Severe Cramps Research Articles

P-17 THE HIDDEN CULPRIT: CELIAC DISEASE IN A POSTPARTUM OSTEOPOROSIS PATIENT

Abstract Introduction Pregnancy and lactation-associated osteoporosis is a rare type of osteoporosis that is often accompanied by vertebral fractures. It is considered to be a result of pregnancy-related factors, as well as due to underlying secondary causes. Here we present a case of severe hypocalcemia following parenteral zoledronic acid administration for postpartum osteoporosis, in which further evaluation for secondary causes had not been made and underlying Celiac disease was missed. Clinical Case A 34-year-old female patient had applied to an out-patient clinic with widespread bone pain at third month postpartum. She was diagnosed as postpartum osteoporosis based on examination with the dual X-ray absorptiometry (DXA) scan. Lumbar spine L1-L4 bone mineral density (BMD) and Z-score was found 0.614 g/cm²; and -3.9 respectively. No data was present regarding a fracture. She was referred to our clinic with severe muscle cramps and numbness following administration of Zolendronic acid 5 mg intravenously. The patient denied any chronic diseases, but she noted that she had undergone an intestinal operation due to ileus when she was 22 years old. She had a history of four pregnancies and had breastfed each of her children for at least a year. Family history was insignificant. On physical examination, symptoms of proximal myopathy, Chvostek and Trousseau signs were evident. Laboratory investigation revealed severe hypocalcemia; results of laboratory were as follows: Corrected-Ca: 5.5 mg/dL, P: 1.8 mg/dL, 25-Hydroxyvitamin D: 6.4 g/L, Parathormone (PTH): 1044 pg/mL, and Alkaline phosphatase (ALP): 269 U/L. In addition to parenteral and oral calcium, calcitriol and cholecalciferol treatments were started subsequently. Upon further evaluation for the secondary causes of osteoporosis, Celiac antibodies tested positive, additionally the appearance of the upper gastrointestinal system endoscopy and the biopsy of the second part of the duodenum were found to be compatible with Celiac disease. Thus, the patient's follow-up continued with calcium and vitamin D replacements, as well as dietary adjustments for celiac disease. The patient has been followed up in our clinic for approximately two years, a significant increase in bone density and improvement in biochemical values were detected with the current diet and replacements. DXA scans: 2022: Femoral neck BMD 0.694 g/cm², Z-score -1.5; Lumbar spine L1-L4 BMD: 0.614 g/cm², Z-score: -3.9 2024: Femoral neck BMD 1.080 g/cm², Z-score +1.2 Lumbar spine L1-L4 BMD 1.246 g/cm², Z-score: +0.8 Conclusion In patients presenting with postpartum osteoporosis, secondary causes should be investigated and treatment should be determined according to diagnosis. Bisphosphonate treatment in postpartum osteoporosis can be applied only to a group of individually selected patients and adequate calcium and vitamin D supplementation should be given prior to treatment.Table 1:Laboratory FindingsLaboratory findings during the two-year follow-up of the patient

An electrolyte disturbance masquerading as a panic attack.

Because proton pump inhibitors (PPIs) are so commonly used, their safety and potential adverse reactions often are not considered. This article describes a patient whose paresthesias and severe muscle cramps were attributed to panic attacks but actually were caused by hypocalcemia secondary to PPI-induced hypomagnesemia. This case serves as a reminder that PPIs should be used cautiously and appropriately with consideration for regular monitoring of electrolytes and vitamin B12.

Paraneoplastic limbic encephalitis in a patient with small cell lung cancer. Case report

