Effect of Knee Hyperextension on Femoral Cartilage Thickness in Stroke Patients.

OBJECTIVE: Knee hyperextension is one of the most common compensatory mechanisms in stroke patients. The first aim of the study was to measure knee hyperextension and femoral cartilage thickness in stroke patients. The second aim was to compare the femoral cartilage thickness of the paretic and nonparetic limbs in stroke patients with and without knee hyperextension. DESIGN: Forty stroke patients were included in the study. The patients were divided into two groups according to the presence of knee hyperextension based on kinematic analyses performed during walking with a three-dimensional motion analysis system. The medial femoral cartilage, lateral femoral cartilage, and intercondylar cartilage thicknesses of the paretic and nonparetic sides of the patients were measured by ultrasonography. RESULTS: In the study group, medial femoral cartilage, intercondylar, and lateral femoral cartilage thicknesses were less on the paretic side than on the nonparetic side, while the femoral cartilage thicknesses on the paretic and nonparetic sides were similar in the control group. Paretic side medial femoral cartilage and intercondylar thicknesses were less in the study group compared with the control group, and lateral femoral cartilage thickness was similar between the two groups. CONCLUSIONS: Knee hyperextension during walking causes femoral cartilage degeneration in stroke patients.Clinical Trial code: NCT05513157.

Psychometric properties of Fullerton Advanced Balance Scale in patients with stroke.

BACKGROUND: Patients experience falls frequently after stroke. Preserved or acquired balance skills decrease fall risk and improve independence. Feasibility of Fullerton Advanced Balance Scale (FAB) has been shown in balance assessment in some neurological diseases except stroke. OBJECTIVES: The purpose of this study was to investigate the reliability and validity of Turkish version of FAB (FAB-T) in patients with stroke (PwS). METHODS: This cross-sectional study included 51 PwS (60.64 ± 7.66 years). Reliability analyses were conducted with Cronbach's alpha, intraclass correlation coefficient (ICC), and Spearman correlation analysis. Intra-rater and inter-rater reliability were assessed with three raters. FAB-T, Stroke Rehabilitation Assessment of Movement (STREAM), Brunnstrom Recovery Stages (BRS), Barthel Index (BI), and 36-Item Short Form Health Survey (SF-36) were used for convergent validity. Correlations of FAB-T with Berg Balance Scale (BBS) and Mini-Balance Evaluation Systems Test (Mini-BESTest) were measured for concurrent validity. Spearman correlation analysis was used for convergent and concurrent validity. For predictive validity patients' self-reports of falling were analyzed with ROC. RESULTS: Intra-rater (ICC = 0.998) and inter-rater reliability (ICCs = 0.984; 0.984; 0.990), and internal consistency (Cronbach's alpha = 0.930) were excellent. FAB-T had good correlations with STREAM (ρ = 0.677) and BI (ρ = 0.628), moderate correlations with BRS (ρ = 0.504 and ρ = 0.579) and physical function of SF-36 (ρ = 0.436). FAB-T excellently correlated with Mini-BESTest and BBS (ρ = 0.928 and ρ = 0.942). The cutoff score of FAB-T was determined to be 21.5 points, with sensitivity of 84% and specificity of 61% (AUC = 0.749). CONCLUSIONS: FAB-T is a reliable and valid balance assessment tool with an acceptable accuracy of fall prediction in PwS.

The reliability and validity of the balance tests in hearing-impaired athletes.

