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Background This study aimed to evaluate the short-term efficacy of repetitive transcranial magnetic stimulation (rTMS) on the treatment of failed back surgery syndrome (FBSS). Methods In this prospective clinical trial study, 13 patients with FBSS were selected to undergo rTMS, including 5 sessions of stimulation of the primary motor cortex of 90 trains with a frequency of 10 Hz for 2 seconds and an intertrain interval of 20 seconds with a total pulse rate of 1800 per session. The time of each session was 30 minutes with an intensity of 80% of the motor threshold. The severity of pain before and after the intervention was measured by the short-form McGill Pain Questionnaire and visual analog scale (VAS). Results The mean of pain severity was 26.54 ± 6.78 and 14.92 ± 10.1 before and after rTMS, respectively. The severity of pain was significantly decreased after the intervention (p = 0.001). According to the McGill Pain Questionnaire, the severity of pain in the patients was decreased by 44.09 ± 27.32. The mean of the severity of pain according to VAS was 77.31 ± 16.66 before rTMS and 53.46 ± 22.49 after rTMS, which showed that pain intensity was significantly decreased after the intervention (p = 0.006). Conclusions The use of rTMS of the primary motor cortex in patients who have undergone lumbosacral spine surgery and suffer from pain related to FBSS is associated with a significant reduction in the severity of pain. Because rTMS is a noninvasive treatment method, it can be used as a suitable treatment in these patients. [ABSTRACT FROM AUTHOR]

Background Intracranial aneurysms are more commonly associated with inflammation as a cause of their development, progression, and rupture. Macrophages and other cells can express the CD68 antigen. The aim of this study was to assess the CD68 antigen levels in cerebral aneurysm (CA) patients compared to a control group at a referral center in Iran. Methods A case-control investigation was undertaken on 88 individuals (44 of whom were cases and 44 were controls). Individuals with CA as the case group consisted of 28 ruptured and 16 unruptured subgroups. Clinical, radiographic, and CD68 levels were evaluated and registered. Results The average age of the participants was 49 years. Males comprised 43.2% of the patients, while 56.8% were females (p = 0.002). There was a statistically significant difference in the CD68 levels between the two groups. There was no significant difference (p = 0.42) between the ruptured and unruptured subgroups (23.66 and 20.47, respectively) in this comparison. No significant correlation was seen between the patients' CD68 and Glasgow Coma Scale (GCS) levels and their aneurysm diameter (p = 0.74 and 0.45, respectively). A link between CD68 levels and age was found, but it was not statistically significant (r = 0.44 and p = 0.002). Conclusions A possible involvement of CD68 as an inflammatory agent in the development of CAs but not in aneurysm rupture has been suggested. Inflammation and CD68 were positively associated with age. The CD68 antigen should be studied further in population-based cohort studies. [ABSTRACT FROM AUTHOR]

Several studies have investigated the association between students' seating positions and their classroom performance. However, the role of personality traits on seating preference in the classroom has not been well investigated. The aim of the study was to understand how students choose their seats according to their personality traits in a classroom context and the influence of personality characteristics and seat selection on educational achievement. The seating positions of the medical students were recorded on an architectural plan during each class session, and the means and standard deviations of the students' locations were calculated in X and Y orientations. The locations of the students in the class were analyzed based on three architectural classifications: interactional zone, distance from the board, and access to the aisles. The NEO Five-Factor Inventory was used to evaluate the five main personality characteristics of the students. Midterm and final exam scores were used to measure the students' educational achievement. Analysis of variance showed a statistical significance correlation between the interactional zones and both agreeableness and conscientiousness. Mantel-Haenszel analysis showed a statistical significance association between sex and agreeableness and openness to experiences, which was mainly caused by zone II. Among the tested characteristics, a statistically significant relationship was observed between agreeableness and final exam scores. There was a statistical significance difference in openness and extraversion between the students with a high number of absences and their classmates. A relationship between the student's locations in the class, their educational achievements, and some of their personality characteristics are addressed.