Paraneoplastic limbic encephalitis (PLE) is a rare autoimmune neurological syndrome caused by selective involvement of the limbic system with the development of neuropsychiatric symptoms and cognitive impairment. PLE is associated with malignancies. We observed PLE in a patient with small cell lung cancer (SCLC). Patient B. complained of severe weakness, headache attacks, irritability, memory loss, and cramps in the muscles of the limbs for 2 months. Contrast-enhanced magnetic resonance imaging of the brain showed signs of PLE. Anti-neuronal antibodies were detected in the blood serum: anti-Hu, anti-CV2 and anti-Ma2, anti-amphiphysin. In the cerebrospinal fluid, anti-Hu antibodies, lymphocytosis of 88%, and increased protein of 0.6 g/L were found. The patient was consulted by a neurologist and diagnosed with PLE. No treatment was administered. After 2 months, the patient reported a significant deterioration. Memory impairment progressed, convulsive seizures with short-term loss of consciousness became more frequent, and the patient became aggressive and withdrawn. Positron emission tomography combined with computed tomography with 18F-fluorodeoxyglucose was performed. There was an excessive radiopharmaceutical uptake in a limited area of the medial parts of the left temporal lobe. A tumor was detected in the upper lobe of the right lung. A bronchoscopy with biopsy was performed. Histological examination showed SCLC. Clinical diagnosis: SCLC of the right lung, stage IIb cT2bN1M0; PLE. Cytotoxic and immunotherapy were administered. The case shows that PLE is a rare neurological syndrome associated in most cases with SCLC, usually in the early stages of the malignancy. Neuropsychiatric and cognitive disorders and seizures are predominant in clinical presentation. PLE neuroimaging is performed using contrast-enhanced magnetic resonance imaging and positron emission tomography combined with computed tomography with 18F-fluorodeoxyglucose, the latter being the method of choice. The presence of antineuronal antibodies in serum and cerebrospinal fluid confirms the autoimmune (paraneoplastic) nature of the process.

9263 Characterization Of A Novel Oral Small Molecule PTH1R Agonist: Proof Of Concept For An Alternative To Injectable Peptide-Based Therapy For Hypoparathyroidism

Abstract Disclosure: J. Zhang: Employee; Self; Septerna Inc.. I. Gomez: None. C. He: Employee; Self; Septerna Inc. J. Wang: Employee; Self; Septerna Inc. X. Du: Employee; Self; Septerna Inc. K. Nguyen: Employee; Self; Septerna Inc. K. Alvarez: Employee; Self; Septerna Inc. A.M. Mirza: Employee; Self; Septerna Inc.. Hypoparathyroidism (HP), a rare endocrine disorder characterized by insufficient levels of parathyroid hormone (PTH), leads to hypocalcemia and hyperphosphatemia. Most HP cases arise due to damage of the parathyroid glands during thyroid or neck surgery. HP symptoms include severe muscle cramps, tingling, burning and numbness, memory loss, and headaches, all leading to a decreased quality of life. Calcium and vitamin D supplementation do not fully ameliorate the disease and may contribute to renal disease. Chronic HP increases the risk of major complications, such as calcium depositions in the brain, eye, and kidneys. Similarly, it can lead to low bone turnover and increased bone mineral density with associated increased bone mineralization. In comparison to standard of care and traditional injectable peptide-based therapies, oral small molecules may have multiple advantages clinically. However, there are no oral small molecules currently in development. PTH functions through activation of the parathyroid hormone 1 receptor (PTH1R), a class B G protein-coupled receptor. The main target tissues for PTH1R activation include bone and kidney. In the kidney, PTH increases tubular reabsorption of calcium and promotes renal excretion of phosphate. In bone, PTH stimulates bone turnover and mobilizes calcium into the circulation to maintain serum calcium. Here we describe the characterization of SP-1462, a novel, potent, and selective oral small molecule, and show that, like the PTH peptides, it acts on PTH1R as an agonist and elicits similar downstream functions in vitro and in vivo. To assess PTH1R engagement in the major targeted organs, kidney and bone, primary human renal proximal epithelial cells (RPTEC) and a human osteoblast cell line (Saos-2) were used, respectively. RPTECs treated with PTH and SP-1462 showed significant changes in transporter genes (SLC22A2 and SLC13A1), immune related genes (CCL2 & DPP4), and matrix reorganization genes (ITGA5 and COL1A1). Saos-2 cells treated with PTH and SP-1462 both significantly affected the expression of Wnt signaling genes (DKK1 and TCF7) and the expression of coupling genes that bridge anabolic/catabolic activities (M-CSF, RANKL, HDAC4, and OPG). Importantly, oral administration of a single dose of SP-1805 in a rat surgical thyroparathyroidectomy (TPTx) model resulted in significant upregulation of serum calcium levels for a period of 24 hours in a dose dependent manner at 3, 10 and 30 mg/kg. The window of calcium upregulation is comparable to injectable PTH peptides currently in development to treat hypoparathyroidism. These data suggest that oral small molecule PTH1R agonists engage PTH pathways similar to native PTH and have the potential to replace injectable PTH peptides to treat PTH-related disorders, including hypoparathyroidism. Presentation: 6/3/2024

