Melatonin mitigates cisplatin-induced cognitive impairment in rats and improves hippocampal dendritic spine density.

Cisplatin-induced cognitive impairment (chemobrain) affects a considerable percentage of cancer patients and has no established pharmacological treatment. Chemobrain can be associated with neuroinflammation and oxidative stress. Melatonin, a pineal hormone, is known to have antioxidant, anti-inflammatory and neuroprotective potential. In this study, we investigated cisplatin-induced cognitive impairment in rats and whether melatonin can improve or reverse this impairment. Behavioral testing involved measuring working memory using the novel location recognition test (NLRT) under conditions of cisplatin or cisplatin + melatonin treatment, followed by the collection of rats' brains. The brains were subsequently stained with Golgi-Cox stain and then the hippocampus area CA3 of each one was examined, and dendritic spine density was calculated. Treatment with cisplatin resulted in deficits in the rats' performance in the NLRT (P < 0.05). These deficits were prevented by the coadministration of melatonin (P < 0.05). Cisplatin also reduced the density of dendritic spines in the hippocampus (P < 0.0001), specifically CA3 area, while the coadministration of melatonin significantly reversed this reduction (P < 0.001). This study showed that melatonin can ameliorate cisplatin-induced spatial memory deficits and dendritic spines density abnormalities in rats. Given that melatonin is a safe and wildly used supplement, it is feasible to explore its use as a palliative intervention in cancer treatment.

Jordanian parental perception of screen time and its association with psychological distress: A cross-sectional design.

BACKGROUND: The excessive use of electronic devices among children is a global concern because of its negative impact on behavior. This cross-sectional study aimed to assess parents' awareness of their children's electronic device use and their perspective on how screen time affects behavior for 4-10-year-olds in Jordan. METHODS: A cross-sectional study was conducted to assess parents' awareness of their children's electronic device usage. The study included 807 mothers and fathers from Jordan with at least one child aged 4 to 10. The data collection instrument consisted of a self-administered survey with 43 questions, including sociodemographic characteristics and the Strength and Difficulties Questionnaire. Descriptive analysis, categorical Chi-square test, Independent t-test, and Mann-Whitney U test were used for statistical analysis. The study followed ethical standards and principles. RESULTS: A survey of 807 parents in Jordan found that gaming and videos were the most common content watched by children, and 61.3% used devices alone. Only 37.1% of parents believed that device use could improve their children's psychological growth, while 72.7% and 65.9% believed it could impact negatively their children's mental and psychological growth, respectively. The Strengths and Difficulties Questionnaire showed that 51.4% of children were normal, while 25.3% were borderline and 23.3% were abnormal. CONCLUSION: Children in the study used electronic devices excessively and this was linked to severe behavioral problems. Parents should follow AAP guidelines and spend more time with their children through non-electronic activities to improve their behavior.

Migration intent among Jordanian medical students: a nationwide cross-sectional investigation.

PURPOSE OF THE STUDY: To investigate postgraduation emigration intents of medical students throughout different years and different universities in Jordan. STUDY DESIGN: This cross-sectional study was conducted via an online self-administered questionnaire from medical students in six schools of medicine in Jordan. Our questionnaire included two sections with questions regarding sociodemographic, intentions and reasons behind residency and fellowship abroad, and views on Jordanian residency programmes. RESULTS: Of a sample of 1006, 55.7% were females, and 90.7% were holding Jordanian citizenship. 85% and 63% of respondents intended to pursue residency and fellowship abroad, respectively. Intention to continue residency abroad was associated with males, expatriates and those living in urban areas. The main three destinations were the USA (37.4%), UK (22.3%) and Germany (16.6%). 30% of respondents intended to leave the country permanently, because of low salaries, poor education and lower ranking of Jordan residency programmes. When asked about ranking Jordanian residency programmes, it was found that on average, students ranked military hospitals first and government hospitals last with university hospitals being in second place and private hospitals in third. CONCLUSION: Unfortunately, a striking number of Jordanian medical students intended to leave the country postgraduation, which points towards the necessity for Ministry of health to take immediate actions to reduce the loss of our best students.

The role of adenosine receptor ligands on inflammatory pain: possible modulation of TRPV1 receptor function.

