Objective: Traditional denoising algorithms perform less due Limited Directional Selectivity problem and do not adequately capture directional information in pixels. Traditional algorithms' edge representation and texture details are insufficient for the earlier detection of DH. Limited Directional Selectivity leads to inaccurate diagnosis and classification of Disc Herniation (DH) stages. The DH stages are (i) Degeneration (ii) Prolapse (iii) Extrusion and (iv) Sequestration. Moreover, detection of DH size below 2mm using MR image is the major problem.

Methods: To solve the above problem, spinal cord MR images fed to the proposed Parrot optimization tuned Denoising Convolutional Neural Network (Po- DnCNN) algorithm for perspective enhancement of nucleus pulposus region in the spinal cord, vertebrae. The perspective enhancement of Spinal cord image led to the accurate classification of stages and earlier detection of DH by using the proposed Hippopotamus optimization- Fast Hybrid Vision Transformer (Ho–FastViT) algorithm. For this study, spinal cord MR images are obtained from the Grand Challenge website – SPIDER dataset.

Results: The proposed Po-DnCNN method and Ho-FastViT results are analysed quantitatively and qualitatively based on the edge, contrast, classification of the stage, and enhancement of the projected nucleus pulposus region in the spinal cord and vertebrae. The predicted DH results using the proposed method are compared with the manual Pfirrman Grade value of the spinal card method.

Conclusion: Proposed method is better than traditional methods for earlier detection of DH. Po-DnCNN and Ho-FastViat methods give high accuracy of about 98% and 97% compared to traditional methods.

Objectives: This comprehensive review aims to provide an insightful understanding of traditional uses, chemical composition, and pharmacological properties of P. foetida (from 1976 up to 2023), which may provide a foundation for further study and for the proper utilization of P. foetida resources.

Methods: Literature survey was conducted using known databases and the relevant keywords.

Results: P. foetida has been widely used in Chinese traditional medicine (CTM) for the treatment of dyspepsia, jaundice, pains, diarrhea and others. Several ethnic groups throughout the world used this plant to cure common health complaints namely, abdominal pain, gastritis, dysentery, diarrhoea, constipation, joint pain, etc. A total of 24 bioactive phytocompounds, such as asperuloside, paederosidic acid, sitosterols, stigmasterol, campesterol, ellagic acid, iridoids, ursolic acid, epifriedelinol, and others are reported to possess antiulcer, antidiarrheal, antihyperglycemic, antioxidant, antitussive, anthelmintic, and hepatoprotective activities.

Conclusion: The present review not only summarizes the alternative approaches using this herb by ethnic people for treating various disorders, but also focuses on the latest scientific investigations to elucidate different bioactivities of this plant, thereby facilitating the understanding of its correlation with contemporary pharmacology. However, till date, very few studies elucidated the biological properties of these phytochemicals that were isolated exclusively from this particular plant. Moreover, the correlation between phytocompounds from P. foetida and its pharmacological activities aiming towards clinical drug development is still lacking. Finally, further research should be oriented towards determining the optimal dosage and toxicological limits, and thereby providing guidance for clinical applications.

Case Presentation: The patient was a 23-year-old female with palmar and plantar fibromatosis accompanied by erosive arthritis. In addition, the patient had facial dysmorphic features, optic atrophy, and nystagmus. Extensive investigations were conducted, and no evidence of inflammatory rheumatic disease was found. The Patient exhibited features consistent with polyfibromatosis.

Discussion: A rare association between polyfibromatosis and erosive arthropathy with osteolysis has been demonstrated in literature through four case reports spanning from 1979 to 2018. The presence of dysmorphic facial features and ocular complications suggests a possible genetic or metabolic etiology, such as mucopolysaccharidosis.

Conclusion: This patient presents a diagnostic and therapeutic challenge. It is important to recognise the non-inflammatory etiology in order to avoid unnecessary treatment with anti-rheumatic drugs.

Methods: This descriptive study was conducted with 111 individuals suffering from musculoskeletal diseases who were undergoing treatment in a university hospital in a metropolitan city in Turkey. Personal information forms, the Emotion Expression Scale, and Psychological Well-Being Scale were utilized in the research questionnaire.

Results: A significant positive relationship was detected between expressing emotions and psychological well-being scores, and it was determined that expressing emotions positively influenced psychological well-being. Emotion expression accounted for 15.8 percent of psychological well-being (F=21.668, p<0.001). It was also unearthed that there was a significant difference between the groups according to the variables of level of education, gender, marital status, family structure, personal history, and whether there was a history of illness in the family. The model explained 34.7% of the variance in psychological well-being (F=12.708, p<0.001). In order of importance, expressing closeness (β=0.470; p<0.001), a higher education level (β=0.249; p<0.05), and expressing negative emotion (β=0.178, p<0.05) variables positively predict psychological well-being. However, single marital status (β=-0.239, p<0.05) predicts psychological well-being negatively.

Conclusion: It has been observed that expressing emotions in musculoskeletal disorders contributes, albeit limited, to the level of psychological well-being. Accordingly, it is believed that encouraging individuals with musculoskeletal diseases to communicate their feelings with others or to express their feelings in various ways, providing supportive and reliable environments, and conducting therapeutic studies to increase their behaviors to express their feelings will contribute to patient care.

]]> https://www.benthamscience.comarticle/135967Background: Tertiary hyperparathyroidism (THPT) is a well-known complication of end-stage kidney disease (ESKD), resulting from a loss of functional renal tissue with subsequent alterations in calcium and phosphate metabolism. Tertiary hyperparathyroidism reflects severe parathyroid hyperplasia with autonomous excessive secretion of parathyroid hormone (PTH) that is no longer responsive to the concentration of plasma calcium and leads to abnormal bone remodelling, soft tissue calcifications, vasculopathy, and other systemic complications.

Case Presentation: The authors, hereby, highlight varied presentations of tertiary hyperparathyroidism (THPT) by presenting 3 interesting cases, describing their clinical course and outcomes. Through sharing these experiences and insights, we hope to contribute to a better understanding of THPT and its optimal management in patients with ESKD.

Conclusion: THPT can have a significant impact on patient health and quality of life. Despite the widespread use of interventions, such as vitamin D analogues, calcimimetics and parathyroidectomy, THPT remains a significant clinical challenge for patients with ESKD.

Case Presentation: This case report describes a 68-year-old male, transferred to our hospital for rehabilitation. He was tracheostomized. He is hypertensive with a history of CVA. BP was elevated during the admission. He has no family history of immunological diseases or any allergies. 6 months after hydralazine, the patient started to have a purpuric rash over the lower limbs and an elevated renal profile. Only Direct Coomb’s test was positive. He had hematuria and pancytopenia also. He was started on steroids and he became edematous. On March 2021, the hydralazine was stopped and the patient's blood tests improved, the rash disappeared and hematuria stopped. Unfortunately, he got fungemia and septicemia with pneumonia. He became hypotensive and anuric. The patient kept deteriorating and passed away.

Discussion: Hydralazine is not a first line choice for the treatment of hypertension. Common side effects include tachycardia and headache. It can also cause drug-induced lupus.

Conclusion: Hydralazine has been used in the treatment of hypertension and heart failure for a long time. It has been associated with the development of Vasculitis and Drug induced lupus.

Objectives: Despite advancements in biological therapies, significant clinical needs persist. This review aims to discuss novel treatments, guiding future guidelines and drug discoveries for rheumatoid arthritis.

