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

Abstract Abstract

Facial dermal filler injections are increasingly popular for aesthetic enhancement and facial reconstruction, yet they may be associated with serious vascular complications, including skin necrosis, vision impairment, and tissue damage. This systematic review and meta-analysis aimed to evaluate the incidence and severity of vascular adverse events according to injection sites and to identify high-risk facial regions. A comprehensive search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library for studies published up to 2025. Included studies encompassed case reports, case series, cross-sectional, and prospective studies reporting detailed information on injection sites and vascular complications. Data extraction was performed independently by two reviewers, and study quality was assessed using the Newcastle-Ottawa Scale and ROBINS-I tool. Random-effects meta-analysis was employed to estimate the overall prevalence of vascular complications and their association with injection location. Results indicated that the most common vascular adverse events were skin necrosis, severe bruising, and vascular occlusion, with the highest risk observed in the nose, cheeks, and lips. Sensitivity analyses suggested that injector experience and technique significantly influenced complication rates. This systematic review and meta-analysis underscores the importance of anatomical knowledge and careful site selection in facial filler procedures. The findings provide clinical guidance for minimizing vascular complications and enhancing patient safety in aesthetic facial injections.

Abstract Introduction: Chronic rhinosinusitis remains a challenging condition with a significant proportion of patients requiring revision sinus surgery despite initial intervention. Multiple disease‑related, anatomical, inflammatory, and patient‑specific factors contribute to surgical failure. Identifying these risk factors is essential for improving patient selection, optimizing surgical strategies, and enhancing long‑term postoperative outcomes.

Material and methods: This retrospective cohort study evaluated adult patients with chronic rhinosinusitis who underwent endoscopic sinus surgery over a ten‑year period. Data were collected using standardized forms and analyzed with IBM SPSS. Demographic, clinical, and disease variables were compared between revision and primary surgery groups using chi‑square, t‑tests, and binary logistic regression.

Results: Postoperative complications were common following nasal fracture surgery, with nasal obstruction as the predominant outcome. Revision surgery was significantly associated with smoking, asthma, elevated white blood cell count, and diabetes, whereas CRSsNP was protective. Complication incidence declined significantly over time, particularly for minor functional sequelae, indicating progressive improvement in perioperative management.

Conclusion: These findings underscore the multifactorial nature of postoperative outcomes following nasal fracture surgery. Patient comorbidities, inflammatory status, disease phenotype, and temporal improvements in care all interact to influence surgical success.

Abstract Complex facial surgical reconstruction extends beyond functional restoration and enters the domain of identity, psychosocial reintegration, and aesthetic harmony. The human face represents a multidimensional structure in which anatomy, symmetry, proportion, and expression converge to define individuality. In cases involving severe trauma, oncologic resection, congenital malformations, or infection-related tissue loss, surgical planning must adopt a framework comparable to architectural design—systematic, layered, and structurally integrative. Architectural approaches to facial reconstruction emphasize foundational stability, spatial organization, load distribution, and surface refinement. Bone reconstruction functions as the structural framework, analogous to architectural scaffolding, ensuring support for soft tissues and long-term biomechanical integrity. Advances in three-dimensional imaging, computer-assisted design (CAD), virtual surgical planning, and patient-specific implants have enhanced precision and predictability. Microvascular free tissue transfer further allows for composite reconstruction, restoring both volume and contour while maintaining vascular viability. Equally critical is the aesthetic dimension: symmetry, proportional analysis, and subunit reconstruction principles guide surgeons in recreating natural facial landmarks. The integration of regenerative medicine, biomaterials, and tissue engineering introduces adaptive strategies that mirror sustainable architectural innovation. Interdisciplinary collaboration among maxillofacial surgeons, plastic surgeons, prosthodontists, and biomedical engineers reinforces the architectural paradigm, ensuring both structural durability and aesthetic coherence. Ultimately, reconstructing the face entails reconstructing identity. Successful outcomes measured not only by surgical survival and anatomical restoration but also by psychological recovery and social reintegration. By conceptualizing facial reconstruction through an architectural lens, clinicians can systematically address complexity while preserving the essence of human identity.

Abstract Assessing Mismatch Repair MMR status via immunohistochemical loss of MLH1 and PMS2 proteins is paramount in endometrial carcinoma EC. This deficiency, indicative of a hypermutable phenotype, serves as a critical prognostic factor and, more significantly, a strong predictive biomarker for therapeutic response, particularly guiding the successful application of immune checkpoint blockade therapies in patients with advanced or recurrent disease. This narrative review synthesized literature on MMR deficiency in Endometrial Carcinoma using systematic searches (PubMed, Scopus, etc.) up to January 2026. Key terms focused on MMR status, molecular subtyping, and immunotherapy in EC. Inclusion required peer-reviewed studies addressing pathological assessment or molecular classification with direct clinical correlation, ensuring a robust foundation for synthesis. MMR deficiency dictates the therapeutic strategy in Endometrial Carcinoma due to the resulting high Tumor Mutational Burden, which generates abundant neoantigens and creates “hot” tumors. This genomic instability confers exquisite sensitivity to Immune Checkpoint Inhibitors (ICBs), leading to tumor-agnostic FDA approval for anti-PD-1 therapy in MSI-H cancers. Therefore, MMR status functions primarily as a predictive biomarker, guiding access to highly effective immunotherapy, especially in advanced or recurrent disease settings, superseding its complex prognostic implications.

