10.31661/gmj.v15i.3740

Evaluation of Hemodialysis Efficacy for Serum and Salivary Clearance of Urea, Creatinine, and Uric Acid in Chronic Kidney Disease Patients
type: item
description: ackground: Chronic kidney disease (CKD) is a progressive and irreversible loss of kidney function that may progress to end-stage renal disease requiring hemodialysis. While hemodialysis is an established life-saving therapy, simple methods to assess its adequacy are needed. This study evaluated changes in urea, creatinine, and uric acid levels in serum before and after hemodialysis and compared them with salivary levels to assess the adequacy of hemodialysis. Materials and Methods: A case-control study was conducted on 32 patients undergoing hemodialysis and 30 healthy controls. Blood and saliva samples were collected immediately before and after dialysis from patients and controls. Serum and salivary levels of markers were analyzed by biochemical methods. Serum and salivary levels of markers were compared between the patient group and the control group by t-test and the diagnostic accuracy of salivary markers compared to serum markers was evaluated by the receiver-operating characteristic (ROC) curve and area under the curve (AUC). Results: There were significant differences between the serum and salivary levels of urea, creatinine, and uric acid in patients before and after hemodialysis, and also with the control group (P<0.05). There was a positive correlation between the serum and salivary levels of urea, creatinine and uric acid before hemodialysis, and creatinine after hemodialysis. The AUC for salivary urea and creatinine was 0.87 and 0.88, respectively, and the cut-off point for urea and creatinine was 55 mg/dL and 0.5 mg/dL, respectively. The ROC analysis for uric acid was not significant. Conclusion: This study showed that before hemodialysis, the changes in salivary urea, creatinine, and uric acid in CKD patients (in the fasting state) were similar to serum. Additionally, after hemodialysis, changes in salivary creatinine levels were similar to serum. Therefore, saliva analysis is suggested as a non-invasive alternative to serum analysis for assessment of…
creator: Azam Hosseini
creator: Farid Abbasi
creator: Iraj Mirzaii-Dizgah
creator: Reza Afshar
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-05-04
publication date: 2026-05-04
volume: 15
starting page: e4098
ending page: e4098
doi: 10.31661/gmj.v15i.4098

Melatoninergic Modulation of Benzene-Induced Pre-Leukemic Alterations in Rats: Effects of Melatonin, Agomelatine, and Luzindole
type: item
description: Background: Benzene is a well-established leukemogen associated with hematotoxicity, oxidative injury, inflammation, and genotoxic alterations, particularly in relation to acute myeloid leukemia (AML). Melatonin has antioxidant and anti-inflammatory properties that may exert protective effects against benzene-induced pre-leukemic alterations. Materials and Methods: This study evaluated melatoninergic modulation in a benzene-induced pre-leukemic rat model. Rats were assigned to five groups (n=8): control, benzene-only, benzene + melatonin (10 mg/kg), benzene + agomelatine (10 mg/kg), and benzene + melatonin + luzindole (0.2 mg/kg). Benzene was administered intravenously as a benzene:2-propanol: distilled water mixture (1:5:5, v/v/v) every 48 h for 4 weeks. Melatonin and agomelatine were administered orally once daily, while luzindole was used to assess melatonin receptor blockade. Hematological indices, leukocyte ratios, platelet parameters, bone marrow micronucleus endpoints, Activin A, Follistatin, MDA, 8-OHdG, CAT, and SOD were assessed. Results: Benzene exposure induced hematological disruption, altered leukocyte and platelet-related indices, increased micronucleus formation, and disturbed oxidative stress markers. Melatonin and agomelatine attenuated several benzene-induced alterations, including changes in erythropoietic indices, micronucleus frequency, leukocyte distribution, platelet-related parameters, MDA, and CAT activity. Luzindole partially reduced selected protective effects, suggesting that some responses may involve melatonin receptor-related pathways. However, inconsistent Activin A trends and unchanged Follistatin levels require cautious interpretation. Conclusion: Melatonin and agomelatine attenuated several hematological, genotoxic, and oxidative alterations in benzene-exposed rats. Luzindole partially modified these effects, suggesting possible melatonin receptor involvement alongside non-receptor antioxidant and anti-inflammatory actions.
creator: Mohammed M.Raouf
creator: Ismail M Maulood
creator: Zrar Saleem Marzany
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-06-26
publication date: 2026-06-26
volume: 15
doi: 10.31661/gmj.v15i.4245

Evaluation of the Predominant Dietary Pattern and Sleep Disorders in Obese Diabetic Patients and Non-diabetic Obese Individuals
type: item
description: Background: Objective: Diabetes mellitus is a chronic metabolic disorder and a major public health concern worldwide, particularly in developing countries. Dietary habits and sleep quality are important factors influencing metabolic health and diabetes outcomes. This study aimed to compare dietary patterns and sleep disorders among obese patients with diabetes and obese individuals without diabetes. Materials and Methods: This quasi-experimental study was conducted in 2023 on 140 obese adults, including 70 patients with diabetes and 70 non-diabetic individuals, who attended the endocrinology subspecialty clinic of Imam Khomeini Hospital in Ahvaz, Iran. Dietary intake was assessed using a 147-item Food Frequency Questionnaire (FFQ), while sleep quality and daytime sleepiness were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS), respectively. Healthy, traditional, and Western dietary patterns were identified and compared between the groups. Results: No significant difference was observed in mean age between the two groups. However, diabetic participants had significantly higher body weight than non-diabetic subjects (P=0.02). Sleep quality was poor in both groups, but diabetic patients had significantly worse PSQI scores than non-diabetic individuals (13.35±1.26 vs. 9.41±0.98, P=0.001). Consumption of fruits, vegetables, and low-fat dairy products did not differ significantly between groups, whereas intake of high-fat dairy products was significantly higher among diabetic patients (P=0.03). Adherence to the traditional and Western dietary patterns was associated with a 4.42-fold and 3.63-fold increased risk of type 2 diabetes, respectively, while no significant association was found for the healthy dietary pattern. Conclusion: Obese patients with diabetes exhibit poorer sleep quality and less favorable dietary habits than obese non-diabetic individuals. These findings highlight the importance of promoting healthy dietar…
creator: Fatemeh Amiri
creator: Homeira Rashidi
creator: Alireza Sedaghat
creator: Fatemeh Esmaeili
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-06-29
publication date: 2026-06-29
volume: 15
starting page: e3888
ending page: e3888
doi: 10.31661/gmj.v15i.3888

The Impact of the COVID-19 Pandemic on Medical Faculty's Academic Performance and Well-Being
type: item
description: Background: To investigate the effects of stress related to the pandemic on the medical faculty's well-being. Materials and Methods: This study investigated the impact of pandemic-related stress on the well-being of medical faculty at King Abdulaziz University. Using a mixed-methods approach, 82 faculty members completed online surveys, including the GAD-7 and PHQ-9 scales to measure anxiety and depression, and participated in focus group discussions. The analysis explored the relationship between these psychological stress factors and self-reported academic performance across different demographics. Results: A high prevalence of psychological distress was found: 89.6% of faculty reported at least mild anxiety, and 84.4% reported at least mild depressive symptoms. Most participants self-rated their academic performance as good (54.5%) or excellent (36.4%), and 80.5% reported missing no crucial deadlines. Regression analyses revealed a significant positive association between depression severity and higher self-reported academic performance (β = 1.48, p = 0.025). Male gender (OR = 0.20, p = 0.022) and longer weekly working hours (OR = 0.53, p = 0.019) were associated with significantly lower odds of missing deadlines. Anxiety, depression, and other covariates were not significant predictors of overall quality of life. Conclusion: While the pandemic was associated with a high burden of anxiety and depression among faculty, this distress did not translate into widespread self-perceived declines in academic output. The counterintuitive link between higher depression scores and self-reported performance, alongside the protective effect of male gender and increased work hours against missed deadlines, suggests complex coping mechanisms and potential resilience or presenteeism.
creator: Asim Sharif
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-03-02
publication date: 2026-03-02
volume: 15
starting page: e4139
ending page: e4139
doi: 10.31661/gmj.v15i.4139

Clinico-pathologic Evaluation of Patients with Hemangioendothelioma: A 10-year Experience from Shiraz, Southern of Iran
type: item
description: Background: Hemangioendothelioma (HE) represents a group of rare, borderline malignant vascular tumors with diverse clinical presentations and diagnostic challenges. This study aims to investigate the demographic, clinical, radiological data, histological findings, treatment modalities, survival rates, and other key characteristics of HE cases in both pediatric and adult patients. Materials and Methods: This is a case series cross-sectional study conducted at Namazi Teaching Hospital and Abuali Sina Hospital, Shiraz University of Medical Sciences. The study involved a retrospective review of medical records from 2009 to 2019, focusing on 22 patients diagnosed with HE. Data were collected using a standardized collection form. For precise histological examination, tissue slides were extracted and analyzed, incorporating pathological variables and immunohistochemical markers. Results: In this study, a total of 22 patients diagnosed with HE was examined. Their mean age was 40.6 years with male-to-female ratio of 12:10. The majority of cases in this study were diagnosed with hepatic epithelioid HE (59%). The most commonly reported symptoms included abdominal pain and palpable masses. Radiologically, the tumors primarily appeared as hypo-dense lesions, often accompanied by peripheral rim enhancement. Pathologically, the features such as intracytoplasmic vacuolization, eosinophilic cytoplasm, and specific markers (CD31, CD34) were crucial in accurate diagnosis. Importantly, the study also revealed a positive outcome in terms of patient survival, with only 10% of surgically treated patients succumbing to the disease. Conclusion: This study provides a detailed clinico-pathologic evaluation of HE from Southern Iran, underscoring the critical relationship between tumor location and clinical presentation. The research highlights that HE, though rare, can occur in pediatric and adults and must be included in the differential diagnosis of vascular lesions across all age groups. F…
creator: Mohammad Hossein Anbardar
creator: Mohammad Ali Rahmani
creator: Ali Ameli
creator: Sholeh Afshinpoor
creator: Hamid Zaferani Arani
creator: Nastaran Fooladivanda
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-08-16
publication date: 2026-08-16
volume: 15
starting page: e3875
ending page: e3875

