Identification of a Novel Homozygous Mutation in PRDM12 Gene in a Patient with Hereditary Sensory and Autonomic Neuropathy Type VIII.

Hereditary sensory autonomic neuropathy type VIII (HSAN-VIII) is a rare genetic disease that occurs due to mutations in the PRDM12 gene. Here, we describe a novel homozygous mutation c.826_840dupTGCAACCGCCGCTTC (p.Cys276_Phe280dup) on exon 5 in the PRDM12 gene identified by WES and confirmed using Sanger sequencing method.

Comparison of low-level laser therapy and standard treatment for temporomandibular disorders: An assessment of therapeutic and placebo effects.

BACKGROUND: Despite extensive research on the use of low-power lasers for TMD treatment, the extent of their effectiveness remains uncertain. OBJECTIVE: This study aimed to investigate the therapeutic or placebo effect of LLLT for TMD, and to compare it with standard treatment methods. A unique aspect of this study was the inclusion of a control group that received only standard treatment, allowing for an assessment of the placebo effect of LLLT. METHODS: A total of 42 patients with TMD were referred to Kerman Dental School Pain Clinic and were randomly assigned to three groups: group A received LLLT, group B was a placebo group and group C was a control group that received only standard treatment. The laser groups received gallium-aluminium-arsenide laser treatment twice a week for 10 sessions. Patients' jaw movement rate indicators and VAS index were evaluated at the start of treatment, and indicators were re-recorded every week for 5 weeks. SPSS 21 was used for statistical analysis, including ANOVA and Tukey's post hoc tests for inter-group comparisons. The repeated measurement test was used to analyse the data. RESULTS: All groups showed significant improvement in VAS indicators (p = .0001), lateral jaw movements (p = .0001), forward jaw movement (p = .007) but not for maximum mouth opening. No significant difference was observed between the groups at the end of the study (p = .000). CONCLUSION: Our study provides insights into LLLT's effectiveness for TMD, suggesting it cannot replace standard treatment alone. These findings contribute to the literature and emphasise the importance of including a control group in future studies to assess the placebo effect of LLLT.

Solitary Plasmacytoma of the Mandible: A Case Report.

Plasmacytoma is an abnormal proliferation of monoclonal B-cells, and it can occur in several forms including multiple myeloma, solitary plasmacytoma of the bone, and extramedullary plasmacytoma primary. The solitary plasmacytoma of the bone accounts for about 3-10% of all plasma cell neoplasms, and occurs most often in the vertebrae, whereas the solitary plasmacytoma of the mandible is an extremely rare occurrence. This case report presents a 61-year-old woman with various underlying diseases diagnosed with solitary plasmacytoma of the mandible. This case is very well documented with radiographic imagery, clinical, and histopathological findings.

Simulation of time-fractional oxygen diffusion in cornea coated by contact-lens.

In this paper, the time-fractional oxygen diffusion has been simulated in a one-dimensional (1D) corneal-contact lens (CL) system. Different CLs have been employed as Balafilcon, thin- and thick-Polymacon. It is assumed that homogeneous and isotropic porous mediums of cornea and CL is saturated with compressible oxygen. The computations of the time-fractional derivations are done based on the Caputo method. The obtained results show that the fractional derivative order (FDO) severely affects pressure distribution in cornea and CL. Consequently, the magnitudes of post-lens-tear-film (PoLTF) pressure change due to diverse FDOs. Particularly, maximum changes have been observed in the results gained from the CLs with thicknesses more than 100 µm. The agreement of the results obtained from the time-fractional modeling with the experimental data compared to the standard diffusion modeling has been improved by more than 36%. Finally, it has been demonstrated that high-thickness CLs can cause exist anomalous diffusion process in cornea tissue.

Comparison of Face-to-Face Education and Multimedia Software Education on Adjustment of Patients With Intestinal Ostomy: A Randomized Controlled Trial.

