Spinal Epidural Abscess Caused by Campylobacter jejuni Without Gastrointestinal Symptoms.

Campylobacter jejuni (C. jejuni) is a gram-negative bacterium known to cause gastroenteritis with fever, abdominal pain, and bloody diarrhea. Although Campylobacter bacteremia is reported in patients with gastroenteritis, localized abscess formation, particularly spinal epidural abscess (SEA), is extremely rare and can easily be missed. Herein, we report a case of a 54-year-old immunocompromised female presenting with severe back pain without gastrointestinal symptoms, who was ultimately diagnosed with an L5/S1 SEA due to C.jejuni, requiring laminectomy and drainage. As far as we know, this is the second reported case of SEA due to C. jejuni without any preceding gastrointestinal symptoms. This case highlights the critical importance of performing a contrasted MRI for the early and accurate diagnosis of SEA.

Prevalence of spine pain among Tunisian children and adolescents and related factors.

BACKGROUND: The prevalence of back and neck pain is common in children and adolescents, and in some series the numbers are alarming. Various risk factors have been identified, although some are controversial. OBJECTIVE: To determine the prevalence of neck and back pain in children and adolescents and to investigate the potential association with various risk factors identified in the literature. METHODS: We established a questionnaire targeting parents of children and adolescents aged between 6 and 18 years old in Tunisia. The recruitment of participants was done online using the Google Forms application. The questionnaire was divided into 2 parts: Part one collected the sociodemographics characteristics of the participants : age, gender, body mass index (BMI), exposure to passive smoking, the practice of a physical activity, puberty status and age at puberty if applicable, type and weight of the schoolbag, mean daily time spent on electronic devices, type of school the child attends (private/public), mode of transport from home to school, parental history of neck and/or back pain (mid or low back pain (LBP)), posture of the sitting position of the child, and finally whether the child reports neck/ back pain. The second part was aimed at parents whose child reported neck and/or back pain. We asked about the weekly frequency of neck/back pain, school absenteeism due to neck/back pain, whether it prevented the child from practicing physical activity and, finally, whether the child had ever seen a doctor/chiropractor/physiotherapist for their neck/back pain. RESULTS: Eighty-eight children (45 females, 43 males) were enrolled. Mean age was 11.9 ± 3.8 years [6-18]. Mean BMI was 18.8 ± 4.2 [15.8-35.5]. Thirty-four (38.6%) were pubescent. Twenty-five (28.4%) children were exposed to passive smoking. Parental history of spine pain was found in 58% of cases. A poor sitting position was noted in n = 49 (55.7%). Mean daily screen time was 88.3 ± 75.56 min [0-360]. Prevalence of spine pain was 44% (n = 39) distributed as follows: neck pain (n = 21, 23.8%), mid back pain (n = 15, 17%), LBP (n = 26, 29.5%), neck, mid back and low back pain (n = 4, 4.5%) Professional help seeking for spine pain in children was reported by 15 participants (25.3%). Among them, 20.3% visited a physician and 5% consulted a chiropractor or physiotherapist. A significant correlation was found between spine pain and age (p = 0.006) and BMI (p = 0.006). A significant association was found between LBP and exposure to passive smoking, puberty status, type of school bag and poor posture. A positive parental history of spine pain was significantly associated with the presence of spine pain in their children with p = 0.053 (neck pain), p = 0.013 (back pain) and p < 0.00 (LBP) respectively. A significant association was found between the presence of spine pain and school absenteeism, participation in sports, consultation with a doctor or physiotherapist/chiropractor (p < 0.0001 respectively). CONCLUSION: The prevalence of spinal pain was frequent in our series. A positive parental history of spinal pain, a bad posture while sitting, passive smoking, use of backpack, higher age and higher BMI were potential associated factors.

CellKine clinical trial: first report from a phase 1 trial of allogeneic bone marrow-derived mesenchymal stem cells in subjects with painful lumbar facet joint arthropathy.

