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The uncontrolled administration of the cisplatin drug (CPTN) resulted in numerous drawbacks. Therefore, effective, affordable, and biocompatible delivery systems were suggested to regulate the loading, release, and therapeutic effect of CPTN. Zinc phosphate/hydroxyapatite hybrid form (ZP/HP) and core-shell nano-rod morphology, as well as its functionalized derivative with cellulose (CF@ZP/HP), were synthesized by the facile dissolution precipitation method followed by mixing with cellulose fibers, respectively. The developed CF@ZP/HP displayed remarkable enhanced CPTN loading properties (418.2 mg/g) as compared to ZP/HP (259.8 mg/g). The CPTN loading behaviors into CF@ZP/HP follow the Langmuir isotherm properties (R 2  > 0.98) in addition to the kinetic activities of the pseudo-first-order model (R 2  > 0.96). The steric assessment validates the notable increase in the existing loading receptors after the functionalization of ZP/HP with CF from 57.7 mg/g (ZP/HP) to 90.5 mg/g. The functionalization also impacted the capacity of each existing receptor to be able to ensure 5 CPTN molecules. This, in addition to the loading energies (<40 kJ/mol), donates the loading of CPTN by physical multi-molecular processes and in vertical orientation. The CPTN releasing patterns of CF@ZP/HP exhibit slow and controlled properties (95.7 % after 200 h at pH 7.4 and 100 % after 120 h at pH 5.5), but faster than the properties of ZP/HP. The kinetic modeling of the release activities together with the diffusion exponent (>0.45) reflected the release of CPTN according to both erosion and diffusion mechanisms. The loading of CPTN into both ZP/HP and CF@ZP/HP also resulted in a marked enhancement in the anticancer activity of CPTN against human cervical epithelial malignancies (HeLa) (cell viability = 5.6 % (CPTN), 3.2 % (CPTN loaded ZP/HP), and 1.12 % (CPTN loaded CF@ZP/HP))., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Zinc-phosphate/hydroxyapatite hybrid form (ZP/HP) in core-shell nanostructure was developed and functionalized with both chitosan (CS@ZP/HP) and β-cyclodextrin (CD@ZP/HP) as bio-composite of enhanced physicochemical and biological properties. These structures were assessed as potential deliveries of 5-fluorouracil, exhibiting enhanced loading, release, and anti-cancer behaviors. The functionalization strongly prompted the loading effectiveness to be 301.3 mg/g (CS@ZP/HP) and 342.8 mg/g (CD@ZP/HP) instead of 238.9 mg/g for ZP/HP. The loading activities were assessed based on the hypotheses of traditional kinetic and isotherm models, alongside the computational variables of the monolayer model with a single energetic site as an advanced isotherm model. The functionalized versions exhibit much greater loading efficacy compared to ZP/HP as a result of the increment in the density of the existing loading sites [Nm (5-Fu) = 78.85 mg/g (ZP/HP), 93.87 mg/g (CS@ZP/HP), and 117.8 mg/g (CD@ZP/HP)]. Furthermore, the loading energies of approximately 40 kJ/mol, together with the loading potential of each receptor (n > 1) and Gaussian energies of approximately 8 kJ/mol, indicate the physical entrapment of 5-Fu molecules according to a vertical orientation. The materials mentioned verify long-term and continuous release characteristics. Following the modification processes, this behavior became faster as both CS@ZP/HP and CD@ZP/HP displayed complete release within 120 h at pH 1.2. The kinetic studies and diffusing exponent (>0.45) indicate that release characteristics are controlled by both diffusion and erosion processes. These carriers also markedly increase the cytotoxicity of 5-Fu against HCT-116 colorectal cancer cell lines: 5-Fu-ZP/HP (3.2% cell viability), 5-Fu-CS@ZP/HP (1.12% cell viability), and 5-Fu-CD@ZP/HP (0.63% cell viability)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Bin Jumah, Al Othman, Alomari, Allam, Bellucci and Abukhadra.)

