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Trigeminal neuralgia, considered by many the worst pain that humankind can experience, has been called “the suicide disease.” Neuroablative procedures are good options when conservative treatment fails to promote pain relief or in those whose side effects are unbearable. The objective was to compare the effectiveness and safety of trigeminal percutaneous radiofrequency ablation in classical refractory trigeminal neuralgia in a prospective, randomized, double-blind, sham-controlled clinical trial. We included 30 consecutive patients with classical trigeminal neuralgia who had failed to respond to drug treatment. The patients were randomly assigned into two groups: a thermal radiofrequency and a sham group. The thermal radiofrequency group were submitted to a 75°C lesion for 60 seconds after proper sensory and motor stimulation. All steps were carried out in the sham group except the thermal lesion. Patients were evaluated using the Numerical Rating Scale (NRS), the 36-Item Short-Form Health Survey questionnaire, and anticonvulsant dose. After 1 month, the mean NRS score decreased from 9.2 to 0.7 in the radiofrequency group and from 8.9 to 5.8 in the sham group. This significant reduction was measurable starting at day one after the procedure and remained significant throughout the first month. Changing groups was allowed after one month, after which the pain reduction was similar between the two groups. Percutaneous trigeminal radiofrequency ablation results in statistically and clinically significant greater pain relief than the sham procedure after 1 month of follow-up. These results support using radiofrequency nerve ablation as a treatment for refractory trigeminal neuralgia.

This study investigates preoperative lymph node metastases (LNM) detection accuracy by MRI and CT in patients with prostate cancer (PCA).All patients with preoperative MRI, CT or both and subsequent radical prostatectomy (RPE) and lymphadenectomy (LA) were included in this retrospective cohort study. Prostate specific antigen (PSA), PI-RADS, ISUP grade group, clinical and pathological tumor (T) stage was compared between negative and positive nodal (N) stage. LNM were assessed with size and localization and weather they were preoperatively detected or not. In patients with preoperative CT and MRI, the results were compared intermodally. The reference standard was the histopathological results after RPE and LA.A total of 228 patients were analysed including 24 patients with confirmed LNM (N1; 11%). PSA (median 9.7 vs. 14 ng/ml), PI-RADS (median 4 vs. 5), ISUP (median 2 vs. 4), and cT/pT-stage (median T2 vs. T3) was significantly higher in patients with LNM. No LNM were found in patients with ISUP-1-PCA. MRI was able to detect 67% of patients with LNM. Lymph node metastases presented on MRI predominantly small, round-shaped, located parailiacally with a minimum SAD of 4 mm (vs. CT SAD of 8 mm). In comparison, MRI was superior to CT in the detection of LNM (sensitivity 81% vs. 33%; specificity 99% vs. 97).LNM were very rare in patients with PSA 10 ng/ml, PI-RADS ≤ 4, and ≤ cT2. MRI could detect LNM up to 4 mm with a moderate sensitivity and high specificity. Thus, MRI might optimise the preoperative diagnostic and therapy planning of patients with PCA, whereas CT was clearly limited for N-stage assessment.

BACKGROUND The demographic change and an increasing multimorbidity of patients represent increasing challenges for the adequate prehospital treatment of emergency patients. The incorporation of supplementary telemedical concepts and systems can lead to an improved guideline-conform treatment. Beneficial evidence of telemedical procedures is only known for isolated disease patterns; however, no mobile telemedical concept exists which is suitable for use in the wide variety of different clinical situations. AIM This article presents a newly developed and evaluated total telemedical concept (TemRas) that encompasses organizational, medical and technical components. The use of intelligent and robust communication technology and the implementation of this add-on system allows the telemedical support of the rescue service for all emergencies. METHODS After development of the telemedical rescue assistance system, which includes organizational, medical and technical components, a telemedical centre and six ambulances in five different districts in North-Rhine Westphalia were equipped with this new tool. During the evaluation phase of 1 year in the routine emergency medical service the rate of complications as well as differences between urban and rural areas were analyzed with respect to different target parameters. RESULTS Between August 2012 and July 2013 a total of 401 teleconsultations were performed during emergency missions and 24 during secondary interhospital transfers. No complications due to teleconsultation were observed. The mean duration (±SD) of teleconsultations was longer in rural areas than in urban areas with 28.6±12.0 min vs. 25.5±11.1 min (p

