Tension-free Primary Closure, Secondary Intention, and Limberg Flap, Which Is More Effective in Treatment of Uncomplicated Pilonidal Sinus Disease?

Background: This study was performed to compare the efficacy and long-term outcomes of three surgical treatments for uncomplicated pilonidal sinus disease, tension-free primary closure, Limberg flap, and secondary intention (wide excision and packing).Methods: In this randomized clinical trial study, 66 patients with uncomplicated pilonidal sinus disease were randomly assigned to be surgically treated using tension-free primary closure, Limberg flap, or secondary intention methods. The outcomes including pain, healing time, recurrence, complications, disability, reoperation, and patient satisfaction were compared between three groups after two years of follow-up.Findings: In Limberg flap group, the healing time and disability were significantly less than the two other groups; besides, the pain was significantly less than secondary intention group and more than the primary closure group (P < 0.0001 for all). There were no significant differences between the groups regarding recurrence, complications, reoperation, and patient satisfaction (P > 0.05 for all).Conclusions: Totally, according to our findings and comparison with other studies, it may be concluded that Limberg flap is relatively better than primary and secondary intention in patients with uncomplicated pilonidal sinus disease

Clinical outcomes after MRI connectivity-guided radiofrequency thalamotomy for tremor

OBJECTIVE: Radiofrequency thalamotomy (RF-T) is an established treatment for refractory tremor. It is unclear whether connectivity-guided targeting strategies could further augment outcomes. The aim of this study was to evaluate the efficacy and safety of MRI connectivity-guided RF-T in severe tremor. METHODS: Twenty-one consecutive patients with severe tremor (14 with essential tremor [ET], 7 with Parkinson's disease [PD]) underwent unilateral RF-T at a single institution between 2017 and 2020. Connectivity-derived thalamic segmentation was used to guide targeting. Changes in the Fahn-Tolosa-Marin Rating Scale (FTMRS) were recorded in treated and nontreated hands as well as procedure-related side effects. RESULTS: Twenty-three thalamotomies were performed (with 2 patients receiving a repeated intervention). The mean postoperative assessment time point was 14.1 months. Treated-hand tremor scores improved by 63.8%, whereas nontreated-hand scores deteriorated by 10.1% (p < 0.01). Total FTMRS scores were significantly better at follow-up compared with baseline (mean 34.7 vs 51.7, p = 0.016). Baseline treated-hand tremor severity (rho = 0.786, p < 0.01) and total FTMRS score (rho = 0.64, p < 0.01) best correlated with tremor improvement. The most reported side effect was mild gait ataxia (n = 11 patients). CONCLUSIONS: RF-T guided by connectivity-derived segmentation is a safe and effective option for severe tremor in both PD and ET

Mental Health Status, Life Satisfaction, and Mood State of Elite Athletes During the COVID-19 Pandemic:a follow-up study in the phases of home confinement, reopening, and semi-lockdown condition

Scientific reports notified that the pandemic caused by the Coronavirus disease 2019 (COVID-19) has raised an unprecedented mental health emergency worldwide. Abrupt changes in daily routine, environmental constraints, adopted home confinement measures, and uncertainty about a date for returning to usual activities can potentially affect mental health and sports activities in athletes. Hence, we designed a cross-sectional study with a within-subjects design to investigate the impact of the pandemic on mental health, mood states, and life satisfaction of elite athletes. During the three phases of home confinement (April 14–24, n = 525), reopening (May 9–19, n = 464), and current semi-lockdown (July 20–31, n = 428), elite athletes voluntarily responded to an online survey. The self-report questionnaire was prepared to collect demographic and epidemiological variables of interest and the COVID-19-related information. All participants also completed the Profile of Mood State (POMS), General Health Questionnaire-28 (GHQ-28), and Satisfaction with Life Scale (SWLS). The main result is that the training rate, mental health, life satisfaction, and positive mood have decreased during the home confinement period as compared with the reopening and semi-lockdown phases. However, the need for psychosocial services has increased during the pandemic period. The present study provides the first preliminary evidence that home confinement conditions during the COVID-19 pandemic might have negatively influenced elite athlete’s mood state, mental health, and life satisfaction, as well as training rates. Monitoring the psychological parameters of elite athletes and developing strategies to improve their mental health during the COVID-19 pandemic should be on the agenda. Next studies, therefore, seem reasonable to focus on active interventions for athletes during the ongoing COVID-19 pandemic

