Anatomical considerations for percutaneous trans ilio-sacroiliac S1 and S2 screw placement.

OBJECTIVE: To determine the presence of a consistent osseous corridor through S1 and S2 and fluoroscopic landmarks thereof, which could be used for safe trans ilio-sacroiliac screw fixation of posterior pelvic ring disorders. STUDY DESIGN: Computed tomography (CT) based anatomical investigation utilising multiplanar image and trajectory reconstruction (Agfa-IMPAX Version 5.2 software). Determination of the presence and dimension of a continuous osseous corridor in the coronal plane of the sacrum at the S1 and S2 vertebral levels. OUTCOME MEASURES: Determination of: (a) the presence of an osseous corridor in the coronal plane through S1 and S2 in males and females; (b) the dimension of the corridor with regard to diameter and length; (c) the fluoroscopic landmarks of the corridor. RESULTS: The mean cross-sectional area for S1 corridors in males and females was 2.13 and 1.47 cm(2) , respectively. The mean cross-sectional area for the S2 corridor in males and females was 1.46 and 1.13 cm(2), respectively. The limiting anatomical factor is the sagittal diameter of the sacral ala at the junction to the vertebral body. The centre of the S1 and S2 corridor is located in close proximity to the centre of the S1 and S2 vertebrae on the lateral fluoroscopic view as determined by the adjacent endplates and anterior and posterior vertebral cortices. CONCLUSION: Two-thirds of males and females have a complete osseous corridor to pass a trans-sacroiliac S1 screw of 8 mm diameter. The S2 corridor was present in all males but only in 87 % of females. Preoperative review of the axial CT slices at the midpoint of the S1 or S2 vertebral body allows the presence of a trans-sacroiliac osseous corridor to be determined by assessing the passage at the narrowest point of the corridor at the junction of the sacral ala to the vertebral body.

Newcastle Disease Virus Virotherapy: Unveiling Oncolytic Efficacy and Immunomodulation.

In virotherapy, cancer cells are eradicated via viral infection, replication, and dissemination (oncolysis). BACKGROUND: This study aims to evaluate the oncolytic potential of Newcastle disease virus (NDV) against colon cancer and explore the immune response associated with its therapeutic effects. METHODS: NDV was tested for its oncolytic potential in colon cancer cell lines using MTT assays and apoptosis assessments. Tumor-induced mice were treated with NDV, tumor cell lysate (TCL), or a combination of both. After the euthanasia of murine subjects, an assessment of oncolytic efficacy was performed through flow cytometry analysis of murine blood and tumor tissue, targeting CD83, CD86, CD8, and CD4. An ELISA was also performed to examine interferon-gamma levels, interleukin-4 levels, interleukin-12 levels, and interleukin-10 levels in serum and spleen homogenate. RESULTS: Cell viability was low in HCT116 and HT-29, indicating a cytotoxic effect in the MTT assay. NDV+TCL recorded the highest rate of cell death (56.72%). NDV+TCL had accelerated cell death after 48 h, reaching 58.4%. The flow cytometry analysis of the blood and tumor of mice with induced tumor treated with combined treatment revealed elevated levels of CD83, CD86, CD8, and CD4 (76.3, 66.9, 83.7, and 14.4%, respectively). The ELISA levels of IFN-γ, IL-4, and IL-12 in serum and the spleen homogenate were elevated (107.6 ± 9.25 pg/mL). In contrast, the expression of IL-10 was significantly reduced (1 ± 0.79).

Herpesvirus Entry Mediator as an Immune Checkpoint Target and a Potential Prognostic Biomarker in Myeloid and Lymphoid Leukemia.

