Giant cell tumor of distal radius: En bloc resection with allograft reconstruction: A case report.

Key Clinical Message: Giant cell tumor of bone (GCT) is a rare neoplasm which often presents as a lytic lesion in the epiphyseal region of long bones and which are usually accompanied by pain, swelling, and restricted movement. Abstract: Giant cell tumor of bone (GCT) is a rare neoplasm that affects individuals in their third and fourth decades of life. Clinically, it often presents as a lytic lesion in the epiphyseal region of bones, notably the distal femur and proximal tibia. Radiologically, GCT appears as a distinct lytic lesion in the epiphyseal region. Histopathologically, GCTs are composed of mononuclear cells, macrophages, and multinuclear giant cells, indicative of osteoclastogenic stromal tumors. A 37-year-old man presented with left wrist pain, swelling, and restricted movement persisting for a year, worsening over the last 7 months. Radiographic assessments revealed a distal radius bone mass involving the radiocarpal joint. Biopsy confirmed a GCT with extension into peripheral muscle. PET/CT scan showed localized pathology without metastasis. Histopathologically, GCT exhibited multinucleated giant cells, spindle cells, and aneurysmal bone cyst-like regions with coagulation necrosis. Surgical resection involved en-bloc removal and reconstruction with a non-vascularized radius bone graft. Postoperatively, the patient showed no complications at the one-year follow-up, suggesting successful intervention.

Rare oto-tricho-tussia/tinnitus: A case report.

Key clinical message: Oto-tricho is associated with the symptoms of gag reflex and non-neuropathic tinnitus, which can be treated by removing the hair and its follicle. Abstract: Oto-tricho refers to a disorder of hair growth in the tympanic membrane (TM). In its early stages, it can manifest as symptoms such as tinnitus, chronic pain, cough, and nausea. If left untreated, it can potentially lead to tympanosclerosis, TM micro-perforation, and hearing loss. In this report, we present a case study of a 33-year-old male with hair and follicle growth observed on the left TM. Over the course of the past year, the patient experienced various symptoms including tinnitus, dry cough, and chronic pain. An examination with an otoscope revealed the presence of oto-tricho-tussia/tinnitus. To address the issue, the hair and hair follicles were surgically removed using direct visual guidance. Subsequent follow-up was conducted over a period of 5 months, during which no pain or infection was observed at the site of the TM. The patient's previous symptoms were successfully resolved. Furthermore, further observation of the TM revealed no evidence of hair follicles or hair regrowth.

Modified nail folding approach: A novel strategy for the treatment of subungual glomus tumors-A case series study.

Key Clinical Message: The modified nail folding approach, a new surgical technique, has been shown to be safe and effective for the treatment of subungual glomus tumors, providing clinicians with a new treatment option for patients with this condition. Abstract: Glomus tumors (GTs) are rare benign tumors that originate from the glomus body in the skin of the fingertips, toes, and nail beds. GTs are more prevalent in women than in men and can occur sporadically or as part of an inherited condition known as multiple GTs. The exact cause of GTs is unknown, but it is believed that mutations in the cells of the glomus body contribute to their development. In this study, we present the efficacy of a novel surgical technique called the modified nail folding approach for treating subungual GTs. We report a case series involving 17 patients who underwent the nail folding approach for surgical removal of subungual GTs. The primary objective of this article is to provide evidence supporting the safety and effectiveness of this technique. Additionally, we aim to introduce clinicians to a new, secure, and efficient treatment option for patients with subungual GTs.

Rare retro-patellar multiple osteochondromas in patellar tendon: A case report.

Osteochondromas (OCs) are developmental anomalies that originate from the periosteum and typically form during enchondral ossification near the joints. Retro-patellar OC caused by exostosis forms in various intracapsular, intra-tendon, and joint-adjacent positions within the knee joint. In this case, a 19-year-old male presented with swelling and a mass in his left knee, which raised suspicion of bone tumors. After evaluating x-ray images and conducting histopathological examinations, the diagnosis was confirmed as retro-patellar OC.

Rare forearm intramuscular myxoma: A case report.

