Evaluation of physicochemical, textural, and microbial characteristics of probiotic soy cheese during storage: Generation and isolation of bioactive peptides.

The purpose of this study was to ascertain how probiotic culture affected the physicochemical, textural, and microbiological characteristics of probiotic soy cheese during storage. Moreover, the release of bioactive peptides during fermentation and storage was examined. Each cheese sample was made from one of the probiotic cultures of Lactobacillus acidophilus, Lacticaseibacillus casei, and Bifidobacterium lactis. Peptide extracts were prepared from these samples and fractionated using reversed-phase high-performance liquid chromatography. The sample containing L. acidophilus had the highest dry matter and hardness. The samples with L. acidophilus and B. lactis, respectively, had the highest concentrations of lactic acid and acetic acid. During storage the acidity, dry matter, lactic acid, acetic acid, and hardness of the samples increased but the pH, springiness, and cohesiveness reduced (P < 0.05). All samples had a probiotic count greater than 107 CFU/g at the end of the storage. Antibacterial and antioxidant properties were found in the peptide fractions that were extracted from the samples. T2F4 (the fourth fraction separated from L. casei sample) had the greatest functional properties. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis revealed the existence of peptide with a molecular mass of 5-10 kDa. Therefore, produced cheese is regarded as a suitable source of potentially bioactive peptides which can be utilized in food industry.

Improving effect of soy whey-derived peptide on the quality characteristics of functional yogurt.

The purpose of this research was to investigate the effect of bioactive peptides isolated from soy whey on the physicochemical, sensory, and microbiological characteristics of yogurt during storage. Trypsin was utilized to hydrolyze soy whey protein at 45°C for 4 h. Then, the resulting protein hydrolysate was fractionated using reversed phase-high performance liquid chromatography (RP-HPLC). Since the F7 fraction showed the best antioxidant and antibacterial capabilities, different levels (6.5, 13, and 17 mg/mL) of this peptide fraction were added to yogurt. A control sample (without the bioactive peptide) was also prepared. Yogurt samples were stored for 3 weeks. With the increase in peptide concentration, the antioxidant activity of yogurt increased while viscosity and syneresis decreased (p < .05). During storage, yogurt acidity, syneresis, and viscosity increased while pH and antioxidant activity declined (p < .05). The addition of bioactive peptide reduced the quantity of Escherichia coli and Staphylococcus aureus bacteria in yogurt during storage (p < .05), and the reduction in bacterial quantity was stronger as the peptide content was increased. The sample containing the largest concentration of peptide (17 mg/mL) got the lowest overall acceptability score. The level of 13 mg/mL of the peptide was chosen as the best concentration for yogurt fortification in terms of overall acceptance and functional properties. Therefore, soy whey-derived peptide can be utilized as a functional component as well as a natural preservative in yogurt.

Novel Carboxymethyl Cellulose-Based Hydrogel with Core-Shell Fe3O4@SiO2 Nanoparticles for Quercetin Delivery.

A nanocomposite composed of carboxymethyl cellulose (CMC) and core-shell nanoparticles of Fe3O4@SiO2 was prepared as a pH-responsive nanocarrier for quercetin (QC) delivery. The nanoparticles were further entrapped in a water-in-oil-in-water emulsion system for a sustained release profile. The CMC/Fe3O4@SiO2/QC nanoparticles were characterized using dynamic light scattering (DLS), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), a field emission scanning electron microscope (FE-SEM), and a vibrating sample magnetometer (VSM) to obtain insights into their size, stability, functional groups/chemical bonds, crystalline structure, morphology, and magnetic properties, respectively. The entrapment and loading efficiency were slightly improved after the incorporation of Fe3O4@SiO2 NPs within the hydrogel network. The dialysis method was applied for drug release studies. It was found that the amount of QC released increased with the decrease in pH from 7.4 to 5.4, while the sustained-release pattern was preserved. The A549 cell line was chosen to assess the anticancer activity of the CMC/Fe3O4@SiO2/QC nanoemulsion and its components for lung cancer treatment via an MTT assay. The L929 cell line was used in the MTT assay to determine the possible side effects of the nanoemulsion. Moreover, a flow cytometry test was performed to measure the level of apoptosis and necrosis. Based on the obtained results, CMC/Fe3O4@SiO2 can be regarded as a novel promising system for cancer therapy.

Ocular Complications of Pediatric Inflammatory Bowel Disease: A Case Series From a Pediatric Tertiary Medical Center.

