Middle East Journal of Rehabilitation and Health Studies
Year:2018 | Volume:5 | Issue:2|Papers Count:10

Context: Sleep impairment after Traumatic Brain Injury (TBI) is a common consequence of the injury and frequently complicates recovery. To review in brief the current knowledge in regard to sleep impairment following traumatic brain injury. Evidence Acquisition: The relevant literature was reviewed. Results: Practical issues in regard to epidemiology, clinical presentation, medical workup, as well as pathophysiology and treatment modes were addressed. Conclusion: As the spectrum of civil head and brain trauma is quickly expanding, it is important to increase our knowledge of sleep impairment characteristics in victims of TBI and look for more efficient treatment modes for those impairments than those used today.

Background: Colorectal cancer (CRC) is one of the mostcommoncancers worldwide. CRC therapy is still a serious problem because of the presence of cancer stem cells (CSCs) within the tumor. BMI1 (B lymphoma Mo-MLV insertion region 1 homolog) is one of the important molecules for self-renewal of the CSCs and a component of poly comb repressive complex 1 that plays an important role in stimulating the progression of the cell cycle through epigenetic inhibition of tumor suppressors. BMI1 is a marker of colon stem cells that its expression increases in colorectal CSCs. The inhibition of BMI1 expression by miRNA could be one of the promising treatment options in CRC. Furthermore, investigating the regulation of BMI1 expression by miRNAs during tumorigenesis could be valuable in the identification of molecular mechanisms involved in CRC. Our aim was to conduct a bioinformatics analysis of known tumor suppressor miRNAs in CRC that have a potential to inhibit BMI1 expression. Methods: The presence of BMI-1, as a potential target of the selected miRNAs, was explored in various databases of miRNA target prediction including TargetScan, DIANA-microT, PicTar, miRanada, miRtar, mirMAP, and miRDB. These databases are based on algorithms such as miRNA-target interactions and thermodynamic stability (
G). miRNA with the highest score was selected according to the prediction score. Results: According to bioinformatics analysis, the highest score was derived for miR-330-3p. As a new miRNA to suppress BMI-1, miR-330-3p can be used in applied studies. Conclusions: Compared to other tumor suppressor miRNAs in CRC, miR-330-3p has the greatest probability to inhibit BMI1. Therefore, the experimental validation of miR-330-3p/BMI1 axis would be useful in identifying novel therapeutics and biomarkers in CRC.

Background: RNA extraction from Formalin Fixed Paraffin Embedded tissue (FFPE) provides valuable information. The main obstacle for pure RNA extraction from FFPE specimens is RNA degradation over time and low yield of RNA due to chemical processing. In the present study, RNA extraction from FFPE specimens were optimized for storage time, proteinase K concentration, and tissue size hemogenation. Methods: To evaluate the effect of storage time on RNA extraction yield, total RNA from 78 FFPE breast tissue specimens (1-3 years n = 52, and less than one year, n = 26) were extracted by High Pure Paraffin Kit (Roche). The effect of 2 different proteinase K on RNA was evaluated by proteinase K, and the effect of homogenization was evaluated using 2 different section sizes (10  mand 5X2  m). Extracted RNA was converted to cDNA. The SYBER Green Real time PCR was performed for quantitative analysis using ABI7900 Real time PCR. Results: The results indicated that FFPE storage time affected the yield of RNA extraction. The more the time of storage, the less RNA could be obtained (r =-0. 38, P = 0. 01). Smaller tissue section size seems to increase the amount of efficient RNA extraction from FFPE, probably through appropriate tissue lysis and more RNA release. According to the current study, proteinase K (Endopeptidase K) from different companies also affected on the quality of RNA extracted from FFPE (P = 0. 032). Conclusion: Different optimization strategies enhance quality, purity, and quantity of RNA extracted from FFPE, which is critical in gene expression studies, like qRT-PCR.

Background: Inactivity and sedentary lifestyle are a well-known risk factors for health effects. Many questionnaires evaluate physical activity (PA) level; however, the evaluation of sedentary behavior needs more attention. Sedentary behavior questionnaire (SBQ) is a reliable, valid, and easy-to-administer tool. The current study aimed at cross-culturally adapting and assessing the reliability and validity of the Turkish version of SBQ. Methods: SBQ consists of 9 items related to sedentary lifestyle both on weekdays and weekends. SBQ was administrated to 235 participants with the attrition rate of 24%, followed by a repeated administration after 7 days to assess its reliability. Criterion-related validity was analyzed with the international physical activity questionnaire-short form (IPAQ-SF) within the construct validity of the SBQ. Test-retest reliability was assessed by the intraclass correlation coefficient (ICC), while the Spearman rho was used for criterionrelated validity. Results: The ICC scores for each parameter ranged from 0. 388 to 0. 771. The obtained results showed moderate to good test-retest reliability. The validity results of SBQ somewhat violated the standards, which are generally accepted. Items of SBQ “ watching TV (including videos on VCD/DVD)” , “ sitting and talking on the phone or being busy on the phone” , and “ doing paperwork or computer work (office work, e-mails, paying bills, etc. )” correlated significantly with body mass index (BMI) (r =-0. 138 to 0. 247, P < 0. 05). Conclusions: The SBQ had good reliability and acceptable validity to assess sedentary behaviors in a Turkish population.