BACKGROUND: It is known that balance is affected in hearing-impaired athletes and its effects on performance. However, studies on the reliability and validity of scales evaluating balance are insufficient. AIM: To analyze and demonstrate the effectiveness of various clinical tests using assessment balance for hearing-impaired athletes. METHOD: The study included 60 elite athletes (aged between 18 and 25) with (n = 30) and without (n = 30) hearing impairment. The static balance was evaluated with the Flamingo Test (FT) and the dynamic balance with the Functional Reach Test (FRT), Four-Step Square Test (FSST), Star Excursion Balance Test (SEBT), and Y Balance Test (YBT). All balance tests were repeated at 1-week intervals. Test-retest reliability, known-group validity, and predictive validity of the scales were investigated. RESULT: All balancing tests demonstrated strong test-retest reliability. FT and FSST had known-group and predictive validity. While FRT and the components of both YBT and SEBT involving anterior reaching were not valid tests for hearing-impaired individuals, YBT and SEBT had validity considering the composite score and other components. CONCLUSION: It was revealed that the balance of hearing-impaired athletes was comparable to the balance of healthy athletes in test conditions in which visual information could be used effectively. For this reason, it is important to consider the visual information factor when evaluating the balance of hearing-impaired athletes. Additionally, taking into account time and tiredness, FT for static balance and FSST for dynamic balance may be helpful to evaluate hearing-impaired athletes.

The acute effect of cervical mobilization on balance in patients with multiple sclerosis: a single-blind, randomized, controlled trial.

The cervical region plays an important role in providing proprioceptive and vestibular input to the postural control system. OBJECTIVE: To investigate the effect of cervical mobilization on balance in multiple sclerosis (MS) patients. METHODS: The study was undertaken at the neurological rehabilitation unit with 36 MS participants who were assigned randomly to the study (n = 18) and control group (n = 18). While the study group received a single session of 15 minutes of cervical and soft tissue mobilization, no intervention was applied to the control group to investigate the learning effect of the assessment. Patients were evaluated using Computerized Dynamic Posturography (CDP) (Sensory Organization Test (SOT), Limits of Stability (LoS), and Adaptation Test (ADT)), which reflects postural stability. RESULTS: In the study group, a treatment effect was found on the vestibular ratio (VEST) score (p < 0.001) and the composite score of SOT (p = 0.002). Improvements were achieved in all parameters of the LoS and ADT in the study group. There was no statistically significant difference in terms of CDP results in the control group. CONCLUSION: Cervical mobilization has beneficial effects on balance in MS patients. Our findings support that cervical mobilization can be included in MS balance rehabilitation programs.

Reliability and Validity of The Fullerton Advanced Balance Scale in People with Multiple Sclerosis.

PURPOSE: This study was conducted to evaluate the reliability and validity of the Fullerton Advanced Balance Scale (FAB) in people with Multiple Sclerosis (PwMS). METHODS: A total of 65 people with multiple sclerosis, Expanded Disability Status Scale (EDSS) ranging from 1 to 5.5, were included in the study. Test-retest reliability, intra-rater, inter-rater reliability, and internal consistency (item-total score correlation, Cronbach's alpha coefficient) were investigated to examine the reliability of FAB. In the intra-rater and inter-rater reliability analysis, the FAB application of 34 patients, whose initial evaluation was gathered, was video-recorded and re-watched by two physiotherapists at different times and scored. For the Validity of FAB, concurrent validity with criterion validity; construct validity with hypothesis testing were calculated. Convergent validity was assessed for correlations with EDDS, Dynamic Gait Index (DGI), and Timed Up and Go Test (TUG). RESULTS: Test-retest reliability of FAB Intraclass Correlation Coefficient (ICC) values was excellent (ICC= 0.994, p < 0.001). While the intra-rater reliability (ICC=0.986, p < 0.001) and inter-rater reliability (ICC=0.985, p < 0.001) of the FAB were calculated at an excellent level. Cronbach's alpha value was determined to perfect correlation. (Cronbach's alpha coefficient: 0.929). FAB had an excellent correlation with BBS (0.919 (p < 0.001). For convergent validity of FAB, EDSS (r=-0.885, p < 0.001), TUG (r=-0.833, p < 0.001), and DGI (r = 0.916, p < 0.001), it was determined that the scale had convergent validity. CONCLUSION: The FAB proved to be a reliable and valid in PwMS. The study showed that the FAB could be applied regardless of the physiotherapists' clinical experiences. It has been determined that the scale can be used in PwMS with a wide EDSS score. Considering the inter-rater and intra-rater reliability results, it is thought that the FAB is also suitable for use in the online environment.

Acute effects of lumbosacral mobilization on balance and functional activities in idiopathic Parkinson's disease:A randomised controlled trial.