Background: Elderly patients with vestibular schwannoma (VS) are commonly observed., Object: Retrospective analysis of 25 patients aging ≥ 70 operated on in our neurosurgical department for unilateral VS. The purpose of our study is to propose an algorithm for the treatment of VS in elderly patients., Methods: American Society of Anesthesiology (ASA) Grade I-II patients and Grade III with life-threatening tumors were enrolled. Karnofsky Performance Status Scale (KPS) was used for evalutation of the quality of life. The House-Brackmann (HB) scale for facial nerve (FN) outcome was used. Tumor size was categorized according to Koos' classification. A retrosigmoid approach was used in all cases, except one in which a translabyrinthine approach was performed. Surgical removal graduation: total (GTR), near total (NTR > 95%), subtotal (STR > 90%). The clinical and radiological follow-up period was set first at six months and then at one year after surgery. FN results evaluation was performed at one year, categorized according to House-Brackmann grades I-VI., Results: Mean age: 74,4 years (70-83); 28% ASA I, 56% ASA II, 16% ASA III. Mean tumor size: 2,7 cm (1,5-4,2 cm)., Gtr/ntr: 68%, STR 32%. Mortality was zero. At last follow-up (one year after surgery) FN results were: HBI 81%, HBII 9.5%, HBIII 9.5%; HB IV 0%. Only 4 patients had preoperative HB IV, of whom one improved from HB IV to HB III. Transient complications occurred only in large VS. Re-growth of residue after STR was observed in 3 cases, treated with SRS in 2 cases and observed in 1., Conclusions: An algorithm of treatment of vestibular schwannoma in the elderly is proposed. In particular, in patients in general good conditions, age does not appear to be a major contraindication for microsurgery of VS. FN results at last follow-up are satisfactory and the complication rates are acceptable., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: The main objective of this comprehensive mixed-methods investigation conducted in Jordan were to explore and understand men's engagement in cancer screening., Methods: The research employed a mixed-methods approach, combining a survey with 209 participants and focus group interviews with 30 individuals. The survey involved quantitative data collection methods to gather information on cancer screening participation rates among men in Amman. Focus group interviews were conducted to collect qualitative data on the factors influencing cancer screening utilization among men in Amman., Results: The study revealed a notably low participation rate, with less than 37% of men engaging in cancer screening. The diminished involvement was attributed to several factors, including health illiteracy, language barriers, restricted access to health-related information and screening services, and cultural considerations., Conclusions: Based on the findings, the research strongly advocates for tailored interventions that are culturally specific. The emphasis is on the importance of training community health workers to address the identified challenges and enhance both cancer prevention awareness and screening accessibility in Jordan.

We present the case of an 18-year-old male with a ventriculoperitoneal (VP) shunt for hydrocephalus who experienced right shoulder pain. The patient was thoroughly investigated for gastrointestinal disease, including abdominal ultrasound and upper endoscopy, which revealed no abnormalities that could explain his symptoms. X-ray imaging subsequently revealed that the shunt's distal peritoneal tubing was positioned in a supra-hepatic subdiaphragmatic location. Surgical shortening and repositioning of the peritoneal tubing successfully alleviated the patient's shoulder pain. A review of the literature uncovered four articles, comprising a total of six patients, who exhibited similar symptoms of shoulder pain linked to their VP shunts. Given the rarity of this complication, it can be easily overlooked or misdiagnosed. It is crucial for physicians to consider this possibility when evaluating patients with VP shunts who present with shoulder pain to ensure prompt and effective treatment., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Samara et al.)

Background: Iatrogenic hypoparathyroidism is a common cause of postthyroidectomy hypocalcaemia. It has varying incidence rates after neck surgery in Saudi Arabia, ranging from 0.07% to 65.30%. Hypoparathyroidism can manifest with a spectrum of symptoms, ranging from mild to severe and life-threatening. This study aimed to assess the rate and predictors of iatrogenic hypoparathyroidism after thyroid surgery and its natural course., Methods: This retrospective cohort study used a data collection form to extract patient information from the electronic healthcare system (Best-Care) for patients treated from 2017 to 2022. Patients' demographics, surgical specifics and biochemical profiles were recorded for subsequent analysis., Results: Among the 343 patients who underwent thyroidectomy, 130 (37.9%) developed hypoparathyroidism, primarily within the first day after surgery. Calcium or vitamin D supplementation before surgery did not significantly influence hypoparathyroidism development. Notably, extensive combined lymph node dissection was significantly associated with postoperative hypoparathyroidism development (p = 0.0004). More patients who underwent central and lateral lymph node dissection (n = 19, 79.17%) developed hypoparathyroidism than patients who underwent central (n = 18, 40.91%) or lateral (n = 8, 38.10%) dissection alone. Permanent hypoparathyroidism was observed in 40 patients (11.66%)., Conclusion: This study revealed a high incidence of iatrogenic hypoparathyroidism and high rates of permanent hypoparathyroidism. Further research is warranted to better comprehend the risk factors and optimise management strategies for iatrogenic hypoparathyroidism. Overall, our findings emphasise the need for vigilant monitoring and effective management of patients undergoing thyroidectomy and the significance of postoperative replacement therapies., (© 2024 The Author(s). Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.)

