Pathogenesis, etiology and treatment of failed back surgery syndrome

Failed back surgery syndrome (FBSS) is associated with persistent lower back pain after and despite one or more surgical interventions. A number of factors underlie and maintain FBSS and successful management of pain chiefly depends on identifying them. Pharmacological, surgical, and non-surgical therapeutic measures are taken to treat the pain. Spinal cord stimulation and nerve stimulation have been widely practiced in this regard and enhanced pain reduction and patient satisfaction. In hernia and recurrent disc degeneration and sagittal imbalance, discectomy and/or fusion are indicated. The present review focuses on FBSS and its underlying components and on available treatment options.

The outcome of olfactory impairment in patients with otherwise paucisymptomatic coronavirus disease 2019 during the pandemic

OBJECTIVE

This study aimed to measure the duration and recovery rate of olfactory loss in patients complaining of recent smell loss as their prominent symptom during the coronavirus disease 2019 outbreak.

METHOD

This was a prospective telephone follow-up observational study of 243 participants who completed an online survey that started on 12 March 2020.

RESULTS

After a mean of 5.5 months from the loss of smell onset, 98.3 per cent of participants reported improvement with a 71.2 per cent complete recovery rate after a median of 21 days. The chance of complete recovery significantly decreased after 131 days from the onset of loss of smell (100 per cent sensitive and 97.7 per cent specific). Younger age and isolated smell loss were associated with a rapid recovery, whereas accompanying rhinological and gastrointestinal symptoms were associated with longer loss of smell duration.

CONCLUSION

Smell loss, occurring as a prominent symptom during the coronavirus disease 2019 pandemic, showed a favourable outcome. However, after 5.5 months from the onset, around 10 per cent of participants still complained of moderate or severe hyposmia.

Synthesis, spectral and luminescence study, crystal structure determination and DFT calculation of binuclear palladium(II) complexes

Binuclear palladium(II) complexes with metal-metal (d⁸-d⁸) bonding interaction were synthesized by reactions of the 1-methyl-1H-1,2,3,4-tetrazole-5-thiol (Hmtzt) or a mixture of Hmtzt and 1,3-propanediamine (1,3-pda) ligands. Complex [Pd₂(μ-mtzt)₄]·2CH₃CN (1) was synthesized by the reaction of Pd(OAc)₂ with Hmtzt dissolved in acetonitrile and complex [Pd₂(μ-mtzt)₂(mtzt)₂(1,3-pda)] (2) was synthesized by reaction of a mixture of Hmtzt and 1,3-propanediamine (dissolved in methanol) with PdCl₂ (dissolved in acetonitrile) and were identified through elemental analysis, IR, UV-Vis, ¹H NMR, luminescence spectroscopy as well as single-crystal X-ray diffraction method. A single-crystal of complex 1 shows that two Pd(II) centers are linked together by four bridging tetrazole ligands providing a paddle wheel-like arrangement. Also a crystal structure of complex 2 shows that this complex possesses a symmetric structure in which one Pd atom is tetra-coordinated by four sulfur atoms to forms PdS₄ and other Pd atom is tetra-coordinated by four nitrogen to forms PdN₄ coordination sphere. Density functional theory (DFT) was performed in this study for the Hmtzt ligand and binuclear palladium(II) complexes (1) and (2). The DFT calculation shows Pd^II-Pd^II bond lengths of 2.831 and 3.086Å in complex 1 and 2, respectively which are close to the observed bond lengths of 2.802(11) and 3.0911(17)Å from single-crystal X-ray structure. The optimized geometry of the complexes is shown good agreement by X-ray data. Structural properties and molecular descriptors including bond lengths, bond angles, chemical hardness, dipole moment, HOMO-LUMO energy levels, electron transfer were analyzed. The IR spectroscopy was performed using VEDA4 software and UV-Vis spectra were analyzed using time-dependent density functional theory (TD-DFT) method. The theoretical and experimental data were also compared with each other.

Detection of drug resistance gene in cutaneous leishmaniasis by PCR in some endemic areas of iran

BACKGROUND

Cutaneous leishmaniasis is still a health problem in many rural and urban regions of Iran and drug resistance has emerged as a major impediment in the treatment of leishmaniasis. This study aims to determine the drug resistance gene in cutaneous leishmaniasis by PCR in some endemic areas of Iran.