BACKGROUND: Decreased axial rotation, impaired coordination between axial segments and axial tone contribute to gait, balance and postural disorders in Parkinson's Disease. AIMS: The aim of our study was to examine the acute effects of lumbosacral mobilization on balance and functional activities in patients with idiopathic Parkinson's Disease. METHODS: This study was a randomized controlled clinical trial conducted at Hacettepe University. The study included 28 patients with Parkinson's Disease who were between stage 2-3 according to the Modified Hoehn&Yahr Staging Scale. Participants were randomised to the study group, including 10 minutes of lumbosacral mobilization, or the control group, including no intervention. The Unified Parkinson's Disease Rating Scale (UPDRS), Modified Parkinson's Activity Scale (MPAS), Dynamic Gait Index (DGI), and static posturography test (Modified Clinical Test of Sensory Interaction and Balance - mCTSIB) were all examined twice. RESULTS: The UPDRS, MPAS, DGI values and the composite score with the soft ground eyes open condition in the mCTSIB were improved in the study group (p < 0.05). DGI and MPAS values reached the level of significance between the groups (p < 0.05). CONCLUSION: This study is the first to examine the effect of lumbosacral mobilization on balance and functional activities in patients with Parkinson's disease. Lumbosacral mobilization is an effective method in PwPD. Lumbosacral mobilization may be an alternative way for these patients to improve their balance and functional activities.

Reliability and validity of the incremental shuttle walk test in patients with fully ambulatory multiple sclerosis.

BACKGROUND: Functional exercise capacity evaluation is crucial to monitor treatment effects and disease progression in people with multiple sclerosis (pwMS). Compared to other tests, the incremental shuttle walking test (ISWT), which more accurately reflects cardiovascular responses, may be more useful for assessing exercise capacity. The aim of the study is to investigate the reliability and validity of the ISWT. METHODS: Thirty-six pwMS with an Expanded Disability Status Scale (EDSS) score<4.5 between the ages of 25 and 65 were included in the study. The subjects underwent practice (ISWT-p) before undergoing the test-retest protocol in order to rule out the ISWT learning effect (ISWT-1 - ISWT-2). ISWT-1 and ISWT-2 were administered with a 3-7 day interval for test-retest reliability. Six-minutes walking test (6MWT) were applied for concurrent validity. The EDSS, pulmonary function tests, Fatigue Impact Scale (FIS), respiratory muscle strength [maximum inspiratory and expiratory pressure (MIP-MEP)] measurements were made for convergent validity. RESULTS: ISWT was found to have excellent test-retest reliability with an ICC value of 0.97. The area under the curve value was 0.904 indicating that ISWT has a good performance for predicting disease severity. The moderate correlation between ISWT and 6MWT (rho: 0.68, p<0,001) proved concurrent validity. It was also moderately correlated with EDSS, MEP (rho: -0.58 and 0.47 respectively), weakly correlated with MIP and FIS (rho:0.37 and -0.36, respectively) while not correlated with pulmonary function tests. CONCLUSION: The ISWT had excellent test-retest reliability, acceptable criterion and construct validity in ambulatory MS patients.

Dimensionality, psychometric properties, and population-based norms of the Turkish version of the Chalder Fatigue Scale among adults.