Herpesvirus entry mediator (HVEM) is a molecular switch that can modulate immune responses against cancer. The significance of HVEM as an immune checkpoint target and a potential prognostic biomarker in malignancies is still controversial. This study aims to determine whether HVEM is an immune checkpoint target with inhibitory effects on anti-tumor CD4+ T cell responses in vitro and whether HVEM gene expression is dysregulated in patients with acute lymphocytic leukemia (ALL). HVEM gene expression in tumor cell lines and peripheral blood mononuclear cells (PBMCs) from ALL patients and healthy controls was measured using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Tumor cells were left untreated (control) or were treated with an HVEM blocker before co-culturing with CD4+ T cells in vitro in a carboxyfluorescein succinimidyl ester (CFSE)-dependent proliferation assay. HVEM expression was upregulated in the chronic myelogenous leukemia cell line (K562) (FC = 376.3, p = 0.086) compared with normal embryonic kidney cells (Hek293). CD4+ T cell proliferation was significantly increased in the HVEM blocker-treated K562 cells (p = 0.0033). Significant HVEM differences were detected in ALL PBMCs compared with the controls, and these were associated with newly diagnosed ALL (p = 0.0011) and relapsed/refractory (p = 0.0051) B cell ALL (p = 0.0039) patients. A significant differentiation between malignant ALL and the controls was observed in a receiver operating characteristic (ROC) curve analysis with AUC = 0.78 ± 0.092 (p = 0.014). These results indicate that HVEM is an inhibitory molecule that may serve as a target for immunotherapy and a potential ALL biomarker.

Effect of epigallocatechin-3-gallate on inflammatory mediators release in LPS-induced Parkinson's disease in rats.

Degeneration of dopamine (DA)-containing neurons in the substantia nigra of the midbrain causes Parkinson's disease (PD). Although neuroinflammatory response of the brain has long been speculated to play a role in the pathogenesis of this neurological disorder, the mechanism is still poorly understood. The aim of the present study was to examine the effect of epigallocatechin-3-gallate (EGCG) in prevention of inflammatory mediators release and protection of dopaminergic neurons from lipopolysaccharide (LPS)-induced neurotoxicity. A single intraperitoneal injection of LPS (15 mg/kg) in male Sprague Dawley rats resulted in an increase of midbrain content of TNF-alpha, NO and a decrease of DA level at 4, 24 h, 3 and 7 days compared to the control. In addition, LPS reduced the number and the density of tyrosine hydroxylase-immunoreactive (TH-ir) neurons in the midbrain at 7 days. Pretreatment with EGCG (10 mg/kg) 24 h before LPS for 7 days decreased TNF-alpha and NO compared to LPS-treated rats. Moreover, it increased DA level and preserved the number and the density of TH-ir neurons compared to LPS group. In conclusion, EGCG was found to have a potential therapeutic effect against LPS-induced neurotoxicity via reducing TNF-alpha and NO inflammatory mediators and preserving DA level in midbrain.

Saussurea costus extract as bio mediator in synthesis iron oxide nanoparticles (IONPs) and their antimicrobial ability.

Saussurea costus is from medicinal plants and have therapeutic properties that were recorded in a variety of medical functions. The usage of biomaterials in the synthesis of nanoparticles is an essential strategy in green nanotechnology. Iron oxide nanoparticles (IONPs) were composed in the stage of (2:1, FeCl2: FeCl3) solution by using the aqueous extract of Saussurea costus peel in an eco-friendly method to evaluate their antimicrobial property. The properties of the obtained IONPs were evaluated using a scanning (SEM) and transmission (TEM) electron microscope. The mean size of IONPs discovered by Zetasizer varies between 100 and 300 nm, with a mean particle size of 295 nm. The morphology of IONPs (γ-Fe2O3) was determined to be nearly spherical and prismatic-curved. Moreover, the antimicrobial property of IONPs was assessed with nine pathogenic microbes, revealing that the nanoparticles have antimicrobial activities with Pseudomonas aeruginosa, Escherichia coli, Shigella sp., Staphylococcus sp. and Aspergillus niger, with possible applications in the therapeutic and biomedical fields.

Surgical management of U-shaped sacral fractures: a systematic review of current treatment strategies.

