Traumatic Spinal Cord Research Articles

Myelin Imaging of the Spinal Cord in Animal Models and Patients with Multiple Sclerosis Using [11C]MeDAS PET: A Translational Study.

Multiple sclerosis (MS) is a neurodegenerative disease characterized by demyelinated lesions in the brain and spinal cord. A few clinical studies using PET to image myelin in the brain have been performed, but none investigated the spinal cord. Because clinically relevant motor symptoms are primarily due to spinal cord damage, this translational study evaluated [11C]N-methyl-4,4'-diaminostilbene (MeDAS) as a PET tracer for myelin imaging in the rat and human spinal cord. Methods: [11C]MeDAS PET of the spinal cord was conducted in experimental autoimmune encephalomyelitis, lysophosphatidylcholine, and spinal cord injury animal models of focal demyelination. Then, 6 healthy controls and 11 MS patients were subjected to MRI and [11C]MeDAS PET of the spinal cord between C5 and T6 vertebrae. Regions of interest covering 100%, 60%, and 40% of the diameter of the spinal canal were drawn, and tracer uptake was normalized to the activity in the blood pool, muscle, or injected dose per unit of body weight (SUV). Results: [11C]MeDAS uptake was significantly reduced in spinal cord lesions in all animal models. In humans, tracer uptake was significantly higher in the cervical than the thoracic spinal cord, which corresponds well with the known physiologic rostral-caudal gradient in myelin density. MS patients had significantly lower [11C]MeDAS uptake in the upper spinal cord (C5-T3) than did controls. The [11C]MeDAS PET signal was inversely correlated with the presence of MS lesions in specific sections of the spinal cord. The best differentiation among regions with different myelin density was obtained when the smallest region of interest was used and spinal cord uptake was expressed as SUV. Conclusion: [11C]MeDAS PET shows the potential to quantify myelin density in the spinal cord. It enables detection of physiologic differences in myelin density between spinal cord segments and between MS patients and healthy controls, which warrants further evaluation of this technique.

Neuroprotective Effects of Chaperonin Containing TCP1 Subunit 2 (CCT2) on Motor Neurons Following Oxidative or Ischemic Stress.

Chaperonin containing TCP1 (CCT) is an essential protein that controls proteostasis following spinal cord damage. In particular, CCT2 plays an important role in neuronal death in various neurological disorders; however, few studies have investigated the effects of CCT2 on ischemic damage in the spinal cord. In the present study, we synthesized a cell-permeable Tat-CCT2 fusion protein and observed its effects on H2O2-induced oxidative damage in NSC34 motoneuron-like cells and in the spinal cord after ischemic injury. Tat-CCT2, but not its control protein CCTs, was delivered into NSC34 cells in a concentration- and incubation time-dependent manner, and a clear cytosolic location of the delivered protein was observed. In addition, the delivered protein gradually degraded, and nearly control levels were observed 24h after Tat-CCT2 treatment. Tat-CCT2 treatment significantly ameliorated 200 µM H2O2-induced neuronal damage in NSC34 cells at 8.0 µM protein treatment. Additionally, Tat-CCT2 significantly ameliorated H2O2-induced reactive oxygen species formation and DNA fragmentation. In the rabbit spinal cord, Tat-CCT2 was efficiently delivered into the spinal cord 4h after 0.125mg/kg protein treatment. In addition, treatment with Tat-CCT2 significantly improved the neurological scores based on the Tarlov criteria 24 and 72h after ischemia/reperfusion. Moreover, the number of surviving neurons in the ventral horn of the spinal cord was significantly increased in the Tat-CCT2-treated group 3 and 7 days after ischemia compared to vehicle-treated group. Treatment with Tat-CCT2 alleviated the ischemia-induced oxidative stress and ferroptosis-related factor (malondialdehyde, 8-iso-prostaglandin F2α, and high mobility group box 1) and pro-inflammatory cytokine (interleukin-1β, interleukin-6, and tumor necrosis factor-α) releases in the ventral horn of the spinal cord 8 and 24h after ischemia/reperfusion. In addition, Tat-CCT2 treatment significantly ameliorated ischemia-induced microglial activation in the ventral horn of spinal cord 24h after reperfusion. These results suggest that Tat-CCT2 mitigates ischemia-induced neuronal damage in the spinal cord.