Background: Vestibular schwannoma (VS), also known as acoustic neuroma, is a benign, well-encapsulated, and slow-growing tumor that originates from Schwann cells, which form the myelin sheath around the vestibulocochlear nerve (VIII cranial nerve). The surgical treatment of this condition presents a challenging task for surgeons, as the tumor's location and size make it difficult to remove without causing damage to the surrounding structures. In recent years, fluorescein sodium (FS) has been proposed as a tool to enhance surgical outcomes in VS surgery. This essay will provide an analytical comparison of the use of FS in VS surgery, evaluating its benefits and limitations and comparing surgical outcomes with and without FS-assisted surgery., Methods: In a retrospective study conducted at San Filippo Neri Hospital, we examined VS cases that were operated on between January 2017 and December 2023. The patients were divided into two groups: group A, which consisted of patients who underwent surgery without the use of FS until January 2020 (102 cases), and group B, which included patients who underwent surgery with FS after January 2020 (55 cases). All operations were performed using the retrosigmoid approach, and tumor size was classified according to the Koos, et al. classification system. The extent of surgical removal was evaluated using both the intraoperative surgeon's opinion and postoperative MRI imaging. Preoperatively and postoperatively, facial nerve function and hearing were assessed. In group B, FS was used to assist the surgical procedures, which were performed using a surgical microscope equipped with an integrated fluorescein filter. Postoperative clinical and MRI controls were performed at six months and annually, with no patients lost to follow-up., Results: This study investigated the impact of intraoperative fluorescein exposure on tumor resection and clinical outcomes in patients with VS. The study found a statistically significant difference in the tumor resection rates between patients who received fluorescein intraoperatively ( p = 0.037). Further analyses using the Koos classification system revealed a significant effect of fluorescein exposure, particularly in the Koos 3 subgroup ( p = 0.001). Notably, no significant differences were observed in hearing loss or facial nerve function between the two groups. A Spearman correlation analysis revealed a positive correlation between tumor size and Koos, age, and size, but no significant correlation was found between facial nerve function tests., Conclusions: FS-assisted surgery for VS may potentially enhance tumor resection, allowing for more comprehensive tumor removal.

Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

An advanced form of magnesium-rich hydroxyapatite (Mg·HAP) was modified with two types of biopolymers, namely chitosan (CH/Mg·HAP) and β-cyclodextrin (CD/Mg·HAP), producing two types of bio-composites. The synthesized materials were developed as enhanced carriers for levofloxacin to control its loading, release, and anti-inflammatory properties. The polymeric modification significantly improved the loading efficiency to 281.4 mg g -1 for CH/Mg·HAP and 332.4 mg g -1 for CD/Mg·HAP compared with 218.3 mg g -1 for Mg·HAP. The loading behaviors were determined using conventional kinetic and isotherm models and mathematical parameters of new equilibrium models (the monolayer model of one energy). The estimated density of effective loading sites ( N m (LVX) = 88.03 mg g -1 (Mg·HAP), 115.8 mg g -1 (CH/Mg·HAP), and 138.5 mg g -1 (CD/Mg·HAP)) illustrates the markedly higher loading performance of the modified forms of Mg·HAP. Moreover, the loading energies (<40 kJ mol -1 ) in conjunction with the capacity of each loading site ( n > 1) and Gaussian energies (<8 kJ mol -1 ) signify the physical trapping of LVX molecules in vertical orientation. The addressed materials validate prolonged and continuous release behaviors. These behaviors accelerated after the modification procedures, as the complete release was identified after 160 h (CH/Mg·HAP) and 200 h (CD/Mg·HAP). The releasing behaviors are regulated by both diffusion and erosion mechanisms, according to the kinetic investigations and diffusion exponent analysis (>0.45). The entrapping of LVX into Mg·HAP induces its anti-inflammatory properties against the generation of cytokines (IL-6 and IL-8) in human bronchial epithelia cells (NL20), and this effect displays further enhancement after the integration of chitosan and β-cyclodextrin., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Introduction ChatGPT (OpenAI Incorporated, Mission District, San Francisco, United States) is an artificial intelligence (AI) chatbot with advanced communication skills and a massive knowledge database. However, its application in medicine, specifically in neurolocalization, necessitates clinical reasoning in addition to deep neuroanatomical knowledge. This article examines ChatGPT's capabilities in neurolocalization. Methods Forty-six text-based neurolocalization case scenarios were presented to ChatGPT-3.5 from November 6th, 2023, to November 16th, 2023. Seven neurosurgeons evaluated ChatGPT's responses to these cases, utilizing a 5-point scoring system recommended by ChatGPT, to score the accuracy of these responses. Results ChatGPT-3.5 achieved an accuracy score of 84.8% in generating "completely correct" and "mostly correct" responses. ANOVA analysis suggested a consistent scoring approach between different evaluators. The mean length of the case text was 69.8 tokens (SD 20.8). Conclusion While this accuracy score is promising, it is not yet reliable for routine patient care. We recommend keeping interactions with ChatGPT concise, precise, and simple to improve response accuracy. As AI continues to evolve, it will hold significant and innovative breakthroughs in medicine., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Dabbas et al.)

Introduction: Surgical strategy for meningioma resection in the elderly is controversial: diverse studies in the literature have pointed at the age as a negative prognostic factor in terms of postoperative results., Research Question: The aim of this study is to compare surgical outcomes after resection of posterior fossa meningiomas in <70 and ≥ 70 years-old age groups., Material and Methods: We reviewed 72 patients affected by posterior fossa meningiomas who underwent surgical treatment at San Filippo Neri Hospital, Rome, Italy between September 2010 and December 2022. We analyzed data regarding tumor size, clinical presentation, extent of resection and complication/mortality., Results: The groups consisted of 52 (72,2%) young and 20 (27,8%) elderly patients. Gross total resection rate was significantly higher among youngsters ( p = 0,013 ), mainly for planned subtotal removal in older patients. At 3-month follow-up, clinical improvement was seen in 19 (36,5%) young and 7 (35,0%) elderly patients, which raised at last follow-up, being 84,6% (44) and 80,0% (16), respectively ( p = 0,406 ). Two cases of progression/recurrence among the elderly and 1 among youngsters were observed; one case of mortality among the elderly was reported., Discussion and Conclusions: Safety data regarding postoperative complications and mortality in our series seem to confirm that there is no significant difference between older and younger patients, as long as older patients are carefully selected. Therefore, if surgery is proposed, it should be radical if gross total resection could be safely attempted., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Rome (ITALY) January 7, 2024., (© 2024 The Authors.)

Objective: The objective of this study is to investigate the perceived obstacles and willingness of Lebanese men aged 40 and above to undergo screening for prostate cancer., Material and Method: A cross-sectional research design was employed. The study utilized a survey questionnaire to collect data on various factors influencing screening behaviors. The research instrument consisted of a comprehensive survey questionnaire that incorporated validated scales to assess barriers to prostate cancer screening, intention to screen, and the International Prostate Symptom Score (IPSS)., Results: The study found that the 120 participants had an average IPSS score of 7.20 ± 2.23, most people (70%) had mild symptoms of prostate cancer, whereas others had moderate (20%) or severe symptoms (10%). The majority of the men indicated a low to moderate inclination to undergo screening through Prostate-specific antigen testing, or digital rectal examination (DRE) (PSA), with 76% considering DRE and 70% considering PSA. The main barriers to screening included the dread of receiving distressing outcomes (48%) and a lack of understanding about the screening procedure (54%). The study identified key factors affecting the intention to undergo a prostate cancer screening. Regarding DREs, these factors included the perceived danger of the illness and prior information from doctors about prostate conditions. When it came to the intention to undergo screening through the prostate-specific antigen test (PSA), determinants included the perceived threat of the disease, one's general health perception, and prior information from doctors about prostate-related issues. Additionally, a significant proportion of participants believed that prostate cancer was not a serious illness (56%) and 57% thought DRE was embarrassing., Conclusions: The participants displayed a low willingness to get screened for prostate cancer. Implementing interventions that focus on increasing awareness of the disease and its associated risks could potentially reduce the barriers and boost participation in prostate cancer screening.