Background. Ocular extraintestinal manifestations (O-EIMs) are one of the most well-known EIMs in patients with inflammatory bowel disease (IBD). This study aimed to identify the frequency of O-EIMs in children with IBD, referred to Mofid Children's Hospital, Tehran, Iran, during 2014 to 2019. Methods. Children with IBD, younger than the age of 18 years, who were referred to an ophthalmologist, were included in this study. Results. Ninety-six patients with IBD were examined. Four patients had ocular manifestation of IBD. Two patients had complications due to treatment of IBD. The mean age of the patients was 11.25 ± 4.17 years (range: 5.5-17 years). The O-EIMs included 3 (50.0%) cases of anterior uveitis, 1 (16.7%) case of episcleritis, and 2 (33.3%) cases of posterior subcapsular cataract. Conclusion. O-EIMs are important in children with IBD. Therefore, it is recommended that annual screening for ocular complications be performed in all children with IBD.

Rhino-orbital mucormycosis during steroid therapy in COVID-19 patients: A case report.

PURPOSE: To report two cases of COVID-19 under treatment with a corticosteroid; in one case rhino-orbitocerebral mucormycosis and in another one rhino-orbital mucormycosis developed. CASE PRESENTATION: A 40-year old woman and a 54-year old man with severe COVID-19 underwent corticosteroid therapy for immune-related lung injuries. The first case presented with a bilateral visual loss and complete ophthalmoplegia of the right eye. The second case presented with vision loss, proptosis, orbital inflammation, and complete ophthalmoplegia on the left side. Histopathologic, nasal endoscopic examinations, and radiologic findings confirmed mucormycosis in both patients. The patients denied orbital exenteration and were managed with systemic amphotericin B and daily endoscopic sinus debridement and irrigation with diluted amphotericin B. Because of the intracranial space involvement, the first case died. The second case was successfully managed surgically and medically. CONCLUSION: Rhino-orbital/cerebral mucormycosis may be developed in COVID-19 patients under treatment with corticosteroid, and requires prompt diagnosis and management.

A smart meat packaging to show ciprofloxacin residues based on immunochromatography.

The aim of this study was to design a novel smart packaging based on immunochromatography to show ciprofloxacin residues in beef meat. Sensitivity, specificity, accuracy, and precision of this smart packaging were 97%, 100%, 100%, and 97%, respectively. The minimum diagnostic concentration and the minimum diagnostic time were 25 µg/kg and 1 min, respectively. Also, intra- and inter-assays showed all assays were all identical. This means that the smart packaging was a stable and reproducible tool for ciprofloxacin analysis. It is recommended that this type of smart packaging be designed, analyzed, and used to show the residues of common antibiotics in the livestock industry. It is hoped that by obtaining the necessary permits and relevant approvals, this type of packaging can be used for the export and import of various types of meat.

The Effect of Microencapsulation of Phenolic Compounds from Lemon Waste by Persian and Basil Seed Gums on the Chemical and Microbiological Properties of Mayonnaise.

Natural preservatives with high level of phenolic compounds, antioxidants and antimicrobial activities are used in mayonnaise to improve quality and safety due to their potential health benefits. Application of these compounds in production processes highlights many difficulties due to instability of their physical and chemical properties. Microencapsulation is used to address these restrictions. In this study, phenolic compounds from lemon waste were encapsulated with Persian gum (PG) and basil seed gum (BSG) as coating materials at different ratios (0:1, 1:0, and 1:1) at 15% (w/w) total biopolymer. We confirmed microencapsulation by scanning electron microscopy, and evaluate phenolic content, antioxidant activity, encapsulation efficiency, morphology, water solubility indexes, and water absorption indexes. Sample mayonnaise was prepared using microencapsulated polyphenols from lemon waste and extract (1,000 ppm of concentration), and control samples without extracts or microcapsules. All samples were subjected to chemical (measuring the peroxide, thiobarbituric acid, acidity, and color) and microbial (total count of microorganisms and Escherichia coli) analysis during 30 days of storage. BSG samples exhibited the highest antioxidant activity (61.19%) and encapsulation efficiency (70.72%), and PG/BSG microcapsules had the highest capability to prevent oxidative deterioration during storage. Addition of microcapsules led to increases in parameter b* and decreases in parameters a* and L*. In general, PG/BSG microcapsules were considered optimal samples for production of mayonnaise, since they prevented mayonnaise deterioration and exhibited antioxidant and antimicrobial properties.

Predictive factors of stereopsis outcomes following strabismus surgery.

