The Emerging Role of Non-Coding RNAs in Osteoarthritis

Osteoarthritis (OS) is the most frequent degenerative condition in the joints, disabling many adults. Several abnormalities in the articular cartilage, subchondral bone, synovial tissue, and meniscus have been detected in the course of OA. Destruction of articular cartilage, the formation of osteophytes, subchondral sclerosis, and hyperplasia of synovial tissue are hallmarks of OA. More recently, several investigations have underscored the regulatory roles of non-coding RNAs (ncRNAs) in OA development. Different classes of non-coding RNAs, including long ncRNAs (lncRNAs), microRNAs (miRNAs), and circular RNAs (circRNAs), have been reported to affect the development of OA. The expression level of these transcripts has also been used as diagnostic tools in OA. In the present article, we aimed at reporting the role of these transcripts in this process. We need to give a specific angle on the pathology to provide meaningful thoughts on it

Risk factors associated with positional plagiocephaly in healthy Iranian infants: a case-control study

Abstract Objectives Deformation of the skull by external forces in the absence of synostosis has been defined as positional plagiocephaly. The aim of this investigation was to determine the risk factors of positional plagiocephaly (PP) in healthy Iranian infants. Materials & Methods This case-control study was performed on 300 healthy Iranian infants aged 8-12 weeks who referred to pediatric neurology clinic at Shahid Beheshti Hospital of Kashan. Plagiocephaly evaluations were done by using Argenta’s scale. Results Based on multivariate logistic regression analysis, there was significant association between PP and male gender (OR=2.26; P=0.002), head circumference (OR=1.22; P=0.006), multiple pregnancy (OR=2.55; P=0.03), abnormal presentation in uterine (OR=2.18; P=0.02), primiparity (OR=2.43; P=0.003), and supine sleep position (OR=2.97; P<0.001). But type of delivery, firmness of headrest, oligohydramnios, and prolonged labor were not correlated with PP. Conclusions The current investigation supports the idea that head circumference, male gender, primiparity, multiple pregnancy, supine sleep position, and abnormal presentation in uterine are correlated with a greater incidence of PP. Further investigations should be undertaken to fully understand PP and its related risk factors

Prevalence of Cerebrospinal Fluid Rhinorrhea Following Trans-Sphenoidal Surgery for Pituitary Adenoma in Patients Referred to Loghman Hakim Hospital from 2016 to 2020

Background: Endoscopic endonasal transsphenoidal surgery is commonly used to remove pituitary adenomas. However, it can lead to cerebrospinal fluid (CSF) leakage, with an incidence of around 5% in sphenoid transnasal procedures and up to 20% in extended endonasal approaches. A retrospective study was conducted on 160 pituitary adenoma patients admitted to Loghman Hakim Hospital from 2016 to 2020 to evaluate the factors influencing CSF leak. Aim: The aim of this study was evaluating the occurrence of cerebrospinal fluid leakage and analyzing the factors involved. Methods: This is a retrospective analysis of patients diagnosed with pituitary adenoma at Loghman-Hakim hospital over a four-year period. Demographic information, tumor characteristics, surgical procedures, and complications were collected. All patients gave their consent, and the study was approved by the ethics committee. Surgical procedures were conducted using a direct endonasal trans-sphenoidal approach under general anesthesia, and antibiotics were given. Statistical analysis was conducted using SPSS to evaluate the relation between measured variables and the occurrence of CSF leak. Results: The study found that 19.4% of the patients developed CSF leak during their hospital stay. Age and body mass index (BMI) of patients with CSF leak significantly differed from those without. The size of the tumor did not differ significantly between patients with and without CSF leak. The only variable associated with CSF leak was sphenoid sinus anatomy. Conclusion: The study concluded that older patients with a lower BMI and a larger defect size are more prone to CSF leak, but no significant difference was found in tumor size between the groups with and without CSF leak. Sphenoid sinus anatomy correlated with CSF leak, while other factors did not show any correlation with the incidence of CSF leak

Isolated trochlear nerve schwannoma presenting with diplopia: A case report and literature review

Background: Trochlear nerve schwannoma is a very rare tumor encountered especially in patients without type 2 neurofibromatosis (NF2). Most of the time, this tumor is diagnosed intraoperatively. We describe a rare case of trochlear nerve schwannoma. Clinical Presentation: A 63-year-old male presented with generalized headache from 8 months earlier, without nausea and vomiting. The headache had worsened during the last months. Clinically, he suffered from transient diplopia. Magnetic resonance imaging (MRI) demonstrated a mass in the left ambient and interpeduncular cisterns that was compressing the midbrain and upper pons. The preoperative impression was of trigeminal schwannoma. However, intraoperatively, the tumor originated in the trochlear nerve. The mass was removed entirely via left suboccipital retrosigmoid approach. The histopathology diagnosis confirmed schwannoma. The patient's diplopia did not improve postoperatively. Conclusion: Trochlear nerve schwannoma is a rare type of schwannoma and in almost all of the cases is diagnosed intraoperatively. There are three types of trochlear nerve schwannoma according to the classification proposed for trigeminal schwannoma: cisternal type—confined to the precavernous segment of the trochlear nerve; cistocavernous type—invading the cavernous sinus and the retroclival and retropetrosal cistern; cavernous type—located in the middle cranial fossa on the cavernous or paracavernous segment of the fourth cranial nerves, with or without cavernous sinus invasion. The cisternal type was the most common type encountered in previous studies. The clinical signs and symptoms of trochlear nerve schwannoma are similar to the trigeminal schwannoma and should be considered in the differential diagnosis of trigeminal schwannoma