PURPOSE: U-shaped sacral fractures usually result from axial loading of the spine with simultaneous sacral pivoting due to a horizontal fracture which leads to a highly unstable spino-pelvic dissociation. Due to the rarity of these fractures, there is lack of an agreed treatment strategy. METHODS: A thorough literature search was carried out to identify current treatment concepts. The studies were analysed for mechanism of injury, diagnostic imaging, associated injuries, type of surgery, follow-up times, complications, neurological, clinical and radiological outcome. RESULTS: Sixty-three cases were found in 12 articles. No Class I, II or III evidence was found in the literature. The most common mechanism of injury was a fall or jump from height. Pre-operative neurological deficit was noted in 50 (94.3%) out of 53 cases (not available in 10 patients). The most used surgical options were spino-pelvic fixation with or without decompression and ilio-sacral screws. Post-operative complications occurred in 24 (38.1%) patients. Average follow-up time was 18.6 months (range 2-34 months). Full neurological recovery was noted in 20 cases, partial recovery in 14 and 9 patients had no neurological recovery (5 patients were lost in follow-up). Fracture healing was mentioned in 7 articles with only 1 case of fracture reduction loss. CONCLUSION: From the current available data, an evidence based treatment strategy regarding outcome, neurological recovery or fracture healing could not be identified. Limited access and minimal-invasive surgery focussing on sacral reduction and restoration seems to offer comparable results to large spino-pelvic constructs with fewer complications and should be considered as the method of choice. If the fracture is highly unstable and displaced, spino-pelvic fixation might offer better stability.

Corrigendum to "Antioxidant, cytotoxic and antibacterial potentials of biosynthesized silver nanoparticles using bee's honey from two different floral sources in Saudi Arabia" [Saudi J. Biol. Sci. 27(1) (2020) 363-373].

[This corrects the article DOI: 10.1016/j.sjbs.2019.10.006.].

Employment of Cassia angustifolia leaf extract for zinc nanoparticles fabrication and their antibacterial and cytotoxicity.

The plant Cassia angustifolia belongs to Saudi Arabia, which is one of the native places and now cultured throughout the global countries. Medical care in the Arab world is an essential outlet for medicinal plants, both because they are crucial elements for prophetic medicine and due to their lengthy background in the Middle East. C.angustifolia is one of the medicinal plants used in the Saudi Arabia. The usage of plant extracts for synthesizing nanoparticles is conducive to other biological material, since it avoids the lengthy phase of cell culture maintenance. Silver nanoparticles attract further attention due to their strong conductivity, stability and antimicrobial activity across different metal nanoparticles. The present study was designed in the Saudi C. angustifolia leaves with the zinc synthesis of nanoparticles and its antibacterial ability. The plant extracts of C. angustifolia was used for synthesis of zinc nanoparticles, antimicrobial activities against bacterial strains have been tested along with transmission electron microscope (TEM), UV spectroscopy and antimicrobial activities have been conducted. This study showed that silver ions may be transferred from the plant extract to silver nanoparticles. AgNPs biogenic capacity to antibacterial with lovo cell with IC50 ranged from 33.5 ± 0.2 µg/mL demonstrated strong antibacterial capacity to antibody. The overall absorption value for the extract was between 420 and 440 nm and the color transition to green was the plasma absorption of the AgNPs. TEM results was showed in 200,000 magnification. The uniqueness of the current study is that Cassia angustifolia leaf extract from Saudi Arabia was used to prepare the metallic nanoparticles. Additionally, ZnCl2 may also be used as nanoparticles of mineral salt and zinc, which, since their application has been confirmed, are antimicrobial.

Levels and predictors of fear and health anxiety during the current outbreak of COVID-19 in immunocompromised and chronic disease patients in Saudi Arabia: A cross-sectional correlational study.

Coronavirus disease 2019 (COVID-19) infection has become a clinical threat to healthy people as well as immunocompromised patients and those with pre-existing chronic diseases around the world. This study, which used a cross-sectional correlational design, aimed to assess the levels of fear and health anxiety and to investigate their predictors during the current outbreak of COVID-19 in immunocompromised and chronic disease patients in Saudi Arabia. Sociodemographic and clinical data, fear of COVID-19, and health anxiety measurements were collected by online surveys from June 15 to July 15, 2020. Univariate and multiple linear regression analysis was used to identify predictors. A total of 1,030 patients in 13 provinces in Saudi Arabia completed the questionnaire. A significant number of patients with chronic diseases experienced considerable levels of fear and anxiety during the COVID-19 outbreak. It was found that 21.44% of participants met the criteria for anxiety cases, and 19.4% were considered borderline anxiety cases. In regression analysis, significant predictors of fear and health anxiety were female gender, lower education, middle-aged, divorced or widowed, receiving immunosuppressants, type of chronic disease (Crohn's disease, hypertension, and cardiovascular diseases), and media use as a source of knowledge about COVID-19. Immunocompromised and chronic disease patients are vulnerable to fear and anxiety during epidemic infectious diseases such as COVID-19. Optimizing this population's compliance with appropriate infection prevention and control strategies is crucial during the infectious outbreaks to ensure their safety, to decrease the risk of infection and serious complications, and reduce their fear and health anxiety. Effective positive psychological interventions and support strategies also need to be immediately implemented to increase psychological resilience and improve the mental health of these patients. Due to the COVID-19 outbreak, chronic disease patients in Saudi Arabia need special attention from health authorities, policymakers, and healthcare professionals to manage maladaptive forms of health anxiety and fear.