Chronic pain has a debilitating consequences on health and lifestyle. The currently available analgesics are often ineffective and accompanied by undesirable adverse effects. Although adenosine receptors (AR) activation can affect nociceptive, inflammatory, and neuropathic pain states, the specific regulatory functions of its subtypes (A1, A2A, A2B and A3 ARs) are not fully understood. The aim of this study was to investigate the role of different AR ligands on inflammatory pain. The von Frey filament test was used to assess the anti-nociceptive effects of adenosine ligands on Complete Freund's Adjuvant (CFA)-induced mechanical allodynia in (180-220 g) adult male Sprague Dawley rats (expressed as paw withdrawal threshold, PWT). Neither the A2AAR selective agonist CGS 21680 hydrochloride (0.1, 0.32 and 1 mg/kg) nor the A2BAR selective agonist BAY 60-6583 (0.1, 0.32 and 1 mg/kg) produced any significant reversal of the PWT. However, the A1AR selective agonist ( ±)-5'-Chloro-5'-deoxy-ENBA, the A3AR selective agonist 2-Cl-IB-MECA, the A2AAR selective antagonist ZM 241385 and the A2BAR selective antagonist PSB 603 produced a significant reversal of the PWT at the highest dose of 1 mg/kg. Co-administration of the selective antagonists of A1AR and A3AR PSB36 (1 mg/ml) and MRS-3777 (1 mg/ml); respectively, significantly reversed the anti-nociceptive effects of their corresponding agonists. Furthermore, calcium imaging studies reveled that the effective AR ligands in the behavioral assay also significantly inhibit capsaicin-evoked calcium responses in cultured rat dorsal root ganglia (DRG) neurons. In conclusion, modulating the activity of the transient receptor potential vanilloid 1 (TRPV1) receptor by ARs ligands could explain their anti-nociceptive effects observed in vivo. Therefore, the cross talk between ARs and TRPV1 receptor may represent a promising targets for the treatment of inflammatory pain conditions.

Burnout among university students during distance learning period due to the COVID-19 pandemic: A cross sectional study at the University of Jordan.

OBJECTIVE: The COVID-19 pandemic led to a deviation from classical face-to-face learning to distance learning. Few studies examined burnout among university students during the distance learning period due to the COVID-19 pandemic. This study that aims to investigate the prevalence of burnout among university students during distance learning and the factors associated with it. METHOD: A cross-sectional study was conducted among undergraduate students at the University of Jordan. The modified version of the Maslach Burnout Inventory for students (MBI-SS) was used to assess burnout. RESULTS: The total number of participants was 587 and the mean total of MBI-SS score was 63.34 ± 8.85. Based on the MBI-SS definition, 6.6% of the study participants were found to have symptoms of burnout. Practicing hobbies, level of satisfaction with distance learning, and thoughts about quitting courses were significant predictors of burnout. CONCLUSION: This study showed a relatively low prevalence of burnout among students during the distance learning period with several factors associated with it. As a result, identifying these factors will help both students and educational institutions to implement strategies that are needed for the primary and secondary prevention of burnout.

Safety and Efficacy of SSRIs in Improving Poststroke Recovery: A Systematic Review and Meta-Analysis.

Background Several studies investigated the role of selective serotonin reuptake inhibitors (SSRIs) in improving poststroke recovery; thus, we have decided to conduct this systematic review and meta-analysis to investigate the efficacy and safety of SSRIs in poststroke recovery. Methods and Results In this meta-analysis we searched the following databases: PubMed, Cochrane, Scopus, and Google Scholar. The studies were included if they were placebo-controlled trials in design and reported SSRIs' effects on poststroke depression, anxiety, disability, dependence, motor abilities, and cognitive functions. The quality of the included studies was assessed using the revised Cochrane risk-of-bias tool for randomized trials. The search yielded 44 articles that included 16 164 patients, and about half of the participants were treated with SSRIs. Our results showed that SSRIs had a significant effect on preventing depression (weighted mean difference [WMD], -7.05 [95% CI, -11.78 to -2.31]), treating depression according to the Hamilton Rating Scale for Depression score (WMD, -1.45 [95% CI, -2.77 to -0.14]), anxiety (relative risk, 0.23 [95% CI, 0.09-0.61]), dependence (WMD, 8.86 [95% CI, 1.23-16.48]), motor abilities according to National Institutes of Health Stroke Scale score (WMD, -0.79 [95% CI, -1.42 to -0.15]), and cognitive functions (WMD, 1.00 [95% CI, 0.12-1.89]). On the other hand, no significant effect of SSRIs on disability was observed. Additionally, we found that treating with SSRIs increased the risk of seizures (relative risk, 1.44 [95% CI, 1.13-1.83]), whereas there was no difference in the incidence of gastrointestinal symptoms or bleeding between SSRIs and a placebo. Conclusions Our study showed that SSRIs are effective in preventing and treating depression, and improving anxiety, motor function, cognitive function, and dependence in patients after stroke. These benefits were only reproducible with the citalopram subanalysis but not fluoxetine. Further well-conducted placebo-controlled trials are needed to investigate the safety and efficacy of citalopram among patients after stroke. Registration URL: www.crd.york.ac.uk/prospero/; Unique identifier: CRD42021285766.