Background: Lumbar facet joint arthropathy (LFJA) is a major cause of low back pain (LBP), with current treatments offering limited long-term benefits. Bone marrow-derived mesenchymal stem cells (BM-MSCs) show promise due to their immunomodulatory and trophic effects, potentially addressing underlying degenerative processes in LFJA. Objectives: This initial report describes the outcomes of the first treated patient in an ongoing mutidisciplinary phase 1 clinical trial evaluating the safety and feasibility of intra-articular allogeneic BM-MSCs for painful LFJA. Methods: Following enrollment in our IRB-approved protocol, symptomatic LFJA was confirmed through double blocks on L4 and L5 medial branches. Two 1-mL syringes, each containing 10 million BM-MSCs, were prepared in the cGMP facility and administered bilaterally to the patient's L4-L5 lumbar facet joints. The patient underwent standardized follow-ups, including clinical examinations and functional and imaging assessments for 2 years, utilizing patient-reported outcomes measurement information system-computer adaptive tests (PROMIS CATs), visual analogue scale, Oswestry disability index, work functional status and opioid pain medication use, and MR imaging Fenton-Czervionke score. Results: The patient tolerated the procedure well, with no drug-related adverse events during the study period. Pain, spine function, and work functional status improved at multiple follow-ups. This patient also reported improvements in mental and social health, along with a notable improvement in the grade of facet synovitis observed at the one-year follow-up MRI evaluation. Conclusions: This case report suggests the safety and feasibility of administering intra-articular allogeneic BM-MSCs, offering therapeutic benefits for pain management and functional activities.

Clinical values of oblique lumbar interbody fusion on the treatment of single-level degenerative lumbar diseases.

Objectives: Minimally invasive transforaminal lumbar interbody fusion (Mis-TLIF) and oblique lumbar interbody fusion (OLIF) are increasingly replacing traditional approaches. This study aimed to compare the clinical outcomes of OLIF and Mis-TLIF in treating single-level degenerative lumbar diseases. Methods: Patients with single-level degenerative lumbar diseases underwent either OLIF (30 patients) or Mis-TLIF (30 patients). Surgical data, including operation time, blood loss, postoperative drainage, and postoperative bed rest duration, were collected. Clinical outcomes were assessed using the Oswestry disability index, the visual analog scale scores for low back pain and leg pain, and Japanese Orthopaedic Association scores for daily ability, along with monitoring of complications. Results: The OLIF group showed significantly shorter operative times, less blood loss, reduced postoperative drainage, and shorter bed rest durations than the Mis-TLIF group. At the 1-month follow-up, OLIF patients also demonstrated significantly better clinical outcome scores than Mis-TLIF patients. No significant differences were observed between OLIF and Mis-TLIF patients before surgery and after 3 months. Furthermore, lumbar lordosis and disc height were significantly greater in the OLIF group at the final follow-up. Conclusions: Both OLIF and Mis-TLIF achieved satisfactory and effective long-term clinical outcomes for single-level lumbar degenerative diseases. However, OLIF resulted in less tissue damage, reduced bleeding, better short-term clinical outcomes, and improved recovery of segmental lordosis compared to Mis-TLIF. Therefore, OLIF appears to be the preferable option over Mis-TLIF.

Effect and mechanism of Lycium barbarum polysaccharide on gastrointestinal motility in slow transit constipation.

