A traumatic carotid-cavernous fistula (CCF) is a significant neurovascular condition characterized by an abnormal connection between the carotid artery and the cavernous sinus, often resulting from head trauma. This condition can lead to serious complications, necessitating effective management strategies. Endovascular treatment is the preferred approach for managing this condition. We present a case of a 23-year-old male with persistent left eye pain and redness seven months post-motor vehicle collision. Cerebral angiography confirmed a high-flow CCF with compromised intracranial flow, successfully treated with a 5 mm PK Papyrus covered stent using a novel tri-axial delivery system. This case highlights the efficacy of covered stents in neurovascular interventions and introduces an innovative approach for deploying a large-diameter stent across the cavernous internal carotid artery.

Vertebro-vertebral fistulas (VVFs) are vascular lesions that may develop after trauma or spontaneously in association with connective tissue disorders. We present a rare case of a post-traumatic VVF in a young patient presenting with a painless swelling and a bruit in her left upper neck. Digital subtraction angiography showed an arteriovenous fistula between the left vertebral artery (VA) and the vertebral venous plexus with significant steal phenomenon. Endovascular therapy was performed using a Woven EndoBridgeTM (WEB)-device combined with coils that allowed preservation of the VA. The patient fully recovered from her symptoms and follow-up imaging showed stable occlusion. In conclusion, VVFs can be effectively treated using intrasaccular flow diverters such as the WEB-device, allowing for complete and stable occlusion while preserving the parent artery.

Anesthesia and analgesia are major components of many interventional studies on laboratory animals. However, various studies have shown improper reporting or use of anesthetics/analgesics in research proposals and published articles. In many cases, it seems “anesthesia” and “analgesia” are used interchangeably, while they are referring to two different concepts. Not only this is an unethical practice, but also it may be one of the reasons for the proven sub‑ optimal quality of many animal researches. This is a widespread problem among investigations on various species of animals. However, it could be imagined that it may be more prevalent for the most common species of laboratory animals, such as the laboratory mice. In this review, proper anesthetic/analgesic methods for routine procedures on laboratory mice are discussed. We considered the available literature and critically reviewed their anesthetic/analge‑ sic methods. Detailed dosing and pharmacological information for the relevant drugs are provided and some of the drugs’ side effects are discussed. This paper provides the necessary data for an informed choice of anesthetic/analge‑ sic methods in some routine procedures on laboratory mice.

Humans ; COVID-19/epidemiology* ; Environmental Pollution/statistics & numerical data*

Students’ engagement in academic-related learning activities is one of the important determinants of students’ success. Identifying the best teaching strategies to sustain and promote nursing students’ engagement in academic and clinical settings has always been a challenge for nurse educators. Hence, it is essential to provide a set of strategies for maintaining and enhancing the academic engagement of nursing students. The purpose of this review was to explore and summarize the strategies that nurse educators use to sustain and promote nursing students’ engagement in academic and clinical settings. A narrative literature review was conducted. CINAHL (nursing content), ProQuest, Medline, the Cochrane, Google Scholar, and Scopus were searched. Of 1,185 retrieved articles, 32 teaching strategies were identified and extracted from the nursing literature. We used thematic analysis approach to organize these strategies into five main categories as follows: technology-based strategies (15 articles), collaborative strategies (10 articles), simulation-based strategies (two articles), research-based strategies (two articles), and miscellanea learning strategies (three articles). As a general comment, these strategies have the potential to promote nursing students’ engagement. Among the strategies discussed in this review, the use of technology, particularly the response system and online learning, was more common among nursing educators, which is in line with today’s advances in smart technologies. The collection presented in this review can be used as a starting point for future research to evaluate the effectiveness of an educational intervention on the academic engagement of nursing students. Nevertheless, due to the lack of experimental studies, the optimal strategies remain to be elucidated through future high-quality experimental study.

Objective: The present study investigated sperm chromatin quality and testosterone levels in acrylamide-treated mice and the possible protective effects of vitamin E on the fertility potential of spermatozoa. Methods: Thirty-two adult male mice were divided equally into four groups. Group 1 was the control, group 2 received acrylamide (10 mg/kg, water solution), group 3 received vitamin E (100 mg/kg, intraperitoneal), and group 4 received both acrylamide and vitamin E. After 35 days, spermatozoa from the right cauda epididymis were analyzed in terms of count, motility, morphology, and viability. Sperm DNA integrity and chromatin condensation were assessed by acridine orange (AO), aniline blue (AB), toluidine blue (TB), and chromomycin A3 (CMA3) staining. Results: In acrylamide-treated mice, significantly lower sperm concentration, viability, motility, and testosterone levels were found in comparison with the control and acrylamide+vitamin E groups (p<0.05). In the vitamin E group, significantly more favorable sperm parameters and testosterone levels were found than in the other groups (p<0.05). There were also significantly more spermatozoa with less condensed chromatin in the acrylamide-treated mice than in the other groups. Moreover, significantly more spermatozoa with mature nuclei (assessed by AB, CMA3, AO, and TB staining) were present in the vitamin E group than in the control and acrylamide+vitamin E groups. Conclusion This study revealed the deleterious effects of acrylamide on sperm parameters and sperm chromatin quality. Vitamin E can not only compensate for the toxic effects of acrylamide, but also improve sperm chromatin quality in mice.