Antioxidant, cytotoxic and antibacterial potential of biosynthesized nanoparticles using bee honey from two different floral sources in Saudi Arabia.

Nowadays, the innovative study of silver nanoparticles (AgNPs) is excessive since they have incredible biomedical applications. The current study aimed to find out the potential of honey from two different floral sources (Ziziphus spina-christi and Acacia gerrardii) as biogenic mediators to synthesize AgNPs and to evaluate their antioxidant, cytotoxic and antimicrobial abilities. Biogenic AgNPs were studied for particle characterizations and the expected biomolecules helped in the reduction process of silver (Ag) ions to AgNPs. Results demonstrated different size (50-98 nm) and potential -42 and -30 for AgNPs prepared using different biological materials, therefore different 1,1-Diphenyl-2-picrylhydrazyl (DPPH) scavenging free radicals were observed. Cytotoxic effect in a dose-dependent manner was detected against LoVo and HepG2 ca cells for biogenic AgNPs resulted from cell apoptosis that detected by caspase 3/7 activation in the treated cells compared to their corresponding controls. Furthermore, biogenic AgNPs suppressed the growth of Methicillin-resistant bacteria Staphylococcus aureus (Gram-positive) besides Escherichia coli and Peseudomonas aeruginosa (Gram-negative). The LC50 of AgNPs was between 12.8 and 19 µg/mL and the antibacterial capability was between 20.8 ±â€¯1.2 and 15.6 ±â€¯0.8 mm. Bacterial membrane disturbance was evident in the current study when treated bacteria were studied by field emission scanning electron microscopy (FE-SEM) in relation to untreated controls. Overall, the present findings indicated the possibility of simple green synthesis of AgNPs using honeybee, which are effective agents in some biomedical applications. Detailed future work is needed to further validate the results.

Evaluation of antibiotic-induced behavioral changes in mice.

Gut microbiota (GM) plays a critical role in health maintenance. Previous reports connected GM with metabolic, immunologic and neurologic pathways. The main purpose of the current investigation was to study whether antibiotic-induced disturbances of GM affects psychological or behavioral conditions on mice as animal model. Mice were exposed to clindamycin or amoxicillin, and their behaviors were evaluated. Antibiotic-treated groups displayed reduced recognition memory and increased depression. No significant changes in the locomotor activity and anxiety were observed. Our data suggested that changes in GM composition by antibiotics may lead to the cognitive and behavioral deficit.

Association of Zinc Deficiency with Iron Deficiency Anemia and its Symptoms: Results from a Case-control Study.

Iron deficiency anemia (IDA) is the most common type of anemia. Impaired iron absorption can be caused by a decrease in trace elements as zinc, which is found in the structure of enzymes that coordinate or catalyst iron metabolism. The aim of this study is to detect if zinc deficiency is associated with IDA and to determine the effect of associated zinc deficiency on symptoms of IDA in adult IDA patients. This case-control study included 30 IDA patients with matched healthy control group (n = 30) for age and sex. For each subject, the parameters were evaluated: hemoglobin (Hb); mean corpuscular volume (MCV), total iron binding capacity (TIBC), serum iron, serum ferritin (SF). Serum zinc levels were measured by atomic absorption method with the PerkinElmer Analyst. Symptoms attributed to iron deficiency or depletion, defined as fatigue, cardiopulmonary symptoms, mental manifestations, epithelial manifestations, and neuromuscular symptoms were recorded. Serum zinc levels were lower in IDA patients (43.4 ± 7.9 mg/dL) than in the control subjects (94.7 ± 16.75 mg/dL; p < 0.0001). Zinc deficiency was associated with worse cardiovascular symptoms (p = 0.04), epithelial symptoms (p = 0.027), and restless leg syndrome (p < 0.001) in patients with IDA. Measurement of zinc levels should be considered for IDA patients. With the help of our study, iron and zinc supplementation instead of only iron replacement may be considered in cases of iron deficiency particularly, in patients with severe epithelial dysfunctions. Further studies are still needed to evaluate the benefit of zinc and iron supplementation in IDA patients.

