Expression of anti-heterogenous nuclear ribonucleoprotein (anti-hnRNP) in limited systemic sclerosis patients: Relation to radiographic findings of the hand

Background

Systemic sclerosis (SSc) is an autoimmune connective tissue disease with vascular, fibrotic and immune changes of skin and some internal organs. Anti-heterogeneous nuclear ribonucleoproteins (anti-hnRNP) were found in SSc patients.

Bee venom acupuncture therapy ameliorates neuroinflammatory alterations in a pilocarpine-induced epilepticus model

Metabolic Brain Disease - Bee venom (BV) is applied in different traditional medicinal therapies and is used worldwide to prevent and treat many acute and chronic diseases. Epilepsy has various...     

Ischemic Pressure vs Postisometric Relaxation for Treatment of Rhomboid Latent Myofascial Trigger Points: A Randomized,Blinded Clinical Trial

ObjectiveThe purpose of this study was to investigate the effects of ischemic pressure (IP) vs postisometric relaxation (PIR) on rhomboid-muscle latent trigger points (LTrPs).MethodsForty-five participants with rhomboid-muscle LTrPs were randomly assigned into 3 groups and received 3 weeks of treatment—group A: IP and traditional treatment (infrared radiation, ultrasonic therapy, and transcutaneous electrical nerve stimulation); group B: PIR and traditional treatment; and group C: traditional treatment. Shoulder pain and disability, neck pain and disability, and pressure pain threshold (PPT) of 3 points on each side were measured before and after treatment.ResultsMultivariate analysis of variance indicated a statistically significant Group × Time interaction (P = .005). The PPT for the right lower point was increased in group A more than in groups B or C. Neck pain was reduced in group B more than in group C. Moreover, shoulder and neck disability were reduced in both groups A and B more than in group C. The PPTs of the left lower and middle points were increased in group B compared with groups A and C. The PPT of the left upper point was increased in group A more than in group C. There were significant changes in all outcomes in the 2 experimental groups (P < .05). No changes were found in the control group except in pain intensity, shoulder disability, and PPT of the left lower point.ConclusionThis study found that IP may be more effective than PIR regarding PPT, but both techniques showed changes in the treatment of rhomboid-muscle LTrPs.     

Restless legs syndrome among Saudi end-stage renal disease patients on hemodialysis

Objectives:

To determine the prevalence of restless legs syndrome (RLS) in Saudi patients with end-stage renal disease (ESRD) on hemodialysis.

Methods:

A cross-sectional study was carried out in 3 hemodialysis centers in Jeddah, Saudi Arabia, between June 2012 and September 2013. All patients were individually interviewed and data was collected on the following demographic features, medical history, laboratory test, the International Restless Legs Syndrome Study Group questionnaire, Epworth Sleepiness Scale (ESS), and Berlin Questionnaire.

Results:

Three hundred and fifty-five patients were recruited. The prevalence of RLS among ESRD patients was 19.4%, with most patients having moderate to severe disease. The RLS was significantly associated with obstructive sleep apnea (p<0.0001) and excessive daytime sleepiness based on the ESS (p=0.009). The RLS showed no correlation with hemodialysis adequacy, chronicity, frequency per week, and hemodialysis duration per session; however, there was a weak negative relation between adequacy of hemodialysis and RLS severity. None of the comorbidities showed any association with RLS. The odds of developing RLS increased significantly with an increasing body mass index (p=0.001). Administration of aspirin (p=0.037) and anticoagulants (p=0.035) were also associated with increased risk of RLS.

Conclusion:

Restless legs syndrome is common in ESRD patients on hemodialysis, and it is an important source of sleep disruption. In addition to body mass index, Aspirin and anticoagulants may be important risk factors.Willis-Ekbom disease or restless legs syndrome (RLS) is a sleep-related, sensorimotor, neurological disorder that primarily affects the legs.1 When severe, the disorder can also affect the arms and other parts of the body. The RLS is characterized by sore sensations in the legs and accompanied by an urge to move them, typically in the evening and night. It is worse at rest and at least temporarily relieved by activity.1,2 The prevalence of RLS in the general population ranges from 5-15%.3 It can be idiopathic in nature or secondary to conditions such as diabetes mellitus, renal failure, iron deficiency anemia, multiple sclerosis, and pregnancy. The restlessness experienced by patients with RLS can cause problems such as insomnia, excessive daytime sleepiness, poor quality of life, and depression. In its severe forms, it can develop into a chronic and devastating disorder that may require long-term treatment. The clinical management of this condition is to treat the possible causes as well as to use different drugs for symptomatic relief. However, there is no definitive cure for this condition. Patients on regular hemodialysis (HD) for the management of end-stage renal disease (ESRD) are prone to various neurological disorders, including RLS. The prevalence of RLS among HD patients is approximately 20-30%.4,5 In a Serbian study, Nikić et al6 evaluated 166 patients on HD using the International Restless Legs Syndrome Study Group (IRLSSG) criteria and found that the prevalence of RLS was 22.7%. Goffredo Filho et al7 also reported the frequency of RLS to be 14.8% among 176 Brazilian patients. With regard to our region, Salman8 reported that the prevalence of RLS was 20.3% in 123 Syrian patients on chronic HD. Finally, Al-Jahdali et al9 conducted the single local study on 227 ESRD patients on chronic hemodialysis and found that the prevalence of RLS was 50.2%. This rate was much higher than that reported previously in majority of similar studies, particularly in light of the fact that the reported percentage of RLS in the Saudi population was only 5.2%.10 In this study, our aim was to determine the prevalence of RLS among a sample of Saudi patients with ESRD maintained on regular HD, and to compare the obtained value with that previously reported. Additionally, we explored the association between the adequacy of hemodialysis and severity of RLS symptoms.     