Aggressive prolactinomas responsive to temozolomide treatment: Report of two cases

Abstract Refractory aggressive prolactinomas are detected after the unresponsiveness to conventional therapies. We report two cases that underwent temozolomide treatment and have been in near‐complete remission ever since. We suggest the pathology techniques for earlier detection and, subsequently, treatment with temozolomide to reduce morbidities and better respond to therapy

The Extra-axial Cerebellopontine Angle Medulloblastoma in an Adult Patient: A Case Report and Review of Literature

Background and Importance: Medulloblastoma (MB) is regarded as a scarce primary brain neoplasm in adulthood, originating from the fourth ventricle or the cerebellum, and cerebellopontine angle (CPA)-MB has been described less often in the literature. Few cases of CPA MB have been reported in the English-written literature, most of which are intra-axial, mainly in children; adults' extra-axial CPAMB is even scarcer. To the best of the authors’ knowledge, 12 cases of extra-axial CPA MBs have been reported in the English-written literature. Case Presentation: A 23-year-old man presented to our center complaining of a generalized pulsatile headache, imbalance, swallowing impairment, and right-sided hearing loss for the past 20 days. Computed tomography (CT) scan of the brain showed a hyper-dense extra-axial mass lesion (41*37mm) in the right CPA with a significant compression effect on the fourth ventricle, causing a three ventricular obstructive hydrocephalus. Magnetic resonance imaging (MRI) showed a well-defined heterogeneous extra-axial, lobulated, dural-based mass lesion in the right CPA, hypointense on the T1 sequence, and hyperintense on the T2 sequence compared with the adjacent parenchyma, which has a bright heterogeneous enhancement during gadolinium injection. A significant mass effect was observed on the adjacent parenchyma, brain stem, and fourth ventricle without evidence of parenchymal edema. The patient underwent emergent surgery the next day regarding the mass effect and hydrocephalus. On the postoperative examination in the intensive care unit, no new neurological deficit was detected, and the swallowing and gag reflex significantly improved. Conclusion: Though rare, clinical considerations, along with early supportive radiologic measures, should be considered in subjects with suspected MB. A total tumor excision approach followed by aggregative chemotherapy/radiotherapy is designed to hinder tumor relapse

Early post-operative diabetes insipidus following resection of craniopharyngioma: Incidence and predictors

Objective: Craniopharyngiomas are tumors derived from the remains of epithelial cells that are attributed to incomplete closure of the pituitary or cricopharyngeal ducts. Although the tumor is considered benign, it has significant complications at diagnosis and following full resolution. The present study aimed to determine the prevalence and predictive factors of diabetes insipidus (DI) shortly after craniopharyngioma surgery. Methods: This study was retrospectively performed on 46 patients suffering from craniopharyngioma referred to Loghman Hakim Hospital sparing from 2011 to 2016. In patients with magnetic resonance imaging (MRI) and computerized tomography (CT) scans, endocrinology tests, other related tests, and complete neuromuscular examinations were performed before and after surgery. All patient information was collected descriptively according to their case, and quantitative data are displayed using mean, Standard Deviation, intermediate, and Interquartile range, and qualitative data are displayed using frequency and percentage. For analytical analysis, the data were calculated from independent samples t, Mann-Whitney statistical tests, K2 test, and, if necessary, Fisher's precise P-Value. A significant level was considered for the 5 % statistical tests, and the SPSS statistical software version 25 was used to analyze the data. Results: Most patients were male (58 %), and the mean age of patients was 33 years, the youngest being 5 years and the oldest being 71 years. Patients' symptoms at the time of referral include visual impairment (58 %), headache (56 %), balance disorder 19 %, nausea and vomiting 13 %, and memory impairment (8 %). The prevalence of DI was reported to be 50 % after surgery, significantly associated with tumor size. No other significant association was found between the plurality of DI after surgery and other variables studied. Conclusions: The present study showed no predictive factor for post-operative DI in patients with craniopharyngioma. It can only be concluded that patients with larger tumor sizes are more likely to develop DI; however, more studies are warranted to achieve a definitive conclusion