The definition of recurrent shoulder dislocation in tramadol induced seizure patients

Background: Prevalence of recurrent shoulder dislocation in patients taking tramadol has not been studied yet; so, this study aims to study the recurrent shoulder dislocation following tramadol induced seizure. Methods: In this cross-sectional study, 205 patients with recurrent shoulder dislocation complaints (2 or more) referred to Shafa Orthopedic and Iranmehr hospitals Tehran, Iran, from October 2012 to October 2014 were studied. Data on patient history and physical examination, patient demographic information such as age, sex, age at first dislocation, total number of dislocation, cause of the first dislocation, history of tramadol use, number of dislocation following tramadol induced seizure, history of other drugs use, the dominant hand, involved side, direction of dislocations and greater tuberosity fracture was recorded using a pre-designed questionnaire. Categorical variables were compared by chi-square test and the means were compared with student T-test. Results: In this study, 50 patients (24.4) suffered from tramadol induced seizures and recurrent shoulder dislocation. Results showed that there was a significant relationship between the number of dislocation and tramadol use (P = 0.02). Recurrent shoulder dislocation following tramadol induced seizure was significantly associated with greater tuberosity fracture of humerus (P = 0.04); in 49 out of 50 patients (98) dislocation was of anterior type. Conclusion: The findings of this study suggest that tramadol induced seizure may increase the risk of recurrent shoulder dislocation. Furthermore, the prevalence of greater tuberosity fracture in shoulder dislocation increases following tramadol induced seizure; and anterior shoulder dislocation is the most common type of dislocation following tramadol induced seizure

Enhancing community resilience in arid regions: A smart framework for flash flood risk assessment

This paper presents a novel framework for smart integrated risk management in arid regions. The framework combines flash flood modelling, statistical methods, artificial intelligence (AI), geographic evaluations, risk analysis, and decision-making modules to enhance community resilience. Flash flood is simulated by using Watershed Modelling System (WMS). Statistical methods are also used to trim outlier data from physical systems and climatic data. Furthermore, three AI methods, including Support Vector Machine (SVM), Artificial Neural Network (ANN), and Nearest Neighbours Classification (NNC), are used to predict and classify flash flood occurrences. Geographic Information System (GIS) is also utilised to assess potential risks in vulnerable regions, together with Failure Mode and Effects Analysis (FMEA) and Hazard and Operability Study (HAZOP) methods. The decision-making module employs the Classic Delphi technique to classify the appropriate solutions for flood risk control. The methodology is demonstrated by its application to the real case study of the Khosf region in Iran, which suffers from both drought and severe floods simultaneously, exacerbated by recent climate changes. The results show high Coefficient of determination (R2) scores for the three AI methods, with SVM at 0.88, ANN at 0.79, and NNC at 0.89. FMEA results indicate that over 50% of scenarios are at high flood risk, while HAZOP indicates 30% of scenarios with the same risk rate. Additionally, peak flows of over 24 m3/s are considered flood occurrences that can cause financial damage in all scenarios and risk techniques of the case study. Finally, our research findings indicate a practical decision support system that is compatible with sustainable development concepts and can enhance community resilience in arid regions

Familial Mediterranean fever: Unusual age of presentation and the role of genetic diagnosis

Familial Mediterranean fever (FMF) is a genetic disease characterized by periodic fever and/or painful inflammatory manifestations. Repeated attacks at irregular intervals and in an unpredictable sequence are typical of the disease. Most of the patients become symptomatic between ages 5 to 15 years. Rarely, the disease may manifest as early as during the first year. Until recently, the diagnosis of FMF was mainly based on the presence of typical clinical picture and dramatic response to colchicine. Recent insight to the genetic basis of the disease has made DNA study available for diagnosis of FMF. We report a 20-month-old Iranian boy with recurrent attacks of abdominal pain and fever since the 4th month of birth. A molecular analysis was carried out, confirming mutation of the FMF-gene

How does functional constipation affect growth status in children?

Background: There are some evidences suggesting functional constipation-related growth retardation in children, especially in early childhood. Considering high prevalence of constipation, early diagnosis and treatment of constipated patients may improve the quality of life in these children. In this study, weight and height of Iranian children aged 2 to 12 years with functional constipation was evaluated compared to healthy children. Methods: A total of 130 Iranian children aged 2-12 years, 65 with functional constipation and 65 as healthy children referred to pediatric gastroenterology clinic during Jan to Dec of 2016, were enrolled in this case-control study. Functional constipation was defined as Rome III criteria. The growth status was evaluated using the growth charts, and Z scores of weight and height for age were recorded, with the consent of parents and child willingness. Results: 65 constipated patients (44 boys, 21 girls) with the mean age of 8.28 ± 3.24 years and 65 healthy children (25 boys, 40 girls) with the mean age of 8.32 ± 3.42 years were evaluated. The mean weight of case group was 23.69 ± 4.14 kg and mean height 126.49 ± 10.34 cm. The mean weight of control group with 31.62 ± 4.85 kg and mean height 153.47 ± 13.88 cm, demonstrated significant difference with the case group. The observed mean weight and height were significantly lower in constipated group and the differences of height-for-age and weight-for-age Z scores were statistically meaningful in constipated and healthy children. Conclusions: Functional constipation in children aged 2 to 12 years may retard their weight and height growth, so early diagnosis and treatment of children with constipation is beneficial in their adequate growth status. © 2019, Author(s)