Background: Mangrove associated fungi are the second most diverse organisms that remain less explored. Cytotoxic and antibacterial activities of foliar fungus Meyerozyma guillier- mondii were investigated. Methods: Foliar fungus was isolated from the leaves of Rhizophora mucronata collected from Pich- avaram mangrove forest, Tamilnadu. Extracts from liquid state culture were tested for cytotoxicity against two cancer cell lines using the MTT assay. Antibacterial activity was determined using the well diffusion method. The DNA was isolated from the fungi, and the ITS region of 5.8s RNA was sequenced. The spectral properties (GC/MS) of the purified compounds were determined. Results: The ethyl acetate extracts showed potent cytotoxicity against Hep2 and human breast ade- nocarcinoma (MCF-7) cell lines with IC50 values of 1.25 and 0.625 lg/ml, respectively. Antibacte- rial activity of the fungal extract was demonstrated against five test organisms. The fungus was found to be a new strain based on ITS sequence and database in NCBI Blast tool. Conclusion: Results indicate the potential for production of bioactive agents from mangrove foliar fungi. a 2013 Production and hosting by Elsevier B.V. on behalf of Alexandria University Faculty of Medicine.

Mangrove is one of the oldest living tree species and its leaves are among the most extensively studied botanicals in use today. Scientific research throughout the world has found evidence to support the fact that its foliar extracts have great potential against human microbial pathogens. This study highlights the isolation of foliar fungi from Rhizophora mucronata, Avicenna officialis and Avicenna marina.It was isolated in Sabouroud's Dextrose Agar and mass cultivation was done in Sabouroud's Dextrose broth.The ethyl acetate extract showed maximum antibacterial activity which inturn checked for different concentration against bacterial pathogens and anticancer activity for Hep2 and MCF7 cell line in vitro. The DNA was isolated from the fungi and the ITS region of 5.8 s RNA was sequenced and assigned to new species as they are separated from the type strains phylogenetic neighbors by sequence similarities.This preliminary screening of fungal endophytes revealed their potential to yield potent bioactive compounds for drug discovery programmes.

Objective: To explore antibacterial activity and characterization of secondary metabolites isolated from mangrove plant Avicennia officinalis (A. officinalis). Methods: In the present study the leaf extracts of A. officinalis were examined for its antibacterial potential using five different solvents against some reference strains of human pathogenic bacteria for the crude extract. Maximum activity was observed for ethyl acetate and hence different concentrations like 15 μL, 25 μL, and 50 μL of ethyl extracts was checked for its antibacterial activity. Partial purification of crude extract was earned by column chromatography and fractions were analyzed using gas chromatography-mass spectrometry (GC-MS) to identify compounds. Results: The crude ethyl acetate extracts of A. officinalis showed remarkable antibacterial activity with zones of inhibition of 13 mm against Eschericia coli (E. coli) and 11 mm against Staphylococcus aureus (S. aureus). Fraction 13 (ethyl acetate: methanol= 8:2) as the most potent one against with the minimal inhibitory concentration of 30 mm against E. coli and 25 mm against S. aureus. The GC-MS resultsof active column fraction (F13) revealed that the active principals were a mixture of hydroxy-4 methoxybenzoic acid, diethyl phthalate, oleic acid. Conclusions: The leaf extracts with proven antibacterial effects can clearly be directed towards cancer treatment as to inhibiting cancer cell growth. The limited number of test organisms owes to a constraint of resource. So, the effect of strong bursts of leaf extracts on human pathogenic bacteria should further be tested on a wide range of test organisms.

Objective: To evaluate the antibacterial activity of foliar extracts of Rhizophora mucronata (R. mucronata) against pathogens belonging to human origin and to identify the compound hitherto unprecedented in nature by GC-MS analysis. Methods: Soxhlet extraction method was used to get the corresponding extracts of ethanol, petroleum ether, acetone, methanol and ethyl acetate. The antimicrobial activities of the organic solvent extracts on the various test organisms using agar well diffusion technique were carried out. Ethyl acetate extract exhibited promising antimicrobial activity and hence minimum inhibitory concentration (MIC) was performed for the same. Column chromatography was done for partial purification of crude extract and fractions were analyzed by GC-MS. Results: A column chromatographic fractionation of the extracts and further UV visible and CS-MS analysis suggested the active principle compound were a mixture of squalene (19.19%), n-Hexadecanoic acid (6.59%), phytol (4.74%), 2-cyclohexane-1-one, 4-hydroxy-3,5, (4.20%) and oleic acid (2.88%). Conclusions: The results are good enough to serve to transform the practice of research in this sub field across a range of different benefit streams that include drug development. By and large this type of structure analyses are most important as aids to more rational decision taking in safety models versus effectiveness. In general, structural data provide prima facie support for drug hypothesis.