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To ensure equitable representation of women and BIPOC (Black, Indigenous, person of colour) individuals in surgical specialties, it is first necessary to understand the presence and extent of the disparities that exist. We explored the websites of the 17 Canadian faculties of medicine to examine sex and racial diversity in surgical specialties and in surgical leadership positions in Canada. We categorized faculty members of each department of surgery as either male or female and White or BIPOC. The relative percentage of female academic surgeons was very low compared with Canadian demographic data, and the relative percentage of BIPOC academic surgeons was similar to Canadian demographic data. Our observations suggest that actions must be taken to improve diversity and inclusion in surgery., Competing Interests: Competing interests: S. Turner has participated on an advisory board for AstraZeneca and has receive honoraria from AstraZeneca for lectures, presentations, manuscript writing or educational events. No other competing interests were declared., (© 2023 CMA Impact Inc. or its licensors.)

Background: In 1986, Surgical Critical Care (SCC) was formally recognized as a specialty by the American Board of Surgery (ABS), however it took another two decades to develop a formal national training structure in SCC. In 2003, the program directors of SCC fellowships began to meet and the Surgical Critical Care Program Directors Society (SCCPDS) was officially formed in 2004, with recognition of the SCCPDS as a non-profit organization in 2008. Over the next several years, and in conjunction with other interested groups, such as the American Association for the Surgery of Trauma (AAST) and the Society of Critical Care Medicine (SCCM), SCCPDS created a formal curriculum, developed a unified system for the fellowship application process, and increased recruitment and match such that now approximately 1 in 6 general surgery graduates are pursuing training in SCC. In discussion with past and present leadership of SCCPDS, there are several ongoing initiatives to further improve the educational opportunities of the fellows and increase inclusion of other organizations and other specialties interested in SCC. The purpose of this article is to discuss the role of SCCPDS in the development and evolution of SCC and Acute Care Surgery (ACS) training., Level of Evidence: Expert Opinion; Level V., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

This study was carried out to determine the level of support towards the proposed National Health Insurance scheme among Malaysian patients attending specialist clinics at the National University of Malaysia Medical centre and its influencing factors. The cross sectional study was carried out from July-October 2012. 260 patients were selected using multistage sampling method. 71.2% of respondents supported the proposed National Health insurance scheme. 61.4% of respondents are willing to pay up to RM240 per year to join the National Health Insurance and 76.6% of respondents are of the view that enrollment in NHI should be made compulsory. Knowledge had a positive influence on respondent's support towards National Health Insurance. National Health Insurance when implemented in Malaysia can be used to raise funds for health care financing, increase access to health services and achieve the desired health status. More efforts should be taken to promote the scheme and educate the public in order to achieve higher support towards the proposed National Health Insurance. The cost to enroll in NHI as well as services to be included under the scheme should be duly considered.

Objective: To determine the association of age and parity with gestational hypertension. Study Design: Case-control study. Place and Duration of Study: Department of Gynaecology and Obstetrics, Combined Military Hospital, Sibi Pakistan, from Oct 2020 to Sep 2021. Methodology: A total of two hundred and sixty-eight (n=268) patients (134 controls and 134 cases) were included in this study. Data about age, parity, economic status and education status was recorded. Two consecutive readings of blood pressure were recorded in sitting position, 4 hours apart, and the second reading was entered on the proforma. Results: Mean age of the patients was 28.10±5.61 years and 28.99±6.29 years in cases and controls, respectively. Mean gestational age was 38.46±1.02 weeks in cases and 38.04±1.00 weeks in controls. In cases, primigravida were 88(65.7%) and multigravida were 46(34.3%) and in controls 58(43.3%) were primigravida and 46(56.7%) were multigravida. Odds ratio was 2.50(95% CI: 1.53-4.10), p value was

Abstract The continual use of synthetic insecticides to control mosquito larvae has severe implications for human health and the ecosystem, highlighting the need for alternative natural insecticides. Macroalgae may be a good alternative because of their biologically active metabolites with distinctive chemical structures that have been reported for their insecticidal properties. The study aimed to investigate the potential of different extracts from Jania rubens (Linnaeus) J.V.Lamouroux and Colpomenia sinuosa (Mertens ex Roth) Derbès & Solier as genotoxic and larvicidal agents against Culex pipiens Linnaeus larvae. The algae thallus was subjected to extraction using methanol, acetone, and methylene chloride. The phytochemical composition was quantified. The larvicidal activity of the different algae extracts was assessed against the third instar larvae of Culex pipiens. Genotoxic evaluation through comet assays and compound characterization by GC/MS was done. The results demonstrated that J. rubens methylene chloride extract exhibited the highest contents of phenolics, alkaloids, flavonoids, terpenoids, and tannins while C. sinuosa methanol extract demonstrated the highest levels of flavonoids, alkaloids, phenolics, and saponins. The larvicidal activity results revealed that J. rubens methylene chloride extract was the most toxic for C. pipiens larvae with LC50 = 9.30 ppm followed by C. sinuosa acetone extract with LC50 = 82.58 ppm after 72 h of exposure. At 50 and 250 ppm, J. rubens methylene chloride and C. sinuosa acetone extracts maintained 100 and 93.33% larval mortality rates, respectively. Comet assay results demonstrated the genotoxicity of both algae extracts in C. pipiens larvae. This study would be a beginning towards replacing chemical insecticides with algae-based bioinsecticides against C. pipiens mosquitos.

Abstract Background Maternal stress during pregnancy may impact offspring development via changes in the intrauterine environment. However, genetic and environmental factors shared between mothers and children might skew our understanding of this pathway. This study assesses whether prenatal maternal stress has causal links to offspring outcomes: birthweight, gestational age, or emotional and behavioral difficulties, triangulating across methods that account for various measured and unmeasured confounders. Methods We used data from the Norwegian Mother, Father, and Child Cohort Study (MoBa), including maternal reports on prenatal stress at work, at home, and via stressful life events as exposures. Outcomes were children’s birthweight and gestational age, from the Medical Birth Registry of Norway, and maternal reports on early offspring emotional and behavioral difficulties. We assessed associations using four approaches: sibling control analyses, gene-environment interaction analyses, intergenerational Mendelian randomization (MR), and negative control (i.e., postnatal stress) analyses. Results Maternal prenatal stress was observationally associated with offspring lower birthweight (e.g., βwork = − 0.01 [95%CI: − 0.02, − 0.01]), earlier birth (e.g., βwork = − 0.04 [95%CI: − 0.04, − 0.03])), and more emotional (e.g., βevents = 0.08 [95%CI: 0.07, 0.09]) and behavioral difficulties (e.g., βrelationship = 0.08 [95%CI: 0.07, 0.09]) in the full sample (N = 112,784). However, sibling control analyses (N = 36,511) revealed substantial attenuation of all associations after accounting for familial factors. Gene-environment interaction models (N = 76,288) showed no clear evidence of moderation of associations by mothers’ polygenic scores for traits linked to stress sensitivity. Intergenerational MR analyses (N = 29,288) showed no clear evidence of causal effects of maternal plasma cortisol on any offspring outcomes. Negative control exposure analyses revealed similar effect sizes whether exposures were measured prenatally or postnatally. Conclusions Our results indicate that links between prenatal maternal stress and variation in early offspring outcomes are more likely to be confounded than causal. While no observational study can rule out causality, the consistency of our findings across different approaches is striking. Other sources of prenatal stress or more extreme levels may represent intrauterine causal risk factors for offspring development. Nonetheless, our research contributes to identifying boundary conditions of the fetal programming and developmental origins of health and disease hypotheses, which may not be as universal as sometimes assumed.