Methods: This review follows the 2020 PRISMA statement, utilising PubMed and Google Scholar for literature search and emphasizing recent meta-analyses on the safety and efficacy of targeted immunobiological medications.

Results: Small molecule inhibitors, whether utilised independently or in conjunction with Methotrexate, have been shown to contribute to effective disease management and have the potential for better adherence to the American College of Rheumatology criteria. Tocilizumab therapy demonstrates a significant reduction in disease activity and improves rates of disease remission when combined with Methotrexate. Investigations of mesenchymal stromal cell therapies have had promising outcomes, improving both cartilage quality (as evaluated by Macroscopic Cartilage Repair Assessment) and joint tenderness and swelling in clinical joint counts. Intra-articular administration of tolerogenic dendritic cells has displayed a capacity to alleviate pain, as measured by Visual Analog Scale scores, and enhance the Disease Activity Score across 28 joints. Resveratrol capsules supplemented with allopathic therapy show potential in reducing TNF-α and interleukin-6 serum levels.

Conclusion: More investigations and their analysis will improve patient outcomes and reduce adverse effects and the costs involved in developing and obtaining immunobiological drugs. Moreover, assessing the safety and efficacy of anti-RA properties of the bioactive compounds could offer less toxic and more cost-effective natural treatment options.

Objective: This study examined the expression profile of FGFR3 in human synovial biopsy tissues and evaluated its gene-silencing effects on behaviors of synovial cells.

Methods: Immunohistochemical staining was used to measure FGFR3 expression in human RA joint tissues. Cell proliferation, migration, and apoptosis assays were used to monitor behavioral changes in cultured synovial SW-982 cells with siRNA-mediated FGFR3 gene silencing. Immunofluorescent staining and western blotting were used to detect molecular changes in the FGFR3 gene-silenced cells.

Results: FGFR3 up-regulation was noted in both cytoplasms and nuclei of synovial cells in human RA joints. FGFR3 siRNA delivery experiments corroborated that FGFR3 knockdown decreased proliferation and migration, and triggered apoptosis of synovial cells. The FGFR3 gene knockdown enhanced constitutive expression of epithelial marker E-cadherin and conversely suppressed expression of epithelial-mesenchymal transition (EMT) markers, including Snail, fibronectin, and vimentin. In addition, FGFR3 silencing significantly reduced the constitutive expressions of TNF-α, transcription factor NF-κΒ, and downstream COX-2 protein and collagenolytic enzyme MMP-9. MAPK inhibition markedly suppressed constitutive levels of NF-κΒ, COX-2, and MMP-9.

Conclusion: Genetic interference of FGFR3 could modulate the expression of inflammatory mediators and EMT markers in the synovial cells. Targeting the FGFR3/MAPK signal axis may be considered a useful therapeutic strategy to ameliorate the development of RA.

Methods: Human monocytes were isolated from the heparinized blood of SLE patients and healthy individuals, which were then exposed to cytokines (IL-4 and GM-CSF) for five days to produce immature DCs. Then, the obtained DCs were characterized by FITC-uptake assay and then cultured in the presence of CUR, BBR, or lipopolysaccharide (LPS) for 48 h. Finally, the maturation of DCs was analyzed by the level of maturation using flow cytometry or real-time PCR methods.

Results: The results showed promising anti-inflammatory effects of CUR and BBR in comparison with LPS, supported by a significant reduction of not only co-stimulatory and antigen-presenting factors such as CD80, CD86, CD83, CD1a, CD14, and HLA-DR but also inflammatory cytokines such as IL-12.

Conclusion: CUR and BBR could arrest DC maturation and develop a tolerogenic DC phenotype that subsequently promoted the expression of inhibitory cytokines and reduced the secretion of proinflammatory markers.

Objective: The objective of this study was to examine the impact of paeoniflorin (PF) on anxiety and visceral hypersensitivity in maternal separation-induced IBS-like rats.

Methods: The IBS-like rat model was established through the implementation of Maternal Separation (MS) and subsequently subjected to various doses of PF administered via oral gavage for 14 days. Anxiety-like behavior was evaluated using the Open Field Test (OFT) and Elevated Plus Maze (EPM) test. The assessment of visceral sensitivity involved the utilization of the Abdominal Withdrawal Reflex (AWR) score and electromyographic (EMG) responses of the external oblique muscle in response to colorectal distention. The levels of adrenocorticotropic hormone (ACTH), corticosterone (CORT), and corticotrophin-releasing hormone (CRH) were examined by ELISA. Quantitative real-time PCR (qRT-PCR) and immunofluorescence were employed to detect the expressions of CRH receptors 1 (CRHR1) and 2 (CRHR2). Glucocorticoid receptors (GR), mineralocorticoid receptor (MR), brain-derived neurotrophic factor (BDNF), tyrosine receptor kinase B (TrkB), and phospholipase C γ1 (PLCγ1) were examined by Western blot.

Results and Discussion: The results showed that MS induced anxiety-like behavior and visceral hypersensitivity, while PF treatment attenuated these changes. Furthermore, the HPA axis hyperactivity in MS rats was attenuated by PF treatment, indicated by reduced serum ACTH, CORT, and CRH levels and recovered hippocampal CRHR1 and GR expressions. In addition, PF inhibited BDNF/TrkB signaling by downregulating the protein levels of BDNF, TrkB, and phospho-PLCγ1 in the colon.

Conclusion: These findings suggest that PF alleviated anxiety and visceral hypersensitivity in MS-induced IBS-like rats, which may be the modulation of HPA axis activity and BDNF/TrkB/PLCγ1 signaling pathway.

Background: Severe acute pancreatitis (SAP) is an extremely dangerous disease with high mortality, which is associated with inflammatory response and acinar cell death. The caspase family plays an important role in cell death, such as caspase-1 and caspase-11 in pyroptosis. In recent years, caspases have been shown to be a novel pharmacological target of Fenbufen.

Objective: Effects of Fenbufen on pancreatic tissue damage and serum levels of lipase and amylase in SAP in mice; Effect of Fenbufen on caspase-1 pathway in SAP in mice; Effect of Fenbufen on caspase-1/caspase-11-mediated pyroptosis of PACs in SAP in mice; Effect of Fenbufen on isolated PACs and caspase-1/caspase-11-mediated pyroptosis in vitro.

Methods: In vivo, eighteen female C57BL/6 mice were randomly divided into 3 groups: the NC group, the SAP group, and the Fenbufen +SAP group with 6 mice in each group. The SAP model was induced by intraperitoneal injection of caerulein and lipopolysaccharide. The pathological changes in pancreatic and the serum levels of lipase and amylase and the relative gene and protein expressions in each group were compared. In vitro, pancreatic acinar cells were assigned to 5 groups: medium group, SAP group, Fenbufen 100μM group, Fenbufen 200μM group, and Fenbufen 400μM group. The cell damage and the relative gene and protein expressions in each group were evaluated.

Results: Our results showed that Fenbufen ameliorated the severity of SAP and decreased the serum levels of lipase and amylase. Meanwhile, the in vivo and in vitro data demonstrated that Fenbufen inhibited the activation of caspase-1 and caspase-11, decreasing the levels of IL-1β, IL-18, and GSDMD. In in vitro experiments, we found that by inhibiting the activation of caspase-1 and caspase-11, Fenbufen significantly reduced lactate dehydrogenase (LDH) excretion by acinar cells.

Conclusion: In general, our data showed that Fenbufen could protect the pancreatic acinar cell from injury by inhibiting pyroptosis.

Objective: This study identifies the potential role of Fan in inducing apoptosis in Jurkat T cells.