Targeted Germline Sequencing Identifies Ultra-Rare DDR Variants in High-Risk Prostate Cancer
type: item
description: Background: Prostate cancer (PCa) is a biologically heterogeneous disease, with a subset of cases driven by hereditary germline alterations. Methods: Targeted germline sequencing using the Twist Fixed Panel was performed in nine high-risk PCa patients (median age 47; range 30–61). Variants were classified based on ClinVar, gnomAD, and in silico prediction tools. Results: Pathogenic and likely pathogenic variants in DNA damage repair (DDR) genes were identified, including BRCA2, BRIP1, PALB2, and BRCA1. A homozygous ATM variant was observed in one patient. Several ultra-rare variants in MLH3 and BARD1 were also detected. Most variants had allele frequencies <10-6. Conclusions: High-risk and early-onset PCa is associated with rare germline DDR alterations. These findings support expanded germline testing in younger patients and suggest potential relevance for precision oncology approaches, although functional validation is required..
creator: Rawaz Rizgar Hassan
creator: Abdulkarim Yasin Karim
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-08-10
publication date: 2026-08-10
volume: 15
starting page: e4248
ending page: e4248

Effect of traditional Chinese medicine external treatment in older patients with nocturia: a meta-analysis
type: item
description: Aim: To assess the efficacy and clinical value of traditional Chinese medicine external treatment (TCMET) for older patients with nocturia. Methods: A systematic search was conducted in PubMed, Embase, Cochrane Library, Chinese National KnowledgeInfrastructure (CNKI), Chinese Biological Medicine Database (CBM), VIP Chinese Science and Technology Journal Full-text Database (VP-CSJFD), and Wanfang database from their inception to September 30, 2024. Studies focusing on applying TCMET for older patients with nocturia were included. Primary outcome measures comprised the times of nocturia, Pittsburgh sleep quality index (PSQI) scores, and overall response rate. The extracted data was analyzed using Stata software (Version 17.0). Results: 15 articles were included in this study, including 580 patients in the TCMET group and 318 patients in the conventional western medicine treatment (CWMT) group. The overall response rate after TCMET treatment in patients with nocturia was 94% [ES = 0.94, 95%CI (0.91, 0.94)]. The number of nocturia episodes after treatment decreased by 2.39 times compared to before treatment [SMD = 2.39, 95% CI (1.30, 3.48)]. TCMET treatment resulted in a 4.77-point decrease in patients’ PSQI scores from baseline [SMD =4.77, 95% CI: 1.67, 7.86]. Compared with CWMT, TCMET did not show significant superiority improve overall response rate and PSQI score (P > 0.05) but reduced the number of nocturia after TCMET treatment [SMD = -2.03, 95%CI (-3.15, -0.91), P < 0.05]. Conclusion: According to the existing literature evidence, TCMET can reduce the times of nocturia and improve sleep quality in older patients with nocturia. It is an effective treatment for older patients with nocturia.
creator: Huiying Zhang
creator: Jinhua Geng
creator: Chunyan Ruan
creator: Qiaoli Lin
creator: Liqin Chen
creator: Yanxiang Luo
creator: Shaoqing Liu
creator: Shaoxia Wu
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-01-30
publication date: 2026-01-30
volume: 15
starting page: e3986
ending page: e3986
doi: 10.31661/gmj.v15i.3986

Evaluation of Outcomes from Pedicle Screw Fixation Before and After Laminectomy
type: item
description: Background: Pedicle screw fixation is a standard technique for spinal stabilization in patients undergoing laminectomy for decompression. This study aims to compare the outcomes of pedicle screw fixation performed before versus after laminectomy. Materials and Methods: This retrospective cohort study, conducted from July 2017 to July 2020 at the Neurosurgery Departments of Imam Reza and Shohada Hospitals in Tabriz, Iran, assessed outcomes of two approaches to pedicle screw fixation in 104 patients undergoing laminectomy for degenerative spinal conditions. The patients were equally divided into two groups of 52: one group receiving pedicle screw fixation before laminectomy, and the other following laminectomy. Key intraoperative parameters—such as blood loss, operative time, and screw placement accuracy—were evaluated and compared between groups. Data were analyzed using SPSS software, employing Independent Samples T-Tests and Chi-square tests, with statistical significance defined at P<0.05. This retrospective cohort study compares two surgical sequences—pedicle screw fixation before versus after laminectomy—in patients undergoing lumbar decompression, aiming to evaluate intraoperative efficiency and short-term outcomes. Results: The laminectomy-first group had a lower infection rate (5.76% vs. 9.61%) and required fewer blood transfusions (96.1% vs. 90.3%) than the screw-first group, though these differences were not significant (P>0.05). Blood loss and drain output were significantly higher in the laminectomy-first group (P<0.05), but surgery duration was shorter (P=0.01), with similar hospital stays between groups. The laminectomy-first approach also required fewer screw path corrections and fluoroscopy uses, indicating greater intraoperative efficiency (P=0.001). Conclusion: This study demonstrates that pedicle screw fixation after laminectomy demonstrated greater intraoperative efficiency with fewer adjustments and reduced fluoroscopy use. However, due to the re…
creator: Vahid Sadeghi
creator: Seyed Taher Mousavi
creator: Mohammad Shimia
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-06-12
publication date: 2026-06-12
volume: 15
starting page: e3856
ending page: e3856
doi: 10.31661/gmj.v15i.3856

Transformative Approaches to Biomarker Assessment and Clinical Profiles in Pulmonary Hypertension Patients
type: item
description: Background: Pulmonary hypertension (PH) is a progressive disorder marked by elevated pulmonary arterial pressure, leading to right heart failure and high mortality. Emerging evidence links metabolic disturbances, renal dysfunction, and molecular dysregulation to PH pathogenesis. This study aimed to investigate biochemical and molecular biomarkers associated with PH, focusing on renal, metabolic, and vascular parameters. Materials and Methods: A hospital-based case–control study was conducted at Al-Sadr Teaching Hospital, Iraq, from January to June 2024. Sixty-two PH patients and 30 age- and sex-matched healthy controls were recruited. Fasting venous blood samples were analyzed for urea, creatinine, glucose, insulin, uric acid, troponin I, homocysteine, and KCNK3. Insulin resistance (IR) was estimated using HOMA-IR. Comparisons between groups were performed using independent t-tests, correlations via Pearson’s coefficient, and diagnostic performance assessed using ROC curve analysis. Results: PH patients exhibited significantly elevated urea, creatinine, glucose, insulin, uric acid, homocysteine, and IR (P < 0.05) and reduced KCNK3 levels (P = 0.006) compared to controls. ROC analysis showed IR (AUC 0.903), homocysteine (AUC 0.762), and insulin (AUC 0.808) as effective discriminators of PH, whereas KCNK3 had limited diagnostic accuracy (AUC 0.350). Correlation analysis demonstrated positive associations between homocysteine and insulin/glucose, while KCNK3 inversely correlated with renal and metabolic parameters. Subgroup analysis indicated higher urea and glucose in male patients (P < 0.05). Conclusion: PH is associated with systemic metabolic dysregulation, renal impairment, and molecular alterations, including reduced KCNK3 and elevated homocysteine. Insulin resistance and homocysteine may serve as potential non-invasive biomarkers, highlighting the need for integrated biochemical and molecular assessment in PH management.
creator: Basim M Ali
creator: Furqan Moein Auda
creator: Fatima Abdali Hassooni
rights: Copyright (c) 2025 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-18
publication date: 2025-12-18
volume: 15
starting page: e4132
ending page: e4132
doi: 10.31661/gmj.vi.4132

Effects of Botanical Supplementation on Benzene-Induced Hematological, Histopathological, and Molecular Alterations in Rats
type: item
description: Background: Leukemia is a hematological malignancy characterized by uncontrolled proliferation of immature white blood cells, influenced by both genetic and environmental factors. Benzene is a recognized leukemogenic agent associated with hematopoietic toxicity following prolonged exposure. This study investigated the protective effects of Withania somnifera (ashwagandha), Camellia sinensis (green tea), and curcumin against benzene-induced leukemic alterations in rats. Materials and Methods: Adult male albino rats received intravenous benzene (99.9%) every two days for 3 weeks to induce leukemic changes. Following induction, rats were divided into three groups (n=6/group), 1:a combination-treated group receiving oral Withania somnifera (200 mg/kg), Camellia sinensis extract (250 mg/kg), and curcumin (200 mg/kg) daily for 30 days; 2:a Withania somnifera-treated group receiving 300 mg/kg daily for 30 days; and 3:a control group. Hematological, histopathological, and molecular analyses were performed using blood, bone marrow, spleen, and liver samples. Results: Both treatment regimens reduced several benzene-induced hematological, histopathological, and molecular alterations. Hematological parameters in treated groups were maintained within near-normal ranges. Histopathological examination demonstrated partial preservation of liver and spleen architecture in both treatment groups, with reduced inflammatory and degenerative changes compared with untreated benzene-exposed rats. Molecular analysis showed restoration of Nrf2 expression and modulation of Caspase-3 expression following treatment, particularly in the combination-treated group. Blast cell counts were reduced in both treatment groups compared with untreated benzene-exposed animals. Conclusion: Withania somnifera, alone or in combination with curcumin and green tea extract, demonstrated protective effects against benzene-induced hematological, histopathological, and molecular alterations in rats. The combination…
creator: Nzar Ibrahim Yousif
creator: Sarween Sherzad Rasool
creator: Zhala B. Taha
creator: Mohammed M. Hussein M. Raouf
creator: Bakhtawar Ziad Omer
creator: Zahraakhan Maaroof Taher
creator: Abdullah Jawdat Zebari
creator: Zeenath Sufderhusain Sheikh
creator: Hero Ismael Mohammed
creator: Shahrokh Mojarradgandoukmolla
creator: Tanya Salam Salih
creator: Usha Rani Kandula
creator: Sherzad Hassan Radha
creator: Abdulrahman Ismael
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-07-15
publication date: 2026-07-15
volume: 15
starting page: e4246
ending page: e4246
doi: 10.31661/gmj.v15i.4246