Abstract Background Reflection fosters self-regulated learning by enabling learners to critically evaluate their performance, identify gaps, and make plans to improve. Feedback, in turn, provides external insights that complement reflection, helping learners recognize their strengths and weaknesses, adjust their learning strategies, and enhance clinical reasoning and decision-making skills. However, reflection alone may not produce the desirable effects unless coupled with feedback. This study aimed to investigate the impact of feedback integrated reflection on meaningful learning and higher order MCQ score among under-grade medical students. Objective To evaluate the impact of feedback-integrated reflection versus reflection alone on higher-order MCQ scores among undergraduate medical students in a gynecology clinical setting. Methods A randomized controlled trial was conducted with 68 final-year medical students randomly assigned to a study group (feedback-integrated reflection) and a control group (reflection alone). Both groups completed a pre-test, followed by six daily teaching sessions on gynecology topics. Participants engaged in written reflections after each session, and the study group additionally received individualized feedback. Independent sample t-tests were used to compare pre and post-test scores between the groups, while paired t-tests assessed within-group improvements. Results Pre-test scores were comparable between the study group (11.68 ± 2.60, 38.93%) and the control group (11.29 ± 2.38, 37.15%; P = 0.52). Post-test scores showed a significant improvement in the study group (20.88 ± 2.98, 69.32%) compared to the control group (15.29 ± 2.66, 51.00%; P = 0.0001). The percentage gain in learning was 35.43% for the control group (reflection alone) and 78.77% for the study group (feedback-integrated reflection). The normalized learning gain (NLG) was calculated to compare the effectiveness of the intervention (feedback-integrated reflection) with that of the control (reflection alone). The study group demonstrated a mean normalized learning gain of 69.07%, compared to 29.18% in the control group. The net learning gain, calculated as the difference in normalized learning gains between the study and control groups, was found to be 39.89%. Conclusion The findings highlight the effectiveness of feedback-integrated reflection versus reflection alone in fostering deeper learning by improving higher-order MCQ scores in a gynecologic setting in the undergraduate medical education. Trial registration This trial was registered retrospectively on 27th July 2024. Trial registration no is CTU/07/2024/010/RMU.

Introduction Osteoarthritis (OA) is a worldwide, disabling condition, more prevalent in older people. Although anxiety and depression disorders are common in OA and may affect compliance with treatment, both disorders are still underrecognized and undertreated. The present study aimed to screen for anxiety and depression among patients with primary knee OA, and to study the relationship between Hospital Anxiety and Depression Scale (HADS) score and different disease parameters. Material and methods Fifty patients fulfilling primary knee OA classification criteria were recruited for the study, and 50 age- and sex-matched healthy individuals served as a control group. Medical history was taken, clinical examination was done, and pain intensity was assessed using the Visual Analogue Scale. The 6-minute walk test was used for functional status assessment, and plain X-ray knees were scored according to the Kellgren and Lawrence classification system. Participants completed the HADS questionnaire. Results Twenty-nine patients were female (58%) and 21 were male (42%). The mean HADS score was significantly higher in OA patients than controls ( p = 0.001). The mean HADS-A (Anxiety) score was statistically significantly higher in OA patients than controls ( p < 0.001). Anxiety was more frequent in patients (44%) than in controls (10%) ( p < 0.001). In regression analysis, female sex could be considered as a predictor for each of HADS-A and HADS-D (Depression) (b: 0.4, 0.3; t : 3.28, 2.2; p = 0.002, 0.03; CI: 1.3–5.6, 0.2–4.4), respectively, while knee giving way was considered as a predictor for HADS-A (b: 0.34, t : 2.8, p = 0.007, CI: 0.96–5.87). Conclusions The results of the present study showed that anxiety level rather than depression was significantly higher in patients with primary knee OA than in controls. Female sex could be considered as a predictor for each of HADS-A and HADS-D, while knee giving way was considered as a predictor for HADS-A.

Pseudoephedrine (PSE), often known as Sudafed, belongs to a class of medications known as sympathomimetic amines, which affect the digestive system, respiratory system, and cardiovascular system. This drug has a long history of medical use; it is helpful in treating symptoms of the common cold and flu, sinusitis, asthma, and bronchitis. Due to its central nervous system (CNS) stimulant properties and structural similarity to amphe­tamine, it is also used for non-medical purposes such as doping agent, to increase focus, and as a substance that gets rid of exhaustion and drowsiness. Nevertheless only a few studies, backed up its impact on solid abdominal organs. The aim of this task is to investigate the effect of some dosages of PSE medication on the histology of albino mice's spleens. The current study included 18 albino mice grouped into 2 groups: control (3 mice), and acute group (15 mice). The acute group was further divided into five subcategories with 3 mice in each, and the animals received a single intraperitoneal injection of 0.3 ml of each of the following concentrations of drug for 24 hours: 500 mg/kg, 250 mg/kg, 125 mg/kg, 62.52 mg/kg, and 31.24 mg/kg. After the mentioned period, the mice of all subgroups were sacrificed and the spleens were removed, processed, sectioned and stained for histological analysis. Results showed that the amount of PSE administered at 500 mg/kg caused considerable sago spleen, numerous amyloid depositions in peripheral zone, sinusoidal red pulp congestion, and hyperplasia inside the germinal center. While less powerful effects or no detectable pathological alterations were seen at lower doses (125, 62.52, and 31.24 mg/Kg). This investigation demonstrated some pathological effects of this drug on spleen of albino mice at higher doses as compared to lower doses and control which recommends the use of minimal doses of PSE to avoid its adverse effects.

Abstract Background Bile acid synthesis defects (BASDs) can be severely disabling involving the liver and nervous system, potentially due to elevated levels of toxic C27-bile acid intermediates. Cholic acid (CA) supplementation is hypothesized to decrease bile acid production, stimulate bile secretion and -flow, and slowing down disease progression. This systematic review assesses the clinical and biochemical effectiveness, and safety of CA in BASDs patients. Methods A systematic review of MEDLINE, Embase and clinical trial registries (ClinicalTrials.gov, ICTRP registry) using controlled MeSH- and Emtree terms. Results From 526 articles 70 publications were deemed eligible for inclusion based on title and abstract. 14 publications were included after full-text assessment comprising case reports and -series with 1–35 patients (162 patients in total) receiving 1 week to 16,5 years of CA treatment. All presented data on effectiveness, 8 studies also presented data on safety. The included population concerned patients with Zellweger spectrum disorders (n = 73), 3β-Hydroxy-Δ5-C27-steroid oxidoreductase deficiency (n = 62), cerebrotendinous xanthomatosis (n = 22), Δ4-3-oxosteroid 5β-reductase deficiency (n = 13), and α-methylacyl-CoA racemase deficiency (n = 3). Main outcomes concerned liver disease (12 studies), general physical examinations, biochemical outcomes, and safety (9 studies), and fat-soluble vitamin absorption (7 studies). The overall risk of bias score was considered to be critical (1 study), serious (4 studies), and moderate (9 studies). Major issues were missing data (10 studies), generalized data (8 studies), and no wash-out between treatments (4 studies). Conclusion More controlled studies are required as the available data is insufficient to draw definite conclusions on the effectiveness and safety of CA treatment in BASD patients. Establishing an independent international disease registry could better utilize existing real-world data.