6821 Characterization Of A Novel Oral Small Molecule PTH1R Agonist: Proof Of Concept For An Alternative To Injectable Peptide-Based Therapy For Hypoparathyroidism

Abstract Disclosure: J. Zhang: None. I. Gomez: None. C. He: None. J. Wang: None. X. Du: None. K. Nguyen: None. K. Alvarez: None. A.M. Mirza: None. Hypoparathyroidism (HP), a rare endocrine disorder characterized by insufficient levels of parathyroid hormone (PTH), leads to hypocalcemia and hyperphosphatemia. Most HP cases arise due to damage of the parathyroid glands during thyroid or neck surgery. HP symptoms include severe muscle cramps, tingling, burning and numbness, memory loss, and headaches, all leading to a decreased quality of life. Calcium and vitamin D supplementation do not fully ameliorate the disease and may contribute to renal disease. Chronic HP increases the risk of major complications, such as calcium depositions in the brain, eye, and kidneys. Similarly, it can lead to low bone turnover and increased bone mineral density with associated increased bone mineralization. In comparison to standard of care and traditional injectable peptide-based therapies, oral small molecules may have multiple advantages clinically. However, there are no oral small molecules currently in development. PTH functions through activation of the parathyroid hormone 1 receptor (PTH1R), a class B G protein-coupled receptor. The main target tissues for PTH1R activation include bone and kidney. In the kidney, PTH increases tubular reabsorption of calcium and promotes renal excretion of phosphate. In bone, PTH stimulates bone turnover and mobilizes calcium into the circulation to maintain serum calcium. Here we describe the characterization of SP-1462, a novel, potent, and selective oral small molecule, and show that, like the PTH peptides, it acts on PTH1R as an agonist and elicits similar downstream functions in vitro and in vivo. To assess PTH1R engagement in the major targeted organs, kidney and bone, primary human renal proximal epithelial cells (RPTEC) and a human osteoblast cell line (Saos-2) were used, respectively. RPTECs treated with PTH and SP-1462 showed significant changes in transporter genes (SLC22A2 and SLC13A1), immune related genes (CCL2 & DPP4), and matrix reorganization genes (ITGA5 and COL1A1). Saos-2 cells treated with PTH and SP-1462 both significantly affected the expression of Wnt signaling genes (DKK1 and TCF7) and the expression of coupling genes that bridge anabolic/catabolic activities (M-CSF, RANKL, HDAC4, and OPG). Importantly, oral administration of a single dose of SP-1805 in a rat surgical thyroparathyroidectomy (TPTx) model resulted in significant upregulation of serum calcium levels for a period of 24 hours in a dose dependent manner at 3, 10 and 30 mg/kg. The window of calcium upregulation is comparable to injectable PTH peptides currently in development to treat hypoparathyroidism. These data suggest that oral small molecule PTH1R agonists engage PTH pathways similar to native PTH and have the potential to replace injectable PTH peptides to treat PTH-related disorders, including hypoparathyroidism. Presentation: 6/3/2024

Evaluation of Electromagnetic Therapy in the Treatment of Severe Dysmenorrhea in Young Women of Basrah.

Primary dysmenorrhea (PD) is a public disease of young female worldwide, it affects their daily performances. Severe recurrent uterine cramps are the main complaints in 90% of adolescents and 50% of reproductive-age females. This study aimed to evaluate the use of magnetic field therapy in the treatment of severe dysmenorrhea grade 3 and provide an encouraging goal to continue daily work without pain. Two hundred and fifty female patients were recruited in this study from gynecological clinics in Basrah, southern Iraq. All had severe dysmenorrhea, patients were subjected to a questionnaire form, Visual Analog Scale, and verbal multidimensional scoring system to determine the pain intensity and grade of dysmenorrhea. Only 38 young females had severe dysmenorrhea grade 3 with ages ranging from 16 to 28 years with a mean age of 22.04 ± 1.43 years and body mass index 23.81 ± 1.94, patients subjected to electromagnetic field therapy (EMFT), two sessions per week for 20 min each for 6 weeks. Three categories were assessed, working ability, associated symptoms, and drugs used. Data were collected and statistically analyzed using SPSS version 22. The present study showed statistically significant progress (P < 0.05) in reducing pain, rare physical and mental complaints, and improved working ability with no need for drugs in majority of patients. EMFT has better results than other methods in relieving pain and symptoms of dysmenorrhea with a settled lifestyle.