Facilitators and Barriers to Role Adaptation in Newly Graduated Nurses in Medical-Surgical Units: A Qualitative Content Analysis Study
type: item
description: Background: The high turnover rate among newly graduated nurses (NGNs) is a significant concern globally, particularly in medical-surgical units (MSUs). Identifying the key facilitators and barriers to their professional role adaptation is crucial for improving retention and facilitating a smoother transition into clinical practice. This study explored facilitators and barriers to professional role adaptation among NGNs in MSUs. Materials and Methods: A qualitative study was conducted using inductive content analysis. Twenty-one NGNs with less than one year of clinical experience were purposively selected from teaching hospitals affiliated with Tehran University of Medical Sciences. Data were gathered through semi-structured in-depth interviews and analyzed using Graneheim and Lundman’s five-step approach with MAXQDA software. Results: The findings revealed that multiple interacting factors shape role adaptation at three levels: individual, interpersonal, and organizational. Facilitating factors included personal motivation, clinical preparedness, supportive colleagues, and structured organizational support. In contrast, barriers such as stress, lack of structured orientation programs, negative work culture, and excessive workload hindered adaptation. Conclusion: This study revealed that the adaptation of NGNs to professional roles in MSUs is shaped by individual, interpersonal, and organizational factors. Enhancing structured support at all three levels — through targeted educational programs, professional communication, and organizational infrastructure — can improve transition outcomes, reduce early turnover, and promote workforce retention in healthcare settings.
creator: Hadi Jafarimanesh
creator: Shahrzad Ghiyasvandian
creator: Bret Lyman
creator: Hossein Ghanaati
creator: Masoumeh Zakerimoghadam
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-06-19
publication date: 2026-06-19
volume: 15
starting page: e3910
ending page: e3910
doi: 10.31661/gmj.v15i.3910

Impact of Trauma System Implementation on Mortality Rate in Alahsa, Saudi Arabia: A Retrospective Comparative Study
type: item
description: Introduction: Trauma is leading cause of morbidity and mortality worldwide, with major public health burden in Saudi Arabia. Although structured trauma systems improve outcomes internationally, their impact in the Kingdom remains insufficiently evaluated. This study assessed effect of trauma system implementation in the Alahsa Health Cluster. Methods: retrospective study was conducted at King Fahad Hospital, Level I trauma center in Alahsa, Saudi Arabia. Trauma registry data from the pre-implementation (2017–2018) and post-implementation (2022–2023) periods were analyzed. Eligible patients had an Injury Severity Score (ISS) ≥15 and hospital stay >24 hours. Variables included demographics, injury mechanism and site, length of stay, and in-hospital mortality. Comparisons were performed using chi-square and Mann–Whitney U tests. Multivariable logistic regression estimated adjusted odds ratios for mortality after adjustment for age, injury mechanism, and ISS. Results: total of 631 patients were included (mean age 31.8 years; 87.3% male). Crude in-hospital mortality declined from 19.0% (70/368) before implementation to 16.3% (43/263) afterward (p = 0.011). However, study period was not independent predictor of mortality after adjustment (AOR = 0.97, 95% CI: 0.45–2.10; p = 0.945). Independent predictors of mortality were ISS (AOR = 1.22; p < 0.001) and age (AOR = 1.04; p < 0.001). Motor vehicle accidents decreased from 58.4% to 41.6% (p < 0.001), with significant reductions in head, face, and neck injuries. Mortality decreased among adults but not children. Conclusion: Implementation regional trauma system was associated with reduction in mortality and favorable shifts injury patterns. However, multivariable analysis suggests that the observed improvement was primarily driven by variations in patient case-mix and baseline injury severity rather than a standalone systemic effect. These findings emphasize necessity of rigorous case-mix adjustment in trauma research and supp…
creator: Naif T. AlQahtani
creator: Abdulelah Alanazi
creator: Mujtaba M. Alkhamees
creator: Faisal T. AlQahtani AlQahtani
creator: Ahmed S. Ahmed S. Alsaidlani
creator: Ahmed F. Alharbi
creator: Omer S. Alharbi
creator: Mohammed Asiri
creator: Abdulaziz Alrabiah
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-08-13
publication date: 2026-08-13
volume: 15
starting page: e4298
ending page: e4298

Preoperative Synbiotic Supplementation and Postoperative Outcomes in Elective GI Surgery: A Double-blinded, Placebo-controlled Trial
type: item
description: Background: Surgery harms the gastrointestinal (GI) tract barrier and changes intestinal microbiota composition, disrupting the balance of gut flora. Synbiotics, which are mixtures of beneficial bacteria and chemicals that promote gut flora growth, are particularly important for recovery after GI surgery. We aimed to assess the effect of consumption of synbiotics prior to the gastrointestinal surgeries on complications. Materials and Methods: 40 patients who planned to undergo elective gastrointestinal surgery randomized in a double-blinded, placebo-controlled, phase 3 trial to a single dose perioperative and seven-day postoperative intervention with a synbiotic, LactoCare®, or placebo provided by knowledge-based spin-off company, Zist Takhmir. Randomisation was performed by a computer algorithm. Results: 42.5% of participants were men. Nausea and vomiting occurred in eight patients in the placebo group, and seven patients in the synbiotic group, and the two groups were not statistically significant (P>0.99). Other complications, such as (surgical site infection, fever, surgical site infection, pneumonia, and anastomosis site leakage) were not observed in the placebo or synbiotic groups. In assessing variables dependent on time, the mean time to start oral feeding in the synbiotic group was 32.35±28.84 hours after surgery, and in the placebo group was 28.45±24.91 hours (P=0.796). The first gas passing time was 13.00±15.81 hours in the synbiotic group and 9.65±13.90 hours in the placebo group after surgery(P=0.406). The hospitalisation length of patients in the synbiotic group was 2.6±1.27 days, and for patients in the placebo group was 2.35±1.08 days(P=0.42). Conclusion: Administration of synbiotics as a single dose before surgery and seven days postoperatively did not have a significant effect on infectious complications and time-dependent variables in patients with abdominal surgery.
creator: Pourya Adibi
creator: Ahmad Reza Karimi
creator: Mehrdad Sayadinia
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-06-08
publication date: 2026-06-08
volume: 15
starting page: e3580
ending page: e3580
doi: 10.31661/gmj.v15i.3580

Comparing the Effect of Subcutaneous and Intradermal Mesotherapy on Pain and Function in Knee Osteoarthritis: A Randomized Clinical Trial
type: item
description: Background: Knee osteoarthritis (KOA) is the most common form of osteoarthritis and is associated with pain and functional impairment. Mesotherapy, which involves localized intradermal or subcutaneous injection of active agents, may provide targeted pain relief. This study aimed to compare the effects of intradermal and subcutaneous mesotherapy on pain and function in patients with KOA. Materials and Methods: A single-center, randomized, assessor-blinded clinical trial was conducted in Isfahan, Iran, between 2023 and 2024 among patients with mild-to-moderate KOA. Each patient received six sessions of intradermal or subcutaneous piroxicam-lidocaine mesotherapy at six acupuncture points over three weeks (two sessions per week). Pain and function were assessed at baseline, immediately after treatment, and one month after treatment. Statistical analyses included chi-square tests for qualitative variables, independent-samples t-tests for quantitative variables, and repeated-measures analysis of variance to assess changes over time. Statistical significance was set at P<0.05. Results: A total of 50 patients were included. The demographic characteristics and baseline pain and function scores did not differ significantly between the two groups. At the one-month follow-up, the intradermal group showed significantly greater improvement, with a mean difference in pain score reduction of 1.6 points (95% CI: 0.57 to 2.67, P=0.003) compared to the subcutaneous group. For dysfunction scores, the intradermal group demonstrated immediate post-treatment benefits (mean difference: 9.4 points, 95% CI: 1.36 to 17.44, P=0.02), with sustained improvement at the one-month post-treatment follow-up (mean difference: 15.5 points, 95% CI: 7.95 to 23.01, P<0.001). Repeated measures ANOVA showed that pain and dysfunction scores significantly changed over time in both groups (P<0.001). Conclusion: Both subcutaneous and intradermal mesotherapy appeared to be effective short-term treatments for pat…
creator: Parisa Taheri
creator: Soroush Sadri
creator: Maryam Behroozinia
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-07-12
publication date: 2026-07-12
volume: 15
starting page: e4095
ending page: e4095
doi: 10.31661/gmj.v15i.4095

The Relationship between Jaundice and Weight Loss after Birth in Neonates Referring to the KOSAR Hospital, Qazvin-Iran
type: item
description: Background: This study aimed to determine the association between the incidence of neonatal jaundice and the weight loss of newborns in postnatal days. Materials and Methods: In this cross-sectional study, 200 infants with jaundice were examined. The required information was obtained from the medical records. In this study, newborns were divided into two groups based on hyperbilirubinemia. Bilirubin level was compared in two groups on the fourth day of referral. Effect of weight loss was determined on hyperbilirubinemia by logistic regression. Results: The study compared 137 healthy neonates with 53 hyperbilirubinemic neonates, finding significantly greater weight loss (0.25±0.18 kg vs. 0.09±0.11 kg, P<0.001) and higher bilirubin levels (17.13±1.05 vs. 12.60±1.89 mg/dL, P<0.001) in the latter group. Hyperbilirubinemic neonates had younger mothers (27.23±3.26 vs. 28.63±3.21 years, P=0.007), lower nulliparity (60.4% vs. 75.9%, P=0.033), and higher breastfeeding rates (96.2% vs. 18.6%, P<0.001). Logistic regression confirmed weight loss as a strong predictor (aOR=2.14×106, P<0.001), with ROC analysis showing high diagnostic accuracy (AUC=0.86-0.88). Optimal cutoffs were 0.175 kg (89% sensitivity) and 4.95% weight loss (91% sensitivity). Maternal and neonatal blood groups also influenced risk. Conclusion: Neonates at risk need to be more closely monitored for jaundice and weighting, thus, early detection and timely treatment can be done.
creator: MohammadReza Maleki
creator: Fatemeh Samiee Rad
creator: Masoomeh Hadi
creator: Asghar Ghorbani
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-01-30
publication date: 2026-01-30
volume: 15
starting page: e3896
ending page: e3896
doi: 10.31661/gmj.v15i.3896

