Background: and Purpose: Green nanotechnology is an interesting method for the synthesis of functional nanoparticles. Because of their wide application, they have set up great attention in recent years. Objective: The present research examines the green synthesis of Ag and zero-valent iron nanoparticles (AgNPs, ZVINPs) by Feijoa sellowiana fruit extract. In this synthesis, no stabilizers or surfactants were applied. Methods: Eco-friendly synthesis of Iron and biogenic synthesis of Ag nanoparticles were accomplished by controlling critical parameters such as concentration, incubation period and temperature. Scanning Electron Microscopy (SEM), Transmission Electron Microscope (TEM), Energy-Dispersive X-ray Spectroscopy (EDS), Fourier-Transform Infrared (FT-IR) spectroscopy, X-ray Diffraction analysis (XRD), Dynamic Light Scattering (DLS) and UV-Vis were applied to characterize NPs. The cytotoxicity of NPs was investigated in two cell lines, MCF-7 (breast cancer) and AGS (human gastric carcinoma). A high-performance liquid chromatography (HPLC) analysis was also performed for characterization of phenolic acids in the extract. Results: Both NPs displayed powerful anticancer activities against two tumor cell lines with little effect on BEAS-2B normal cells. Synthesized AgNPs and ZVINPs inhibited the growth of all selected bacteria. Pseudomonas aeruginosa, Proteus mirabilis, Klebsiella pneumonia, Staphylococcus aureus, Enterococcus faecalis, Acinetobacter baumannii and Escherichia coli have been studied in two stages. We initially examined the ATCCs followed by clinical strain isolation. Based on the results from resistant strains, we showed that nanoparticles were superior to conventional antibiotics. DPPH (diphenyl-1-picrylhydrazyl) free radical scavenging assay and iron chelating activity were used for the determination of antioxidant properties. Results showed a high antioxidant activity of scavenging free radicals for ZVINPs and powerful iron-chelating activity for AgNPs. Based on the HPLC data, catechin was the major phenolic compound in the extract. Conclusion: Our synthesized nanoparticles displayed potent cytotoxic, antibacterial and antioxidant activities.

Symptoms of temporomandibular disorders (TMD) could be present as otologic symptoms like earache and dizziness in some patients. In most cases, these symptoms are not recognized because otolaryngologists fail to diagnose TMD as a source of the problem. This investigation was conducted to evaluate the effect of TMD treatments on the otologic symptoms which after taking history and clinical examinations seemed to be related to TMD. In the present study, the patients who were complaining of otalgia, ear fullness, tinnitus, hearing loss, and dizziness were evaluated by an ear fellow. Forty patients who had no known otologic or other primary causes to explain their symptoms, were referred to the orofacial pain clinic with the possible diagnosis of TMD. If the diagnosis was confirmed by an orofacial pain specialist, a combination of TMD treatments was administered to each case and the patients were followed up. The results showed that following implementation of treatment protocols for TMD, more than 50% of the patients reported complete or partial recovery in the second follow-up (p < 0.05). The most common otologic symptom of the referred cases was earache, and the most common associated complaint was neck pain. All the patients had one or more parafunctional habits. This study showed that TMD treatments were significantly efficient in improving otologic symptoms partially or completely and the authors concluded that for the patients with otolaryngologic unexplained symptoms, an overhaul examination is needed to assess TMD as a possible cause of the patient complaint. It is recommended that in cases with unexplained otologic symptoms, otolaryngologists care more about the neck trigger points (TP) and ask about the patient’s parafunctional habits. Otolaryngologists and dentists need to be aware of the risk of developing otologic symptoms caused by these habits or cervical TPs.

Objectives: This review aimed to compare the effectiveness of three treatments: BTX A, CBZ, and OXB, in managing trigeminal neuralgia (TN).Material and Methods: We conducted a thorough search for research articles related to our issue using specific keywords on several databases, including Cochrane Central Register of Controlled Trials, Science Direct, Scopus, PubMed, Elsevier, Springer Journals, Ovid Medline, EBSCO, and Web of Science. Our focus was on publications from 1965 to 2023.Results: We retrieved 46 articles from the search and reviewed them carefully. Out of these, we selected 29 articles that met the inclusion criteria. Among the selected articles, 11 investigated the effects of CBZ and OXB, while 18 explored the impact of BTX A on the improvement of TN symptoms. The response rate ranged between 56% and 90.5% for CBZ and between 90.9% and 94% for OXB. The response rate for BTX A ranged between 51.4% and 100%. All these three treatments had a remarkable effect on the improvement of TN. Importantly, findings highlighted that side effects of CBZ and OXB could lead to treatment discontinuation in some cases, whereas BTX A's side effects have been minimal and less frequent.Conclusions: Consequently, BTX A emerges as a promising alternative for TN treatment. However, additional clinical trials are necessary to validate this finding, and further research is required to establish a standardized protocol for administering BTX A in TN.