Recurrent Severe Spasmophylia from Hypocalcaemia: A Case Report

Hypocalcemia can present with a variety of clinical symptoms and indications. In situations of nerve-related hypocalcemia, muscle cramps and tetany are signs of increased excitability in either peripheral nerves or the central nervous system. Here, we described the case of a 58-year-old woman experiencing ongoing pain and cramping in both her upper and lower extremities. Through careful physical, neurophysiological, and radiological examinations, we were able to identify hypocalcemia as the primary cause of her severe muscle spasms and cramps, known as spasmophilia. Further detailed history-taking revealed a past total thyroidectomy. Administration of adequate calcium supplementation successfully relieved the symptoms.

Ileo-ileal knot causing acute gangrenous small bowel obstruction: a case report

BackgroundIleo-ileal knotting is a very rare cause of small bowel obstruction, and only a few reports have been published. Small bowel obstruction (SBO) is one of the most common emergency surgical conditions that require urgent evaluation and treatment and is one of the leading causes of emergency surgical admission. There are many causes of SBO that are known in general surgical practice, and these causes are different in the developing and developed worlds.Clinical presentationIn this article, we present a case of acute gangrenous SBO secondary to ileo-ileal knotting in a 37-year-old Ethiopian female patient after she presented with severe abdominal cramp, vomiting, and abdominal distension of 4 hours duration. The patient was operated on intraoperatively; she had gangrenous small bowel obstruction caused by ileo-ileal knotting. Later, the patient was discharged and improved after 12 days of hospital stay.ConclusionIleo-ileal knotting should always be considered in the differential diagnosis of acute small-bowel obstruction. The diagnostic difficulty and the need for urgent treatment of this condition to yield optimal results are discussed.

A178 GASTROINTESTINAL STRICTURES IN A PEDIATRIC PATIENT WITH SATOYOSHI SYNDROME

Abstract Background Satoyoshi syndrome (SS) is a rare, progressive, multisystem disease including muscle spasms, alopecia, skeletal deformities, and diarrhea, with suspected autoimmune etiology. Treatment includes corticosteroids, immunoglobulin therapy, or immunosuppression. Reported endoscopic findings include loss of intestinal folds and nodularity in the stomach and the intestine, with histology showing gastritis cystica polyposa and lymphoplasmacytic infiltrate, as well as fibrosis noted on autopsy reports. To date, no cases of intestinal stricture have been described in SS. Aims To describe an original case of intestinal strictures in SS. Methods Case report and literature review. Results We present a case of a 10-year-old girl with chronic diarrhea and intermittent hematochezia, postprandial abdominal pain, intermittent non-bilious emesis, stunted growth, and weight loss, with acquired alopecia and severe muscle cramps. Examination showed a non-dysmorphic, small child with alopecia totalis and a distended, tender abdomen. Investigations demonstrated an unremarkable endocrine work-up, mild hypoalbuminemia, microcytic anemia, and anti-transglutaminase serology at 3-4x ULN with no improvement on the gluten-free diet. Endoscopy identified a duodenal stricture with a very distended stomach and duodenal bulb, mucosal nodularity and bridging creating a web-like appearance, and edema and friability of the left-sided colon. MR enterography confirmed an isolated duodenal stricture. Pathology displayed patchy fibrosis with crypt/glandular dilatation in the antrum, duodenum, and rectum. Skeletal imaging detected physeal widening and sclerosis with mild slipping of the epiphyses. Auto-immune markers included positive ENA profile for anti-Sm, anti-Sm/RNP, and anti-RNP-A. The patient was treated with corticosteroids in addition to a series of endoscopic dilatations for duodenal stricture with symptomatic benefit, with addition of upadacitinib for alopecia management. Follow-up revealed intermittent worsening of symptoms with steroid taper, necessitating further duodenal dilatations, and evidence of a new anal stricture. The patient remains on corticosteroid therapy with ongoing surveillance. Conclusions This case identifies the first report of intestinal strictures in SS, which may suggest that in addition to suspected autoimmune pathogenesis, disorders of fibrogenesis may need to be considered. Funding Agencies None