PURPOSE: To determine the predictive factors of post-operative stereopsis in patients with strabismus. METHOD: In this retrospective study, records of patients who received surgical treatment for strabismus were reviewed. All types of strabismus were included. Pre- and post-treatment stereoacuity were measured using the Titmus Stereo Fly test, and predictive factors of stereopsis were evaluated. RESULTS: A total of 194 patients (132 females and 62 males) with a mean age of 14.8 ± 8.4 years were included. There was a statistically significant improvement in stereopsis following surgery (p value < 0.001). Patients with a higher amount of deviation at baseline had poorer stereopsis on the final examination (p value < 0.001). Stereopsis improvement was more prominent in the pure horizontal strabismus group, compared to combined horizontal and vertical deviations. Baseline and the final stereopsis were higher in the "exotropia" group as compared to the "esotropia" group (p value = 0.003 and 0.0155, respectively); however, the within group change of stereopsis was not significantly different between these two groups (p value = 0.144). Post surgical residual deviation was associated with a poorer stereopsis (p value = 0.002, r = 0.251). A longer duration of strabismus before surgery was associated with poorer final stereopsis levels (p value = 0.026). The presence of amblyopia before surgery was associated with poorer stereopsis on last examination (p value < 0.001 for both correlations). CONCLUSION: Based on the result of this study, final stereopsis after strabismus surgery could be affected by the type, duration, and the amount of deviation before surgery, amblyopia, and post operative ocular deviation.

Surgical management of ptosis in chronic progressive external ophthalmoplegia.

PURPOSE: To determine possible complications and efficacy of ptosis surgery in a series of chronic progressive external ophthalmoplegia (CPEO) patients with healthy tear film. METHOD: It is a prospective interventional study on 24 eyes from 12 patients with the diagnosis of CPEO and ptosis. Pre-operatively, tear breakup test (TBUT) and Schirmer test were performed to assess lacrimal function unit. Levator resection was performed for 16 eyes with levator function (LF) more than 4 mm, while eight eyes from four patients with poorer LF underwent frontalis silicone sling surgery. Main outcome measures included change in marginal-to-reflex distance (MRD1) and incidence of post-operative exposure keratopathy. RESULTS: The mean age of the patients was 45 ± 15 years. The mean of TBUT and Schirmer test were 12 ± 1.98 s and 15 ± 2.76 mm, respectively. The mean follow-up period was 34 months. Four eyes encountered mild to moderate exposure keratopathy. All cases were managed medically, with no need for surgical revision. The mean pre-operative MRD1, LF, and chin-up angle were -0.54 ± 1.03 mm, 4.21 ± 1.41 mm, and 21.6 ± 6.01 degrees, respectively. The mean post-operative MRD1, LF, and chin-up angle were 2.42 ± 0.60, 4.46 ± 1.53 mm, and 3.3 ± 1.01 degrees, respectively. At 1-year follow-up visit, improvement in MRD1 and chin-up posture was statistically significant (p-value < 0.05). CONCLUSION: Normal TBUT and Schirmer test results, prophylactic lubricating therapy, and close follow-up can be as important as Bell's phenomenon and palpebral fissure height in predicting post-operative complications.

Investigating the effect of aqueous extracts of basil and savory on antioxidant activity, microbial and sensory properties of probiotic yogurt.

BACKGROUND: The low viability of probiotics causes the short shelf life of fermented products. Therefore compounds which prolong the viability of probiotic bacteria can increase or at least maintain the health- benefiting properties of these products. On the other hand, the addition of antioxidants is one of the methods to increase the shelf life of food products which has recently become more prevalent. In this respect, herbal extracts which are a good source of antioxidants can be appropriate alternative. The aim of this study was  to evaluate the effect of adding basil and savory extracts on antioxidant activity, and on the microbial and organoleptic characteristics of probiotic yogurt. METHODS: The effect of adding basil extract (8% and 10%) and savory extract (6% and 8%) separately to low fat yogurt (1.5% fat) containing Lactobacillus paracasei subsp. paracasei was investigated. The samples were stored at 4°C. The viability of Lactobacillus paracasei subsp. paracasei, antioxidant activ- ity and sensory properties of probiotic yogurt were evaluated on the 1st, 7th, 14th and 21st days. RESULTS: Basil and savory extracts significantly increased the viability of probiotic bacteria (p < 0.05). Dur- ing storage, probiotic counts markedly decreased (p < 0.05) in comparison to the control sample. The addi- tion of herbal extracts significantly increased antioxidant activity, but this activity decreased during storage (p < 0.05). The scores for taste, odor, color and overall acceptance decreased as herbal extracts increased, but there was no significant difference between the test samples and control sample in terms of the texture score (p > 0.05). During storage, there was no significant difference between the organoleptic scores of the samples (p > 0.05), but the taste score did increase significantly (p < 0.05). CONCLUSIONS: It can be concluded that adding herbal extracts had a positive effect on the viability of probiotics and antioxidant activity of probiotic yogurt.