PURPOSE: The aim of this study was to compare the effect of face-to-face versus multimedia education on the adjustment of patients to an intestinal ostomy. DESIGN: Randomized clinical trial. SUBJECT AND SETTING: The sample comprised 135 patients with new ostomies randomly assigned to 3 groups (control, face-to-face, and multimedia education). Data were collected from November 2018 to May 2019; the study setting was Rasul-e Akram and Imam Khomeini Hospitals, Tehran, Iran. METHODS: The control group received no additional ostomy education. The face-to-face education group was educated individually in the hospital environment during four 3-hour sessions delivered over 4 consecutive days. The multimedia group viewed a multimedia educational program using a laptop. Data were collected at baseline and 3 months after the intervention. Data collection forms comprised a demographic questionnaire and the Ostomy Adjustment Inventory-23 (OAI-23). RESULTS: Before the intervention, the mean OAI-23 adjustment score did not significantly differ among the 3 groups (P = .752). Three months after the intervention, the mean score of adjustment score in the multimedia software group was significantly higher than those of the face-to-face and control groups (P = .000). In addition, the mean score of adjustment of the face-to-face education group was significantly higher than that of the control group (P = .002). CONCLUSION: Findings indicate that multimedia education was associated with higher levels of adjustment when compared to face-to-face teaching.

The impact of data quality assurance and control solutions on the completeness, accuracy, and consistency of data in a national spinal cord injury registry of Iran (NSCIR-IR).

STUDY DESIGN: Descriptive study. OBJECTIVE: This study aimed to develop and evaluate a systematic arrangement for improvement and monitoring of data quality of the National Spinal Cord (and Column) Injury Registry of Iran (NSCIR-IR)-a multicenter hospital-based registry. SETTING: SCI community in Iran. METHODS: Quality assurance and quality control were the primary objectives in improving overall quality of data that were considered in designing a paper-based and computerized case report. To prevent incorrect data entry, we implemented several validation algorithms, including 70 semantic rules, 18 syntactic rules, seven temporal rules, and 13 rules for acceptable value range. Qualified and trained staff members were also employed to review and identify any defect, inaccuracy, or inconsistency in the data to improve data quality. A set of functions were implemented in the software to cross-validate, and feedback on data was provided by reviewers and registrars. RESULTS: Socio-demographic data items were 100% complete, except for national ID and education level, which were 97% and 92.3% complete, respectively. Completeness of admission data and emergency medical services data were 100% except for arrival and transfer time (99.4%) and oxygen saturation (48.9%). Evaluation of data received from two centers located in Tehran proved to be 100% accurate following validation by quality reviewers. All data was also found to be 100% consistent. CONCLUSIONS: This approach to quality assurance and consistency validation proved to be effective. Our solutions resulted in a significant decrease in the number of missing data.

Nitric oxide role in anxiety-like behavior, memory and cognitive impairments in animal model of chronic migraine.

The occurrence of cognitive dysfunctions and anxiety and mood disorders has been shown to be higher in migraine patients. Nitric Oxide (NO) is a significant neurotransmitter in the pathophysiology of migraine, anxiety and neurodegenerative disorders. Therefore, the present study was conducted to evaluate the role of NO system in migraine-induced memory impairment and anxiety like behaviors. Nitroglycerin (NTG) was administered to the animals as an animal model of migraine and pretreatment with L-Arginine, L-NAME and saline were implemented to evaluate the role of NO system in possible cognitive impairments in animal model of migraine. Avoidance learning and memory performance, object recognition memory, anxiety-like behavior and motor activity were assessed using a shuttle box apparatus, novel object recognition, elevated plus-maze, and open field tests respectively. The data showed that the injection of nitroglycerin disturbs learning and memory and elicit anxiety like behavior in the animals. L-NAME administration suppressed the observed effect of nitroglycerin on memory and anxiety. Overall, the results indicated that nitric oxide system is implicated in memory impairments and anxiety like behavior in an animal model of migraine.

Inflammatory and fibroblastic effects of azithromycin on cyclosporine-induced gingival overgrowth in renal transplanted patients with and without scaling: A randomized clinical trial.

