Inflammatory myofibroblastic tumor (IMT) of the soft tissues of the neck is a rare pathological entity. We present the case of a 32-year-old patient who had a painful, slowly enlarging mass in the neck’s soft tissues. Radiological examination revealed a well-defined, dense lesion. The mass was surgically removed through local excision. Immunohistological analysis confirmed the diagnosis of IMT. After nearly 2 years of follow-up, there was no evidence of recurrence or distant metastases. In conclusion, although IMT of the soft tissues of the neck is uncommon, it should be considered in the differential diagnosis of neck tumors. Further research is necessary to understand the pathogenetic mechanisms of IMT, which could lead to the development of more effective treatments for this tumor.

Inflammatory myofibroblastic tumor (IMT) of the soft tissues of the neck is a rare pathological entity. We present the case of a 32-year-old patient who had a painful, slowly enlarging mass in the neck’s soft tissues. Radiological examination revealed a well-defined, dense lesion. The mass was surgically removed through local excision. Immunohistological analysis confirmed the diagnosis of IMT. After nearly 2 years of follow-up, there was no evidence of recurrence or distant metastases. In conclusion, although IMT of the soft tissues of the neck is uncommon, it should be considered in the differential diagnosis of neck tumors. Further research is necessary to understand the pathogenetic mechanisms of IMT, which could lead to the development of more effective treatments for this tumor.

Inflammatory myofibroblastic tumor (IMT) of the soft tissues of the neck is a rare pathological entity. We present the case of a 32-year-old patient who had a painful, slowly enlarging mass in the neck’s soft tissues. Radiological examination revealed a well-defined, dense lesion. The mass was surgically removed through local excision. Immunohistological analysis confirmed the diagnosis of IMT. After nearly 2 years of follow-up, there was no evidence of recurrence or distant metastases. In conclusion, although IMT of the soft tissues of the neck is uncommon, it should be considered in the differential diagnosis of neck tumors. Further research is necessary to understand the pathogenetic mechanisms of IMT, which could lead to the development of more effective treatments for this tumor.

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.

This mini-review was conducted to present an overview of the use of exosomes in regenerating the dentin-pulp complex (DPC). The PubMed and Scopus databases were searched for relevant articles published between January 1, 2013 and January 1, 2023.The findings of basic in vitro studies indicated that exosomes enhance the proliferation and migration of mesenchymal cells, as human dental pulp stem cells, via mitogenactivated protein kinases and Wingless-Int signaling pathways. In addition, they possess proangiogenic potential and contribute to neovascularization and capillary tube formation by promoting endothelial cell proliferation and migration of human umbilical vein endothelial cells. Likewise, they regulate the migration and differentiation of Schwann cells, facilitate the conversion of M1 pro-inflammatory macrophages to M2 anti-inflammatory phenotypes, and mediate immune suppression as they promote regulatory T cell conversion. Basic in vivo studies have indicated that exosomes triggered the regeneration of dentin-pulp–like tissue, and exosomes isolated under odontogenic circumstances are particularly strong inducers of tissue regeneration and stem cell differentiation. Exosomes are a promising regenerative tool for DPC in cases of small pulp exposure or for whole-pulp tissue regeneration.

Background: Smoking is a preventable cause of chronic morbidity. Patient empowerment is a process through which people establish greater control over their health-related decisions and actions. To assess the effect of patient empowerment versus health education on the nicotine dependence score and progress of patients under different stages of smoking cessation. Methods: This was a single-blinded randomized controlled clinical trial that included 76 smokers attending family medicine clinics. Participants were divided into two groups: empowerment and health education groups. Their nicotine-dependence score and smoking cessation stage were identified. All study participants were subjected to five health education sessions with a 3-month follow-up period. Results: The mean nicotine-dependence score decreased significantly in both groups after the intervention. This decrease was slightly higher in the empowerment group; however, the difference was not statistically significant. After the intervention, 16.7% of the health education and 30.0% of the empowerment group transitioned from stage 1 to stages 2–4 of smoking cessation, with the change being statistically significant only in the empowerment group. There was no statistically significant difference in the number of study participants who stopped smoking between the health education and empowerment groups. Conclusion Both the empowerment model and traditional health education have similar positive effects on decreasing the nicotine-dependence level. There was a significant improvement in the stage of change for patients under the empowerment model, although there was no statistically significant difference between the groups regarding the number of participants who stopped smoking.

Background: Smoking is a preventable cause of chronic morbidity. Patient empowerment is a process through which people establish greater control over their health-related decisions and actions. To assess the effect of patient empowerment versus health education on the nicotine dependence score and progress of patients under different stages of smoking cessation. Methods: This was a single-blinded randomized controlled clinical trial that included 76 smokers attending family medicine clinics. Participants were divided into two groups: empowerment and health education groups. Their nicotine-dependence score and smoking cessation stage were identified. All study participants were subjected to five health education sessions with a 3-month follow-up period. Results: The mean nicotine-dependence score decreased significantly in both groups after the intervention. This decrease was slightly higher in the empowerment group; however, the difference was not statistically significant. After the intervention, 16.7% of the health education and 30.0% of the empowerment group transitioned from stage 1 to stages 2–4 of smoking cessation, with the change being statistically significant only in the empowerment group. There was no statistically significant difference in the number of study participants who stopped smoking between the health education and empowerment groups. Conclusion Both the empowerment model and traditional health education have similar positive effects on decreasing the nicotine-dependence level. There was a significant improvement in the stage of change for patients under the empowerment model, although there was no statistically significant difference between the groups regarding the number of participants who stopped smoking.