Health-related quality of life in patients treated with en bloc resection for primary tumors of the spine.

Retrospective analysis. The aim of this study is to evaluate the functional outcomes and the health-related quality of life (HRQOL) in patients undergoing en bloc resection of spinal tumor. En bloc resection in the spine is a surgical procedure designed to completely remove a tumor in one piece, with wide margins preserved, in order to reduce the risk of local recurrences. This demanding procedure has been shown to improve local control and survival rate, besides a relatively high morbidity. Between 2016 and 2021, 70 patients underwent en bloc resection surgery for a primary spine tumor and 38 came out to be eligible for this analysis. Eligibility criteria include at least one follow-up visit within a two-year period from surgery and Patient Reported Outcomes evaluation collected prospectively at baseline and at least one follow- up in the range 4-24 months. The outcome variables (EQ5D Numeric Scale and Index, SF36 scores and NRS score) were analyzed with multilevel linear mixed-effects regression. Baseline- (age, gender, localization, histotype, number of levels of resection, previous surgery) and time-dependent covariates (adverse events, spinal cord damage) were included. Beside a slight improvement of all the scores, no significant differences were found between baseline and follow up times for EQ-5D-3L Numeric Scale and Index and for SF-36 Standardized Physical component. SF-36 Standardized Mental component appeared to be significantly better at 12-month FU compared to baseline. Ultimately, age over 50 years old and the occurrence of adverse events emerged to be as the two main factor determining worsening in several HRQOL scores. Pain came out to be significantly reduce at 24-month compared to baseline. The aim of en bloc resection in the treatment of primary spinal tumors is to improve survival rates and reduce local recurrences. Despite its radicality, our preliminary results suggest that patients experience a slight to moderate improvement postoperatively compared to their preoperative perceived health status.

Thoracic spinal cord trauma: an adequate functional outcome with timely surgical management

Thoracic spinal cord trauma: an adequate functional outcome with timely surgical management

Curcumin/pEGCG-encapsulated nanoparticles enhance spinal cord injury recovery by regulating CD74 to alleviate oxidative stress and inflammation

Spinal cord injury (SCI) often accompanies impairment of motor function, yet there is currently no highly effective treatment method specifically for this condition. Oxidative stress and inflammation are pivotal factors contributing to severe neurological deficits after SCI. In this study, a type of curcumin (Cur) nanoparticle (HA-CurNPs) was developed to address this challenge by alleviating oxidative stress and inflammation. Through non-covalent interactions, curcumin (Cur) and poly (-)-epigallocatechin-3-gallate (pEGCG) are co-encapsulated within hyaluronic acid (HA), resulting in nanoparticles termed HA-CurNPs. These nanoparticles gradually release curcumin and pEGCG at the SCI site. The released pEGCG and curcumin not only scavenge reactive oxygen species (ROS) and prevents apoptosis, thereby improving the neuronal microenvironment, but also regulate CD74 to promote microglial polarization toward an M2 phenotype, and inhibits M1 polarization, thereby suppressing the inflammatory response and fostering neuronal regeneration. Moreover, in vivo experiments on SCI mice demonstrate that HA-CurNPs effectively protect neuronal cells and myelin, reduce glial scar formation, thereby facilitating the repair of damaged spinal cord tissues, restoring electrical signaling at the injury site, and improving motor functions. Overall, this study demonstrates that HA-CurNPs significantly reduce oxidative stress and inflammation following SCI, markedly improving motor function in SCI mice. This provides a promising therapeutic approach for the treatment of SCI.

Alterations in Endogenous Stem Cell Populations in the Acute Phase of Blast-Induced Spinal Cord Injury.