Background The demanding nature of neurosurgical practice requires a reliable system for documentation and record-keeping. The cost of electronic health record systems can limit their availability in low- and middle-income countries. That is why less expensive and easily accessible technological alternatives should be sought. In this article, we describe our adopted system for medical record-keeping based on WhatsApp (Meta Platforms, Inc., Menlo Park, CA). Methods In our chain of six clinics, each clinic has its record-keeping WhatsApp group dedicated to sharing medical data of outpatients following up in that specific clinic and of inpatients cared for in hospitals in its area. After each encounter, our surgeons share smartphone-captured pictures of their patients' medical data on the WhatsApp group of the related clinic. The medical data are then categorized and stored by the secretary on the clinic's computer to be accessed at any time for record retrieval. Discussion Our five years of experience with the WhatsApp-based record-keeping system with medical records of 11,729 patients proved to be reliable, cost-effective, user-friendly, and efficient, and it positively impacted patient care. Responsible behavior, security precautions, and regulating policies are essential to protect patient confidentiality. Conclusion Our system can be an inexpensive alternative to the electronic health record system in small healthcare facilities. It can help physicians practicing in low- and middle-income countries to improve medical records documentation, thereby improving patient care. There is a need for policies to regulate the use of instant messaging applications in professional medical communication., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Odeibat et al.)

A retro-odontoid pseudotumor (ROP) is commonly associated with atlantoaxial instability (AAI) or rheumatoid arthritis (RA). However, we describe a patient with ROP in the absence of AAI or RA. An 81-year-old man who did not have a history of trauma to the head and neck admitted with neck pain, right upper extremity numbness, lower limb weakness, and walking disturbance. He had a history of C2 dome and C3-7 laminoplasty 10 years ago. Magnetic resonance imaging revealed a retro-odontoid mass with cervical cord compression. Dynamic radiography did not show signs of AAI. He underwent C1 laminectomy without fixation for the ROP. We speculated that the load on C1 and C2 increased because of the progression of kyphosis from C2 to C7 with increases in range of motion, which in turn caused change in the biomechanics of the cervical spine, leading to recurrent partial tear and degradation of the transverse ligament that induced formation of the ROP. Spinal surgeons should keep this complication in mind and inform patients about this potential postoperative complication.

Background: Treatment of small vestibular schwannomas (VS) depends on size, growth pattern, age, symptoms, co-morbidities. Watchful waiting, stereotactic radiosurgery and microsurgery are three valid options of treatment., Methods: We reviewed clinical sheets, surgical data and results of 100 consecutive patients with Koos Grade I-II VS, operated at our department via a retrosigmoid microsurgical approach between September 2010 and July 2021. Extent of resection was assessed as total, near-total or subtotal. The course of facial nerve (FN) around the tumor was classified as anterior (A), anterior-inferior (AI), anterior-superior (AS) and dorsal (D). FN function was assessed according to House-Brackmann (HB) Scale and hearing level according to AAO-HNS Classification., Results: Mean tumor size was 1.52 cm. FN course was mainly AS (46.0%) in the overall cohort; in Koos I VS, FN was AS in 83.3%. Postoperative FN function was HB I in 97% and HB II in 3% of cases. Hearing preservation (AAO-HNS class A-B) was possible in 63.2% of procedures. Total/near-total removal was achieved in 98%. Postoperative mortality was zero. Transient complications were observed in 8% of patients; permanent complications never occurred. Tumor remnant progression was observed in one case, 5 years after subtotal removal., Conclusions: Microsurgery represents a valid option for management of VS, including Koos I-II grades, with an acceptable complication rate. In particular, in small VS long-term FN facial outcome, HP and total/near-total removal rate are favorable.