Background and Aim: Monkeypox (Mpox) is a viral disease mainly found in central and western Africa, with symptoms similar to variola virus (smallpox) but distinguished by the early lymph node swelling specific to Mpox. This review summarizes the neuropsychiatric manifestations of Mpox infection and vaccination, along with management approaches. Method: We searched different databases such as PubMed, Scopus, WoS, and Google Scholar about the neuropsychiatric manifestations of Mpox disease and the associated strategies of management. Results and conclusions: Mpox can cause a wide range of neurological symptoms. These range from mild symptoms like headaches, muscle aches, fatigue, and pain to severe symptoms, including seizures, blindness, photophobia, delirium, coma, encephalitis, and transverse myelitis. It is essential to distinguish Mpox from smallpox and other orthopox viruses. Psychiatric issues, such as stigma, disfigurement, isolation, and physical pain, are common in Mpox patients. To address these, healthcare providers should provide accurate information, counseling, and virtual support. Neurological side effects were associated with the previous smallpox vaccine, which offered cross-protection against Mpox. This vaccine has since been replaced by JYNNEOS, which does not pose any neurological risks. Mpox-related neurological symptoms are generally managed with supportive care, including NSAIDs, antibiotics, antiepileptics, and sedatives for seizures. Antivirals like acyclovir are also used. Severe cases may require hospitalization or intubation. So, we recommend early diagnosis, isolation, and prompt treatment, as Mpox spreading to the central nervous system can lead to serious and potentially fatal complications.

Abstract Developing robust and secure image encryption methods for transmitting multiple images in batches over unprotected networks has become imperative. This necessity arises from the limitations of single-image encryption techniques in managing the escalating volume of extensive data. This paper introduces a novel three-layer multiple-image encryption (MIE) technique to encrypt batch images based on three 2D-chaotic maps. All multiple-color images are divided into RGB channels in the first layer. The images in each channel go through a randomization process to be arranged at random before being combined to form a single image (batch) used as the input for the following layer. In the second layer, chaotic sequences for scrambling pixels in each channel independently are generated using Baker, Henon, and 2-D Logistic chaotic maps, resulting in a scrambled image. The diffusion process is applied in the final layer by independently changing the values of the pixels in each channel using different chaotic sequences generated from the three maps and the XORing operation. The efficiency of the proposed scheme is validated through key sensitivity, key space analysis, complexity analysis, entropy assessment, and tests, including horizontal, vertical, and diagonal correlation, MSE, PSNR, UACI, and NPCR. Moreover, experimental results and a thorough security analysis affirm that the proposed encryption technique has effectively attained confidentiality and robust resistance against various attacks.

Abstract The rice plant is one of the most significant crops in the world, and it suffers from various diseases. The traditional methods for rice disease detection are complex and time-consuming, mainly depending on the expert’s experience. The explosive growth in image processing, computer vision, and deep learning techniques provides effective and innovative agriculture solutions for automatically detecting and classifying these diseases. Moreover, more information can be extracted from the input images due to different feature extraction techniques. This paper proposes a new system for detecting and classifying rice plant leaf diseases by fusing different features, including color texture with Local Binary Pattern (LBP) and color features with Color Correlogram (CC). The proposed system consists of five stages. First, input images acquire RGB images of rice plants. Second, image preprocessing applies data augmentation to solve imbalanced problems, and logarithmic transformation enhancement to handle illumination problems has been applied. Third, the features extraction stage is responsible for extracting color features using CC and color texture features using multi-level multi-channel local binary pattern (MCLBP). Fourth, the feature fusion stage provides complementary and discriminative information by concatenating the two types of features. Finally, the rice image classification stage has been applied using a one-against-all support vector machine (SVM). The proposed system has been evaluated on three benchmark datasets with six classes: Blast (BL), Bacterial Leaf Blight (BLB), Brown Spot (BS), Tungro (TU), Sheath Blight (SB), and Leaf Smut (LS) have been used. Rice Leaf Diseases First Dataset, Second Dataset, and Third Dataset achieved maximum accuracy of 99.53%, 99.4%, and 99.14%, respectively, with processing time from $$100(\pm 17)ms$$ . Hence, the proposed system has achieved promising results compared to other state-of-the-art approaches.

Abstract Trema micranthum (Cannabaceae) has emerged as a promising new source of cannabinoids, including cannabidiol (CBD). Given the substantial medicinal demand for cannabinoids and the regulatory challenges associated with Cannabis sativa due to the presence of Δ9-tetrahydrocannabinol (THC), this study sought to explore the presence of CBD, THC, and their precursors, Δ9-tetrahydrocannabinolic acid A (THCA A) and cannabidiolic acid (CBDA), in various parts of Trema micranthum using UHPLC-HRMS/MS (Orbitrap). Extracts from fruits, leaves, inflorescences, and stems were obtained using a methanol/hexane (9:1, v/v) solvent mixture. UHPLC coupled with an Orbitrap mass spectrometer was employed for cannabinoid identification and quantification, with standard mixtures prepared in methanol. The extracts yielded significant quantities, such as 6.6%/g from leaves and 3%/g from fruits. Cannabinoids were detected in fruits, leaves, and inflorescences, with acidic forms (CBDA and THCA A) present in higher concentrations than their neutral counterparts. Notably, leaves contained 4.43 × 10−3 µg/g of CBD and 1.05 × 10−3 µg/g of THC. These findings, facilitated by high-resolution analytical methods, underscore the potential of Trema micranthum as an alternative source for cannabinoids, guiding future research in this area.

Abstract Controlled release of a desired drug from porous polymeric biomaterials was analyzed via computational method. The method is based on simulation of mass transfer and utilization of artificial intelligence (AI). This study explores the efficacy of three regression models, i.e., Kernel Ridge Regression (KRR), Gaussian Process Regression (GPR), and Gradient Boosting (GB) in determining the concentration of a chemical substance (C) based on coordinates (r, z). Leveraging Firefly Optimization (FFA) for hyperparameter optimization, the models are fine-tuned to maximize their predictive performance. The findings unveil notable disparities in the performance metrics of the models, with GB showcasing the most impressive R2 score of 0.9977, indicative of a remarkable alignment with the data. GPR closely trails with an R2 score of 0.88754, while KRR falls short with an R2 score of 0.76134. Additionally, GB manifests the most modest Mean Squared Error (MSE) and Root Mean Squared Error (RMSE) among the trio of models, further cementing its supremacy in predictive precision. These outcomes accentuate the significance of judiciously selecting regression methodologies and optimization approaches for adeptly modeling intricate spatial datasets.

Objective. To stratify areas at risk of measles transmission in the state of Rio de Janeiro, using the risk assessment tool developed by the World Health Organization and Centers for Disease Control and Prevention, with adaptations to the regional context. Methods. This ecological study used municipalities of Rio de Janeiro state as the units of analysis. The overall risk of measles transmission was evaluated based on the scores of indicators grouped into four categories: vaccination, threat assessment, quality of health care services, and living conditions. After summing and normalizing the scores for each category, weights were assigned to obtain the risk index. The 20%, 60%, and 90% centiles were used to establish cut-off points, classifying municipalities as low risk, medium risk, high risk, and very high risk. To evaluate the performance of the measles transmission risk index, a spatial overlay was performed with the cases reported in the epidemic period 2018–2020. Results. A progressive increase in incidence rates of measles cases was observed across municipalities, corresponding to escalating transmission risk in different strata. About 97% of measles cases occurred in municipalities classified as high or very high risk, primarily located in the state’s metropolitan region. Conclusion. Given the potential risk of measles transmission during the post-elimination period, our findings reinforce the importance of developing and implementing tools to identify priority areas for surveillance. The spatial overlay indicated the method’s effectiveness in identifying vulnerabilities associated with transmission other than low vaccine coverage, such as precarious living conditions and poor quality of health care services.

