Daytime sleepiness during Ramadan intermittent fasting: polysomnographic and quantitative waking EEG study

During the lunar month of Ramadan, Muslims abstain from eating, drinking and smoking from sunrise to sunset. We reported previously that Ramadan provokes a shortening in nocturnal total sleep time by 40 min, an increase in sleep latency, and a decrease in slow-wave sleep (SWS) and rapid eye movement (REM) sleep duration during Ramadan. During the same study, the effects of Ramadan intermittent fasting on daytime sleepiness were also investigated in eight healthy young male subjects using a quantitative waking electroencephalograph (EEG) analysis following the multiple sleep latency test (MSLT) procedure. This procedure was combined with subjective alertness and mood ratings and was conducted during four successive experimental sessions: (1) baseline (BL) 15 days before Ramadan, (2) beginning of Ramadan (R11) on the 11th day of Ramadan, (3) end of Ramadan (R25) on the 25th day of Ramadan, (4) recovery 2 weeks after Ramadan (AR). During each session, four 20-min nap opportunities (MSLTs) were given at 10:00, 12:00, 14:00 and 16:00 h and were preceded by rectal temperature readings. Nocturnal sleep was recorded before each daytime session. Subjective daytime alertness did not change in R25 but decreased in R11 at 12:00 h, and subjective mood decreased at 16:00 h, both in R11 and R25. During the MSLT, mean sleep latency decreased by an average of 2 min in R11 (especially at 10:00 and 16:00 h) and 6 min in R25 (especially at 10:00 and 12:00 h) compared with BL. There was an increase in the daily mean of waking EEG absolute power in the theta (5.5-8.5 Hz) frequency band. Significant correlations were found between sleep latency during the MSLT and the waking EEG absolute power of the fast alpha (10.5-12.5 Hz), sigma (11.5-15.5 Hz) and beta (12.5-30 Hz) frequency bands. Sleep latency was also related to rectal temperature. In conclusion, Ramadan diurnal fasting induced an increase in subjective and objective daytime sleepiness associated with changes in diurnal rectal temperature.     

Sleep during Ramadan intermittent fasting

During the month of Ramadan intermittent fasting, Muslims eat exclusively between sunset and sunrise, which may affect nocturnal sleep. The effects of Ramadan on sleep and rectal temperature (Tre) were examined in eight healthy young male subjects who reported at the laboratory on four occasions: (i) baseline 15 days before Ramadan (BL); (ii) on the eleventh day of Ramadan (beginning of Ramadan, BR); (iii) on the twenty-fifth day of Ramadan (end of Ramadan, ER); and (iv) 2 weeks after Ramadan (AR). Although each session was preceded by an adaptation night, data from the first night were discarded. Polysomnography was taken on ambulatory 8-channel Oxford Medilog MR-9000 II recorders. Standard electroencephalogram (EEG), electro-oculogram (EOG) and electromyogram (EMG) recordings were scored visually with the PhiTools ERA. The main finding of the study was that during Ramadan sleep latency is increased and sleep architecture modified. Sleep period time and total sleep time decreased in BR and ER. The proportion of non-rapid eye movement (NREM) sleep increased during Ramadan and its structure changed, with an increase in stage 2 proportion and a decrease in slow wave sleep (SWS) duration. Rapid eye movement (REM) sleep duration and proportion decreased during Ramadan. These changes in sleep parameters were associated with a delay in the occurrence of the acrophase of Tre and an increase in nocturnal Tre during Ramadan. However, the 24-h mean value (mesor) of Tre did not vary. The nocturnal elevation of Tre was related to a 2-3-h delay in the acrophase of the circadian rhythm. The amplitude of the circadian rhythm of Tre was decreased during Ramadan. The effects of Ramadan fasting on nocturnal sleep, with an increase in sleep latency and a decrease in SWS and REM sleep, and changes in Tre, were attributed to the inversion of drinking and meal schedule, rather than to an altered energy intake which was preserved in this study.     