Key Clinical Message: Intramuscular myxoma (IMM) is a benign soft tissue tumor of mesenchymal origin that occurs mainly in skeletal muscles which can be removed through surgery after diagnosis. Abstract: Intramuscular myxoma (IMM) is a benign soft tissue tumor of mesenchymal origin that typically occurs in skeletal muscles. Its diagnosis is based on magnetic resonance imaging (MRI) and histopathologic evaluation of the lesion. In our report, we describe the case of a 60-year-old female with an IMM in the supinator muscle of the right forearm, which was confirmed by MRI and histopathologic examination. Following surgery to remove the mass, a follow-up confirmed the patient's recovery and the absence of movement limitations in the elbow joint.

Female infertility and herbal medicine: An overview of the new findings.

Infertility is defined as the failure to achieve a successful pregnancy after 12 months' sexual activity that affects 15%-17% of couples in the world and about 50% of them are related to female infertility factors. In this study, using the PRISMA checklist and MeSH keywords, 128 articles were extracted from various databases (PubMed, Cochrane library, WHO, Iranmedex, Science Direct, SID, and Google Scholar search engine) without language and time restrictions, and 128 articles were selected after eliminating duplicate studies. In this review, we present some solid evidence for role of herbal medicine in the treatment of female infertility. The results of this study showed that different parts of some plants are rich in polyphenolic compounds (isoflavones and flavonoids) and other compounds which are beneficial to in reproductive health in women. The compounds in these plants, along with regulating the female endocrine pathways, and improving symptoms of menopause, treat female reproductive disorders such as polycystic ovary syndrome (PCOS), premature ovarian failure (POF), endometriosis, hyperprolactinemia, and hypothalamic dysfunction; moreover, because of their anticancer, antioxidant, and antidepressant properties, they can be used in traditional medicine or in the pharmaceutical industry as safe compounds in women's health.

The ameliorative effects of Lactobacillus coagulans and Lactobacillus casei probiotics on CCl4-induced testicular toxicity based on biochemical, histological and molecular analyses in rat.

Probiotics are commonly present in foods and role as dietary adjuncts and alternatives to pharmacological products in many medical fields. The aim of this study was to investigate the effects of Lactobacillus coagulans and Lactobacillus casei probiotics on carbon tetrachloride (CCl4 )-induced reproductive injury and sperm toxicity in rats. Thirty-two Wistar rats were divided into four groups as follows: sham, CCl4 (2 ml/kg), L. casei probiotic + 2 ml/kg CCl4 and L. coagulans probiotic + 2 ml/kg CCl4 . On the 36th day after the intervention, serum levels of follicle-stimulating hormone (FSH), luteinising hormone (LH) and total testosterone (T), as well as catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities, were measured. Testicular malondialdehyde (MDA) level, the expressions of apoptosis-related genes (Bcl-2 and Bax), Bax/Bcl-2 ratio, histomorphometric indices such as tubular differentiation index (TDI), repopulation index (RI), spermiogenesis index (SPI) and sperm parameters were evaluated. L. casei and L. coagulans probiotics improved the levels of reproductive hormones and antioxidant capacity in rats. Both the probiotics, especially L. casei, increased the rate spermatogenesis which accompanied with significant increments in testicular TDI, RI and SPI. Furthermore, both probiotics down-regulated Bax and up-regulated Bcl-2, following by decreased Bax/Bcl-2 ratio. Our key findings indicated that L. casei and L. coagulans have protective effects against CCl4 -induced testicular toxicity.

Anti-inflammatory, anti-oxidative and anti-apoptotic effects of Heracleum persicum L. extract on rats with gentamicin-induced nephrotoxicity