BACKGROUND: This study aimed to evaluate the effect of azithromycin (AZM) on the inflammatory and fibroblastic part of cyclosporine A (CsA)-induced gingival overgrowth (GO) in renal transplanted patients. METHODS: In this randomized clinical trial, subjects with GO receiving CsA were randomly divided into two groups: those receiving 5-day AZM only (n = 12; group 1) and those receiving scaling and prescribed AZM after 2 months (n = 12; group 2). Both groups were evaluated for several indices (gingival hyperplastic index, plaque and bleeding index, clinical crown length) at the first visit and the 4th and 8th week in group 1, and at the first visit and the 4th, 8th, 12th, and 16th week in group 2. RESULTS: The sample included 24 individuals. The mean (SD) age of participants was 30.81 (11.13) and 34.80 (9.33) years in group 1 and 2, respectively. Based on ANCOVA, the changes in the hyperplastic index (GHI) and apico-coronal dimension (ACD) of it were statistically significant in professional scaling accompanied by AZM group (P = 0.012 and 0.031, respectively). However, no significant change was observed in mean indices after prescribing AZM in 5-day AZM regimen group (P = 0.664 and 0.882, respectively). According to one-way ANOVA, we found a statistically significant correlation in GHI, ACD, bleeding index (BI), and plaque index (PI) accounting for P = 0.012, 0.003, 0.002, and <0.001, respectively. CONCLUSIONS: Findings suggest that AZM cannot influence the fibroblastic part of GO in presence of gum inflammation while the therapy can improve GO after resolving it with scaling.

Chronic migraine caused a higher rate of tendency to cannabinoid agonist compared to morphine.

BACKGROUND AND AIM: Opioid and cannabinoid systems have considerable roles in modulation of chronic pain as well as regulation reward circuit and addiction responses. This study investigated the effect of nitroglycerin (NTG)-induced migraine attack on the acquisition of morphine and cannabinoid-induced conditioned place preference (CPP) in male rats. METHODS: Adult male rats (230-250 gr) were used. Experimental groups were included (n=10): control, opioid receptor agonist morphine (10mg/kg), WIN55,212-2 (1mg/kg) as a cannabinoid receptor agonist, NTG + morphine (10mg/kg) and NTG + WIN55,212-2 (1mg/kg). Nitroglycerin (10 mg/kg) was used to induce migraine attack every other day for 9 days. After migraine induction, conditioning performance was assessed by CPP test. During conditioning days, morphine and WIN55,212-2 were injected subcutaneously and intraperitoneally, respectively. Anxiety and locomotor activity were evaluated using open field test (OFT). RESULTS: According to data, conditioning score for morphine-treated rats was significantly decreased following NTG-induced migraine. However, NTG-induced migraine was able to increase the conditioning score in WIN55,212-2 as compared to control group.  In OFT, there were no significant differences in locomotor activity and grooming behaviors between experimental groups. However, time spent in the center of OFT box was significantly decreased in NTG plus morphine-treated rats as compared to control. Moreover, rearing response in NTG-treated groups which received either morphine or WIN55,212-2 decreased as compared to control group. CONCLUSION: NTG induced migraine prompts a decrease in morphine and an increase in cannabinoid performances. So, these compounds effects on drug dependency during migraine attack may occur at different mechanism or mechanisms.

Sensory and Affective Dimensions of Pain and Anxiety Like Behaviors Are Altered in an Animal Model of Pain Empathy.