Quality of Distance Learning After One and a Half Year From Its Integration Due to the COVID-19 Pandemic: A Cross-Sectional Study at the University of Jordan.

Background The coronavirus disease 2019 (COVID-19) pandemic mandated the change from face-to-face learning to distance learning. As a result, the quality of distance learning worldwide is questionable. Objectives and aims The aim of this study is to investigate the quality of distance learning among university students at the University of Jordan, as well as its determinants and obstacles. Methods A questionnaire-based cross-sectional study was conducted among undergraduate students at the University of Jordan from May 29 to July 11, 2021. Using a quantitative approach, students' attitudes toward and perceptions of online and distance education were analyzed. The Distance Education Learning Environments Survey (DELES) tool was used to evaluate the quality of distance learning during COVID-19 pandemic. IBM SPSS Version 25 was used for data analysis. Results The total number of participants was 486, and the mean total DELES score was 61.6 ± 24.6. The lowest mean of DELES score components was for the active learning component (6.9 ± 2.9). Moreover, 65.9% of the students were very dissatisfied or dissatisfied with the quality of distance learning. The quality of distance learning derived by the total DELES score was determined by several general demographics, and students' perceptions and attitudes. Conclusions The present study showed a low quality of distance learning and high levels of dissatisfaction among students at the University of Jordan. Thus, improvement of distance learning quality by filling its infrastructural defects and the implementation of its adjunct tools are required. In addition, we recommend collaboration with regional and international educational institutions to improve the quality of distance learning.

Estimation of sex based on metrics of the sternum in a contemporary Jordanian population: A computed tomographic study.

ABSTRACT: There is a paucity of osteometric standards for sex estimation from unknown skeletal remains in Jordan and the sexual dimorphism of the sternum has not yet been investigated. The aim of this study was to evaluate the sexual dimorphism in sternal measurements using 3D multidetector computed tomography (MDCT), and to assess their reliability for sex estimation in a Jordanian population. A total of 600 MDCT scans (300 males and 300 females) were used and a total of 8 sternal measurements were studied (manubrium length, sternal body length, combined length of manubrium and body, corpus sterni width at 1st and 3rd sternebrae, sternal index and area). Sexual dimorphism was evaluated by means of discriminant function analyses. Significant sexual dimorphism was found mainly in middle-aged and older adults. Including all subjects, multivariate, and stepwise functions gave an overall accuracy of 83.0% and 84.0%, respectively. Additionally, multivariate and stepwise analyses were conducted separately for each age group. The accuracy of sex estimation in multivariate analysis (all variables) varied from 63.2% in the young, and 83.7% in the middle adults to 84.9% for older adults. In stepwise analysis, the highest accuracy rates were provided by only sternal area in young adults (81.6%), and sternal area combined with sternal body length in middle-aged and older adults (84.2% and 85.3%, respectively). The best sex discriminator using univariate analysis (single variable) was sternal area followed by sternal body length (84.0% and 80.8% respectively). Notably, univariate analyses for most variables gave relatively higher classification accuracies in females but were poor at predicting males in the sample (sex bias ranged between -6.4% and -20%). Our data suggest that dimorphism in the human sternum increases with advancing age and separate discriminant functions are needed for each age group in Jordanians. In addition, multivariate and stepwise analyses using sternum gave higher classification accuracies with comparatively lower sex biases compared to univariate analyses.

Age of the donor affects the nature of in vitro cultured human dental pulp stem cells.