Purpose::Some surgeons believe that chest computed tomography (CT) scan should be used more prudently in management of blunt chest trauma patients. This study aimed to evaluate the clinical predictors of abnormal chest CT scan findings in trauma patients.Methods::This cross-sectional study was conducted on blunt chest trauma patients aged ≥18 years who were referred to the emergency departments of two educational hospitals and underwent chest CT scan. These patients were enrolled in the study using a non-probability sampling method. The exclusion criteria included: class III or IV hemodynamic shock, need for immediate surgical or neurosurgical interventions, penetrating trauma, lack of required information, and pregnancy. Demographic factors, accident details, trauma mechanism, vital signs, and level of consciousness in predicting abnormal chest CT scan findings were evaluated. Analysis was performed using IBM SPSS statistics 21.Results::A total of 977 patients (male 51.5%, female 48.5%) with the mean age of (41.71 ± 14.24) years, range 18-88 years were studied; 34.2% of them with high energy trauma mechanism. With 334 (34.2%) patients had abnormal findings on chest X-ray (CXR) and 332 (34.0%) cases had an abnormal findings on chest CT scan (agreement rate was 99.4%). There was a significant correlation between male gender ( p < 0.0001), GCS<15 ( p < 0.0001), high energy trauma mechanism ( p < 0.0001), unstable hemodynamics ( p < 0.01), and clinical signs and symptoms ( p < 0.0001) with chest CT findings. Chest wall deformity ( odds = 8; p < 0.0001), generalized tenderness ( odds = 6.6, p < 0.0001), and decreased cardiac sound ( odds = 3.8, p < 0.0001) were the important and independent clinical predictors of abnormal chest CT scan findings. Conclusion::Based on the findings, chest wall deformity, generalized tenderness, decreased cardiac sound, distracting pain, chest wall tenderness, high energy trauma mechanism, male gender, respiratory rate > 20 breathes/min, decreased pulmonary sound, and chest wall crepitation were independent clinical predictors of abnormal chest CT scan findings following blunt trauma.

BACKGROUND: Sickle cell anemia (SCA) is a hereditary chronic hemolytic anemia with several clinical consequences. Intravascular sickling of red blood cells leads to multi-organ dysfunction. Moreover, several biochemical abnormalities have been associated with SCA. Gum arabic (GA) is an edible dried gummy exudate obtained from Acacia Senegal tree. GA showed antioxidant and cytoprotective activities and demonstrated protection against hepatic, renal, and cardiac toxicities in experimental rats. We hypothesized that regular intake of GA improves renal and liver functions in patients with SCA. METHODS: Forty-seven patients (5–42 yr) carrying hemoglobin SS were recruited. The patients received 30 g/day GA for 12 weeks. Blood samples were collected before administering GA and then after 4, 8, and 12 weeks. Liver enzymes, total protein, albumin, electrolytes, urea, creatinine, and uric acid were determined in the serum. The study was approved by the Al Neelain University Institutional Review Board and Research Ethics Committee Ministry of Health. The trial was registered at ClinicalTrials.gov (identifier: NCT02467257). RESULTS: GA significantly decreased direct bilirubin level [statistical significance (P-value)=0.04]. It also significantly decreased serum alanine transaminase level after 4 weeks, which was sustained till the 8th week. GA, however, had no effect on serum aspartate transaminase level. In terms of renal function, GA decreased serum urea level but the effect was not sustained after the first month. CONCLUSION: GA may alter the disease severity in SCA as demonstrated by its ability to decrease direct bilirubin and urea levels in the serum.
Acacia ; Alanine Transaminase ; Anemia, Hemolytic ; Anemia, Sickle Cell ; Animals ; Aspartate Aminotransferases ; Bilirubin ; Cardiotoxicity ; Creatinine ; Electrolytes ; Erythrocytes ; Ethics Committees, Research ; Exudates and Transudates ; Gingiva ; Gum Arabic ; Hemoglobin, Sickle ; Humans ; Liver ; Rats ; Senegal ; Trees ; Urea ; Uric Acid

BACKGROUND AND OBJECTIVES: The imperative role of dental pulp stem cells (DPSCs) in regenerative therapy demands an in-vitro expansion which must deal with the safety and ethical problems associated with fetal bovine serum (FBS). The primary aim of this study was to compare the effects of human platelet rich fibrin (hPRF) exudate Vs FBS on proliferation and osteodifferentiation of human dental pulp stem cells (hDPSCs). The secondary one was to determine the optimum concentration of hPRF exudate inducing hDPSCs proliferation and osteodifferentiation. METHODS: The direct method was used to prepare hPRF exudate. hDPSCs were isolated from impacted mandibular third molars of twelve donors by the outgrowth method. For cell viability and proliferation rate testing, 96 well plates were used and the assay was done in duplicate and the trial repeated four times under the same conditions. Six wells were used to contain 10% FBS, serum free media, 1%, 5%, 10% and 20% concentrations of hPRF exudates, respectively. The proliferation assay was carried out by MTS tetrazolium cell proliferation assay kit and Elisa reader. The study design for osteodifferentiation protocol was exactly as the proliferation one and instead the assay was carried out by alizarin red with Elisa reader. RESULTS: Compared to 10% FBS, 10% hPRF exudate was the optimum concentration for hDPSCs proliferation, while 1% hPRF exudate was the optimum concentration for osteodifferentiation of hDPSCs. CONCLUSIONS: Avoiding the risk of zoonosis which may be occurred with FBS, it is recommended to use 10% hPRF exudate for proliferation and 1% for osteodifferentiation.
Blood Platelets* ; Cell Proliferation ; Cell Survival ; Culture Media, Serum-Free ; Dental Pulp* ; Enzyme-Linked Immunosorbent Assay ; Exudates and Transudates* ; Fibrin* ; Humans* ; Methods ; Molar, Third ; Stem Cells* ; Tissue Donors