Blast-induced spinal cord injury (bSCI) is prevalent among military populations and frequently leads to irreversible spinal cord tissue damage that manifests as sensorimotor and autonomic nervous system dysfunction. Clinical recovery from bSCI has been proven to be multifactorial, as it is heavily dependent on the function of numerous cell populations in the tissue environment, as well as extensive ongoing inflammatory processes. This varied recovery process is thought to be due to irreversible spinal cord damage after 72 hours post-injury. Stem cell therapy for spinal cord injuries has long been investigated due to these cells' proliferative nature, ability to enhance neuro-regeneration, neuroprotection, remyelination of axons, and modulation of the immune and inflammatory responses. Therefore, this study hypothesizes that the impaired function after injury is due to a lack of specific ectoderm and neural stem cell population activity at the injury site. This study aimed to elucidate changes in endogenous stem cell patterns by evaluating immunohistochemical staining densities of various stem cell markers using a preclinical thoracolumbar bSCI model. Analysis was performed 24-, 48-, and 72 hours following blast exposure. Behavior tests to assess sensory and mechanical functions were also performed. The following Cluster of differentiation (CD) markers CD105, CD45, CD133, and Vimentin, Nanog homebox (NANOG), and sex determining region Y HMG-box 2 (SOX2) positive cell populations were significantly elevated with trending increases in Octamer-binding transcription factor 4 (OCT4) in the thoracolumbar region of spinal cord tissue at 72 hours following bSCI (p < 0.05). Behavior analyses showed significant decreases in paw withdrawal thresholds in the hind limbs and changes in locomotion at 48- and 72 hours post-injury (p < 0.05). The significant increase in mesenchymal, pluripotent, and neural stem cell populations within the thoracolumbar region post-injury suggests that migratory patterns of stem cell populations are likely altered in response to bSCI. Behavioral deficits were consistent with those experienced by military personnel, such as increased pain-like behavior, reduced proprioception and coordination, and increased anxiety-like behavior post-bSCI, which underlines the translational capabilities of this model. While further research is vital to understand better the intrinsic and synergistic chemical and mechanical factors driving the migration of stem cells after traumatic injury, increased endogenous stem cell populations at the injury site indicate that stem cell-based treatments in patients suffering from bSCI could prove beneficial.

Comparison of Outcomes of Bell’s Palsy Patients Treated with Steroid and Steroid with Antiviral Drug in a Tertiary Care Hospital

Background: Bell’s palsy is the most common acute mononeuropathy associated with idiopathic unilateral facial weakness, characterized by facial asymmetry. Though steroids have effectiveness in managing Bell’s palsy, the use of antiviral is still debatable. Objective: To compare the outcome of Bell’s palsy with treatment by steroid versus combination of steroid and antiviral drugs. Methodology: A prospective analytical study was performed on 84 patients with acute Bell’s palsy attending at Neurology outpatient department of Mymensingh Medical College Hospital from July 2014 to June 2016. The patients were divided into two groups purposively after initial assessment as per House-Brackmann grading system (HBS). Group-I patients were treated with oral prednisolone and oral valacyclovir and Group-II patients were treated with oral prednisolone only. Both groups received facial exercises as per demonstration and proper eye care throughout the study period. Follow-up was done after 2 weeks, 4 weeks and 3 months for collection of data about recovery according to reassessment. Results: The analysis revealed that recovery rates at all 3 follow-ups were higher in the combination group than that of the prednisolone-only group [29(67.44%) versus 18 (43.90%) at 2nd week follow-up, 35(81.39%) versus 25(60.97%) at 4th week follow up and 40 (93.02%) versus 30(73.17%) at 3rd month follow-up]. Moreover, the expected recovery rate was higher in severe Bell’s palsy patients in the combination group than in steroid-alone group (22, 88.0% complete recovery versus 13, 54.17% complete recovery at the end of 3 months of treatment) [p=0.034]. haemorrhagic shock, spinal cord damage, septic shock and crush syndrome. Conclusion: The study showed antiviral (valacyclovir) plus steroid (prednisolone) to be more effective than steroid (prednisolone) alone in the treatment of Bell’s palsy. Moreover, outcome was more favorable in combination groups presenting with severe disease. Lessen their severity. Journal of Monno Medical College December, 2023; 9 (2):58-62