METHODS

Ninety seven samples were collected from ulcers of leishmaniasis patients from some endemic areas of Iran. The Giemsa stained samples were examined microscopically and cultured in NNN and RPMI 1640 mediums for parasite detection. After DNA extraction, PCR was done by a pair of specific primers. For detection of mutation in DNA, first PCR products were electrophoresed on CSGE gel. The suspected samples were compared by sequencing and RFLP results were demonstrated. Comparison of DNA derived from a wild type cell and mutant cell was undertaken by CSGE and sequencing methods.

RESULTS

Among 90 isolates (92.8%) examined for detection of mutation in gene with CSGE and RFLP, 10 (11.1%) revealed a disorder in sequencing selection for unresponsive to drug.

CONCLUSION

Drug resistance in cutaneous leishmaniasis to sodium stiboglocanat is probably due to a mutation in a genome. A field study is needed to determine the distribution of drug resistance and other gene mutations involved in unresponsiveness to drugs in leishmaniasis endemic areas of Iran.

Study on ITS1 Gene of Iranian Trichomonas vaginalis by Molecular Methods

BACKGROUND

Trichomoniasis is a worldwide protozoan parasitic disease and metronidazole is a choice drug for its treatment. Because of disease importance in public health and its controversial ideas about the prevalence of drug resistance, this study was carried out.

METHODS

Fifty-two suspected vaginal samples were collected from 2006 to 2007 in Gynecology Maryam Hospital, Tehran, Iran. All isolates were examined by microscopic, culture and PCR techniques. The PCR products were analyzed by RFLP and CSGE methods and two suspected samples were sequenced.

RESULTS

Trichomonas vaginalis was identified from all 52 samples. Of 52 isolates, 45 samples were successfully cultured and amplified by PCR except one. Seven were positive only by PCR. Finally, ITS1 fragment was successfully amplified in 51 of 52. CSGE analysis and PCR products digestion by MspI followed by sequencing showed nucleotide mutation at position 209 (C209T) of the ITS1 fragment in two (3.9%) of them.

CONCLUSION

The results showed mutation in ITS1 fragment of T. vaginalis in two (3.9%) of Iranian isolates which may be related to metronidazole resistance.

Anti-apoA-1 IgG and oxidized LDL are raised in rheumatoid arthritis (RA): potential associations with cardiovascular disease and RA disease activity

OBJECTIVE

To determine whether emerging cardiovascular risk factors such as anti-apolipoprotein A-1 (anti-apoA-1) immunoglobulin (Ig)G and oxidized low density lipoprotein (oxLDL) are associated with cardiovascular disease (CVD), carotid intima-media thickness (IMT), and disease activity in rheumatoid arthritis (RA).

METHOD

We determined the aforementioned associations in 69 RA patients with disease duration of 5 years and 46 controls matched by age, sex, and smoking status. Anti-apoA-1 IgG and oxLDL were measured by enzyme-linked immunosorbent assay (ELISA). Carotid arteries were examined by ultrasound. Disease Activity Score calculated on 28 joints (DAS28) was used to assess disease activity.

RESULTS

CVD prevalence was higher among RA patients than controls (17% vs. 2%, p = 0.01) but there was no difference in IMT (median: 0.67 vs. 0.66, p = 0.33). RA patients had a higher anti-apoA-1 IgG prevalence than controls (20% vs. 0%, p = 0.001). Anti-apoA-1 IgG and oxLDL levels were higher in cases than controls [median: 0.33 vs. 0.175 optical density (OD), p = 0.03; and 121 vs. 37.2 U/L, p = 0.0001, respectively]. Anti-apoA-1 IgG-positive patients had higher levels of oxLDL (median: 140.5 vs. 112 U/L, p = 0.01) than those tested negative. Receiver operating characteristic (ROC) curve analysis showed that only anti-apoA-1 IgG was a modest but significant predictor of CVD [area under the curve (AUC) = 0.65, p = 0.03] in RA patients. oxLDL was significantly associated with RA disease activity, whereas anti-apoA-1 IgG was not.

CONCLUSIONS

Anti-apoA-1 IgG could be a marker of CVD in RA, whereas oxLDL levels seem to reflect RA disease activity. Other causes of CVD than a general increase in atherosclerosis (as determined by IMT measurements) including plaque stability may therefore be of importance to explain the increased incidence of CVD in RA.

Analysis and assessment of ground-level ozone measured at two stations in Tehran

In this study, variations of ambient ozone level are thoroughly analysed according to the monitored data in a mixed residential, commercial and industrial city, Tehran, based on considering the meteorological factors. Ozone as a pollutant shows typical annual, weekly and diurnal cycles. This analysis has shown that the ozone level concentrations were below the WHO guidelines in Tehran during 2000-2003. The relation between ozone level at two different stations (Aghdasieh and Fatemi) is found (r = 0.51). The ozone level response to meteorological parameters is investigated. The results suggest that the ozone level is affected (positively or negatively) by meteorological conditions, e.g. relative humidity, solar radiation, air temperature, wind speed and wind direction.