Inflammatory bowel disease (IBD) is a chronic complicated inflammatory gut pathological disorder and is categorized into ulcerative colitis (UC) and Crohn’s disease (CD). Although the cause of IBD is unclear, dysbiosis of the gut microbiota is thought to be a key factor in the disease’s progression. The gut microbiome serves as a metabolic organ and promotes wellness by carrying out several biological activities. Any modification in the makeup of the gut microbiome leads to several pathological conditions, including IBD. In this review, we emphasize the key metabolic processes that control host–microbiome interaction and its impact on host health. We also discuss the association between microbiome dysbiosis (bacteriome, virome, and mycobiome) and the progression of IBD. Finally, we will highlight microbiome-based therapy as a novel and promising strategy to treat and manage IBD.

Background: Low-grade gliomas (LGGs) are slow-growing, World Health Organization Grade I and II tumors that can transform into more aggres-sive malignancies over time. This transformation pre- sents significant challenges in managing the burden of health care. Laser-induced thermal therapy (LITT) has emerged as a promising minimally invasive treat-ment option for LGGs, offering precise tumor ablation with minimal damage to surrounding tissues. Method: This narrative review synthesizes data from relevant studies on the evolution, clinical manifestations, mo-lecular characteristics, and emerging management strategies for LGGs, with a focus on the role of LITT. Results: LITT, a minimally invasive technique, offers targeted tumor ablation with the added benefit of disrupting the blood-brain barrier to enhance drug delivery. Studies have shown that LITT can effectively reduce tumor size and improve survival rates in patients with both primary and recurrent gliomas. However, challenges such as procedure-related complications, including motor deficits and cerebral edema, as well as the need for further research on long-term efficacy, remain. Conclusion: LITT represents a significant advancement in the treatment of LGGs, combining precision and minimal invasiveness. Future studies should focus on optimiz-ing protocols, integrating molecular and genetic in-sights, and assessing long-term outcomes to enhance therapeutic efficacy and patient quality of life.

Multidrug resistant bacteria are causing health problems and economic burden worldwide; alternative treatment options such as natural products and nanoparticles have attained great attention recently. Therefore, we aimed to determine the phytochemicals, antibacterial potential, and anticancer activity of W. unigemmata. Extracts in different organic and inorganic solvents were prepared, silver nanoparticles were prepared using the green synthesis method. Phytochemicals and antioxidant activity was determined spectrophotometry, anticancer potential was determined against gastric cancer and normal gastric epithelial cells using CCK8 and colony formation assays W. unigemmata was found to have a significant enrichment of various phytochemicals including flavonoids, terpenoids, alkaloids, carotenoids, tannins, saponins, quinines, carbohydrates, phenols, coumarins and phlobatanins. Among them phenolics (5289.89 ± 112.67) had high enrichment followed by reducing sugar (851.53 ± 120.15), flavonoids (408.28 ± 20.26) and ascorbic acid (347.64 ± 16.32), respectively. The extracts prepared in organic solvents showed strong antibacterial activity against P. aeruginosa (chloroform, 13.66±0.88, ethyl acetate, 8.66±4.33, methyl alcohol, 13.33±1.66, N-hexane, 12.33±0.88) and S. aureus (chloroform, 15±0.57, ethyl acetate, 16.33±0.33, methyl alcohol, 17.66±0.33 and N-hexane, 16.33±0.33). Aqueously prepared AgNPs showed remarkable activity against P. aeruginosa follwed by E. coli, 17.66 ± 1.85, S. aureus, 16.00 ± 1.73, K. pneumoniae, 14.33 ± 1.20, respectively. The ethanolic extracts (500 μg, 1000 μg, 2000 μg) of the W. unigemmata were found to have cytotoxicity against both gastric cancer (AGS and SGC7901) and normal cell lines (GES-1); a significant cellular proliferation arrest was observed. These results suggest that W. Unigemmata contains numerous bioactive phytochemicals and can be useful as a drug against MDR bacterial strains. These biomolecules covering AgNPs may enhance their biological activities, which can be employed in the treatment of various microbial infections.

Cataracts are significant causes of blindness, closely linked to prolonged hypercholesterolemia. While saffron has the potential for eye health, its effects on lens lesions remain understudied. This study aimed to investigate the effect of saffron on the lens changes in atherosclerotic-induced New Zealand white rabbits (NZWR). Thirty-five NZWRs were subjected to four to eight weeks of high-cholesterol diet to induce atherosclerosis, resulting in cataractous lens changes. The rabbits were categorised randomly into three groups: normal diet group, pre-treated group and treated group. The pre-treated group was divided into early atherosclerosis(HC4) and established atherosclerosis (HC8). The saffron-treated group was fed with the HCD diet followed by saffron treatment of 50mg/kg/day (TG450, TG840) and 100mg/kg/day (TG4100, TG8100) of saffron ethanolic extract (SEE) respectively. The normal diet group was given a normal diet over the 8 weeks. After completing the 16-week experimental protocol, the NZWR were euthanized, and their lenses were extracted for histopathological evaluation. The pre-treated group exhibited cataractous lens changes of grade 2, characterized by increased homogenisation, swollen lens fibers, and intracellular vacuolisation. Interestingly, these cataract changes showed a positive trend from grade 2 to grade 1 post-treatment with SEE. In the saffron-treated group, vacuoles and pinkish homogenised areas were reduced. Additionally, a uniform layer of anterior epithelium and decreased non-swollen lens fibers indicated significant cataract lesion improvement. The normal diet group displayed minimal to zero cataractous changes (Grade 0). HPLC analysis demonstrated the presence of crocin, crocetin, and picocrocin in the saffron ethanolic extract, with peak absorptions at 440nm (12.817min), 440nm (1.620min), and 254nm (6.553min) respectively. The phytochemical screening of saffron ethanolic extract was conducted and showed the presence of phytochemical compounds including saponins, flavonoids, tannins, and steroids. The positive effects on lenses in the TG groups could be due to crocin and crocetin, bioactive components of saffron, and its phytochemical compounds. This study highlights saffron's potential in managing cataract-induced conditions, emphasizing the importance of further research for its full therapeutic potential in cataract management.

Introduction Central nervous system (CNS) tumors are the most common solid tumors in childhood, comprising 20% of all neoplasms in that age. Besides, they constitute the biggest cause of morbidity and mortality among childhood tumors, and about two thirds of the surviving patients have sequelae. The build-up of sequelae due to neoplastic growth is directly related with the time until diagnosis. Therefore, late diagnosis has a negative influence on the prognosis.

Heart disease remains a leading cause of mortality and morbidity worldwide, necessitating the development of accurate and reliable predictive models to facilitate early detection and intervention. While state of the art work has focused on various machine learning approaches for predicting heart disease, but they could not able to achieve remarkable accuracy. In response to this need, we applied nine machine learning algorithms XGBoost, logistic regression, decision tree, random forest, k-nearest neighbors (KNN), support vector machine (SVM), gaussian naïve bayes (NB gaussian), adaptive boosting, and linear regression to predict heart disease based on a range of physiological indicators. Our approach involved feature selection techniques to identify the most relevant predictors, aimed at refining the models to enhance both performance and interpretability. The models were trained, incorporating processes such as grid search hyperparameter tuning, and cross-validation to minimize overfitting. Additionally, we have developed a novel voting system with feature selection techniques to advance heart disease classification. Furthermore, we have evaluated the models using key performance metrics including accuracy, precision, recall, F1-score, and the area under the receiver operating characteristic curve (ROC AUC). Among the models, XGBoost demonstrated exceptional performance, achieving 99% accuracy, precision, F1-Score, 98% recall, and 100% ROC AUC. This study offers a promising approach to early heart disease diagnosis and preventive healthcare.

