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This experimental study was done in order to determine the effect of Pentozocin to antagonise respiratory depression due to Fentanyle during general anesthesia in selected hospitals of the Medical Science University of Iran and Tehran. Subjects of this study consisted of 50 patients who were chosen randomly, and divided into two group of 25 each. Group one received pentazocine before the end of general anesthesia but group two did not. The method use to collect data in this study consisted of a check list and questionnaire. the check list included questions related to demographic characteristics of subjects and the questionnaire consisted of 4 items related to the respiratory rate. before the end of general anesthesia and also before extubation by endothracheal Tube.

Background: Bisphosphonate use is associated with atypical non-traumatic fractures, which are most commonly seen in the femur., Case Presentation: We report a 63-year-old postmenopausal woman who presented acutely with progressively worsening lumbar pain radiating to her left hip for 10 days. There was no antecedent trauma. On examination, the patient could not bear weight on her left leg due to the severity of the pain. Radiography and computed tomography of the pelvis demonstrated an iliac wing fracture which was treated conservatively. The patient had a significant past medical history of breast cancer and intense bisphosphonate use for several years which was discontinued 3 years previously. No discrete bone lesion was seen at the fracture site on computed tomography, and there was no evidence of metastatic disease elsewhere. A dual-energy X-ray absorptiometry scan showed the lowest bone mineral density T-score of - 1.2. A diagnosis of an atypical fracture related to long-term bisphosphonate therapy was made., Conclusion: To the best of our knowledge, this is the first reported case of an isolated iliac wing fracture associated with long-term bisphosphonate therapy in the literature. Whilst the incidence of such fractures is exceedingly rare, it is an important differential in patients with atypical fractures on long-term bisphosphonates., Competing Interests: Declarations. Consent to participate: Informed consent was obtained from the subject described in this report. Conflict of interest: The authors declare no competing interests., (© 2024. The Author(s).)

Endovascular treatment of iliofemoral deep vein thrombosis (IF DVT) can become more complex when thrombus extends below the knee. This article discusses various techniques that can be used to treat IF DVT with distal involvement.

This review article provides an overview of acute and chronic venous occlusion, a condition that can cause significant morbidity and mortality if not diagnosed and treated promptly. The article begins with an introduction to the anatomy of the venous system, followed by a discussion of the causes and clinical features of venous occlusion. The diagnostic tools available for the assessment of venous occlusion, including imaging modalities such as ultrasound, CT, and MRI, are then discussed, along with their respective advantages and limitations. The article also covers the treatment options for acute and chronic venous occlusion, including anticoagulant therapy and endovascular interventions. This review aims to provide radiologists with an updated understanding of the pathophysiology, diagnosis, and management of acute and chronic venous occlusion., Competing Interests: Competing interestsGO’S: Paid medical advisor/speakers bureau for Cook Medical, BSCI, Bard, Medtronic, Merit, Marvao, Versono, Intact Vascular, Creagh Medical, Vetex.

The purpose of this article is to initiate a discussion around the growing trend of sharing images of patients' scans without their consent on social media. While there are certainly merits in sharing images on social media, if undertaken without due care, it has the potential to be unprofessional and harmful to both patients and the radiology profession. In this article, I will outline some of the positive and negative aspects of sharing radiological images on social media, as well as some proposed solutions to help improve this practice., (© 2023 The Author. Journal of Medical Imaging and Radiation Oncology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Radiologists.)