Correction: Association of Zinc Deficiency with Iron Deficiency Anemia and its Symptoms: Results from a Case-control Study.

[This corrects the article DOI: 10.7759/cureus.3811.].

Calligonum comosum and Fusarium sp. extracts as bio-mediator in silver nanoparticles formation: characterization, antioxidant and antibacterial capability.

In the current study, extracellular biosynthesis of silver nanoparticles (AgNPs) was carried out using aqueous extracts of green Calligonum comosum stem, besides Fusarium sp. Synthesized AgNPs were characterized using ultraviolet (UV)-Vis spectrophotometer, transmission electron microscopy (TEM) and zeta potential. Moreover, biosynthesized AgNPs were estimated for the scavenging ability on DPPH radical as well as tested for their antibacterial activity using well diffusion method against Gram-positive bacteria Staphylococcus aureus. On the other hand, DNA content from untreated and AgNPs treated bacterial cells was evaluated by (UV)-Vis spectrophotometer and agarose gel electrophoresis. Results revealed the formation of AgNPs, which was first detected by color change of the reaction mixture. The characteristic surface plasmon resonance absorption was detected at 450 and 410 nm for the plant and myco-synthesized AgNPs. Furthermore, TEM micrograph and zeta sizer showed formation of spherical particles with an average size of about 105.8 and 228.4 nm for plant and myco-synthesized AgNPs, respectively. Plant-synthesized AgNPs exhibited higher scavenging of DPPH radicals than that of the myco-synthesized one. For bactericidal action, plant-synthesized AgNPs showed higher inhibition zone compared with myco-synthesized one, which was negatively correlated with the nanoparticle size. Furthermore, low DNA concentration was detected for AgNPs treated bacteria, which might be a consequence of inactivation for DNA replication. Further experimental work is required to find out if there is any correlation between nanoparticles size and efficacy against bacteria.

Non-invasive positive pressure ventilation in acute respiratory failure. An alternative modality to invasive ventilation at a general hospital.

OBJECTIVE: Non-invasive positive pressure ventilation (NPPV) is a relatively new modality of managing acute respiratory failure (ARF). It has not been applied before in our area. The aim of this study is to verify the use of NPPV on patients with ARF at a general hospital level. METHODS: All patients admitted at the Al-Amiri Hospital, Kuwait (a secondary medical center) between 1999 and 2001 with ARF and met the inclusion criteria were included in the study. The non-invasive mode of nasal ventilation was used as the respiratory support. RESULTS: A total of 21 patients were included in the final analysis. The major cause of ARF type 2 was chronic obstructive pulmonary disease (COPD) in 71%. The overall success rate of NPPV trials was 71.4%. In the successful trials of ARF type 2, the arterial blood gas parameters of PaCo2 (p<0.005), pH (p=0.023), and PaO2 (p<0.001) showed improvement from the first hour of intervention. Analysis of variance with repeated measurement for the arterial blood gas variables showed statistical significance of changes in favor of NPPV during initial close monitoring with p<0.001. The percentage of successful trials at the general wards was 82% versus 67% for the intensive care unit cases (ICU). Surprisingly, failure of trials related mainly to the clinical status of the patients. CONCLUSION: Non-invasive positive pressure ventilation is an effective ventilatory support in ARF in a proper clinical setting. It may be used safely in the general hospital outside the ICU.

Posters as a tool for disseminating health related information in a developing country: a pilot experience.