Introduction Until now, the thyroid cancer case number has increased, and it is not entirely possible to attribute this continuous growth to more meticulous thyroid nodule selection and more accurate diagnostic techniques. While there is currently no conclusive evidence linking dietary factors to thyroid cancer, certain dietary patterns seem to have an impact on the development of the disease. There are interesting connections among diet, environment, metabolism and thyroid carcinogenesis; a deeper comprehension of the underlying mechanisms should help the identification of modifiable risk factors for thyroid cancer. This protocol aims to guide a systematic review and meta-analysis of the literature to search for an association between dietary pattern and risk of thyroid cancer.Methods and analysis The databases to search for observational studies will be PubMed, Embase, Scopus, Web of Science and LILACS, from inception to 10 December 2024. No language limitation or publication period will be imposed. The outcome will be the patients with thyroid cancer. Three impartial reviewers will choose the studies and extract data from the original publications. The Newcastle-Ottawa Quality Scale will assess the risk of bias, and the certainty of the evidence will be achieved by using the Grading of Recommendations Assessment, Development and Evaluation. The R (V.4.3.1) will be performed for data synthesis, and to measure heterogeneity, we will compute the I2 statistics. Additionally, a quantitative synthesis will be performed if the included studies are sufficiently homogenous.Ethics and dissemination It is not necessary to acquire ethical approval, as this study will be a review of the published data. A peer-reviewed publication will publish the systematic review’s findings.PROSPERO registration number International Prospective Register of Systematic Reviews (PROSPERO) CRD 42023463802.

BackgroundPoststroke depression (PSD) is a highly prevalent and serious mental health condition affecting a significant proportion of stroke survivors worldwide. While its exact causes remain under investigation, managing PSD presents a significant challenge.AimThis study aimed to evaluate the prevalence and predictors of depression among Bangladeshi stroke victims.MethodsA cross-sectional study was carried out with 725 stroke victims who were receiving medical care at three designated tertiary care hospitals in Sylhet from January to December 2023. Depression and disability were measured using the Patient Health Questionnaire-9 and the Modified Rankin Scale. Logistic regression analysis was employed to examine the predictors linked to depression.ResultsAccording to the study, 80.8% of individuals had moderate to severe disability, and 58.1% of them experienced a moderate to severe level of depression. Individuals who had hemorrhagic stroke (AOR 1.31, 95% CI: 0.77-2.25), repeated episodes (AOR 3.41, 95% CI: 1.89-6.14), tobacco use (AOR 1.76, 95% CI: 1.16-2.67), or coexisting health conditions (AOR 1.68, 95% CI: 1.00-2.82) exhibited elevated levels of depression. Participants whose medical expenses covered by relatives or others were six times more likely to experience depressive symptoms (AOR 6.32, 95% CI: 1.61-24.76). Individuals who did not receive rehabilitation services had two times greater odds of being depressed (OR 1.85, 95% CI: 1.23-2.77, p = 0.003). Consequently, individuals with low functional status had eleven times greater levels of depression (AOR 11.03, 95% CI: 7.14-17.04).ConclusionMore than half of the participants in this present study reported moderate to extreme levels of depression which is a serious health issue among Bangladeshi stroke survivors. Understanding the predictors of depression linked to stroke could enhance the effectiveness of therapeutic interventions for this condition. In addition, multidisciplinary teams should work collaboratively to address this serious issue.

Epigenetic processes are the critical events in carcinogenesis. Histone modification plays a crucial role in gene expression regulation, where histone deacetylases (HDACs) are key players in epigenetic processes. Inhibiting HDACs has shown promise in modern cancer therapy. However, the non-selective nature and drug resistance of most HDAC inhibitors (HDACIs) limits their clinical use. This limitation prompts a search for isoform-selective and more effective inhibitors. Histone deacetylase 1 (HDAC1) is a member of the class I HDAC family and has emerged as a promising target in various diseases, including cancer and neurodegeneration. Drug repurposing has gained significant interest in identifying treatments for new targets, which involves finding new uses for existing drugs beyond their original medical indications. Here, we employed virtual screening of repurposed drugs from the DrugBank database to identify potential HDAC1 inhibitors. We conducted a series of analyses, including molecular docking, drug profiling, PASS evaluation, and interaction analysis. Molecular dynamics (MD) simulations and MM-PBSA analysis were also performed for 300 ns. Through these analyses, we pinpointed Alectinib, which exhibits a promising drug profile in PASS analysis and higher affinity and efficiency for HDAC1 than the reference inhibitor. MD simulations revealed that Alectinib stabilizes HDAC1 with minimal structural perturbations. The findings suggest that Alectinib holds promise as a therapeutic lead for HDAC1-associated carcinogenesis after required validation.

Background Stunting is commonly used as an indicator of malnutrition. Both are especially prevalent in Sub-Saharan Africa. Recently, the association between nutrition and growth has been questioned. Objectives This study examined whether low weight status for age is significantly associated with short height for age of Kenyan children aged 3 to 10 years. Sample and Methods Data were collected in Nairobi, Kiambu, and Kisumu in 1982, including 109 Kikuyu and 82 Luo children. The associations between age, sex, population, weight status, and body height were analysed. Results Sex and low weight status for age showed no significant associations with short height for age. With increasing age, the likelihood of showing short height for age increased significantly (p=0.001). Furthermore, population affiliation had a significant impact (p

Introduction: Gestational diabetes mellitus is glucose intolerance diagnosed or detected for the first-time during pregnancy and has serious implications for fetal and maternal health if left untreated. Hyperglycemia during pregnancy is caused by the progressive increase in insulin resistance from mid to third trimester. Increased insulin resistance is a consequence of an increase in adipose tissue in mother and desensitizing effect to insulin by placental factors. Adipokine, visfatin, is multifunctional protein. Its levels are much higher in pregnant women. Aims and Objectives: To determine and compare levels of serum visfatin and insulin resistance before and after delivery in gestational diabetics. Place and Duration of Study: Lahore General Hospital Lahore/ PGMI, Lahore, during 2024. Materials and Methods: It was a Case control study. 21 Pregnant females at gestational age of 32-36 weeks were selected using non-probability purposive sampling as diagnosed cases of GDM (OGTT) matched with 21 control without GDM. Serum levels of Visfatin, Insulin, fasting blood Glucose and HOMA IR were determined. Data was analyzed by using SPSS version 20. Results were checked for normality. Paired t test was used to compare normally distributed data before and after delivery in the both groups. The Wilcoxon sign rank test was used to compare non normally distributed data before and after delivery. Spearman’s and Pearson correlation was used to correlate data. A p-value of

Abstract Introduction The impact of aligners in the periodontal conditions and protocols for hygiene were investigated. Objective This study assessed the periodontal condition of patients undergoing orthodontic treatment with ClearCorrect aligners and compare periodontal health conditions after the use of BlueM mouthwash and foam as clinical protocols for oral and aligner hygiene. Material and method In 16 patients’ treatment was performed using aligners, and a periodontal follow-up was conducted. The sample was divided into 3 randomized groups: Control, Mouthwash, and Foam, with each patient passing through all groups. The use of a standardized toothpaste was indicated. A periodontal examination was performed on baseline and every 2 months using gingival sulcus probing, insertion level, recession, bleeding on probe index, and biofilm presence. Result Significant differences were observed in distal probing of the teeth when comparing baseline and the mouthwash group in the intergroup analysis, irrespective of the side of the mouth and the tooth evaluated. When assessing bleeding on probe, baseline showed 1.8 times more risk of bleeding on probe than foam, 1.9 times more risk than the control, and 2.4 times more than mouthwash group. Regarding biofilm presence, baseline data showed 1.4 times more risk of having biofilm than foam, and 1.9 times more risk than mouthwash groups. In relation to the control, there was no statistically significant difference. Conclusion Patients when using BlueM mouthwash had a lower chance of bleeding on probe and presence of biofilm, as well as an improvement in distal periodontal probing depth when compared to baseline situation.