Venous stents are being used with increasing frequency, with a multitude of dedicated venous stents now well established or emerging onto the market. This review explores the multifaceted aspects of venous stenting. We discuss the history of venous stents, indications for their use, the imaging required before, during and after stenting, as well as some technical tips and tricks which we have found to be helpful in our own daily practice with a particular focus on iliofemoral venous stenting. Ultimately, this article seeks to enhance the understanding of venous stenting, offering insights into what we feel are best practices, challenges, and prospects for improved patient outcomes., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Triple-negative breast cancer (TNBC) is the most aggressive type of cancer without any approved targeted therapy. Epigenetic processes have a pivotal role in cancer cell progression and while histone deacetylase 8 (HDAC8) has been proven as a potential oncogene in breast cancer, its underlying molecular mechanism is not known. Therefore, the present study, aimed to evaluate the underlying mechanism of the HDAC8 carcinogenesis in breast cancer progression., Methods: The potential role of HDAC8 in cancer cell processes such as apoptosis, invasion, migration, angiogenesis, and cancer stem cells (CSCs) markers were evaluated by using flow cytometry Annexin V-FITC/propidium iodide (PI), reverse transcription-polymerase chain reaction (RT-qPCR), Matrigel-coated transwell plates and wound healing assay on both cell lines. The impact of HDAC8 on tumor development was also studied using a breast cancer xenograft model., Results: HDAC8 expression was significantly downregulated in the cell lines, post-transfection with KO-vector. Downregulation of HDAC8 dramatically decreased cell migration, angiogenesis, and invasion while inducing apoptosis in MDAMB-468 and MDA-MB-231 cell lines. HDAC8 knocked out TNBC cell lines had lower levels of cancer stemness markers, such as prominin-1 (CD133), CD44, BMI1, and Aldehyde dehydrogenase 1 (ALDH1). Additionally, the knockout of HDAC8 inhibited tumor growth in a breast cancer xenograft model., Conclusion: The findings show that knocking out HDAC8 retains several anticancer actions in BC cells, such as inducing apoptosis, reducing migration, invasion, angiogenesis and removing CSCs markers., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2022. Published by Elsevier Inc.)

Aim: To develop and test a model based on a convolutional neural network that can identify enteric tube position accurately on chest radiography., Materials and Methods: The chest radiographs of adult patients were classified by radiologists based on enteric tube position as either critically misplaced (within the respiratory tract) or not critically misplaced (misplaced within the oesophagus or safely positioned below the diaphragm). A deep-learning model based on the 121-layer DenseNet architecture was developed using a training and validation set of 4,693 chest radiographs. The model was evaluated on an external test data set from a separate institution that consisted of 1,514 consecutive radiographs with a real-world incidence of critically misplaced enteric tubes., Results: The receiver operator characteristic area under the curve was 0.90 and 0.92 for the internal validation and external test data sets, respectively. For the external data set with a prevalence of 4.4% of critically misplaced enteric tubes, the model achieved high accuracy (92%), sensitivity (80%), and specificity (92%) for identifying a critically misplaced enteric tube. The negative predictive value (99%) was higher than the positive predictive value (32%)., Conclusion: The present study describes the development and external testing of a model that accurately identifies an enteric tube misplaced within the respiratory tract. This model could help reduce the risk of the catastrophic consequences of feeding through a misplaced enteric tube., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Land subsidence susceptibility mapping is a necessary prerequisite for land subsidence management. Proper assessment of land subsidence requires determining parameters affecting subsidence to discover the spatial relationships with subsidence. For this purpose, two frameworks were prepared, according to the land site subsidence, eight parameters affecting the subsidence in the Damaneh-Daran plain. In the first framework, eight parameters including annual groundwater level drawdown, aquifer medium, land use, discharge, aquifer saturation thickness, net recharge, fault proximity and topography called PWRSTFAL based on weighting parameters and the second model based on optimization and compatibility of eight active layers on subsidence, were prepared by AHP-fuzzy method and the final map of subsidence vulnerability obtained. Radar images and the InSAR method validated the methods. The results show that both maps show a good correlation with radar data. Still, the map prepared by the AHP-fuzzy method offers the highest correlation with radar data and subsidence in the plain. It separates subsidence vulnerability in more detail on the whole surface of the plain. According to this model, most plain areas, especially the eastern part, are subject to subsidence, and management programs should control subsidence. The results ROC diagram obtained from the performance of the PWRSTFAL framework based on the AHP-fuzzy method was more promising than the ordinary PWRSTFAL framework., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Purpose: To assess the feasibility of delivering microwave ablation for targeted treatment of aldosterone producing adenomas using image-based computational models., Methods: We curated an anonymized dataset of diagnostic 11 C-metomidate PET/CT images of 14 patients with aldosterone producing adenomas (APA). A semi-automated approach was developed to segment the APA, adrenal gland, and adjacent organs within 2 cm of the APA boundary. The segmented volumes were used to implement patient-specific 3D electromagnetic-bioheat transfer models of microwave ablation with a 2.45 GHz directional microwave ablation applicator. Ablation profiles were quantitatively assessed based on the extent of the APA target encompassed by an ablative thermal dose, while limiting thermal damage to the adjacent normal adrenal tissue and sensitive critical structures., Results: Across the 14 patients, adrenal tumor volumes ranged between 393 mm 3 and 2,395 mm 3 . On average, 70% of the adrenal tumor volumes received an ablative thermal dose of 240CEM43, while limiting thermal damage to non-target structures, and thermally sparing 83.5-96.4% of normal adrenal gland. Average ablation duration was 293 s (range: 60-600 s). Simulations indicated coverage of the APA with an ablative dose was limited when the axis of the ablation applicator was not well aligned with the major axis of the targeted APA., Conclusions: Image-based computational models demonstrate the potential for delivering microwave ablation to APA targets within the adrenal gland, while limiting thermal damage to surrounding non-target structures.