BACKGROUND: Fatigue is emerging as a major public health problem that is highly associated with poor health-related quality of life and disability. Among adults, fatigue has become increasingly common because of workload or lifestyle changes. This study aimed to cross-culturally adapt the Chalder Fatigue Scale (CFS) into Turkish, to investigate its psychometric properties, and to establish normative data in healthy adults by age and gender. METHODS: The validity of the CFS was tested with a total sample of 476 healthy adults aged 20-40 years (264 males and 212 females) and test-retest/measurement error analyses were performed with 161 participants (94 males and 67 females). The test-retest reliability was examined using the intraclass correlation coefficient (ICC), and internal consistency was determined using Cronbach's α-coefficient. Predictive validity was assessed using the Receiver Operating Characteristic to validate the cut-off value of the CFS for non-fatigued and fatigued participants. Factor analyses and hypothesis testing were conducted to assess construct validity. Hypothesis testing examined convergent and known-group validity by testing 14 predefined hypotheses. RESULTS: The mean (SD) and median (25-75%) CFS scores were 10.7 (4.9) and 11 (7-14) for the total sample (n = 476). The cut-off point for CFS was set at ≥ 12 with a sensitivity of 65.8% and a specificity of 85.9%. The CFS provided evidence of excellent fit of the two-factor structure (CFI = 0.963, RMSEA = 0.06, SRMR = 0.02). There was evidence of strong internal consistency demonstrated by Cronbach's α = 0.863 and good test-retest reliability by ICC = 0.76. Thirteen out of 14 hypotheses (92.9%) were confirmed and the scale showed low to moderate correlation with other measurement instruments (r = 0.31-0.51). CONCLUSIONS: The CFS has been shown to be a reliable and valid instrument that can be used in various populations for the assessment of fatigue. LEVEL OF EVIDENCE: Level II.

Design and synthesis of new 2-oxoquinoxalinyl-1,2,4-triazoles as antitumor VEGFR-2 inhibitors.

VEGFR-2 is a tyrosine kinase receptor for VEGFs that play a central role in tumor angiogenesis. The inhibition of the tyrosine kinase domain of VEGFR-2 has become an attractive therapeutic strategy in recent years for inhibiting tumor growth. In this study, a series of novel 2-oxoquinoxalinyl-1,2,4-triazoles were designed and synthesized as potential antitumor agents and VEGFR-2 inhibitors. Eight compounds in this series showed high growth inhibition against MCF-7 with GI50 ranging from 1.6 to 8.06 µM compared to staurosporine (GI50 = 8.39 µM) and sorafenib (GI50 = 11.20 µM). In addition, the results of the in vitro tyrosine kinase inhibition of VEGFR-2 revealed that most of the compounds possessed IC50 values in the sub-micromolar range. Compound 6g (IC50 = 0.037 µM) showed more potent VEGFR-2 inhibitory activity than sorafenib (IC50 = 0.045 µM). Furthermore, docking studies of the compounds with tyrosine kinase domain of VEGFR-2 (PDB ID: 4ASD) were performed. According to the results, 6g exhibited hydrogen bonding interactions with Glu885, Asp1046 and Cys919 amino acids in a similar way to sorafenib. Finally, physicochemical predictions of target compounds were examined in silico. The results revealed that all the compounds possessed promising drug-likeness profile.

The effects of spinal stabilization exercises in patients with myasthenia gravis: a randomized crossover study.

PURPOSE: The effects of spinal stabilization exercises (SSE) on fatigue, muscle strength, respiratory functions, functional capacity, and quality of life (QoL) in myasthenia gravis (MG) patients were investigated. MATERIALS AND METHODS: This study which was designed a single-blinded, randomized crossover trial were included mild to moderate 10 MG patients, aged between 18 and 65. SSE and home program were applied to the patients for six weeks, four weeks between each exercise program. Fatigue assessed with Fatigue Severity Scale (FSS) and Visual Analog Fatigue Scale (VAFS). Muscle strengths were assessed with dynamometric measures. Respiratory Function Test, 6 Minute Walk Test (6MWT), Quantitative Myasthenia Gravis Score (QMGS), Myasthenia Gravis Quality of Life Scale-15 (MGQOL-15) were used. RESULTS: All parameters were improved in SSE group, but not neck muscles strength, QMGS, and respiratory functions in home program group. FSS, VAFS, muscle strength, 6MWT, MGQOL-15 values were found significantly different in SSE group (p = .005 in all parameters). CONCLUSIONS: SSE are safe and effective on fatigue, muscle strength, respiratory functions, functional capacity, and QoL for MG patients, so it may be suggested to include SSE in rehabilitation programs of MG patients.Implications For RehabilitationSpinal stabilization exercises are safe and effective for Myasthenia Gravis patients.Home exercise program which included breathing exercises and callisthenic exercises tailored to the patients' needs is safe and effective for Myasthenia Gravis patients.Rehabilitation programs of Myasthenia Gravis patients should include spinal stabilization exercises.