Objectives: The aim of this study was to evaluate if ozone is capable of decreasing biomarkers of inflammation (CRP/ESR) and pain, and to improve function and quality of life in knee osteoarthrtitis (OA) patients. Methods: A prospective quasi experimental (before-and-after study) research was performed to investigate the effect of Ozone therapy protocol. The intervention included 4 sessions (1 session/week) of an intra-articular infiltration of a medical mixture of Oxygen-Ozone (95% to 5%) at 20 ug/mL concentration. Biochemical evaluation (CRP and ESR), pain VAS, and WOMAC scales were evaluated before and after the treatment. Results: Overall, 33 patients were evaluated. Mean age was 68. 18  8. 43 years. Female patients accounted for 75. 7% (n = 25) and male patients corresponded to 24. 3% (n = 8). Female: male ratio was 3: 1. The most frequent radiological KL grade was 2º (n = 22, 66. 7%), followed by 3º (n = 8, 24. 2%), and 4º (n = 3, 9. 1%). Biomarkers of inflammation decreased significantly. C-reactive protein (CRP) diminished from 0. 33  0. 32 mg/dL to 0. 25  0. 23 mg/dL (P = 0. 0456). Erythrocyte sedimentation rate (ESR) decreased from 15. 06  12. 09 mm/h to 11. 81  8. 32 mm/h (P = 0. 01). Before treatment, pain measured by VAS was 7. 33  1. 31 points and decreased to 2. 84  1. 76 (P < 0. 0001). The WOMAC-pain subscale was 14. 84 2. 77 points and diminished to 5. 96 3. 53 (P < 0. 0001), WOMAC stiffness subscale was 3. 06  1. 95 points and ameliorated to 1. 15  1. 3 (P < 0. 0001), WOMAC-function subscale was 41. 15  12. 58 points and decreased to 22. 3 11. 64 (P < 0. 0001). Conclusions: Ozone is capable of both decreasing pain and stiffness and improving function and quality of life in knee OA patients, yet decreases biomarkers of inflammation, such as CRP and ESR.

Background: Depression is one the most prevalent diseases. It is believed that the level of Brain Derived Neurotropic Factor (BDNF (protein is reduced in the hippocampus of depressed patients and animal models of depression. Antidepressants, such as serotonin reuptake inhibitors, increase BDNF levels in the brain. The present study investigated the effect of vitamin D, a possible drug for depression treatment, on BDNF levels in the hippocampus in a rat model of depression. Methods and Materials: Male Wistar rats (n = 42, 180 to 200g) were undergone a series of Chronic Mild Stressful (CMS) procedures on a daily bases for 3 weeks and after approval of their depression by Sucrose Preference Test (SPT), they were divided to 5 groups (n = 6); two received vitamin D treatment with either 5 or 10 microgram/kg; one, vehicle of vitamin D; one, antidepressant fluoxetine 5mg/kg, and the other group did not receive any treatment for 5 weeks. In parallel, there were 3 control non-CMS groups; one treated with vitamin D, the other with fluoxetine, and the last one without any treatment. At the end of the 8-week experiment, SPT was repeated, the hippocampus was extracted, and BDNF protein was assayed using the Enzyme Linked Immunosorbent Assay (ELISA). Results: The SPT at the end of 3 weeks of CMS revealed a significant difference (P < 0. 0001) in sucrose preference to water between the CMS treated (mean SEM, 35. 18 4. 86) and non-CMS treated group (82. 72 5. 73), showing the induction of depression by the CMS procedure. Treatment with vitamin D and fluoxetine improved SPT in CMS-treated rats to the level of control rats (CMS, 33. 43  6. 26 versus vit D treated 68. 78  5. 07, P < 0. 001; CMS versus fluoxetine treated 87. 19  3. 62, P < 0. 001). The BDNF levels did not show any change in depressed versus non-depressed rats (P = 0. 12). Neither vitamin D nor fluoxetine could change BDNF levels in depressed rats, though fluoxetine significantly increased protein in non-depressed rats (P < 0. 0001). Conclusion: The current study showed that vitamin D did not affect BDNF protein level in the hippocampus of the depressed animals, suggesting that vitamin D could alleviate the symptoms of depression via BDNF-independent mechanisms.