Recent studies have shown that the histone deacetylase-8 (HDAC8), as one of the HDACs, regulates the expression and activity of various genes involved in cancer initiation and progression. The HDAC8 plays an epigenetic role to dysregulate expressions or to interact with transcription factors. Most researchers had focused on the HDAC 1-3 and 6, but today the HDAC8 isotype is a promising target in cancer therapy. Different studies, on breast cancer (BC) cells, have recently shown the HDAC8 overexpression and suggested its oncogenic potential. It seems that the HDAC8 could be a novel and promising target in breast cancer treatment. Some studies on BC demonstrated therapeutic properties of the inhibitors of HDAC8 such as suberoylanilide hydroxamic acid (SAHA), Trichostatin A, valproic acid, sodium butyrate, 1,3,4 oxadiazole with alanine hybrid [(R)-2-amino-N-((5-phenyl-1,3,4-oxadiazol-2-yl) methyl) propanamide (10b)], N-(2-Hydroxyphenyl)-2propylpentanamide (compound 2) and PCI-34051. In this review, we highlight the role and existing inhibitors of HDAC8 in BC pathogenesis and therapy., (Copyright © 2021 Elsevier GmbH. All rights reserved.)

This study investigated the effects of garlic on anxiety- and depression-related behaviors and brain oxidative markers in streptozotocin (STZ)-induced diabetes in rats. Fifty-six male Wistar rats were randomly divided into seven experimental groups ( n  = 8/group): control, diabetic + saline, diabetic + garlic, diabetic + imipramine, and diabetic + diazepam groups. Animals received garlic homogenate (0.1, 0.25, and 0.5 g/kg) for 10 days. At the end of the treatments, anxiety- and depressive-related behaviors were evaluated by elevated plus maze (EPM) and forced swimming test (FST), respectively. Superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities and malondialdehyde (MDA) levels were measured in the brain. Diabetic + garlic (0.5 g/kg) group showed lower anxiety- and- depressive-like behaviors as compared to the diabetic rats. Furthermore, garlic treatment (0.5 g/kg) attenuated MDA levels and enhanced SOD and GPx activities in the brain. Our findings indicate that garlic alleviates anxiety- and depression-related behaviors in the diabetic rats possibly by attenuation of brain oxidative stress.