Objective:To evaluate the effect of Heracleum persicum L. against gentamicin-induced nephrotoxicity in rats. Methods:Thirty-six Wistar rats were divided into 6 groups including control (normal saline), gentamicin (80 mg/kg/d for 10 d), Heracleum persicum (750 mg/kg/d), and gentamicin (10 d) + Heracleum persicum extract at three different doses (250, 500, and 750 mg/kg/d for 40 d). Urine creatinine, urea, protein, and albumin levels were determined. In addition, serum urea, creatinine, sodium, potassium, cytokines (TNF-α, IL-1β, IL-6, and IL-10), glutathione peroxidase activity, total antioxidant capacity, kidney malondialdehyde, stereological parameters, and expressions of apoptosis-related genes (p53, Bax, Bcl-2, and caspase-3) were measured. The LD50 of Heracleum persicum extract was determined based on Lorke's method. Histopathological evaluation was also performed. Results:In addition to decreased urine protein and albumin, and increased creatinine and urea, co-treatment with gentamicin and Heracleum persicum significantly reduced levels of creatinine and urea, and increased sodium and potassium in serum. Heracleum persicum treatment also improved stereological parameters and serum inflammatory cytokines. There was a significant increase in serum glutathione peroxidase activity and total antioxidant capacity as well as a reduction in malondialdehyde level. Furthermore, treatment with Heracleum persicum extracts downregulated p53, caspase-3, and Bax and upregulated Bcl-2 expressions. In histopathological evaluation, Heracleum persicum extracts showed protection against gentamicin-induced renal damages. Conclusions:Heracleum persicum exhibits protective effects against gentamicin-induced structural and functional renal impairments.

Doxorubicin and Trifolium pratense L. (Red clover) extract synergistically inhibits brain and lung metastases in 4T1 tumor-bearing BALB/c mice.

Trifolium pratense L. (Red clover-T. pratense) commonly consumed as a healthy beverage has been demonstrated to have various biological activities including antioxidant and anticancer effects. The aim of this study was to investigate the antimetastasis effects of doxorubicin (DOX) and T. pratense extract in 4T1 tumor-bearing BALB/c mice. In this study, 56 female BALB/c mice were randomly divided into seven groups (n = 8/group) to receive DOX and T. pratense extract in three different doses (100, 200, and 400 mg/kg/day) for 35 days. On day 36 after starting treatments, serum cytokines (IL-8 and IL-6) were measured. Immunohistochemical (IHC) staining was performed for GATA-3 in the brain and lung, and for CK5/6 in tumor tissues. Metastasis-related gene (matrix metalloproteinase-2 [MMP-2] and sirtuin-1 [SIRT-1]) expressions were also measured by real-time PCR. Our results showed that cotreatment with DOX and T. pratense extract improved stereological parameters (i.e., reduction in the volume of metastatic tumors) in the lung and brain and decreased the serum levels of inflammatory cytokines (IL-8 and IL-6). DOX and T. pratense extract synergistically down-regulated MMP-2 and up-regulated SIRT-1 genes, decreased the number of CK5/6-positive cells in tumor tissues, and inhibited metastasis of GATA-3-positive cells into the lung and brain. The combination of T. pratense extract and DOX synergistically inhibited the metastasis of 4T1 xenograft cells in a dose-dependent manner.

Trifolium pratense L. (red clover) extract and doxorubicin synergistically inhibits proliferation of 4T1 breast cancer in tumor-bearing BALB/c mice through modulation of apoptosis and increase antioxidant and anti-inflammatory related pathways.

Therapeutic strategies against triple-negative breast cancer (TNBC) are associated with drug-induced toxicities. The tropical edible red clover (Trifolium pratense L.) is rich in polyphenolic compounds which confer the plant potential anticancer properties. The aim of this study was to investigate the effects of T. pratense and doxorubicin (DOX) on the apoptosis and proliferation of 4T1 tumor cells in an allograft model of tumor-bearing BALB/c mice. Fifty-six female 4T1-tumor bearing- BALB/c mice were randomly divided into 7 groups (n = 8/group) to receive different doses and combinations of DOX and T. pratense extract for 35 days. On the 36th day, serum estradiol (E2), IL-12 and IFN-γ cytokines, and glutathione peroxidase (GPx) activity were measured. Tumor's ferric reducing antioxidant power (FRAP) and the expressions of apoptosis-related genes (p53, Bax, Bcl-2, and caspase-3) were also evaluated. Immunohistochemical staining for Ki-67 and p53 were performed. Our results showed that the co-treatment of DOX and T. pratense (100-400 mg/kg) inhibited the proliferation of 4T1 tumor cells in dose- and time-dependent manners. The co-treatment of DOX and T. pratense (especially at the dose of 400 mg/kg) decreased the serum level of E2 (as a stimulant for breast tumor growth) and increased the serum levels of IL-12 and IFN-γ along with significant increments in serum GPx and tumor FRAP activities. The co-administration of DOX and T. pratense also decreased the expression of Ki-67 proliferation marker and increased the number p53 positive (i.e., apoptotic) cells within tumors. This was accompanied with the upregulation of pro-apoptotic and down-regulation of antiapoptotic genes. The key findings indicated the synergistic effects of DOX and T. pratense against TNBC xenografts.