Metallic Nanoparticles for the Modulation of Tumor Microenvironment; A New Horizon

Cancer is one of the most critical human challenges which endangers many people’s lives every year with enormous direct and indirect costs worldwide. Unfortunately, despite many advanced treatments used in cancer clinics today, the treatments are deficiently encumbered with many side effects often encountered by clinicians while deploying general methods such as chemotherapy, radiotherapy, surgery, or a combination thereof. Due to their low clinical efficacy, numerous side effects, higher economic costs, and relatively poor acceptance by patients, researchers are striving to find better alternatives for treating this life-threatening complication. As a result, Metal nanoparticles (Metal NPs) have been developed for nearly 2 decades due to their important therapeutic properties. Nanoparticles are quite close in size to biological molecules and can easily penetrate into the cell, so one of the goals of nanotechnology is to mount molecules and drugs on nanoparticles and transfer them to the cell. These NPs are effective as multifunctional nanoplatforms for cancer treatment. They have an advantage over routine drugs in delivering anticancer drugs to a specific location. However, targeting cancer sites while performing anti-cancer treatment can be effective in improving the disease and reducing its complications. Among these, the usage of these nanoparticles (NPs) in photodynamic therapy and sonodynamic therapy are notable. Herein, this review is aimed at investigating the effect and appliances of Metal NPs in the modulation tumor microenvironment which bodes well for the utilization of vast and emerging nanomaterial resources

Xerostomia after radiotherapy and its effect on quality of life in head and neck cancer patients

Background: Xerostomia is one of the one complications following radiotherapy that can affect quality of life (QoL). This study aims to assess the severity of xerostomia in patients with head and neck cancers after radiotherapy and its effect on QoL. Methods: In this longitudinal prospective study, the severity of xerostomia and related QoL was assessed in 63 head and neck cancer patients who referred to the Radiotherapy Ward. Patients completed a xerostomia questionnaire (XQ) at the beginning, and 2, 4, and 6 weeks after treatment over a period of 6 months. Additionally, unstimulated saliva was collected using the spitting method at all 4 visits. Results: QoL significantly worsened with increased time (P = 0.0001); meanwhile, the severity of xerostomia increased significantly (P = 0.0001). However, there was no significant change in the amount of saliva at these 4 time points (P = 0.23). Regression analysis showed that with each milliliter decrease in saliva secretion, the QoL score decreased 2.25. With one score increase in xerostomia, from the QoL mean score there was a 1.65 decrease. Conclusion: The decrease in saliva and xerostomia that resulted from radiotherapy plays an important role in worsening QoL among patients who undergo radiotherapy for head and neck cancers. Although the amount of saliva has a significant association with QoL, the xerostomia score which shows subjects' general feeling also independently impacts QoL. In future studies, we recommend patient assessments for periods longer than 6 months

A literature review on the parvovirus B19 infection in sickle cell anemia and β-thalassemia patients

Background: Parvovirus B19 is the causative agent for erythema infectiosum, and also as a potentially life-threatening infectious agent, it is mainly presented in high erythrocyte turnover patients. Sickle cell disease (SCD) is an inherited monogenic hematological disorder resulting from the mutations in the hemoglobin β-chain gene. Thalassemia is a hereditary hematological syndrome that happens in consequence of deficiencies in the production of one or more globin chains. We summarize current knowledge about the prevalence rates of the parvovirus B19 infection in sickle cell anemia and thalassemia patients. Methods: Several online databases were searched including, Scopus, EMBASE, Web of Science, Google Scholar, and PubMed, which were performed amidst 2009�2019 by using distinct keywords: �Thalassemia,� �Parvovirus,� �Anemia,� �Sickle cell anemia,� �parvoviridae,� �parvoviridae infection,� and �parvovirus B19.� Results: Search results indicated 4 and 7 studies for the prevalence of the parvovirus B19 in β-thalassemia and SCD, respectively. Among the β-thalassemia patients, the B19V seroprevalence for IgG and IgM were ranged from 18.2�81 and 14.5�41.1, respectively; meanwhile, B19V DNA positively results was 4�15.3. Moreover, in the SCD group, the extent of B19V IgG was varied from 37.6 to 65.9 and that of IgM was in a range of 2.9�30, and the DNA detection rate was 4�54. Conclusion: B19V seroprevalence changes in several conditions including, different epidemiological features, socio-economic status, and overpopulation. Age can expand the incidence of anti-B19V IgG/IgM in SCD and beta-thalassemia patients. Reinfection and diverse genotypes are relevant factors in the seroprevalence of B19v. The patients� immunological-hematological station and higher abundance of transfusions can affect the B19V seroprevalence in SCD and beta-thalassemia group. Further investigations in this field could be suggested to better understand the virus distribution in this susceptible population of patients. © 2020, The Author(s)