Unicameral bone cyst of the scaphoid: a report of two cases.

Unicameral bone cysts are benign, fluid-filled lesions that occur mostly in long bones (proximal humerus, 50-60%; femur, 30%) of male children aged 5 to 15 years. Occurrence in the scaphoid of an adult is rare. We report 2 such patients who presented with wrist pain, with and without a history of trauma. Both underwent curettage and bone grafting (harvested from the distal radius) and achieved good functional recovery.

Fixed versus mobile weight-bearing prosthesis in total knee arthroplasty.

PURPOSE: This study was designed to compare clinical, radiological, and general health results of two prostheses (mobile vs. fixed weight-bearing devices) that are used in total knee arthroplasty with a 5-year follow-up. METHODS: This randomized controlled study was conducted from 2004 to 2010 in the Department of Orthopedic Surgery at two university hospitals in Isfahan, Iran. Three hundred patients with expected primary total knee arthroplasty (TKA) without severe deformity (a fixed varus or valgus deformity greater than 20°) received fixed weight-bearing (n = 150) or mobile weight-bearing (n = 150) devices. Clinical, radiological, and quality of life outcomes were compared between the two groups at six-month intervals for the first year, after which the comparisons were made annually for the next 4 years. RESULTS: Both groups had similar baseline characteristics. Although there was significant improvement in both groups, there was no significant difference between the groups with regard to the means of the Knee Society Scores, which were 92 (SD: 12.1) for the fixed weight-bearing device and 93 (SD: 14.2) for the mobile weight-bearing device (n.s.) at the final follow-up point. Radiographs showed that there was no significant difference in prosthetic alignment and no evidence of loosening. After TKA, the SF-36 score increased in both groups, but there was no statistical difference between the groups in quality of life at the final follow-up (62 (12.2) vs. 64 (14.3), n.s.). There was no revision after 5 years. CONCLUSIONS: In terms of clinical, radiological or general health outcomes for people who underwent TKA, the results of this study showed no clear advantage of mobile weight-bearing over the fixed weight-bearing prosthesis at the five-year follow-up. LEVEL OF EVIDENCE: I.

Xanthogranulomatous osteomyelitis.

Xanthogranulomatous osteomyelitis is a rare type of inflammatory process which is characterized by composition of immune cell aggregation on histological studies. Delayed-type hypersensitivity reaction of cell-mediated immunity may be implicated in its pathogenesis. Gross and radiological examination can mimic malignancy, and differentiation should be confirmed by histopathological evaluation. We describe the case of a 14-year-old Afghan boy presenting with pain in right shoulder and left leg with prior history of trauma. Fever, limitation in right shoulder range of motion, and tenderness in right shoulder and left thigh were detected following examination. Mild leukocytosis, elevated alkaline phosphatase, and increased erythrocyte sedimentation rate with negative C-reactive protein (CRP) were revealed. X-ray imaging showed mixed density, periosteal reaction, and cortical disruption. Computed tomography (CT) scan revealed lesions involving medulla and cortex, periosteal reaction with soft tissue component, and bone marrow infiltration in right humerus and left fibula. On magnetic resonance imaging (MRI), signal abnormalities in medulla, metaphysis, and diaphysis of the left fibula associated with cortical irregularity and diffuse soft tissue hypersignal areas were demonstrated. Finally, xanthogranulomatous osteomyelitis was confirmed by histological sample. The clinical manifestations and radiographic and laboratory findings of this rare condition are discussed.

Diagnostic accuracy of preoperative clinical examination in upper limb injuries.