Paraneoplastic rheumatic syndromes: report of eight cases and review of literature

Malignant neoplasms are associated with a wide variety of paraneoplastic rheumatological syndromes. The paraneoplastic nature should be based on specific criteria. We report a series of eight cases of paraneoplastic rheumatic syndromes revealing an underlying neoplasia. Our series consists of six men and two women, with a mean age of 46.1 (20-69?years). The first case is a hypertrophic osteoarthropathy of Pierre Marie that occurred in a 20-year-old man 1?month after treatment for his nasopharyngeal carcinoma; the paraclinical examinations showed lung and bone metastasis. The second case is that of a bilateral shoulder-hand syndrome revealing an invasive squamous cell carcinoma of the cervix in a 63-year-old woman. The third case involved a 69-year-old patient who had surgery 2?years ago for prostate adenocarcinoma and presented with polymyalgia rheumatica revealing bone metastasis. We also report two cases of leukemia in adults revealed by polyarthritis. The sixth observation is that of a paraneoplastic scleroderma that occurred concomitantly with prostate cancer. The seventh case of an acute arthritis showed a B lymphoma. The eighth case is that of a 52-year-old patient who presented with inflammatory arthralgias, and digital clubbing revealing a squamous cell carcinoma of the skin. Paraneoplastic rheumatism remains a rare event, but knowledge of it is essential for early diagnosis of underlying cancer.     

Comparison of the BASDAI and the miniBASDAI in assessing disease activity in patients with ankylosing spondylitis

The BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) is the most widely used instrument for the assessment of disease activity in ankylosing spondylitis (AS). Objective. The aims to investigate whether the alternative BASDAI, here termed as the miniBASDAI [(Question (Q) 1 fatigue + Q2 spinal pain) + mean of (Q5 strength morning stiffness + Q6 duration morning stiffness)] / 3], measures disease activity more accurately in the subgroup of AS patients without peripheral manifestations. One hundred and ten patients were included in this cross-sectional study according to the modified New York criteria for AS. Clinical and biological parameters were evaluated. The disease activity was evaluated by the BASDAI. We calculated the miniBASDAI by omitting both the peripheral joints and the enthesitis questions: questions 3 and 4. Patients were dichotomized into a “P+” group if peripheral manifestations were present (at least arthritis or enthesitis) and a “P−” group, the subgroup without peripheral involvement (with either arthritis or enthesitis). Correlation of the BASDAI and miniBASDAI with other disease parameters were examined with the Spearman's rank correlation analysis. One hundred and ten patients were recruited. The percentage of patients with pure axial disease manifestation without peripheral involvement “P − group” was 42.7%. We found a similarly good correlation of the miniBASDAI with patient global, physician on disease activity, BASFI, ESR and CRP if compared to the correlation of the original BASDAI with these disease parameters, also in the group without peripheral involvement. Our study suggests that the BASDAI remains valid in assessing disease activity in AS patients with and without peripheral manifestations.     

Unraveling the microstructural and optoelectronic properties of solution-processed Pr-doped SrSnO3 perovskite oxide thin films

The inorganic stannous-based perovskite oxide SrSnO₃ has been utilized in various optoelectronic applications. Facilitating the synthesis process and engineering its properties, however, are still considered challenging due to several aspects. This paper reports on a thorough investigation of the influence of rare-earth (praseodymium) doping on the microstructural and optoelectronic properties of pure and Pr-doped SrSnO₃ perovskite oxide thin films synthesized by a two-step simple chemical solution deposition route. Structural analysis indicated the high quality of the obtained phase and the alteration generated from the insertion of impurities. Surface scanning illustrated the formation of homogenous and crack-free SrSnO₃ thin films with a nanorod morphology, with an augmentation in size as the dopant ratios increased. Optical properties analysis showed an enhancement in the samples optical absorption with wide-range bandgap tuning. First-principles calculations revealed the exchange interactions between the 3d–4f states and their impact on the electronic properties of the pristine material. Hall-effect measurements revealed an immense decrement in the resistivity of the films upon increment of doping ratios, passing from 7.3 × 10⁻² Ω cm for the undoped sample to 4.8 × 10⁻² Ω cm for 7% Pr content, while a reverse trend was observed on the carrier mobility, rising from 2.5 to 7.6 cm² V⁻¹ s⁻¹ for 7% Pr content. The results emphasized the efficiency of the simple synthesis route to produce high-quality samples. The current findings will contribute to paving the way towards expanding the utilization of simple and cost-effective chemical solution deposition methods for the fast and large area growth of stannous-based perovskite oxides for optoelectronic applications.

Unraveling the optical, electronic and electrical properties of high-quality nanorod morphology spray-coated Pr-doped SrSnO₃ perovskite oxide thin films.     

