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Key Clinical Message: The precise management of hypersensitivity reactions to direct oral anticoagulants (DOACs) and the potential for cross‐reactivity among different DOACs remain unclear. In such cases, switching between DOACs may be feasible and could be considered, but close monitoring for adverse effects is essential, tailored to individual patient responses and tolerability. Hypersensitivity reactions to DOACs, though considered rare, have been documented. This report describes the case of a 28‐year‐old male with a history of testicular cancer who was recently diagnosed with deep vein thrombosis. He was referred to an outpatient pharmacotherapy clinic due to suspected rivaroxaban‐induced cutaneous reactions. Following a thorough evaluation, his anticoagulant therapy was switched from rivaroxaban to apixaban. This change was successfully implemented, and no hypersensitivity symptoms recurred during subsequent follow‐up. This case demonstrates the importance of recognizing potential adverse reactions to DOACs and illustrates the feasibility of switching anticoagulants under close medical supervision to ensure patient safety and effective treatment. [ABSTRACT FROM AUTHOR]

Background: 10%-15% of the world's population suffers from kidney stones. Nearly 50% increase was observed in diagnosing and treating nephrolithiasis in the last decades. Effective medical treatment for the disease is not yet well established. Moreover, there is an increasing global demand to manage diseases using complementary and alternative medicine. This study aimed to formulate and assess the safety and efficacy of a multi-ingredient formulation from traditional Persian medicine (TPM) known as Mofatet powder in patients suffering from calcium kidney stones. Materials and Methods: The aqueous extract of Mofatet powder was prepared, freeze-dried, and formulated as capsules. 26 patients in the drug group and 25 patients in the placebo group used 500 mg capsules of the drug/placebo twice daily for 5 weeks. Ultrasonography/kidney, ureter and bladder imaging, urine analysis, and biochemical parameters were evaluated before and after the intervention. Results: The imaging results showed a 60.73% decrease (P < 0.001) in stone size in the drug group. Moreover, the urinary calcium decreased (P = 0.02) and the urinary magnesium increased (P < 0.001) in the drug group. No remarkable changes were observed in the placebo group in these parameters. No significant effect was observed in aspartate transaminase, alanine transaminase, serum creatinine, and blood urea nitrogen levels in none of the groups. Conclusion: This study suggests that Mofatet powder was effective in reducing calcium kidney stones size with no potential nephro/hepatotoxicity. After confirming these results in larger clinical trials with longer duration, this formulation can be considered a treatment for nephrolithiasis. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Generalized tetanus is still a global concern with a mortality rate of up to 50%, especially in low and middle‐income countries. We reported a 23‐year‐old man from Afghanistan admitted to emergency department, with the chief complaint of generalized severe spasms and lockjaw. The patient had skin lesions and had never been vaccinated against tetanus. He intubated and admitted to the intensive care unit (ICU) with diagnose of severe generalized tetanus. After receiving tetanus immunoglobulin and intravenous metronidazole, a combination therapy of midazolam, propofol, atracurium, and morphine was administered. Due to the refractory muscular spasms intravenous phenobarbital started and little by little recovery was achieved. The patient receiving the first two doses of the Td vaccine, and discharged on Day 42 of hospitalization with no symptom recurrence. This case management showed adding phenobarbital to severe tetanus treatment regimen could significantly reduce refractory spasm caused by tetanus, also decrease other medication requirement. [ABSTRACT FROM AUTHOR]

Background: Celiac disease (CD) is one of the most common and chronic immune-mediated disorders of the gastrointestinal tract that affects the small intestine. Genetic factors, including human leukocyte antigen (HLA), and non-HLA genes are major risk factors in CD pathology. Moreover, environmental factors such as infections may affect CD incidence. Materials and Methods: The goal of the present study is to investigate the association between CD and viral, bacterial, fungal, and parasitic infections. Databases including Scopus, PubMed, Google Scholar, and Web of Science were searched for relevant literature until 2022. Results: Several infections have been reported to be associated with CD including reovirus, rotavirus, hepatitis B virus, influenza virus, helicobacter pylori, campylobacter jejuni, giardia lamblia, toxoplasma gondii, candida albicans, etc. Conclusion: Moreover, antibiotic administration might be a risk factor for further CD development. On the other hand, there are reports regarding the susceptibility of patients with CD to some infections, as well as protective infections against CD. Consequently, more studies are required to explain the two-sided relations between CD and infectious diseases. [ABSTRACT FROM AUTHOR]