Methods: First, we explored the biological process (BP) associated with SS development by performing a gene ontology analysis of SS salivary gland-related mRNA microarray data. The effect of Fan on Jurkat cells was investigated by analyzing the viability, proliferation, apoptosis, reactive oxygen species (ROS) production, and DNA damage.

Results: Biological process analysis showed that T cells played a role in salivary gland lesions in patients with SS, indicating the significance of T cell inhibition in SS treatment. Viability assays revealed that the half-maximal inhibitory concentration of Fan was 2.49 μM in Jurkat T cells, while the proliferation assay revealed that Fan had an inhibitory effect on the proliferation of Jurkat T cells. The results of the apoptotic, ROS, agarose gel electrophoresis, and immunofluorescence assays showed that Fan induced oxidative stress-induced apoptosis and DNA damage in a dosedependent manner.

Conclusion: These results indicate that Fan could significantly induce oxidative stress-induced apoptosis and DNA damage and inhibit the proliferation of Jurkat T cells. Moreover, Fan further enhanced the inhibitory effect on DNA damage and apoptosis by inhibiting the pro-survival Akt signal.

Methods: An imiquimod (IMQ)-induced psoriasis-like dermatitis mouse model was generated to evaluate the anti-inflammatory effect of GCK. Hematoxylin and eosin (H&E) staining was used to assess skin pathological changes. Protein expression of K17 and p-p65 in mice skin was assayed by immunohistochemical. Protein expression and phosphorylation of p65 IκB were assayed by Western blot. Protein expression of K1, K6, K10, K16, K17, and GR were assayed by Western blot and immunofluorescence. Enzyme-linked immunosorbent assay (ELISA) was used to determine cytokine levels of TNF-α, IL-6, CXCL-8, and ICAM-1. Real-time polymerase chain reaction (RT-PCR) was used to quantify TNF-α, IL-6, IL-8, and ICAM-1 mRNA expression. Cell viability was determined by Cell Counting Kit-8(CCK-8) assay. A high-content cell-imaging system was used to assay cell proliferation. Nuclear translocation of p65 and GR was assayed by imaging flow cytometry and immunofluorescence microscopy. Small interfering RNA was used to confirm the role of GR in the anti-inflammatory and immunoregulatory effect of GCK in normal human epidermal keratinecytes (NHEKs).

Results: GCK reduced the psoriasis area, severity index, and epidermal thickening in IMQ-induced mice. GCK significantly attenuated the mRNA levels of IL-6, IL-8, TNF-α, and ICAM-1 and reduced epidermal hyperproliferation in the skin of IMQ-induced mice. GCK inhibited in vitro activation of NF-κB, leading to attenuated release of inflammatory mediators (IL-6, IL-8, TNF-α, and ICAM-1) and suppression of NHEK hyperproliferation and abnormal differentiation. These inhibitory effects of GCK were diminished by GR silencing in NHEKs.

Conclusion: GCK suppressed psoriasis-related inflammation by suppressing keratinocyte activation, which may be related to promoting GR nuclear translocation and inhibiting NF-κB activation. In summary, GCK appears to be a GR activator and a promising therapeutic candidate for antipsoriatic agents.

Objective: In this comprehensive review, we have elaborated on the pathophysiology, and various signaling pathways linked with Sarcopenia. Also, discussed the preclinical models and current interventional therapeutics to treat muscle wasting in older patients.

Conclusion: In a nutshell, a comprehensive description of the pathophysiology, mechanisms, animal models, and interventions of Sarcopenia. We also shed light on pharmacotherapeutics present in clinical trials which are being developed as potential therapeutic options for wasting diseases. Thus, this review could fill in the knowledge gaps regarding Sarcopenia-related muscle loss and muscle quality for both researchers and clinicians.

Objectives: In this paper, we present a summary of the current drug in use and its side effects, associated with RA. The paper gives an account of alternate modes of treatment that have been explored for the treatment of rheumatoid arthritis.

Conclusion: Initially designed to inhibit the enzyme dihydrofolate reductase and treat various types of cancer, methotrexate found application as an anti-rheumatic drug in 1984 although suggestions for the same have been made since the 1950s. Since then, a substantial amount of clinical evidence has been obtained to clearly indicate the cytotoxic activity of the drug against the cells responsible for joint inflammation associated with RA. Thus, methotrexate is a clear choice when it comes to treating RA despite the advent of other lines of treatment being explored and implemented.

Objectives: The purpose of this article is to familiarize pediatricians with the clinical manifestations of lichen striatus to avoid misdiagnosis, unnecessary investigations, unnecessary referrals, and mismanagement of lichen striatus.

Methods: A search was conducted in June 2023 in PubMed Clinical Queries using the key term “Lichen striatus”. The search strategy included all observational studies, clinical trials, and reviews published within the past ten years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of this article.

Results: Lichen striatus is a benign self-limited T-cell mediated dermatosis characterized by a linear inflammatory papular eruption seen primarily in children. The onset is usually sudden with minimal or absent symptomatology. The eruption in typical lichen striatus consists of discrete, skin- colored, pink, erythematous, or violaceous, flat-topped, slightly elevated, smooth or scaly papules that coalesce to form a dull red, potentially scaly, interrupted or continuous band over days to weeks. Although any part of the body may be involved, the extremities are the sites of predilection. Typically, the rash is solitary, unilateral, and follows Blaschko lines. In dark-skinned individuals, the skin lesions may be hypopigmented at onset. Nails may be affected alone or, more commonly, along with the skin lesions of lichen striatus. The differential diagnoses of lichen striatus are many and the salient features of other conditions are highlighted in the text.

Conclusion: Lichen striatus is a self-limited condition that often resolves within one year without residual scarring but may have transient post-inflammatory hypopigmentation or hyperpigmentation. As such, treatment may not be necessary. For patients who desire treatment for cosmesis or for the symptomatic treatment of pruritus, a low- to mid-potency topical corticosteroid or a topical immunomodulator can be used. A fading cream can be used for post-inflammatory hyperpigmentation.

Methods: Health-beneficial aspects of atractylodin in medicine have been investigated in the present work through collected scientific information on atractylodin from different literature databases. Scientific data on atractylodin has been collected from Google, Science Direct, Scopus, and PubMed. Further, detailed pharmacological activities and analytical aspects of atractylodin were discussed in this paper in order to know its biological potential in medicine. Analytical techniques of atractylodin were also discussed in the present work for separation, isolation, and identification of atractylodin.

Results: Scientific data analysis signified the biological importance of Atractylodes lancea Thunb. and its active phytochemical atractylodin in medicine. Scientific data signified the presence of atractylodin in Atractylodes lancea, Atractylodes chinensis, Atractylodes japonica, Atractylodes macrocephala, Atractylodes ovate and Atractylodis Rhizoma. Atractylodin has a significant biological effect on cholangiocarcinoma, hepatocellular carcinoma, breast cancer, lung cancer, cancer anorexiacachexia syndrome, colitis, rheumatoid arthritis, respiratory complications, GIT complications, hepatic complications, atopic dermatitis, aging process, neurodegenerative disease, calcified aortic valve disease, hypertension, pulmonary fibrosis, body temperature, olfactory neurons, podocyte hypermotility and toxicity. Further, its anti-nociceptive, anti-fibrotic, anti-angiogenic, anti-virulence, antibacterial, insecticidal, lipase inhibitory potential, immunomodulatory, and positive inotropic effects were also discussed in the present paper. Analytical techniques for the separation, isolation and identification of atractylodin in different samples were also discussed in the present work.