Introduction Mental illness remains a significant global health concern that affects diverse populations, including individuals living with hypertension and/or type 2 diabetes, predominantly in lower-income to middle-income countries. The association between non-communicable diseases (NCDs) and mental illness is firmly established globally, however, this connection has yet to be comprehensively explored in West Africa. Our systematic review and meta-analysis aim to synthesise existing evidence on the prevalence, incidence, and risk factors for comorbid mental illness with hypertension and/or type 2 diabetes in West Africa. This effort seeks to contribute to bridging the knowledge gap and facilitating the implementation of interventions tailored to this context.Methods and analysis A comprehensive search will be conducted across multiple databases (PubMed, Google Scholar, PsycINFO, Carin Info and CINAHL), supplemented by searches on the websites of the WHO and various countries’ ministries of health, and references cited in relevant papers. Inclusion criteria specify studies conducted in countries from the Economic Community of West African States, reported from January 2000 until date of search, focusing on adults with hypertension and/or type 2 diabetes and mental illness. Exclusion criteria encompass studies outside the specified time frame, involving pregnant women, or lacking relevant outcomes. There will be no language restrictions for inclusion. Study selection, data extraction and risk of bias assessment will be carried out independently by at least two reviewers. We will employ pooled proportions of OR, risk ratio and mean differences to assess prevalence, and incidence of mental illness and heterogeneity will be assessed.Ethics and dissemination This protocol does not require ethical approval; however, it is a part of a larger study on NCDs, which has received ethical clearance from the Ghana Health Service (ID NO: GHS-ERC 013/02/23). The results will be presented to stakeholders (policymakers and practitioners) and disseminated through conferences and peer-reviewed publications.PROSPERO registration number CRD42023450732.

Objectives To quantify the association between Gestational Diabetes Mellitus (GDM) and adverse pregnancy outcomes and primarily compare the associations between diagnostic criteria following the International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommendations and non-IADPSG criteria, which use higher blood glucose cut-offs.Design Systematic review and meta-analysis of observational studies using contemporary GDM diagnostic criteria.Data sources PubMed, Scopus, Google Scholar, Cochrane Database of Systematic Reviews and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for articles published between 2010 and 2023. The search was carried out on 15 May 2023.Eligibility criteria Studies were included if they were observational studies that reported adjusted effect sizes for GDM-related adverse outcomes and compared outcomes between women with and without GDM, used contemporary diagnostic criteria and were conducted after 2010.Data extraction and synthesis Two reviewers independently extracted data and assessed study quality using the MethodologicAl STandards for Epidemiological Research (MASTER) scale. Bias-adjusted inverse variance heterogeneity meta-analysis models were used to synthesise adjusted effect sizes. The same meta-analytic models were used to synthesise the overall OR and their 95% CIs for comparisons of the criteria which followed the IADPSG recommendations to other criteria, mostly with higher blood glucose cut-offs (non-IADPSG).Results We included 30 studies involving 642 355 participants. GDM was associated with higher odds of maternal outcomes, namely; caesarean section (adjusted OR (aOR) 1.24, 95% CI 1.01 to 1.51) and pregnancy-induced hypertension (aOR 1.55, 95% CI 1.03 to 2.34). GDM was associated with higher odds of neonatal outcomes, specifically; macrosomia (aOR 1.38, 95% CI 1.13 to 1.69), large for gestational age (aOR 1.42, 95% CI 1.23 to 1.63), preterm birth (aOR 1.41, 95% CI 1.21 to 1.64), neonatal intensive care unit admission (aOR 1.42, 95% CI 1.12 to 1.78), neonatal hypoglycaemia (aOR 3.08, 95% CI 1.80 to 5.26) and jaundice (aOR 1.47, 95% CI 1.12 to 1.91). Further analyses showed no major differences in adverse pregnancy outcomes between IADPSG and non-IADPSG criteria.Conclusions GDM is consistently associated with adverse pregnancy, maternal and foetal outcomes, regardless of the diagnostic criteria used. These findings suggest no significant difference in risk between lower and higher blood glucose cut-offs used in GDM diagnosis.

Objectives This goal of this research is to present a comprehensive method for evaluating stress and the factors that contribute to it in mothers of premature babies.Design Analytical cross-sectional study.Setting Data were collected from inpatient service for preterm infants including neonatal intensive care unit, and neonatal step-down units of the Aga Khan University Hospital—a private tertiary care hospital in Karachi, Pakistan.Participants Mothers aged 18 years and above who delivered preterm infants (gestational age of preterm below 37 weeks) in a private tertiary care hospital in Karachi, Pakistan.Primary outcome Stress in mothers of preterm infants.Results 200 participants with a mean age of 30.12 years (SD ±5.21) were assessed. The level of stress identified using the perceived stress scale (PSS) among mothers who had delivered preterm infants was significantly higher as compared with other countries around the world. Based on the criteria of PSS scoring, the majority of the participants (92%, n=184) were categorised as having high perceived stress and 8% (n=16) of the mothers fell into the category of moderate stress.Conclusions The study findings suggest high levels of perceived stress among mothers of preterm infants. The factors associated with the stress among mothers of preterm infants included immunisation of newborn, education and occupation status of mothers, substance abuse by mother, gender preference from family, planning for further children, consumption of balance diet, education status of husband, mode of socialisation, years of marriage and hours of sleep.

Previous research on child/teenage sexual experiences has largely focussed on negative outcomes such as teen pregnancy or acquiring sexually transmitted infections and are mainly cross-sectional. Longitudinal research is required to assess normal sexual development and the attainment of psychologically healthy attitudes towards sexuality. The Avon Longitudinal Study of Parents and Children (ALSPAC) has administered questions on relationships and sexual experiences from the age of 11 years to the index children. This data note describes these data.

Objective To critically analyse literature on the anticancer properties of andrographolide in in vitro studies on gastric cancer cells. Method This study systematically reviewed articles from 2013 to 2024 across five prominent databases; PubMed, Google Scholar, Web of Science, Scopus, and Science Direct, EMBASE, Cochrane library and DOAJ. The study eligibility criteria include original studies assessing using gastric cancer cell lines and articles utilizing extracted andrographolide from Andrographis paniculata or standard andrographolide source treatment. The following exclusion criteria were articles written in a different language, review articles, book chapters, conference articles, scientific reports. Duplicated articles were removed using Mendeley software. Result Out of 93 articles, six were relevant, primarily focusing on in vitro analyses with gastric adenocarcinoma cell lines. Conclusion These studies indicate that andrographolide can hinder the cell cycle, suppress cell proliferation, alleviate oxidative stress, and induce apoptosis by prompting gastric cancer cells to undergo self-destruction, which is a crucial mechanism for controlling and eliminating cancerous growths.