Objective: Pain is a unique and subjective experience that has a prominent function in animals' survival. Observation of pain in others leads to alterations in pain sensation and affection, termed "Empathy for pain". The present study aimed to evaluate the effect of empathy on sensory and affective dimensions of pain and its effect on anxiety-like behaviors. Method : In this study, male Wistar rats were used. Two cage mates were selected, one of which underwent administration of a noxious stimuli for 10 days and the other observed the conspecific in pain. Hot plate, tail flick, and conditioned place aversion were used to evaluate sensory and affective dimensions of pain, respectively. Anxiety-like behavior was assayed using elevated plus maze paradigm and time spent in open and close arms and number of entrance into each arm was recorded as the anxiety indicator within a 5-minute framework. Results: Rats observing the cage mate in pain had a lower threshold to noxious stimuli in comparison to controls. They also had an increased aversion from painful stimuli, demonstrating heightened affective response to pain. Anxiety-like behavior was also enhanced in the observers. Conclusion: Results of this study demonstrate that both sensory and affective dimensions of pain are altered following observation of pain in a conspecific. Further studies evaluating the underlying mechanisms are encouraged to elucidate the role of different neurotransmitters in this phenomenon.

On the chemical nature of precipitation in a populated Middle Eastern Region (Ahvaz, Iran) with diverse sources.

This study reports on the chemical composition of rainwater collected at three ground sites with varying degrees of pollution in Ahvaz, Iran, between January 2014 and February 2015. A total of 24 rainwater samples were analyzed for pH and concentrations of trace elements (Fe, Al, Pb, and Cd) and major ions (Na+, NH4+, Ca2+, Mg2+, HCO3-, NO3-, Cl- and SO42-). Principle Component Analysis (PCA) was used to identify sources of the measured species. The equivalent concentration of the components followed the order of Ca2+ > SO42- > HCO3- > NH4+ > Cl- > Na+ > NO3- > Mg2+. The average pH of the rainwater samples was 6, and only three events exhibited acidic conditions below a pH of 5.6. The lowest and the highest average pH values were observed in the high traffic area (5.96) and industrial area (6.54), respectively. The highest and lowest Ca2+ levels were observed in the industrial and high traffic areas, respectively. Na+, Mg2+, and SO42- exhibited their highest and lowest concentrations in the industrial and high traffic areas, respectively. 70.36% of the total variance was due to anthropogenic species (Ca2+, SO42-, Mg2+, NO3-, Cl-), soil particles (Cl-, Na+, and HCO3-), and biomass burning (NH4+, pH). The results of this study show that local anthropogenic sources and Middle Eastern Dust (MED) storms affect the rainwater chemistry strongly, which the latter stems from the Arabian Peninsula, Kuwait, Iraq, and some parts of Iran.

Effect of chronic stress on capsaicin-induced dental nociception in a model of pulpitis in rats.

OBJECTIVE: Chronic stress can alter nociceptive sensitivity. However, the effect of stress exposure on dental nociception has been less addressed. Therefore, the present study investigated the effects of chronic exposures to some social and psychological stresses on pulpal nociceptive responses. DESIGN: The stress groups were constructed as follows: forced swimming (n=6), restraint (n=6), and mild (n=10) and severe (n=15) crowding stresses. Rats were subjected to stress for 1h per day for a week. At the end of the stress session, pulp irritation was induced by intradental application of capsaicin (100µg). There were another capsaicin or capsaicin plus stress training groups that received articaine 5min before the administration of capsaicin. Nociceptive responses were recorded for 40min. The time (ins) of continuous shaking of the lower jaw and excessive grooming and rubbing of the mouth near the procedure site was measured as nociceptive behaviors. Data was analyzed using one-way analysis of variance (ANOVA) followed by post hoc Tukey's test. RESULTS: Significant nociceptive responses were evoked by the administration of capsaicin. Exposures to forced swimming (p<0.01), restraint (p<0.001), and both mild and severe crowding stresses (p<0.05) exaggerated capsaicin-induced nociceptive reaction. There was, however, no significant difference in nociceptive reaction time between the different stress groups. Articaine buccal infiltration attenuated nociceptive time in capsaicin and capsaicin plus stress training groups (p<0.001). CONCLUSIONS: The current data support the association between chronic stress exposures and nociceptive behavior following intradental capsaicin administration.

Evidence of Altered Trigeminal Nociception in an Animal Model of Fibromyalgia.