Reliability and Validity of Turkish Myasthenia Gravis-Activities of Daily Living Scale.

Linguistic, reliable, and valid secondary efficacy measures are important in clinical settings and studies. The aim of the study is to report test-retest reliability and construct validity of Turkish version of Myasthenia Gravis-Activities of Daily Living Scale (MG-ADL-T) in Myasthenia Gravis (MG) patients. Fifty-two ocular and generalized individuals with MG, applying to rehabilitation center, were included in the study. MG-ADL-T, MG quality-of-life questionnaire (MG-QoL), MG composite (MGC), quantitative MG score (QMGS), and pulmonary function test were administered. Reliability was assessed with intraclass correlation coefficient (ICC) and Cronbach's alpha. Spearman correlation test and receiver operating characteristic (ROC) analysis were performed for construct validity. MG-ADL-T had fair internal consistency (Cronbach's α = .67), excellent test-retest reliability (ICC = 0.96) and moderate construct validity (MG-QoL, r = 0.59; QMGS, r = .58; MGC, r = .68). MG-ADL, a unique scale that evaluates activities of daily living (ADL), has good test-retest reliability and construct validity in Turkish MG patients.

Synthesis, molecular docking, and biological evaluation of novel 2-pyrazoline derivatives as multifunctional agents for the treatment of Alzheimer's disease.

A novel series of 2-pyrazoline derivatives were designed, synthesized, and evaluated for cholinesterase (ChE) inhibitory, Aß anti-aggregating and neuroprotective activities. Among these, 3d, 3e, 3g, and 3h were established as the most potent and selective BChE inhibitors (IC50 = 0.5-3.9 µM), while 3f presented dual inhibitory activity against BChE and AChE (IC50 = 6.0 and 6.5 µM, respectively). Kinetic analyses revealed that 3g is a partial noncompetitive inhibitor of BChE (Ki = 2.22 µM), while 3f exerts competitive inhibition on AChE (Ki = 0.63 µM). The active compounds were subsequently screened for further assessments. 3f, 3g and 3h reduced Aß1-42 aggregation levels significantly (72.6, 83.4 and 63.4%, respectively). In addition, 3f demonstrated outstanding neuroprotective effects against Aß1-42-induced and H2O2-induced cell toxicity (95.6 and 93.6%, respectively). Molecular docking studies were performed with 3g and 3f to investigate binding interactions inside the active sites of BChE and AChE. Compounds 3g and 3f might have the multifunctional potential for use against Alzheimer's disease.

The trunk control: Which scale is the best in very acute stroke patients?

Background: It is important to evaluate trunk control, given that it is one of the indicators of adequate functional and motor recovery in patients following a stroke. The assessment should be feasible and adequate in clinical conditions in the acute phase. Objectives: The aim of this study was to detect the most appropriate scale used for trunk control assessment in very acute stroke patients in terms of time and ease of implementation. Methods: Sixty-five patients with very acute stroke were included in the study. The patients were assessed with the Trunk Impairment Scale-1 (VTIS), the Trunk Impairment Scale-2 (FTIS), the Motor Assessment Scale trunk subscale (T-MAS) and the Trunk Control Test (TCT), and Functional Impairment Measure (FIM). Floor/ceiling effects, reliability, validity responsiveness of all trunk control scales analyzed. The correlation between all scales and FIM were calculated. Results: All scales had similar reliability, responsiveness and construct validity level. T-MAS and TCT were more advantageous than other scales according to time. TCT and VTIS showed floor effect. The best predictive validity values were observed for the T-MAS and TCT. Conclusions: Four scales investigated in this study can also be used to evaluate the patients with very acute stroke. On the other hand, the advantages and disadvantages of the scales should be thoroughly assessed and researchers can use one of four scales considering their aim, patient populations and clinical characteristics of patients.

Expiratory muscle strength as a predictor of functional exercise capacity in generalized myasthenia gravis.

