Journal of Advanced in Medicinal, Pharmaceutical and Biomedical Research (JAMPBR)

Abstract Dermal fillers have become a cornerstone in aesthetic medicine, offering minimally invasive solutions for facial rejuvenation, contour enhancement, and volume restoration. This review explores the various types of dermal fillers, their clinical indications, and potential complications associated with their use. Dermal fillers are broadly categorized into temporary, semi-permanent, and permanent types, with hyaluronic acid-based fillers being the most popular due to their biocompatibility and reversibility. Other commonly used materials include calcium hydroxylapatite, poly-L-lactic acid, and polymethylmethacrylate microspheres. Indications for dermal filler application encompass correction of age-related volume loss, soft tissue augmentation, wrinkle reduction, and facial contour remodeling. Proper patient selection and individualized treatment planning are essential to maximize aesthetic outcomes and minimize risks. Despite their safety profile, dermal fillers carry potential complications ranging from mild and transient, such as swelling, bruising, and erythema, to more serious adverse events including infection, vascular occlusion, and granuloma formation. The prevention and management of complications require a thorough understanding of facial anatomy, appropriate injection techniques, and prompt recognition of adverse signs. Advances in filler technology and imaging techniques have improved treatment precision and patient satisfaction; however, challenges remain in achieving consistent long-term results and managing rare but severe complications. This review underscores the importance of clinician expertise, patient education, and ongoing research to optimize the safety and efficacy of dermal filler treatments. Future developments may focus on novel biomaterials, personalized treatment protocols, and improved diagnostic tools to further enhance clinical outcomes.

Abstract Facial aesthetic treatment with injectable hyaluronic acid (HA) fillers has become a pivotal technique in modern non-surgical facial rejuvenation. This minimally invasive approach offers a safe, effective, and customizable solution to restore facial volume, improve contours, and reduce signs of aging. The methodological approach to HA filler treatments is comprehensive, involving a detailed understanding of facial anatomy, aging patterns, filler properties, and injection techniques. The selection of appropriate HA fillers depends on their rheological characteristics such as viscosity, elasticity, and cohesivity, which influence their suitability for different facial regions and depths. Treatment planning requires a thorough facial assessment to identify areas of volume loss, asymmetry, and dynamic movement, guiding tailored injection strategies to achieve harmonious and natural outcomes. Techniques including linear threading, bolus injections, fanning, and cross-hatching are employed based on specific aesthetic goals and anatomical considerations. Safety is paramount in all procedural steps, with knowledge of critical vascular and neural structures essential to minimize risks such as vascular occlusion or nerve injury. Additionally, the reversibility of HA fillers with hyaluronidase provides an important safety net, enhancing patient confidence. This methodological framework integrates both scientific rigor and artistic judgment, balancing objective anatomical corrections with subjective aesthetic desires. Continuous advances in filler technology and injection techniques, combined with growing clinical experience, contribute to improving treatment efficacy and patient satisfaction. Overall, a structured, evidence-based approach to injectable HA fillers is crucial for achieving optimal, reproducible, and safe facial aesthetic outcomes.

Abstract Triple-negative breast cancer (TNBC) represents an aggressive subtype of breast cancer characterized by the absence of estrogen receptors, progesterone receptors, and HER2 amplification. The optimal surgical approach for TNBC remains debated, particularly regarding whether mastectomy or breast-conserving surgery (BCS) yields superior overall survival (OS). This systematic review and meta-analysis aimed to synthesize current evidence comparing OS in TNBC patients treated with mastectomy versus BCS. A comprehensive search of PubMed, Scopus, Web of Science, and Cochrane Library was conducted for studies published between 2005 and 2024. Eligible studies included observational cohorts, randomized controlled trials, and population-based analyses reporting OS outcomes for TNBC patients undergoing mastectomy or BCS. Data extraction and risk-of-bias assessments were performed independently by two reviewers. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model.