A Comparison of the Antibacterial Effects of Moringa Oleifera and Eucalyptus As Intracanal Irrigants on Enterococcus Faecalis: An in Vitro Study
type: item
description: Background: Enterococcus faecalis has been considered as a main factor for rendodontic treatment failure. Herbal products are increasingly used as their antimicrobial efficacy. This study aimed to investigate and compare the in vitro antimicrobial effects of two plants, Moringa oleifera and eucalyptus, with sodium hypochlorite as the standard irrigation solution against Enterococcus faecalis. Materials and Methods: In the present in-vitro study, thirty mandibular premolars were decoronated, and root canal instrumentation was performed. Each sample was separately autoclaved, inoculated with E. faecalis, and incubated. The samples were divided into six groups based on the type of intervention (n=5 in each group): 1) microemulsion of M. oleifera, 2) microemulsion of eucalyptus, 3) 2.5% sodium hypochlorite, 4) a solution combining both M. oleifera and eucalyptus, 5) positive control, and 6) negative control. The root canals were obturated with gutta-percha and incubated for 90 days. Microbial sampling from the root canals was performed before (S1) and after root canal irrigation (S2), and the viability of microorganisms was reported in terms of the number of colony-forming units. Results: A significant difference in CFU/mL was observed among all groups (P<0.001). The negative control showed complete inhibition, whereas the positive control exhibited >105 CFU/mL. Mean bacterial counts were lowest in the Moringa+Eucalyptus group (4921±3571 CFU/mL), followed by NaOCl (5720 ± 8952 CFU/mL), Eucalyptus (7246±9257 CFU/mL), and Moringa (8053±6247 CFU/mL). Pairwise comparisons revealed no statistically significant differences between the experimental irrigants (P>0.05). Conclusion: M. oleifera and eucalyptus microemulsions exhibited similar antimicrobial effects against E. faecalis, and no synergistic effect of these two extracts was observed.
creator: Sahar Shakoui
creator: Shirin Fattahi
creator: Ladan Paya
creator: Parya Emamverdizadeh
creator: Negin Neshanifard
creator: Mohammad Ali Irani
creator: Shaghayegh Ghadimi
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-02-21
publication date: 2026-02-21
volume: 15
starting page: e4141
ending page: e4141
doi: 10.31661/gmj.v15i.4141

Effect of Tamsulosin on Osteopontin Gene Expression in Preventing Ethylene Glycol-Induced Kidney Stone in Male Wistar Rats
type: item
description: Background: Tamsulosin, an α1-adrenergic receptor antagonist, has been proposed as a potential therapeutic agent against urolithiasis-induced renal damage. However, limited in vivo evidence exists regarding its renoprotective mechanisms. Materials and Methods: Forty male Wistar rats were randomly allocated into four groups (n=10/group): positive control, negative control (ethylene glycol-induced urolithiasis), prevention (tamsulosin administered simultaneously with ethylene glycol), and treatment (tamsulosin administered after model induction). Biochemical parameters including serum creatinine, urea, uric acid, calcium, and phosphorus were measured using rat-validated commercial kits (Pars Azmun, Iran). Normal ranges were defined based on published reference values. Gene expression was analyzed by qPCR using the 2^−ΔΔCt method. Study design and reporting followed the ARRIVE checklist. Results: At day 30, the prevention group exhibited significantly lower serum creatinine (0.60 ± 0.08 mg/dL) compared to the negative control (0.98 ± 0.12 mg/dL, P<0.01). Although urea levels were slightly higher in the prevention group (4.0 ± 0.7 mg/dL) versus the negative control (3.22 ± 0.6 mg/dL), the calculated BUN/creatinine ratio was significantly improved (46.7 vs. 33.0, P<0.05). No significant changes were observed in serum calcium or phosphorus. Gene expression analysis showed upregulation of protective markers in the prevention group. Conclusion: In vivo findings on the beneficial effects of tamsulosin on the renal profile in ethylene glycol-induced urolithiasis illustrate its protective effects on the renal system through improvement of creatinine clearance and BUN/creatinine balance. This underscores its probable use as a protective therapeutic agent against renal injury of crystallization origin.
creator: Ramin Parvizrad
creator: Elahe Ghorbani Marghamlki
creator: Somayeh Nikfar
creator: Sara Khalili Dermani
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-01-30
publication date: 2026-01-30
volume: 15
starting page: e4050
ending page: e4050
doi: 10.31661/gmj.v15i.4050

Reasons for Retraction of Biomedical Articles Written by Eastern Mediterranean and Turkish Authors; A Comprehensive Cross-Sectional Study During 2010-2019
type: item
description: Background: Article retraction means removing a published article from the journal because of ethical issues or scientific errors in order to correct the literature. In this study, we aimed to determine the reasons for retracting biomedical articles written by authors from Iran, Saudi Arabia, Pakistan, Egypt, and Turkey. Materials and Methods: This cross-sectional study included all retracted biomedical articles with first authors affiliated with Iran, Saudi Arabia, Pakistan, Egypt, or Turkey, retracted between September 1, 2010, and September 1, 2019. Data were extracted from Retraction Watch, MEDLINE, PubMed Central (PMC), Clarivate Analytics, and Scopus. Each article’s information was entered into a data collection form and analyzed using SPSS version 24. Results: Of 436 retracted articles, Iran had the highest number (223), followed by Turkey (80), Egypt (72), Saudi Arabia (35), and Pakistan (26). Common causes of retraction included plagiarism, duplication, authorship issues, and fake peer review. In Iran, fake peer review (42.6%) and authorship issues (41.3%) were most prevalent. Significant inter-country differences were found in retraction frequency and causes. The most affected fields were biology, biochemistry, oncology, cardiovascular, surgery, and pathology. Conclusion: The results showed that scientific misconducts (plagiarism, duplication, authorship issues, and fake peer review) were the main reasons for retracting the articles in the five studied countries. To reduce such misconducts, regional regulatory policies, improved editorial practices, and enhanced research ethics training are urgently needed.
creator: Kezhal Bijari
creator: Mehrdad Askarian
creator: Behrooz Astaneh
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-01-30
publication date: 2026-01-30
volume: 15
starting page: e3885
ending page: e3885
doi: 10.31661/gmj.v15i.3885

Safety and Efficacy of Laser Versus Cryotherapy in the Treatment of Lentigines: A Systematic Review and Meta-analysis of Randomized Controlled Trials
type: item
description: Background: Lentignies is one of the pigmentary skin lesions causing abnormal skin color in sun-exposed areas in particular the hands and the face. In this systematic review and meta-analysis, we aimed to study the safety and efficacy of cryotherapy versus laser in lentigines treatment. Materials and Methods: Beginning from inception and up to 19th May 2023, we did a comprehensive search strategy including five databases (Web of Science=33, Scopus=79, PubMed=28, Virtual Health Library=30 and Scholar=622). The search strategy was performed according to the search term “(“solar lentigines” OR “solar lentigo” OR “lentigines” OR “lentigo”) AND (“laser”) AND (“cryotherapy”)”. Results: total of 5 studies (n=13–120, mean age 39–60) comparing lasers (Q-switched Nd:YAG, PDL, argon, CO2, etc.) vs cryotherapy for solar lentigines, mostly using intrapatient randomization, were included. Meta-analysis revealed no significant difference in marked (OR=1.15, 95% CI [-0.42, 2.73], P=0.151, I²=0.6%) or moderate improvement (OR=0.63, 95% CI [-0.01, 1.26], P=0.055, I²=0%), but lasers yielded significantly higher ≥50% improvement in patients (OR=1.36, 95% CI [0.5, 2.21], P=0.002, I²=0.3%), lower mild (OR=-0.96, 95% CI [-1.65, -0.26], P=0.007, I²=0%) and poor response in lesions (OR=-1.72, 95% CI [-3.2, -0.24], P=0.023, I²=0%). Side effects were comparable; heterogeneity remained very low (I²≤0.9%). Four studies showed high risk of bias. One trial demonstrated fractional CO2 or cryotherapy plus 4% pidobenzone significantly outperformed monotherapy. Conclusion: Laser may be superior to cryotherapy in the treatment of lentigines with comparable side effects among the two groups. However, we recommend further RCTs comparing the two modalities to confirm our findings which had many limitations.
creator: Mohammad Almohideb
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-03-02
publication date: 2026-03-02
volume: 15
starting page: e4137
ending page: e4137
doi: 10.31661/gmj.v15i.4137

Physician-Reported Practices and Innovation Adoption in Acute Kidney Injury Care in Saudi Arabia: A Nationwide Cross-Sectional Survey
type: item
description: Background: Acute kidney injury (AKI) is a major public health concern in Saudi Arabia, where diabetes mellitus, hypertension, sepsis, and critical illness contribute substantially to kidney-related morbidity and mortality. Although international standards for AKI diagnosis and treatment are widely available, national data on physician-reported practice patterns and adoption of emerging diagnostic and therapeutic innovations remain limited. Materials and Methods: This nationwide cross-sectional survey was conducted from January to June 2025 among physicians involved in AKI care across public, private, and military healthcare facilities in all 13 administrative regions of Saudi Arabia. Participants were recruited through purposive-stratified sampling. The survey assessed physician characteristics, AKI definition and screening practices, current management strategies, biomarker use, artificial intelligence (AI)-enabled tools, telemedicine, emerging therapies, and perceived barriers and facilitators. Results: A total of 850 of 1,250 invited physicians responded, yielding a response rate of 68%. Most respondents reported using Kidney Disease: Improving Global Outcomes (KDIGO) criteria for AKI definition (82%), fluid optimization protocols (91%), and nephrotoxin-avoidance checklists (88%). Early nephrology consultation within 24 hours was reported by 64% of hospitals and was more frequent in tertiary than secondary centers (78% vs. 45%; P<0.001). Any biomarker use was reported by 37% of physicians, with higher adoption in tertiary centers than secondary centers (52% vs. 18%; P<0.001). Awareness of selected emerging therapies was moderate, but clinical implementation remained below 12%. The main reported barriers were cost (68%), insufficient training (55%), and lack of local clinical guidelines (47%). Conclusion: Physician-reported AKI management in Saudi Arabia shows substantial alignment with international standards, particularly in preventive and supportive care. Howe…
creator: Abdulaziz Backer Albacker
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-07-20
publication date: 2026-07-20
volume: 15
starting page: e4260
ending page: e4260
doi: 10.31661/gmj.v15i.4260