OBJECTIVE: To investigate the correlations between the 6-minute walk test and disease severity, pulmonary functions, and respiratory muscle performance in patients with generalized myasthenia gravis (MG) and to determine whether MG disease severity, pulmonary functions, and respiratory muscle performance contribute to 6-minute walk test distance in generalized MG. METHODS: This cross-sectional trial was conducted at Hacettepe University in Ankara, Turkey. The study was carried out from February to August 2017. Twenty-eight class II-III MG patients participated in the study. Patients` disease severity was determined with the Myasthenia gravis composite scale. All participants underwent the 6-minute walk test, pulmonary function tests, and respiratory muscle strength and endurance assessment. RESULTS: Approximately 40% of patients` expiratory muscle strength were under the lower limit of normal. Multiple linear regression analysis revealed that the percentage of predicted expiratory muscle strength that patients reached were significant and independent predictor of percentage of 6-minute walk test distance that patients reached according to reference values (R2=0.493, F [1-27]=25.275, p less than 0.001). CONCLUSION: Expiratory muscle strength is a significant determinant of functional exercise performance in generalized MG with mild or moderate weakness affecting muscles other than the ocular muscles.

Functional exercise capacity evaluated by timed walk tests in myasthenia gravis.

INTRODUCTION: We sought to evaluate the test-retest reliability and construct validity of the 6- and 2-minute walk tests (6mWT and 2mWT, respectively) in patients with myasthenia gravis (MG). METHODS: Thirty-one patients with generalized MG were enrolled in this study. The 6mWT, 2mWT, MG-specific quality of life questionnaire Turkish version (MG-QoL15T), quantitative myasthenia gravis test (QMG), and pulmonary function tests were administered. RESULTS: The intraclass correlation coefficients of 2mWT and 6mWT were 0.894 and 0.932, respectively. The 6mWT and 2mWT had moderate correlations with forced vital capacity, maximal inspiratory pressure, QMG score, and MG-QoL15T score (ρ for 6mWT: 0.579, 0.539, -0.572, and -0.474; ρ for 2mWT: 0.460, 0.446, -0.532, -0.457). Both tests had similar performances for predicting disease severity (area under the curve = 0.761 for 6mWT and 0.759 for 2mWT). DISCUSSION: The 6mWT and 2mWT have excellent test-retest reliability as well as moderate construct validity for the evaluation of functional exercise capacity patients with MG. Muscle Nerve 59:208-212, 2019.

Some New Hydrazone Derivatives Bearing the 1,2,4-Triazole Moiety as Potential Antimycobacterial Agents.

OBJECTIVES: The aim of this study was to synthesize, characterize, and screen some new 1-(4-((2-(4-substitutedphenyl)hydrazono)methyl)phenyl)-1H-1,2,4-triazole derivatives for their antimycobacterial activities. MATERIALS AND METHODS: The target compounds (2a-h) were gained by condensation of 4-(1H-1,2,4-triazol-1-yl)benzaldehyde with appropriate phenylhydrazines. Their structures were elucidated by IR, 1H-NMR, and mass spectrometry. The antimycobacterial activities of the compounds were determined in vitro against Mycobacterium tuberculosis H37Rv. RESULTS: The biological assay results showed that the methylsulfonyl-substituted derivative 2f displayed the highest antimycobacterial activity in this series. CONCLUSION: Although the methylsulfonyl-substituted derivative exhibited significant antimycobacterial activity, none of the synthesized compounds was as effective as isoniazid, rifampin, ethambutol, and ciprofloxacin against M. tuberculosis.

Sensorimotor integration training in Parkinson`s disease.

OBJECTIVE: To determine the effects of sensorimotor integration training on postural control in Parkinson`s disease. METHODS: This prospective, randomized controlled trial was conducted at Hacettepe University (Ankara, Turkey). The study was carried out from August 2012 until March 2015 and included 24 Parkinson`s patients with stage 2-3 according to the Modified Hoehn&Yahr Rating Scale. The patients were divided into 2 groups (control and study). The control group received conventional physiotherapy; the study group received sensorimotor integration training combined with conventional physiotherapy, 2 times per week for 6 weeks. We assessed the patients with clinical balance tests and computerized dynamic posturography. Assessments were performed at baseline, 7- and 12-weeks follow-up. RESULTS: Computerized dynamic posturography posturography values (5th and 6th positions, composite balance, and vestibular system scores) were higher in the study group than in the control group. The improvements were maintained at the 12-week follow up except 6th positions scores (p<0.05). CONCLUSION: Sensorimotor integration training combined with conventional physiotherapy approach ameliorated postural control by improving vestibular system in patients with Parkinson`s disease by improving sensory processes.