Slow transit constipation (STC) seriously affects the physical and mental health of patients. While the active ingredients of traditional Chinese medicine (TCM) are widely used in the treatment of STC due to their low toxicity and side effects, the aim of this study was to investigate the effect of Lycium barbarum polysaccharide (LBP) on STC. The STC mouse model was induced by the compound diphenoxylate. Defecation, fecal moisture, and weight loss of the STC models were monitored. Gastrointestinal (GI) motility was assessed by intestinal propulsive rate, and enzyme-linked immunosorbent assay (ELISA) kits were used to analyze the levels of substance P (SP) and vasoactive intestinal peptide (VIP). The expression levels of inflammatory cytokines (Tnf-α, Il-6, and Il-1ß), stem cell factor receptor (C-kit), stem cell factor (Scf), Bcl-2, Bax, and Caspase-3 were evaluated by qRT-PCR. The defecation, fecal moisture, and body weight of mice with STC were significantly improved by LBP, and LBP increased the intestinal propulsive rate of STC, increased the secretion of SP, and decreased the secretion of VIP. The intervention of LBP further suppressed the expression levels of Tnf-α, Il-6, and Il-1ß in STC. LBP promoted the expression of the C-kit, Scf, and Bcl-2 and inhibited the expression of Bax and Caspase-3. LBP may alleviate symptoms of slow transit constipation (STC) and enhance gastrointestinal motility by modulating gastrointestinal hormone levels, promoting proliferation, and inhibiting the apoptosis of interstitial cells of Cajal (ICCs).

Mechanistic insights into the interaction of Lycium barbarum polysaccharide with whey protein isolate: Functional and structural characterization.

Protein-polysaccharide interactions are crucial for food system structure and stability. This study investigates the interaction of Lycium barbarum polysaccharide (LBP) at 0-2.00 % concentrations with whey protein isolate (WPI), focusing on functionality and structural changes. LBP covalently grafted onto WPI, as confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), forming WPI-LBP complexes with a maximum degree of grafting (DG) of 44.58 % at 2.00 % LBP. This grafting reduced WPI's surface hydrophobicity (H0) and improved solubility, emulsifying properties, and digestibility under certain conditions, with optimal antioxidant activity at 1.00 % LBP. Multispectral analysis and microscopy showed LBP grafting alters WPI's secondary, tertiary, crystalline, and micro/nanostructures. The comprehensive analysis indicates that the interaction between LBP and WPI involves covalent bonding, hydrogen bonding, hydrophobic interactions, and electrostatic forces, as supported by zeta potential and chemical forces results. These findings suggest LBP-protein complexes as promising food materials for enhancing functionality and stability in the food industry.

A Randomized Controlled Trial of Active Stretching of the Hamstrings and Core Control for Low Back Pain and Musculoskeletal Discomfort during Prolonged Sitting among Young People.

Introduction: Stretching exercises are important in both the prevention and treatment of nonspecific low back pain (NLBP). The aim of this trial was to determine whether an 8-week active hamstring stretching protocol combined with core stabilization and education regarding the maintenance of a neutral lumbar spine during activities could reduce NLBP and low back discomfort during prolonged sitting among young people. Methods: Participants (52 students aged 18-25) were randomly assigned to one of two groups: the Experimental group (the hamstring stretching group) and the Control group (only education). The intervention was conducted for 8 weeks. The primary outcome measures were pain intensity (VAS), low back discomfort (LBD), and functional disability (ODI). The secondary outcome measures were satisfaction with the intervention (GPE) and flexibility of the hamstring (SLR). Results: After the 8-week intervention in the E-group, results of VAS, ODI, and LBD were significantly lower comparing to baseline. In the C-group, no significant differences were observed. After the exercises program, there were differences between the E-group and C-group in VAS, LBD, GPE, and SLR tests (p < 0.05, p < 0.05, p < 0.05, and p < 0.0001, respectively). Conclusions: In conclusion, our study provides compelling evidence that an eight-week program of active hamstring stretching and core stabilization exercises can significantly reduce NLBP and musculoskeletal discomfort during prolonged sitting in young adults. These findings highlight the importance of targeted exercise interventions in managing and preventing NLBP, particularly among sedentary populations. Further research is warranted to confirm these findings and explore their applicability to broader populations and over extended periods.

Serum markers of microbial translocation and intestinal damage in assessment of gastrointestinal tract involvement in systemic sclerosis.

