Background: and Purpose Repetitive transcranial magnetic stimulation (rTMS) of the cerebellar hemisphere represents a new option in treating essential tremor (ET) patients. We aimed to determine the efficacy of cerebellar rTMS in treating ET using different protocols regarding the number of sessions, exposure duration, and follow-up duration. Methods: A randomized sham-controlled trial was conducted, in which 45 recruit patients were randomly allocated to 2 groups. The first (active group) comprised 23 patients who were exposed to 12 sessions of active rTMS with 900 pulses of 1-Hz rTMS at 90% of the resting motor threshold daily on each side of the cerebellar hemispheres over 4 weeks. The second group (sham group) comprised 22 patients who were exposed to 12 sessions of sham rTMS. Both groups were reassessed at baseline and after 1 day, 1 month, 2 months, and 3 months using the Fahn-Tolosa-Marin tremor-rating scale (FTM). Results: Demographic characteristics did no differ between the two groups. There were significant reductions both in FTM subscores A and B and in the FTM total score in the active-rTMS group during the period of assessment and after 3 months (p=0.031 and 0.011, respectively).However, subscore C did not change significantly from baseline when assessed at 2 and 3 months (p=0.073 and 0.236, respectively). Furthermore, the global assessment score was significantly higher in the active-rTMS group (p>0.001). Conclusions Low-frequency rTMS over the cerebellar cortex for 1 month showed relative safety and long-lasting efficacy in patients with ET. Further large-sample clinical trials are needed that include different sites of stimulation and longer follow-ups.

Objective: Irregular patterns of marital cohabitation are a common problem in upper Egypt due to employment conditions. The objective of this study was to investigate the effect of irregular marital cohabitation on the quality of life and sexual function of infertile men. Methods: In total, 208 infertile men were included and divided into two groups. The first group included 134 infertile men with an irregular pattern of marital cohabitation and the second group included 74 infertile men with a regular pattern of marital cohabitation. All subjects were assessed through a clinical evaluation, conventional semen analysis, the fertility quality of life (FertiQoL) questionnaire, the International Index of Erectile Function (IIEF-5) score, and the premature ejaculation diagnostic tool (PMEDT). Results: The two groups were compared in terms of conventional semen parameters, FertiQoL, IIEF-5 score, and PMEDT. Infertile men with an irregular pattern of marital cohabitation had significantly lower subscale and total FertiQoL and IIEF-5 scores. Additionally, they had significantly higher PMEDT scores. Erectile dysfunction and premature ejaculation were more common in them than in infertile men with a regular pattern of marital cohabitation. Conclusion Irregular patterns of marital cohabitation had an adverse effect on quality of life and sexual function in infertile men.

BACKGROUND: Immune responses appear to be affected by anesthetics and analgesics. We investigated the effects of caudal tramadol on the postoperative immune response and pain management in pediatric patients. METHODS: Sixty ASA-I pediatric patients aged 3–10 years undergoing lower abdominal surgery. Patients were randomly assigned either to a caudal bupivacaine (0.25%) group (group B), or a group that received caudal tramadol (1 mg/kg) added to the bupivacaine (0.25%) (group T). Both were diluted in a 0.9% NaCl solution to a total volume of 1ml/kg. The systemic immune response was measured by collecting blood samples preoperatively, at the end of anesthesia, and at 24 and 72 hours postoperatively, and studied for interleukin IL-6, C-reactive proteins (CRP) cortisol levels, and leucocytes with its differential count. Postoperative pain was assessed along with sedation scales. RESULTS: Postoperative production of IL-6 was significantly higher in group B at the end of anesthesia, than at the 24th hour, and at the 72nd hour in group B and group T, respectively. The immune response showed leukocytosis with increased percentages of neutrophil and monocytes, and a decreased lymphocyte response rate within both groups with no significant differences between the groups. Cortisol and CRP were significantly higher in group B. CONCLUSIONS: Adding tramadol to a caudal bupivacaine block can attenuate the pro-inflammatory cytokine response, Cortisol, and CRP in children undergoing lower abdominal surgery.
Abdomen ; Analgesics ; Anesthesia ; Anesthesia, Caudal ; Anesthetics ; Bupivacaine ; C-Reactive Protein ; Child ; Humans ; Hydrocortisone ; Interleukin-6 ; Interleukins ; Leukocyte Count ; Leukocytes ; Leukocytosis ; Lymphocytes ; Monocytes ; Neutrophils ; Pain Management ; Pain, Postoperative ; Pediatrics ; Tramadol ; Weights and Measures