Abstract Background and Objectives: The collaborative care model facilitates effective communication between nurses and patients, improving the quality of care and ultimately leading to better patient outcomes. This study aimed to evaluate the effect of nursing interventions based on the collaborative care model on the resilience of cancer patients in educational hospitals in Shahr-e-Kord.

Materials and Methods: This semi-experimental study was conducted in 2021 with 60 cancer patients in educational hospitals of Shahr-e-Kord. Participants were initially selected using purposive sampling and then randomly assigned to either the intervention or control group. The educational intervention, grounded in the collaborative care model, was delivered individually in four stages: motivation, preparation, engagement, and evaluation. Data were collected using a demographic questionnaire and the Connor-Davidson Resilience Scale (CD-RISC). Mean resilience scores were measured before, immediately after, and two months following the intervention. Statistical analyses, including independent t-tests, chi-square tests, and repeated measures ANOVA, were performed using SPSS version 24.

Results: Before the intervention, no significant difference in mean resilience scores was observed between the intervention and control groups (p > 0.05). However, immediately after the intervention and two months later, the intervention group showed a statistically significant increase in resilience compared to the control group (p < 0.05).

Conclusion: The findings suggest that nursing interventions based on the collaborative care model can effectively enhance resilience in cancer patients. Given its effectiveness, safety, and cost-efficiency, it is recommended that hospital administrators implement this approach to improve patient health outcomes and increase patients’ knowledge and awareness.

Abstract Glioblastoma (GBM) remains the most lethal primary brain tumor in adults, driven in large part by a subpopulation of glioblastoma stem cells (GSCs) that exhibit self-renewal, multipotency, and pronounced resistance to conventional therapies. This narrative review synthesizes contemporary evidence on the mechanisms by which GSCs mediate therapeutic resistance, including enhanced DNA repair, drug efflux, cell cycle regulation and quiescence, microenvironmental influences, and phenotypic plasticity. We integrate findings across intrinsic cellular adaptations, tumor microenvironment interactions, and intratumoral heterogeneity to delineate how these features converge to sustain GBM recurrence. We also summarize current and emerging therapeutic strategies aimed at overcoming GSC-driven resistance, such as targeting signaling pathways (Hedgehog/GLI, JAK/STAT3, Wnt/β-catenin), disrupting cell cycle regulators, metabolic and epigenetic reprogramming, and combinatorial regimens designed to sensitize GSCs to chemotherapy and radiation. Throughout, we emphasize areas of consensus and points of contention in the literature, and we highlight knowledge gaps that impede translation to the clinic. This synthesis underscores the imperative to target GSC biology in concert with bulk tumor-directed therapies to achieve more durable GBM control.

Abstract Background: Hereditary Breast and Ovarian Cancer (HBOC) syndrome is most commonly associated with pathogenic variants in the BRCA1 gene and characterized by an increased lifetime risk of breast and ovarian cancers with variable penetrance. Familial case series provide valuable insights into genotype–phenotype correlations and the impact of preventive strategies.

Case Presentation: We report a family consisting of six sisters, four of whom were confirmed carriers of a pathogenic BRCA1 frameshift mutation (c.68_69del; p.Glu23ValfsTer17). Among the mutation carriers, two developed breast cancer, one developed ovarian cancer, and one developed both breast and ovarian cancer. The proband, a 44-year-old woman, was initially diagnosed with ductal carcinoma in situ of the breast, followed by high-grade serous ovarian carcinoma two years later. She underwent partial mastectomy, total abdominal hysterectomy with bilateral salpingo-oophorectomy, platinum-based chemotherapy, and is currently receiving maintenance therapy with olaparib. One BRCA1-positive sister underwent prophylactic gynecologic surgery and remains disease-free, while two sisters tested negative for the mutation and have no evidence of malignancy. A significant family history noted in a paternal aunt with early-onset breast cancer followed by ovarian cancer.

Discussion: This case series demonstrates the heterogeneous clinical expression of a single pathogenic BRCA1 mutation within one family, ranging from prophylactic surgery without malignancy to metachronous breast and ovarian cancers. The findings highlight the importance of cascade genetic testing, adherence to guideline-recommended surveillance, and timely risk-reducing interventions. Socioeconomic factors may influence access to preventive surgeries and considered in clinical decision-making.

Conclusion: This familial case series highlights the marked clinical heterogeneity of BRCA1-associated malignancies, even among individuals carrying the same pathogenic variant. The findings underscore the critical role of early genetic testing, cascade screening, and adherence to guideline-recommended surveillance and risk-reducing strategies.

Abstract Background: The global increase in the aging population has led to a rising incidence of cancer among older adults. This demographic presents unique physiological, functional, and psychosocial challenges that necessitate tailored nursing interventions. This systematic review aims to synthesize evidence-based principles of nursing care for elderly cancer patients, focusing on clinical and practical considerations.

