Passiflora incarnata attenuation of neuropathic allodynia and vulvodynia apropos GABA-ergic and opioidergic antinociceptive and behavioural mechanisms

Background: Passiflora incarnata is widely used as an anxiolytic and sedative due to its putative GABAergic properties. Passiflora incarnata L. methanolic extract (PI-ME) was evaluated in an animal model of streptozotocininduced diabetic neuropathic allodynia and vulvodynia in rats along with antinociceptive, anxiolytic and sedative activities in mice in order to examine possible underlying mechanisms. Methods: PI-ME was tested preliminary for qualitative phytochemical analysis and then quantitatively by proximate and GC-MS analysis. The antinociceptive property was evaluated using the abdominal constriction assay and hot plate test. The anxiolytic activity was performed in a stair case model and sedative activity in an open field test. The antagonistic activities were evaluated using naloxone and/or pentylenetetrazole (PTZ). PI-ME was evaluated for prospective anti-allodynic and anti-vulvodynic properties in a rat model of streptozotocin induced neuropathic pain using the static and dynamic testing paradigms of mechanical allodynia and vulvodynia. Results: GC-MS analysis revealed that PI-ME contained predominant quantities of oleamide (9-octadecenamide), palmitic acid (hexadecanoic acid) and 3-hydroxy-dodecanoic acid, among other active constituents. In the abdominal constriction assay and hot plate test, PI-ME produced dose dependant, naloxone and pentylenetetrazole reversible antinociception suggesting an involvement of opioidergic and GABAergic mechanisms. In the stair case test, PI-ME at 200 mg/kg increased the number of steps climbed while at 600 mg/kg a significant decrease was observed. The rearing incidence was diminished by PI-ME at all tested doses and in the open field test, PI-ME decreased locomotor activity to an extent that was analagous to diazepam. The effects of PI-ME were antagonized by PTZ in both the staircase and open field tests implicating GABAergic mechanisms in its anxiolytic and sedative activities. In the streptozotocin-induced neuropathic nociceptive model, PI-ME (200 and 300 mg/kg) exhibited static and dynamic anti-allodynic effects exemplified by an increase in paw withdrawal threshold and paw withdrawal latency. PI-ME relieved only the dynamic component of vulvodynia by increasing flinching response latency. Conclusions: These findings suggest that Passiflora incarnata might be useful for treating neuropathic pain. The antinociceptive and behavioural findings inferring that its activity may stem from underlying opioidergic and GABAergic mechanisms though a potential oleamide-sourced cannabimimetic involvement is also discussed

PREVALENCE OF SPINAL FRACTURES AND ORTHOPEDIC FRACTURES CAUSED BY ROAD TRAFFIC INJURIES

Background: Road traffic injures (RTIs) are the third leading cause of death in the world after heart diseases and cancer. The aim of the present study was to determine the prevalence of spinal cord fractures (SCF) and other general orthopedic fractures (GOF) caused by road traffic injuries.Materials & Methods: This was a retrospective cross sectional study performed on patients with RTIs-related fractures or SCIs from January 2020 to January 2021.The study population consisted of the medical records of patients admitted to Imam Khomeini Hospital with a diagnosis of GOFs or SCFs. The participants were included in the study by census method. Inclusion criteria included RTIs-related orthopedic fractures or SCIs. The data was analyzed using the SPSS 16 software.Results: The study result showed, that the prevalence of two types of fracture in patients was 9.33. Also, the prevalence of spinal cord fractures was in the form of Multiple spinal levels with a rate of 88 (32.6) and the lowest rate was in the Dorsal spine area with a rate of 38 (14.1). Regarding general orthopedic fractures, the result showed Multiple Orthopedic regions with a rate of 67 (24.8) and the lowest rate was in the Pelvis region with a rate of 29 (10.7).Conclusions: The prevalence of spinal cord and general orthopedic fractures in the examined patients was high, so it is necessary to take corrective measures to prevent traffic accidents

Postpartum monitoring of women with a history of gestational diabetes - A cross-sectional study of an inner-city population.