Chitosan-based nano-scaffolds as antileishmanial wound dressing in BALB/c mice treatment: Characterization and design of tissue regeneration.

OBJECTIVES: Rapid healing of cutaneous leishmaniasis as one of the most important parasitic diseases leads to the decrease of scars and prevention of a great threat to the looks of the affected people. Today, the use of nano-scaffolds is rapidly increasing in tissue engineering and regenerative medicine with structures similar to the target tissue. Chitosan (CS) is a bioactive polymer with antimicrobial and accelerating features of healing wounds, which is commonly used in biomedicine. This study aimed to investigate the effects of CS/polyethylene oxide (PEO)/berberine (BBR) nanofibers on the experimental ulcers of Leishmania major in BALB/c mice. MATERIALS AND METHODS: CS/PEO/BBR nanofibers were prepared by the electrospinning method, and their morphology was examined by SEM, TEM, and AFM. Then, water absorption, stability, biocompatibility, porosity, and drug release from nano-scaffolds were explored. Afterward, 28 BALB/c mice infected with the parasite were randomly divided into control and experimental groups, and their wounds were dressed with the produced nano-scaffolds. Finally, the effect of nanobandage on the animals was investigated by macroscopic, histopathologic, and in vivo imaging examinations. RESULTS: The prepared nanofibers were completely uniform, cylindrical, bead-free, and biocompatible with an average diameter of 94±12 nm and had appropriate drug release. In addition, the reduced skin ulcer diameter (P=0.000), parasite burden (P=0.003), changes in the epidermis (P=0.023), and dermis (P=0.032) indicated significantly strong effectiveness of the produced nano-scaffolds against leishmania ulcers. CONCLUSION: Studies showed that CS/PEO/BBR nanofibers have a positive effect on the rapid healing of leishmania ulcers. Future studies should focus on other chronic ulcers treatment.

Vesical schistosomiasis and squamous cell carcinoma associated with schistosoma haematobium: A re-emerging neglected tropical disease in Tehran, Iran.

Hematobium species of this parasite tends to bladder and mesenteric arteries and it causes lesions in the bladder wall, urethra, and renal tubes. A 25-year-old man living in Tehran (a non-endemic and very rare area for schistosoma) suffers from symptoms such as hematuria with suprapubic pain, dysuria, fever, nausea and vomiting. Urine analysis showed a lot of red blood cells, after using cystoscopy of the area and receiving a bladder biopsy, a definitive diagnosis of schistosomiasis was made and after determining the extent of damage to the urinary tract, appropriate treatment with surgery and praziquantel (40 mg/kg) were prescribed.

Phytochemicals and antioxidant activity of alcoholic/hydroalcoholic extract of Trifolium pratense.

