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: This study examined the risk factors and survival outcomes of dogs infected with CPV-2. Molecular characterization of CPV-2 genotypes circulating in Egypt was performed to determine the evolution of CPV-2 nationally and globally. Methods: An age-matched case-control study was conducted on 47 control and 47 CPVinfected dogs. Conditional logistic regression analysis examined the association between the potential risk factors and CPE in dogs. Survival analysis was performed to determine the survival pattern of the infected dogs. Thirteen fecal samples from infected dogs were collected to confirm the CPV genotype by CPV-2 VP2 gene sequencing, assembly of nucleotide sequences, and phylogenic analysis. Results: Unvaccinated and roamer dogs had eight and 2.3 times higher risks of CPV infection than vaccinated dogs and non-roamer dogs, respectively. The risk of death from CPE was high among dogs without routine visits to veterinary clinics and among non-roamer dogs.Molecular characterization of CPV-2 confirmed its genotype identity and relationship with the CPV-2 c and b clade types. Conclusions and Relevance: This study highlights the potential factors for CPE control, especially vaccination and preventing dogs from roaming freely outside houses. Isolated CPV genotypes are closely related to southern Asian genotypes, suggesting a substantial opportunity for global transmission.

Worldwide, cardiovascular disease is the main cause of death, which accordingly increased by hyperlipidemia. Hyperlipidemia therapy can include lifestyle changes and medications to control cholesterol levels. Statins are the medications of the first choice for dealing with lipid abnormalities. Rosuvastatin founds to control high lipid levels by hindering liver production of cholesterol and to achieve the targeted levels of low-density lipoprotein cholesterol, another lipid lowering agents named ezetimibe may be used as an added therapy. Both rosuvastatin and ezetimibe have low bioavailability which will stand as barrier to decrease cholesterol levels, because of such depictions, formulations of this combined therapy in nanotechnology will be of a great assistance. Our study demonstrated preparations of nanoparticles of this combined therapy, showing their physical characterizations, and examined their behavior in laboratory conditions and vivo habitation. The mean particle size was uniform, polydispersity index and zeta potential of formulations were found to be in the ranges of (0.181–0.72) and (–13.4 to –6.24), respectively. Acceptable limits of entrapment efficiency were affirmed with appearance of spherical and uniform nanoparticles. In vitro testing showed a sustained release of drug exceeded 90% over 24 h. In vivo study revealed an enhanced dissolution and bioavailability from loaded nanoparticles, which was evidenced by calculated pharmacokinetic parameters using triton for hyperlipidemia induction. Stability studies were performed and assured that the formulations are kept the same up to one month. Therefore, nano formulations is a suitable transporter for combined therapy of rosuvastatin and ezetimibe with improvement in their dissolution and bioavailability.

Aims: Mobile phones are used extensively by healthcare workers (HCWs) who are unaware of the amount of contamination these phones carry and act as reservoirs for organisms causing hospital-acquired infections. This investigation was aimed to find the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) contamination and antimicrobial resistance patterns of isolates from HCW’s cellphones. Methodology and results: This study was a hospital-based cross-sectional study. A total of 120 samples were isolated from HCWs’ cellphones and subjected to culture and sensitivity as per the standard guidelines. Five (18.1%) out of 120 collected samples were from 11 lab technicians’ phones and were positive for S. aureus and 6.25% were obtained from 48 nurses’ cellphone swabs. Conclusion, significance and impact of study The findings of this study reveal that HCWs’ cellphones could be apossible source of infection since a high prevalence of MRSA was found on lab technicians and nurse cellphone sample swabs. On the other hand, all S. aureus isolates were resistant to methicillin and ceftazidime. Also, no significant relationship between the prevalence of MRSA was detected.