Comparison of the Antibacterial Effect of Nano-calcium Hydroxide and Nano-chlorhexidine Against Enterococcus Faecalis
type: item
description: Background: Intracanal medicaments are used to eliminate residual microorganisms and provide a suitable environment for the healing of periapical tissues. This study aimed to compare the antibacterial effect of nano-calcium hydroxide and nano-chlorhexidine as intracanal medicaments against Enterococcus faecalis. Materials and Methods: In this study, 170 single-rooted mandibular premolars were included. After crown removal, canal preparation was performed. Five teeth were randomly selected as the negative control group. Nano-intracanal medicaments were synthesized using the encapsulation method. Drug release tests were carried out, and particle sizes were determined using electron microscopy and dynamic light scattering analysis. Samples were inoculated with E. faecalis for 21 days. Subsequently, five teeth were randomly selected as the positive control group. The remaining samples were randomly divided into four groups of 40 teeth each (20 for day 3 and 20 for day 7). The intracanal medicaments used in each group were: calcium hydroxide, nano-Ca(OH)2-PLGA, 2% chlorhexidine gel, and 2% nano-chlorhexidine gel (MCM-41), respectively. After 3 and 7 days, microbial biofilm samples were collected, and bacterial colony-forming units (CFU) were counted. Two-way ANOVA was used to compare the mean CFU counts among the groups at different time intervals. The significance level was set at 0.05. Results: Based on statistical analysis, on day 3, the 2% nano-chlorhexidine gel (MCM-41) and nano-Ca(OH)2-PLGA groups showed a significantly greater reduction in CFU/ml (P<0.05) compared to the other groups. On day 7, the 2% nano-chlorhexidine gel (MCM-41) and 2% chlorhexidine gel groups demonstrated significantly greater reductions in CFU/ml (P<0.05) than the remaining groups. Over time, the antibacterial efficacy of the nano-formulations declined, whereas the effectiveness of the 2% chlorhexidine gel and calcium hydroxide increased. Conclusion: According to the findings of the present …
creator: Mamak Adel
creator: Zohreh Asgari
creator: Neda Hajihassani
creator: Zohreh Bahrami
creator: Mehdi Ranjbaran
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-05-17
publication date: 2026-05-17
volume: 15
starting page: e4023
ending page: e4023
doi: 10.31661/gmj.v15i.4023

Surface Topography and Pushout Bond Strength of Glass Fiber Posts with Different Surface Treatments to Root Dentin Following Cementation by Precuring and Co-Curing Methods
type: item
description: Background: This study assessed the surface topography and pushout bond strength (PBS) of glass fiber posts (GFPs) with different surface treatments to root dentin following cementation by precuring and co-curing methods. Materials and Methods: In this in vitro study, 80 extracted single-rooted premolars were decoronated and randomly assigned to 4 groups (n=20) for surface treatment of GFPs with 20% H2O2, Er,Cr:YSGG laser (2780 nm, 90 mJ, 4.5 W, 50 Hz, 60 seconds) and sandblasting (50 µm aluminum oxide particles, 2.8 bar pressure, 10 mm distance, 20 seconds). No surface treatment was performed in group 4. Each group was randomly divided into two subgroups (n=10) for cementation of GFPs with precuring and co-curing methods. The PBS was measured, the mode of failure was determined, and the surface topography of the posts was assessed under a scanning electron microscope (SEM). Data were analyzed by ANOVA, Tukey, and Dunnett tests (alpha=0.05). Results: The mean PBS of H2O2-treated GFPs was significantly higher in co-curing than precuring method (P=0.04). No significant difference was found between the precuring and co-curing in PBS of GFPs with other surface treatments (P>0.05). The mean PBS of sandblasted, laser-treated, and H2O2-treated GFPs was not significantly different in precuring method. In co-curing cementation, sandblasting significantly decreased the PBS (P=0.04) while laser and H2O2 surface treatments had no significant effect on PBS (P>0.05). Conclusion: The co-curing cementation method yielded a significantly higher PBS than the precuring method in H2O2-treated GFPs. Sandblasting significantly decreased the PBS of GFPs cemented by the co-curing method.
creator: Azita Kaviani
creator: Pardis Khoshnood
creator: Faramarz Zakavi
rights: Copyright (c) 2025 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-05-02
publication date: 2026-05-02
volume: 15
starting page: e3865
ending page: e3865
doi: 10.31661/gmj.v15i.3865

Awareness of Ovotoxic Cosmetic and Personal Care Products Among Women in KSA
type: item
description: Background: Attention to ovotoxic chemicals in cosmetics has increased worldwide and emerging evidence shows these substances can damage female reproductive health. This study aimed to examine Saudi women’s knowledge about ovotoxic chemicals in cosmetic and personal care products that indicates their daily habits and possible links with reproductive problems. Materials and Methods: An online cross-sectional survey was carried out in Saudi Arabia that included 568 women. The questionnaire had five parts that showed demographics, product use, knowledge of harmful chemicals, reproductive health history, and attitudes toward safety. Results were analysed with suitable statistics. Results: Daily makeup use was reported by 48.2% of women which indicates lip products were used by 81.5% and mascara by 71.1%. Awareness of harmful chemicals reached 52.5% that showed parabens were known by 42.6% and phthalates by 31.5%, yet only 25% usually read ingredient lists. A total of 33.1% believed cosmetics caused reproductive problems that showed irregular periods in 26.8%. Support for stricter laws was expressed by 85.2% which indicates 80.1% wanted educational information and 62.1% would change to safer brands. Higher education strongly predicted knowledge that showed 72.1% of postgraduate women knew harmful chemicals compared to 32.6% of high-school graduates (p<0.001). Age also mattered (p=0.003) that showed married women less often linked cosmetics to fertility risk (38.2% vs. 45.6% single, p=0.011). Women who already had reproductive disorders gave stronger support for regulation (93.1% vs. 83.8%, p=0.003). Conclusion: The survey indicated moderate knowledge of ovotoxic chemicals among Saudi women that shows a clear gap between knowing and doing something about it. The high demand for teaching programs and better rules underlines the need for focused public health efforts.
creator: Ahmed Baker A Alshaikh
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-03-02
publication date: 2026-03-02
volume: 15
starting page: e4133
ending page: e4133
doi: 10.31661/gmj.v15i.4133

Protective Effect of Aqueous Centella asiatica Extract on Ethanol-Induced Gastric Mucosal Injury
type: item
description: Background: Gastric ulcer disease is associated with oxidative stress, inflammation, and disruption of gastric mucosal defense mechanisms. Ethanol-induced gastric injury is a widely used experimental model for evaluating gastroprotective agents. Centella asiatica is a medicinal plant rich in bioactive phytochemicals, including flavonoids, phenolic compounds, saponins, and triterpenoids, which possess antioxidant and anti-inflammatory activities.This study evaluated the gastroprotective effect of aqueous C.asiatica extract against ethanol-induced gastric mucosal injury in rats. Materials and Methods: Adult male Sprague-Dawley rats were divided into five groups (n=6): ulcer control, omeprazole-treated group (20 mg/kg), and three groups pretreated orally with aqueous C.asiatica extract at doses of 150, 300, and 600 mg/kg. Preliminary qualitative phytochemical screening of the extract was performed using standard methods. Gastric ulceration was induced using absolute ethanol (5 mL/kg). Gastric pH, mucus weight, ulcer area, and ulcer inhibition percentage were evaluated. Histopathological examination and quantitative real-time PCR analysis of Nrf2 and HO-1 expression were also performed. Results: Phytochemical screening confirmed the presence of flavonoids, phenolic compounds, saponins, and triterpenoids in the aqueous C.asiatica extract. Pretreatment with the extract significantly reduced ethanol-induced gastric injury in a dose-dependent manner (P<0.05). Treated rats showed increased gastric pH and mucus weight with reduced ulcer area compared with the ulcer control group. The 600 mg/kg dose produced the highest ulcer inhibition (98.88%) and preserved gastric mucosal architecture with minimal epithelial disruption, edema, and inflammatory-cell infiltration. In addition, the extract significantly upregulated Nrf2 and HO-1 expression levels. Conclusion: Aqueous C.asiatica extract demonstrated significant gastroprotective activity against ethanol-induced gastric mucosal i…
creator: Nzar Ibrahim Yousif
creator: Zhala B. Taha
creator: Mohammed M. Hussein M. Raouf
creator: Bakhtawar Ziad
creator: Zahraakhan Maaroof Taher
creator: Abdullah Jawdat Zebari
creator: Zeenath S. Sheikh
creator: Hero Ismael Mohammed
creator: Shahrokh Mojarradgandoukmolla
creator: Tanya Salam Salih
creator: Usha Rani Kandula
creator: Sherzad Hassan Radha
creator: Abdulrahman Ismael
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-08-15
publication date: 2026-08-15
volume: 15
starting page: e4247
ending page: e4247