OBJECTIVES: The dental pulp stem cells (DPSCs) of six donors (three young donors aged < 19 years and three adult donors aged > 25 and < 30 years) were characterized for their stem cell marker expression and differentiation potential to study the effect of donor age on DPSCs in vitro. METHODS: DPSCs were cultured in αMEM supplemented with 20% fetal calf serum (conventional conditions) or on fibronectin-coated flasks with neurobasal medium supplemented with B27, bFGF and EGF (alternative conditions). DPSCs were characterized by immunofluorescence staining to detect the neural crest/mesenchymal stem cells markers P75 and CD146, respectively. The differentiation potential was tested by the induction of DPSCs into osteogenic, adipogenic and glial lineages and then by detecting the corresponding markers osteocalcin, lipidtox and S100ß, respectively. RESULTS: The DPSCs of the young donors expressed CD146 only under the conventional conditions and expressed P75 regardless of the culture conditions. However, the DPSCs of adult donors expressed CD146 only under the alternative conditions and expressed P75 only under conventional conditions. Only the DPSCs of the young donors differentiated into the glial linage. The DPSCs of the adult donors differentiated more efficiently into the adipogenic linage. Osteogenic differentiation was comparable. CONCLUSION: Donor age affects the expression of stem cell markers and differentiation potential of DPSCs. Moreover, the effect of culture conditions on DPSCs is age dependent.

Accessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population.

Background and Objectives: The incidence of accessory bones in the region of foot and ankle is quite variable between studies and are often confused with avulsion fractures in trauma patients with musculoskeletal injuries. The aim of this study was to assess the incidence of accessory ossicles of the foot and ankle according to gender, side and coexistence, and to determine how frequently accessory ossicles were misdiagnosed as avulsion fractures. Materials and Methods: Oblique and/or lateral foot radiographs of 1000 adult patients referred from emergency departments to foot and ankle clinic were retrospectively reviewed for the presence of accessory ossicles. The Kappa statistic was used in order to assess the validity of radiographic interpretation for the presence of these bones. Results: Accessory ossicles were detected in 40.2% of the radiographs. The incidence rates for the accessory ossicles in order of frequency were: Os trigonum (15.4%), accessory navicular (13.7%), os peroneum (11.5%), os vesalianum (1.1%), os supranaviculare (0.7%), os subfibulare (0.6%), os talotibiale (0.4%), os calcaneus secundarius (0.3%), os supratalare (0.3%), os infranaviculare (0.3%), os intermetatarseum (0.2%), and os subtibiale (0.1%). Coexistence of two or three ossicles in the same foot was observed in 4.4% of the cases, mostly coexistence with os peroneum (2.9%), followed by accessory navicular (1.6%). 2.7% of accessory ossicles were initially misdiagnosed as avulsion fractures at emergency departments. Interrater agreement over identification of different accessory ossicles was found to be reasonably reliable, with a Kappa greater than 0.80 for all assessed bones. Conclusions: In clinical practice, a thorough knowledge of normal anatomical variants is essential to facilitate appropriate diagnosis and treatment and can help to prevent diagnostic errors.

A comprehensive study of the anatomical variations of the posterolateral tubercle of talus / Un estudio integral de las variaciones anatómicas del tubérculo posterolateral del talo

SUMMARY: The aim of our study was to determine the prevalence and the anatomical variations of the posterolateral tubercle of talus in relation to sex on CT imaging. A total of 1478 ankle CT scans was retrospectively reviewed for the different anatomical variants of the posterolateral tubercle of talus, the type and size of os trigonum. Normal sized lateral tubercle was found in 46.1 %, an enlarged posterolateral tubercle (Stieda's process) in 26.1 %, os trigonum in 20.5 % and almost absent tubercle in 7.3 %. A statistically higher prevalence of Stieda's process was found in males while os trigonum was higher in females (p0.05). The posterolateral tubercle of talus and its accessory ossicle, the os trigonum, could vary morphologically. The data of this study could be helpful in understanding the clinical problems that could be associated with some of these variants.