Conclusion: The present work's scientific data signified the biological importance of atractylodin in medicine.

The present study aims at analysing the frequency of calcific tendinitis in uncommon sites, in order to fill a gap in knowledge and awareness regarding non-rotator cuff calcific tendinopathy, thus avoiding improper clinical choices and helping to identify this condition.

Methods: This systematic review was conducted following the PRISMA guidelines. We performed a search on Pubmed and Scopus databases concerning atypically sited extra-rotator cuff calcific tendinopathy published since 1950.

Results: The research found a total of 267 articles and 793 non-rotator cuff cases of calcific tendinopathy registered. The spine (213 – 26.86%), foot and ankle (191 – 23.95%), and hip (175 – 22.06%) appeared to be the most common sites of calcific tendinopathy after the rotator cuff, whereas the longus colli C1-C2 (204 – 25.72%), Achilles (173 – 21.81%), and rectus femori (61 – 7.69%) were the most commonly affected tendons.

Conclusion: A better awareness of this condition in several different sites of the body than the rotator cuff could avoid unnecessary choices both in assessment and treatment.

Objective: The primary purpose of this study was to determine whether incidentally detected bone marrow signal changes on MRI performed for various reasons (at the time of admission or during follow-up) are clinically significant.

Methods: We retrospectively evaluated the bone marrow biopsy clinical and laboratory findings of 42 patients with incidental bone marrow signal changes on MRI between September 2016 and January 2020. We also determined whether the patients were diagnosed with malignancy during admission or follow-up.

Results: Of the 42 patients, three (7%) were diagnosed with hematological malignancies during admission, while two were diagnosed with multiple myeloma and one with B-cell acute lymphoblastic leukemia. Of the 42 patients, 35 had a mean follow-up of 40.6 ± 5.3 months. One patient was diagnosed with monoclonal gammopathy of undetermined significance four months after their first admission.

Conclusions: In addition to MRI, detailed clinical and laboratory evaluations should be performed to inform the decision for bone marrow biopsy and exclude hematological malignancy. If there is any doubt, a bone marrow biopsy should be performed. Moreover, since bone marrow signal changes may be a preliminary finding, follow-up of these patients is essential.

Materials and Methods 123 patients with cirrhosis were retrospectively analyzed; all our patients underwent pre-contrast MRI, triphasic (arterial phase, venous phase, equilibrium phase) Gd-EOB-DTPA dynamic enhancement and hepatobiliary phase (20 minutes delayed). The relative enhancement (RE) of the patient's liver, the liver-spleen signal ratio in the hepatobiliary phase (SI liver/ spleen), the liver-vertical muscle signal ratio in the hepatobiliary phase (SI liver/ muscle), the bile duct signal intensity contrast ratio (SIR), and the radiomics features were evaluated. The support vector machine (SVM) was used as the core of machine learning to construct the liver function classification model using image and radiomics characteristics, respectively.

Results: The area under the curve was the largest in SIR to identify Child-Pugh group A versus Child-Pugh group B+C in the image characteristics, AUC = 0.740, and Perc. 10% to identify Child-Pugh group A versus Child-Pugh group B+C in the radiomics characteristics, AUC = 0.9337. The efficacy of the SVM model constructed using radiomics characteristics was better, with an area under the curve of 0.918, a sensitivity of 95.45%, a specificity of 80.00%, and an accuracy of 89.19%.

Conclusion: The image and radiomics characteristics based on Gd-EOB-DTPA-enhanced MRI can reflect liver function, and the model constructed based on radiomics characteristics combined with machine learning methods can better assess functional liver reserve.

Materials and Methods: A total of 314 patients were categorized into two groups according to thyroid stimulating hormone (TSH) level: RA without hypothyroidism and RA with hypothyroidism. All patients underwent routine laboratory investigation, including thyroid function testing, and complete clinical assessment. These included the determination of the erythrocyte sedimentation rate as well as the level of TSH, free triiodothyronine, free thyroxine, total triiodothyronine level, total thyroxine level, C-reactive protein, rheumatoid factor immunoglobulin (RF-Ig), RF-IgA, RF-IgG, RFIgM, cyclic citrullinated peptide immunoglobulin G (CCP IgG), complement component 3, and complement component 4. Based on these data, thyroid function, and rheumatoid factor levels were analyzed.

Results and Discussion: Curve estimation using linear regression revealed that CCP Ig level was significantly correlated with the TSH level (r = 0.122, P = 0.031).

Conclusion: TSH level may be used as an auxiliary test to assess disease severity in patients with RA and to evaluate thyroid function. This evaluation parameter may be considered for determining clinical prognosis in patients with RA.

Background: The role of ultrasound has not been evaluated in predicting osteosarcopenia.

Objective: Reduced muscle thickness (MT) and cross-sectional area (CSA) have often been observed in individuals with sarcopenia, reflecting muscle loss and atrophy. Meanwhile, the potential role of muscle ultrasound has not been evaluated in predicting osteosarcopenia.

Methods: We have conducted a prospective, observational study between January 2021 and 2022. We have recorded the demographics, comorbidities, and nutritional status by using the mini nutritional assessment-short form. We measured handgrip strength with a hand dynamometer and the muscle mass with dual X-ray absorptiometry. Sarcopenia was defined by the European Working Group on Sarcopenia in Older People 2 criteria. Osteoporosis was diagnosed according to the World Health Organization criteria. We have categorized the body phenotypes into four groups: “non-sarcopenic non-osteoporotic,” “sarcopenic alone,” “osteoporotic alone,” and “sarcopenic osteoporotic.” We have measured the subcutaneous fat thickness (SFT), MT, and CSA of the rectus femoris (RF) and biceps brachii (BB) via ultrasonography. A multivariate regression analysis was performed and area under curve (AUC) values were used to evaluate the accuracy of UMPs.

Results: We included 31 patients (mean age: 74.6±12.1 years, 54.8%: male). The prevalences of sarcopenia, osteoporosis, and sarcopenic osteoporosis were 71%, 48.4%, and 41.9%, respectively. Only the “sarcopenic osteoporotic” phenotype was negatively correlated with all UMPs. In the regression analysis, only the “sarcopenic osteoporotic” phenotype was independently associated with RFCSA (ß=-0.456, p= 0.024). The AUC for all patients was >0.700.

Conclusion: RFCSA measurement might be useful in the screening for osteosarcopenia. This has been the first study investigating the relationship between UMPs and body phenotypes. Multi-center and large-scale studies are, however, needed.

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Objective: To determine whether T1 mapping of wrist BME predicts early treatment response in RA.

Methods: This study prospectively enrolled 48 RA patients administered oral anti-rheumatic drugs. MRI of the most severely affected wrist was performed before and after 4 (48 patients) and 8 weeks of treatment (38 patients). Mean T1 values of BME in the lunate, triangular, and capitate bones; RAMRIS for each wrist; Erythrocyte-Sedimentation Rate (ESR); and 28-joint Disease Activity Score (DAS28)-ESR score were analyzed. Patients were divided into responders (4 weeks, 30 patients; 8 weeks, 32 patients) and non-responders (4 weeks, 18 patients; 8 weeks, 6 patients), according to EULAR response criteria. Receiver operating characteristic (ROC) curves were used to evaluate the efficacy of T1 values.