Gastrointestinal (GI) tract involvement affects up to 90% of Systemic sclerosis (SSc) patients. The presence of GI symptoms is assessed by the University of California, Los Angeles, and Scleroderma Clinical Trials Consortium Gastrointestinal Scale (UCLA SCTC GIT 2.0). Microbial translocation (MT) is reported in SSc patients consequently to increased intestinal permeability due to intestinal damage (ID) and dysbiosis. Aim of this study was to assess circulating levels of LBP and EndoCab IgM (markers of MT), IL-6 (marker of inflammation), I-FABP and Zonulin (markers of ID) in a cohort of SSc patients and healthy controls (HC). Moreover, we aimed to correlate these parameters with severity of GI symptoms. UCLA SCTC GIT 2.0 questionnaire was administered to 60 consecutive SSc patients. Markers of MT, inflammation and ID were evaluated in SSc patients and HC. SSc patients had higher median value of markers of MT, inflammation and ID than HC. The logistic regression analysis showed LBP as the only variable associated with an UCLA total score "moderate-to-very severe" [OR 1.001 (CI 95%: 1.001-1.002), p < 0.001]. The logistic regression analysis showed LBP [OR 1.002 (CI 95%: 1.001-1.003), p < 0.01] and disease duration [OR 1.242 (CI 95%: 1.023-1.506), p < 0.05] as variables associated with UCLA distension/bloating "moderate-to-very severe". The logistic regression analysis showed LBP as the only variable associated with UCLA diarrhea "moderate-to-very severe" [OR 1.002 (CI 95%: 1.001-1.003), p < 0.01]. SSc patients with dysregulation gut mucosal integrity expressed by high levels of MT and ID biomarkers had more severe GI symptoms.

Transformer-based decoder of melanoma classification using hand-crafted texture feature fusion and Gray Wolf Optimization algorithm.

Melanoma is a type of skin cancer that poses significant health risks and requires early detection for effective treatment. This study proposing a novel approach that integrates a transformer-based model with hand-crafted texture features and Gray Wolf Optimization, aiming to enhance efficiency of melanoma classification. Preprocessing involves standardizing image dimensions and enhancing image quality through median filtering techniques. Texture features, including GLCM and LBP, are extracted to capture spatial patterns indicative of melanoma. The GWO algorithm is applied to select the most discriminative features. A transformer-based decoder is then employed for classification, leveraging attention mechanisms to capture contextual dependencies. The experimental validation on the HAM10000 dataset and ISIC2019 dataset showcases the effectiveness of the proposed methodology. The transformer-based model, integrated with hand-crafted texture features and guided by Gray Wolf Optimization, achieves outstanding results. The results showed that the proposed method performed well in melanoma detection tasks, achieving an accuracy and F1-score of 99.54% and 99.11% on the HAM10000 dataset, and an accuracy of 99.47%, and F1-score of 99.25% on the ISIC2019 dataset. • We use the concepts of LBP and GLCM to extract features from the skin lesion images. • The Gray Wolf Optimization (GWO) algorithm is employed for feature selection. • A decoder based on Transformers is utilized for melanoma classification.

The Framework of Quantifying Biomarkers of OCT and OCTA Images in Retinal Diseases.

Despite the significant advancements facilitated by previous research in introducing a plethora of retinal biomarkers, there is a lack of research addressing the clinical need for quantifying different biomarkers and prioritizing their importance for guiding clinical decision making in the context of retinal diseases. To address this issue, our study introduces a novel framework for quantifying biomarkers derived from optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) images in retinal diseases. We extract 452 feature parameters from five feature types, including local binary patterns (LBP) features of OCT and OCTA, capillary and large vessel features, and the foveal avascular zone (FAZ) feature. Leveraging this extensive feature set, we construct a classification model using a statistically relevant p value for feature selection to predict retinal diseases. We obtain a high accuracy of 0.912 and F1-score of 0.906 in the task of disease classification using this framework. We find that OCT and OCTA's LBP features provide a significant contribution of 77.12% to the significance of biomarkers in predicting retinal diseases, suggesting their potential as latent indicators for clinical diagnosis. This study employs a quantitative analysis framework to identify potential biomarkers for retinal diseases in OCT and OCTA images. Our findings suggest that LBP parameters, skewness and kurtosis values of capillary, the maximum, mean, median, and standard deviation of large vessel, as well as the eccentricity, compactness, flatness, and anisotropy index of FAZ, may serve as significant indicators of retinal conditions.