Idiopathic chylopericardium: A case report from Saudi Arabia

Chylopericardium is a rare clinical condition in which chyle leaks into the pericardial space owing to lymphatic system derangement. It can be idiopathic or occur secondarily to another clinical condition. Optimal management is accomplished through surgical intervention to impede leaks and drain fluid. In this report, we discuss an initially asymptomatic patient with a pre-employment chest radiograph that revealed cardiomegaly. An echocardiogram revealed pericardial effusion. Medical workup was unable to determine secondary causes for effusion. Pericardiocentesis revealed milky-colored fluid with a high lymphocyte count, and a lymphoscintigraphy lymphangiogram revealed a leak into the pericardium and decreased flow through left iliac and left periaortic lymph nodes. Since the patient was asymptomatic, she was treated conservatively with diet changes, pericardial drainage, and a pericardial window procedure. This type of case risks being misdiagnosed as tuberculosis, especially in countries where tuberculosis is endemic. In such cases, assessing pericardial fluid for chyle is crucial.     

Remote loading of curcumin-in-modified β-cyclodextrins into liposomes using a transmembrane pH gradient

Curcumin (CRM) is a natural polyphenol with antioxidative, anti-inflammatory, and anticancer therapeutic properties. However, CRM therapeutic potential is limited by low water solubility and bioavailability. Intraliposomal remote loading describes the retention of drugs in liposome cores in response to transmembrane pH gradient. The current study describes for the first time the remote loading of CRM into liposomes using secondary (E-βCD) and tertiary (D-βCD) amino-modified β-cyclodextrins (βCDs) as carriers and solubilizers. βCDs were chemically modified to prepare the ionizable weak base functional group followed by forming a guest-host complex of CRM in the modified βCDs hydrophobic cavities via a solvent evaporation encapsulation technique. These complexes were then actively loaded into preformed liposomes, composed of DPPC/cholesterol (65/35 molar ratio) via pH gradient. The formation of CRM-βCDs inclusion complexes was characterized using UV-Vis spectroscopy, thermal analysis, and NMR spectroscopy. The complex stoichiometric ratio was determined to be 1 : 1 of CRM-βCDs based on Job''s plot which was also confirmed by the modified Benesi–Hildebrand equation with increasing probability of forming the 1 : 2 ratio of CRM-βCDs. The apparent formation constants (K_f) of 51.6, 100.9 and 55.4 mM⁻² were determined for CRM-βCD, CRM-E-βCD, and CRM-D-βCD complexes, respectively. Liposome size, charge and polydispersity index indicate the presence of a homogeneous population before and after active loading. The encapsulation efficiencies of CRM-βCD complexes into pH gradient preformed liposomes were 16.5, 51.1, and 41.7 for CRM-βCD, CRM-E-βCD, and CRM-D-βCD, respectively, showing more than 5 fold increase compared to normal liposomes. The current study provides a novel remote loading approach utilizing chemically modified cyclodextrins to incorporate hydrophobic drugs into liposomes.

The current study provides a novel remote loading approach utilizing chemically modified cyclodextrins to incorporate hydrophobic drugs into liposomes.     

Natural product diversity from the endophytic fungi of the genus Aspergillus

The endophytic fungus Aspergillus is considered as an enormous source of chemical leads with promising biological activities. Different Aspergillus species have proved their ability to produce plenty of secondary metabolites including butenolides, alkaloids, terpenoids, cytochalasins, phenalenones, ρ-terphenyls, xanthones, sterols, diphenyl ether and anthraquinone derivatives with diverse biological activities, such as anti-cancer, antifungal, anti-bacterial, anti-viral, anti-inflammatory, antitrypanosomal and antileishmanial activities. From January 2015 until December 2019, three hundred and sixty-one secondary metabolites were reported from different endophytic Aspergillus species. This review discusses the isolated secondary metabolites from different endophytic Aspergillus species reported from January 2015 to December 2019 along with their reported biological activities and structural aspects whenever applicable.

The endophytic fungus Aspergillus is the precious source of chemical biodiversity.