Results: ESR and DAS28-ESR were not correlated with T1 value and RAMRIS at each examination (P > 0.05). Changes in T1 value and DAS28-ESR relative to the baseline were moderately positively correlated with each other at 4 and 8 weeks (r = 0.555 and 0.527, respectively; P < 0.05). At 4 weeks, the change and rate of change in T1 value significantly differed between responders and non-responders (-85.63 vs. -19.92 ms; -12.89% vs. -2.81%; P < 0.05). The optimal threshold of the rate of change in T1 value at 4 weeks for predicting treatment response was -5.32% (area under the ROC curve, 0.833; sensitivity, 0.900; specificity, 0.667).

Conclusion: T1 mapping provides a new imaging method for monitoring RA lesions; changes in wrist BME T1 values reflect early treatment response.

Methods: A total of 25 healthy participants with an average age of 35 years (20 men and 5 women) were selected in April 2022. Thermogram images were captured using a FLIR T series thermal camera. Conventional image processing techniques, such as filtering and edge detection, were used to preprocess thermograms. Next, the level set approach was used with the edge-detected pattern as an input to an automated segmented region of interest (ROI).

Results: Five metrics, namely Dice Coefficient, Tanimoto Index, Jaccard Index, Volume Similarity, and Structural Similarity, were used to assess the performance of the segmentation technique compared to ground truth, which showed 97.5%, 92.5%, 94.5%, 96.5%, and 96.5% correlation, respectively, between the segmented and the ground truth images with average values for both the eyes. Statistical analysis demonstrated that the contralateral portions of the ocular thermograms were significantly different in terms of vascular distribution between the left and right eyes (p < 0.005).

Conclusion: The level set method efficiently segmented the ROI in ocular thermograms with maximum correlation. According to the segmentation’s results, the model showed the dissimilarity between the contralateral parts of the left and right eyes in healthy cases.

Case Summary: We report a 44-year-old woman with aggravated right hip pain during the past decade. The patient presented with severe pain and a functional disorder of the right hip. X-ray examination revealed severely narrowed right hip joint space and abnormal trabecular bone loss in the femoral neck and trochanter area. Doppler ultrasound, magnetic resonance imaging and computed tomography angiography revealed AVMs surrounding the right hip, along with erosion. To ensure the safety of THR, we performed vascular embolization and temporary balloon occlusion of the iliac artery three times during the operation. However, serious hemorrhage occurred, which was rescued by the multimodality blood conservation strategy. THR was successfully performed, and the patient was discharged 8 d later for rehabilitation. Postoperative pathological examination showed osteonecrosis of the femoral head with malformed thick-walled vessels and focal granulomatous inflammation of the surrounding soft tissues. The Harris Hip Scale score increased from 31 to 82 at 3 mo of follow-up. The patient was followed up for 1 year, and all her clinical symptoms were significantly alleviated.

Conclusion: Arthritis of the hip caused by AVMs is rare in clinical practice. The activity and function of the involved hip joint can be effectively treated with THR after comprehensive imaging and multidisciplinary consultation.

Core Tip: Arthritis of the hip caused by arteriovenous malformations is rarely reported. Total hip replacement (THR) is a reliable and effective option for the treatment of advanced arthritis of the hip. We report a 44-year-old woman with aggravated pain in the right hip during the past decade. With the vascular intervention and multimodality blood conservation strategy. THR can be successfully performed in patients with AVM-induced arthritis of the hip.

Case Presentation: In this paper, we describe a case of a 58-year-old female with Devic’s syndrome, blindness, and neurological involvement who responded exceptionally well to rituximab but developed a severe flare of psoriatic arthritis. After withdrawing from the use of rituximab, her psoriatic arthritis symptoms had resolved. However, she did have another episode of blindness, and rituximab was started once again. Although her vision improved, her psoriatic arthritis symptoms had reoccurred. The patient was switched to eculizumab and ustekinumab, which controlled both her psoriatic arthritis and Devic’s syndrome.

Conclusion: Very few reports have identified rituximab to induce a flare-up of psoriatic arthritis, raising uncertainty regarding its potential effects on psoriatic symptoms. The precise mechanism underlying the exacerbation of psoriatic arthritis by rituximab remains uncertain. This case report highlights that rituximab can worsen psoriasis and psoriatic arthritis, and that the complexities of Devic’s syndrome may require medication adjustments.

Objectives: The primary objective of this investigation was to pass on sulfasalazine-loaded cubosomes over the skin to treat rheumatoid arthritis. On the way to overcome this issue of oral sulfasalazine and provide localized effect, Cubosomes were chosen for the transdermal drug delivery system.

Methods: Sulfasalazine-loaded cubosomes were prepared by the top-down method using GMO and Poloxamer 407. Different concentrations of lipid and surfactant were used in the formulation using 3² full factorial designs. The prepared formulations were assessed for p.s, z,p, %EE, FTIR, SEM, in-vitro release, ex-vivo permeation, and deposition studies with pH 7.4 phosphate buffer saline.

Results: The particle size varies between 65 nm to 129 nm, while the negative zeta potential ranged from - 18.8 mV to -24.8 mV. The entrapment efficiency was between 87% and 95%. The formulations' in-vitro drug release was carried out for 12 hours. The optimized formulation showed a controlled release of sulfasalazine and better ex-vivo permeation and deposition properties than sulfasalazine suspension.

Conclusion: Overall study findings support the possibility of applying transdermal sulfasalazineloaded cubosomes to alleviate rheumatoid arthritis.

Objective: The primary goal of the work was to outline the research activities on versatile nanocarriers, like polymeric micelles, nanoparticles, liposomes, etc., with controlled/sustained drug release patterns fabricated to elevate the effectiveness of drug delivery.

Methods: This review mainly focuses on emerging strategies to deliver various nanocarriers encapsulating anti-rheumatic drugs, enzymes, genes, phytoconstituents, etc. It also includes upto- date progress regarding patents and clinical trials filed for the treatment of RA.

Results: In most of the recent studies, nanocarrier-based drug delivery has gained attention worldwide and led to the development of new approaches for treating RA. A better understanding of pathophysiology and signalling pathways helps to select the antirheumatic drug. The encapsulation of active moiety into the novel nanocarrier enhances the solubility of insoluble drugs. It restricts the exposure of the drug to the non-inflamed site using various targeting strategies, like active, passive, or biomimetic targeting and stimuli-responsive carrier systems to enhance the drug delivery mechanism.

Conclusion: A brief description of current RA treatments using nanocarrier technology is provided in this paper, along with predictions for potential enhancements to the nanotherapeutic regimen.

Morphology : They contain a solid matrix at room temperature and are thought to be superior to many other conventional lipids-based nanocarriers, such as solid lipid nanoparticles (SLNs), nanoemulsions, and liposomes because of their improved stability, drug loading capacity, good biocompatibility, enhanced permeability, bioavailability, extended half-life, fewer side effects, tissue- specific delivery and wide range of potential applications.

Significance : NLCs have multiple applications in the manufacturing of pharmaceuticals and cosmetics due to their ease of preparation, the feasibility of scale-up, non-toxic, improved targeting efficiency and potential for site-specific delivery via various routes of administration.

Scope of Review: This review enlightens about the most recent developments of NLCs as a drug delivery system, types of NLCs, current techniques to prepare NLCs, and characterization techniques that are essential for the development of safe, effective and stable formulation. It also encompasses the potential of using NLCs for various administration routes and recent developments in pharmaceutical applications with successful outcomes.

Conclusion: This review certainly provide great insight into formulation considerations using design experts and modification strategies for improved targeting. On the whole, NLCs are broadly explored and preferred lipid nanocarrier systems with several advantages.