Investigating the dynamic plantar pressure distribution and loading pattern in subjects with multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is a complex disorder affecting subjects by multiple system impairments. Gait problems are common in subjects with MS and various factors such as; ataxia, hypertonic muscles or/and seconder musculoskeletal system deformities affect the normal plantigrade contact by disturbing accommodation of foot to the ground while walking. The aim of this study was investigating the dynamic plantar pressure distribution and time of maximum pressure in subjects with MS and determining the differences from healthy subjects (HS). METHODS: Fifty-five subjects with MS (110 foot) and 20 HS (40 foot) were the participants of the study. The dynamic pedobarograph was utilized for evaluation of dynamic loading parameters; maximum pressure (N/cm2) and time of maximum pressure (ms) collected from heel medial, heel lateral, midfoot, heads of first, second, third, fourth and fifth metatarsal bones. RESULTS: There were differences between the groups in maximum pressure of heel medial (p < .001) and heel lateral (p < .001) was higher in HS. Also, there were differences between the groups the time of maximum pressure of all metatarsal head areas, midfoot, heel medial and heel lateral (p < .001). Subjects with MS spent lesser time to reach maximum pressure for forefoot loading and longer time for hindfoot loading. CONCLUSION: The study provided basic data about foot pressure distribution and time of maximum pressure in subjects with MS. Results of the study showed that the hindfoot loading was disrupted and inappropriate timing during load transfer from hindfoot to forefoot is exist in subjects with MS.

Novel multi-targeted agents for Alzheimer's disease: Synthesis, biological evaluation, and molecular modeling of novel 2-[4-(4-substitutedpiperazin-1-yl)phenyl]benzimidazoles.

The present study describes the synthesis, pharmacological evaluation (BChE/AChE inhibition, Aß antiaggregation, and neuroprotective effects), and molecular modeling studies of novel 2-[4-(4-substitutedpiperazin-1-yl)phenyl]benzimidazole derivatives. The alkyl-substituted derivatives exhibited selective inhibition on BChE with varying efficiency. Compounds 3b and 3d were found to be the most potent inhibitors of BChE with IC50 values of 5.18 and 5.22µM, respectively. The kinetic studies revealed that 3b is a partial non-competitive BChE inhibitor. Molecular modeling studies also showed that the alkyl-substituted derivatives were able to reach the catalytic anionic site of the BChE. The compounds with an inhibitory effect on BChE were subsequently screened for their Aß antiaggregating and neuroprotective activities. Compounds 3a and 3b exerted a potential neuroprotective effect against H2O2 and Aß-induced cytotoxicity in SH-SY5Y cells. Collectively, 3b was found as the most promising compound for the development of multi-target directed ligands against Alzheimer's disease.

Novel Thiazolidinone-Azole Hybrids: Design, Synthesis and Antimycobacterial Activity Studies.

To develop novel antimycobacterial agents, a new series of thiazolidinone-azole hybrids 4a-b, 5a-b and 6-13 were designed and synthesized. Thiazolidin-4-ones (4a-b and 5a-b) were obtained by the reaction of Schiff bases and hydrazones (2a-b and 3a-b) with mercaptoacetic acid. 5-Benzylidene derivatives (6-13) were gained by treatment of 5a-b with appropriate benzaldehydes according to Knoevenagel condensation. To evaluate their structures 1H NMR, IR, mass spectrometry and elemental analysis data were used. The target compounds were screened for their antimycobacterial activity against M. tuberculosis H37Rv strain using the microplate alamar blue assay method. Among them, 6, 10 and 12 (MIC: 14.27-14.74 µM) were found as most active compounds in the series. It was seen that both phenylamino and benzylidene substitutions on thiazolidin-4-one ring caused an improvement in the antimycobacterial activity.