Pneumocephalus in the absence of trauma, tumour, or surgery is a rare entity. We report a case of a 73-year-old lady who presented with sepsis leading to confusion and unresponsiveness. A CT of brain revealed mastoiditis, sinusitis, and associated pneumocephalus. Further investigations led to an eventual diagnosis of pneumococcal meningitis. The combination of pneumocephalus and meningitis as complications of mastoiditis is rare with very few cases published in the literature. We describe one such case.

Recent studies show that cancer cells are sometimes able to evade the host immunity in the tumor microenvironment. Cancer cells can express high levels of immune inhibitory signaling proteins. One of the most critical checkpoint pathways in this system is a tumor-induced immune suppression (immune checkpoint) mediated by the programmed cell death protein 1 (PD-1) and its ligand, programmed death ligand 1 (PD-L1). PD-1 is highly expressed by activated T cells, B cells, dendritic cells, and natural killer cells, whereas PD-L1 is expressed on several types of tumor cells. Many studies have shown that blocking the interaction between PD-1 and PD-L1 enhances the T-cell response and mediates antitumor activity. In this review, we highlight a brief overview of the molecular and biochemical events that are regulated by the PD-1 and PD-L1 interaction in various cancers., (© 2018 Wiley Periodicals, Inc.)

Background: The self-assembling peptide barrier T45K (SAPB-T45K) is an oligopeptide that rapidly forms a biocompatible hemostatic barrier when applied to wounds., Objective: Evaluate safety and performance of SAPB-T45K in cutaneous surgery., Materials and Methods: In this single-blind study, after sequential shave excision of 2 lesions, wounds were randomized (intrapatient) to SAPB-T45K or control treatment. Safety was assessed at treatment, Day 7, and Day 30. Performance was evaluated using time to hemostasis (TTH) and ASEPSIS wound scores, with a subgroup analysis for patients with or without antiplatelet therapy., Results: Each of 46 patients (10 [22%] with antiplatelet therapy) received randomized SAPB-T45K or control treatment for 2 wounds. Safety assessments were similar, and ASEPSIS scores reflected normal healing in both wound groups. SAPB-T45K demonstrated significantly faster median TTH (24.5 [range, 7-165] seconds) compared with control (44 [10-387] seconds), for a 41% median TTH reduction (18 [95% confidence interval, 7-35] seconds, p < .001). SAPB-T45K provided an identical median TTH of 24 seconds, regardless of antiplatelet therapy. Control median TTH was 90 and 40 seconds for patients taking or not taking antiplatelet therapy, respectively., Conclusions: SAPB-T45K provided significantly faster median TTH versus control, especially with antiplatelet therapy, and safety profiles were similar.

Background: Mixed martial arts is a sport that has recently enjoyed a significant increase in popularity. This rise in popularity has catapulted many of these "cage fighters" into stardom and many regularly use social media to reach out to their fans. An interesting result of this interaction on social media is that athletes are sharing images of their radiological examinations when they sustain an injury., Purpose: To review instances where mixed martial arts fighters shared images of their radiological examinations on social media and in what context they were shared., Material and Methods: An Internet search was performed using the Google search engine. Search terms included "MMA," "mixed martial arts," "injury," "scan," "X-ray," "fracture," and "break." Articles which discussed injuries to MMA fighters were examined and those in which the fighter themselves shared a radiological image of their injury on social media were identified., Results: During our search, we identified 20 MMA fighters that had shared radiological images of their injuries on social media. There were 15 different types of injury, with a fracture of the mid-shaft of the ulna being the most common. The most popular social media platform was Twitter. The most common imaging modality X-ray (71%). The majority of injuries were sustained during competition (81%) and 35% of these fights resulted in a win for the fighter., Conclusion: Professional mixed martial artists are sharing radiological images of their injuries on social media. This may be in an attempt to connect with fans and raise their profile among other fighters.