Studies on combination of oxaliplatin and dendrosomal nanocurcumin on proliferation, apoptosis induction, and long non-coding RNA expression in ovarian cancer cells

Drug resistance remains a major challenge in the treatment of patients with ovarian cancer. Therefore, the development of new anticancer drugs is a clinical priority to develop more effective therapies. New approaches to improve clinical outcomes and limit the toxicity of anticancer drugs focus on chemoprevention. The aim of this study was to determine the effects of dendrosomal nanocurcumin (DNC) and oxaliplatin (Oxa) and their combination on cell death and apoptosis induction in human ovarian carcinoma cell lines analyzed by MTT assay and flow cytometry, respectively. The synergism effect of Oxa and DNC was analyzed using the equation derived from Chou and Talalay. In addition, real-time PCR was used to measure the effect of this combination on the expression levels of long non-coding RNAs with different expression in ovarian cancer and normal ovaries. Our data showed that the effect of DNC on cell death is more than curcumin alone in the same concentration. The greatest cell death effect was observed in combination of Oxa with DNC, while Oxa was added first, followed by DNC at 4 h interval (0/4 h). The findings indicated that DNC induced apoptosis significantly in both cell lines as compared to control groups; however, combination of both agents had no significant effect in apoptosis induction. In addition, combination of both agents significantly affects the relative expression of long non-coding RNAs investigated in the study as compared with mono therapy. © 2018, Springer Nature B.V

IQGAP1 Interacts with Components of the Slit Diaphragm Complex in Podocytes and Is Involved in Podocyte Migration and Permeability In Vitro

IQGAP1 is a scaffold protein that interacts with proteins of the cytoskeleton and the intercellular adhesion complex. In podocytes, IQGAP1 is associated with nephrin in the glomerular slit diaphragm (SD) complex, but its role remains ill-defined. In this work, we investigated the interaction of IQGAP1 with the cytoskeleton and SD proteins in podocytes in culture, and its role in podocyte migration and permeability. Expression, localization, and interactions between IQGAP1 and SD or cytoskeletal proteins were determined in cultured human podocytes by Western blot (WB), immunocytolocalization (IC), immunoprecipitation (IP), and In situ Proximity Ligation assay (IsPL). Involvement of IQGAP1 in migration and permeability was also assessed. IQGAP1 expression in normal kidney biopsies was studied by immunohistochemistry. IQGAP1 expression by podocytes increased during their in vitro differentiation. IC, IP, and IsPL experiments showed colocalizations and/or interactions between IQGAP1 and SD proteins (nephrin, MAGI-1, CD2AP, NCK 1/2, podocin), podocalyxin, and cytoskeletal proteins (α-actinin-4). IQGAP1 silencing decreased podocyte migration and increased the permeability of a podocyte layer. Immunohistochemistry on normal human kidney confirmed IQGAP1 expression in podocytes and distal tubular epithelial cells and also showed an expression in glomerular parietal epithelial cells. In summary, our results suggest that IQGAP1, through its interaction with components of SD and cytoskeletal proteins, is involved in podocyte barrier properties

Vesicular Stomatitis Virus Infection Promotes Immune Evasion by Preventing NKG2D-Ligand Surface Expression

Vesicular stomatitis virus (VSV) has recently gained attention for its oncolytic ability in cancer treatment. Initially, we hypothesized that VSV infection could increase immune recognition of cancer cells through induction of the immune stimulatory NKG2D-ligands. Here we show that VSV infection leads to a robust induction of MICA mRNA expression, however the subsequent surface expression is potently hindered. Thus, VSV lines up with human cytomegalovirus (HCMV) and adenovirus, which actively subvert the immune system by negatively affecting NKG2D-ligand surface expression. VSV infection caused an active suppression of NKG2D-ligand surface expression, affecting both endogenous and histone deacetylase (HDAC)-inhibitor induced MICA, MICB and ULBP-2 expression. The classical immune escape mechanism of VSV (i.e., the M protein blockade of nucleocytoplasmic mRNA transport) was not involved, as the VSV mutant strain, VSVΔM51, which possess a defective M protein, prevented MICA surface expression similarly to wild-type VSV. The VSV mediated down modulation of NKG2D-ligand expression did not involve apoptosis. Constitutive expression of MICA bypassed the escape mechanism, suggesting that VSV affect NKG2D-ligand expression at an early post-transcriptional level. Our results show that VSV possess an escape mechanism, which could affect the immune recognition of VSV infected cancer cells. This may also have implications for immune recognition of cancer cells after combined treatment with VSV and chemotherapeutic drugs