A total of 17 studies involving 58,430 TNBC patients met the inclusion criteria. Meta-analysis revealed that BCS combined with radiotherapy was associated with improved OS compared with mastectomy (pooled HR = 0.82; 95% CI: 0.74–0.91). Subgroup analyses showed consistent survival benefits of BCS in early-stage disease (stage I–II) and among patients receiving adjuvant systemic therapy. There was moderate heterogeneity (I² = 48%). Sensitivity analyses excluding high-risk-of-bias studies demonstrated similar findings, confirming robustness. No significant publication bias was detected.

The results suggest that BCS, when followed by radiotherapy, offers at least equivalent and often superior OS compared with mastectomy in appropriately selected TNBC patients. These findings support current guidelines advocating BCS as a safe and effective surgical option. Future prospective studies are warranted to identify biological and clinical predictors for tailoring surgical decisions in TNBC.

Abstract Background: Women carrying BRCA1 and BRCA2 pathogenic variants face a significantly increased lifetime risk of breast cancer. Bilateral prophylactic mastectomy (BPM) is the most aggressive preventive strategy, yet its magnitude of risk reduction and long-term outcomes remain crucial considerations for decision-making. This systematic review and meta-analysis evaluates the impact of BPM on subsequent breast cancer incidence among BRCA mutation carriers.

Methods: A systematic search of major medical databases (PubMed, Scopus, Web of Science, and Cochrane Library) was conducted for studies published from 1990 to 2025. Eligible studies included prospective or retrospective cohorts and case-series evaluating BPM in BRCA1/2 carriers with cancer incidence as an outcome. Data extraction was performed independently by two reviewers, and study quality was assessed using the Newcastle–Ottawa Scale. Given heterogeneity in design and follow-up duration, a random-effects model was applied for pooled effect estimation.

Results: Across the included studies, BPM consistently demonstrated a marked reduction in breast cancer incidence compared with surveillance-only groups. Most cohorts reported near-complete elimination of new breast cancer cases following BPM, particularly among BRCA1 carriers who possess a higher baseline risk. Studies with the longest follow-up periods (exceeding 10–15 years) showed sustained protection without evidence of late events. Psychosocial outcomes varied, with many women reporting reduced cancer-related anxiety but acknowledging challenges related to body image and reconstruction. No study reported increased mortality attributable to BPM.

Conclusion: BPM provides profound and durable reduction in breast cancer incidence among women with BRCA mutations, representing the most effective risk-lowering strategy currently available. Shared decision-making remains essential, integrating oncologic benefit with surgical risk, psychological impact, and patient values. Further research should refine long-term quality-of-life outcomes and compare BPM with emerging non-surgical preventive modalities.

Abstract Background and aim: Diagnosis and prognosis of brain tumors remains a clinical challenge, and noninvasive biomarkers can play a key role in improving the diagnosis and management of these patients. This study aimed to evaluate the diagnostic and predictive value of circulating microRNAs (miRNAs) in adult brain tumors.

Method: present systematic review and meta-analysis included studies from international databases, PubMed, Scopus, Web of Science, and Embase, from January 1, 2015 to November 23, 2025, using keywords aligned with the study objective. Studies included measurements of peripheral miRNAs in patients with brain tumors and healthy controls. Data included AUC, sensitivity, specificity, and information on miRNA type, sample source, and tumor type were collected. Study quality was assessed using the QUADAS-2 tool, and meta-analysis was performed with random and fixed-effects models. The statistical analysis was performed with Stata/MP.v17 as fixed effect models.

Result: A total of 15 studies with 1093 (case) and 753 (control) participants were included in the analysis. The meta-analysis showed that miRNAs had high diagnostic accuracy (AUC = 0.84, sensitivity = 0.81, specificity = 0.80). Subgroup analysis showed that serum samples had higher AUC than plasma and exosomes (serum AUC = 0.87).

Conclusion: Circulating miRNAs, especially in serum samples, are reliable diagnostic and predictive markers for brain tumors.