Purpose: One of the essential goals regarding the successful control of rabies infection is the development of a safe, effective, and inexpensive vaccine. the current study aimed to evaluate the inactivation potential of β-propiolactone (βPL), binary ethyleneimine (BEI), and hydrogen peroxide (H2O2). Materials and Methods: Estimating the inactivation kinetics of βPL, BEI, and H2O2 revealed that the tested inactivants could completely and irreversibly inactivate rabies virus within 2, 12, and 4 hours, respectively while maintaining its viral immunogenicity. The potency of βPL, BEI, and H2O2 inactivated vaccines was higher than the World Health Organization acceptance limit and were in the order of 3.75, 4.21, and 3.64 IU/mL, respectively. Monitoring the humoral and cellular immunity elicited post-immunization using Staphylococcus aureus derived hyaluronic acid (HA) and bacillus Calmette-Guérin purified protein derivative (PPD) adjuvanted rabies vaccine candidates were carried out using enzyme-linked immunosorbent assay. Results: Results: demonstrated that both adjuvants could progressively enhance the release of anti-rabies total immunoglobulin G as well as the pro-inflammatory mediators (interferon-gamma and interleukin-5) relative to time. However, a higher immune response was developed in the case of HA adjuvanted rabies vaccine compared to PPD adjuvanted one. The harmful consequences of the tested adjuvants were considered via investigating the histopathological changes in the tissues of the immunized rats using hematoxylin and eosin stain. Lower adverse effects were observed post-vaccination with HA and PPD adjuvanted vaccines compared to that detected following administration of the currently used alum as standard adjuvant. Conclusion Our findings suggested that HA and PPD could serve as a promising platform for the development of newly adjuvanted rabies vaccines with elevated immune enhancing potentials and lower risk of health hazards.

BACKGROUND: Ever since lipoabdominoplasty was first developed to achieve better aesthetic outcomes and less morbidity, the rate of seroma formation, especially in obese patients, has disturbed plastic surgeons. The aim of this study was to evaluate the effect of fibrin sealant in the prevention of seroma formation after lipoabdominoplasty in obese patients. METHODS: Sixty patients with a body mass index (BMI) between 30 and 39.9 were assigned randomly to 1 of 2 groups (30 patients each). Group A underwent lipoabdominoplasty with fibrin glue, while group B underwent traditional lipoabdominoplasty; both had closed suction drainage applied to the abdomen. The patients' demographics and postoperative complications were recorded. Seroma was detected using abdominal ultrasound examinations at two postoperative periods: between postoperative days 10 and 12 and, between postoperative days 18 and 21. RESULTS: The age range was 31 to 55 years (38.5+/-9.5 years) in group A and 25 to 58 years (37.8+/-9.1 years) in group B, while the mean BMI was 31.4 to 39.9 kg/m2 (32.6 kg/m2) in group A and 32.7 to 37.4 kg/m2 (31.5 kg/m2) in group B. In group A, the patients had a complication rate of 10% in group A versus 43% in group B (P<0.05). The incidence of seroma formation was 3% in the fibrin glue group but 37% in the lipoabdominoplasty-alone group (P<0.05). CONCLUSIONS: Lipoabdominoplasty with the use of autologous fibrin sealant is a very effective method that significantly reduces the rate of postoperative seroma.
Abdomen ; Body Mass Index ; Demography ; Fibrin ; Fibrin Tissue Adhesive ; Humans ; Incidence ; Obesity ; Postoperative Complications ; Seroma ; Suction

BACKGROUND AND OBJECTIVES: Colitis is inflammation of the colon which can be transmural or confined to the mucosa. Colitis may be acute or chronic. In case of serious intestinal discontinuity of epithelium, the regeneration capacity of local stem cells is not enough to complete tissue repair. Bone marrow mesenchymal stem cells (BM-MSCs) migrate into the gastrointestinal wall, where they may contribute to the repair progress. The present study aimed at evaluating the possible therapeutic effect of MSCs on induced colitis in albino rat. METHODS AND RESULTS: Twenty male albino rats were divided into 3 groups (control, colitis, MSCs), control group (4 rats), colitis group (8 rats) received once intra-rectal injection of 2 ml of 3% acetic acid. MSCs therapy group (8 rats) injected with MSCs 24 hours after colitis induction. In each group, rats were subdivided into subgroups (a & b). Subgroup (a) corresponds to rats sacrificed 3 days and subgroup (b) corresponds to rats sacrificed 10 days after colitis induction. Isolation and culture of MSCs from rat bone marrow were performed. Colon sections were examined using light and fluorescent microscopy. Colon specimens were subjected to histological, morphometric and statistical studies. In colitis group, ulceration, loss of surface columnar epithelium, disturbed crypts architecture with few goblet cells and huge lymphatic nodule piercing the muscularis mucosa were reported. In stem cell therapy group, MSCs stimulate colonic repair through differentiation into several cells and dampen the inflammation. CONCLUSIONS: MSCs represent future therapeutic hopes for intestinal injury and chronic intestinal inflammatory states.
Acetic Acid ; Animals ; Bone Marrow ; Colitis* ; Colon ; Epithelium ; Goblet Cells ; Humans ; Inflammation ; Male* ; Mesenchymal Stromal Cells* ; Microscopy ; Mucous Membrane ; Organic Chemicals ; Rats* ; Regeneration ; Statistics as Topic ; Stem Cells ; Ulcer