DRUJ instability after distal radius fracture: A comparison between cases with and without ulnar styloid fracture

AbstractBackgroundBecause of the importance of the DRUJ in upper extremity function and the prevalence of distal radius fractures, either with or without ulnar styloid fracture, this study was designed to assess the relationship between ulnar styloid fracture and the incidence of DRUJ instability after treatment of distal radius fractures treated with ORIF (volar plate).Methods112 patients suffering from type two and three distal radius fractures (Fernandez classification), were evaluated. Depending on the presence of ulnar styloid avulsion fracture, patients were divided into two groups: 86 cases with isolated radial fracture and 26 cases with a distal radius fracture accompanied by ulnar styloid fracture. All patients underwent distal radius fracture ORIF. CT scanning was done both immediately after surgery and 3 months post-op. DRUJ stability was examined using the modified radioulnar line method and the incidence of DRUJ instability was compared between the two groups.ResultsImmediate instability was seen in 11 patients. Three of these patients had concomitant ulnar styloid fracture and were excluded for further fixation. Three months later, another 9 cases were diagnosed with DRUJ instability, 2 of whom had concomitant ulnar styloid fracture and the other 7 suffered from isolated distal radius fracture. Chi-square test revealed no significant difference (p < 0.05). There were no cases of delayed union or non-union distal radius fracture.ConclusionOur study demonstrated that untreated stable or minimally displaced ulnar styloid fracture accompanied by distal radius fracture, has no adverse effect on DRUJ stability following ORIF of the radius

Evaluation of the Effect of Combination Therapy on Treatment of COVID-19: A Cohort Study

Background: COVID-19 is a new disease for which a definitive treatment has not yet been proposed. Objectives: The present study aimed to investigate the effect of combination therapy on the treatment of COVID-19 due to the importance of finding an appropriate treatment for this epidemic disease. Methods: This two-center cohort study included 175 confirmed COVID-19 inpatients at two medical centers designated for the treatment of COVID-19 patients in Qom and Qazvin, Iran. In this study, four different groups of drug regimens were studied which included G1 (azithromycin, prednisolone, and naproxen), G2 (lopinavir/ritonavir, azithromycin, naproxen, and prednisolone), G3 (hydroxychloroquine, azithromycin, naproxen, and prednisolone), and G4 (levofloxacin, vancomycin, hydroxychloroquine, and oseltamivir). It should be noted that G1, G2, G3, and G4 treatment regimens were used on 48, 39,30, and 77 patients, respectively. Results: The study participants included 175 confirmed COVID-19 patients with mean±SD age of 58.9 ±15.1 years, out of whom 80 (46%) patients were male and the rest were females. The results indicated that the hospital stay period was significantly shorter in the G1 compared to other groups (G1:5.9±2.4, G2:8.1±4.2, G3: 6.3±1.7, and G4: 6.4±2.9; [P-value=0.008]). It should be noted that pulse rate, oxygen saturation, hemoglobin, and platelet count (PLT) changed significantly during the study in four treatment groups; however, a significant change in temperature, creatinine, and white blood cell (WBC) was observed only in G3, G4, and G1 groups, respectively. The number of ICU admissions and deaths were not statistically significant among the patients who received the four treatment regimens (P=0.785). Based on the results, the history of ischemic heart disease, baseline oxygen saturation, WBC, neutrophil, lymphocyte count, and C-reactive protein (CRP) are the risk factors for the prolonged hospital stay in COVID-19 patients. Conclusion: The obtained results in this study indicated that the combination of azithromycin, prednisolone, and naproxen is the most effective regimen for the treatment of COVID-19, compared to three other combination treatment regimens. Keywords: Anti-inflammatory drugs, Antiviral drugs, Combination therapy, Corticosteroid, COVID-19, Immunomodulators drug

Original article title: "Comparison of therapeutic efficacy of topical corticosteroid and oral zinc sulfate-topical corticosteroid combination in the treatment of vitiligo patients: a clinical trial"

<p>Abstract</p> <p>Background</p> <p>Vitiligo is the most prevalent pigmentary disorder which occurs worldwide, with an incidence rate between 0.1-4 percent. It is anticipated that the discovery of biological pathways of vitiligo pathogenesis will provide novel therapeutic and prophylactic targets for future approaches to the treatment and prevention of vitiligo. The purposes of this study were evaluating the efficacy of supplemental zinc on the treatment of vitiligo.</p> <p>Methods</p> <p>This randomized clinical trial was conducted for a period of one year. Thirty five patients among 86 participants were eligible to entrance to the study. The patients in two equal randomized groups took topical corticosteroid and combination of oral zinc sulfate-topical corticosteroid.</p> <p>Results</p> <p>The mean of responses in the corticosteroid group and the zinc sulfate-corticosteroid combination group were 21.43% and 24.7%, respectively.</p> <p>Conclusion</p> <p>Although, the response to corticosteroid plus zinc sulfate was more than corticosteroid, there was no statistically significant difference between them. It appeared that more robust long-term randomized controlled trials on more patients, maybe with higher doses of zinc sulfate, are needed to fully establish the efficacy of oral zinc in management of vitiligo.</p> <p>Trial Registration</p> <p>chiCTRTRC10000930</p

Callosity of ankles among people with the habit of sitting with crossed legs: a cosmetic problem

Many people living in developing countries still prefer to sit on the carpet or uncarpeted floor, and many times they sit in a cross legged position. Continuous rubbing and friction of the ankles over the carpet or the plain hard surface may cause callosity of the ankles. This can cause a cosmetic problem. We describe a case series of ankle hyperkeratosis referred to our outpatient clinic in Ahwaz in the south west of Iran from 2005-2010. These patients had localized hyperkeratosis on two ankles or the front of ankles. This article aims to help the clinician become more familiar with the morphological characteristic of this problem which may occur in people of Eastern origin