Background: Parathyroid hormone-related protein (PTHrP) is a multi-functional protein with a sequence “ aa 1-34” similar to that of parathyroidhormone(PTH). In spite of growthfactor activity, there isnostandardized analyticalmethodto determine the biological activity of recombinant PTHrP. Methods: The current study isolated the cDNA encoding 141 N-terminal amino acid sequence of PTHrP, cloned it in plasmid vector pET32a, and produced recombinant PTHrP in Escherichia coli. The biological activity analysis of the recombinant protein was evaluated using a precise and practical method that measured PTHrP-mediated cell proliferation of a breast cancer cell line MCF-7. Additionally, to investigate the accuracy and precision of MCF-7 method used, chondrogenic differentiation condition of PTHrP treated mesenchymal stem cells (MSCs) was evaluated. Results: DNA sequencing and protein mass spectrometry analysis confirmed the accuracy of cloned cDNA sequence and expressed the protein. Biological activity analysis showed the increasing effect of recombinant PTHrP on cell proliferation of cancer cell line MCF-7. Alkaline phosphatase and gene expression analysis validated the anti-hypertrophy effects of recombinant PTHrP on chondrogenic differentiation of MSCs. Conclusions: The current study removed potential challenges and errors in comparability and reproducibility studies focusing on stem cell differentiation and pathogenesis of breast cancer arising from PTHrP biological activity analysis.

Background: Low back pain is a common health problem in the younger population. Spinal degeneration is the most common cause of low back pain. Objectives: The purpose of this study was to investigate the most common causes of low back pain with MRI in young people under the age of 40 and to determine gender differences, if any. Methods: This is a retrospective study on 200 consecutive patients between the ages of 17-39 who had lumbar MRI (1. 5 T MRI). Patients were included in the study based on the information collected from the radiological database system and neurosurgical clinical archives between September-October 2017. Spinal mass, spondylolisthesis, disc degeneration, multifidus muscular atrophy, and congenital anomalies were investigated. Studied parameters were compared in male and female patients. Results: Disc degeneration or hernia was observed in 132 patients (66%) and no gender difference was found for a disc hernia (P = 0. 376 Chi-Square test). The most frequent disc hernia was detected at the level L5-S1. Multifidus muscular atrophy was identified in 54 (27%) of all patients and it was higher in women (P < 0. 001). Accepted change of lumbar lordosis was detected only in 10 patients. Conclusions: Disc herniation is the most common causes of low back pain in young people under the age of 40 and there are no gender differences.

Introduction: Calcifying tendonitis is the deposition of hydroxyapatite within tendons. It could affect different tendons. In the current case report, bilateral Achilles’ tendons were affected. The etiology is multifactorial. The treatment is conservative and surgical. Iontophoresis is a conservative technique that favors the penetration of 5% acetic acid, based on the attraction and repulsion of charges with the help of continuous electric current. Case Presentation: A 57-year-old female presented a 12-month experience of bilateral Achilles’ tendon pain. Conservative treatment (nonsteroidal anti-inflammatory drugs (NSAIDs), laser therapy, and physiotherapy) and advanced treatment (shock waves) did not alleviate her pain. Radiography and ultrasound scan showed bilateral insertional formative calcification on both Achilles’ tendons, 9. 3mmon left Achilles’ tendon and 6. 6mmon right one. After 15 sessions of 5% acetic acid iontophoresis (2 mL, 4. 7 mA 10 minutes) and continuous ultrasound (1 W/cm2, 1 MHz 5 minutes) over the calcification area, calcification sizes decreased from 9. 3 to 4. 3 mm (left Achille’ s tendon) and disappeared on right Achille’ s tendon. Pain also decreased from 9/10 to 4/10 on left Achille’ s tendon and from 5/10 to nothing on right tendon. Conclusions: Based on the authors‘ best knowledge, the current study was the first case report that confirmed the effectiveness of 5% acetic acid iontophoresis plus ultrasound to treat bilateral Achilles’ calcifying tendonitis.

Background: Stroke has a great adverse effect not only on the lives of stroke survivors but also on the informal caregivers, as they provide care ranging from assistance in activities of daily living, leading to a high risk of depression and other psychological morbidities. Objectives: This study explored the prevalence of depression and associated factors among primary caregivers of stroke survivors in Nigeria. Methods: A cross sectional survey on the prevalence of depression among primary caregivers of stroke survivors was conducted at selected hospitals in Maiduguri, Nigeria. A sample of convenience was used to recruit participants in this study. The Beck depression inventory was used to screen for depression. Data form and patients folders were used to obtain socio-demographics and clinical characteristics of participants and stroke survivors. Result: A total of 115 primary caregivers participated, out of which 53% were male and 47% were female. The mean age and overall beck depression inventory score were 30. 78 9. 66 and 15. 42 7. 84, respectively. The overall prevalence of depression was found to be 46. 1%. Type of stroke (P = 0. 03) and post stroke duration (P = 0. 02) of stroke survivors cared for was found to be associated with depression among caregivers of stroke survivors. Conclusions: Caring for the patients with stroke presents increased in the psychological impact of caregiving for stroke survivors, it is therefore recommended that information, education, and support should be provided to primary caregivers as they are key in sustaining rehabilitation gains and long term overall well-being of stroke survivors.