LPS-LBP complex induced endothelial cell pyroptosis in aortic dissection is associated with gut dysbiosis.

Acute aortic dissection (AAD) is the most severe traumatic disease affecting the aorta. Pyroptosis-mediated vascular wall inflammation is a crucial trigger for AAD, and the exact mechanism requires further investigation. In this study, our proteomic analysis showed that Lipopolysaccharide (LPS)-binding protein (LBP) was significantly upregulated in the plasma and aortic tissue of patients with AAD. Further, 16S rRNA sequencing of stool samples suggested that patients with AAD exhibit gut dysbiosis, which may lead to an impaired intestinal barrier and LPS leakage. By comparing with control mice, we found that LBP, including Pyrin Domain Containing Protein3 (NLRP3), the CARD-containing adapter apoptosis-associated speck-like protein (ASC), and Cleaved caspase-1, were upregulated in the AAD aorta, whereas gut intestinal barrier-related proteins were downregulated. Moreover, treated with LBPK95A (an LBP inhibitor) attenuated the incidence of AAD, the expression levels of pyroptosis-related factors, and the extent of vascular pathological changes compared to those in AAD mice. In addition, LPS and LBP treatment of human umbilical vein endothelial cells (HUVECs) activated TLR4 signaling and intracellular reactive oxygen species (ROS) production, which stimulated NLRP3 inflammasome formation and mediated pyroptosis in endothelial cells. Our findings showed that gut dysbiosis mediates pyroptosis by the LPS-LBP complex, thus providing new insights into developing AAD.

Prevalence of Low Back Pain and Its Associated Factors Among Medical Students at Nineveh University in Iraq: A Cross-Sectional Study.

Background Low back pain (LBP) is a common problem encountered in medical practice, leading to limitations in daily activities and causing social and economic hardships. Objectives This study aimed to assess the prevalence of LBP and its associated factors among medical students at Nineveh University in Iraq. Methods Between December 2022 and January 2023, a cross-sectional study was conducted among medical students at Nineveh University. A modified version of the Standard Nordic Questionnaire was used for data collection. Results Out of 308 students, 229 (74.4%) experienced LBP at some point in their lives. In addition, 209 (67.9%) reported having LBP during the last 12 months, 148 (48.1%) during the previous seven days, and 126 (40.9%) at the time of answering the survey. Factors significantly associated with LBP during the last 12 months were being in the fifth-stage academic year (p=0.047), family history of LBP (p=0.003), and history of trauma (p=0.006). On the multivariable logistic regression analysis, factors significantly associated with LBP during the last 12 months were family history of LBP (p=0.02) and history of trauma (p=0.01). Conclusions The prevalence of LBP among medical students at Nineveh University was comparatively high. A family history of LBP and a history of trauma were factors significantly associated with LBP during the last 12 months. Managing this health concern should be a priority for the administration of medical schools.

Role of End Plate Changes and Paraspinal Muscle Pathology in Lower Back Pain: A Narrative Review.