The pulsed dye laser is more effective and rapidly acting than intralesional meglumine antimoniate therapy for cutaneous leishmaniasis

Background and objective: The pulsed dye laser (PDL) is not tested yet for the treatment of cutaneous leishmaniasis (CL). We compared the efficacy of 585 nm PDL with intralesional meglumine antimoniate (MA) on 17 patients with 81 lesions of CL. Patients and methods: Out of the 81 lesions, 42 lesions were treated with one or two passes of PDL fortnightly and 39 lesions in the same patients were treated with intralesional MA weekly. The fluence chosen for the laser was 7 Joules/cm² with 5 mm spot size. The MA treated lesions were infiltrated gently with MA to blanch the lesions completely. Results: All laser treated lesions were responded well with almost 66.7% cure after the first, and more than 90% after the second treatment. One patient was recovered after third, and the last one after fourth sessions. All 39 MA treated lesions were also responded after third to eighth sessions. The mean number of the sessions required for the patients to be treated with PDL is 1.85, and the mean number of the sessions required for the patients to be treated with MA is 4.6. Conclusions: The PDL can cure many cases of CL particularly in their early stages faster than MA

A Model of Emotional-Spiritual Self-Awareness Based on Islamic Sources

Understanding and self-awareness of spiritual emotions as well as paying attention to the presence and need for God when a spiritual experience occurs are among the topics that have been emphasized in Islamic sources. This study aims to provide a model of emotional-spiritual self-awareness based on the teachings of Islam. The present study is of qualitative type and the documentary community in it is the verses of the Quran and the narrations of the books of Shiite Hadith. The sample of this research is 45 propositions related to emotional-spiritual self-awareness that have been selected using by purposeful sampling method. Facing the spiritual realm, introspective self-assessment and relating spiritual emotion to divine attributes are the three main components that were extracted for the model of emotional-spiritual self-awareness. Also, the four main areas of prayer, creation, entanglement and self-nature were identified as common areas of spiritual experiences. Due to the gap in the field of emotional approach to spirituality, this study explains emotional-spiritual self-awareness based on Islamic texts

HYPOTHESIS: ZINC CAN BE EFFECTIVE IN TREATMENT OF VITILIGO

Vitiligo is a common depigmenting skin disorder (prevalence 0.1-2%), still represents a cause of stigmatization and quality of life impairment in a large population. Several theories on vitiligo etiopathogenesis have been suggested including in trauma, stress, and autoimmune and genetic predisposition, accumulation of toxic compounds, altered cellular environment, imbalance in the oxidant-antioxidant system, impaired melanocyte migration and/or proliferation, infection, and psychological factors. Zinc, as a trace element, has many vital functions in human. It is antiapoptotic factor and needed as a cofactor for antioxidant defense system. It plays an important role in the process of melanogenesis. It may be effective in prevention and treatment of vitiligo via some mechanism. Herein, we suggested some probable protective mechanism for zinc in association with vitiligo

Antibacterial superabsorbing hydrogels with high saline-swelling properties without gel blockage: Toward ideal superabsorbents for hygienic applications

Superabsorbent polymer hydrogels with antibacterial activity were prepared by an ion exchange reaction as a feasible approach to induce high saline absorption without gel blockage. Hydroethanolic solutions of cetyltrimethylammonium bromide were used to modify surface particles of cross-linked sodium acrylate-co-acrylic acid copolymers which already synthesized under defined conditions. Fourier transform infrared spectroscopy was employed to study the structural characteristic of the finished products. The influence of cetyltrimethylammonium bromide on free (in water) and loaded (in saline) swelling capacity as well as antibacterial activity of superabsorbent polymer hydrogels against Staphylococcus aureus was investigated. Modified samples displayed an improved free and loaded swelling in water and saline, as well as no gel-blocking. These improvements were found to be affected by the reaction time, cetyltrimethylammonium bromide concentration, and water percentage in the solvent mixture. The results from energy dispersive X-ray analysis showed that cetyltrimethylammonium bromide was distributed uniformly in the superabsorbent polymer hydrogel particle surface. Moreover, the modified superabsorbent polymer hydrogels showed high antibacterial activity against S. aureus. Both bacteriostatic and bactericide effects were observed depending on the reaction conditions. Overall, several improvements were concurrently achieved via a single cost-effective post-treatment on the superabsorbent polymer hydrogel particles. Therefore, the results can effectively be used in designing larger scale production of antibacterial superabsorbent polymer hydrogels with desirable swelling properties in hygiene applications

Maternal and Other Risk Factors Including Bovine IgG in Developing Infantile Colic

Objective: Infantile colic is one of the most current problems in the first few months of life. It is suggested that organic or psychologic and behavioral factors can predispose to involve this disorder. Here, we have studied the role of some maternal risk factors including bovine IgG levels in breast milk for appearing the colic in young babies.Material & Methods: This retrospective study was performed on 50 infants as case group and 30 infants aged 3 weeks to 3 months who had normal growth and development as control group for one year in Mashad. Data was analyzed with Pearson Chi-Square and Fisher’s exact tests.Findings: Most colicky infants were male (62% vs 38% female). They were mainly symptomatic at neonatal period. In 64% of cases, it occurred in the first offspring. Infantile colic was more common in babies who delivered normally than by cesarean section and in mothers aged 20-30 years. According to our finding, there was no relationship between bovine IgG in breast milk and infantile colic. It revealed that anxious pregnant women had more colicky babies and paternal smoking seemed to develop colic in young infants. Conclusion: In order to reduce the occurrence of colic in infants, primigravid mothers aged 20-30 years should have a stressfree environment especially during pregnancy and no smoking exposure in this period