Abstract Objective: Chin retrusion (micro or retro gnathia) can adversely affect facial harmony and patient self esteem. Injectable dermal fillers—especially those based on Hyaluronic Acid (HA)—have been increasingly used as a non surgical alternative to traditional chin augmentation. This systematic review and meta analysis aims to evaluate clinical outcomes, patient satisfaction, and complication rates associated with HA chin augmentation. Methods: We searched PubMed, Embase, Web of Science, and other databases up to June 2023, following PRISMA guidelines. Studies reporting chin augmentation with injectable fillers in adult patients, with patient reported outcomes and/or data on complications, were included. Data extracted included number of patients, filler type and volume, aesthetic outcome measures (e.g., Global Aesthetic Improvement Scale (GAIS), FACE Q), satisfaction rates, and reported adverse events. Results: From 2,738 initial records, 24 articles comprising 2,259 patients receiving HA injections for chin augmentation met inclusion criteria. Most studies reported marked improvement in chin projection and contour, with high levels of patient satisfaction. In several studies, over 90% of patients reported improvement on FACE Q or similar scales; many maintained perceived improvement at 6–12 months post injection. Common adverse events included swelling, edema, ecchymosis/bruising, pain or tenderness, erythema, and occasional nodules or asymmetry; these were generally mild and resolved spontaneously. Only one study reported a serious complication (skin necrosis). No vascular complications or vision loss were reported in the majority of studies. Conclusion: HA based injectable fillers for chin augmentation appear to be an effective, well tolerated, and highly satisfactory nonsurgical option for facial contour enhancement. The complication profile is generally mild and transient; serious adverse events are rare. Nevertheless, the heterogeneity in injection protocols, outcome measures, and follow-up durations limits definitive conclusions. Large-scale controlled trials with standardized methodology are warranted.

Abstract Background: Hyaluronic acid (HA) fillers are widely used for nonsurgical facial contouring, especially in the jawline and chin regions, due to their favorable safety profile and reversibility. However, the duration of effectiveness in these anatomical areas remains variably reported, influenced by product formulation, injection technique, and patient characteristics. This systematic review and meta analysis aimed to quantitatively assess the duration of effectiveness of HA fillers specifically in the jawline and chin, synthesizing evidence from clinical studies and patient reported outcomes.

Methods: A comprehensive literature search of PubMed, EMBASE, Scopus, and Cochrane CENTRAL was conducted through December 2025, including randomized controlled trials, prospective cohort studies, and observational designs that reported on HA filler outcomes in the jawline or chin with at least 6 months follow up. Effectiveness measures included validated aesthetic scales (e.g., Galderma Chin Retrusion Scale, Jawline Contour Rating Scale), Global Aesthetic Improvement Scale (GAIS), and patient satisfaction metrics. Data on duration of effect, defined as time to clinically meaningful decline, were extracted and pooled using random effects meta analysis.

Results: Eighteen eligible studies including 1,200+ patients demonstrated that HA fillers provided significant aesthetic enhancement in both jawline and chin regions. Mean effective duration ranged from 9 to 18 months, with pooled estimates suggesting a sustained effect at 12 months post injection in most subjects. High cohesivity, structurally robust fillers yielded longer sustained volume and contour improvements compared with softer formulations.

Conclusions: Hyaluronic acid fillers are effective for jawline and chin enhancement, with typical clinical effects lasting approximately 12–18 months. Longer lasting outcomes are more consistently reported with firmer, high elasticity formulations and deeper supraperiosteal placement.

Abstract Introduction: Acute myocardial infarction remains a major cause of long‑term morbidity and mortality despite advances in primary percutaneous coronary intervention. Early identification of high‑risk patients is therefore essential. The aim of this study was to evaluate the role of the Modified Shock Index as a simple hemodynamic marker for predicting long‑term clinical outcomes in patients with acute myocardial infarction undergoing primary PCI.