Methods: A systematic search conducted in PubMed, CINAHL, Scopus, and Web of Science for studies published between 2015 and 2025. Included studies addressed nursing care for cancer patients aged ≥65 years, emphasizing clinical outcomes, safety, and quality of life. Data extraction and quality assessment using the Joanna Briggs Institute checklists performed independently by two reviewers.

Results: From 1,248 initial records, 42 studies met inclusion criteria. Five core-nursing principles emerged:

First: comprehensive geriatric assessment (CGA)-guided care to identify frailty, comorbidities, polypharmacy,

Second: individualized symptom management with special attention to pain, fatigue, and chemotherapy-related toxicities,

Third: fall prevention strategies integrating mobility aids environmental modifications,

Fourth: cognitive and psychosocial support addressing delirium risk, depression, social isolation,

Fifths: proactive care coordination and advance care planning to align treatment with patient goals and avoid unnecessary hospitalizations.

Conclusion: Effective nursing care for elderly cancer patients requires shifting from a disease-centered to a geriatric-centered model. Key principles include routine CGA, tailored symptom control, fall prevention, cognitive support, and coordinated advance planning. Implementing these principles can improve treatment tolerance, functional independence, and quality of life. Future research should focus on nurse-led transitional care models and family caregiver training.

Abstract Background: Reduction mammaplasty effectively relieves symptoms of macromastia but carries inherent risks of postoperative complications. Numerous surgical techniques exist, yet the impact of specific technical variations on complication profiles remains unclear. This systematic review compares complication rates across different pedicle types, resection patterns, and closure methods.

Methods: A systematic search of PubMed, Embase, and Cochrane Library (2010–2023) identified 48 eligible studies reporting complication outcomes in reduction mammaplasty. Included studies involved bilateral reductions for symptomatic macromastia with minimum 6-month follow-up. Primary outcomes included wound dehiscence, nipple-areola complex (NAC) necrosis, fat necrosis, infection, and hypertrophic scarring.

Results: Inferior pedicle techniques demonstrated the lowest NAC necrosis rates (<1%) but higher rates of bottoming deformity (8–12%). Superior and medial pedicles showed higher NAC ischemia (2–4%) but reduced bottoming (2–5%). Superomedial pedicles combined good NAC viability (98.5% survival) with favorable projection. Wise-pattern incisions had significantly higher T-junction dehiscence (12–18%) compared to vertical scar techniques (5–8%). Liposuction-assisted approaches reduced overall minor complications (OR 0.52; p=0.01) but not major necrosis. Drains did not significantly affect seroma or infection rates. Weight of resection >1000g per breast independently predicted higher overall complications (OR 2.34; p<0.001).

Conclusions: No single technique eliminates all complications. Superomedial pedicle with vertical scar offers the most favorable balance of low NAC necrosis and acceptable wound healing. Resection weight remains the strongest predictor of adverse outcomes. Technique selection should prioritize pedicle reliability over scar pattern when resection exceeds 1000g.

Abstract Background: Nitroglycerin is a vital medication in cardiac intensive care units,
but headache induced by it is a common and distressing complication that can
lead to reduced patient cooperation and even treatment discontinuation.
Acupressure at point P6 considered a non-pharmacological, safe, and cost-
effective method. This study aimed to determine the effect of pressure band on
point P6 on the prevention of nitroglycerin infusion-induced headache in
patients hospitalized in the cardiac intensive care unit.
Methods: This study was a three-group parallel-randomized clinical trial
conducted on 78 patients hospitalized in the cardiac intensive care unit of
Farshchian Heart Hospital in Hamadan during 2024-2025. Patients were
allocated using permuted block sampling method into three groups of 26
patients each: P6 pressure band group, sham group (band without pressure),
and control group (routine care). Time of headache onset, headache severity
(NRS scale), and vital signs including mean arterial pressure, heart rate, and
oxygen saturation were measured at 0, 15, 30, 60, and 120 minutes after
starting the infusion. Data analyzed using Kruskal-Wallis test, one-way ANOVA,
Tukey's post hoc test, repeated measures ANOVA, and Friedman test.
Results: The mean time of headache onset in the pressure band group (101.92
minutes) was significantly longer than the sham group (73.27 minutes) and
control group (54.96 minutes) (P<0.001). The mean headache severity in the
pressure band group (0.62) was significantly lower than the sham group (2.15)
and control group (3.69) (P<0.001). Mean arterial pressure at 15 and 30
minutes showed significant differences among the three groups (P=0.026 and
P=0.001, respectively). Heart rate showed no significant difference among the
groups. Oxygen saturation showed significant changes only in the pressure
band group (P=0.039).
Conclusion: P6 point pressure band is an effective, safe, non-invasive, and
cost-effective method for delaying the onset and reducing the severity of
nitroglycerin infusion-induced headache in patients hospitalized in cardiac
intensive care units. This method integrated into care protocols as an evidence-
based nursing intervention