A Study to Compare the Effectiveness of Structured Aerobic Exercises and Core Strengthening Exercises in Women with Primary Dysmenorrhea

Background: Dysmenorrhea is a menstrual abnormality which results in severe cramps in the lower back, abdomen,and the legs even in the presence of no pathology of the pelvis. Thus, an early diagnosis and management isnecessary to prevent discomfort.Purpose: To study the effectiveness of structured aerobic exercises and core strengthening exercises in women with primarydysmenorrhea.Materials and Methods: A total of 74 volunteers who gave their consent were divided into two groups, and allwere given a thorough explanation of the procedures. One group was given structured aerobic exercises thatincluded stretching, warmup, cool down and aerobics for 45 mins/Day for 4 days a week and the other group wasgiven core strengthening exercises for the same duration. Pre and post intervention assessment was done usingWaLIDD. Study period : September 2022-May 2023.Result: The data was statistically examined using paired and unpaired t test. The calculated “t” values for thegroups were 15.5710 and 18.8766 respectively and p value was &lt;0.0001 for both the groups indicating the result issignificant Group A showed a better result compared to Group B.Conclusion: The study concludes that structured aerobic exercise proves to be more effective for better and quickerrecovery from primary dysmenorrhea.

Histopathological and Immunohistochemical Analysis of Ruptured Tubal Ectopic Pregnancy

Ectopic Pregnancy (EP) is reported to be causative of high incidence of maternal death and morbidity. It must be diagnosed during the first trimester immediately after symptoms of severe bleeding, abdominal pain, and cramping. Ultrasonography is the only possible detection method to confirm EP. Patients are at greater risk of EP due to inefficient early detection methods. An early detection of the EP based on cellular markers would possibly improve the diagnosis and clinical management. Therefore, an attempt was made to study the histoarchitecture of, and to identify the biomarkers in, the fallopian tube during rupture of ectopic pregnancy. Histological analysis revealed the formation of hematosalpinx and hydrosalpinx in the fallopian tube. Further, immunohistochemical study of the fallopian tissue of EP patients showed remarkable evidence of protein markers such as Bcl2 and desmin which may be considered as potential cellular markers for the detection of EP.

The Antigen-Processing Pathway via Major Histocompatibility Complex I as a New Perspective in the Diagnosis and Treatment of Endometriosis.

Endometriosis is a debilitating gynecological disease defined as the presence of endometrium-like epithelium and/or stroma outside the uterine cavity. The most commonly affected sites are the pelvic peritoneum, ovaries, uterosacral ligaments, and the rectovaginal septum. The aberrant tissue responds to hormonal stimulation, undergoing cyclical growth and shedding similar to appropriately located endometrial tissue in the uterus. Common symptoms of endometriosis are painful periods and ovulation, severe pelvic cramping, heavy bleeding, pain during sex, urination and bowel pain, bleeding, and pain between periods. Numerous theories have been proposed to explain the pathogenesis of endometriosis. Sampson's theory of retrograde menstruation is considered to be the most accepted. This theory assumes that endometriosis occurs due to the retrograde flow of endometrial cells through the fallopian tubes during menstruation. However, it has been shown that this process takes place in 90% of women, while endometriosis is diagnosed in only 10% of them. This means that there must be a mechanism that blocks the immune system from removing endometrial cells and interferes with its function, leading to implantation of the ectopic endometrium and the formation of lesions. In this review, we consider the contribution of components of the Major Histocompatibility Complex (MHC)-I-mediated antigen-processing pathway, such as the ERAP, TAP, LMP, LNPEP, and tapasin, to the susceptibility, onset, and severity of endometriosis. These elements can induce significant changes in MHC-I-bound peptidomes that may influence the response of immune cells to ectopic endometrial cells.

