Retraction: Complete Lumbar Spine Dislocation With Full Neurological Recovery.

[This retracts the article DOI: 10.7759/cureus.19249.].

Bilateral Knee Septic Arthritis in a Seven-Month-Old Girl.

Septic arthritis (SA) is a type of joint inflammation caused by an infection. It is an orthopedic emergency that requires immediate treatment to avoid serious complications such as joint destruction, osteomyelitis, and sepsis. We present a case of bilateral knee SA in a seven-month-old female who presented to our emergency department with left knee SA, followed by right knee SA one month later.

Ginkgo biloba leaves extract's cosmeceutical evaluation: a preliminary assessments on human volunteers towards achieving improved skin condition and rejuvenation.

BACKGROUND: Ginkgo biloba (GB) leaves extract is known to possess potent antioxidants and other bioactivities such as improved skin conditions and rejuvenation. OBJECTIVE: This study aimed to develop a cosmeceutical preparation to utilize the strong antioxidant potential of GB leaves as part of the skincare formulation. METHODS: Cream incorporated GB (GBC) was prepared by mixing the obtained extract with stearic acid-sodium hydroxide components in an emulsion format. The obtained GBC was characterized for GB contents, uniformity, pH, compatibility, stability, and skin's human application. RESULTS: A homogeneous, physically, and chemically stable, with pH near the skin pH and shiny cream, was obtained. The prepared cream was easy to rub and pearly in appearance. It was effective and safe during the two-week trial conducted on human volunteers according to clinical trial registry protocols. The cream scavenged free radicals in DPPH assay tests. The cream incorporated GB made the skin more spirited and tauter. Furthermore, the wrinkles were reduced and the skin was renewed vigor. CONCLUSION: The GBC worked at the topical level and provided benefits when applied daily for the trial duration. The formulation also provided visually observable anti-wrinkle effects on the skin, with visible improvements in the skin's shape and texture. The prepared cream can be used to rejuvenate the skin.

Giant Cell Tumor of Tendon Sheath of the Distal Phalanx.

Giant cell tumor of tendon sheath (GCTTS) is a benign proliferative disorder of the synovial joints and tendon sheaths that typically manifests as a painless, firm, localized, and slow-growing mass. Commonly seen among women in the third to fifth decades, GCTTS can be diagnosed clinically; however, histopathological confirmation is required. The tumor is primarily removed surgically. Recurrence after excision is possible and occurs in up to 45% of cases.

Structural-Guided Identification of Small Molecule Inhibitor of UHRF1 Methyltransferase Activity.

Ubiquitin-like containing plant homeodomain Ring Finger 1 (UHRF1) protein is recognized as a cell-cycle-regulated multidomain protein. UHRF1 importantly manifests the maintenance of DNA methylation mediated by the interaction between its SRA (SET and RING associated) domain and DNA methyltransferase-1 (DNMT1)-like epigenetic modulators. However, overexpression of UHRF1 epigenetically responds to the aberrant global methylation and promotes tumorigenesis. To date, no potential molecular inhibitor has been studied against the SRA domain. Therefore, this study focused on identifying the active natural drug-like candidates against the SRA domain. A comprehensive set of in silico approaches including molecular docking, molecular dynamics (MD) simulation, and toxicity analysis was performed to identify potential candidates. A dataset of 709 natural compounds was screened through molecular docking where chicoric acid and nystose have been found showing higher binding affinities to the SRA domain. The MD simulations also showed the protein ligand interaction stability of and in silico toxicity analysis has also showed chicoric acid as a safe and nontoxic drug. In addition, chicoric acid possessed a longer interaction time and higher LD50 of 5000 mg/kg. Moreover, the global methylation level (%5 mC) has been assessed after chicoric acid treatment was in the colorectal cancer cell line (HCT116) at different doses. The result showed that 7.5 µM chicoric acid treatment reduced methylation levels significantly. Thus, the study found chicoric acid can become a possible epidrug-like inhibitor against the SRA domain of UHRF1 protein.

Complete Lumbar Spine Dislocation With Full Neurological Recovery.