RESUMEN: El objetivo de nuestro estudio fue determinar la prevalencia y las variaciones anatómicas del tubérculo posterolateral del talo en relación con el sexo en la imagen de TC. Se revisaron retrospectivamente un total de 1478 TC de tobillo para las diferentes variantes anatómicas del tubérculo posterolateral del talo, el tipo y tamaño del os trigonum. Se encontró tubérculo lateral de tamaño normal en 46,1 %, tubérculo posterolateral (proceso de Stieda) en 26,1 %, os trigonum en 20,5% y tubérculo casi ausente en 7,3 %. Se encontró una prevalencia estadísticamente más alta del proceso de Stieda en los hombres, mientras que el os trigonum fue mayor en las mujeres (p 0,05) no se observaron diferencias significativas. El tubérculo posterolateral del talo y su osículo accesorio, el os trigonum, podrían originar problemas clínicos que podrían estar asociados con algunas de estas variantes.

Estimation of sex from measurements of foramen magnum region in a contemporary Jordanian population: A computed tomographic study.

Several studies have shown variability in basicranial measurements between populations. Therefore, each population should have specific standards to optimize the accuracy of identification. The aim of this study was to evaluate the sexual dimorphism in foramen magnum and occipital condyles measurements using 3D multidetector computed tomography (MDCT), and to assess their utility and reliability for sex estimation in a Jordanian population by means of discriminant function analyses. A total of 500 MDCT scans (288 males and 212 females) were used and a total of 8 basicranial measurements were studied (3 measurements were derived from foramen magnum, and 5 measurements were derived from occipital condyles). Significant sexual dimorphism was found in all basicranial measurements. The most dimorphic variables were length of occipital condyle and maximum bicondylar distance. Including all variables, multivariate and stepwise functions gave an overall accuracy of 77.8% and 78.6%, respectively. However, the multivariate analyses conducted separately for measurements derived from foramen magnum and occipital condyles gave lower overall accuracy of 68.6% and 70.0%, respectively. Basicranial measurements derived from foramen magnum alone predicted males with relatively higher accuracy but were poor at predicting females in the sample (82.6% were males, 49.5% were females, sex bias 33.1%). Adding occipital condyles measurements to the multivariate analysis increased the percentage of correct sexing in females and reduced considerably the sex bias (78.8% male, 76.4% female, sex bias 1.4%). Discriminant function analysis using basicranial measurements derived from both foramen magnum and occipital condyles measurements can be utilized to estimate sex in our population.

Alkaptonuria with extensive ochronotic degeneration of the Achilles tendon and its surgical treatment: a case report and literature review.

Background: Alkaptonuria is a rare genetic metabolic disorder due to deficiency of homogentisate 1,2-dioxygenase (HGD), an enzyme catalyzing the conversion of homogentisate to 4-maleylacetoacetate in the pathway for the catabolism of phenylalanine and tyrosine. HGD deficiency results in accumulation of homogentisic acid and its pigmented polymer. Ochronosis is a bluish-black discoloration due to the deposition of the polymer in collagenous tissues. Extensive ochronotic involvement of the Achilles tendon in alkaptonuria and its surgical treatment is rarely reported. Case report: A 43-year-old man presented to our clinic in March 2019 with sudden onset of left Achilles tendon pain with no history of prior trauma. Surgical exploration revealed a complete disruption of the tendon at its attachment to the calcaneus. Black pigmentation was extensive and reached the calcaneal tuberosity, extending about 7 cm from the insertion. Discussion: Achilles reconstruction was performed using flexor hallucis longus tendon transfer. The patient experienced uncomplicated healing with satisfactory functional results. Conclusion: Orthopedic surgeons should be aware of the progressive nature of alkaptonuria. Extensive degenerative changes of the ruptured tendon should be suspected so that physicians can plan tendon repair and facilitate prompt surgical intervention.

Impairment in locomotor activity as an objective measure of pain and analgesia in a rat model of osteoarthritis.

A major problem with current animal models of pain is their lack of face validity and their vulnerability for false positive results. The present study evaluated the efficacy of the open field locomotor system, as an objective measure of pain-related behavior and analgesic efficacy in rodents. Adult, male, Sprague-Dawley rats (180-250 g) received intra-articular injections of monoiodoacetate (MIA; 1 mg) in the left knee joint. Mechanical allodynia using von Frey filaments, the weight bearing difference test and the open field locomotor activity test were performed every other day for 21 days, following the MIA injection. The antinociceptive effects of ibuprofen (50 and 100 mg/kg) on the MIA-induced nociception were also evaluated. MIA induced a significant reduction in the paw withdrawal threshold (PWT) and a significant alteration in the weight bearing difference compared with control rats. Similarly, MIA induced a significant reduction in locomotor activity, with respect to X total counts, that represent the overall locomotor activity in the horizontal plane, and X ambulatory counts, which in turn represent small scale movements, such as scratching and grooming, and lastly, Z total counts, that represent rearing or standing. Both doses of ibuprofen resulted in a significant reversal of the MIA-induced alterations in PWT and weight bearing difference. Furthermore, the two doses of ibuprofen resulted in a significant reversal of the MIA-induced reduction in locomotor activity, with respect to X ambulatory counts, but not Z total counts. Only the higher dose of ibuprofen reversed the X total counts. The open field locomotor system may successfully be used to predict the analgesic efficacy of compounds in models of joint inflammation and osteoarthritis.

