New nano-complexes targeting protein 3S7S in breast cancer and protein 4OO6 in liver cancer investigated in cell line.

Cancer, a lethal ailment, possesses a multitude of therapeutic alternatives to combat its presence, metal complexes have emerged as significant classes of medicinal compounds, exhibiting considerable biological efficacy, especially as anticancer agents. The utilization of cis-platin in the treatment of various cancer types, including breast cancer, has served as inspiration to devise novel nanostructured metal complexes for breast cancer therapy. Notably, homo- and hetero-octahedral bimetallic complexes of an innovative multifunctional ether ligand (comprising Mn(II), Ni(II), Cu(II), Zn(II), Hg(II), and Ag(I) ions) have been synthesized. To ascertain their structural characteristics, elemental and spectral analyses, encompassing IR, UV-Vis, 1H-NMR, mass and electron spin resonance (ESR) spectra, magnetic moments, molar conductance, thermal analysis, and electron microscopy, were employed. The molar conductance of these complexes in DMF demonstrated a non-electrolytic nature. Nanostructured forms of the complexes were identified through electron microscopic data. At ambient temperature, the ESR spectra of the solid complexes exhibited anisotropic and isotropic variants, indicative of covalent bonding. The ligand and several of its metal complexes were subjected to cytotoxicity testing against breast cancer protein 3S7S and liver cancer protein 4OO6, with the Ag(I) complex (7) evincing the most potent effect, followed by the Cu(II) with ligand (complex (2)), Cis-platin, the ligand itself, and the Cu(II)/Zn(II) complex (8). Molecular docking data unveiled the inhibitory order of several complexes.

Wound Fluid Extracellular Microvesicles: A Potential Innovative Biomarker for Wound Healing.

Background: Extracellular vesicles, or microvesicles, are a large family of membrane-bound fluid-filled sacs that cells release into the extracellular environment. Extracellular microvesicles (EMVs) are essential for cell-to-cell communications that promote wound healing. We hypothesize a correlation between the concentration of EMVs in wound fluid and the percentage of wound healing in treated chronic, nonhealing, wounds. A prospective, multicenter, randomized, single-blind clinical trial was conducted to evaluate EMV concentration in relation to wound healing percentages. Methods: Wound fluid samples were obtained from 16 patients with stage IV trunk pressure ulcers. Patients were divided equally into two groups: (1) control group on negative pressure wound therapy (NPWT) alone and (2) study group with NPWT plus porcine extracellular matrix dressing. NPWT was replaced two times a week, and porcine extracellular matrix applied once weekly for all subjects. An NPWT canister device, called a wound vacuum-assisted closure, containing wound fluid was collected from each patient every 4 weeks. EMVs were isolated and the concentration measured by nanoparticle tracking analysis. Results: The study group's total healing percentage was around 89% after 12 weeks compared with the control group's percentage of about 52% (P ≤ 0.05). Using R programming software, simple linear regression was carried out to investigate the hypothesis. Data demonstrated significant positive correlation (R2 = 0.70; P = 0.05) between EMV concentrations and the healing percentage. Conclusions: There is a positive correlation between EMV concentration and wound healing percentages. Results propose that the EMVs in wound fluid could serve as a biomarker for healing.

Absent Meckel's cave as a possible cause of trigeminal neuralgia: A case report.

Trigeminal neuralgia (TN) is a debilitating yet potentially treatable facial pain disorder.TN is difficult to miss clinically, as patients' clinical presentation is often strikingly stereotypical: unilateral, paroxysmal, stimulus-dependent pain involving the trigeminal territory. Magnetic resonance imaging (MRI), which is used for further evaluation of an underlying etiology of TN, most commonly shows neurovascular compression of the trigeminal nerve to be the culprit. Secondary etiologies, though less common, do exist. An absent Meckel's cave with ipsilateral TN was reported in a few case reports and series, and whether an etiological relationship exists is yet to be established. We herein present a case of a 22-year-old female patient who presented with typical TN clinical manifestations. MRI was ordered to assess for the underlying cause and an ipsilateral absent Meckel's cave was the only significant finding. This case report adds to the scarcity of literature highlighting this entity, further larger clinical studies are needed to establish a causal relationship.