The thoracolumbar region is the most vulnerable segment of the spine to traumatic injuries. It represents a region of transition of the relatively fixed and immobile thoracic spine and flexible lumbar spine. Injuries to the thoracolumbar region often result from high-energy trauma. We present the case of a 24-year-old woman who was brought to the emergency department after a fall from a great height. She presented with severe back pain that was associated with the inability to move both of her lower limbs with absent sensation and loss of urinary and bowel continence. Otherwise, she was hemodynamically stable. The patient underwent a computed tomography scan of the abdomen and pelvis. It demonstrated a complete fracture-dislocation of the second lumbar vertebra relative to the first lumbar vertebra causing shortening of the vertebral column. The second lumbar vertebra had a complete lateral dislocation and appeared in the same axial plane as the first lumbar vertebra giving the appearance of a "double vertebrae" sign. The patient was prepared for emergency open reduction internal fixation with a posterior surgical approach. The operation was done under general anesthesia with the use of sensory-evoked potential responses to avoid any neurological injury. Good realignment of the thoracolumbar spine was achieved. Six months after the operation, the patient was asymptomatic and resumed her regular activities. Complete traumatic lateral dislocation of the lumbar spine is very rare. Early diagnosis of such fracture by computed tomography scan is crucial to avoid maneuvers that may cause unintended spinal cord injuries.

Comparative Analysis of the Impact of Urolithins on the Composition of the Gut Microbiota in Normal-Diet Fed Rats.

The gut microbiota consists of a community of microorganisms that inhabit the large intestine. These microbes play important roles in maintaining gut barrier integrity, inflammation, lipid and carbohydrate metabolism, immunity, and protection against pathogens. However, recent studies have shown that dysfunction in the gut microbiota composition can lead to the development of several diseases. Urolithin A has recently been approved as a functional food ingredient. In this study, we examined the potentials of urolithin A (Uro-A) and B (Uro-B) in improving metabolic functions and their impact on gut microbiota composition under a metabolically unchallenged state in normal rats. Male Wistar rats (n = 18) were randomly segregated into three groups, with Group 1 serving as the control group. Groups 2 and 3 were administered with 2.5 mg/kg Uro-A and Uro-B, respectively, for four weeks. Our results showed that both Uro-A and B improved liver and kidney functions without affecting body weight. Metagenomic analysis revealed that both Uro-A and B induced the growth of Akkermansia. However, Uro-A decreased species diversity and microbial richness and negatively impacted the composition of pathogenic microbes in normal rats. Taken together, this study showed the differential impacts of Uro-A and B on the gut microbiota composition in normal rats and would thus serve as a guide in the choice of these metabolites as a functional food ingredient or prebiotic.

Prevalence of burnout syndrome and its related risk factors among physicians working in primary health care centers of the Ministry of Health, Al Ahsa region, Saudi Arabia, 2018-2019.

Burnout syndrome (BS) is a relatively common occupational problem. It is a psychological and behavioral syndrome described by three dimensions: emotional exhaustion (EE); depersonalization (DP); and low personal accomplishment (PA). OBJECTIVES: This study aims to calculate the prevalence of BS and its related risk factors among physicians of primary health care centers (PHCCs) of the Ministry of Health (MOH, Al Ahsa, Saudi Arabia. MATERIALS AND METHOD: A cross-sectional study was conducted in which 280 physicians working in PHCCs were selected as a comprehensive sample, the response rate was 80.7%. We excluded the trainee of residency programs, interns, and hospital physicians providing partial service in PHCCs. The data was collected by using two-part self-administered questionnaire including sociodemographic data, working conditions, and Maslach Burnout Inventory™-Human Services Survey for Medical Personnel-MBI-HSS (MP). This data was analyzed using Statistical Package for Social Sciences (SPSS) program. RESULTS: The mean score for EE was 24.99 ± 11.54 SD. The mean score for DP was 9.19 ± 6.13 SD. For PA, it was 29.41 ± 9.9 SD. The percentage of participants who scored high in EE was 47.3%. About one-half of the participants scored high DP and 59.7% had diminished PA. About one-quarter of the participants (24.3%) scored high burnout in all three dimensions. High EE was present in ages from 35 to 45 years, Saudi participants, rotating or covering physicians, and participants who were satisfied with their job. High DP was seen in Saudi physicians, family physicians, rotating or covering physicians, those who were not satisfied with their job, and physicians who work in rural areas. Low PA was seen in physicians who were not satisfied with their job, rotating or covering physicians, participants who do not have tasks other than clinical work, and physicians who work in Omran sector. CONCLUSION: There is a significant level of burnout among physicians working in PHCCs in Al Ahsa. High burnout was associated with some risk factors. Further research is needed to study this problem in depth.