Forensic Profiling of Road Traffic Accident Victims- A Retrospective Study

Background: Road traffic accidents (RTAs) have become a significant public health problem that requires a multi-disciplinary strategy to solve. Every year, 1.35 million people die because of RTAs. The effects of a traffic accident not only cause the sufferer to suffer physically, emotionally, and financially, but they also have a deadly impact on the way the entire family functions. Objectives: This study's objective was to assess the current RTA situation in Manikganj district, determine the injury pattern, explore the causes and frequency of accidents, and find out the sociodemographic characteristics of the victims. Methodology: This retrospective study was carried out in the Manikganj District hospital, Bangladesh, during the period of January, 2019 to December, 2020. Results: During the study period, there were 381 postmortems performed, of which 83 (21.78%) instances involved RTA. Of the victims, 49(59.04%) were men and 34(40.96%) women. Incidence of RTA (24, 28.91%) was the highest among people aged 21 to 30 years. The most accidents happened during the daytime (32, 38.55%). All victims sustained many abrasions and bruises (83, 100%), laceration was present in 46(55.42%), fractured ribs in 33(39.75%), fractured hipbones in 32(38.55%), skull bones fractured in 16(19.27%), head injury in 26 (31.32%) and intracranial haemorrhages in 26(31.32%) cases. Most victims (59, 71.08%) were pedestrians, followed by passengers and drivers. In 83 instances, head injuries accounted for most fatalities (22, 26.53%), followed by multiple traumas, haemorrhagic shock, spinal cord damage, septic shock and crush syndrome. Conclusion: Strict adherence to traffic laws, public awareness campaigns, and adequate driver training all reduce the likelihood of road accidents and lessen their severity. Journal of Monno Medical College December, 2023; 9 (2):53-57

Role of Amniotic Fluid Toxicity in the Pathophysiology of Myelomeningocele: A Narrative Literature Review.

Myelomeningocele is a birth defect whose clinical manifestations are due both to incomplete neural tube closure and the progressive destruction of exposed neuroepithelium during pregnancy. Two hypotheses have been formulated to explain the spinal cord damage in utero: mechanical trauma and chemical factors. The objective of this review was to summarize the current insights about the potential role of amniotic fluid in spinal cord damage in myelomeningocele. Numerous histological and clinical data on animals and humans strongly suggest a progressive degeneration of neural tissue including loss of neural cells, astrogliosis, inflammation, and loss of normal architecture. However, few data have been published about the direct toxicity of amniotic fluid in this neural degeneration, including the potentially toxic effect of meconium. Finally, the chemical and cellular modifications of amniotic fluid composition in myelomeningocele could reflect both the process (toxic effect of meconium) and the consequences of neuroepithelium destruction (release of neural cells). Fetal surgery not only stops the leakage of the cerebrospinal fluid but also reduces the toxic effect of amniotic fluid by restoring the intrauterine environment. Identification of amniotic fluid neurotoxic factors could lead to the development of therapeutic agents designed to protect spinal tissue and improve fetal myelomeningocele outcomes.

7635 Severe Osteoporosis in a Patient with Heterotopic Calcification: A Case Report

Abstract Disclosure: D. Salih Bacha: None. L.Z. Khan: None. Background: While osteoporosis and heterotopic ossification (HO) are distinct conditions affecting bone health, their coexistence poses intriguing clinical challenges. Osteoporosis, characterized by increased bone fragility, typically results from various factors such as aging, steroid use, or malabsorption. HO is a condition where bone forms abnormally in soft tissues. Risk factors that predispose to HO include male sex, spinal cord injury, trauma, surgery, and genetic factors. Treatment of HO is typically surgical resection and NSAIDs. Initial evidence supported the use of bisphosphonates for preventing ectopic bone formation post-trauma, but recent data failed to show significant benefit in HO prevention. This case presents a patient with unique challenges of both HO and bone fragility with multiple severe vertebral fractures. Case: A 44-year-old male patient had a major motor vehicle accident necessitating multiple recurrent abdominal surgeries. During one exploratory laparotomy, diffuse mesenteric calcifications were noted, indicative of HO. A baseline Dual X-ray Absorptiometry (DXA) scan revealed bone density of 1.003 g/cm2 and 0.788 g/cm2 at the spine and femoral neck, respectively, concerning for osteopenia. He was started on zoledronic acid in preparation for upcoming intestinal transplant. Few months after the transplant, he was started on daily tacrolimus and hydrocortisone for immunosuppression. Within months, he experienced sudden back pain while riding an elevator, and was found to have acute fractures in T8 and T9 vertebrae. A repeat DXA scan showed a further decline in bone density to 0.909 g/cm2 and 0.748 g/cm2 at the spine and femoral neck, respectively. Within a year, additional fractures occurred in the thoracic and lumbar spine (T10, T11, T12, L1, L2, L3, and L4), requiring multiple kyphoplasty interventions. Over time, worsening kyphosis, back pain, and height loss occurred, significantly affecting the patient's quality of life. He continued receiving yearly zoledronic acid infusions and underwent regular DXA scans, which revealed mild improvement in his bone density. Currently, there are no established guidelines specifying the optimal duration for bisphosphonate treatment in such cases. Therefore, our individualized treatment plan involves a tentative 10-year course of bisphosphonate treatment with yearly assessment of bone mineral density. Conclusion: Although the patient had some risk factors for osteoporosis, including daily steroid and tacrolimus use, the severity and frequency of his fractures suggested a potential synergy between osteoporosis and HO, where the formation of heterotopic calcifications may have been exacerbating his bone loss. The coexistence of osteoporosis and HO in this patient underscores the need for individualized care and establishment of treatment guidelines in patients with multiple bone disorders. Presentation: 6/3/2024