Heat stroke is among the most hazardous hyperthermia-related illnesses and an emerging threat to humans from climate change. Acute brain injury and long-lasting brain damage are the hallmarks of this condition. Hyperthermic neurological manifestations are remarkable for their damage correlation with stress amplitude and long-term persistence. Hyperthermia-induced protein unfolding, and nonspecific aggregation accumulation have neurotoxic effects and contribute to the pathogenesis of brain damage in heat stroke. Therefore, we generated heat-induced, dose-responsive extreme and mild proteotoxic stress models in medulloblastoma [Daoy] and neuroblastoma [SH-SY5Y] and differentiated SH-SY5Y neuronal cells. We show that heat-induced protein aggregation is associated with reduced cell proliferation and viability. Higher protein aggregation in differentiated neurons than in neuroblastoma precursors suggests a differential neuronal vulnerability to heat. We characterized the neuronal heat shock response through RT-PCR array analysis of eighty-four genes involved in protein folding and protein quality control (PQC). We identify seventeen significantly expressed genes, five of which are Hsp70 chaperones, and four of their known complementing function proteins. Protein expression analysis determined the individual differential contribution of the five Hsp70 chaperones to the proteotoxic stress response and the significance of only two members under mild conditions. The co-expression analysis reveals significantly high co-expression between the Hsp70 chaperones and their interacting partners. The findings of this study lend support to the hypothesis that hyperthermia-induced proteotoxicity may underlie the brain injury of heat stroke. Additionally, this study presents a comprehensive map of the Hsp70 network in these models with potential clinical and translational implications.

Background: Post-COVID-19 Syndrome (PCS) is characterized by residual symptoms following the initial recovery from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The prevalence of PCS is known to be the highest among severe and critical forms of the disease. However, the occurrence and risk factors for PCS after mild or moderate SARS-CoV-2 infection has not been extensively investigated., Methods: Online and offline via both paper or mailed questionnaires distributed among Jordan collected between 1st and 21st August 2021, including a total number of 800 respondents, of whom 495 had previous mild to moderate COVID-19 infection. The Newcastle post-COVID syndrome Follow-up Screening Questionnaire was modified, translated, and used as a standard instrument for data collection regarding psychological, medical, and socio-economic symptoms post-infection. The primary outcome was the prevalence of PCS after mild to moderate COVID-19 in Jordan. Secondary outcome was the identification of PCS risk factors., Results: The most common PCS symptom was mood disturbance followed by fatigue, anxiety, and myalgia. Female gender significantly increased the risk for multiple PCS symptoms. Age < 30 years was found to be an independent risk factor for myalgia ( p = 0.001)., Conclusion: PCS is highly prevalent among COVID-19 survivors in Jordan, especially in females and patients with comorbidities. Planning physical and mental rehabilitation services is recommended for those patients with PCS symptoms after mild to moderate COVID-19 infection., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Al-Husinat, Nusir, Al-Gharaibeh, Alomari, Smadi, Battaglini and Pelosi.)

Objectives: Recent estimates have indicated that the weighted community prevalence of body dysmorphic disorder (BDD) is rising. This study aimed to identify the prevalence and determinants of BDD among female adolescents in Jeddah, KSA., Methods: A cross-sectional study was conducted among female students in governmental secondary schools. Students presenting with abnormal health conditions were excluded. A multi-stage stratified sampling technique was used to select the target number of students (N = 495). BDD screening was performed using a BDD questionnaire., Results: The students' mean (standard deviation) age was 16.78 (1.11) years, and the prevalence of BDD was 12.3% (95% confidence interval: 9.6-15.5%). The body parts associated with the most concern were the skin (18.4%), hair (10.7%), teeth (9.9%), and nose (9.5%). Psychosocial assessment showed that the body part of concern was associated with sadness in 20.6%, avoidance reactions in 17.6%, and problems in school, work, or other activities in 3.8% while playing a role in social relationships in 21.5%. The aspects associated with the highest risk included the skin (odds ratio (OR) = 8.33, p < 0.001), followed by body fat (OR = 8.17, p < 0.001) and the nose (OR = 7.35, p < 0.001). With the number of affected body parts, the prevalence of BDD increased from 21.7% (one body part) to 60%., Conclusions: In this study, BDD was a common, difficult-to-recognise disorder with a prevalence of one in eight female Saudi adolescents. It was associated with marked changes in social interactions, self-esteem, and quality of life., (© 2019 Taibah University. Production and hosting by Elsevier Ltd.)