Community survey of knowledge about oral cancer in Babol: effect of an education intervention

A study in Babol, Islamic Republic of Iran, used a questionnaire to gather information on knowledge about oral cancer and its risk factors and to evaluate the efficacy of an educational brochure. From a community sample of 400 people, 76.0% had no knowledge of oral cancer. Mean knowledge score before the education intervention was 1.47 (standard deviation 3.40) out of 10. Knowledge about oral cancer was not associated with age, sex or education level but urban residents had better knowledge than rural residents. Mean knowledge score improved significantly by 5.92 (SD 3.30) at 1 month after the intervention among the 226 respondents who had read the brochure.

Statistical models and time series forecasting of sulfur dioxide: a case study Tehran

This study performed a time-series analysis, frequency distribution and prediction of SO(2) levels for five stations (Pardisan, Vila, Azadi, Gholhak and Bahman) in Tehran for the period of 2000-2005. Most sites show a quite similar characteristic with highest pollution in autumn-winter time and least pollution in spring-summer. The frequency distributions show higher peaks at two residential sites. The potential for SO(2) problems is high because of high emissions and the close geographical proximity of the major industrial and urban centers. The ACF and PACF are nonzero for several lags, indicating a mixed (ARMA) model, then at Bahman station an ARMA model was used for forecasting SO(2). The partial autocorrelations become close to 0 after about 5 lags while the autocorrelations remain strong through all the lags shown. The results proved that ARMA (2,2) model can provides reliable, satisfactory predictions for time series.

Effect of a new phenanthroline derivative on testicular tissue and serum testosterone concentration and its contraceptive affects on adult Balb/C mouse strain

In this research, the effect of 2, 6-diaminopyridinum as a new phenanthroline derivative was studied on the hypophysis-gonad axis, testicular tissue and sperm production in male Balb/C mice. Fifty adult male Balb/C mice were divided in five groups. First group was considered as untreated control. Saline was injected to second group and the remaining three groups received intraperitoneal injection of 15, 20 and 25 mg kg(-1) of 2, 6-diaminopyridinum every other day for 20 days. The LD50 was determined to be 35 mg kg(-1) body weight. The testicular tissues were studied morphologically and the serum concentration of FSH, LH and testosterone were measured. The results showed that 25 mg kg(-1) diaminopyridinum decreased the number of germ cells significantly and serum testosterone level with no change on FSH and LH levels. This study indicates that 25 mg kg(-1) of phenanthroline may directly affect testicular tissue causing a lower testosterone level and spermatogenesis in mice.

First anionic 1,10-phenanthroline-2,9-dicarboxylate containing metal complex obtained from a novel 1:1 proton-transfer compound: synthesis, characterization, crystal structure, and solution studies

The new 1,10-phenanthroline containing 1:1 proton-transfer compound LH(2), [pyda.H(2)](2+)[phendc](2-), was synthesized from the reaction of 2,6-pyridinediamine, pyda, and 1,10-phenanthroline-2,9-dicarboxylic acid, phendc.H(2), and characterized by elemental analysis, ES-Ms, IR, (1)H, (13)C NMR, and UV/vis spectroscopies. Subsequently, the first example of [phendc](2)(-) containing anionic complex [pyda.H](2)[Co(phendc)(2)].10H(2)O, was prepared, using the above novel proton-transfer compound, and structurally characterized by single-crystal X-ray diffraction. The complex crystallizes in the space group P2(1)/n of the monoclinic system with four molecules in a unit cell of dimensions a = 11.877(3) A, b = 31.473(9) A, c = 12.915(4) A, and beta = 116.223(5) degrees. The structure has been refined to a final value for the crystallographic R factor of 0.0524 based on 9021 observed independent reflections. The complexation reactions of pyda, phendc.H(2), and LH(2) with H(+) as well as LH(2) with Co(II) in aqueous solution were investigated by potentiometric pH titrations, and the equilibrium constants for all major complexes formed are described. The results are presented in the form of distribution diagrams revealing the concentrations of individual complex species as a function of pH. The results revealed that, at a pH range of 5.2-6.2, the major complex species is [(pyda.H)](2)[Co(phendc)(2)], similar to the isolated crystalline complex.