Combined intra-extradural approach for posterolateral thoracic disk herniations: how I do it.

Thoracic disc herniation is a rare degenerative spine disease that can cause severe neurological deficits. Nowadays, controversies still stand on the most effective surgical route. Herein, we describe the combined intra-extradural approach for a posterolateral thoracic disk herniation. We divided the technique into four steps: bony, extradural, intradural and intra-extradural. We disclose perioperative shrewdness aimed at improving outcomes and reducing complications. The combined intra-extradural approach represents an effective technique for posterolateral thoracic disk herniations, reducing both the risk of spinal cord damages and post-operative CSF leaks.

Radiological perspective on earthquake trauma: differences in children and adults.

February 2023 saw major earthquakes in Pazarcık and Elbistan, causing significant devastation in Turkey. Patients were transferred to hospitals in neighboring provinces, with multiple traumas-especially fractures and organ injuries-forming the main reasons for hospital admissions. This study aimed to examine earthquake-related injuries in pediatric and adult populations to understand differences. This study analyzed 1,220 adults and 590 pediatric patients with radiological imaging out of 8,704 earthquake trauma cases. Radiological images were assessed independently by two radiologists. Statistical analysis using SPSS examined relationships between variables such as age group and injury type. Results showed 40% of adults and 64% of children had normal radiological findings. Cerebral and extremity traumas were most common in pediatrics, while adults showed more extremity, thoracic, and spinal traumas. Significant differences between adult and pediatric groups were observed in cranial fractures, thoracic and lumbar vertebral fractures, hemopneumothorax, lung contusions, rib fractures, femur and talocalcaneal fractures, and compartment syndrome (p<0.001). Earthquake-related injuries may vary between children and adults. Due to children's more flexible anatomical structure, it is believed that earthquake-related injuries occur less frequently in children. In this study, head traumas were more common in children compared to adults. The rate of cranial fractures was significantly higher in children, with a higher incidence of epidural hematoma compared to adults. Spinal traumas were more frequent in adults than in children, attributed to children's greater flexibility reducing the risk of entrapment under rubble. Pediatric thoracic compliance being significantly higher than in adults often resulted in milder chest traumas. However, compartment syndrome was more common in children, with a lower rate of accompanying bone fractures compared to adults. No significant difference was observed between children and adults in maxillofacial, abdominal, and pelvic traumas. These findings provide insights for future disaster healthcare planning and management.

Cervical ossification of the posterior longitudinal ligament revealed by cervical trauma: A case report with literature review

Background: Ossification of the posterior longitudinal ligament (OPLL) refers to bone formation within the posterior longitudinal ligament of the spinal column. This disease of the cervical spine results in a reduced volume of the spinal canal and can cause spinal cord damage. The onset of cervical OPLL is insidious. OPLL may increase the risk of spinal cord injury with various neurological deficits after minor trauma. An acute event can reveal a previously unknown or paucysymptomatic cervical OLLP. The aim: To present a case of unknown cervical OLLP revealed by cervical trauma after a traffic road accident. Case report: A 47-year-old female presented intractable cervicobrachial neuralgia in the posttraumatic aftermath of a traffic road accident. Computed Tomography (CT) and Magnetic resonance imaging (MRI) demonstrated an isolated OPLL from C5 to C6, causing significant nerve compression operated via anterior approach with discectomy and intervertebral cervical cage. Conclusion: Acute cervical trauma must be considered a mode of revelation of previously unknown or paucisymptomatic cervical OLLP and must be considered in the emergency room.