Introduction: One of the most important complications after burning is hypo/depigmentation. This study was designed to compare two methods of cell spray and intradermal injection of epidermal cell suspension for treatment of burn induced hypopigmentation. Material and Methods: In this study, 28 patients with post burn hypo/depigmentation were selected and divided in 2 groups. A small skin biopsy was taken from normal skin of patients in operation room and epidermal cell suspension was prepared using NaBr 4N and trypsin. In the first group, the epidermal cell suspension was sprayed on the wound surface and then the area was dressed with amniotic membrane and gauze. In the second group, the cell suspension was injected in intradermal manner in the hypopigmented area. The patients were followed up and to evaluate the effect of the cells, photos were taken from the area before operation and also at follow-up. Clinical evaluation was done by the surgeon and a clinical score between "0" to "4" was used to demonstrate the clinical status from poor to excellent pigmentation. Skin biopsies were taken from depigmented area before and after interventions. Melanocytes were stained using anti S100 antibody and were counted in ×400 magnification fields. Results: Eighteen patients were in cell spray and 10 were in cell injection groups. Mean change of pigmentation in two group showed that there was no statistical significant differences in pigmentation between two groups, (P value = 0.52) although a limited improvement in pigmentation status was observed in both groups. Regarding melanocyte numbers per field, there was not a significant difference between two groups and also before and after interventions, but melanocyte number increased after treatment in both groups. Conclusion: We did not find noticeable differences between cell spray and intradermal injection methods. Although both methods showed a limited effect on pigmentation of depigmented skin, the clinical results were not satisfactorily for both patients and clinicians.

Interaction between a healthy microbiome and the immune system leads to body homeostasis, as dysbiosis in microbiome content and loss of diversity may result in disease development. Due to the ability of probiotics to help and modify microbiome constitution, probiotics are now widely used for the prevention and treatment of different gastrointestinal, inflammatory, and, more recently, respiratory diseases. In this regard, chronic respiratory diseases including chronic obstructive pulmonary disease (COPD), asthma and allergic rhinitis are among the most common and complicated respiratory diseases with no specific treatment until now. Accordingly, many studies have evaluated the therapeutic efficacy of probiotic administration (mostly via the oral route and much lesser nasal route) on chronic respiratory diseases. We tried to summarise and evaluate these studies to give a perspective of probiotic therapy via both the oral and nasal routes for respiratory infections (in general) and chronic respiratory diseases (specifically). We finally concluded that probiotics might be useful for allergic diseases. For asthmatic patients, probiotics can modulate serum cytokines and IgE and decrease eosinophilia, but with no significant reduction in clinical symptoms. For COPD, only limited studies were found with uncertain clinical efficacy. For intranasal administration, although some studies propose more efficiency than the oral route, more clinical evaluations are warranted. [ABSTRACT FROM AUTHOR]

Byline: Mohsen. Maharlooei, Ali. Mohammadi, Ali. Farsi, Iman. Ahrari, Armin. Attar, Ahmad. Monabati Background: Burn surgeons use autologous skin graft technique for patients, but a challenge remains for large surface [...]

Background: Cutaneous malignancies are common in dermatologic practice. Due to their relation to sun exposure the characteristics of these malignancies can differ in various geographic locations. This study intends to determine the characteristics of surgically treated cutaneous malignancies and various surgical modalities that have been applied. Methods: This was a retrospective study of patients with cutaneous malignancies who underwent surgery over a six-year period. Data regarding the general information, type of malignancy, location, surgical margin involvement and specific surgical modalities were recorded and analyzed. Results: A total of 432 patients were included. Basal cell carcinoma was the most common malignancy (82.8%) followed by squamous cell carcinoma (13.4%). Lentigo maligna, keratoacanthoma, basosquamous carcinoma, sebaceous carcinoma and Bowen's disease accounted for the minority of cases. Patients' mean age was 65.7 years and the most common location was the nose and cheeks. The mean diameter was 2.97 cm. Excision was performed with safe margins. Incomplete excision was seen in 14% of basal cell and 15% of squamous cell carcinoma cases. The most common type of defect closure was a simple closure (43.9%). Conclusion: Basal cell carcinoma is the most common type of cutaneous malignancy. Surgery yields a satisfactory response as treatment for this cutaneous malignancy. [ABSTRACT FROM AUTHOR]

