The potential of probiotics for treating acne vulgaris: A review of literature on acne and microbiota.

Acne is known as a chronic inflammatory skin disease with sever adverse effects on quality of life in the patients. The increasing resistance to antibiotics has decreased their effectiveness in treating acne. As viable microbial dietary supplements, probiotics provide health benefits through fighting pathogens and maintaining the homeostasis of the gut and skin microbiome. The present article reviewed the potential of probiotics as beneficial microorganisms for treating acne vulgaris. This review of literature was conducted through a bibliographic search of popular databases, including Science Direct, PubMed, Scielo and Medline, using keywords such as probiotics, prebiotics, synbiotics, microbiome, and acne vulgaris to determine potential applications of these beneficial microbiomes in treating acne vulgaris. Acne lesions are associated with increases in proportion of Propionibacterium acnes as a skin commensal bacterium. The environmental studies showed inhibitory effects of probiotics on P. acnes, mediating by antibacterial proteins and bacteriocin-like inhibitory substances, and their immunomodulatory effects onkeratinocytes and epithelial cells. Probiotics were also found to inhibit cytokine IL-8 in epithelial cells and keratinocytes, suggesting immunomodulatory activities. Moreover, glycerol fermentation by Staphylococcus epidermidis was found to be a natural skin defense against acne and an overgrowth inhibitor of P. acnes. As an antimicrobial agent in lotions and cosmetic formulations, Lactococcus sp. can decrease the inflammatory mediators that are produced by P. acnes and cause vasodilation, edema, mast cell degranulation and TNF-alpha release. Oral administration of probiotics was found to constitute an adjuvant therapy to conventional modalities for treating mild-to-moderate acne vulgaris.

Geriatric challenges in the new coronavirus disease-19 (COVID-19) pandemic: A systematic review.

Background: During the COVID-19 pandemic, elderly individuals (with the chronological age of 65 years and above) are more susceptible to the SARS-CoV-2 infection complications due to altered immune system response and the higher rate of underlying comorbidities. A vast majority of mortalities are reported in elderly patients; thus, this study aimed to evaluate complications of COVID-19 in elderly patients. Methods: A systematic review was conducted according to MOOSE guidelines. Science Direct, Google Scholar, Scopus, PubMed databases were searched for published articles related to COVID-19 in the elderly up to March 26, 2020. Search MeSh terms included "Severe acute respiratory syndrome coronavirus 2", "2019-nCoV", "SARS-CoV-2", "comorbidity", "elderly", and "geriatrics". Results: In total 1360 potentially relevant articles were screened, of which 35 were relevant and their full texts were considered for the review. Organ damages to the pulmonary system, cardiovascular, liver, and renal system are more prevalent in the elderly with SARS-CoV-2 infection. As the chance of multiorgan involvement is more common among elderly patients, preventive, multidisciplinary, and holistic evaluations are essential to reduce disease consequences. Conclusion: More attention needs to be paid to elderly individuals in the quarantine. Social contact should be made and maintained through online facilities, media, and phone calls to ensure patients' mental health during this stressful situation. Also, they should be provided with enough food and medications by their families or friends. Also, providing social and volunteer services might play an important role in the mental health of those patients who have no social network.

Repeated transsphenoidal surgery or gamma knife radiosurgery in recurrent cushing disease after transsphenoidal surgery.

BACKGROUND: This study compared Gamma knife radiosurgery (GKRS) and repeated transsphenoidal adenomectomy (TSA) to find the best approach for recurrence of Cushing disease (CD) after unsuccessful first TSA. MATERIAL AND METHODS: Fifty-two patients with relapse of CD after TSA were enrolled and randomly underwent a second surgery or GKRS as the next therapeutic approach. They were followed for a mean period of 3.05 ± 0.8 years by physical examination and hormone measurement as well as magnetic resonance imaging. RESULTS: No significant difference was observed in sex ratio, mean age, adenoma type, follow-up duration, and initial hormone level between the two groups. No significant relationship was found between preoperative 24-hour free urine cortisol and disease-free months or tumor volume among both groups. Our statistical analysis showed higher recurrence-free interval in the GKRS group compared with TSA group. CONCLUSION: With longer recurrence-free interval, GKRS could be considered a good treatment alternative to repeated TSA in recurrent CD.

Restless legs syndrome in Iranian patients with multiple sclerosis.

Restless legs syndrome (RLS) is a common neurological movement disorder that is often seen in multiple sclerosis patients. However, the association between RLS and multiple sclerosis (MS) is still unclear and RLS is not considered as one of the MS symptoms. This study was conducted to assess the frequency of RLS and its associated factors in patients with MS. This was a cross-sectional study conducted during January and April 2010. A total of 205 patients diagnosed with multiple sclerosis (164 females, 41 males, mean age 32.8 ± 8.9 years) were enrolled in the study and underwent a medical history interview and a neurological examination. The diagnosis of RLS was based on International Restless Legs Syndrome Study Group Criteria. 57 patients (27.8%) met the RLS diagnostic criteria. In 90.1% of the patients, the onset of RLS was simultaneous with or followed by MS onset. There was no significant difference between patients with and without RLS in respect of age, gender, disease duration, and MS pattern. There was an increased incidence of leg jerks before sleep in patients with RLS (P = 0.04). In patients suffering from RLS, there is greater complaint of insomnia (P = 0.03). Body mass index, history of anemia, excessive day-time somnolence, consuming caffeine-containing beverages, pregnancy numbers, smoking, and alcohol consumption were not associated with the presence of RLS. This study revealed high prevalence of RLS in MS patients. Screening of RLS in these patients should always be considered to improve management of MS.

Corpus callosotomy with gamma knife radiosurgery for a case of intractable generalised epilepsy.

Gamma knife radiosurgery is a minimally invasive procedure which can be used for patients with intractable epilepsies as an alternative for surgical corpus callosotomy. We report a 13-year-old boy with intractable epilepsy who underwent radiosurgical callosotomy. The patient demonstrated significant clinical improvement after gamma knife radiosurgery and was free of seizures 10 months after the procedure. However, He developed four short focal seizures with clonic movements during the 20 months post radiosurgery. Corpus callosotomy decreased epileptiform discharges in both hemispheres, indicating a role for the callosal neurons to facilitate an asymmetric epileptogenic susceptible state within the two hemispheres such that bisynchronous and bisymmetrical epileptiform discharges develop. Our result demonstrates that this novel therapeutic approach is a safe and effective option for the treatment of intractable generalised epilepsies.

Ileal intussusception secondary to both lipoma and angiolipoma: a case report.

Lipoma and angiolipoma are common benign neoplasms that occur in the subcutaneous tissue and rarely in the gastrointestinal tract. These tumors are usually asymptomatic but may present with abdominal pain, bleeding and obstruction. We present a 53-years-old woman with abdominal discomfort for several weeks accompanied with bloody diarrhea and recurrent vomiting. Ileo-ileal invagination was diagnosed by computed tomography scan. Laparotomy revealed five intraluminal masses that caused intussusception. Histopathological study showed that one was angiolipoma and other lesions were lipoma. We have described some aspects of diagnosis and treatment of this rare cause of intestinal intussusception.