Insidious and lethal course of duodenal perforation in crohn’s disease with retroperitoneal abscess formation and right kidney necrosis

A 60-year-old woman with a long history of Crohn‘s disease and rheumatoid arthritis was admitted to the emergency department due to progressive severe cramping with abdominal pain (right upper quadrant), subfebrile temperature, and obstipation since 3 weeks. She had been treated by her rheumatologist for rheumatoid arthritis with certolizumab pegol, prednisolone and leflunomide

The Effect of Valerian Root Extract on Reducing Dysmenorrhea Pain Levels and Endorphin Hormone Levels in Women of Childbearing Age

Dysmenorrhea is pain in the stomach that interferes with activities. The incidence of dysmenorrhea is 64.25% of the total number of fertile women. Dysmenorrhea causes complaints of weakness, to anxiety due to severe cramps. Dysmenorrhea treatment can be carried out non-pharmacologically with valerian root extract which can have a relaxing effect on the central nervous system, reduce stress and anxiety, and improve sleep quality. This study aimed to analyze the effect of valerian root extract on dysmenorrhea pain levels and endorphins levels in women of childbearing age. This study used an experimental design with a pretest posttest randomized control group design. Sampling using simple sampling technique was divided into 2 groups to measure the intensity of menstrual pain. The intervention group 18 people were given valerian root extract and the control group 18 people were given standard drugs for the treatment of dysmenorrhea. Giving valerian root extract 100 mg was effective in reducing the level of dysmenorrhea pain, p&lt;0.05. Endorphin levels in the intervention group differed from the control group by, p &lt;0.05. Giving valerian root extract is effective in reducing dysmenorrhea pain and increasing endorphins in women of childbearing age.

Voltage-Gated Potassium Channels (VGKC) Complex-Associated Disorders: Anti-LGI1 Encephalitis and Anti-Caspr2 Encephalitis

Autoantibodies against LGI1 and Caspr2 complexed with voltage-gated potassium channels (VGKC) cause limbic encephalitis. Anti-LGI1 encephalitis progresses in a subacute course with memory impairment, disorientation, and focal epileptic seizures. Anti-LGI1 encephalitis is preceded by faciobrachial dystonic seizures (FBDS), which are specific involuntary movements and frequently complicated by hyponatremia due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Neutralization of LGI1 by anti-LGI1 antibodies reduces AMPA receptors and induces epileptic seizures and memory impairment. Anti-Caspr2 encephalitis (Morvan's syndrome) is associated with limbic symptoms, severe autonomic disorders, muscle cramps and burning extremity pain due to peripheral nerve hyperexcitability. Thymomas and other malignant tumors may be complicated, and search for them is necessary. Anti-Caspr2 antibodies bind to Caspr2 on the surface of afferent cells in the dorsal root ganglion, and internalization of VGKCs causes a decrease in the K+ current, resulting in neuronal hyperexcitation and severe pain. Early immunotherapeutic intervention may improve the prognosis of these diseases, and measuring these autoantibodies should be performed in the presence of specific clinical signs, even with normal cerebrospinal fluid findings.

The Pressure Is Rising: Evaluation and Treatment of Chronic Exertional Compartment Syndrome.

Chronic exertional compartment syndrome is a condition that typically affects athletic/active individuals. Chronic exertional compartment syndrome predominantly affects the lower leg; however, there are cases involving the hand, forearm, foot, and thigh. The signs and symptoms of chronic exertional compartment syndrome are severe pain, tightness, cramping, muscle weakness, and paresthesias during participation in exercise. Dynamic intramuscular compartmental pressure (preexertion and postexertion) is the standard diagnostic test. Although other imaging modalities, such as radiography, ultrasound, and magnetic resonance imaging are typically incorporated to rule out other pathologies. In addition, these modalities are being utilized to limit invasiveness of the diagnostic experience. Initial care commonly involves conservative treatment, such as physical therapy, modifications of patient's exercise technique, foot orthoses, and various procedures over a period of 3 to 6 months. Recalcitrant cases may be referred for surgical intervention (fasciotomy), which has inconclusive head-to-head data with conservative management with regard to return to prior sport and specific activity level.