Material and methods: This cross‑sectional study was conducted at Shahid Madani Heart Hospital between 2022 and 2023 using a census sampling method. A total of 234 patients with acute myocardial infarction undergoing primary percutaneous coronary intervention were included. Clinical, hemodynamic, laboratory, echocardiographic, and angiographic data were collected, and the Modified Shock Index was calculated before and after PCI for analysis.

Results: Patients with a higher Modified Shock Index (P ≥0.897) were older and exhibited more hypertension (P=0.008), diabetes (P=0.002), and dyslipidemia (P=0.009), along with longer chest pain duration (P = 0.004) and higher leukocyte count, troponin, and creatinine (all P≤0.002). In‑hospital mortality was markedly greater in both high pre‑ and post‑PPCI MSI groups (each P<0.001).

Conclusion: The present study demonstrates that the Modified Shock Index is a strong, readily obtainable prognostic indicator in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. An elevated MSI, reflecting the interplay between tachycardia and hypotension, accurately identified subjects with greater cardiovascular risk, prolonged ischemic burden, and biochemical evidence of systemic inflammation and myocardial damage.

Abstract Introduction: Differentiating ischemic from non ischemic cardiomyopathy remains a major clinical challenge despite advances in cardiac imaging. Subtle electrocardiographic markers, particularly repolarization patterns, may provide valuable etiologic clues. This study aimed to evaluate the diagnostic role of T wave amplitude in lead aVR for distinguishing ischemic cardiomyopathy from non ischemic cardiomyopathy.

Material and methods: This retrospective cross‑sectional study was conducted at Shahid Madani Heart Center, Tabriz, Iran, between March 2023 and March 2024. Using a census sampling approach, 315 patients with echocardiographically confirmed cardiomyopathy and left ventricular systolic dysfunction were included. Clinical data, electrocardiograms, and echocardiographic findings were retrospectively reviewed and analyzed.

Results: The cohort was predominantly male with a high burden of traditional cardiovascular risk factors, particularly in ischemic cardiomyopathy. In hospital clinical parameters showed moderate stability. T wave amplitude in lead aVR was not associated with length of stay (P = 0.590) or in hospital mortality and adverse outcomes (P = 0.667) in either etiologic group.

Conclusion: This study demonstrates that patients with cardiomyopathy, especially those with an ischemic etiology, exhibit a characteristic clustering of demographic features and atherosclerotic risk factors, reflecting fundamental differences in disease mechanisms between ischemic and non ischemic forms.

Abstract Introduction: Acute anterior myocardial infarction is associated with extensive ischemic injury and variable responses to mechanical reperfusion despite successful primary PCI. Emerging electrocardiographic markers may reflect microvascular and electrical recovery. This study aimed to evaluate the association between P wave peak time and the effectiveness of mechanical reperfusion in patients with first acute anterior myocardial infarction undergoing PPCI.

Material and methods: This descriptive cross sectional study was conducted at Shahid Madani Heart Center, Tabriz, Iran, during the year 1402. Using a census sampling method, 73 patients with first acute anterior myocardial infarction undergoing primary percutaneous coronary intervention were enrolled. Clinical data and serial electrocardiograms were collected to assess P wave peak time before and after intervention and its relationship with reperfusion outcomes.

Results: Baseline demographic, laboratory, and clinical characteristics were largely comparable between the reflow and no‑reflow groups. However, total ischemic time was significantly longer (p = 0.024) and left ventricular ejection fraction was markedly lower (p < 0.001) in patients with no‑reflow. P‑wave peak time difference was significantly associated with ST‑segment resolution (p < 0.001), extent of coronary artery involvement (p = 0.023), and modestly predicted no‑reflow on ROC analysis (p = 0.047).

Conclusion: This study demonstrates that the no reflow phenomenon in acute anterior myocardial infarction is primarily driven by ischemic burden and impaired ventricular systolic function rather than baseline demographic characteristics or conventional cardiovascular risk factors. Prolonged total ischemic time and reduced left ventricular ejection fraction emerged as the most important clinical correlates of inadequate myocardial reperfusion.