Objective: Fibromyalgia (FM) is a debilitating chronic condition that significantly affects quality of life. A strong association has been demonstrated between FM and chronic pain in the trigeminal region in clinical studies. This study was performed to evaluate the response to acute and chronic noxious stimuli applied to the facial region. Methods: Adult male Wistar rats (250-270 g, N = 10 for each group) were used in the current study. A subchronic swim stress model was used as the animal model of FM. Anxiety-like behaviors and response to acute and chronic noxious stimuli were assayed using the elevated plus maze, eye wiping test, and orofacial formalin test, respectively. Balance and motor function were evaluated using rotarod and wire grip tests. Results: An increased anxiety-like behavior was observed in swim stress rats in comparison with control and sham subjects. Response to acute and chronic noxious stimuli in the trigeminal region was increased in the stressed rats. Motor and balance function were not altered following stress. Conclusions: Results of the current study demonstrated a hyperalgesic state in the trigeminal region in a possible animal model of FM. This study provides a reliable animal model for further research on the possible mechanisms of orofacial pain in FM.

Feasibility and Data Quality of the National Spinal Cord Injury Registry of Iran (NSCIR-IR): A Pilot Study.

BACKGROUND: Spinal cord injury (SCI) is one of the most disabling consequences of trauma with unparalleled economic, social, and personal burden. Any attempt aimed at improving quality of care should be based on comprehensive and reliable data. This pilot investigation studied the feasibility of implementing the National Spinal Cord and Column Injury Registry of Iran (NSCIR-IR) and scrutinized the quality of the registered data. METHODS: From October 2015 to May 2016, over an 8-month period, 65 eligible trauma patients who were admitted to hospitals in three academic centers in mainland Iran were included in this pilot study. Certified registered nurses and neurosurgeons were in charge of data collection, quality verification, and registration. RESULTS: Sixty-five patients with vertebral column fracture dislocations were registered in the study, of whom 14 (21.5%) patients had evidence of SCI. Mechanisms of injury included mechanical falls in 30 patients (46.2%) and motor vehicle accidents in 29 (44.6%). The case identification rate i.e. clinical and radiographic confirmation of spine and SCI, ranged from 10.0% to 88.9% in different registry centers. The completion rate of all data items was 100%, except for five data elements in patients who could not provide clinical information because of their medical status. Consistency i.e. identification of the same elements by all the registrars, was 100% and accuracy of identification of the same pathology ranged from 66.6% to 100%. CONCLUSIONS: Our pilot study showed both the feasibility and acceptable data quality of the NSCIR-IR. However, effective and successful implementation of NSCIR-IR data use requires some modifications such as presence of a dedicated registrar in each center, verification of data by a neurosurgeon, and continuous assessment of patients' neurological status and complications.

Evaluation of Honey as a Topical Therapy for Intraoral Wound Healing in Rats.

OBJECTIVE: Honey is one of the oldest known medicines. Its medical and therapeutic importance has been recently rediscovered. Honey is an effective treatment for infected wounds and ulcers. The aim of this study was to determine the effect of honey as a topical therapy for intraoral wound healing in rats. MATERIALS AND METHODS: Thirty-two male rats were divided into experimental and control groups (consisting of 16 rats, 4 animals in each group). A 2-mm mucosal defect was made to the depth of the periosteum using punch biopsy. Honey was applied to the wound every day, and the ulcer size was measured daily. On days 2, 4, 6, and 8, four rats were euthanized from each group (experimental and control groups), and tissues were histopathologically evaluated. Healing processes were studied as follows: the size of ulcer, inflammatory response, reepithelialization, and granulation tissue formation. RESULTS: The mean rank of wound size was significantly reduced in the honey group (2.50), as compared to the control group (6.50). Reepithelialization and granulation tissue formation mean rank were significantly higher in the honey group (6.50) than in the control group (2.50). Inflammation mean rank was statistically lower in the honey group (2.63) compared with the control group (6.38). CONCLUSION: Honey was shown to have a beneficial effect on the healing of oral ulcers in rats in this model. Further research may shed light on the effects of honey on different types of ulcers in humans.

