The patellofemoral joint alignment in patients with symptomatic accessory navicular bone

Quadriceps angle (Q angle) provides useful information about the alignment of the patellofemoral joint. The aim of the present study was to assess a possible link between malalignment of the patellofemoral joint and symptomatic accessory navicular (AN) bone as an underlying cause in early adolescence using Q angle measurements. This study was performed on patients presenting to the Foot and Ankle Clinic at the Jordanian Royal Medical Services because of pain on the medial side of the foot that worsened with activities or shoe wearing, with no history of knee pain, between September 2013 and April 2015. The Q angle was measured using a goniometer in 27 early adolescents aged 10-18 years diagnosed clinically and radiologically with symptomatic AN bone, only seven patients had associated pes planus deformity; the data were compared with age appropriate normal arched feet without AN. Navicular drop test (NDT) was used to assess the amount of foot pronation. The mean Q angle value among male and female patients with symptomatic AN with/without pes planus was significantly higher than in controls with normal arched feet without AN (p<0.05). Symptomatic AN feet were also associated with higher NDT values (p<0.001). The present findings suggest an early change in patellofemoral joint alignment in patients with symptomatic AN bone with/without arch collapse. Therefore, it is recommended that Q angle assessment should be an essential component of the examination in patients with symptomatic AN bone

Analgesic effect of neohesperidin is mediated by TRPV1 antagonism

Context: Transient receptor potential vanilloid type 1 (TRPV1) is a non-specific cation channel. It is one of the most important targets in pain research. Aims: To evaluate new TRPV1 antagonists without altering body temperature. Methods: Docking simulation was performed, and one of the candidate compounds, neohesperidin, was tested using thermal and chemical pain models in BALB/c mice. Rectal body temperature was measured using a temperature meter with a thermocouple probe detector, and the capsaicin-evoked calcium response was determined in dorsal root ganglia (DRG) neurons. Results: Docking resulted in the identification of 30 compounds able to interact with the essential amino acids required for the antagonistic activity of TRPV1. Neohesperidin was chosen for further investigations because of its good binding energy (-6.63 kcal/mol) and because its TRPV1 antagonistic activity was not tested before. This study reported for the first time that neohesperidin exerted analgesic activity through TRPV1 antagonism without altering body temperature. Its activity was comparable to the known TRPV1 antagonist N-(4-tertiarybutylphenyl)-4-(3-chloropyridin-2-yl)tetrahydropyrazine-1(2H)-carbox-amide (BCTC). In the writhing test, acetic acid-induced abdominal cramps decreased by 66% using 30 mg/kg of neohesperidin. All tested doses of neohesperidin significantly decreased paw-licking time in the capsaicin-induced paw-licking test. A significant increase in the latency time in hot plate and tail flick tests was observed using 30 and 60 mg/kg of neohesperidin. In DRG neurons, neohesperidin reduced capsaicin-evoked calcium responses. Conclusions: Neohesperidin exerts a significant analgesic activity without altering body temperature, which could be due, at least partially, to its antagonistic activity against TRPV1

Using YouTube to Learn Anatomy: Perspectives of Jordanian Medical Students

Purpose. The study is aimed at exploring the popularity, impact, and usefulness of using YouTube in learning anatomy as perceived by Jordanian medical students studying at Jordan University of Science and Technology. Methods. The present work is a cross-sectional questionnaire-based study. First-, second-, and third-year medical students were invited to complete an anonymous questionnaire. Students’ responses were numerically coded, and the results were analyzed to reveal any statistically significant differences related to gender or level of study. Results. The results showed that 96.4% of the students used YouTube in general, 91.2% used it as a source of information, and 83.9% used YouTube as a learning tool in medical school. Further, YouTube was used by 79.1% of the students as an anatomy-learning tool. Most of these students used this platform in learning gross anatomy. The study also revealed that dissection videos were the most viewed anatomy-related content. Regarding the perceived value of YouTube as an anatomy-learning tool, the majority of the students reported that YouTube offered them useful anatomical information and enhanced their understanding, memorization, and recall of anatomical information. In addition, most of them recommended using YouTube as an anatomy-learning tool. Statistical analysis of the results revealed the presence of gender-related significant differences in students’ perspectives. Such differences were also found among students of different levels of study. Conclusion. Medical students have positive attitudes toward using YouTube in augmenting their anatomy learning. For this, educators are encouraged to adopt YouTube as an educational tool in their anatomy instruction and to create new anatomy-related YouTube videos to enhance their students’ learning.</jats:p