Methods: We synthesized EF-AuNps using a direct reduction method and characterized the NPs by employing various techniques, including UV-visible spectroscopy, DLS, XRD, EDX, TEM, and FT-IR. The anti-proliferative activity against MDA-MB-231 cells was assessed using MTT and colony formation assays, alongside evaluating cell viability with PI-FACS and live/dead assays. Furthermore, a Western blot was performed to determine the mechanism of action of EFAuNps in TNBC cells.

Result: We successfully synthesized triangular EF-AuNps (<100nm) and observed a substantial inhibition of cell proliferation (IC₅₀ 18μg/ml). Compared to EF alone, EF-AuNps significantly enhanced cell death in TNBC cells, as confirmed by flow cytometry and viability assays. Besides, Western blot analysis verified that the expression of apoptotic-related signal proteins, such as survivin, caspase 3, and caspase 9, were modulated by EF-AuNps.

Conclusion: EF-AuNps showed higher anti-cancer efficacy than EF in the MDA-MB-231 cell line. These findings suggest the therapeutic potential of EF-AuNps for TNBC treatment, advocating for further preclinical and clinical investigations into this promising anti-cancer formulation.

Methods: The 12-hour sustained effect of pepsin floating microspheres was planned. This also improves the stability of the Pepsin by immobilizing them on the microsphere. Pepsin is widely used in chronic gastritis, so developing a floating drug delivery system is therefore necessary. In light of the aforementioned principles, a critical need for the creation of a dosage form to administer Pepsin in the stomach and boost the enzyme's effectiveness, enabling sustained action, was identified. The current study used a methodical strategy to create floating microspheres of Pepsin dosage forms.

Results: Optimization was done for floating ability, yield, entrapment efficiency, and release study using different concentrations of ethylcellulose & HPMC E4M. For parameter optimization and to demonstrate the significant impact of variables, 32 full factorial designs were used. The manufactured microspheres had good encapsulation rates, excellent floating, & excellent micromeritic properties as single-unit dosage forms.

Conclusion: It has been demonstrated that pepsin prepared as floating microspheres can be used to improve proteolytic activity and extend pepsin's gastric residence.

Methods: In this study, a preliminary phytochemical investigation of Moringa oleifera leaves ethanolic extract was conducted using qualitative analysis followed by Gas Chromatography-Mass Spectrometry (GC-MS) analysis to determine the constituents in the extracts.

Results: The results indicated the presence of various phytochemical compounds (about 316). Out of these, about 16 compounds were identified that covered 54.63 % of the total ethanolic extract. A molecular docking study was further performed using selected two compounds i.e. 3, 7, 11, 15- tetramethylhexadec-2-en-1-ol and neophytadiene and different targets proteins MMP9 (1L6J), PGE2 (1Z9H), TLR-1-TLR-2 (2Z80), COX-II (3NT1 and 5F19), iNOS (3NW2), HtrA1 (3TJO), JAK-1 (4K6Z), MCSF (5LXF) and TLR-4 (5NAO). Later on, an online tool was used to perform ADME/T analysis of the identified compounds. The DPPH and ABTS assay confirmed the strong potential of this extract for antioxidant activity, which correlates with anti-arthritic potential.

Conclusion: Based on molecular docking, the mechanism for these compounds for the anti-arthritic activity of these magical plant leaves was identified. It is concluded from the study that Moringa oleifera leaves ethanolic extract have potential compounds that may be used to develop more effective formulations for better therapeutic exercise against inflammatory diseases like rheumatoid arthritis.

Methods: Anthropometric data collected for 150 cases from the hospital was contrasted with the typical implant data from the Johnson & Johnson Company and Zimmer. In the data collected for 150 cases, 91 were female patients and 59 were male patients. The maximum cases were for osteoarthritis and rheumatoid arthritis. For each patient—male and female—the mismatch error was computed separately. Major focus of the study was laid on the femoral condyle.

Results: Zimmer implant mismatch errors were computed as follows: -1.18 for A/P and 4.95 for M/L in patients who were male; -5.6 for A/P and -3.3 for M/L in patients who were female and male. -3.4 for A/P and -0.4 for M/L in female patients; 1.85 for A/P and 8.18 for M/L in male patients was the mismatch error computed for Johnson & Johnson implants. The total discrepancy in implant results was 1.83 for men and -4.4 for women for Zimmer, and 5.01 for men and -1.89 for women for Johnson & Johnson. A mismatch of -19 (for females), -15 (for men) was identified for Zimmer, and -11 (for females), -7 (for males) was found for Johnson & Johnson. The femoral condyle was the cause of several inaccuracies.

Conclusion: On the basis of results from data analysis it was found that female patients were more into pray of high mismatch errors. Also, femoral condyle mismatch was majorly responsible for the improper fitting of implants error. So, a 3-D model was developed using Slicr3r to justify that the gap between the implant and implanted knee must not exceed 2mm for femoral condyle in order to get the best fit. A patent on Asymmetric Prosthetic Tibial Component is available to explain a similar concept.

Aim: Using the Analytical Quality by Design (AQbD) methodology, a simple, robust spectrophotometric method for the detection of BCTB in API form and Niosomes drug delivery system is designed and assessed.

Methods: In the AQbD approach, a face-centered CCD design of Design Expert 13 software was used to evaluate two critical method variables: scanning speed and sampling interval. The design space suitability was confirmed by standard error and overlay plots. The 2-D contour and 3-D response surface plots were used to forecast the relationship between the response variable and predictor variables.

Results: Baricitinib displays an absorption maximum at 249.40 nm in saline phosphate buffer pH 7.4. The distinguished linearity of the method was obtained over a concentration of 5-30 μg/ml with a correlation coefficient (R²) value of 0.998. BCTB % assay was found to be near 99%. Intraday and Interday precision were found to have % RSDs of 0.067-0.488 and 0.146-0.942, respectively.

Conclusion: The established spectrophotometric technique was observed to be precise as per ICH revised guidelines ICH Q2 (R1) and Q14 for analytical method validation. Our findings are instructional for the future design and development of safe and reliable therapeutic dosage forms of BCTB for rheumatoid arthritis.

Methods: We employed the type of MSCs, human umbilical cord (huc) MSCs in an experimental CS model and therapeutic efficacy was assessed. hucMSCs exerted this therapeutic effect by regulating macrophage function. To verify the regulatory effects of hucMSCs on the macrophage, macrophage line RAW264.7 markers were analyzed under LPS stimulation with or without co-culturing with hucMSCs for 12h and 24h. In addition, flow cytometry analysis was applied to reveal the interaction of co-culture. For animal studies, CS was induced by the MoPn strain Chlamydia trachomatis (CT), hucMSCs were intravaginally injected in the CS, and we analyzed the infiltrated macrophage by immunofluorescence.

Results: We found the markers IL-10 was markedly increased and IL-1β, caspase-1 was notably downregulated after co-culturing with hucMSCs by RT-PCR. hucMSCs promote macrophage line RAW264.7 apoptosis. We also found that hucMSCs treatment can alleviate CS by decreasing the mRNA expression of IL-1β, caspase-1 and MCP-1 in the tubal tissue by RT-PCR and decreasing the protein expression of IL-1β, caspase-1 and TGF-β by western blotting.

Conclusion: These results suggest that macrophage function may be related to the immune-modulating characteristics of hucMSCs that contribute to CS.