OBJECTIVE: To investigate the effectiveness of posters as a tool, for imparting information related to high blood pressure. METHODS: The intervention involved hanging posters conveying information about blood pressure, in the waiting rooms of 339 health facilities. The impact of this intervention was assessed after 30 days of hanging the posters with the main assessment component of the survey aimed at the target audience at the facilities. 1017 people attending the facilities were interviewed. RESULTS: Mean age of this population was 40.4 (SD 11.06) years. There were 79% males and 21% females. 80.2% (n=816) of the respondents had noticed the posters. 84.5% of the people were of the opinion that the poster was good. 63.7% of the people understood the overall message of the poster correctly. Regarding change in behaviour, 96.7% (n=789) of the people thought that the poster was asking them to do something; 85.9% (n=501) of these got their blood pressure checked compared to 60.9% (n=14) of those who did not think the poster was asking them to do anything (p=0.004). Of those who said that the poster was asking them to do something, there were varied responses as to what they thought the poster was asking them to do. If the response was that they should have their blood pressure checked, it was taken as a correct response. 87.3% of those who said that the poster was asking them to get their blood pressure checked, actually got their blood pressure checked compared to 83.7% of those who did not understand this message (p=0.241). CONCLUSIONS: Given the limitations of the study it is difficult to assess the effectiveness of the poster in changing people's behaviour regarding blood pressure check up. This experience will serve as a pilot for a larger prospective study to assess poster as a tool for prompting people to get their blood pressure checked.

Clinical results of the intra cytoplasmic sperm injection (ICSI) at Baqai Institute of Reproduction and Developmental Sciences (BIRDS).

OBJECTIVE: To analyse the results of the new revolutionary technique of Intra Cytoplasmic Sperm Injection (ICSI) for male infertility. Furthermore, to find out the ways of reducing cost of the expensive methods of Assisted Reproductive Techniques. DESIGN: This is an analytical study of results of 71 patients (86 Cycles) of ICSI performed in first year of its launching in Baqai Institute of Reproduction and Developmental Sciences (BIRDS) from May 1997 to April 1998. Men with semen reports of parameters less than WHO criteria were treated including Azoospermic men. RESULTS: After ICSI procedure a fertilisation rate of 58.9% was achieved in 86 cycles. A total of 17 clinical pregnancies were had from the transfer of fresh embryos. This includes three pregnancies from Surgical Sperm Collection in azoospermic men. Cost could be reduced by avoiding high dosage of drugs and by cutting out serial serum estrogen levels. Ultrasonic assessment for follicle monitoring is equally satisfactory. CONCLUSION: ICSI proved to be the only successful treatment for men with poor semen quality. It is giving nearly 20% chances of fatherhood in a man who was labeled infertile previously. Results are promising and will be improving with time. The cost could be reduced to an extent by cutting down drug doses and laboratory investigations without compromising the results.

Human alcohol dehydrogenase ADH2 and ADH3 polymorphisms in ethnic Chinese and Indians of West Malaysia.

Human alcohol dehydrogenase ADH2 and ADH3 were investigated in liver and stomach specimens of Chinese and Indians from West Malaysia. Eight-nine percent of the Chinese carry the atypical ADH2 type, a proportion very similar to that reported in Japanese. However, among 43 Indian specimens there was not a single case of atypical ADH2. In Indians, the gene frequency of ADH13 is 0.64 and of ADH23 0.36, similar to the frequencies in Caucasians, whereas in Chinese, the gene frequency for ADH13 and ADH23 is 0.91 and 0.09, respectively. We also report some unusual enzymatic characteristics in the course of our study.

Characterization of Dictyostelium discoideum cathepsin D.

Previous studies using magnetic purification of Dictyostelium discoideum endocytic vesicles led us to the identification of some major vesicle proteins. Using the same purification procedure, we have now focused our interest on a 44 kDa soluble vesicle protein. Microsequencing of internal peptides and subsequent cloning of the corresponding cDNA identified this protein as the Dictyostelium homolog of mammalian cathepsins D. The only glycosylation detected on Dictyostelium cathepsin D (CatD) is common antigen 1, a cluster of mannose 6-sulfate residues on N-linked oligosaccharide chains. CatD intracellular trafficking has been studied, showing the presence of the protein throughout the entire endocytic pathway. During the differentiation process, the catD gene presents a developmental regulation, which is also observed at the protein level. catD gene disruption does not alter significantly the cell behaviour, either in the vegetative form or the differentiation stage. However, modifications in the SDS-PAGE profiles of proteins bearing common antigen 1 were detected, when comparing parental and catD(-) cells. These modifications point to a possible role of CatD in the maturation of a few Dictyostelium lysosomal proteins.