Background: Ultrasound has been used in the diagnosis of soft-tissue lesions for well over a decade. Lipomas are the most common, benign, soft-tissue tumor and comprise adipose tissue. The sensitivity and specificity of diagnosing lipomas on ultrasound vary greatly in the literature., Purpose: To perform a systematic review on ultrasonography in soft-tissue lipomas to better ascertain the true diagnostic value of this test., Material and Methods: A systematic review of the diagnostic value of ultrasound in lipomas was performed where possible in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of the literature was conducted using several well-known databases Scopus®, PubMed®, Ovid® Medline, and Web of Science®., Results: A total of 455 articles were identified in the initial literature search. Six papers were included in the final systematic review, which revealed an overall sensitivity and specificity of 86.87% (95% confidence interval [CI] = 82.14-90.73) and 95.95% (95% CI = 93.75-97.54), respectively., Conclusion: Ultrasound is a useful tool in the diagnosis of superficial lipomas with good sensitivity and even better specificity and should continue to be the first line investigation in such cases.

Pyogenic liver abscess is a potentially devastating clinical entity associated with significant morbidity and mortality [1] . A myriad of causes for liver abscess have been described including intra-abdominal infections such as diverticulitis [2] . Due to a non-specific presentation, clinicians often require a high level of suspicion in their diagnosis of this condition. A handful of cases of liver abscess have been described following colonoscopy which was usually a complicated procedure or one where multiple biopsies had been taken [3,4] . The case of a patient presenting pyrexia of unknown origin one week after undergoing an uncomplicated colonoscopy in which no biopsies were taken is reported. She was ultimately diagnosed with a pyogenic liver abscess., Learning Points: Pyogenic liver abscess is an important differential when investigating pyrexia of unknown origin.Liver abscesses can rarely occur following colonoscopy., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests.

A 16-year-old male presented to the Emergency Department with a painful 3 × 3 cm left-sided neck swelling six hours following blunt trauma to the neck from a heavy swinging door. A CT angiogram was performed which revealed a large haemorrhagic lymph node as well as generalised cervical lymphadenopathy. The patient was eventually diagnosed with infectious mononucleosis. This case report describes a rare case of traumatic haemorrhagic cervical lymphadenopathy with an underlying diagnosis of infectious mononucleosis.

The literature on Dupuytren's contracture is vast yet little information is known as to which papers have been the most influential. The purpose of this study was to identify the 50 most cited papers on Dupuytren's contracture and perform a citation analysis. Utilizing the Web of Science, 23 surgical, medical, plastic and hand surgery journals were searched for papers on Dupuytren's contracture. Resulting articles were ranked in order of times cited and each paper was analyzed for article-type, year of publication, country of origin, institution and level of evidence. The 50 most cited articles represent many important landmarks in Dupuytren's treatment and contain several seminal works by experts in the field. Whilst the top 50 list highlights the important papers on the condition, they certainly do not provide information about the quality of the evidence of the research, as most papers presented level 4 or 5 evidence.

Background: There has been substantial rise in the volume of published works on fat transfer in the medical literature in the past 25 years, and this is indicative of its growing popularity. However, many unanswered questions remain, and there is no consensus as to the optimum technique. Consequently, the scientific and clinical research on fat grafting continues to increase rapidly. The purpose of our study was to perform a bibliometric analysis of the most-cited articles in fat transfer., Methods: Through the Web of Science, all articles relating to fat grafting were identified in the plastic and reconstructive literature. The 100 most-cited articles were identified and analyzed individually., Results: Total citations ranged from 35 to 363 and the most-cited paper by Sidney Coleman was published in Plastic and Reconstructive Surgery. The United States produced 46% of the most-cited papers, and the University of California was the most prolific institution. Twenty-one articles focused on lipofilling to the face while 14 articles looked at fat grafting to the breast., Conclusions: The scientific relevance of a published work is reflected in the number of citations from peers that it receives. Therefore, the 100 most-cited papers in fat grafting have been the most influential articles on this field, and they are likely to be the ones that are remembered most.