Safety Profiles of Ionic and Non-Ionic Contrast Agents Used in Percutaneous Coronary Intervention: Analysis of FAERS Data
type: item
description: Background: Contrast agents are used in percutaneous coronary intervention (PCI), yet differences in adverse event profiles between ionic and non-ionic agents remain incompletely characterized. This study aimed to evaluate patient demographics, adverse event patterns, and seriousness of outcomes associated with contrast agents reported in the U.S. FDA Adverse Event Reporting System (FAERS). Materials and Methods: Data were extracted from FAERS for reports involving contrast agents used during PCI, including both ionic (low- and high-osmolar) and non-ionic agents. Datasets were cleaned for duplicates and incomplete records, and product names, patient demographics, and adverse reactions were standardized. Descriptive statistics were calculated for continuous (age, weight) and categorical (sex, seriousness, adverse reactions) variables. Comparative analyses between ionic and non-ionic groups were performed using t-tests for continuous variables and chi-square tests for categorical outcomes. Data visualization was performed using Python libraries. Results: A total of 72 cases were identified, including 18 ionic (25%) and 54 non-ionic (75%) reports. Mean patient ages ranged from 52.8 to 71.0 years across individual agents, with weight varying from 69.7 to 92.9 kg. Adverse events differed by agent type: ionic agents were primarily associated with renal failure and hypersensitivity reactions, while non-ionic agents exhibited broader nephrotoxic and hemodynamic complications, including nephropathy toxic, anaphylaxis, and blood pressure decreases. All products were linked to serious outcomes, with non-ionic agents showing a significantly higher association with serious events (χ²(1, N=72) = 5.92, P = .015). No significant differences in age or weight were observed between ionic and non-ionic groups. Temporal trends varied by agent, with sporadic case reporting over the years; while Ultraist has shown increased trend till 2025. Conclusion: Ionic and non-ionic contrast agents …
creator: Shirin Alord
creator: Farid Tagavi
creator: Haleh Bodagh
creator: Mehdi Maleki
creator: Negar Jafari
creator: Seyed Mohammad Hassan Adel
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-07-13
publication date: 2026-07-13
volume: 15
starting page: e4162
ending page: e4162
doi: 10.31661/gmj.v15i.4162

The Statistical Scalpel: Sharpening Clinical Research Through Statistical Literacy in Neurosurgery: A Short Review
type: item
description: Modern neurosurgery clearly relies on evidence-based medicine. The integrity, interpretation, and application of research depended on a solid understanding of the statistical methods used. This review highlights the important need for neurosurgeons and trainees to gain proficiency in basic statistical concepts. We emphasize this need throughout the research process—from forming hypotheses and defining variables to selecting tests, analyzing power, and interpreting key indices. Also, we provide practical guides for choosing suitable statistical tests and translating research findings into useful clinical metrics. We believe that statistical literacy is not an extra skill but a key part of clinical expertise and academic success. It allows neurosurgeons to evaluate literature, conduct valid research, and effectively apply evidence in patient care.
creator: Ehsan Jangholi
creator: Parivash Hafez Amini
creator: Neda Pak
creator: Atieh Hosseinkhani
creator: Kamkar Aeinfar
creator: Seyed Mohammad Ghodsi
creator: Milad Shafizadeh
creator: Mohammadreza Boustani
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-06-01
publication date: 2026-06-01
volume: 15
starting page: e4142
ending page: e4142
doi: 10.31661/gmj.v15i.4142

Cardiac Surgery-Associated Acute Kidney Injury: A Continuum From Pathophysiological Mechanisms to Prevention, Management, and Long-Term Care
type: item
description: Cardiac surgery-associated acute kidney injury (CSA-AKI) remains a frequent and clinically important complication after coronary artery bypass grafting, valve surgery, and complex aortic procedures. Its development reflects the interaction of pre-existing renal vulnerability with perioperative insults, including renal hypoperfusion, ischemia-reperfusion injury, systemic inflammation, oxidative stress, hemolysis, cardiopulmonary bypass-related injury, and nephrotoxic exposure. Conventional diagnostic markers, particularly serum creatinine and urine output, often identify AKI only after functional decline has occurred, limiting opportunities for early intervention. Novel biomarkers such as NGAL, KIM-1, cystatin C, and TIMP-2/IGFBP7 may improve early risk stratification, although their routine clinical implementation remains limited by cost, availability, and uncertainty regarding biomarker-guided treatment pathways. Current prevention and management strategies therefore rely primarily on early risk assessment, hemodynamic optimization, avoidance of nephrotoxins, careful fluid management, and timely renal support. Importantly, CSA-AKI is increasingly recognized as a continuum extending beyond hospitalization, with increased risks of chronic kidney disease, cardiovascular events, and long-term mortality. This review synthesizes current evidence on the mechanisms, diagnosis, prevention, management, and follow-up of CSA-AKI, while highlighting areas where stronger clinical evidence is still needed.
creator: Sohrab Negargar
creator: Elnaz Javanshir
creator: Sahar Sadeghi
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-07-23
publication date: 2026-07-23
volume: 15
starting page: e4284
ending page: e4284

Comparative Bibliometric Analysis of Herbal Medicine Research in Chinese and Iranian Complementary and Alternative Medicine (CAM) Clinical Trials
type: item
description: Background: Traditional medicine, rooted in ancient history, resurged due to concerns over synthetic pharmaceuticals’ adverse effects. This study goal was to conduct a bibliometric analysis of herbal medicine research in Iranian and Chinese CAM clinical trials to identify trends, patterns, and differences in research productivity. Materials and Methods: This bibliometric study compared Chinese and Iranian CAM clinical trials using Web of Science data. It focused on RCTs, applying search terms for CAM and Chinese or Iranian CAM, with exclusion criteria to filter out irrelevant publications. The dataset included author information, article details, keywords, and citation history. It calculated the Annual Growth Rate (AGR) and used visual tools like the Three-Field Plot to illustrate associations. Additionally, Lotka’s Law was applied to author productivity, and a co-citation collaboration network was analyzed using Bibliometrix r package. Results: Key findings for Iranian CAM include 71 documents by 342 authors with an average document age of 3.11 years. Chinese CAM featured 255 documents by 1857 authors with an average document age of 5.75 years. Iranian CAM showed a negative annual growth rate of -18.05%, while Chinese CAM had a positive rate of 5.65%. The included studies for Chinese CAM span from 2004 to 2024, while those for Iranian CAM range from 2015 to 2024. The most cited Iranian CAM document had 66 citations, and in Chinese CAM, “TONG XL, 2012” and “LIU XL, 2019” had the highest total citations. Decentralized research practices were observed in China, while Tehran and Shiraz universities led clinical trials in Iran. Conclusion: Our study indicates differing research trends in Iranian and Chinese herbal medicine. Iranian CAM research showed a declining trend, with Tehran and Shiraz universities leading clinical trials, while Chinese CAM research displayed a growing landscape with a more decentralized approach among authors.
creator: Shahram Shafa
creator: Tayyebeh Zarei
creator: Majid Vatankhah
creator: Fatemeh Rahmanian
creator: Ehsan Rahmanian
creator: Sara Rahmanian
creator: Mansour Deylami
creator: Mojtaba Ghaedi
creator: Amir Hossein Pourdavood
creator: Lohrasb Taheri
creator: Somayeh Mehrpour
creator: Mehrdad Malekshoar
creator: Bibi Mona Razavi
creator: Fatemeh Eftekharian
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-01-30
publication date: 2026-01-30
volume: 15
starting page: e3573
ending page: e3573
doi: 10.31661/gmj.v15i.3573

Scoping Review of Predictors and Risk Factors for Acute Myocardial Infarction in Patients with Chronic Kidney Disease
type: item
description: Background: Chronic kidney disease (CKD) significantly elevates the risk of acute myocardial infarction (AMI) and associated mortality, with cardiovascular disease accounting for approximately 40% of deaths in CKD patients. Diagnostic and therapeutic challenges arise due to altered biomarker profiles and underutilization of interventions like percutaneous coronary intervention (PCI). This systematic review aims to identify and evaluate predictors of AMI in CKD patients, focusing on clinical, biochemical, demographic, and lifestyle-related risk factors to inform targeted prevention strategies. Materials and Methods: Following PRISMA guidelines, a systematic search was conducted across PubMed, Embase, Scopus, Web of Science, and Cochrane Library up to August 14, 2025, using MeSH terms like “chronic kidney disease” and “myocardial infarction.” Included studies involved adult CKD patients, assessing predictors through observational designs or relevant randomized controlled trial subgroup analyses. Data were extracted by two independent reviewers, with study quality assessed using the Newcastle-Ottawa Scale. Narrative synthesis was employed due to heterogeneity. Results: Twenty studies (54–911,360 participants) identified dyslipidemia, inflammatory (CRP, IL-6) and cardiac biomarkers (NT-proBNP, hs-cTnT), lower eGFR, albuminuria, advanced CKD stage, hypertension, prior AMI, and older age as key AMI predictors. Risk scores (GRACE, PRECISE-DAPT) and novel indices (TyG, TyG-BMI) showed high predictive accuracy. Conclusion: Comprehensive risk assessment integrating biomarkers, clinical factors, and novel indices can enhance AMI prediction and guide interventions in CKD patients, addressing therapeutic underutilization.
creator: Roohollah Rahbani
creator: Farid Taghavi
creator: Mohsen Abbasnezhad
creator: Mehdi Maleki
creator: Leila Liaghat
creator: Hamid Ghazipoor
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-02-02
publication date: 2026-02-02
volume: 15
starting page: e4090
ending page: e4090
doi: 10.31661/gmj.v15i.4090