Analgesic Effects and Impairment in Locomotor Activity Induced by Cannabinoid/Opioid Combinations in Rat Models of Chronic Pain.

Both opioids and cannabinoids have well-known antinociceptive effects in different animal models of chronic pain. However, unwanted side effects limit their use. The aim of this study is to evaluate the antinociceptive effect of combining synthetic cannabinoids with subtherapeutic doses of opioids, and to evaluate the effects of these drugs/combinations on rat's locomotor activity. Intra-plantar injection of Complete Freund's Adjuvant (CFA) into the left hindpaw and intraperitoneal injection of streptozotocin (STZ) were used to induce inflammatory and diabetic neuropathic pain in adult male Sprague-Dawley rats, respectively. Von Frey filaments were used to assess the antinociceptive effects of opioids (morphine and tramadol) and the synthetic cannabinoids (HU210 and WIN55212) or their combinations on CFA and STZ-induced mechanical allodynia. Open field test was used to evaluate the effect of these drugs or their combinations on locomotion. HU210 and WIN55212 did not produce significant antinociceptive effect on inflammatory pain while only the maximal dose of HU210 (1 mg/kg) was effective in neuropathic pain. Only the maximal doses of morphine (3.2 mg/kg) and tramadol (10 mg/kg) had significant anti-allodynic effects in both models. Tramadol (1 mg/kg) enhanced the antinociceptive effects of WIN55212 but not HU210 in neuropathic pain with no effect on inflammatory pain. However, in open field test, the aforementioned combination did not change tramadol-induced depression of locomotion. Tramadol and WIN55212 combination produces antinociceptive effects in neuropathic but not inflammatory pain at low doses with no additional risk of locomotor impairment, which may be useful in clinical practice.

The desensitization of the transient receptor potential vanilloid 1 by nonpungent agonists and its resensitization by bradykinin.

Transient receptor potential vanilloid type-1 (TRPV1) channels have crucial roles in inflammatory hyperalgesia. Different inflammatory mediators can modulate TRPV1 sensitization. Bradykinin is an algogenic substance released at the site of inflammation. The aim of the present study is to investigate the desensitization of TRPV1 receptor by nonpungent agonists and to determine how bradykinin and prostaglandin E2 receptors (EP3 and EP4) modulate the resensitization of TRPV1 receptor after being desensitized by nonpungent agonists. Tail flick test was used to investigate capsaicin-induced thermal hyperalgesia and the desensitization of TRPV1 by the nonpungent agonists (olvanil and arvanil) in male BALB/c mice weighed (22-25 g). Resensitization of TRPV1 by bradykinin and the role of prostaglandin receptors in mediating sensitization of TRPV1 were also investigated. Intraplantar injection of capsaicin (0.3 µg) produced a robust thermal hyperalgesia in mice, while olvanil (0.3 µg) or arvanil (0.3 µg) produced no hyperalgesia, emphasizing their lack of pungency. Olvanil and arvanil significantly attenuated capsaicin-induced thermal hyperalgesia in mice. Bradykinin significantly reversed the desensitizing effects of arvanil, but not olvanil. EP4 but not EP3 receptors mediate the sensitization of TRPV1 By bradykinin in vivo. The present study provides evidence for a novel signaling pathway through which bradykinin can regulate the TRPV1 ion channel function via EP4 receptor.

Assessment of the dental morphological pattern of living Jordanian Arabs suggesting a genetic drift from the Western-Eurasia pattern: A cone beam computed tomography study.