Background: Fasting during the month of Ramadan is of vital significance amongst Muslims; however, little is known about the effects of this kind of fasting on patients with coronary artery disease (CAD)., Objectives: This nonrandomized prospective observational pilot study was designed to investigate the effects of Ramadan fast on the symptoms of CAD., Patients and Methods: Patients with documented CAD were consecutively (nonrandomized) included in the study, and those with heart failure (ejection fraction < 50%), renal failure, gout, and insulin-treated diabetes were excluded. Patients had the choice of fasting during Ramadan if they so wished and to break their fast as soon as symptoms such as dyspnea and chest pain occurred (fasting group) or not fasting (control group)., Results: A total of 148 patients completed the study. Mean (mean ± SD) age of the patients was 61.5 ± 11.7 years and 50% were male. Finally, 66 patients (44.6%) accomplished Ramadan fast with an average of 22.27 ± 10.46 days of fasting. Occurrence of chest pain was not significantly different between the fasting and non-fasting groups (4 out of 66 [6.1%] vs. 8 out of 82 [9.8%] respectively; P = 0.42). In addition, patients who fasted during Ramadan did not experience a higher frequency of a combined endpoint of chest pain and dyspnea (4 out of 66 cases in the fasting group [6.1%] vs. 11 out of 82 in non-fasting group [13.4%]; P = 0.14)., Conclusions: In the present study, the patients with CAD were able to observe Ramadan fast safely and their combined endpoint of chest pain and dyspnea was not significantly different from that of the non-fasting ones. We would suggest that patients with CAD and normal left ventricular function could fast during Ramadan.

Patients with hypertrophic cardiomyopathy classically have preserved systolic function in the setting of impaired diastolic function and decreased left ventricular end-diastolic volume. However, in a small sub-population, patients paradoxically develop systolic dysfunction, left ventricular dilatation, and ventricular wall thinning. This pattern is one that is likened to dilated cardiomyopathy and is known as end-stage hypertrophic cardiomyopathy or "burned-out cardiomyopathy." The role of cardiac magnetic resonance imaging is well defined in narrowing the differential diagnosis of impaired left ventricular function, including that of hypertrophic cardiomyopathy. However, the importance of obtaining a family history and obtaining details of diagnosis for both preceding and future generations cannot be under-estimated. We report a case of end-stage hypertrophic cardiomyopathy that highlights how important family history can be in making a diagnosis. < Learning objective: While most cases of burned-out hypertrophic cardiomyopathy occur long after a patient has been initially seen and subsequently followed by cardiologists for hypertrophic cardiomyopathy, a small proportion of patients initially present with this entity. This is one such case, and it highlights the importance of thorough investigation into a patient's family history.>.

Theophylline, (1,3-dimethylxanthine) is widely used as a smooth muscle relaxant, myocardial stimulant and a diuretic agent. The most frequent use of theophylline is in treatment of acute and chronic asthma as a bronchodilator. To determine the effect of Theophylline on serum electrolyte and uric acid, 21 asthmatic children (age range 1.5-7 years) with severe acute asthma and 25 patients with chronic asthma (5-15 years ) who were being treated with slow-release theophylline were enrolled in this study. Fifty age and sex matched normal children took part as control. Blood samples (5m1) were withdrawn before, during and after completion of the course of intravenous theophylline treatment (0.05-0.70 mg/kg/ hr). Sera obtained were used for analysis of K+, Na+, phosphorus, calcium and uric acid by RA-1000 automated analyzer and the following results were obtained: (1) After treatment, total serum calcium in acute asthmatic patients decreased significantly compared with controls (P<0.01); (2) serum phosphate and K+ levels of acute and chronic asthmatic patients after therapy decreased as compared with controls (P<0.01). (3) Post therapy increase in serum level of uric acid in acute and chronic asthmatic patients was statistically significant as compared with control (P<0.001). We conclude that the serum levels of phosphate, potassium, calcium and uric acid should he monitored in patient receiving theophylline especially during prolonged use and critical emergency cases.