Degenerative changes of the lumbar intervertebral disc are the most significant causes of enduring lower back pain. The possibility of the diagnosis is limited in people with this low back pain. Therefore, it is essential to identify the relevant back pain subgroups. The paraspinal muscles, that is, the muscles that attach to the spine, are necessary for the proper functioning of the spine and the body; insufficiency can result in back pain. Lower back pain disorders are strongly associated with altered function or structure of these paraspinal muscles, especially fibrosis and fatty infiltration. Modic changes are the bone marrow changes of the end plate in the vertebral body seen on MRI. These are strongly related to degeneration of the disc and are common in individuals with back pain symptoms. Articles were selected from Google Scholar using the terms 'Modic changes,' 'end plate changes,' 'paraspinal muscles,' and 'lower back pain. ' This article compiled different studies aiming to enhance the comprehension of biochemical processes resulting in the development of lumbar pain. Search using the keywords 'Modic changes,'' end plate changes lower back pain,' 'paraspinal muscles lower back pain,' and 'Modic changes lower back pain' on Google Scholar yielded 33000, 41000, 49400, and 17,800 results, and 958, 118, 890 and 560 results on Pubmed respectively.

Effects of Multimodal Physical Therapy on Pain, Disability, H-reflex, and Diffusion Tensor Imaging Parameters in Patients With Lumbosacral Radiculopathy Due to Lumbar Disc Herniation: A Preliminary Trial.

Background Lumbosacral radiculopathy (LSR) due to lumbar disc herniation (LDH) is a condition caused by mechanical compression of nerve roots. Various physical therapy interventions have been proposed for the conservative management of LSR due to LDH. However, the study of physical therapy interventions in a multimodal form is lacking. Additionally, the effect of physical therapy on diffusion tensor imaging (DTI) parameters of the compressed nerve root has not been studied. This study aimed to investigate the effects of multimodal physical therapy (MPT) on pain, disability, soleus H-reflex, and DTI parameters of the compressed nerve root in patients with chronic unilateral LSR due to LDH. Methods A prospective preliminary pre-post clinical trial with a convenience sample was conducted. A total of 14 patients with chronic unilateral LSR due to paracentral L4-L5 or L5-S1 LDH were recruited for the study. Participants received a total of 18 sessions of a six-week MPT program that consisted of electrophysical agents, manual therapy interventions, and core stability exercises. Electrophysical agents involved interferential current and hot pack. Manual therapy interventions included myofascial release, side posture positional distraction, passive spinal rotation mobilization, and high-velocity low-amplitude manipulation. Visual analog scale (VAS), Roland-Morris Disability Questionnaire (RMDQ), soleus H-reflex amplitude, side-to-side amplitude (H/H) ratio, fractional anisotropy (FA), and apparent diffusion coefficient (ADC) of the compressed nerve root were measured at baseline and post-intervention. Results There were significant improvements in VAS, RMDQ, H/H ratio, FA, and ADC of the compressed nerve root. Furthermore, significant improvement was found in the affected side compared with the contralateral side in H-reflex amplitude. Conclusions The observations of this preliminary trial suggest that MPT is a successful intervention in patients with chronic unilateral LSR due to LDH. Regarding DTI parameters of the compressed nerve root, FA increased and ADC decreased. Future studies with a control group, large sample sizes, and longer follow-up periods are needed.

Research on image recognition of tomato leaf diseases based on improved AlexNet model.

Aiming at the problems that the traditional image recognition technology is challenging to extract useful features and the recognition time is extended; the AlexNet model is improved to improve the effect of image classification and recognition. This study focuses on 8 types of tomato leaf diseases and healthy leaves. By using HOG and LBP weighted fusion to extract image features, a tomato leaf disease recognition model based on the AlexNet model is proposed, and transfer learning is used to train the AlexNet model. Transfer the knowledge learned by the AlexNet model on the PlantVillage image dataset to this model while reducing the number of fully connected layers. Keras deep learning framework and programming language Python were used. The model was implemented, and the classification and identification of tomato leaf diseases were carried out. The recognition rate of feature-weighted fusion classification is higher than that of serial and parallel methods, and the recognition time is the shortest. When the weight coefficient ratio of HOG and LBP is 3:7, the image recognition rate is the highest, and its value is 97.2 %. From the model performance curve See, when the number of iterations is more than 150 times, the training set and test accuracy rate both exceed 97 %, the loss rate shows a gradient decline, and the change is relatively stable; compared with the traditional AlexNet model, HOG + LBP + SVM model, and VGG model, improved AlexNet model has the highest recognition rate, and it has high recall value, accuracy, and F1 value; Compared with the latest convolutional neural network disease recognition models, improved AlexNet model recognition accuracy was 98.83 %, and the F1 value was 0.994. It shows that the model has good convergence performance, fast prediction speed, and low loss rate and can effectively identify 8 types of tomato leaf images, which provides a reference for the research on crop disease identification.