Botulinum toxin type A (BoNT-A) is an established preventive therapy for chronic migraines; however, uncertainty remains regarding its comparative efficacy and safety. Thus, we aimed to summarize current evidence from high-quality systematic reviews of the therapeutic effects of BoNT-A in migraine management. An umbrella review was conducted following PRISMA guidelines and registered in PROSPERO. High-quality systematic reviews with meta-analysis evaluating BoNT-A efficacy were identified through five databases up to August 2024. Primary outcomes included monthly headache frequency and severity. Methodological quality and risk of bias were assessed using the umbrella review checklist. Fourteen articles were included. Overall, quantitative evidence indicated favorable effects of BoNT-A compared with placebo for chronic migraines, across headache frequency, headache severity, and acute medication use, but less efficacy than topiramate and the CGRP monoclonal antibodies (CGRPmAbs) galcanezumab and fremanezumab. Though the adverse events were frequent, BoNT-A was generally well-tolerated. Comparative data suggested superior tolerability versus topiramate and a safety profile like CGRPmAbs. Although botulinum toxin type A is widely used as a preventive treatment for chronic migraines, the available evidence supports its efficacy at a moderate level. Further head-to-head and long-term analyses are needed to clarify its comparative role alongside newer biologic treatments.

Background: Multi-drug resistant (MDR) Citrobacter freundii (C. freundii) as a causative agent of nosocomial infections is a health threat, especially in hospitals. This study was conducted to determine the prevalence of MDR C. freundii, considering isolation sites and a variety of utilized antibiotics. Materials and Methods: In this cross-sectional study, the clinical samples of C. freundii strains were collected and screened using traditional bacteriological tests in Zareh Hospital, Sari City, Iran, during 2016-2017. We used disk diffusion methods to assess the susceptibility patterns of isolates according to the Clinical Laboratory Standard Institute (CLSI) guidelines. Results: Out of 3248 clinical samples, C. freundii strains were detected in 109 samples (32.1% females and 67.9% males). Susceptibility tests indicated that 89 isolates (81.65%) were MDR strains. Frequencies of MDR C. freundii strains were higher in the Behavioral Intensive Care Unit (BICU) (37.61%) and restoration ward (29.35%) compared with other hospital wards. Conclusion: Considering the MDR C. freundii strains detected from burn hospital wards, it is necessary to implement prevention criteria for their eradication from burn hospitals. The results indicate the urgent need to design more practical methods for controlling infection in hospital wards.

Background: Pain frequency is considered an important aspect of pain chronicity, linked to heightened pain and psychosocial distress. In the International Classification of Orofacial Pain (ICOP), temporomandibular disorders (TMD) are classified as frequent (FR, 1–14 days/month) and highly frequent (HF, ≥ 15 days/month), but whether this is clinically relevant is unknown. Objectives: This retrospective study aimed to examine differences in FR and HF TMD patients regarding demographics, diagnostics, characteristic pain intensity (CPI) and disability (GCPS), jaw function (JFLS), psychosocial variables (depression, anxiety, pain catastrophizing (PCS) and somatic symptoms) and oral‐health‐related quality of life (OHIP‐5). Methods: Records of 208 patients with either FR or HF TMD pain (ICOP), were included. All patients had been examined according to the Diagnostic Criteria for TMD (DC/TMD) axis I and axis II. Univariate statistics were used to compare FR and HF TMD, and multivariate statistics to identify variables differentiating HF from FR TMD ( p < 0.05). Results: Arthralgia and degenerative joint disease were more common in HF TMD compared to FR ( p = 0.004 and p = 0.010). HF TMD had higher CPI ( p < 0.001), JFLS ( p < 0.001), PCS ( p < 0.001) and OHIP‐5 ( p < 0.001) scores. Higher CPI, GCPS, PCS, JFLS and OHIP‐5 distinguished HF from FR TMD patients ( p < 0.05). Conclusion: HF TMD patients showed increased pain intensity, disability, catastrophizing jaw functional limitations, and reduced quality of life distinguishing them from FR TMD patients. This study is the first to demonstrate the clinical relevance of the ICOP frequency‐based classification of TMD, highlighting its importance in the risk assessment and management of these patients.