Pediatric Dental Management for Children With Special Health Care Needs and Disabilities
type: item
description: Background: Children with special health care needs and disabilities experience a disproportionate burden of preventable oral disease, unmet dental needs, behavioral barriers to treatment, and fragmented access to specialist dental services. Materials and Methods: This scoping review mapped contemporary evidence on pediatric dental management strategies for children with special health care needs, with emphasis on prevention, behavior guidance, interdisciplinary care, teledentistry, and service delivery. A structured search was planned across PubMed/MEDLINE, Scopus, Web of Science, Embase, the Cochrane Library, Google Scholar, ClinicalTrials.gov, and grey-literature sources for English-language evidence published from January 2015 to August 2025. Evidence was charted using a population-concept-context framework and synthesized narratively according to source type and clinical theme. Results: The final evidence map comprised 20 topic-relevant sources, including systematic reviews, observational studies, qualitative studies, educational program reports, narrative reviews, textbooks, and expert consensus documents. No randomized controlled trial was verified among the cited sources; therefore, the manuscript was framed as a scoping review rather than an effectiveness-focused systematic review. Four major themes were identified: preventive and caregiver-mediated oral-health support, individualized behavior guidance and sensory adaptation, interdisciplinary medical-dental collaboration, and technology-enabled access, including teledentistry. Conclusion: Current evidence supports integrated, family-centered, function-based, and prevention-oriented dental care for children with special health care needs and disabilities. However, the evidence base remains limited by heterogeneous designs, provider-centered outcomes, small samples, narrative sources, and limited comparative child-outcome data. Future research should prioritize prospective multicenter studies using standardi…
creator: Safa Saeed
creator: Dr Akshay Kiran
creator: Reema Sultan Alshahrani
creator: Rahaf Saud Alobaidi
creator: lena Abdulrahman Alotai
creator: Fatimah Farhan Almalki
creator: Fahad Khalid almasoudi
creator: Hadeel Ali Almalky
creator: Lama Alhatem
creator: Hadeel Horais Alzahrani
creator: Amirah Aldowish
creator: Randa Abdulaziz Aleyoni
creator: Setah Abothnin
creator: Rana Abdullah Almaiman
creator: Leen Alzaaqi
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-07-08
publication date: 2026-07-08
volume: 15
starting page: e4270
ending page: e4270
doi: 10.31661/gmj.v15i.4270

The Role of Preventive Pediatrics Dentistry in Oral Health: A Review of Evidence-Based Strategies
type: item
description: Early childhood caries and other preventable oral diseases remain among the most common chronic conditions affecting children worldwide. Their burden is disproportionately concentrated among socially disadvantaged, rural, and medically vulnerable populations, where delayed dental attendance and limited access to preventive care contribute to disease progression, pain, infection, impaired nutrition, school absenteeism, and reduced quality of life. This narrative review summarizes contemporary evidence on preventive pediatric dentistry, with emphasis on caries-risk assessment, fluoride therapy, pit-and-fissure sealants, oral hygiene instruction, behavior modification, dietary counseling, anticipatory guidance, early dental visits, silver diamine fluoride, minimally invasive care, school-based programs, and emerging preventive technologies. Evidence consistently supports prevention-oriented, risk-based care models that combine professional interventions with caregiver education, dietary change, and community-level strategies. Fluoride exposure, sealant placement, motivational interviewing, and integrated medical-dental prevention are particularly important for high-risk children. Silver diamine fluoride and atraumatic or interim restorative approaches may reduce disease progression and improve access to care when conventional restorative treatment is difficult or unavailable. However, implementation remains limited by caregiver knowledge, socioeconomic inequality, workforce constraints, reimbursement barriers, and inconsistent integration of oral health into primary care systems. Preventive pediatric dentistry should therefore move beyond isolated clinical procedures toward coordinated, culturally responsive, evidence-based care that begins early in life and continues across childhood and adolescence.
creator: Fouad Hassan Althobaiti
creator: Maha Alsane
creator: Myle Akshay
creator: Tasneem Ambon
creator: Latifah Fahad Almashabi
creator: Rawan Ali Alqahtani
creator: Noura Mohammed Aljadaan
creator: Atheer Haif Alotaibi
creator: Sultan Abdullah Alotaibi
creator: Haya Bin Osayl
creator: Jawaher Mohammed Alsubaie
creator: Roaa Saleh Aloraini
creator: Abdulaziz Alribi
creator: Nawaf Alyousef
creator: Bader Ibrahim Alshehri
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-08-03
publication date: 2026-08-03
volume: 15
starting page: e4198
ending page: e4198

Systematic Review and Meta-Analysis of Shear Bond Strength after Photodynamic Therapy Versus Conventional Methods for Orthodontic Bracket Bonding
type: item
description: Background: To systematically evaluate the effect of photodynamic therapy (PDT) on shear bond strength (SBS) of orthodontic brackets compared to conventional bonding methods through meta-analysis of in vitro studies. Materials and Methods: This systematic review and meta-analysis, following PRISMA guidelines, synthesized in vitro studies comparing the shear bond strength of orthodontic brackets following photodynamic therapy pretreatment versus conventional methods, utilizing a comprehensive, peer-reviewed search strategy across four databases up to December 2025. Random-effects meta-analysis was performed using Hedges’ g with 95% confidence intervals. Heterogeneity was assessed using I² statistic and Q-test. Subgroup analysis by photosensitizer type, sensitivity analysis, and publication bias assessment were conducted with subsequent trim-fill adjustments. Results: Eight in vitro studies comprising 13 PDT-control comparisons with 317 samples were included. Overall meta-analysis revealed significantly lower SBS for PDT groups compared to controls (Hedges’ g = -4.17, 95% CI: -6.350 to -3.361, P < 0.001). Substantial heterogeneity was observed (I² = 93.3%, Q = 166.645, P < 0.001). Subgroup analysis showed Methylene Blue PDT had the strongest negative effect (g = -5.795, P < 0.001), also Riboflavin PDT (k=3) demonstrated a significant negative effect (g = -3.54, P = 0.012). Mean SBS was 15.27 MPa for PDT groups versus 19.67 MPa for controls. Significant publication bias was detected (Egger’s test: P = 0.0003); while trim-fill justification remained significant in case of significantly lower SBS for PDT groups compared to controls. Conclusion: PDT, particularly with Methylene Blue photosensitizer, significantly reduces shear bond strength compared to conventional methods. Curcumin-based PDT shows more favorable bond strength profiles. Clinical application requires careful consideration of photosensitizer selection and bonding protocol optimization.
creator: Seyed Mohammad Mahdi Mirmohammadi
creator: Ali Ghanati
creator: Elnaz Tavazozadeh
creator: Kourosh Farhadtouski
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-07-21
publication date: 2026-07-21
volume: 15
starting page: e4164
ending page: e4164

Diagnostic Performance and Radio–Pathologic Correlation of Image-Guided Biopsy in Head and Neck Lesions: A Systematic Review
type: item
description: Background: Accurate diagnosis of head and neck lesions relies heavily on image-guided biopsy techniques, which facilitate targeted sampling and enable radiologic–pathologic correlation. Increasing use of CT-guided fine-needle aspiration cytology (FNAC) and core-needle biopsy (CNB) necessitates updated evaluation of their diagnostic performance and safety. To systematically identify, appraise, and synthesize published evidence on the diagnostic accuracy, tissue adequacy, and radio–pathologic concordance of image-guided biopsy for head and neck lesions. Materials and Methods: This review followed PRISMA 2020 guidelines and a protocol registered in PROSPERO (CRD420251181567). Searches were conducted across PubMed/MEDLINE, Scopus, Cochrane Library, Web of Science, and Google Scholar (January 2018–September 2025). Eligible studies included human subjects undergoing image-guided FNAC or CNB with reported diagnostic outcomes. Two reviewers independently screened, extracted data, and assessed quality using QUADAS-2. Due to methodological and clinical heterogeneity, meta-analysis was not performed. Results: From 345 records, eight studies met inclusion criteria. Most were retrospective (8/10), evaluating CT-guided FNAC, CNB, or percutaneous needle biopsy across cervical, suprahyoid, salivary, lymphatic, thyroid, and skull base lesions. Diagnostic sensitivities ranged from 85–95%, specificities from 92–97%, and overall accuracies from 90–96%. Diagnostic yield was high (85–100%), and radio–pathologic concordance consistently exceeded 87%. Complications were uncommon and generally minor, except for hilar lymph node biopsies, which showed higher pneumothorax rates. Conclusion: Image-guided biopsy of head and neck lesions demonstrates high diagnostic accuracy and excellent radio–pathologic concordance across diverse anatomic regions, supporting its role as a reliable, minimally invasive diagnostic tool. Despite strong performance in deep and complex spaces, procedure-specific co…
creator: Hadi Al Hakami
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-03-02
publication date: 2026-03-02
volume: 15
starting page: e4145
ending page: e4145
doi: 10.31661/gmj.v15i.4145

Intravascular Imaging–Guided Percutaneous Coronary Intervention: A Critical Appraisal of Evidence and Clinical Practice
type: item
description: Intravascular imaging has emerged as a critical adjunct to percutaneous coronary intervention (PCI), providing detailed insights into coronary anatomy, plaque morphology, and stent optimization beyond conventional angiography. Despite advances in PCI, adverse outcomes such as stent thrombosis and restenosis persist, often related to suboptimal lesion assessment and stent deployment. This review critically evaluates contemporary evidence from randomized controlled trials, large registries, and meta-analyses comparing intravascular imaging–guided and angiography-guided PCI. Current data consistently demonstrate that imaging guidance, particularly with intravascular ultrasound (IVUS), improves procedural optimization and reduces adverse cardiovascular events, with the greatest benefit observed in complex coronary lesions. Optical coherence tomography (OCT) provides superior spatial resolution and enhances detection of stent-related complications, although its impact on clinical outcomes appears more context-dependent. While recent guidelines strongly endorse intravascular imaging in complex PCI, real-world adoption remains limited due to economic, procedural, and training-related barriers. Variation in study design and variability in imaging protocols further complicate interpretation of existing evidence. Intravascular imaging–guided PCI represents a transition toward precision-guided coronary revascularization. Future research should focus on standardized imaging strategies, long-term outcomes, and integration with emerging technologies to optimize patient selection and procedural outcomes.
creator: Mohammad Rostamzadeh
creator: Negar Jafari
creator: Abdolmohammad Ranjbar
creator: Hamid Biglary
creator: Shirin Alord
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-05-17
publication date: 2026-05-17
volume: 15
starting page: e4274
ending page: e4274
doi: 10.31661/gmj.v15i.4274