STUDY DESIGN: Descriptive cross-sectional study. PURPOSE: To validate the Persian version of the Million Visual Analogue Scale Questionnaire (MVAS), a self-administered low back pain (LBP) questionnaire. OVERVIEW OF LITERATURE: The majority of LBP questionnaires translated into Persian evaluate the impact of LBP on daily living. The MVAS is one of the most commonly used self-administered LBP questionnaires, and was developed to assess a different direction and effect of activities of daily living on LBP intensity. METHODS: The questionnaire was translated into Persian with the forward-backward method and was administered to 150 patients randomly sampled from an occupational medicine clinic in Tehran in 2017. RESULTS: Cronbach's alpha for all subscales ranged between 0.670 and 0.799. Confirmatory factor analysis showed adequate construct validity of the Persian version of the MVAS, with root mean square error of approximation 0.046, goodness of fit index 0.902, and comparative fit index 0.969. Other indexes were satisfactory. CONCLUSIONS: The Persian MVAS is a valid and reliable instrument that can assess the effect of various daily activities on the intensity of LBP.
Activities of Daily Living ; Cross-Sectional Studies ; Humans ; Low Back Pain ; Methods ; Occupational Medicine ; Pain Measurement

BACKGROUND: A number of studies investigated the general practitioners' and family physicians' knowledge, attitude, and practice (KAP) on diabetes. However, studies on internists' KAP on diabetes management are limited. This study aimed to investigate the Iranian internists' KAP on diabetes mellitus and its management. METHODS: A cross-sectional study was conducted on a random sample of internists who participated in the 26th annual congress of internists in Tehran, Iran. The level of KAP and affecting factor was evaluated by a validated instrument. RESULTS: One-hundred internists with the mean age of 41.98±9.26 years were evaluated. Totally, the physicians possessed 66.29%±19.5%, 50.44%±19.39%, and 64.5%±15.3% of the scores in KAP, respectively. The time since graduation in general medicine had significant negative correlation with their knowledge and practice, that was along with the subjects' age (P<0.05). The KAP level had not significant difference between subjects participated in a continuing medical education (CME) program during the last year compared to subjects did not participated (P>0.05). Attitude, and practice scores were significantly higher in physicians who were working at diabetes clinic (P<0.05), and attitude was more in physicians working at teaching hospitals compared to those who were not working (57.82 vs. 47.72, P=0.020). CONCLUSION: According to our results, subjects' age and time since graduation in general medicine and specialty were inversely correlated by knowledge and practice. So internists with older age seems to be in priority for educational programs. And holding CME programs in current forms seems to be not suitable to increase the KAP regarding diabetes.
Cross-Sectional Studies ; Diabetes Mellitus ; Education, Medical, Continuing ; Hospitals, Teaching ; Humans ; Iran

Objective To investigate the fauna of a highly venomous marine species group, the cone snails (Family Conidae), in the shores of Qeshm Island, of evaluating the possibility of envenomation in the area and summarize recommendations for emergency first aid. Methods Shores surrounding Qeshm Island were surveyed to collect cone snails during cold (February and March) and warm (May and June) seasons of 2017. Collected snails were identified to the species level. Abundance and species richness were estimated in shores of different structures, including muddy and sandy-rocky shores. Also, the most updated medical literature was reviewed to summarize related emergency first aid. Results Three cone snail species were recorded from southern sandy-rocky shores of the Island, in decreasing order of abundance, included crowned cone (Conus coronatus) (65%), feathered cone (Conus pennaceus) (28%), and frigid cone (Conus frigidus) (7%). Abundance of these species were significantly higher in cold season compared to the warm season (P < 0.05). No cone snails were recorded along the northern muddy shores of the Island. Conclusions Envenomation can cause various symptoms ranging from minor local pain to systemic paralysis and death due to respiratory failure. We recommend an awareness programme for the seashore visiting public.

miRNAs are essential factors of an extensively conserved post-transcriptional process controlling gene expression at mRNA level. Varoius biological processes such as growth and differentiation are regulated by miRNAs. Web of Science and PubMed databases were searched using the Endnote software for the publications about the role miRNA-183 family in inner ear: hair cell development and deafness published from 2000 to 2016. A triplet of these miRNAs particularly the miR-183 family is highly expressed in vertebrate hair cells, as with some of the peripheral neurosensory cells. Point mutations in one member of this family, miR-96, underlie DFNA50 autosomal deafness in humans and lead to abnormal hair cell development and survival in mice. In zebrafish, overexpression of the miR-183 family induces extra and ectopic hair cells, while knockdown decreases the number of hair cell. The miR-183 family (miR-183, miR-96 and miR-182) is expressed abundantly in some types of sensory cell in the eye, nose and inner ear. In the inner ear, mechanosensory hair cells have a robust expression level. Despite much similarity of these miRs sequences, small differences lead to distinct targeting of messenger RNAs targets. In the near future, miRNAs are likely to be explored as potential therapeutic agents to repair or regenerate hair cells, cell reprogramming and regenerative medicine applications in animal models because they can simultaneously down-regulate dozens or even hundreds of transcripts.
Animals ; Biological Processes ; Cellular Reprogramming ; Deafness* ; Ear, Inner* ; Gene Expression ; Hair* ; Hearing Loss ; Humans ; Mice ; MicroRNAs ; Models, Animal ; Nose ; Point Mutation ; Regenerative Medicine ; RNA, Messenger ; Triplets ; Vertebrates ; Zebrafish