Background: This study aims to determine and compare phenytoin concentrations in cerebrospinal fluid (CSF), serum, and urine. In addition, it strives to investigate their inter-correlations to provide insight into alternative monitoring methods. Methods: This study was conducted on 16 traumatic brain injury (TBI) patients admitted to the intensive care unit. Phenytoin concentrations were measured in CSF, serum, and urine samples using a liquid chromatography-tandem mass spectrometry. Statistical analysis assessed correlations between phenytoin levels across different samples and between concentrations and the received daily dose, age, and body mass index (BMI). Results: Phenytoin concentrations varied significantly between CSF, serum, and urine, with serum levels being the highest. Correlation analyses revealed significant positive correlations between phenytoin CSF and serum levels (r=0.83, P=0.0005), serum and urine levels (r=0.73, P=0.003), and CSF and urine levels (r=0.64, P=0.013). Serum concentrations were not influenced by age or BMI. No significant correlation was observed between phenytoin levels and its daily dose. Conclusion: This study demonstrated significant correlations between phenytoin levels in CSF and serum, suggesting that CSF could be a viable alternative for therapeutic drug monitoring (TDM) in TBI patients. However, urine concentrations were less reliable. Further studies with larger patient cohorts and different clinical settings are needed to validate these findings and explore the potential of CSF monitoring in routine clinical practice.
Background: The evidence specific for the benefits and harms of exercises in hand osteoarthritis (OA) is limited and conflicting. We set out to investigate whether hand exercise leads to a clinically important change in hand pain, and its function. Methods: A total of 40 patients over 40 years of age whose hand OA was confirmed by the American College of Rheumatology (ACR) criteria, were divided into control and intervention groups and filled the visual analogue scale (VAS) and the Functional Index for Hand Osteoarthritis (FIHOA) questionnaires. 4 weeks of physical hand exercise at home was performed by the intervention group and the control group was assigned to waiting list and the indices were recorded again. Results: The ability to perform daily activities in the patients who received the exercise program showed improvement in their FIHOA questionnaire, and these changes were statistically significant for all movements measured. After four weeks of exercise, the mean FIHOA score in the intervention group was significantly (P=0.008) decreased, while the score changes in the control group was not significant (P=0.344). Intergroup comparison showed that the FIHOA score changes was statistically significant (P=0.036) after intervention between the intervention and control groups. The total VAS score significantly decreased during 4 weeks in the intervention group (P<0.01) but increased in the control group. Conclusion: The hand exercise program resulted in pain reduction and hand function improvement on self-reported measures. Integrating hand exercise in therapy can be beneficial in non-pharmacological treatment of OA of the hand.
Immunosuppression is a crucial component of post-transplantation care in renal transplantation, as it helps to improve patient and graft survival rates. However, all immunosuppressants share a characteristic narrow therapeutic index, which means that even small variations in dosage can lead to toxicity or ineffectiveness. Despite the undeniable benefits of immunosuppressants, monitoring of therapeutic levels is essential for maintaining a balance between optimal treatment and adverse effects. This comprehensive review highlights the advancements in optical nanosensors based on nanoparticles over the past decades, displaying their potential applications in detecting immunosuppressant pharmaceutical drugs. The appeal of these sensors lies in their affordability and ease of use, as they do not necessitate complex or costly equipment, making them an attractive option for such applications. It hopes that this review will facilitate the development of new research directions and methodologies in this field, ultimately contributing to its advancement.
Background: Molecular signatures of the effects of widely used omega-3 and omega-6 fatty acids as dietary supplements and even in cancer therapy have been studied. Of them, microRNAs, have been shown to undergo altered expression after treatment with docosahexaenoic acid (DHA) and linoleic acid (LA) in different cancer types. In this study, the expression level of two well-known onco-microRNAs (miR), miR-10b and miR-20a, and also major histocompatibility complex class I chain-related protein A (MICA) as the target for these oncomiRs were investigated after treatment with DHA, LA, and common therapeutic agent Taxol. Methods: MDA-MB-231 cells were cultured in a complete RPMI 1640 medium and an MTT assay was performed to determine IC50 of DHA, LA, and Taxol. Cells were treated by DHA (100µM), LA (50µM), and Taxol (0.3µM) alone or in different combinations. After RNA extraction and cDNA synthesis, the expression levels of miR-10b, miR-20a, and MICA were determined by quantitative real-time PCR. U6 and β-Actin were used as endogenous controls, respectively. Results: Our findings showed that DHA, LA, and Taxol, and their combinations led to the significantly decreased expression of miR-10b and miR-20a (all P<0.0001). The expression level of miR-10b and miR-20a significantly decreased when treated with the LA+TAX combination. MICA as the target of miR-10b and miR-20a was also down-regulated significantly (P<0.0001) especially when treated with DHA+LA+TAX. Conclusion: Useful effects of DHA, LA, and their combination in breast cancer (BC) could be interpreted in part by decreasing the expression level of oncomiRs. In the case of MICA have had some contrary. High expression of MICA/B caused an approving outcome concerning the relapse-free period in early BC patients, however; some studies have shown that higher MICA expression was found as a sign of poor prognosis in BC. The decreased expression of MICA in the present study suggests the potential role of DHA and LA should be used in dietary supplements of BC patients.
Background: This review aims to categorically describe novel advancements to our understanding and management of COVID-19 and associated short- and long-term sequelae such as Long COVID. Methods: Indexing services (Scopus and PubMed) were used to identify pertinent studies, prioritizing original research, meta reviews and updated institutional guidelines from 2022 onwards. Papers not published in English (or where full-text translation was not available), those skewed in terms of gender distribution of participants, conducted on non-human populations and proposal and opinion papers were excluded. For the purposes of this paper, Long COVID was taken to mean the persistence of symptoms longer than 8 weeks after an acute COVID-19 infection. After deduplication, application of the exclusion criterion and checking for relevance, 52 sources were identified for this review. The keywords used for this literature search were COVID-19, Long COVID, Chronic COVID, SARS-CoV-2. Results: New COVID-19 variants challenge vaccine efficacy, highlighting socioeconomic disparities in vaccination rates. Long COVID exhibits complex symptoms, including cognitive decline and physical health impacts. The virus’s affinity for ACE-2 receptors suggests broader health implications, including reproductive and metabolic disorders. COVID-19 can cause a drop in IQ proportional to severity of disease experienced. Conclusion: COVID-19’s multifaceted health impacts necessitate ongoing research and targeted interventions. Addressing socioeconomic disparities, updating vaccine formulations, and understanding long-term effects are crucial. Equitable healthcare policies are essential to mitigate COVID-19’s global health threat and inform future strategies.
