Whole spinal transverse myelitis in neuromyelitis optica spectrum disorder.

BACKGROUND: Spinal cord is one of the prominent targets of autoimmune mechanisms in Neuromyelitis Optica Spectrum Disorder (NMOSD). Rarely, NMOSD causes damage to the entire length of the spinal cord, from cervical segments to conus medullaris, which has not been characterized in the existing literature. MATERIAL AND METHOD: We reviewed medical records, demographic information, and magnetic resonance imaging (MRI) sequences of 174 NMOSD patients from January 2011 to January 2023 who were admitted to Isfahan Multiple Sclerosis center to find patients with whole spinal transverse myelitis (TM). RESULTS: Whole spinal TM was present in five patients (2.9 %). Three patients were seropositive for Aquaporin-4 (AQP4) antibody; Myelin Oligodendrocyte Glycoprotein antibody (MOG IgG) tested negative for all of them. Lower limb weakness was the most frequent clinical complaint. Two patients presented with optic neuritis; One patient reported having episodes of nausea and vomiting. These patients, overall, yielded a higher expanded disability status scale (EDSS) score than the other NMOSD patients. CONCLUSION: Whole spinal TM is a rare finding in NMOSD, which is strongly associated with a higher severity and a worse outcome of the disease. The role of anti-AQP4 antibodies in the extent of myelitis in NMOSD has yet to be investigated.

Evaluation of Adding Dexmedetomidine to Ropivacaine in Pediatric Caudal Epidural Block: A Randomized, Double-blinded Clinical Trial.

BACKGROUND: Caudal block is one of the methods of pain management performed following lower abdominal surgery, though having its own limitations. OBJECTIVES: In the present study, the effects and side effects of adding dexmedetomidine to ropivacaine in the caudal epidural block were investigated in children after lower abdominal surgery. METHODS: In this randomized, double-blinded clinical trial, 46 children aged three to six years were divided into two groups to perform a caudal block following lower abdominal surgery under general anesthesia. The injectable solution contained ropivacaine in the R group (1 mL/kg ropivacaine 0.2%), as the control group, and dexmedetomidine (2 µg/kg) and ropivacaine 0.2% (1 mL/kg) in the DR group. The pain score (modified CHEOPS score), duration of analgesia, amount of analgesia consumed (i.v. paracetamol), hemodynamic changes, and possible adverse effects were assessed at one, two, and six hours in both groups. RESULTS: The pain score at one and two hours showed no significant difference between the two study groups (P > 0.05). In the DR group, however, the pain score at the sixth hour was significantly lower, and the duration of analgesia was longer (P = 0.001). The amount of analgesic consumption was also lower in the DR group (P = 0.001). However, there was no significant difference in systolic blood pressure and heart rate (P < 0.05), in the case of diastolic blood pressure, a significant difference (P < 0.05) was seen (DR group lower than the R group). There was no statistically significant difference between the study groups in the duration of surgery, recovery time, and side effects (P < 0.05). CONCLUSIONS: In the present study, the addition of dexmedetomidine to ropivacaine in the caudal epidural blockade improved postoperative analgesia without significant adverse effects in pediatric patients.

Factors affecting hookah tobacco smoking among females in the Islamic Republic of Iran: a qualitative study.

BACKGROUND: The prevalence of hookah smoking in the Islamic Republic of Iran is increasing among females, especially in the southern cities. AIMS: The aim of this study was to investigate the factors influencing hookah tobacco smoking among females in the Islamic Republic of Iran. METHODS: In this qualitative study, 52 females who use hookah were selected (25-71 years old) from the cities of Evaz and Gerash and were interviewed. The participants were selected using purposive sampling and the data were gathered using semi-structured interviews. Data analysis was performed using the conventional approach of qualitative content analysis. RESULTS: Most participants were aged between 25 and 35 years old and 55.8% were married. Three main themes were identified from the qualitative data including: personal factors, family factors and social factors. CONCLUSIONS: The findings of this study indicate that the reasons for hookah smoking were based on complex interactions between individual, family, and social factors. In order to successfully reduce hookah smoking in females it is necessary to consider an approach that uses these social factors.

A Comparative Study of Perceived Social Support and Depression among Elderly Members of Senior Day Centers, Elderly Residents in Nursing Homes, and Elderly Living at Home.

