Ulcerative colitis associated mononeuritis multiplex in 75-year-old patient: Rare case report.

Inflammatory bowel disease (IBD) refers to a collection of chronic, idiopathic inflammatory/autoimmune disorders of the gastrointestinal tract characterized by relapsing and remitting episodes. In this case report, we will report a patient who has encountered ulcerative colitis related to mononeuritis multiplex as a rare clinical scenario. A 75-year-old male patient, with a prior medical history including long-standing hypertension, recurring episodes of peripheral joint arthritis, leg skin lesions reminiscent of erythema nodosum, and persistent chronic diarrhea over the past 2 years, was recently hospitalized at the rheumatology department of Imam Reza Hospital in Tabriz. Throughout the patient's hospital stay, a series of diagnostic assessments were conducted, encompassing procedures such as colonoscopy, electromyography and nerve conduction studies, echocardiography, renal ultrasonography, and standard hematological analyses. The patient underwent the following treatment regimen, which resulted in a significant improvement in his condition.

Computing the effects of temperature and osmotic stress on the seed germination of Helianthus annuus L. by using a mathematical model.

An extremely important oil crop in the world, Helianthus annuus L. is one of the world's most significant members of the Asteraceae family. The rate and extent of seed germination and agronomic features are consistently affecting  by temperature (T) and changes in water potential (ψ). A broad hydrothermal time model with T and ψ components could explain sunflower responses over suboptimal T and ψ. A lab experiment was performed using the HTT model to discover both T and ψ and their interactive effects on sunflower germination and also to figure  out the cardinal Ts values. The sunflower seeds were germinated at temperatures (15 °C, 20 °C, 25 °C and 30 °C); each Ts had five constant ψs of 0, 0.3, 0.6, 0.9, and 1.2 MPa via PEG 6000 as osmotic stress inducer. The results revealed that highest germination index was found in seed grown at 20 °C in distilled water (0 MPa) and the lowest at 30 °C with osmotic stress of (- 1.2 MPa). The highest value of germination rate index was found in seed grown at 20 °C in distilled water (0 MPa) and the lowest at 15 °C with an osmotic stress of (- 1.2 MPa). In conclusion, water potential, temperature, and their interactions have a considerable impact on seed germination rate, and other metrics (GI, SVI-I, GRI, GE, SVI-II, and MGT). Seeds sown  at 20 °C with zero water potential showed high germination metrics such as GE, GP, GRI, and T50%. The maximum value to TTsub noted at 30 °C in - 0.9 MPa osmotic stress and the minimum value was calculated at 15 °C in - 1.2 MPa osmotic stress. The result of TTsupra recorded highest at 15 °C in  controlled group (0 MPa). Moreover, θH was  highest at 30 °C in controlled condition (0 MPa) and minimum value was observed at  20 °C under - 1.2 MPa osmotic stress. The value of θHTT were  maximum at  30 °C in controlled group (0 MPa) and minimum value was  recorded at 15 °C under - 1.2 MPa osmotic potential. The base, optimum and ceiling temperatures for sunflower germination metrics in this experiment were noted  6.8, 20 and 30 °C respectively.

Transvesical blockade of the obturator nerve to prevent adductor contraction in transurethral bladder surgery.

PURPOSE: To evaluate the efficacy of transvesical obturator nerve block (ONB) in the prevention of obturator nerve reflex and leg jerking during transurethral resection of bladder tumors (TURBT). PATIENTS AND METHODS: A total of 60 patients were studied, in whom the transurethral resection of tumors on the posterolateral bladder wall were performed under spinal anesthesia (SA). The patients were randomly divided into two groups. In the first group, we performed transvesical ONB and SA together, while the second group received only SA. The patients underwent TURBT using monopolar cautery. Incidence of leg jerking was registered and compared in these two groups. We used a nerve stimulator to detect the obturator nerve next to the lateral bladder wall. The obturator nerve was identified by its response to nerve stimulation. Then, 10 mL of 1% lidocaine was slowly injected through the working channel of a cystoscope. RESULTS: In the intervention group, 34 ONBs (4 bilateral and 26 unilateral) were tried. We could not detect the obturator nerve by nerve stimulation in six patients, and lidocaine injection was carried out blindly in these cases. One patient in the intervention group experienced adductor contraction. Among 30 patients in the control group, 5 patients had leg jerking, and in 2 patients, the procedure ended incompletely because of muscle spasm. Comparing these two groups, transvesical ONB effectively decreased leg jerking during TURBT (16.5% vs 3%; P < 0.05). CONCLUSION: Local blockade of the obturator nerve during cystoscopy is an effective method to avoid its stimulation in TURBT. It can be performed easily, and we did not experience any serious complication.