The objectives were to determine the expression frequency and sexual dimorphism of 15 dental morphological traits on the permanent dentitions of living Jordanians, and to compare the dental morphological pattern of this sample with those of 22 groups representing the various geographic regions of the world, for the purpose of assessing the population structure and genetic history of this group. Cone beam computed tomography images for the dentitions of 150 adult Jordanians (67 males, 83 females; age range = 18-58, mean ages 28.2, sd = 10.0 years) were studied in 2017. The traits were classified using the Arizona State University dental anthropology system, counted with the individual count method, and dichotomized according to the criteria of Scott & Turner for the purpose of group comparisons. Fisher's exact test for dichotomized scores was used to assess sexual dimorphism in these traits. Smith's Mean Measure of Divergence was used to measure all pairwise distance values among the groups. Statistically significant sexual dimorphism was found in two traits (i.e., UI1 shoveling and 4-cusped LM1), and apparent but statistically insignificant difference was found in three traits (i.e., UC canine mesial ridge, 3-rooted LM1, and 1-rooted LM2), all in favour of females. This study revealed that the dental pattern of Jordanians is distinct from the other reported Western Eurasian patterns and all other known dental patterns. This differentiated dental pattern suggests a genetic drift for this population from the Western Eurasian Ancestry.

Antinociceptive and Abuse Potential Effects of Cannabinoid/Opioid Combinations in a Chronic Pain Model in Rats.

Chronic pain is a persistent and debilitating health problem. Although the use of analgesics such as opioids is useful in mitigating pain, their prolonged use is associated with unwanted effects including abuse liability. This study assesses the antinociceptive effect of combining subtherapeutic doses of two opioids (morphine or tramadol) with the synthetic cannabinoid CP55940 (2-[(1R,2R,5R)-5-hydroxy-2-(3-hydroxypropyl)cyclohexyl]-5-(2-methyloctan -2-yl)phenol). It also evaluates the associated adverse effects of these drugs and combinations. Adult male rats were injected with intraplantar complete Freund's adjuvant (CFA) to produce mechanical allodyia. Antinociceptive effect of morphine, tramadol, the synthetic cannabinoid CP55940, or their combinations was evaluated three to nine days post-CFA injections. Intracranial self-stimulation (ICSS) was utilized to evaluate the abuse liability of these drugs or their combinations. All drugs alone produced a dose-dependent antinociceptive effect. Morphine produced minimal effect on ICSS, but both tramadol and CP55940 produced dose-dependent depression of ICSS. Morphine at a dose of 0.32 mg/kg enhanced the antinociceptive effects of CP55940, in that, CP55940 produced antinociception at a lower dose (0.1 mg/kg) when compared to the vehicle. The aforementioned combinations did not change CP55940-induced depression of ICSS. On the other hand, tramadol failed to enhance the antinociceptive effect of CP55940. Our data suggest that combining CP55940 with morphine, but not tramadol, shows a better antinociceptive profile with no additional risk of abuse liability, which represents a potential pain management approach.

Incidence of symptomatic os trigonum among nonathletic patients with ankle sprain.

PURPOSE: Os trigonum syndrome is a rare condition, often affecting athletes. A paucity of data exists on the incidence of os trigonum syndrome in nonathletic population. The study aimed to determine the incidence and clinical characteristics of os trigonum syndrome in nonathletic patients with sprained ankles. METHODS: The sample consisted of 798 adolescent and adult patients that attended the emergency department or Foot and Ankle Clinic with acute ankle sprain. Lateral and/or oblique lateral radiographs of the feet were screened for the presence of os trigonum in relation to age and gender. A cohort of 163 patients with os trigonum was followed up prospectively over a 48-month period to correlate the presence of the os trigonum with patient symptomatology. RESULTS: Os trigonum was found in 20.4% (163/798) of sprained ankles. Patients aged 18-35 exhibited most os trigonum [42.3% (69/163)], with higher incidence in females. 5.5% (9/163) of the os trigonum patients developed an os trigonum syndrome after a standard treatment of an ankle sprain [3.8% (3/78) of males and 7.1% (6/85) of females]. Females aged between 18 and 35 years had higher incidence of os trigonum syndrome compared to males of a similar age. CONCLUSION: Os trigonum syndrome should be suspected in nonathletic patients with an ankle sprain unresponsive to standard treatment. About 1.1% of acute ankle sprain patients develop an os trigonum syndrome. This finding can help identify the source of a patient's symptoms, leading to an accurate diagnosis, appropriate treatment and reducing the potential chronic symptoms.