Preventive Effects of Gonadotropin-Releasing Hormone Treatment on Urinary Bladder and Kidney Damage in Spinal Cord Injured Rats.

One of the main causes of a neurogenic bladder is spinal cord injury (SCI),(SCI), which induces little or no bladder reflex activity. Because of this alteration, there is an increased risk of developing urinary tract infections and kidney damage. Gonadotropin-releasing hormone (GnRH) treatment has been shown to improve micturition in a rat model of SCI. The present study was aimed at determining whether GnRH administration is capable to reduce bladder and kidney damage in rats with SCI. Ovariectomized female Wistar rats were divided into three groups: sham, SCI with saline solution (SCI), and SCI treated with GnRH (SCI+GnRH) for 6 weeks. SCI was induced by compression at the T10 spinal level. At the end of the experiment, bladders and kidneys were processed for morphological and immunofluorescence analysis. For morphometric analysis, the thickness of the urothelium and the muscular layer of the bladder was measured, as well as the intensity of staining related to collagen in the kidney. At the end of the experiment, all animals in the sham group showed normal urination (100%), in contrast, the percentage of untreated injured rats (SCI) that did not require manual stimulation for micturition was 19%, while the treated group (SCI+GnRH) was 68%. A significative increase in bladder weight, urothelial and muscle thickness, and collagen-related coloration in the kidney was observed in SCI when compared to sham rats. GnRH administration decreased damage to the urinary bladder and kidneys after SCI in rats. These results suggest that this hormone could be a potential preventive treatment for SCI patients at risk of neurogenic bladder and kidney damage. Not applicable.

An oil-in-gel type of organohydrogel loaded with methylprednisolone for the treatment of secondary injuries following spinal cord traumas

The secondary injuries following traumatic spinal cord injury (SCI) is a multiphasic and complex process that is difficult to treat. Although methylprednisolone (MP) is the only available pharmacological regime for SCI treatment, its efficacy remains controversial due to its very narrow therapeutic time window and safety concerns associated with high dosage. In this study, we have developed an oil-in-gel type of organohydrogel (OHG) in which the binary oleic-water phases coexist, for the local delivery of MP. This new OHG is fabricated by a glycol chitosan/oxidized hyaluronic acid hydrophilic network that is uniformly embedded with a biocompatible oil phase, and it can be effectively loaded with MP or other hydrophobic compounds. In addition to spatiotemporally control MP release, this biodegradable OHG also provides a brain tissue-mimicking scaffold that can promote tissue regeneration. OHG remarkably decreases the therapeutic dose of MP in animals and extends its treatment course over 21 d, thereby timely manipulating microglia/macrophages and their associated with signaling molecules to restore immune homeostasis, leading to a long-term functional improvement in a complete transection SCI rat model. Thus, this OHG represents a new type of gel for clinical treatment of secondary injuries in SCI.

Design and preparation of hydrogel microspheres for spinal cord injury repair.

A severe disorder known as spinal cord damage causes both motor and sensory impairment in the limbs, significantly reducing the patients' quality of life. After a spinal cord injury, functional recovery and therapy have emerged as critical concerns. Hydrogel microspheres have garnered a lot of interest lately because of their enormous promise in the field of spinal cord injury rehabilitation. The material classification of hydrogel microspheres (natural and synthetic macromolecule polymers) and their synthesis methods are examined in this work. This work also covers the introduction of several kinds of hydrogel microspheres and their use as carriers in the realm of treating spinal cord injuries. Lastly, the study reviews the future prospects for hydrogel microspheres and highlights their limitations and problems. This paper can offer feasible ideas for researchers to advance the application of hydrogel microspheres in the field of spinal cord injury.

Investigation of Prevalence, Etiological Factors and Risk Factors of Urinary Tract Infection in Spinal Cord Injury Patients

Background: Urinary tract infection (UTI) is a common infection that constitutes a significant portion of all hospital infections. Objectives: Given the importance of spinal cord trauma, this study aimed to investigate the prevalence, etiological factors, and risk factors of UTI in spinal cord injury (SCI) patients. Methods: In this study, patients were examined daily. If a diagnosis of UTI was confirmed, based on laboratory results and the attending physician's opinion, they were included in the study. A researcher-made checklist was then completed by the researchers. Results: The results showed that 89 (67.4%) of the patients were male, and 101 (76.5%) were married. Additionally, 44.7% of the patients were hospitalized due to traffic accidents. The results also indicated that 30.3% of patients had hematuria, 35.5% had fever, and 12.9% had scrotal pain or turbid urine. Regarding the microorganisms identified, 55.3% of patients had Escherichia coli, 11.4% had Proteus, 9.1% had Klebsiella, and 7.6% had Candida spp. Conclusions: Given the significant prevalence of UTI in patients, necessary preventive measures should be implemented to prevent infections.