Use of traditional and complementary medicine for COVID 19 prophylaxis among healthcare professionals and students in Jordan: A cross-sectional study.

INTRODUCTION: There is inadequate evidence to recommend the use of any traditional and complementary medicine (T&CM) methods such as vitamin, mineral, herbal or other dietary supplements to prevent or treat COVID 19. Members of the medical team are particularly at risk of exposure to high viral load of coronavirus. They have also the best access to professional information regarding disease treatment and prophylaxis and disseminate such knowledge. The aim of the study was to assess the prevalence of use of T&CM for the prophylaxis of COVID 19 among the healthcare professionals and students in Jordan, along with the most common types and the factors associated with T&CM use. METHODOLOGY: A cross-sectional study of T&CM use was conducted in Jordan using a snowball sampling method to distribute Google Forms and to enrol participants during coronavirus outbreak between June 10, 2021, and August 28, 2021. The study included healthcare professionals or students who consented to participate in the survey. The survey excluded those participants who had filled the questionnaire at least once or were pregnant/breast-feeding at the time of the study. The questionnaire consisted of 29 items, including screening, checkbox, dichotomous, matrix and open-ended questions. RESULTS: The response rate was 97.1%. Out of 560 study respondents, 359 (64.1%) reported using T&CM for COVID 19 prevention. Vitamins and nutrients were consumed by almost half (48.4%) of study participants, while nonpharmacological methods and herbal remedies were consumed by 35.2% and 25.2%, respectively. The most common source of information regarding T&CM use for COVID 19 prophylaxis included scientific publications (59.5%), followed by disease treatment guidelines (38.0%) and social media (32.3%). Adverse effects were reported by 8.5% and possible adverse effects were reported by another 8.5% of participants. The T&CM use was associated with working in contact with COVID 19 patients (OR: 1.625 (95% CI 1.047-2.523) (P = 0.03) and having a colleague as a source of information (OR: 1.720 (95% CI 1.026-2.883) (P = 0.04). CONCLUSIONS: The prevalence of T&CM use for COVID 19 prevention among healthcare professionals and students in Jordan is high, with a significant proportion of participants reporting adverse effects. There is an urgent need for further research toward efficacy and safety of T&CM in COVID 19 prophylaxis as well as development of appropriate public health policy on this issue specific to each country.

Joubert-Plus syndrome with an atretic cephalocele: a case report.

Joubert syndrome is a rare heterogeneous disease affecting the cerebellum. It usually presents with hypotonia, abnormal breathing pattern, with distinctive cerebellar and brain stem malformation called the molar tooth sign. It may present with different organ involvement or with other neurological alterations such as Dandy-Walker syndrome. Joubert syndrome with dandy walker syndrome is called Joubert-Plus syndrome, an exceedingly rare entity. Dandy-Walker syndrome is defined by hypoplasia and upward rotation of the cerebellar vermis and cystic dilation of the fourth ventricle. Atretic cephalocele is another rare diagnosis which is characterized by a herniation of intracranial contents through a skull defect. Herein, we present a case of a 6-month-old patient who presented with floppiness and a scalp nodule. After further evaluation, he was diagnosed with Joubert-Plus syndrome with an atretic cephalocele.

Adult Presentation of Joubert Syndrome Presenting With Dysphagia: A Case Report.

Joubert syndrome (JS) is a rare autosomal recessive disease affecting the cilium, an intracellular organelle. It has a wide spectrum of presentations with the involvement of multiple genes. JS has multiple subtypes that are either pure JS or JS with other organ involvement such as the kidneys, liver, and others. However, all subtypes share the involvement of the cerebellar peduncles and the brainstem, which presents as "a molar tooth sign" on magnetic resonance imaging, hypotonia, and intellectual disability. It has a higher prevalence among children with few able to survive to adulthood. Unfortunately, survivors live with debilitating comorbidities. Here, we present the case of a 20-year-old patient who presented with a new onset of dysphagia that led to a diagnosis of JS.