Kidney stone, as a third important urinary tract disease, is a common disease affecting 10-15% of the world population. Effective medical treatment for the disease is not yet well established. On the other hand, there is an increasing global demand to manage and control various diseases with natural medicine and medicaments originating from Complementary and Alternative Medicine (CAM). Traditional Persian medicine (TPM), as one of the most popular schools in CAM, suggests numerous clinical interventions for kidney stones. This review provides various related compound formulations for kidney/bladder stones from the standpoints of Persian scholars. These remedies have been cited in a series of traditional pharmaceutical manuscripts of Persian medicine, namely Qarābādin or prescription. More than fifty multiingredient formulations for kidney/bladder stones have been found by reviewing five main Persian pharmacopeias. Various dosage forms have been reported for the management of kidney/bladder stones, such as Majoon (confection), Sharāb (syrup), Jawārish (semisolid confection), Qors (Tablet), and Safoof (oral powder). Considering the positive pharmacological or biological activities of the constituents of filtered formulations, many of those can be re-formulated and either experimentally or clinically evaluated to be introduced as new natural remedies in this field. [ABSTRACT FROM AUTHOR]

Emissions from higher excited states are of theoretical and experimental interest but rare. A series of pure organic phosphors, 2,5-dihexyloxy-4-bromobenzaldehyde (Br6A) derivatives, show intriguing dualphosphorescence characteristics. Their phosphorescence emissions are blue-shifted by 20 nm at room temperature compared to those at 78 K. These shifts are accompanied by increasing contributions from a fast-decaying component. The mechanism responsible for the emission shifts observed for Br6A was studied in a 2,5-dihexyloxy-4-bromobenzene (Br6) solid matrix and solvents of various polarities. While the decay curve for Br6A in the Br6 matrix showed a single slow process, pure Br6A exhibited an additional faster decay. We demonstrated that the faster decay of pure Br6A arises from the T2 state, while Br6A in the Br6 matrix emits solely from T1. Compared to the T1 state (π, π*), the n, π* character of the T2 state ensures more efficient spin-orbit coupling with the ground state, which facilitates faster decay. The larger polarity of Br6A compared to that of Br6 leads to a lower T2 level and a smaller T2-T1 energy gap in pure Br6A, but not when in the Br6 solid matrix, which enables a T1 to T2 thermal population shift in pure Br6A at room temperature. Consistently, the emissions from the Br6A solutions gradually red-shifted with increasing solvent polarity at 78 K. Moreover, the decay curves of Br6A in solvents of low polarity were single-exponential unlike the double-exponential ones observed in polar solvents. These results provide insight into the effect of the environment on the dual phosphorescence emissions of pure organic phosphors. [ABSTRACT FROM AUTHOR]

A series of novel techniques, adapted from the field of tumor biology, were developed to quantify vascular structure and function and to explore the role of ANG II receptor AT1 in cardiac remodeling after myocardial infarction (MI). We examined the scar neovasculature at 1-4 wk post-MI in Sprague-Dawley rats with a view toward its ability to deliver and exchange oxygen. CD31 and DiO[C.sub.7](3) staining was used to visualize anatomical vessels vs. those perfused. EF5/Cy3 immunohistochemical staining was used to quantify tissue hypoxia. We compared untreated controls with rats treated with losartan, an AT1 receptor antagonist. Our findings indicated that, at the infarct site, there was not only a 42-75% (1-4 wk post-MI) decrease in the number of anatomical vessels compared with controls but also a decrease in the fraction of perfused vessels from 70% in normal coronary vasculature to 48% at the infarct site. These changes were accompanied by progressive increases in diffusion distance and tissue hypoxia (100% increase in EF5/Cy3 staining at 4 wk post-MI). Losartan-treated rats exhibited a significantly less marked reduction in vascular perfusion and a significantly lesser extent of tissue hypoxia. Over the course of 4 wk post-MI, there is a reduction in coronary vasculature at the infarct site, the extent of which is attenuated by losartan. These findings implicate AT1 receptor upregulation, and perhaps angiotensin-related peptides, as being antiangiogenic. hypoxic marker; perfusion; myocardial infarction; microcirculation