Past, present, and future of microbiome-based therapies.

Technological advances in studying the human microbiome in depth have enabled the identification of microbial signatures associated with health and disease. This confirms the crucial role of microbiota in maintaining homeostasis and the host health status. Nowadays, there are several ways to modulate the microbiota composition to effectively improve host health; therefore, the development of therapeutic treatments based on the gut microbiota is experiencing rapid growth. In this review, we summarize the influence of the gut microbiota on the development of infectious disease and cancer, which are two of the main targets of microbiome-based therapies currently being developed. We analyze the two-way interaction between the gut microbiota and traditional drugs in order to emphasize the influence of gut microbial composition on drug effectivity and treatment response. We explore the different strategies currently available for modulating this ecosystem to our benefit, ranging from 1st generation intervention strategies to more complex 2nd generation microbiome-based therapies and their regulatory framework. Lastly, we finish with a quick overview of what we believe is the future of these strategies, that is 3rd generation microbiome-based therapies developed with the use of artificial intelligence (AI) algorithms.

Evolving Spinal Treatment Modalities: A Review of the Literature on Non-surgical Interferential Differential Dynamics (IDD) Therapy.

Low back pain is one of the most common ailments encountered by physicians and orthopedic surgeons. There are various modalities used to treat low back pain, including conservative management, and a few of them involve rest, medications, massage, bracing, acupuncture, and physical therapy. Though most of the patients improve with conservative management, the burden of this disease has been very high and caused a significant amount of economic loss. Therefore, in-depth knowledge of all conservative methods is essential for physicians managing low back pain. Furthermore, there can be many causes of low back pain. Some of the more common ones are mechanical back pain due to paraspinal muscles or facetal in origin, discogenic back pain, and sacroiliac joint dysfunction. Many patients, especially the older population, have the discogenic origin as the more common cause of back pain, and traction therapy has been used for its treatment for ages. In this review, we discuss non-surgical spinal decompression/traction therapy popularly known as interferential differential dynamics (IDD) therapy with its current standing and recent advancement.

The high-throughput solid-phase extraction of cis-cyclo(L-Leu-L-Pro) and cis-cyclo(L-Phe-L-Pro) from Lactobacillus plantarum demonstrates efficacy against multidrug-resistant bacteria and influenza A (H3N2) virus.