Liquid smoke, a product of the pyrolysis process, includes components such as phenol, furfural, and ketones, and has acidic characteristics. Liquid smoke from various biomass sources has been used as a natural preservative worldwide and reported to be safe in humans. As a bio-economic product, liquid smoke has human health benefits. This review analyzes and describes the health benefits of liquid smoke from various biomass sources, according to in silico, in vitro, and in vivo studies. A systematic review following PRISMA guidelines was conducted to identify published reports of liquid smoke from various biomass sources. The anti-inflammatory, anti-bacterial, anti-diabetic, wound healing, and anti-periodontitis activity of liquid smoke was analyzed. Prior research has investigated liquid smoke produced through pyrolysis of various biomass types, such as rice husks (Oryza sativa), coconut shells (Cocos nucifera L.), palm kernels (Elaeis guineensis Jacq.), cocoa pods (Theobroma cacao L.), tian op, and hickory (Carya tomentosa (Lam.) Nutt.), as well as commercial liquid smoke. Toxicity testing, and in vitro and in vivo studies, are required for the assessment of health benefits. Therapeutic benefits of liquid smoke including anti-oxidant, anti-inflammatory, anti-nociceptive, anti-bacterial, anti-fungal, and anti-viral activity have been described. Further health benefits include anti-diabetic, anti-periodontitis, wound healing, and ulcer healing activity. These findings increase the use value of liquid smoke as a natural product with human health benefits.

The aim of this data note is to describe the sexual experiences, functioning and behaviour data collected from the parent cohorts of the Avon Longitudinal Study of Parents and Children (ALSPAC) occurring during their childhoods and up to 19 years after the birth of the index child. ALSPAC is an ongoing birth cohort which enrolled 14,541 pregnant women living in Avon, an area of southwest England, with expected dates of delivery between April 1991 and December 1992 inclusive. It continues collecting data on these mothers (age range at delivery

Safeguarding patients from emerging infectious diseases demands strategies that prioritise patient well-being and protection. Immunobridging is an established trial methodology which has been increasingly employed to ensure patient protection and provide clinicians with swift access to vaccines. It uses immunological markers to infer the effectiveness of a new drug through a surrogate measure of efficacy. Recently, this method has also been employed to authorise novel drugs, such as COVID-19 vaccines, and this article explores the concepts behind immunobridging trials, their advantages, issues, and significance in the context of COVID-19 and other infectious diseases. Our goal is to improve awareness among clinicians, patient groups, regulators, and health leaders of the opportunities and issues of immunobridging, so that fewer patients are left without protection from infectious diseases, particularly from major pathogens that may emerge.

Background/Objectives: The alarming rise in antibiotic resistance necessitates the discovery of novel antimicrobial agents. This study aims to design, synthesize, and evaluate new benzofuran–pyrazole-based compounds for their antimicrobial, antioxidant, and anti-inflammatory properties. Methods: New benzofuran–pyrazole hybrid molecules were synthesized using the Vilsmeier–Haach reaction and other chemical processes. The structures of the synthesized compounds were confirmed through micro-analytical and spectral analyses. Their antimicrobial activities were assessed against various bacterial and fungal strains, while antioxidant and anti-inflammatory properties were evaluated using DPPH-free radical scavenging and HRBC membrane stabilization assays, respectively. The most promising compounds were further tested for DNA gyrase B inhibition. Results: Compounds 9, 10, and 11b–d exhibited significant broad-spectrum antimicrobial activity with MIC values ranging from 2.50 to 20 µg/mL. Compounds 4, 6, 9, 11b, and 11d demonstrated high antioxidant activity, with DPPH scavenging percentages between 84.16% and 90.52%. Most compounds showed substantial anti-inflammatory effects, with HRBC membrane stabilization percentages ranging from 86.70% to 99.25%. Compound 9 notably inhibited E. coli DNA gyrase B with an IC50 of 9.80 µM, comparable to ciprofloxacin. Conclusions: The benzofuran–pyrazole-based compounds, particularly compound 9, show great potential as new antimicrobial agents due to their broad-spectrum activity and potent DNA gyrase B inhibition. These findings support further development and optimization of these compounds for clinical applications.

Background: The present study aimed to evaluate the potential synergy between pharmaceutical formulations containing Bixa orellana L. (granulated—CHR OR and injectable nanodispersion—CHR IN) in conjunction with a cannabidiol (CBD)-rich extract of Cannabis sativa L. (CSE) on experimental pain models in Wistar rats. Methods: Chemical analysis was performed using gas chromatography (GC-MS). The pain tests employed were acetic acid-induced writhing (injection i.p. of 0.9% acetic acid), formalin (solution 1%), hot plate (55 ± 0.5 °C), and cold-water tail withdrawal tests. Results: Chemical analyses by chromatography confirmed that the oil from B. orellana is rich in δ-tocotrienol (72.0 ± 1.0%), while the oil from Cannabis sativa highlighted the presence of cannabidiol (CBD). The results from the experimental pain tests indicated that the combined administration of formulations containing Bixa orellana and C. sativa, such as the granulated CHR OR (400 mg/kg, orally) with CSE (40 mg/kg, orally) or the nanodispersion CHR IN (10 mg/kg, intramuscularly) with CSE (40 mg/kg, orally), demonstrated significant results (p < 0.001) in pain reduction. Although the formulations containing Bixa orellana extract showed statistical significance in the tests when used in isolation, their effects were inferior compared to the combined use with CSE or the isolated use of CSE. These findings suggest that combining formulations containing extracts of these plant species may represent a viable therapeutic option, considering the synergistic action in reducing pain under the experimental conditions employed. Conclusions: these results imply that combining the phytocomplexes present in B. orellana and C. sativa may be a promising approach for pain treatment.

Air pollution (AP) significantly jeopardises health, with the Royal College of Physicians accepting the adverse effects of AP are not being sufficiently communicated to patients by healthcare professionals (HCP). To explore HCPs' understanding and attitudes toward AP and its health impacts, we conducted a service evaluation survey in a group of hospital doctors.A questionnaire comprising 20 questions about AP and its health associations was completed by 133 hospital doctors working at University Hospital Southampton NHS Foundation Trust, UK.While 65% (n = 86) of respondents strongly agreed that AP is relevant to health, 79% (n = 105) felt insufficiently trained on AP and its health associations.The survey shows that HCPs' knowledge of AP and its connection to poor health is a major barrier in discussions with patients. Further research is needed to understand whether these views are nationally shared among HCPs and to explore the most effective strategies for enhancing AP awareness.

Background/aim Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that leads to joint destruction and disability with increased risk of cardiovascular disease (CVD), a leading cause of morbidity and mortality in RA. Modifying CVD risk factors, such as lowering plasma glucose and total cholesterol, may be helpful for preventing CVD. A disease-modifying antirheumatic drugs (DMARD) hydroxychloroquine (HCQ) with a good safety profile and low cost has been reported to improve lipid profiles and glucose level in RA. The study was designed to evaluate the responsibility of HCQ in the improvement of lipid profile and glucose level in Egyptian Inactive Rheumatoid Arthritis (RA) females. Subjects and methods This trial study included fifty adult RA females in remission treated with 400 mg daily of HCQ orally for 6 months. The patients are regular visiting outpatient clinic of rheumatology unit at the department of Rheumatology and Rehabilitation, Mataria Teaching Hospital, National Institute of Neuro-Motor System (NINMS) and Rheumatology clinic at Centre of Medical Excellence of National Research Centre, Cairo, Egypt. Visits and follow-up are monthly to ensure adherence to treatment. All the patients have been evaluated at the start of the trial, after 3 and 6 months. Lipid profile, fasting blood sugar (FBS), anthropometric parameters and systolic and diastolic blood pressure were assessed. Results After 3 months of treatment, most of the metabolic characteristics were improved significantly. FBS level was significantly lowered (P

The government of Bangladesh has implemented the “Stay Home” policy following the WHO recommendation to resist the community transmission of Covid-19. As a result, the routine activities of all government, semi-government establishments, including educational institutions, are severely affected, and the country's economic growth becomes slowed down. To overcome such a situation, the relevant authorities have introduced the “Work from Home” policy for the employees and “Remote Education” for students. However, due to the persistence of multi-dimensional socio-economic problems, many employees and students face big challenges in performing their regular jobs while adopting such a policy. Consequently, enormous psychological anxiety has been developed for all people, including students, parents, employees, etc., and concurrently created severe changes in their behavior. This study aims to analyze the reasons for the behavioral changes of the employees, students, academic staff, and family members of different ages due to psychological anxiety, stress, or physical issues. A comprehensive online-based survey has been carried out on people working in various sectors in Bangladesh. A modified Apriori Algorithm has been used to sort out the associations between the causes and types of behavioral changes. Analyzed data revealed a massive human behavioral change in most participants. This finding indicates that the negligence of those significant human behavioral changes may cause a higher risk of creating psychological imbalance. Therefore, there is a need to have a solid understanding of the reasons for the behavioral changes and set up standard guidelines to maintain “Work from Home” in this Covid-19 situation to avoid psychological imbalance. Based on this study, some suggestions have been given for implementation by the government on an urgent basis.

