Using a combination of anterograde and retrograde neuronal tract-tracing techniques, the descending projections from the paraventricular nucleus of the hypothalamus (PVN) to the brain/spinal cord and in particular those axonal projections that appear to be contiguous with sympathetic preganglionic neurones (SPN) projecting to the stellate ganglion have been studied. Descending PVN pathways were located by the anterograde transport of biotinylated dextran amine (BDA), whilst SPN were retrogradely labelled with cholera B toxin subunit conjugated to horseradish peroxidase (CB-HRP). BDA-labelled PVN axons terminated in both hypothalamic and extrahypothalamic (including the midbrain, medulla and spinal cord) brain nuclei, with dense terminal labelling observed particularly in the arcuate hypothalamic nucleus and adjacent median eminence, in the solitary tract, vagal nuclei and in the intermediolateral region of the spinal cord (IML). Varicose descending PVN fibres in the IML were often observed to closely appose both the cell soma and dendrites of retrogradely labelled SPN (projecting to the stellate ganglion) in the spinal cord. In addition, it was shown that PVN descending axons crossing to the contralateral side of the spinal cord were closely associated with retrogradely labelled SPN projecting to the superior cervical ganglion. Such findings suggest that descending pathways from the PVN may exhibit a direct influence on cardiac sympathetic outflow and may also influence the behaviour of the contralateral population of SPN projecting to the superior cervical ganglion.

A recent study using transsynaptically transported pseudorabies virus, injected into the adrenal gland, showed labelled neurones in the paraventricular nucleus (PVN) of the hypothalamus, indicating that these neurones send projections to sympathoadrenal preganglionic neurones (SPNs). However, this technique cannot conclusively demonstrate that the pathway is monosynaptic. In order to investigate the possibility of a direct projection from the PVN to SPNs, the present study used the anterograde tracer biotin dextran amine to label paraventricular spinal projections and the retrograde tracer cholera toxin B conjugated to horseradish peroxidase to label SPNs. In addition, because electrophysiological evidence suggests vasopressin to be a neurotransmitter candidate in this pathway, immunocytochemical identification of the peptide and retrograde labelling of SPNs to the adrenal medulla were used to investigate this. The results of these studies show spinally projecting paraventricular axons with terminal varicosities closely associated with SPNs. Therefore some of these associations may represent boutons forming synaptic contact on SPNs. Similarly, vasopressin fibres were found close to the dendrites and soma of SPNs. It is suggested that spinal axons originating from paraventricular neurones can provide a direct influence on adrenal medullary function, that vasopressin is a possible neurotransmitter involved in some of these connections and this is one means by which the paraventricular nucleus can generate a defence to stressful stimuli.

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The prevalence rate of those overweight, as well as obesity among children in Saudi Arabia, keeps rising. The aim of the study was to estimate childhood obesity in the Eastern Province, Saudi Arabia.Over the period 2016 to 2017, a cross-sectional campaign was carried out in the Eastern Province of Saudi Arabia. Data were collected from over 20,000 boys' and girls' schools. The campaign collected data on birthday/age, weight, height, sex, district in which the school is located, level of education, and blood pressure level.The findings from the present study indicated a prevalence of 25.7% for overweight and obesity among high school-age students. More importantly, ≈35% of the study's students have either elevated blood pressure or hypertension. The significant predictors of childhood obesity were education level, age, glucose level, and blood pressure.The children in higher school levels originally from the Eastern Province had a high prevalence of overweight and obesity. Recommendations are made on the need of regular screening program among school-age children, as well as to continue raising awareness about childhood obesity.Abbreviations: BMI = body mass index, IQR = interquartile range.

A body of literature supports the postulation that a persistent lipid metabolic imbalance causes lipotoxicity, “an abnormal fat storage in the peripheral organs”. Hence, lipotoxicity could somewhat explain the process of sarcopenia, an aging-related, gradual, and involuntary decline in skeletal muscle strength and mass associated with several health complications. This review focuses on the recent mechanisms underlying lipotoxicity-related sarcopenia. A vicious cycle occurs between sarcopenia and ectopic fat storage via a complex interplay of mitochondrial dysfunction, pro-inflammatory cytokine production, oxidative stress, collagen deposition, extracellular matrix remodeling, and life habits. The repercussions of lipotoxicity exacerbation of sarcopenia can include increased disability, morbidity, and mortality. This suggests that appropriate lipotoxicity management should be considered the primary target for the prevention and/or treatment of chronic musculoskeletal and other aging-related disorders. Further advanced research is needed to understand the molecular details of lipotoxicity and its consequences for sarcopenia and sarcopenia-related comorbidities.

Background: The deltoid ligament (DL) is a strong triangle-shaped ligament with a complex fascicular arrangement. Understanding the morphological and/or functional typing of the DL structure is hindered by a paucity of clear, quantitative, and reproducible data and is further complicated by inconsistent terminology use. The aim of this work was to describe different components of the DL using strict identification criteria.Methods: Thirty embalmed cadaveric ankles of both sides were dissected on all sides and studied by using gross examination, micro-dissection, and light microscopy by tracing the fascicular pattern of each under 6X magnification.Results: Six ligamentous bands were identified. The tibiotalocalcaneal ligament (TTC) and the superficial posterior tibiotalar ligament (sPTT) were two superficial variants and the anterior tibiotalar ligament (ATT), the anterior tibiotalonavicular ligament (ATTN), the intermediate tibiotalar ligament (ITT), and the deep posterior tibiotalar ligament (dPTT) were four deep variants. The TTC was identified in all 30 embalmed cadaveric specimens. Five additional ligamentous bands (ITT, sPTT, dPTT, ATT, and ATTN) were variable findings in the current cohort.Conclusion: This study presents six ligamentous bands as a regular finding and five additional ligamentous bands as variable findings in the dissected specimen. This data could assist in the radiological diagnosis of DL injuries and advanced procedures related to its surgical repair and reconstruction.

<b>Background: </b>The area of the cubital fossa contains the main superficial veins, including the basilic, cephalic, median cubital, and median antebrachial veins, and their innominate small tributaries. For this reason, it is the area most preferred by medical practitioners to access the circulatory system for various clinical applications.<br /> <b>Objective:</b> The aim of this study was to address the prevalence of different types of antecubital fossa superficial vein patterns observable among Saudi subjects by applying a tourniquet and using a VeinViewer®.<br /> <b>Materials and methods:</b><b> </b>Over the period from September 2020 to April 2021, a cross-sectional study was carried out in the Eastern Province of Saudi Arabia. The 151 study subjects were randomly chosen from the emergency department of King Fahad University Hospital. A total of 302 venous patterns were obtained; 55 were excluded due to the presence of scar tissues over the antecubital fossa, obesity, or thick subcutaneous tissue. Four classes of cubital venous patterns were established according to other studies, and a VeinViewer® and a tourniquet were used to visualize the venous patterns.<br /> <b>Results: </b>Of the 151 people, 21 were female and 130 were male. Among the included 247 venous patterns, the predominant type was type 2 (52.2%), characterized by a branching off the median cubital vein from the cephalic vein and an upward progression to join the basilic vein.<br /> <b>Conclusion: </b>Type 2 appears to be the dominant pattern, with no significant relation to the origins of the parents, in the Saudi population. Gender does not influence the venous patterns. Further studies are needed outside the restrictions of the COVID-19 pandemic to obtain a larger sample.