Revealing the impact of strontium doping on the optical,electronic and electrical properties of nanostructured 2H-CuFeO2 delafossite thin films

Delafossite materials are considered to be a promising range of transparent conductive oxides for optoelectronic applications. The complications that have held back their implementation in practical devices lie in the complex growth methods that are required and in the formation of undesirable secondary phases. Herein, a fast, simple, and low-cost deposition method allowing the deposition of high-quality 2H-CuFeO₂ nanostructured thin films is employed. The effect of Sr doping on the properties of spray-coated CuFeO₂ thin film annealed at 850 °C is reported. X-ray diffraction (XRD) analysis revealed the delafossite structures of all the samples corresponding to the 2H-CuFeO₂ phase. The lattice spacing decreased with increasing substitution of Sr at the Cu site. Raman analysis further authenticated the structural results collected via XRD analysis. Surface scanning using field-emission scanning electron microscopy revealed the formation of nanostructured CuFeO₂ thin film possessing high crystalline quality, with the nanocrystal size increasing as the dopant content was increased. Energy-dispersive X-ray analysis allowed the quantification of the elements content via determining the ratios of the main elements as well as the dopant content in each sample. The optical properties of the samples showed strong light absorption in the visible region with a decrease in the band gap values with Sr insertion. First-principles calculations using density functional theory (DFT) were conducted to strengthen the experimental findings regarding the nature of the bonds in the hexagonal lattice of the CuFeO₂ compound and the effect of Sr doping on its characteristics. The electrical properties measured at room temperature revealed p-type conductivity with tunable resistivity, while the samples displayed increased electron mobility as a function of the dopant content. Consequently, our work introduced an efficient and cost-effective synthesis route for the preparation of high-quality nanostructured 2H-CuFeO₂ thin films, paving the way to facilitate further device applications.

Facile synthesis of the challenging 2H-CuFeO₂ delafossite nanostructured thin films is reported, and the effect of Sr doping is revealed experimentally and theoretically.     

Congenital spondylolytic spondylolisthesis of the cervical spine: A case report and literature review

Congenital spondyloytic spondylolisthesis (CSS) is characterized as a pars-interarticularis well-corticated cleft with antherolithesis. The presence of spina bifida and vertebral dysplastic changes corroborate the possibility of a congenital etiology. It is a rare condition, usually discovered incidentally, especially after a trauma and should be differentiated from traumatic spondylolysis, which requires aggressive treatments. The management is often conservative, with surgery being indicated for symptomatic or unstable lesions. We report the case of a sixth cervical vertebra Congenital Spondylolytic Spondylolisthesis (CCS), discovered fortuitously following a minor trauma, in a 19-year-old male patient, treated conservatively with a favorable evolution.     

Behavioral effects of a calcium channel antagonist: nifedipine

A series of experiments investigated the behavioral effects of a calcium channel antagonist, nifedipine. This antagonist has facilitatory effects on learning and memory as assessed by the active and passive avoidance tests respectively. In the forced swimming test, nifedipine at a dose of 5 mg/kg had an inhibitory effect on immobilization. Finally, nifedipine (2.5 and 5.0 mg/kg) induced an anxiolytic effect in the water consumption test in a novel environment. These findings are discussed with respect to other findings in the same field and to the neurochemical changes known to be induced by calcium channel antagonists.     

A comparative study of cyproheptadine and DL carnitine on psychomotor performance and memory in healthy volunteers

This study was performed in order to investigate the extent and severity of cyproheptadine effects on psychomotor performance, mood and memory functions and to compare them to the effects of DL carnitine, another appetite stimulant. Twelve healthy volunteers received 2 doses (at 800 am and 1200 am) of 6 mg cyproheptadine, 1600 mg DL carnitine and placebo on separate days at a weekly intervals. The study followed a double-blind, latin-square design. Assessment of dependent variables was performed 1 h after the first and 1 h and 5 h after the second administration of the drug. On each of these occasions, the following measurements were performed: choice reaction time (CRT), critical flicker fusion (CFF), digit symbol substitution test (DSST), short-term memory (paired words association test), long-term memory (picture test) and 100 mm visual analogue scales of subjective ratings (VAS). Cyproheptadine significantly impaired objective measures (CFF) and subjective ratings both at 1 h and 5 h after the second dosage. Compared with cyproheptadine, DL carnitine induced a slight improvement in psychomotor performance as assessed by CRT. None of the drugs had any effect on memory and on appetite at the doses studied. In conclusion, cyproheptadine at usual doses had a sedative effect, the intensity and duration of which implied a certain risk in performing daytime functions eg when driving, or manipulating machines. DL carnitine had no effect on vigilance.