C-C motif chemokine 22 (CCL22) C16A genetic variation (rs4359426) and C-C chemokine receptor type 4 (CCR4) C1014T variation (rs2228428) have been suggested to affect the expression level of the cognate proteins. Here we tried to investigate the plausible association of these polymorphisms with development of colorectal cancer. 165 patients with colorectal adenocarcinoma (age 54.4±13.4) and 150 age- and sexmatched healthy individuals were enrolled. Genotyping was performed by PCR-RFLP methods. Results indicated the frequency of 16A allele in CCL22 gene to be 31/330(9.4%) and 33/300(11%) in patients and controls, respectively (p=0.59). The frequencies of CC, CA, and AA genotypes at this locus were not significantly different between patients and controls (135/165; 81.8%, 29/165; 17.6%, 1/165; 0.6% in the patients and 121/150; 80.1%, 25/150; 16.6% and 4/150; 2.6% in the control group, p= 0.34). At the locus 1014 in CCR4, T allele was observed with the frequency of 107/330 (32.4%) and 83/300 (27.7%) in patients and controls, respectively (p=0.22). Analyses indicated no significant differences in the frequencies of CC, CT and TT genotypes at this locus between patients and controls (77/165; 46.7%, 69/165; 41.8% and 19/165; 11.5%; versus 83/150; 55.0%, 51/150; 33.8% and 16/150; 10.6%, respectively, p= 0.29). The presence of individual genotypes was not associated with clinicopathological characteristics of the disease, including tumor size, tumor grade and LN involvement (all with p>0.05). These findings collectively suggested that CCR4 C1014T and CCL22 C16A genetic variations were neither associated with the risk, nor with the progression of colorectal cancer in Iranian population. [ABSTRACT FROM AUTHOR]

Background: Burn surgeons use autologous skin graft technique for patients, but a challenge remains for large surface wounds. Recently, a method was described which used a small piece of skin to cover a 70 times greater surface by spraying epidermal cells on injured skin. We designed a comparative study to find the best method to make an epidermal cell suspension. Materials and Methods: Eleven discarded skin samples were sent to our laboratory from Ghotboddin Burn Hospital, Shiraz. Each sample was sliced into four small pieces (1 cm2) and each piece was treated with a different chemical including sodium bromide (2N) and (4N), ammonium hydroxide (2N), and trypsin (0.05%) for 20 minutes. The epidermis and dermis were separated using forceps. Trypsin was added to all samples (except the trypsinized sample) to begin the intercellular detachment. Afterward, epidermis was sliced into small pieces followed by filtration and centrifugation. Cells were counted using hemocytometer. Identification of keratinocytes and melanocytes was made through immunocytochemical staining for cytokeratin and melanosome antigens, respectively. Results: There was a significant difference in alive cell counts comparing cells obtained from NaBr (4N) method to other methods. Considering total cell count and alive cell count, NaBr (4N) yielded the most cells. Immunocytochemical staining showed that in all methods, some cells are stained positively for cytokeratin antibody and some for melanosome antibody. Conclusion: Although recent papers had advised trypsin method to make a cell suspension to use for burn patients, we found that NaBr (4N) method yields more alive cells and less toxicity. [ABSTRACT FROM AUTHOR]

Background. Psoriasis is a chronic inflammatory skin disease affecting approximately 1-3% of Caucasians. Prolactin has proliferative effects on human keratinocytes, a dominant feature of psoriasis, and it is thought that this hormone may play a role in the pathogenesis of the disease. This study was conducted to confirm or refute these findings in order to better understand the disease pathogenesis. Methods. The subjects were 90 individuals aged between 15 and 47 years. They were divided into three groups of 30 individuals each: psoriatic patients, atopic dermatitis patients, and control group. A questionnaire was filled regarding their demographic and medical history. All of the study subjects underwent venous blood sampling (5 mL), and serum TSH and prolactin levels were checked. Subjects with abnormal TSH were omitted. Results. None of the patients in the study had raised prolactin, and there was no significant difference in the serum prolactin level between patients with psoriasis and atopic dermatitis and the control group. There was no relationship between the severity of psoriasis and serum levels of prolactin. Conclusion. Prolactin does not seem to play a role in the pathogenesis of psoriasis as its serum levels are comparable with atopic dermatitis patients and that of the normal population. [ABSTRACT FROM AUTHOR]

There is no recommendation for the treatment of herpes zoster neuralgia in pregnancy, as it even sometimes needs administration of strong opioids. Main observation: Here, we report a pregnant woman with severe zoster neuralgia who responded favorably to acetaminophen. Due to the drug's safe profile and good efficacy, acetaminophen can be used as an alternative for herpetic neuralgia in pregnant women. However, controlled studies are still needed. [ABSTRACT FROM AUTHOR]