This was a cross-sectional analysis (1980-2017) in Leicester to examine the proportion of women with a history of gestational diabetes (GDM) who (a) attended the 13-week postpartum screening and (b) attended annual type 2 diabetes mellitus (T2DM) screening and assessed the association between screening rates and sociodemographic factors. We found that women with a history of GDM were not adequately screened for type 2 diabetes in primary care. 62% did not have postpartum screening and 84% did not have the recommended annual screening. A significant association was found between South Asian ethnicity and not being screened annually. These results emphasise the need for better targeted education of pregnant women about the risks of T2DM and the need for more research across the UK into the screening of women with a history of GDM and the potential for a national screening programme

Comparison of Sexual Problems in Fertile and Infertile Couples

Introduction: Infertility is known to have a negative effect on couple's life and in most cases it has a profound impact on sexual relations. Sexual problems may be the cause of infertility or may arise as a result of infertility. The aim of this study was to compare the sexual problems in fertile and infertile couples. Methods: This cross-sectional study was performed on 110 infertile and 110 fertile couples referring to Montaserieh infertility center and five health centers in Mashhad which were selected as class clustering method and easy method. Data collection tools included demographic questionnaires and Golombok-Rust Inventory. The collected information was analyzed by SPSS software and descriptive and inferential statistics. Results: No significant difference was found between fertile 26 (17, 37) and infertile 26(18, 37) women in terms of total score of sexual problems and other aspects of sexual problems (except infrequency). The women in the fertile group had higher infrequency than infertile women. Total score of sexual problems in fertile men was 18.5 (13, 27) and in infertile men 25 (19, 31) and the difference was statistically significant. Infertile men reported more problems in no relation, impotency and premature ejaculation compared to fertile men. Men in both fertile and infertile group reported more sexual problems than women. Conclusion: In view of the more frequent sexual problems in infertile men than infertile women, it seems that it is necessary to pay more attention to sexual aspects of infertility in men and design the training programs for sexual and marital skills in infertility centers

Association between polypharmacy and falls in older adults: a longitudinal study from England.

OBJECTIVES: Assess the longitudinal association between polypharmacy and falls and examine the differences in this association by different thresholds for polypharmacy definitions in a nationally representative sample of adults aged over 60 years from England. DESIGN: Longitudinal cohort study. SETTING: The English Longitudinal Study of Ageing waves 6 and 7. PARTICIPANTS: 5213 adults aged 60 or older. MAIN OUTCOME MEASURES: Rates, incidence rate ratio (IRR) and 95% CI for falls in people with and without polypharmacy. RESULTS: A total of 5213 participants contributed 10 502 person-years of follow-up, with a median follow-up of 2.02 years (IQR 1.9-2.1 years). Of the 1611 participants with polypharmacy, 569 reported at least one fall within the past 2 years (rate: 175 per 1000 person-years, 95% CI 161 to 190), and of the 3602 participants without polypharmacy 875 reported at least one fall (rate: 121 per 1000 person-years, 95% CI 113 to 129). The rate of falls was 21% higher in people with polypharmacy compared with people without polypharmacy (adjusted IRR 1.21, 95% CI 1.11 to 1.31). Using ≥4 drugs threshold the rate of falls was 18% higher in people with polypharmacy compared with people without (adjusted IRR 1.18, 95% CI 1.08 to 1.28), whereas using ≥10 drugs threshold polypharmacy was associated with a 50% higher rate of falls (adjusted IRR 1.50, 95% CI 1.34 to 1.67). CONCLUSIONS: We found almost one-third of the total population using five or more drugs, which was significantly associated with 21% increased rate of falls over a 2-year period. Further exploration of the effects of these complex drug combinations in the real world with a detailed standardised assessment of polypharmacy is greatly required along with pragmatic studies in primary care, which will help inform whether the threshold for a detailed medication review should be lowered