Linarin inhibits microglia activation-mediated neuroinflammation and neuronal apoptosis in mouse spinal cord injury by inhibiting the TLR4/NF-κB pathway

To investigate the mechanism underlying the neuroprotective effect of linarin (LIN) against microglia activation-mediated inflammation and neuronal apoptosis following spinal cord injury (SCI). Fifty C57BL/6J mice (8- 10 weeks old) were randomized to receive sham operation, SCI and linarin treatment at 12.5, 25, and 50 mg/kg following SCI (n=10). Locomotor function recovery of the SCI mice was assessed using the Basso Mouse Scale, inclined plane test, and footprint analysis, and spinal cord tissue damage and myelination were evaluated using HE and LFB staining. Nissl staining, immunofluorescence assay and Western blotting were used to observe surviving anterior horn motor neurons in injured spinal cord tissue. In cultured BV2 cells, the effects of linarin against lipopolysaccharide (LPS)‑induced microglia activation, inflammatory factor release and signaling pathway changes were assessed with immunofluorescence staining, Western blotting, RT-qPCR, and ELISA. In a BV2 and HT22 cell co-culture system, Western blotting was performed to examine the effect of linarin against HT22 cell apoptosis mediated by LPS-induced microglia activation. Linarin treatment significantly improved locomotor function (P < 0.05), reduced spinal cord damage area, increased spinal cord myelination, and increased the number of motor neurons in the anterior horn of the SCI mice (P < 0.05). In both SCI mice and cultured BV2 cells, linarin effectively inhibited glial cell activation and suppressed the release of iNOS, COX-2, TNF-α, IL-6, and IL-1β, resulting also in reduced neuronal apoptosis in SCI mice (P < 0.05). Western blotting suggested that linarin-induced microglial activation inhibition was mediated by inhibition of the TLR4/NF- κB signaling pathway. In the cell co-culture experiments, linarin treatment significantly decreased inflammation-mediated apoptosis of HT22 cells (P < 0.05). The neuroprotective effect of linarin is medicated by inhibition of microglia activation via suppressing the TLR4/NF‑κB signaling pathway, which mitigates neural inflammation and reduce neuronal apoptosis to enhance motor function of the SCI mice.

Study of the availability of home modifications in paraplegics

Background: Paraplegia is loss of motor strength, sensations and bowel bladder function below the level of injury due to spinal cord damage. Spinal cord injury is medically managed along with rehabilitation which includes muscle strengthening, and mobility in a wheelchair with proper training and home modification. The paraplegic population is the most demoted section of our society and is confronted with barriers to accessibility, health facilities, educational opportunities, and skill development. Accessibility is very important for the paraplegic population and lack of accessibility may affect their abilities in self-care and employment so our objective was to find out modifications done in the house of paraplegics, compartmentalize and standardize various modifications done. Methods: The study setting and design was done at tertiary care centre, community setting and observational study. The sample size was 40. Inclusion was of both genders, sub-acute to chronic phase spinal cord injury and wheelchair users was taken. Exclusion was quadriplegics and bedridden patient’s spinal cord injury individual. Results: The statistical analysis was done by using SPSS V 26 software. The mean and standard deviation were calculated. In this study, the mean average modification shows in the ascending order of the entrance and exits (69.5%), followed by the hall (64.30%), bedroom (60%) bathroom (60%) and the kitchen (37.5%). Conclusions: The study concluded that most of the spinal cord injury individuals modify their houses. Entrance, exits and followed by the hall were most modified and the kitchen was the least modified compartment in the house.

Influence of the anatomical level of spinal cord injury on the severity of neurological impairments in spinal cord trauma

Influence of the anatomical level of spinal cord injury on the severity of neurological impairments in spinal cord trauma