Objective: Trifolium pratense has many healing properties, including fewer complications of menopause, cancer cell suppression, reducing blood glucose and lipids, as well as cardiovascular beneficial effects. The purpose of this study was to identify the phytochemical and mineral composition of T. pratense. Methods: Plant aerial parts were harvested and dried, and then hydroalcoholic and alcoholic extracts were prepared. Gas chromatography-mass spectrometry (GC-MS) analytical method was used to identify volatile compounds then liquid chromatography-electrospray ionization mass spectrometry (LC-ESI-MS) was used to identify polyphenols and the mineral elements were identify by inductively coupled plasma atomic emission spectrometer/ICP-AES and scanning electron microscope-energy-dispersive X-ray spectroscopy (SEM-EDS) methods. Total phenolic content (TPC) was determined based on colorimetric method, and total flavonoid content (TFC) was established based on the folin-chiocalteau reagent. Furthermore, two assays (DPPH and FRAP) were used to measure the antioxidant capacity of T. pratense ethanolic extract. Results: A total of 37 polyphenols and 107 peaks were identified by LC-ESI-MS analysis, and the GC/MS method also detected 21 volatile compounds, the most important of which were methylcyclopentane, dimethylpentanal and hexadecanol. A total of 18 mineral elements, including K, Mg, Al, Si, Zn, Ni, Cu, Se, Co, Fe, Mn, and Ca in the plant, were identified ICP-AES and SEM-EDS analysis. Conclusion: T. pratense has many therapeutic compounds such as polyphenol (isoflavone and flavonoids), volatile compounds, and essential mineral elements, which can be formulated purely and used in the pharmaceutical and traditional medicine industries.

Novel synthesis of Falcaria vulgaris leaf extract conjugated copper nanoparticles with potent cytotoxicity, antioxidant, antifungal, antibacterial, and cutaneous wound healing activities under in vitro and in vivo condition.

Facile green synthesis of copper nanoparticles from different biological procedures has been indicated, but among all, biosynthesis of copper nanoparticles from medicinal plants is considered as the most suitable method. The use of medicinal plant material increases the therapeutical effects of copper nanoparticles. The aim of this study was green synthesis of copper nanoparticles from aqueous extract of Falcaria vulgaris leaf (CuNPs) and assessment of their cytotoxicity, antioxidant, antifungal, antibacterial, and cutaneous wound healing properties. These nanoparticles were characterized by X-ray diffraction (XRD), fourier-transform infrared spectroscopy (FT-IR), ultraviolet-visible spectroscopy (UV), transmission electron microscopy (TEM), and field emission scanning electron microscopy (FE-SEM) analysis. The synthesized CuNPs had great cell viability dose-dependently (Investigating the effect of the CuNPs on human umbilical vein endothelial cell (HUVEC) line) and indicated this method was nontoxic. Also, 2,2-diphenyl-1-picrylhydrazyl (DPPH) test was done to assess the antioxidant activities, which indicated similar antioxidant potentials for CuNPs and butylated hydroxytoluene. In part of cutaneous wound healing property of CuNPs, after creating the cutaneous wound, the rats were randomly divided into six groups: treatment with 0.2% CuNPs ointment, treatment with 0.2% CuSO4 ointment, treatment with 0.2% F. vulgaris ointment, treatment with 3% tetracycline ointment, treatment with Eucerin basal ointment, and untreated control. These groups were treated for 10 days. Treatment with CuNPs ointment remarkably increased (p ≤ .01) the wound contracture, vessel, hexosamine, hydroxyl proline, hexuronic acid, fibrocyte, and fibrocytes/fibroblast rate and substantially reduced (p ≤ .01) the wound area, total cells, neutrophil, and lymphocyte compared to other groups. In antibacterial and antifungal parts of this research, the concentration of CuNPs with minimum dilution and no turbidity was considered minimum inhibitory concentration (MIC). To determine minimum fungicidal concentration (MFC) and minimum bactericidal concentration (MBC), 60 µL MIC and three preceding chambers were cultured on Sabouraud Dextrose Agar and Muller Hinton Agar, respectively. The minimum concentration with no fungal and bacterial growth were considered MFC and MBC, respectively. CuNPs inhibited the growth of all fungi at 2-4 mg/mL concentrations and removed them at 4-8 mg/mL concentrations (p ≤ .01). In case of antibacterial effects of CuNPs, they inhibited the growth of all bacteria at 2-8 mg/mL concentrations and removed them at 4-16 mg/mL concentrations (p ≤ .01). The results of XRD, FT-IR, UV, TEM, and FE-SEM confirm that the aqueous extract of F. vulgaris leaf can be used to yield copper nanoparticles with notable amount of antioxidant, antifungal, antibacterial, and cutaneous wound healing potentials without any cytotoxicity. Further clinical trials are necessary for confirmation these therapeutical effects of CuNPs in human.