Anti-nociceptive and desensitizing effects of olvanil on capsaicin-induced thermal hyperalgesia in the rat

Background: Olvanil (NE 19550) is a non-pungent synthetic analogue of capsaicin, the natural pungent ingredient of capsicum which activates the transient receptor potential vanilloid type-1 (TRPV1) channel and was developed as a potential analgesic compound. Olvanil has potent anti-hyperalgesic effects in several experimental models of chronic pain. Here we report the inhibitory effects of olvanil on nociceptive processing using cultured dorsal root ganglion (DRG) neurons and compare the effects of capsaicin and olvanil on thermal nociceptive processing in vivo; potential contributions of the cannabinoid CB1 receptor to olvanil’s anti-hyperalgesic effects were also investigated.Methods: A hot plate analgesia meter was used to evaluate the anti-nociceptive effects of olvanil on capsaicin-induced thermal hyperalgesia and the role played by CB1 receptors in mediating these effects. Single cell calcium imaging studies of DRG neurons were employed to determine the desensitizing effects of olvanil on capsaicin-evoked calcium responses. Statistical analysis used Student’s t test or one way ANOVA followed by Dunnett’s post-hoctest as appropriate.Results: Both olvanil (100 nM) and capsaicin (100 nM) produced significant increases in intracellular calcium concentrations [Ca2+]I in cultured DRG neurons. Olvanil was able to des ensitise TRPV1 responses to further capsaicin exposure more effectively than capsaicin. Intra plantar injection of capsaicin (0.1, 0.3 and 1μg) produced a robust TRPV1-dependant thermal hyperalgesia in rats, whilst olvanil (0.1, 0.3 and 1μg) produced no hyperalgesia, emphasizing its lack of pungency. The highest dose of olvanil significantly reduced the hyperalgesic effects of capsaicin in vivo. Intraplantar injection of the selective cannabinoid CB1 receptor antagonist rimonabant (1μg) altered neither capsaicin-induced thermal hyperalgesia nor the desensitizing properties of olvanil, indicating a lack of involvement of CB1receptors.Conclusions: Olvanil is effective in reducing capsaicin-induced thermal hyperalgesia, probably via directly desensitizingTRPV1 channels in a CB 1 receptor-independent fashion. The results presented clearly support the potential for olvanil in the development of new topical analgesic preparations for treating chronic pain conditions while avoiding the unwanted side effects of capsaicin treatments

Role of Bradykinin and Prostaglandin EP4 Receptors in Regulating TRPV1 Channel Sensitization in Rat Dorsal Root Ganglion Neurons

Transient receptor potential vanilloid type-1 (TRPV1) channels play key roles in chronic pain conditions and are modulated by different inflammatory mediators to elicit heat sensitisation. Bradykinin is a 9-amino acid peptide chain that promotes inflammation. The aim of present study is to investigate how bradykinin and prostaglandin receptors (EP3 and EP4) modulate the sensitisation of TRPV1-mediated responses.Calcium imaging studies of rat dorsal root ganglion (DRG) neurons were employed to investigate the desensitizing responses of TRPV1 ion channels by capsaicin, and the re-sensitization of TRPV1 by bradykinin, then to explore the role EP3 and EP4 receptors in mediating these bradykinin-dependent effects. Immunocytochemistry was used to study the co-expression and distribution of EP4, TRPV1, COX-1 and B2 in rat DRG neurons.Desensitization was seen upon repeated capsaicin application, we show that bradykinin-mediated sensitization of capsaicin-evoked calcium responses in rat DRG neurons occurs is dependent on COX-1 activity and utilizes a pathway that involves EP4 but not EP3 receptors. Immunocytochemical techniques revealed that EP4, TRPV1, COX-1 and B2 proteins are expressed mainly in small diameter (&lt;1,000μm2) cell bodies of rat DRG neurons which are typically nociceptors.The present study provides suggestive evidence for a potential signalling pathway through which bradykinin may regulate TRPV1 ion channel function via EP4 receptors. In addition to confirming existing knowledge, the anatomical distribution and colocalization of these proteins in DRG neurons as revealed by this study offer valuable insight