Methods: Various molecular modelling techniques were employed to identify potential compounds and assess the stability and affinity of the predicted molecule. A pharmacophore hypothesis was developed to obtain crucial information about the experimental series of pyrazolopyrimidine studied, which served as the basis for designing new molecules. Additionally, ADMET was utilized to predict and evaluate the pharmacokinetic properties and potential toxicity of the compound prior to synthesis or utilization. To determine the essential residues involved in the interaction between the molecule and the target JAK3 protein, the covalent docking method was applied. We further validated the binding stability of the JAK3 protein with the ligands ZINC62162141 and Tofacitinib, both of which have been approved by the FDA for JAK3/STAT inhibition., using DFT/B3LYP/6-31G molecular dynamics simulations lasting 1000 ns and MM/GBSA.

Results: During the study, we identified compounds that displayed notable activity against JAK3/STAT, specifically those containing thiadiazol, oxadiazol, and chlorophenyl groups. Additionally, the pharmacophore model, ADRRR_1, exhibited promising potential for predicting new molecules. The predicted compound, ZINC62162141, demonstrated favourable ADMET properties, including inhibition of CYP3A4. Furthermore, we assessed its binding stability to the target protein and determined its affinity for the protein-ligand complex using MMGBSA.

Conclusion: The results of this study suggest that the compounds identified have the potential to be promising candidates for inhibiting JAK3/STAT and CYP3A4, offering potential therapeutic benefits for the treatment of rheumatoid arthritis. These findings provide a foundation for subsequent experimental validation and the development of novel drugs in this field.

Methods: The key ingredients and core targets of RRP protecting retinal oxidative damage were obtained by Network pharmacology analysis. A mouse retinal oxidative damage model induced by tail vein injection of 1% NaIO₃ solution (25 mg/kg) was treated with RRP for 4 weeks and used to verify the pharmacodynamics and related mechanism.

Aim: This study aimed to predict and verify the protective effect and mechanism of RRP on retinal oxidative damage in mice based on network pharmacology and animal experiments.

Results: A total of 15 key active components included in RRP interacted with 57 core targets related to retinal oxidative damage (such as AKT1, NFE2L2, HMOX1), mainly involved in the AGE-RAGE signaling pathway in diabetic complications, PI3K-AKT signaling pathway and so on. Further studies in vivo found that RRP improved the retinal oxidative damage, increased the content of SOD and GSH, decreased the content of MDA in mouse serum, promoted the expression of p-PI3K, p-AKT, Nrf2, HO-1 and NQO1 proteins in the mouse retina, and inhibited the expression of Nrf2 in the cytoplasm.

Conclusion: This study revealed that RRP had a protective effect on oxidative damage of the retina in mice, and might exert anti-oxidative effect by activating the PI3K/Akt/Nrf2 signal pathway. This study provided scientific data for the further development of hospital preparations of RRP, and a good theoretical basis for the clinical application of RRP.

Objective: To summarize the evidence of maternal, placental, and fetal alterations that an excessive intake of n-6 polyunsaturated FAs (PUFAs), LA, and AA, could produce during pregnancy.

Methods: A thorough review of the literature regarding the effects of n-6 PUFAs during pregnancy and lactation including in vivo and in vitro models, was carried out using the PubMed database from the National Library of Medicine-National Institutes of Health.

Results: An elevated intake of n-6 PUFA, specifically LA, during pregnancy influences children's motor, cognitive, and verbal development during infancy and early childhood. Similarly, they could harm the placenta and the development of other fetal organs such as the fat tissue, liver, and cardiovascular system.

Conclusion: Maternal diet, specifically LA intake, could have significant repercussions on fetal development and long-term consequences in the offspring, including the possibility of future metabolic and mental diseases. It would be necessary to focus on the prevention of these alterations through timely dietary interventions in the target population.

Objectives: The present study aimed to determine the level of miR-124 in patients with lupus nephritis by reverse transcriptase real-time polymerase chain reaction compared to healthy control and correlate its levels with biochemical findings in those patients.

Methods: The study was a case-control study that included fifty patients with lupus nephritis in addition to fifty healthy controls. Blood samples from the participants were subjected to the determination of serological markers of SLE. Moreover, real-time PCR was used for the determination of miR-124.

Results: The comparison of Micro-RNA124 between patients and control subjects revealed a statistically significant decrease in Micro-RNA124 in patients (1.193 ± 0.56) compared to the control (3.36 ± 0.50, p <0.001); the comparison of the level of MicroRNA 124 in the patients with different clinical and serological findings of SLE revealed a significant decrease in the level of MicroRNA 124 in patients with muscular findings (1.02 ± 0.5) compared to the patients with negative manifestations (1.47 ± 0.5, p =0.005).

Conclusion: In the present study, a comparison of MicroRNA-124 in LN patients with different stages compared to normal control showed a statistically significant decrease in Micro-RNA124 in patients with lupus nephritis p <0.001 with significant correlation to the patients’ different clinical and serological findings of SLE. Therefore, it may be used as a new noninvasive therapeutic approach to monitor response to therapy, predict relapses, and identify the degree of the activity of the disease or the progression to the chronic stage.

Methods: Mice were treated with hydroalcoholic extract of Artimisia dracunculus (HET) at two doses (250 and 500 mg/kg) for 14 days. The host hematological parameters, spleen cellularity histopathology, hemagglutination titer assay (HA), delayed-type hypersensitivity (DTH) responses, IFN-γ and IL-4 levels produced by spelenocytes, and the proliferation of lymphocytes were assayed.

Results: HET at a high dose significantly could increase the number of white blood cells and lymphocytes compared to the control group. The lymphocyte proliferation in exposure to PHA significantly increased in the HET group at both doses compared to the control group, whilst this index in the presence of LPS increased significantly for the 500 mg/kg-HET group only. Moreover, in the HA and DTH tests, HET significantly increased the proliferation of lymphocytes as compared with the control group. Furthermore, HET significantly increased the amount of IFN-γ parallel to a decrease in the level of IL-4 in compared to the control group.

Conclusion: Based on our findings, HET has potent immunostimulant characteristics. More investigation into tarragon's potential to be used in the treatment of disorders caused by a weakened immune response should be conducted.

Methods: ATR-FTIR spectra of sixteen testing sets of herbal product samples for pain and fever indications were used for multivariate chemometrics model construction. Linear Discriminant Analysis (LDA) was selected as a method for model construction with IBM SPSS for statistical analysis. Model development employed feature selection, such as the stepwise method for variable selection. The model with a high %correct classification and cross-validation was selected and was then validated with an independent testing data set with an auto-prediction test, confusion matrix, and Receiver Operating Characteristic (ROC) curve. To validate the developed test for routine use, the result from ATR-FTIR method was compared with the standard HPLC and TLC analyses used for adulteration screening.

Results: The selected model's overall %correct classification result was 97.7%, with a cross-validation of 93.8% rate in training set samples. External validation with an independent testing dataset gave an overall correct classification of 93.8%, with an area under the curve of ROC at 0.979. Comparative testing revealed that model performance was comparable with the HPLC and TLC methods, which routinely detect the presence of paracetamol, aspirin, and ibuprofen. The results of testing set samples classification were consistent with training set samples.

Conclusion: Against the standard chromatographic methods, the multivariate chemometric model based on ATR-FTIR demonstrates comparable detection capability to determine adulteration of paracetamol, ibuprofen, and aspirin in herbal products.

Methods: To achieve this, a comprehensive search was conducted in Persian medicine references and scientific databases to gather information on the traditional uses, chemical composition, and pharmacological effects of spinach. Studies that met the inclusion criteria were meticulously categorized, and relevant data were analyzed to draw insightful comparisons.