Synthesizing Evidence on Adverse Events of Perioperative Clonidine: An Umbrella Review
type: item
description: Background: Clonidine, a potent α2-adrenoceptor agonist, is used in anesthesia for its sedative and analgesic properties, but its administration requires careful monitoring due to potential risks of hypotension and bradycardia. As there are increasing number of trials on clonidine, this study aimed to synthesize a conclusion on unwanted consequences of clonidine use in the perioperative period. Materials and Methods: This umbrella review synthesizes evidence on adverse events associated with perioperative prescription of clonidine, following the PRIOR guidelines using three prominent databases of Scopus, PubMed, and Web of Science with a strategic combination of keywords. Studies included were systematic reviews, meta-analyses, and network meta-analyses published in English; studies reviewing prescribing systematic clonidine perioperative; and reporting adverse events. Primary outcomes were cardiovascular events, respiratory, neurological, and gastrointestinal complications. Data were extracted systematically by two independent reviewers and analyzed using random effects models in Stata. Pooled odds ratios and mean differences were calculated, with heterogeneity assessed using the I² statistic. Results: Our umbrella review of 8 systematic review studies including 223 studies from 1980 till now; all of which included only randomized controlled trials (RCTs). The bradycardia analysis, comprising four studies, shows a significant increased risk of bradycardia compared to control (OR: 1.653, 95% CI: 1.013 to 2.700) with some heterogeneity (P=0.0609). Hypotension meta-analysis (four studies) reveals a substantial increased risk (exp(theta): 3.281, 95% CI: 1.696 to 6.347), albeit with moderate heterogeneity (I^2=62.37%, P=0.0355). Heart rate reduction (two studies) and MAP reduction (two studies) meta-analyses indicate significant effects of clonidine, with substantial heterogeneity. Conclusion: Our comprehensive umbrella review highlights significant associations between…
creator: Mehrdad Sayadinia
creator: Pourya Adibi
creator: Tayyebeh Zarei
creator: Mehrdad Malekshoar
creator: Majid Vatankhah
creator: Mohammad Sadegh Sanie Jahromi
creator: Amir Hossein Pourdavood
creator: Mansour Deylami
creator: Lohrasb Taheri
creator: Bibi Mona Razavi
creator: Reza Sahraei
creator: Shahram Shafa
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-01-30
publication date: 2026-01-30
volume: 15
starting page: e3537
ending page: e3537
doi: 10.31661/gmj.v15i.3537

Maternal Psychological Distress and Repeated Implantation Failure: A Mini Review
type: item
description: Infertile couples can try assisted reproductive technology (ART) interventions to become pregnant. Repeated implantation failure (RIF) is diagnosed when pregnancy is not achieved after three or more transfers of high-quality embryos. Despite the psychological research indicating that repeated ART failure is strongly associated with negative psychological consequences for both men and women, there are currently no studies addressing the potentially traumatic aspects of the experiences of RIF women. Thereby, we present a summary of the current research to emphasize the intersections between traumatic experiences and RIF, particularly the different features of RIF women in ART programs potentially more at risk for trauma. The aim of this study is to examine the role of psychological factors in RIF and to emphasize the need for further research to better understand these processes in ART treatments for women with RIF.
creator: Sina Vakili
creator: Bahia Namavar Jahromi
creator: Sepide Goharitaban
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-06-19
publication date: 2026-06-19
volume: 15
starting page: e4201
ending page: e4201
doi: 10.31661/gmj.v15i.4201

The Role of Surface-Modified Titanium Scaffolds and Implants in Tissue Engineering for Bone Healing in Maxillofacial and Reconstructive Surgery
type: item
description: Titanium and titanium alloys are widely used in maxillofacial and reconstructive surgery because they combine mechanical strength, corrosion resistance, manufacturability, and long-term biocompatibility. Their applications include dental implants, mandibular reconstruction plates, titanium mesh, patient-specific implants, orbital reconstruction systems, cranial implants, zygomatic implants, and additively manufactured porous scaffolds. Although titanium provides reliable mechanical stability, its biological performance depends strongly on the surface–tissue interface rather than on bulk material properties alone. Surface chemistry, oxide-layer characteristics, roughness, wettability, and micro/nanotopography influence protein adsorption, osteoblast adhesion, macrophage phenotype, angiogenesis, bacterial adhesion, and osseointegration. This narrative review critically synthesizes current knowledge on surface-modified titanium scaffolds and implants for bone healing in maxillofacial and reconstructive surgery, with emphasis on biological mechanisms, clinical relevance, translational limitations, and future directions. The available evidence supports the concept that optimized titanium surfaces can promote osteogenesis, vascularization, osteoimmunomodulation, and antibacterial activity, but clinical translation remains limited by heterogeneous surface characterization, simplified preclinical models, and insufficient long-term clinical data.
creator: Mohammed Abbas Jasim
creator: Shaikhaliev Astemir Ikramovich
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-08-16
publication date: 2026-08-16
volume: 15
starting page: e4174
ending page: e4174

Student Self-Assessment and Faculty Evaluation in Dental Education: A Cross-Sectional Study
type: item
description: Background: Student self-assessment is emphasized in dental education because it promotes reflective practice, self-regulated learning, and clinical competence. However, its educational value depends on students’ engagement and faculty members’ consistent use of self-assessment in feedback and evaluation. Materials and Methods: This cross-sectional survey assessed perceptions and practices related to self-assessment among 108 dental students and 46 faculty members. Structured questionnaires collected demographic data, student self-assessment practices, faculty attention to self-assessment forms, perceived influence on final evaluation, and student-reported barriers. Data were analyzed descriptively using frequencies and percentages.Results: Among students, 31 (28.7%) reported always completing self-assessment forms, 58 (53.7%) completed them frequently, and 19 (17.6%) completed them rarely. Among faculty members, 18 (39.1%) always paid attention to students’ self-assessment forms, 11 (23.9%) frequently did so, 12 (26.1%) occasionally did so, and five (10.9%) rarely did so. Sixty students (55.6%) and 19 faculty members (41.3%) agreed or strongly agreed that self-assessment influenced final evaluation. The most frequently reported barrier was lack of time, reported by 34 students (31.5%). Conclusions: Self-assessment was commonly used and generally valued, but implementation was inconsistent. Lack of time and uncertainty regarding faculty consideration were important barriers. Clearer integration into clinical assessment is recommended.
creator: Najla N. Al-Dabbagh
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-07-14
publication date: 2026-07-14
volume: 15
starting page: e3908
ending page: e3908
doi: 10.31661/gmj.v15i.3908

The Importance of Periodic Electrocardiograms in Individuals with Metabolic Disorders: A Policy Brief
type: item
description: Metabolic disorders, including obesity, type 2 diabetes, metabolic dysfunction-associated fatty liver disease (MAFLD), anemia, and insulin resistance, are increasingly prevalent and represent a major contributor to cardiovascular morbidity and mortality. Emerging evidence indicates that these conditions are associated with prolongation of the corrected QT (QTc) interval, a well-established marker of ventricular arrhythmias and sudden cardiac death. Individuals with metabolic disorders have a significantly higher risk of life-threatening arrhythmias, even in the absence of known cardiovascular disease. Insulin resistance, a central component of cardiometabolic dysfunction, has also been linked to QT interval prolongation. Despite this growing body of evidence, QTc monitoring is not currently included in routine clinical guidelines for the management of metabolic disorders. Electrocardiography (ECG) is a low-cost and widely accessible diagnostic tool that enables early identification of high-risk individuals and supports timely preventive interventions. Routine implementation of baseline and annual ECG-based QTc monitoring has the potential to reduce sudden cardiac death, improve cardiovascular risk stratification, and decrease healthcare costs associated with acute cardiac events. This policy brief advocates for the adoption of a national QTc monitoring strategy as a scalable and cost-effective approach to improving cardiovascular outcomes in patients with metabolic disorders.
creator: Seyed Rasool Nazemi fard
creator: Babak Pezeshki
creator: Mojtaba Farjam
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-05-01
publication date: 2026-05-01
volume: 15
starting page: e4206
ending page: e4206
doi: 10.31661/gmj.v15i.4206

Novel Antithrombotics in Geriatric PCI for STEMI: Balancing Ischemic Protection with Bleeding Risk
type: item
creator: Ibrahim Pakizeh
creator: Bahram Sohrabi
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-06-07
publication date: 2026-06-07
volume: 15
starting page: e4032
ending page: e4032
doi: 10.31661/gmj.v15i.4032

Focused Echocardiography to Guide Management in Acute Decompensated Heart Failure: From Rapid Phenotyping to Therapeutic Precision
type: item
creator: Zakieh Amiraslanzadeh
creator: Elnaz Javanshir
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-05-28
publication date: 2026-05-28
volume: 15
starting page: e4224
ending page: e4224
doi: 10.31661/gmj.v15i.4224

Severe Gastroparesis-like Syndrome Following Single-dose Liraglutide Administration: A Case Report
type: item
description: Background: As a GLP-1 analogue, liraglutide is given to patients as a treatment for both obesity and type 2 diabetes. It taken safely most of time, though there are also reports of effects on the digestive system. Case Report: In our case, a 30-year-old healthy female developed severe slowing of her stomach after a single injection of liraglutide (1 mg) for weight loss, without a doctor’s care. Within a few hours of getting the treatment, the patient began having severe abdominal pain and kept vomiting. A thorough review using imaging and lab tests did not find anything wrong with her system to explain her symptoms. It points out that a single dose of liraglutide may result in major gastric motility problems for some patients. She recovered from her condition over two weeks with supportive care which eliminated her symptoms. Conclusion: Further study is required to explain these reactions and to set up rules for safer use of GLP-1 receptor agonists outside the diabetic population.
creator: Eyad A. Makkawy
rights: Copyright (c) 2026 Galen Medical Journal https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2026-03-02
publication date: 2026-03-02
volume: 15
starting page: e4135
ending page: e4135
doi: 10.31661/gmj.v15i.4135