Shape, size, and homogeneity affect the biological activity of gold nanoparticles (AuNPs) in nanomedicine and catalytic applications. Here we biosynthesized monodispersed isotropic and polydispersed anisotropic spherical AuNPs from leaf and seed extract broths of the medicinal plant Peganum harmala L. (Ph. L). Synthesized AuNPs were characterized by ultraviolet-visible spectroscopy, Fourier-transform infrared spectroscopy (FT-IRS), field-emission scanning electron microscopy (FESEM), X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy (EDX), and transmission electron microscopy (TEM). The antimicrobial activity of AuNPs against Gram-negative (Escherichia coli) and Gram-positive (Staphylococcus aureus) human pathogens was also assessed. Leaf- and seed-derived AuNPs had characteristic localized surface plasmon resonances of 530 and 578 nm, respectively. TEM, FE-SEM, EDX, and XRD revealed the formation of elemental face-centered cubic spherical monodispersed isotropic AuNPs of average size 43.44 nm and polydispersed anisotropic AuNPs of average size 52.04 nm from leaf and seed extract broths, respectively. FT-IR revealed polyphenols and alcohols as responsible for AuNP capping, reduction, and protection. Anisotropic AuNPs showed no antibacterial activity, whereas isotropic AuNPs showed good inhibition of both E. coli and S. aureus. This represents a simple and ecofriendly protocol for the green synthesis of monodispersed isotropic spherical AuNPs, which may have value in a variety of applications., (© 2019 International Union of Biochemistry and Molecular Biology, Inc.)

Background: This was a prospective study to evaluate the effect of multilevel vertebral augmentation in addition to conventional therapy in multiple myeloma patients., Methods: We treated 27 patients, whom were recently diagnosed to have multiple myeloma by two ways of treatment. Thirteen patients (group I) were treated with conventional therapy and 14 patients (group II) with adding vertebroplasty and kyphoplasty. Patients were evaluated pre-treatment and at half, one, two and 3-years post-treatment by using Oswestry Disability Index (ODI), the Stanford Score (SS) and the Spinal Instability Neoplastic Score (SINS)., Results: Mean values of ODI, SS and SINS were 31.9 (63.8%), 4.3 and 13.8 for group I and 33.2 (66.4%), 4.6 and 12.8 for group II before starting treatment. Group II showed improvement better than group I at all follow-up intervals with best results at first 6 months. P -values at the end of the study were ODI = 0.047, SS = 0.180 and SINS = 0.002. Mortality rates were equal of both groups (four patients of each group)., Conclusion: Adding vertebral augmentation to conventional therapy improves multiple myeloma patients' quality of life, but didn't affect the mortality rate.

Background: Intracardiac leakage of bone cement after kyphoplasty and vertebroplasty is a rare and life-threatening complication. Cortoss, which is an injectable, non-absorbable, polymer composite that is designed to mimic cortical bone, can be used instead of cement. Here, we present the case of a patient with right intra-cardiac Cortoss embolization., Case Report: A 28-year-old man known to have ulcerative colitis since the age of 15 and treated with corticosteroids for more than 4 years and with anti-immune drugs presented to our hospital complaining of back pain and decreased body height due to osteomalacia with failed conservative treatment. Kyphoplasty and vertebroplasty of the thoracic 10-12 and first lumbar vertebrae were done with any complications. Three months later, the patient underwent kyphoplasty and vertebroplasty of lumbar 2-5 vertebrae by injecting Cortoss instead of cement, which was complicated with paravertebral intravascular leakage. We stopped surgery and transferred him to the recovery room, where he had slight chest pain that resolved spontaneously without neurological deficit. Two days later he developed severe chest pain and chest X-ray showed a large white shadow at the right side of the heart and another 2 small shadows just lateral to it. Sudden deterioration of patient status necessitated an emergency echocardiogram, which showed pericardial tamponade and a perforated right ventricle. Aspiration of pericardial blood and emergency open heart surgery were done. He was discharged 4 days later and was followed up at an outpatient clinic., Conclusions: Cardiac embolism is a serious condition that can complicate vertebral kyphoplasty; it requires a high level of suspicion and immediate action, and may need open heart surgery to save the patient's life.