Results: Persian medicine describes spinach as a nutrient-rich, laxative, and fast-digesting agent with therapeutic effects on inflammation, lung diseases, back pain, sore throats, jaundice, urinary disorders, joint pain, eye inflammation, insomnia, dementia, and more. Modern studies have substantially corroborated these traditional uses, revealing that spinach possesses antioxidant, anti-inflammatory, anti-cancer, blood sugar-lowering, lipid-lowering, anti-obesity, neurological, ocular, and musculoskeletal effects.

Conclusion: Spinach exhibits a wide range of beneficial effects on various health conditions. Its widespread availability, low cost, and exceptional nutritional richness position it as a promising candidate for further investigation. Future studies should explore the clinical effectiveness of spinach in various diseases, while taking into consideration the principles emphasized in Persian medicine to guide research and inform therapeutic strategies.

Methods: The arthritis model was induced in rats by injecting Complete Freund’s adjuvant (CFA) into the right hind paw and was subsequently treated with crocin and curcumin. Evaluation of anti- arthritic activity was carried out using paw swelling, hematological parameters, biochemical parameters, inflammatory cytokines, and histopathology of rats.

Results: The results showed increased paw swelling, increased serum markers levels, including CRP, RF, ALP, ALT, and AST, and inflammatory cytokines (ILlβ and TNFα) along with histology changes (cartilage and bone degradation) in arthritic rats when compared to the normal group. Crocin, curcumin and crocin + curcumin administration at different doses (especially combination at 40 mg/kg and 30 mg/kg, respectively), as well as MTX, revealed a suitable therapeutic effect on AIA rats. Moreover, both phytochemicals and their combination at different doses showed effective anti- arthritic effects owing to their anti-inflammatory effects.

Conclusion: Crocin and curcumin, either alone or in combination, can be a suitable treatment modality for rheumatoid arthritis.

Method: PBMC from both groups was cultured for 24 h. The expression of the canonical and non-canonical MIF receptors and the TF was determined by flow cytometry. Additionally, multiplex bead analysis was employed to assess the levels of cytokines in the culture supernatants. The findings revealed that T CD4+ lymphocytes in the CS group exhibited a heightened expression of CD74 (p<0.05), whereas RA patients displayed an elevated expression of CXCR7 (p<0.001). Furthermore, T CD4+ lymphocytes from RA patients exhibited greater expression of GATA3, RORγt, and FOXP3, along with elevated levels of pro-inflammatory cytokines compared to the CS group (p<0.001).

Result: These results indicate that CD74 is more prominently expressed in PBMC from the CS group, whereas CXCR7 is more expressed in PBMC from RA patients.

Conclusion: We also noted an increased secretion of Th17 profile cytokines in RA, potentially influenced by the activation of FOXP3 via CD74 and RORγt through CXCR7 using the endocytic pathway.

Objective: This comprehensive review was aimed to critically explore diverse pharmacological activities exhibited by diosmetin. Along with that, this review can also identify potential research areas with an elucidation of the multifactorial underlying signaling mechanism of action of diosmetin in different diseases.

Methods: A comprehensive collection of evidence and insights was obtained from scientific journals and books from physical libraries and electronic platforms like Google Scholar and PubMed. The time frame selected was from year 1992 to July 2023.

Results: The review delves into diosmetin's impact on cellular signaling pathways and its potential in various diseases. Due to its ability to modulate signaling pathways and reduce oxidative stress, it can be suggested as a potential versatile therapeutic agent for mitigating oxidative stressassociated pathogenesis.

Conclusion: The amalgamation of the review underscores diosmetin's promising role as a multifaceted therapeutic agent, highlighting its potential for drug development and clinical applications.

Objective: This study aimed to discuss the beneficial impacts of curcumin and its mechanism in treating gout disease.

Methods: Ten English and Persian databases were used to conduct a thorough literature search. Studies examining the anti-gouty arthritis effects of curcumin and meeting the inclusion criteria were included.

Results: According to the studies, curcumin has shown xanthine oxidase and urate transporter- 1 inhibitory properties, uric acid inhibitory characteristics, and antioxidant and anti- inflammatory effects. However, some articles found no prominent reduction in uric acid levels.

Conclusion: In this review, we emphasized the potency of curcumin and its compounds against gouty arthritis. Despite the potency, we suggest an additional well-designed evaluation of curcumin, before its therapeutic effectiveness is completely approved as an antigouty arthritis agent.

Introduction: DN has become one of the most prevalent complications of clinical hyperglycemia, with individual-specific variations in the disease spectrum that leads to fatal consequences. Diverse etiologies involving oxidative and nitrosative stress, activation of polyol pathway, inflammasome formation, Extracellular Matrix (ECM) modifications, fibrosis, and change in dynamics of podocyte functional and mesangial cell proliferation adds up to the clinical complexity of DN. Current synthetic therapeutics lacks target-specific approach, and is associated with the development of inevitable residual toxicity and drug resistance. Phytocompounds provides a vast diversity of novel compounds that can become an alternative therapeutic approach to combat the DN.

Methods: Relevant publications were searched and screened from research databases like GOOGLE SCHOLAR, PUBMED and SCISEARCH. Out of 4895 publications, the most relevant publications were selected and included in this article.

Result: This study critically reviews over 60 most promising phytochemical and provides with their molecular targets, that can be of pharmacological significance in context to current treatment and concomitant research in DN.

Conclusion: This review highlights those most promising phytocompounds that have the potential of becoming new safer naturally-sourced therapeutic candidates and demands further attention at clinical level.

Case Presentation: Mutilating arthritis (arthritis mutilans) can be part of the clinical presentation of a number of rheumatic diseases, most commonly seen in psoriatic arthritis, rheumatoid arthritis, and juvenile idiopathic arthritis, but also in systemic lupus, systemic sclerosis, and multicentric reticulohistiocytosis. Evidence exists that subperiosteal and subchondral bone resorption, seen in PHPT, could induce the so-called ‘osteogenic synovitis’, which could eventually lead to the development of a secondary osteoarthritis with bone deformities.

Conclusion: Here, we present a case report of a patient initially diagnosed with PHPT who presented with mutilating arthritis of the finger joints and discuss whether the severe acro-osteolysis is a manifestation of the endocrinopathy or whether there is a co-existing undiagnosed inflammatory joint disease.

Methods: Swollen joint count (SJC), tender joint count (TJC), and visual activity scale (VAS) were utilized to acquire patients' subjective feelings of wellness and their performance of routine daily activities to determine the disease activity. The patient's erythrocyte sedimentation rate (ESR) was measured at the clinical hematology laboratory using the Westergren method. The Quality of Life was rated on a scale of 1 to 10.

Results: Our study found that disease activity is inversely proportional to the quality of life. Out of 111 patients, 3 (2.7%) were in remission, 1 (0.9%) had mild disease, 51 (45.9%) had moderate disease, and 56 (50.5%) had high disease activity. The ESR was normal (<20) in 11 patients (9.9%), moderately elevated (20-50) in 56 (50.5%) patients, and very high (>50) in 44 (39.6%) patients. The study revealed that 66% of patients in remission had normal, while 33% had moderately elevated ESR. 12.5% of patients with moderate disease activity had normal ESR, and none with high disease activity had normal ESR. Of 44 patients with high ESR, 7 had moderate disease activity, and 37 had high disease activity. In our study, 60% of patients had a less than 50% quality of life compared to patients with pre-arthritis.

Conclusion: High disease activity affects the productivity and quality of life in patients with rheumatoid arthritis. Assessing the impact of different interventions on the QOL should be an essential task that can help define a holistic and integrative treatment and rehabilitation model for RA patients.