The Effect of Psychotropic Medications and Their Combinations on the QTc Interval Among Jordanian Outpatients: A Cross-Sectional Study.

Objective: To investigate the effect of psychotropic drugs and their combinations on the QTc interval as well as the prevalence of long QTc (LQTc) among ambulatory patients with psychiatric illness in Jordan. Methods: A cross-sectional study that included patients treated in an outpatient psychiatric clinic was conducted. The QTc duration was calculated using a combined QT correction (Bazett's formula for heart rate 60-100 and the Framingham formula for extremes of HR). Results: Among 307 patients, about 60% received multiple psychotropic drugs. The LQTc frequency was 1.2%. QTc interval prolongation was observed in patients receiving selective serotonin reuptake inhibitors (SSRIs) (P = .011), tricyclic antidepressants (TCAs) (P = .033), citalopram (P = .044), or psychotropic polytherapy (P = .005). The addition of SSRIs to second-generation antipsychotics (SGAs) also lengthened the QTc interval (P = .029). There was a correlation between the number of psychotropic medications and the QTc length (P = .018). All patients with LQTc carried at least one risk factor for it other than the use of psychotropic medication(s), 3 of 4 patients had a combination therapy, all patients were prescribed SSRIs, and 2 of them had comorbid conditions. Conclusion: There is a high prevalence of psychotropic drugs polytherapy, and it is clearly associated with LQTc. Citalopram, SSRIs, and TCAs prolong QTc interval. It is recommended to assess non-pharmacological factors for LQTc and, if necessary, to obtain an electrocardiogram before starting patients on psychotropic drugs known to prolong the QTc interval.

Modeling climatic effect on physiochemical parameters and microorganisms of Stabilization Pond Performance.

The present study was carried out to evaluate the relationship between physiochemical parameters, microorganisms, wastewater and climate in Stabilization Pond Performance. This study performed as a post-treatment after the secondary wastewater treatment using extended aeration in Rashid city, Egypt. The model of the extended aeration as secondary wastewater treatment was developed based on the combination with lagoon after the secondary sedimentation basin. The Climatic functions have an important impact on the mechanism of ponds as it actuates vertical mixing of the pond contents. The interaction between bacteria, algae and other organisms are the main idea of oxidation pond treatment beside the relationship between the climatic functions, physiochemical parameters and microorganisms biomass. The removal of biodegradable organic loads specially nitrogen and phosphorous are perfectly happens in oxidation maturation ponds which reflects a higher treatment efficiency of the sewage by 98%-99% of Biological Oxygen Demand (BOD), Chemical Oxygen Demand (COD) and heavy metals. The study included some recommendations aiming at improving both water quality and its recycling in plants irrigation.

Use of a Natural Porcine Extracellular Matrix With Negative Pressure Wound Therapy Hastens the Healing Rate in Stage 4 Pressure Ulcers.

INTRODUCTION: Chronic wounds are physically debilitating and painful and are responsible for the addition of more than $25 billion annually in health care costs in the United States. Extracellular matrix (ECM) replacements have been demonstrated to aid in wound healing by providing an optimal environment to facilitate the healing process. OBJECTIVE: This study examines the healing rates of stage 4 pressure ulcers using combination of a commercially available porcine-based wound matrix dressing alongside negative pressure wound therapy (NPWT) versus using NPWT alone. MATERIALS AND METHODS: Patients were randomized to receive either the matrix plus NPWT (study) or NPWT alone (control) for stage 4 sacral pressure ulcer treatment. Wounds were photographed and measured weekly. The experimental group had their ECM dressings changed every other week and their NPWT changed twice weekly. RESULTS: A total of 16 patients, 8 study and 8 control, completed this study. After the 12-week study period, the average control patient healing rate was 45.79% as compared with the 89.98% healing rate in the study group. The difference in healing rate between control and study patients was optimal by 12 weeks. CONCLUSIONS: These studies suggest that ECM dressings may be a promising adjunctive treatment option for stage 4 pressure ulcers.