Background/Objectives: Drugs exhibiting poor aqueous solubility present a challenge to efficient delivery to the site of action. Spanlastics (a nano, surfactant-based drug delivery system) have emerged as a powerful tool to improve solubility, bioavailability, and delivery to the site of action. This study aimed to better understand factors affecting the physicochemical properties of spanlastics, quantify their effects, and use them to enhance the bioavailability of famotidine (FMT), a model histamine H2 receptor antagonist (BCS class IV). Methods: FMT was incorporated into nano-spanlastics drug delivery system. The ethanol injection method, Box–Behnken design, and mathematical modeling were utilized to fabricate famotidine-loaded nano-spanlastics and optimize the formula. Spanlastics were characterized for their particle size, polydispersity index, zeta potential, entrapment efficiency, drug loading, compatibility of the excipients (using DSC), in vitro drug release, and in vivo pharmacokinetics. Results: Span 60 (the non-ionic surfactant) and tween 60 (the edge activator) gave rise to spanlastics with the best characteristics. The optimal spanlastic formulation exhibited small particle size (−30 mV). The entrapment efficiency and drug loading of the optimum formula assured its suitability for hydrophobic drug entrapment as well as practicability for use. DSC assured the compatibility of all formulation components. The drug release manifested a biphasic release pattern, resulting in a fast onset and sustained effect. Spanlastics also showed enhanced Cmax, AUC0–24, and bioavailability. Conclusions: Spanlastics manifested improved FMT dissolution, drug release characteristics, membrane permeation, and pharmacokinetic behavior.

The rapid progress of antibiotic resistance among bacteria has prompted serious medical concerns regarding how to manage multidrug-resistant (MDR) bacterial infections. One emerging strategy to combat antibiotic resistance is the use of antimicrobial peptides (AMPs), which are amino acid chains that act as broad-spectrum antimicrobial molecules and are essential parts of the innate immune system in mammals, fungi, and plants. AMPs have unique antibacterial mechanisms that offer benefits over conventional antibiotics in combating drug-resistant bacterial infections. Currently, scientists have conducted multiple studies on AMPs for combating drug-resistant bacterial infections and found that AMPs are a promising alternative to conventional antibiotics. On the other hand, bacteria can develop several tactics to resist and bypass the effect of AMPs. Therefore, it is like a battle between the bacterial community and the AMPs, but who will win? This review provides thorough insights into the development of antibiotic resistance as well as detailed information about AMPs in terms of their history and classification. Furthermore, it addresses the unique antibacterial mechanisms of action of AMPs, how bacteria resist these mechanisms, and how to ensure AMPs win this battle. Finally, it provides updated information about FDA-approved AMPs and those that were still in clinical trials. This review provides vital information for researchers for the development and therapeutic application of novel AMPs for drug-resistant bacterial infections.

Abstract This article presents the two-dimensional flow of hybrid nanofluid comprising of gyrotactic microorganisms under the consequences of multiple slip conditions, magnetic field and thermal radiation across an elongating curved surface using porous media. The nanoparticles of TiO2 and Fe3O4 have dispersed in water for composition of hybrid nanofluid. Main equations of the problem are converted to ODEs by using an appropriate set of variables. Solution of the present model is determined with the help of bvp4c technique, which is explained in detail in the coming section. Validation of the current results is done versus the published work. The effects of various emerging factors on flow distributions have been considered and explained. Additionally, the slips conditions are incorporated to analyze various flow distributions. The present outcomes show that the rising magnetic factor lessens the velocity profile, whereas rises the temperature profile. The curvature factor has supported both temperature and velocity distributions. Growth in velocity, thermal, concentration, and microorganisms slip factors reduce the corresponding distributions. The greater impact of the embedded parameters is found on hybrid nanofluid flow when matched to nanofluid flow.

Abstract Hepatitis C virus (HCV) infection can regulate the number and dynamics of mitochondria, and is associated with a prominent hepatic mitochondrial injury. Mitochondrial distress conveys oxidative damage which is implicated in liver disease progression. The present study was conducted to assess the change of mitochondrial DNA (mtDNA) copy number in patients with HCV-related chronic liver disease and the impact of direct-acting antiviral (DAA) therapy. Whole blood mtDNA copy number was measured using real-time quantitative polymerase chain reaction at baseline and 12 weeks after the end of therapy in 50 treatment-naïve HCV-infected patients who achieved sustained viral response (SVR) after DAA therapy and 20 healthy controls. Whole blood mtDNA copy number appeared significantly lower in HCV-infected patients before therapy compared to healthy subjects (P 0.05). In conclusion, chronic HCV infection has been associated with a prominent mitochondrial injury which could mediate a progressive liver disease. The improved mtDNA content after DAA therapy highlights a possible potential of these drugs to alleviate mitochondrial damage in HCV-related liver disease.

Abstract Sign Language Recognition is a breakthrough for communication among deaf-mute society and has been a critical research topic for years. Although some of the previous studies have successfully recognized sign language, it requires many costly instruments including sensors, devices, and high-end processing power. However, such drawbacks can be easily overcome by employing artificial intelligence-based techniques. Since, in this modern era of advanced mobile technology, using a camera to take video or images is much easier, this study demonstrates a cost-effective technique to detect American Sign Language (ASL) using an image dataset. Here, “Finger Spelling, A” dataset has been used, with 24 letters (except j and z as they contain motion). The main reason for using this dataset is that these images have a complex background with different environments and scene colors. Two layers of image processing have been used: in the first layer, images are processed as a whole for training, and in the second layer, the hand landmarks are extracted. A multi-headed convolutional neural network (CNN) model has been proposed and tested with 30% of the dataset to train these two layers. To avoid the overfitting problem, data augmentation and dynamic learning rate reduction have been used. With the proposed model, 98.981% test accuracy has been achieved. It is expected that this study may help to develop an efficient human–machine communication system for a deaf-mute society.

High-Intensity Laser Therapy (HILT), also known as Class IV laser, is a relatively modern type of non invasive physical electrotherapy that has been used to treat a variety of conditions. However, there has been little research conducted on this equipment. HILT can be highly beneficial for treating painful neck-related disorders, as it offers various effects including bio stimulation, regeneration, analgesia, anti-inflammatory properties, and anti-oedema properties. Many disorders that cause neck pain can be effectively treated with HILT in combination with exercise. To gather essential information on the subject, electronic databases such as PubMed, Scopus, and Google Scholar were searched. The conclusions of the review indicate that HILT is highly efficient, affordable, and innovative. However, it has received minimal academic research attention and has not been widely used in Indian clinical settings. The evidence suggests that HILT is a highly effective physical treatment technique that significantly improves pain, Range of Motion (ROM), functional status, and Quality of Life (QoL) in patients with neck pain.