Accuracy, precision, and safety of stereotactic, frame-based, intraoperative MRI-guided and MRI-verified deep brain stimulation in 650 consecutive procedures

OBJECTIVE: Suboptimal lead placement is one of the most common indications for deep brain stimulation (DBS) revision procedures. Confirming lead placement in relation to the visible anatomical target with dedicated stereotactic imaging before terminating the procedure can mitigate this risk. In this study, the authors examined the accuracy, precision, and safety of intraoperative MRI (iMRI) to both guide and verify lead placement during frame-based stereotactic surgery. METHODS: A retrospective analysis of 650 consecutive DBS procedures for targeting accuracy, precision, and perioperative complications was performed. Frame-based lead placement took place in an operating room equipped with an MRI machine using stereotactic images to verify lead placement before removing the stereotactic frame. Immediate lead relocation was performed when necessary. Systematic analysis of the targeting error was calculated. RESULTS: Verification of 1201 DBS leads with stereotactic MRI was performed in 643 procedures and with stereotactic CT in 7. The mean ± SD of the final targeting error was 0.9 ± 0.3 mm (range 0.1-2.3 mm). Anatomically acceptable lead placement was achieved with a single brain pass for 97% (n = 1164) of leads; immediate intraoperative relocation was performed in 37 leads (3%) to obtain satisfactory anatomical placement. General anesthesia was used in 91% (n = 593) of the procedures. Hemorrhage was noted after 4 procedures (0.6%); 3 patients (0.4% of procedures) presented with transient neurological symptoms, and 1 experienced delayed cognitive decline. Two bleeds coincided with immediate relocation (2 of 37 leads, 5.4%), which contrasts with hemorrhage in 2 (0.2%) of 1164 leads implanted on the first pass (p = 0.0058). Three patients had transient seizures in the postoperative period. The seizures coincided with hemorrhage in 2 of these patients and with immediate lead relocation in the other. There were 21 infections (3.2% of procedures, 1.5% in 3 months) leading to hardware removal. Delayed (> 3 months) retargeting of 6 leads (0.5%) in 4 patients (0.6% of procedures) was performed because of suboptimal stimulation benefit. There were no MRI-related complications, no permanent motor deficits, and no deaths. CONCLUSIONS: To the authors' knowledge, this is the largest series reporting the use of iMRI to guide and verify lead location during DBS surgery. It demonstrates a high level of accuracy, precision, and safety. Significantly higher hemorrhage was encountered when multiple brain passes were required for lead implantation, although none led to permanent deficit. Meticulous audit and calibration can improve precision and maximize safety

Effects of Fasting on Glucagon-like peptide-1 hormone (GLP-1), and Lipid Profile Indices in Obese and Thin Women

Introduction: Glucagon-like peptide-1 hormone (GLP-1) contributes to the regulation of insulin and glucose concentration. However, the effects of fasting on GLP-1 response in different people has not been determined yet. The aim of the present research was to investigate the effect of fasting on GLP-1 and the lipid profile of obese and thin women.Materials and methods: In this research, 25 obese and thin women whose age ranged from 35 to 45 years were selected through a convenient sampling method and were divided into two groups of obese (n=12, body mass index ˃30 kg/m2) and thin (n=13, body mass index=18-20 kg/m2). GLP-1 in both groups was measured in four phases: 3 days before the beginning of Ramadan, 14 days after the beginning of Ramadan, 28 days after the beginning of Ramadan and 2 weeks after the end of Ramadan. Repeated –measure ANOVA was used to statistically analyse the data. Results: GLP-1 was reduced from phase 1 to 3 of the research. However, it was increased after Ramadan. In the thin group, GLP-1 was increased in 14 days of fasting, but did not show any change at the end of Ramadan, and also two weeks after this month. However, none of these changes were statistically significant. The two groups did not diverge from each other significantly in any of the phases.Conclusion: The present findings showed that fasting has no significant effect on the GLP-1 and lipid profile indices of the obese and thin women