Use of Hyaluronic Acid-Based Biological Bilaminar Matrix in Wound Bed Preparation: A Case Series.

Objective: Hyalomatrix, a matrix that consists of esterified hyaluronic acid, covered with a removable, semipermeable silicone top layer, was used to generate granulation tissue in a series of 12 serious, surgical wounds of different etiologies. Methods: Many defects showed exposed muscle, tendons, and/or bone. After thorough debridement, the matrix was applied, in a number of cases, combined with negative pressure wound therapy. Results: All wounds developed granulation tissue in and on top of the matrix. Nine wounds were then closed with a split skin autograft. There was no graft failure, and all wounds showed complete reepithelialization. Three wounds healed by secondary intention and also reached complete healing. Conclusion: This case series shows a strong trend for Hyalomatrix to play an important role in supporting wound healing in complex, surgical wounds.

Use of Hyaluronic Acid-Based Biological Bilaminar Matrix in Wound Bed Preparation: A Case Series.

Objectives: To analyze the efficacy of a hyaluronic acid--based matrix in the treatment of lesions where the extracellular matrix was lost. Methods: Prospective, noncomparative clinical case series. Results: Twelve patients with 12 serious surgical wounds of different etiologies participated in this project. Many defects showed exposed muscle, tendons, and/or bone. After thorough debridement, a hyaluronic acid--based matrix, with a removable, semipermeable silicone top layer, was applied for the purpose of generating a neodermis. In a number of cases, the matrix was combined with negative pressure wound therapy. All wounds developed granulation tissue. Nine wounds were subsequently closed with a split-skin autograft. There was no graft failure. Three wounds healed by secondary intention. All wounds showed complete reepithelialization. Discussion: Lesions with exposed tendon and bone are difficult to heal. Providing a granulation tissue through the use of an extracellular matrix in which cellular repopulation leads to the development of granulation tissue has been shown to be beneficial with regard to the speed and quality of healing. In this case series, the use of a hyaluronic acid--based matrix was shown to provide a granulation tissue and all lesions healed completely. Conclusion: This case series shows a strong trend for Hyalomatrix to play an important role in supporting wound healing in complex, surgical wounds.

An Unusual Presentation of Deep Tissue Injury, Do We Really Understand It? A Case Report and Literature Review

Deep tissue injury (DTI) is an injury to the soft tissue under the skin due to pressure and is usually over boney prominence. This injury is commonly seen in bedridden patients in hospitals and nursing homes. Although many efforts were made to elucidate the precise mechanism and clinical presentation, the pathogenesis and the final clinical outcome are yet to be determined. Although the current agreed upon presentation describes DTI as purple- or maroon-colored skin with ulceration, presented herein is an unusual case where DTI presented with only erythema and induration over the sacrum and right gluteal area.

Novel Insights on Understanding of Keloid Scar: Article Review.

Keloid scar, dermal benign fibro-proliferative growth that extends outside the original wound and invades adjacent dermal tissue due to extensive production of extracellular matrix, especially collagen, which caused by over expression of cytokines and growth factors. Although many attempts were made to understand the exact pathophysiology and the molecular abnormalities, the pathogenesis of keloid scar is yet to be determined. Even though there are several treatment options for keloid scars include combination of medical and surgical therapies like combination of surgical removal followed by cryotherapy or intralesional steroid therapy, the reoccurrence rate is still high despite the present treatment. In this review, PubMed, clinical key and Wright State Library web site have been used to investigate any update regarding Keloid disease. We used Keloid, scar formation, hypertrophic scar and collagen as key words. More than 40 articles have been reviewed. This paper reviews literature about keloid scar formation mechanism, the most recent therapeutic options including the ones under research.