The role of inflammatory mediators in the pathogenesis of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome.

INTRODUCTION: As a recurrent disease, periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is characterized by episodes of febrile attacks and is often prominent in children under five years of age. However, the etiology of this condition has not been fully understood yet. MATERIALS AND METHODS: The search in the extensive literature of peer-reviewed articles published from the inception to December 2021 was conducted to identify the relevant studies, using the electronic databases of MEDLINE/PubMed, Embase, Scopus, the Cochrane Library, and the Web of Science. RESULTS: The analysis of complex relationships indicates that inflammatory factors, such as various cytokines and acute-phase proteins (APPs), play leading roles in the pathogenesis of this disease. Accordingly, this article summarizes the current state of knowledge to explain the mechanisms involved in inflammatory responses among patients with PFAPA syndrome and investigate its role in the pathogenesis of this disease. Moreover, the possibilities for further implementation of new therapeutic strategies are pointed out. CONCLUSION: It is concluded that some pathophysiological processes are associated with immune dysregulation, which itself may be secondary to environmental factors, genetic background, and underlying diseases, including latent infections that multiply inflammatory mediators. elevated inflammatory markers similarly play a significant part in the clinical outcomes of this condition, whose pyrogenic nature is the reason for the development of episodes of febrile attacks in the population of patients suffering from PFAPA syndrome.

Analysis of factors affecting the implementation of green human resource management using a hybrid fuzzy AHP and type-2 fuzzy DEMATEL approach.

The topic of green human resource management has attracted considerable attention during this last decade. Despite this interest, little research has been conducted to explore the successful implementation of green human resource management to achieve environmental sustainability goals. Therefore, this study aims to identify the factors affecting the effective implementation of green human resource management in petrochemical companies in Bushehr City. This research is the first article that has evaluated green human resource management measures in petrochemical industries, and on the other hand, it can be stated that it is the first paper to perform green measures of human resource management using the combined method of fuzzy hierarchical analysis and type-2 fuzzy DEMATEL. The present study seeks to identify these factors and examine their relationships based on existing theoretical foundations and expert opinions. Based on results, factors affecting green human resource management implementation were divided into five categories: recruitment and employment, training and development, performance appraisal, service compensation and reward, and green organizational culture management. In other words, a total of five criteria and twenty green sub-criteria were identified for the implementation of green human resource management. Fuzzy AHP and type-2 fuzzy DEMATEL were applied to determine the weights of the criteria. The results showed that the process of green training and development is the most critical factor in the effective implementation of green human resource management. Also, training and development processes, service compensation, and green organizational culture management are affecting factors to achieve this critical issue. In order to implement green human resource management, this study has proposed the priority of green measures for petrochemical industry managers.

A dermatopathic Juvenile Dermatomyositis; An Unexpected Case in Childhood.

Juvenile dermatomyositis (JDM) is a rare idiopathic inflammatory disease, which usually presents with skin rashes along with muscle weakness. We report a case of JDM in a 10- year-old girl with no skin manifestations presenting with progressive muscle weakness and fatigue. Further laboratory investigations, along with a muscle biopsy, confirmed the diagnosis of adermatopathic JDM. The patient was treated with intravenous immunoglobulin, corticosteroids, methotrexate, hydroxychloroquine, pamidronate, and rituximab. Following treatment, patients' symptoms subsided, and she gained normal muscular strength over a year.

Another Limping Child: An Interesting Diagnosis Journey.

Limp is described as any deviation from a normal gait pattern for the child's age. Limping takes many forms and is one of the most enigmatic complaints in pediatric medicine. It is never normal, and both benign and life-threatening illnesses can present with limp. The provisional diagnosis can be a challenge to establish even after history, physical, and laboratory examinations.

The quality of life in boys with Duchenne muscular dystrophy.

We conducted a study to evaluate the quality of life in boys with Duchenne muscular dystrophy aged 8-18 years, compared with that in matched healthy controls. A total of 85 boys with Duchenne muscular dystrophy aged 8-18 years and 136 age, sex and living place matched healthy controls were included in this study. Patients and one of their parents separately completed the 27-item Persian version of KIDSCREEN questionnaire (child and adolescent version and parent version). From the children's perspective, the quality of life in patients was found to be lower in two subclasses: "physical activities and health" (p < 0.001) and "friends" (p = 0.005). Parental estimation of their sick child's quality of life was significantly lower than children's own assessment in two subclasses: "physical activities and health" (p < 0.001) and "general mood and feelings" (p < 0.001). Our results indicate that boys with Duchenne muscular dystrophy have quite a satisfactory quality of life. A happier and more hopeful life can be promoted through increasing social support and improving the parental knowledge regarding their child's more positive life perspective.