Cardioprotective effect of Sanguisorba minor against isoprenaline-induced myocardial infarction in rats

Introduction: Oxidative stress is a major instigator of various cardiovascular diseases, including myocardial infarction (MI). Despite available drugs, there is still an increased need to look for alternative therapies or identify new bioactive compounds. Sanguisorba minor (S. minor) is a native herb characterized by its potent antioxidant activity. This study was designed to evaluate the effect of S. minor against isoprenaline-induced MI.Methods: Rats were treated with the hydro-ethanolic extract of the aerial parts of S. minor at doses of 100 or 300 mg/kg orally for 9 days. Isoprenaline was injected subcutaneously at the dose of 85 mg/kg on days 8 and 9. Then, the activities of various cardiac injury markers including cardiac troponin (cTnT), lactate dehydrogenase (LDH), creatinine kinase muscle brain (CK-MB), creatinine phosphokinase (CPK), and antioxidant enzymes in serum were determined. Malondialdehyde (MDA) and thiol content were measured in cardiac tissue, and histopathological analysis was conducted.Results: Our results show that isoprenaline increased the serum levels of cTnT, LDH, CK-MB, and CPK (p &lt; 0.001) and elevated MDA levels (p &lt; 0.001) in cardiac tissue. Isoprenaline also reduced superoxide dismutase (SOD), catalase, and thiol content (p &lt; 0.001). Importantly, the extract abolished isoprenaline-induced MI by elevating SOD and catalase (p &lt; 0.001), reducing levels of MDA, and diminishing levels of cTnT, LDH, CK-MB, and CPK cardiac markers (p &lt; 0.001). Histopathological studies of the cardiac tissue showed isoprenaline-induced injury that was significantly attenuated by the extract.Conclusion: Our results suggest that S. minor could abrogate isoprenaline-induced cardiac toxicity due to its ability to mitigate oxidative stress

This Article has been retracted (( Quorum-Sensing Signaling System in Pseudomonas aeruginosa: A Method to Overcome the Bacteria’s antibioticResistance By Identifying Dual Inhibitors and Using NSAIDs in Combination with Antibiotic Against Biofilm))

This Article has been retracted Background and Aims: Nonsteroidal anti-inflammatory drugs (NSAIDs), are used as analgesic and antipyretic agents. In this study NSAIDs were used to overcome the resistance of Pseudomonas aeruginosa biofilms to Tobramycin antibiotics. The aim of this study was to find an easy and low-cost method, using NSAIDs and Tobramycin, to deal with the biofilms of P. aeruginosa.. Materials and Methods: Follwoing molecular remodeling, NSAIDs were used alongside Tobramycin against PAO1 strain of P. aeroginusa . The Plate Reader measured the absorbance of crystal violet solution in ethanol. The Infiltration rate of NSAIDs in biofilms and its absorbance were measured by Tetrazolium salt and Plate Reader, respectively. Results: After performing the docking techniques, the most suitable conformation of NSAIDs, to inhibit LasR and PqsE proteins, were chosen. Having worked on dual inhibitors, we could find a configuration  in which the inhibition coefficient was at its lowest level for both PqsE and LasR. After analyzing the growth of P. aeruginosa biofilms near NSAIDs by using Tobramycin and measuring the absorption of crystal violet in ethanol, as a measure of composed biofilm, The findings showed a lower rate of biofilm formation by bacteria treated with NSAIDS and Tombramycin. [P1]  Conclusions: Based on the constructional similarities in some NSAIDs, like Piroxicam, Meloxicam and Homoserine lactones (AHLS), these drugs can be used as quorum-sensing system inhibitors to inhibit LasR and PqsE protein and hence reduce the P. aeruginosa pathogenesis.  [P1]Not mentioned in the abstract in Persia