Introduction: 2,5-diketopiperazines are the simplest forms of cyclic dipeptides (CDPs) and have diverse frameworks with chiral side chains that are useful for drug development. Previous research has investigated the antimicrobial properties of proline-linked CDPs and their combinations in the culture filtrate (CF) of Lactobacillus plantarum LBP-K10 using anion exchange chromatography (AEC). However, the quantity of CDPs showcasing notable anti-influenza virus activity derived from AECs was generally lower than those originating from Lactobacillus CF. Methods: To address this issue, the study aims to propose a more efficient method for isolating CDPs and to introduce the antiviral combinations of CDPs obtained using a new method. The study employed a novel technique entailing high-throughput C18-based solid-phase extraction with a methanol gradient (MeSPE). The MeSPE method involved increasing the methanol concentration from 5% to 50% in 5% increments. Results: The methanol SPE fractions (MeSPEfs) eluted with methanol concentrations between 35% and 45% evinced substantial efficacy in inhibiting the influenza A/H3N2 virus via plaque-forming assay. MeSPEf-45, the 45% MeSPEf, exhibited exceptional efficacy in preventing viral infections in Madin-Darby kidney cells, surpassing both individual CDPs and the entire set of MeSPEfs. To identify the specific antiviral components of MeSPEf-45, all MeSPEfs were further fractionated through preparative high-performance liquid chromatography (prep-HPLC). MeSPEf-45 fractions S8 and S11 presented the highest activity against multidrug-resistant bacteria and influenza A/H3N2 virus among all MeSPEfs, with 11 common fractions. Antiviral fractions S8 and S11 were identified as proline-based CDPs, specifically cis-cyclo(L-Leu-L-Pro) and cis-cyclo(L-Phe-L-Pro), using gas chromatography-mass spectrometry. The combination of MeSPEf-45 fractions S8 and S11 displayed superior antibacterial and anti-influenza virus effects compared to the individual fractions S8 and S11. Discussion: High-throughput MeSPE-derived MeSPEfs and subsequent HPLC-fractionated fractions presents an innovative approach to selectively purify large amounts of potent antimicrobial CDPs from bacterial CF. The findings also show the effectiveness of physiologically bioactive combinations that utilize fractions not containing CDP. This study provides the initial evidence demonstrating the antimicrobial properties of CDPs acquired through high-throughput SPE techniques.

Evaluation of the Relationship Between Smartphone Addiction and Lower Back Pain and Neck Pain Among Medical Students at Al-Baha University.

Introduction In recent years, the increased use of smartphones has adversely affected students, leading to issues like musculoskeletal pain. Therefore, our objective was to assess the correlation between smartphone addiction and neck and lower back pain. Methodology An observational cross-sectional study was conducted at Al-Baha University, Al-Baha, Saudi Arabia. The Smartphone Addiction Scale Short Version (SAS-SV) was used to measure the level of smartphone addiction while the Nordic Musculoskeletal Questionnaire (NMQ) was utilized to evaluate musculoskeletal pain. Results Smartphone addiction was prevalent in 72% of the participants (n = 293). Significantly, lower back pain was associated with smartphone addiction (p-value = 0.004). However, none of the demographic characteristics were associated with neck or lower back pain (p-value > 0.05). Students in clinical years had a higher risk of neck pain than those in an internship (p-value = 0.048). Conclusion Almost two-thirds of the students were addicted to smartphones, with a significant association with lower back pain. Students addicted to their smartphones had a higher risk of developing lower back pain, while clinical-year students had a higher risk of developing neck pain. It's important to raise awareness about the health and safety dangers linked to smartphones and other devices.

Effect of Quadratus Lumborum Block in Patients With Acute-Subacute Unilateral Lumbar Strain.

INTRODUCTION: Lumbar strain originating from the quadratus lumborum (QL) is an important cause of low back pain; however, its diagnosis is often missed, and treatment is often inadequate. This leads to unnecessary diagnostic investigations and chronicization of pain. Therefore, it is important to treat it effectively and safely. In this study, we aimed to find out the effect of ultrasound (US)-guided QL block in acute-subacute low back pain caused by a strain of QL. MATERIALS AND METHODS: Our study was retrospective, and the changes in the visual analog scale (VAS) and Oswestry Disability Index (ODI) scores within one week in 50 patients with acute-subacute localized low back pain, unilateral lumbar strain, palpation tenderness, paravertebral spasm, and decreased lumbar range of motion in the QL muscle, in whom we applied US-guided block to the QL muscle, were analyzed. RESULTS: There was a significant decrease in the mean VAS and ODI scores of the patients after the procedure. There was a negative correlation between improvement rates in VAS and ODI scores and age and body mass index (BMI). Recovery rates were higher in female patients than in male patients. CONCLUSION: It can be said that US-guided QL block is an effective treatment method for QL-induced lumbar strains, and younger age, female gender, and lower BMI are associated with better responses after injection.