Ferulic acid grafted into ß-cyclodextrin nanosponges ameliorates Paraquat-induced human MRC-5 fibroblast injury.

Paraquat (PQ) is a commercially important and effective herbicide in the world. Nevertheless, it has higher toxicity causing acute organ damage and different complications, mainly in the lungs and kidneys. Ferulic acid (FA), 4-hydroxy-3-methoxycinnamic acid imposes multiple pharmacological impacts. No protective effect of FA on PQ poisoning-caused human embryonic lung fibroblast damage has not been reported. Despite their many beneficial effects, FA is characterized by poor water solubility, low bioavailability, and phytochemical instability. To solve the problem, ß-cyclodextrin nanosponge (ß-CD NSs) was utilized to increase the solubility of FA so that it was grafted into ß-CD NSs to establish ß-CD@FA NSs. The purpose of this work was to examine for the first time the protective effect of ß-CD@FA NS on MRC-5 human lung cells damages induced by PQ poisoning. MTS assay was performed to investigate the viability of MRC-5 cells at different concentrations of FA/ß-CD@FA NSs when cells were co-cultured with 0.2 µg/mL PQ. The flow cytometry study was carried out to determine apoptosis. Malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) levels were detected using appropriate biochemistry kits. Compared with the PQ group, the cell activity, CAT, and SOD levels were significantly increased in the FA and chiefly in ß-CD@FA NSs intervention groups, whereas apoptosis and MDA levels were markedly decreased. The inflammatory factors tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), and interleukin 22 (IL-22) were detected. The results demonstrate that ß-CD@FA NSs can inhibit PQ-induced cell damage by enhancing antioxidant stress capacity and regulation of inflammatory responses.

Safety and Tolerability of Combining CGRP Monoclonal Antibodies with Gepants in Patients with Migraine: A Retrospective Study.

INTRODUCTION: The introduction of clacitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) has revolutionized the treatment of migraines. In clinical practice gepants might be considered as a valid option to treat acute attacks in patients with migraine who are treated with mAbs. However, the safety and tolerability of such a combination is not well addressed in the real-world setting. We designed this study to evaluate the safety and tolerability of combining CGRP mAbs with gepants in the management of migraines. METHODS: This was a retrospective, real-world, exploratory study. The participants included within the study were adult (≥ 18 years) patients diagnosed with migraine. Screening for patients who were treated with at least one GCRP mAbs was done. Data was collected from one site, the American Center for Psychiatry and Neurology, Abu Dhabi UAE. A total of 516 patients taking CGRP mAbs were identified. Extracted data from patients' electronic medical records included patient demographics, migraine characteristics, prescribed treatments, and adverse events (AEs). The tolerability and safety of the combination therapy was evaluated on the basis of documented AEs. RESULTS: Among the identified 516 patients, 234 were administered gepants in addition to the CRGP mAb (215, rimegepant; 19, ubrogepant). Eleven of the 234 patients switched from rimegepant to urogepant as a result of lack of efficacy; one patient switched from urogepant to zolmitriptan because of the lack of insurance coverage of the former medication. Among all the patients included in this study, three AEs were documented. These AEs were generally mild and transient and hence did not lead to discontinuation of treatment. Moreover, 42 of the 234 (17.9%) patients were switched from one class of CGRP mAbs to another at least once while continuing treatment with the assigned gepants. CONCLUSION: The findings of this study demonstrate that combining CGRP mAbs with gepants is a safe and well-tolerated treatment approach for migraine. Future studies are warranted to further validate these findings and explore long-term outcomes.

Rare fatal poisoning through dermal exposure to paraquat.

Paraquat skin contact occurs less frequently and is rarely fatal. This article reports a case of a 45-year-old man who presented with dysphagia, respiratory distress and grade two, and third skin burns focusing on the upper body after accidental exposure to paraquat. He was admitted to the hospital 6 days after the first contact. The urine sodium dithionate test was strongly positive. The O2 saturation at admission was 52%, which reached 91% with a bag valve mask. Rising blood liver enzymes, urea, creatinine, and respiratory acidosis in the venous blood gas analysis were observed in the lab data. In the course of hospitalization, the patient was intubated due to oxygen level dropping. Evidence of acute respiratory distress syndrome and decreased level of consciousness was also observed. However, despite treatment with corticosteroids, antioxidants, and hemodialysis, he died on the fourth day of hospitalization. It is concluded that dermal exposure with paraquat could be life-threatening if the patient presented late with organ involvement.

Comparing laparoscopy and laparotomy procedures in the radical hysterectomy surgery for endometrial cancer: a basic review.

Gynecological cancers especially endometrial cancer have put a huge burden on health care systems in different societies. In this regard, different studies have evaluated screening, diagnosis and treatments of endometrial cancer. Different survival rates, prognosis and recurrence rates have been reported by variable treatment methods. Laparotomy and laparoscopic radical hysterectomy (RH and LRH) are nowadays two most common surgical methods for endometrial cancer. In this systematic review, we investigated all article comparing two treatment techniques regarding RH and LRH in women with endometrial cancer who were classified as International Federation of Gynecology and Obstetrics (FIGO) stage I to III. Data regarding to blood loss and transfusion rate, operative time, duration of hospital stay, complications as intraoperative and postoperative, mean nodules counts, recurrent rate, adjuvant therapy were collected and analyzed. After reviewing five cohort studies, we indicated that laparoscopic procedures were better than laparotomy for managing endometrial cancer because the duration of hospitalization, blood loss and intraoperative and postoperative complications in laparoscopy procedure were lower than laparotomy procedures.

Platelet-rich plasma or extracorporeal shockwave therapy for plantar fasciitis.

BACKGROUND: Plantar fasciitis is a common cause of plantar pain which is prevalent among adults. Conservative tractions, invasive injections, shock therapies and also surgical procedures are known as beneficial methods in non-responsive cases. Here we evaluated and compared the injection of platelet rich plasma (PRP) and usage of extracorporeal shockwave therapy (ESWT) in pain reduction in patients with chronic plantar fasciitis. METHODS: This is a randomized clinical trial that was performed in 2017-2020 on patients with chronic plantar fasciitis who did not respond to conservative therapies. A total number of 110 patients with plantar fasciitis were entered based on inclusion and exclusion criteria. Patients were then divided into two groups. The pain of patients was measured using visual analogue scale (VAS) before interventions. The first group underwent PRP injections while the second group underwent ESWT using Shock Master 500. Patients were visited 2, 4, 8, 12, 16, and 24 weeks after interventions and the pain scores were noted using VAS. RESULTS: Data of 104 patients were analyzed. Initial VAS scores of patients were also analyzed. These data indicated no significant differences between the pains of patients before interventions (P = 0.413). Pain evaluations in 2, 4, 8, 12, 16, and 24 weeks after interventions with controlling age and sex showed significantly reduced VAS scores in both groups after interventions (P = 0.002). We should also note that pain in the PRP group reduced more than ESWT group and this difference was also significant (P = 0.001). CONCLUSION: Here we showed that PRP injections and ESWT are both beneficial in pain amelioration in patients with chronic plantar fasciitis. We also indicated that PRP injections were associated with better pain reduction results compared to ESWT.