Antibacterial and Antifungal Activity of Novel Synthesized Neodymium-Substituted Cobalt Ferrite Nanoparticles for Biomedical Application

Neodymium (Nd)-substituted cobalt ferrite nanoparticles (NPs), i.e., CoNdxFe2&minus;xO4 (0.0 &le; x &le; 0.2) NPs, were synthesized by the sonochemical method. The compositional characterization was done by scanning electron microscopy (SEM) equipped with energy-dispersive X-ray spectroscopy (EDX) and transmission electron microscopy (TEM). Antistaphylococcal activity was found to be enhanced, i.e., survival rate was 50%, 45%, 40%, and 30% with the increase in the ratio of Nd (0.0 &le; x &le; 0.2), whereas anticandidal activity was found efficient, i.e., 9%, 20%, 22%, and 40% survival rate at all the four ratios. The morphogenesis studies indicated that the synthesized metal&ndash;ligand, improves the antimicrobial capacity by binding them strongly to the microbial walls. To the best of our knowledge, this is the first report which demonstrates the series of CoNdxFe2&minus;xO4 (0.0 &le; x &le; 0.2) NPs being active towards Staphylococcus aureus and Candida albicans and encourages its potential candidature for pharmaceutical and biomedical purposes

Accessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population

Background and Objectives: The incidence of accessory bones in the region of foot and ankle is quite variable between studies and are often confused with avulsion fractures in trauma patients with musculoskeletal injuries. The aim of this study was to assess the incidence of accessory ossicles of the foot and ankle according to gender, side and coexistence, and to determine how frequently accessory ossicles were misdiagnosed as avulsion fractures. Materials and Methods: Oblique and/or lateral foot radiographs of 1000 adult patients referred from emergency departments to foot and ankle clinic were retrospectively reviewed for the presence of accessory ossicles. The Kappa statistic was used in order to assess the validity of radiographic interpretation for the presence of these bones. Results: Accessory ossicles were detected in 40.2% of the radiographs. The incidence rates for the accessory ossicles in order of frequency were: Os trigonum (15.4%), accessory navicular (13.7%), os peroneum (11.5%), os vesalianum (1.1%), os supranaviculare (0.7%), os subfibulare (0.6%), os talotibiale (0.4%), os calcaneus secundarius (0.3%), os supratalare (0.3%), os infranaviculare (0.3%), os intermetatarseum (0.2%), and os subtibiale (0.1%). Coexistence of two or three ossicles in the same foot was observed in 4.4% of the cases, mostly coexistence with os peroneum (2.9%), followed by accessory navicular (1.6%). 2.7% of accessory ossicles were initially misdiagnosed as avulsion fractures at emergency departments. Interrater agreement over identification of different accessory ossicles was found to be reasonably reliable, with a Kappa greater than 0.80 for all assessed bones. Conclusions: In clinical practice, a thorough knowledge of normal anatomical variants is essential to facilitate appropriate diagnosis and treatment and can help to prevent diagnostic errors

Novel frameshift variant in the IDUA gene underlies Mucopolysaccharidoses type I in a consanguineous Yemeni pedigree

Mucopolysaccharidosis type I (MPS I) is an autosomal recessive storage disorder that result as a consequence of a deficiency in the lysosomal hydrolase, a-L-iduronidase enzyme encoded by IDUA gene. Over a hundred causative variants in IDUA have been identified, which result in a progressive multi-systemic disease with a broad range of severity and disease progression reported across affected individuals. The aim of this study was the detection and interpretation of IDUA mutation in a family with two children affected with lethal MPS I. The IDUA gene was sequenced in the parents of two deceased children who had a clinical diagnosis of MPS I, to assess their carrier status and to help inform on risk in future children. The sequencing analysis was performed by PCR and bidirectional Sanger sequencing of the coding region and exon-intron splice junctions at Labor MVZ Westmecklenburg molecular diagnostics laboratory. A heterozygous c.657delA variant in exon 6 was identified in each parent, which is the most likely explanation for disease in their children. This report represents the first Yemeni family to have a molecular diagnosis for MPS I