BACKGROUND: Injuries in hands and forearms may cause significant discomfort and disability. AIM: To evaluate the accuracy of preoperative clinical examination in depicting lesions caused by penetrating wounds of hands or forearms. SETTING AND DESIGN: This prospective study was conducted from August 2006 to September 2009 at Kashani University Hospital, Isfahan University of Medical Sciences, Iran. MATERIALS AND METHODS: Two hundred and fifty patients with clean penetrating injury to the hand/forearm were enrolled in this study. After patient's data registration, a careful clinical examination and routine exploration without expansion of wound were done by an orthopedic resident. Each tendon was tested at each joint level. Nerves were evaluated with a two-point discrimination test, and arteries were tested with palpable pulses. Surgical exploration was done by a single hand surgeon in operation room. Accuracy of clinical examination was compared to surgical examination. RESULTS: During the study period, 180 (72%) males and 70 (28%) females with mean age of 28±4 years participated. The preoperative examination showed a predominance of the volar zone IV injuries followed by volar zone II, III, thumb zone II, volar zone V and thumb zone III. Despite the enough accuracy of preoperative examinations in dorsal side injuries of hands and forearms (error rate = 8.3%), the preoperative examinations significantly underestimated the amount of damage to soft tissues on the volar side of hands and forearms (error rate = 14%). CONCLUSIONS: The precise surgical evaluations should be considered in patients with penetrating injury to the hand or forearm, especially in those with volar side injuries.

Titanium elastic nailing versus hip spica cast in treatment of femoral-shaft fractures in children.

BACKGROUND: There is no consensus on treatment of closed femoral-shaft fractures in children. We compared hip spica cast with titanium elastic nailing (TEN) in the treatment of femoral-shaft fractures in children. MATERIALS AND METHODS: Forty-six children, 6-12 years old, with simple femoral-shaft fractures were randomized to receive skeletal traction followed by hip spica cast (n = 23) or TEN (n = 23). Length of hospital stay, time to start walking with aids, time to start independent walking, time absent from school, parent satisfaction, and range of knee motion were compared between the two groups 6 months after injury. RESULTS: The two groups were similar in background characteristics. Compared with the children treated with spica cast, those treated with TEN had shorter hospital stay (P < 0.001) and took a shorter time to start walking with support or independently (P < 0.001), returned to school sooner (P < 0.001), and had higher parent satisfaction (P = 0.003). Range of knee motion was 138.7 ± 3.4° in the spica cast group and 133.5 ± 13.4° in the TEN group (P = 0.078). Three patients (13.0%) in the spica cast group compared with none in the TEN group had malunion (P = 0.117). Postoperative infection was observed in three patients (13.0%) in the TEN group. CONCLUSIONS: The results showed significant benefits of TEN compared with traction and hip spica cast in the treatment of femoral-shaft fractures in children. Further trials with longer follow-ups and comparison of TEN with other methods, such as external fixation, in children's femoral fractures are warranted.

Relationship of inferior oblique overaction to muscle bulk and position.

INTRODUCTION: The possible association between inferior oblique muscle overaction and inferior oblique muscle mass has been a matter of speculation. This study was performed to evaluate the anatomical position of the inferior oblique muscle and to determine any association between muscle mass and inferior oblique muscle overaction. METHODS: In this observational case series, eyes undergoing primary surgery for inferior oblique overaction underwent measurement of inferior oblique muscle borders distance from the limbus and muscle belly circumference. RESULTS: Overall, 78 eyes of 51 patients with mean age of 18.3 +/- 12.3 years (range, 1-48) were evaluated. The mean distance of the anterior margin of the inferior oblique muscle from the limbus was 16.3 mm +/- 1.8 mm. The distance for the posterior margin was 20.8 mm +/- 1.9 mm. Average muscle circumference was 10.7 mm +/- 0.9 mm (range, 9 to 13). Inferior oblique muscle overaction and muscle belly circumference were not significantly correlated (p = 0.8). CONCLUSION: There was no detectable correlation of inferior oblique overaction with either muscle position or circumference.

Botulinum toxin injection of the inferior oblique muscle for the treatment of superior oblique muscle palsy.

PURPOSE: To evaluate botulinum toxin injection of the inferior oblique muscle for management of superior oblique (SO) paresis. METHODS: We undertook a prospective case series of injections of the ipsilateral inferior oblique (IO) muscle with 10-20 units of botulinum toxin type A in patients with a SO muscle palsy/paresis of less than 2 years' duration. RESULTS: We enrolled 16 patients (18 eyes) with a mean age of 33.7 years. The median time from onset of symptoms until injection was 6 months. The cause of paresis was trauma for 81% of the patients. The mean hypertropia decreased from 6.4(Delta) to 1.9(Delta) at 6 months after treatment. Other clinical measures improved: mean IO overaction from + 1.7 to + 0.6, mean SO underaction from -1.5 to -0.4, mean subjective torsion from 9.3 degrees to 0.4 degrees , and mean head tilt from 8.4 degrees to 1.1 degrees. CONCLUSIONS: Botulinum toxin injection to IO muscle reduces the symptoms of SO paresis while patients are waiting for recovery.