BACKGROUND: Social support perceived by the elderly can reduce mental health problems including depression. In Iranian society, some elderly people spend their elderly years in senior day care centers established to promote social protection for the elderly. Therefore, the purpose of this study was to assess perceived social support and depression in the elderly members of senior day care centers and compare the results with that of elderly individuals living at nursing homes and at home. MATERIALS AND METHODS: This descriptive, cross-sectional study was conducted on 315 elderly people. The participants were selected using stratified random sampling method and a random number table. The data collection tools used consisted of a demographic characteristics questionnaire, the Barthel index for assessing Activities of Daily Living (ADL), Social Support Appraisals (SSS-As) scale, and Geriatric Depression Scale short form (GDS-15). ANOVA, Chi-square, the Pearson correlation coefficient, and linear regression analysis were used to examine the hypotheses. RESULTS: The results showed that with increasing social support, depression decreased in all three groups, which was statistically significant in the two elderly groups living in nursing homes (r = -0.19, p = 0.044) and elderly members of senior day centers (r = -0.18, p = 0.049). CONCLUSIONS: According to the results, it can be concluded that senior day care centers have been able to promote perceived social support in the elderly through their participation in daily activities and social activities, and thus were able to reduce depression significantly compared to the other two groups.

Temozolomide Conjugated Carbon Quantum Dots Embedded in Core/Shell Nanofibers Prepared by Coaxial Electrospinning as an Implantable Delivery System for Cell Imaging and Sustained Drug Release.

The local delivery of chemotherapy drugs using implantable drug delivery systems is a promising strategy to the treatment of malignant brain tumors. In this study, core/shell chitosan-poly ethylene oxide-carbon quantum dots/carboxymethyl cellulose-polyvinyl alcohol (CS-PEO-CQDs/CMC-PVA) nanofibers were successfully prepared through coaxial electrospinning as a biodegradable polymeric implant for the local delivery of temozolomide (TMZ). Fluorescent carbon dots with carboxyl-rich surface were used as a trackable drug delivery agent for the localized cancer treatment. The effects of several preparation parameters such as voltage, shell to core flow rate, CS/PEO ratio, and PVA/CMC ratio on the structure of nanofibers were investigated. The best nanofibers were obtained in the condition of CS/PEO ratio of 80:20, CMC/PVA ratio of 20:80, shell to core flow rate of 3, and voltage of 25 V. SEM images showed that such nanofibers possess a smooth surface and bead-less structures. The results obtained by DSC indicated that TMZ trapped in the nanofibers existed in an amorphous or disordered crystalline status. In vitro release profile of TMZ from core-shell nanofibers had biphasic patterns. After an initial burst, a continuous drug release was observed for up to 28 days. The in vitro antitumor activity of CQDs-TMZ was tested against the tumor U251 cell lines than the free drug. It has been found that the cytotoxicity of TMZ to U251 cancer cells is enhanced when TMZ is conjugated with CQDs.

A comparative study of an up-flow aerobic/anoxic sludge fixed film bioreactor and sequencing batch reactor with intermittent aeration in simultaneous nutrients (N, P) removal from synthetic wastewater.

The performance of two bench scale activated sludge reactors with two feeding regimes, continuous fed (an up-flow aerobic/anoxic sludge fixed film (UAASFF) bioreactor) and batch fed (sequencing batch reactor (SBR)) with intermittent aeration, were evaluated for simultaneous nutrients (N, P) removal. Three significant variables (retention/reaction time, chemical oxygen demand (COD): N (nitrogen): P (phosphorus) ratio and aeration time) were selected for modeling, analyzing, and optimizing the process. At high retention time (≥6 h), two bioreactors showed comparable removal efficiencies, but at lower hydraulic retention time, the UAASFF bioreactor showed a better performance with higher nutrient removal efficiency than the SBR. The experimental results indicated that the total Kjeldahl nitrogen removal efficiency in the UAASFF increased from 70.84% to 79.2% when compared to SBR. It was also found that the COD removal efficiencies of both processes were over 87%, and total nitrogen and total phosphorus removal efficiencies were 79.2% and 72.98% in UAASFF, and 71.2% and 68.9% in SBR, respectively.

Coping strategies in people attempting suicide.

BACKGROUND: Having a set of effective coping skills can prevent suicidal behavior by increasing self-control and self-direction. This study examines coping styles used by suicidal patients. OBJECTIVES: The researchers in this study try to identify coping strategies used by suicide attempters admitted to Shiraz Shahid Faghihi Hospital emergency room. MATERIALS AND METHODS: This is a analytical cross-sectional study. Participants consisted of 50 suicide-attempted people admitted to Shiraz Faghihi Hospital. Instruments for data collections were a demographic checklist and the coping styles scale of Carver, Schier and Wintrope. Data were collected conveniently and analyzed using descriptive and analytic (Pearson Correlation, Student's t-tests, and ANOVA) statistical methods. RESULTS: Suicide attempted people used less useful coping strategies (Mean = 49.32) more than the other strategies (respectively mean of problem focused and emotion focused strategies were 30.27 and 27.83). Using ANOVA, in different educational level, problem focused and less effective coping skills of samples differed significantly (P = 0.009, P = 0.006, respectively). People with low educational level used less effective coping skills. There was a significant difference between men and women scores in use of less effective coping skills (P = 0.029). CONCLUSIONS: Teaching effective coping skills by psychological consultants in suicide attempted people, especially for women and people with low educational level, is important.