BACKGROUND: In extensive deep dermal burn injuries, split-thickness skin graft (STSG) has been the most preferred treatment option for resurfacing burn wounds. A thick split-thickness skin graft is ideal for preventing graft contracture but is associated with delayed donor healing and the lack of adequate donor skin. When applied with STSG, the dermal substitutes offer better-reconstructed skin than STSG alone. Human-derived acellular dermal matrix (HADM) obtained from cadaver skin is a dermal equivalent with good clinical outcomes. However, high cost and limited cadaver donor skin availability limit its clinical utility. Developing a low-cost preparation method and finding an alternate source of human donated skin can help reduce the cost. The objective of this study was to explore the feasibility of making HADM from abdominoplasty panniculus skin. METHODS: Skin samples were collected from the abdominoplasty panniculus of ten eligible donors with their informed consent. A combination of low-cost reagents-sodium chloride and hypotonic solution (water for injection) was used for decellularizing the skin. Characterization of the prepared Acellular Dermis Matrix prototype was done. RESULTS: The skin was deepidermized with one molar NaCl treatment at 37 °C for 24 h. The deepidermized dermis became acellular with hypotonic solution treatment at 4 °C for two weeks. The hematoxylin and eosin staining and cytotoxicity test confirmed the acellularity and non-cytotoxicity of the prepared HADM prototype. The HADM prototype also facilitated the formation of neo-epithelium in the 3D cell co-culture model. CONCLUSION This study confirms that abdominoplasty panniculus can be a viable alternative for HADM preparation. Further characterization studies are required to prove the concept.

Uncorrected refractive error is the leading cause of moderate and severe visual impairment across the globe. An important driver for early detection and management of refractive errors among children is appropriate parental awareness. This study aims to understand the awareness and perception among parents of children with refractive errors utilizing the conceptual framework of Health Belief Model. This qualitative study focused to conduct semi-structured interviews of parents who sought eye care for their children. Thirty-five parents who visited an eye care center for refractive error correction of their children between 5 to 15 years of age were purposively selected. The four constructs of the Health Belief Model (perceived susceptibility, perceived severity, perceived benefits and perceived barriers) were applied to prepare the interview guide. The voice records of participants were transcribed verbatim, coded and qualitatively analyzed to generate relevant themes. All participants were well aware of refractive errors and the implications of them on the visual and social development of children if they leave the errors untreated. However,there were varying perception about refractive error leading to serious consequences. The enanced quality of life with proper refractive correction prompted parents to seek timely eyecare for their children.

To investigate the molecular mechanisms of the antiobese effect of raspberry ketone against high-fat diet fed rats. Methods: Fifty adult male rats were randomly assigned to receive a standard diet, a high fat diet, and the high-fat diet and 0.5%, 1% or 2% raspberry ketone. Body weight, biochemical parameters and gene expression of CCAAT enhancer-binding protein (C/EBP)-d, fatty acid synthase (FAS), acetyl CoA carboxylase (ACC), peroxisome proliferator-activated receptor alpha (PPAR-a), hormone-sensitive lipase (HSL) and hepatic carnitine palmitoyltransferase 1 A (CPT1A) were investigated. Results: Body weight, blood glucose, insulin, total lipids, triacylglycerols, total cholesterol and low-density lipoprotein cholesterol were increased in high-fat diet fed rats. These high fat diet-induced changes were attenuated by treatment with raspberry ketone. High-density lipoprotein cholesterol was decreased in highfat diet fed rats but increased in rats treated with raspberry ketone. Molecular investigations showed induction of gene expression of C/EBP-d , FAS, ACC, CPT1A and inhibition of gene expression of PPAR-a and HSL in high-fat diet fed rats as compared with control. Raspberry ketone treament reversed these changes except CPT1A. Conclusions: Raspberry ketone can prevent obesity induced by a high-fat diet in rats by induction of the expression of enzymes, controlling lipolysis and fatty acids b oxidation as well as inhibition of gene expressions of adipogenic factors.

Abstract Medial meniscus root tear (MMRT) is uncommon and is often associated with osteoarthritis during presentation. Whether it is a cause or effect, it is still debatable at this point of time. However, when a combination of injuries occurs in a middle age group patient, a careful examination before offering a treatment is advised. We herein report a case of a middle-aged gentleman suffering from both arthritis and MMRT.