Migraine patients have a higher prevalence of PTSD symptoms in comparison to chronic tension-type headache and healthy subjects: a case-control study.

OBJECTIVE: Headache is one of the most common disorders and has a heavy socioeconomic burden on both patients and society. Previous studies have demonstrated a high prevalence of psychological issues (e.g. depression and anxiety) in headache and especially migraine patients. The current study was designed to evaluate the prevalence of post-traumatic stress disorder (PTSD) symptomatology in chronic migraine (CM), chronic tension-type headache (CTTH) and healthy subjects. MATERIAL AND METHODS: CM and CTTH subjects were selected consecutively from patients referring to the department of neurology clinic at Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran. PTSD symptomatology was assessed using PTSD checklist civilian version-Persian edition (PCL-C). Control subjects were enrolled from the family members of headache patients who did not have any history of headache. Chi-square test was used to analyse data and p < .05 was considered statistically significant. RESULTS: Of the 60 control subjects, 5 had a PTSD symptomatology (8.3%); this prevalence was 13.3% for CTTH and 40% for CM groups. CM patients had a significantly higher prevalence of PTSD symptomatology in comparison to CTTH and control subjects (p < .05). With reference to gender, most of the subjects with PTSD symptomatology were female. CONCLUSION: Results of the current study demonstrated that CM patients have a higher prevalence of PTSD symptomatology compared to another chronic headache condition (CTTH) and healthy subjects, which should be considered while treating CM patients. Further studies in larger populations are demanded.

Atypical Presentation of Zoster Mimicking Headache and Temporomandibular Disorder: A Case Report.

Herpes zoster in the prodromal stage may be mistaken for other diseases characterized by pain in the area of prodrome, such as dental pain. We report on a case of trigeminal herpes zoster, which presented as sudden onset headache and acute temporomandibular pain in the prodromal phase.

Efficacy of tacrolimus and clobetasol in the treatment of oral lichen planus: a systematic review and meta-analysis.

This study was carried out to assess and compare the efficacy of tacrolimus and clobetasol in the treatment of oral lichen planus (OLP). The Cochrane Central Register of Controlled Trials, PubMed, Scopus, Science Direct, Springer Journals, and Elsevier databases were searched using specific keywords relevant to the research question for articles published from 1998 to December 31, 2012. Finally, 15 articles that assessed the effects of tacrolimus, clobetasol, and pimecrolimus on improvements in OLP were reviewed. In addition, a meta-analysis of odds ratios (ORs) was carried out for data in 10 of the 15 articles. The results showed that the ORs for improvements in OLP in patients taking clobetasol or tacrolimus, compared with those taking placebo or other drugs, were 1.19 and 8.00, respectively. It appears that topical tacrolimus is an effective alternative to topical clobetasol and may be considered as a first-line therapy in the management of OLP.

Elastofibroma of the Face: A Case Report.

Elastofibroma is a rare neoplasm that characteristically occurs in subscapular area in response to microtrauma. There are some reports of this tumor in other sites of the body but, up till now, there has been no report of elastofibroma in the face. A 20-year-old man presented with a slow growing painless mass in the face without any history of trauma. Histopathologic examination revealed a soft tissue mass composed of eosinophilic fibers admixed with aggregation of fat cells, capillary blood vessels, and fibroblasts. Elastic stain and Masson's trichrome stain confirmed the nature of elastic and collagen fibers. It was a case of elastofibroma in the face.

Spinal cord injury in Parkour sport (free running): a rare case report.

A 24-year-old male was transferred to the emergency department while being in the state of quadriplegia with a history of performing Parkour sport, which is also called double front flip. Neurological examination revealed that the patient's muscle power was 0/5 at all extremities. The patient did not show any sense of light touch or pain in his extremities. In radiological studies, cervical spine X-ray and CT scan images showed C4-C5 subluxation with bilateral locked facets and spinal cord injury. The results of this very rare case study revealed that exercising Parkour sport without taking into account safety standards could result in irreversible injuries to the cervical spinal cord with fatal outcome.