A study of mononuclear 3d transition metal bis-Schiff base complexes: Synthesis, characterization, and evaluation of their antibacterial activity

&lt;p&gt;In this study, we have outlined a conventional and user-friendly procedure for the production of &lt;em&gt;(E)-1-(((5-ethyl-1,3,4-thiadiazol-2-yl)imino)methyl)naphthalen-2-ol &lt;/em&gt;&lt;em&gt;(HL-1)&lt;/em&gt; and &lt;em&gt;(E)-1-((thiazol-2-ylimino)methyl)-naphthalen-2-ol&lt;/em&gt; (HL-2) by the reaction of heterocyclic amine, aldehyde in the presence of ethanol as a solvent and acid as the catalyst. The synthesis of new HL-1 and HL-2 may be accomplished with ease using this approach, which is also very efficient. In the presence of dipositive Co, Ni, and Cu metal complexation, HL-1 and HL-2 were carried out in the presence of metal: ligand (1:2). HL-1, HL-2, and metal complexes are characterized with the assistance of UV/visible, FT-IR, Mass, and &lt;sup&gt;1&lt;/sup&gt;H NMR spectroscopy respectively. Furthermore, the ligands mentioned above (HL-1 and HL-2) and their metal complexes were tested for the antimicrobial study and showed an excellent inhibitory zone. These investigations indicated that HL1&lt;strong&gt;-&lt;/strong&gt;Co (II), HL-1Cu (II), complexes and ligands HL-2Co (II), and HL-1Ni(II) had positive effects on &lt;em&gt;Escherichia coli&lt;/em&gt; causing severe stomach cramps (Gram-negative- MTCC 1610) and positive impact on &lt;em&gt;Staphylococcus aureus&lt;/em&gt; (Gram-positive MTCC&lt;strong&gt;-&lt;/strong&gt;96) due to skin infections.&lt;/p&gt;

A Survey of the Menstrual Status of Female College Students.

Education about menstruation is a sensitive topic for young female students; providing appropriate knowledge is essential for maintaining and improving their health. The present study was conducted to collect data corresponding to different factors affecting health among young individuals; the menstrual status, exercise habits, sleep status, and body composition of these individuals as well as the relationships among these factors, were evaluated. Altogether, 200 female students responded to the survey; 129 completed all the physical measurement items. As a case study, face-to-face interviews regarding menstrual symptoms were conducted. Results showed that 49/200 (25%) and 120/200 (60%) participants experienced moderate or severe pain before and during menstruation, respectively. The degree of pain one week before menstruation and during menstruation were significantly positively correlated (r = 0.573, p < 0.01). When analyzed as group data, it was difficult to identify the relationship between menstrual status, exercise habits, and sleep status; these were found to be intricately associated with various factors. The case study analysis confirmed that some individuals experienced physical and psychological symptoms, such as irregular menstrual cycles, premenstrual syndrome, and severe menstrual cramps.

Recurrent Lower Abdominal Pain, Altered Bowel Habits, and Malaise: Conservative or Surgical Approach to a Common Disorder

Recurrent Lower Abdominal Pain, Altered Bowel Habits, and Malaise: Conservative or Surgical Approach to a Common Disorder

Muscles Cramp And Sleep Disturbances Among Hemodialysis Patients

Muscle cramps are often experienced by the patients on hemodialysis that result in discomfort, shortened treatment times, and inadequate dialysis dose.&#x0D; Up to 50% people with chronic renal failure undergoing dialysis suffer from muscle cramps, especially involving the lower limbs. The cramps can happen during dialysis or at home. The cramps in this type of patient are linked to depression, a decline in quality of life, and sleep disorders. The etiology of cramps in hemodialysis patients is not clear.&#x0D; Muscle Cramping of the hands, feet, and legs is fairly common among patients on hemodialysis. Muscle Cramps are also associated with low bloodpressure. However, some Muscle cramping continues even after a normal bloodpressure. When patients are below dry weight, they also experience muscle cramps. The severe muscle cramps are experienced near the end of the dialysis and persisting for a time after dialysis is often due to dehydration. (1)&#x0D; The most frequent sleep disorders seen in patients on dialysis are conditioned insomnia, excessive daytime sleepiness, obstructive or central sleep apnea, as well as restless legs syndrome (RLS) and periodic limb movement disorder. Many uremic and non-uremic factors are thought to participate in the pathogenesis of sleep disorders in these patients. The treatment of sleeping disorders includes non-pharmacological and pharmacological measures that can improve the functionality and quality of life in patients on dialysis. (2)