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Abstract Background Previous research on the risk of dementia associated with education attainment, smoking status, and alcohol use disorder (AUD) has yielded inconsistent results, indicating potential heterogeneous treatment effects (HTEs) of these factors on dementia risk. Thus, this study aimed to identify the important variables that may contribute to HTEs of these factors in older adults. Methods Using 2005–2021 data from the National Alzheimer’s Coordinating Center (NACC), we included older adults (≥ 65 years) with normal cognition at the first visit. The exposure of interest included college education or above, current smoking, and AUD and the outcome was all-cause dementia. We applied doubly robust learning to estimate risk differences (RD) and 95% confidence intervals (CI) between exposed and unexposed groups in the overall cohort and subgroups identified through a decision tree model. Results Of 10,062 participants included, 929 developed all-cause dementia over a median 4.4-year follow-up. College education or above was associated with a lower risk of all-cause dementia in the overall population (RD, -1.5%; 95%CI, -2.8 to -0.3), especially among the subpopulations without hypertension, regardless of the APOE4 status. Current smoking was not related to increased dementia risk overall (2.8%; -1.5 to 7.2) but was significantly associated with increased dementia risk among men with (21.1%, 3.1 to 39.1) and without (8.4%, 0.9 to 15.8) cerebrovascular disease. AUD was not related to increased dementia risk overall (2.0%; -7.7 to 11.7) but was significantly associated with increased dementia risk among men with neuropsychiatric disorders (31.5%; 7.4 to 55.7). Conclusions Our studies identified important factors contributing to HTEs of education, smoking, and AUD on risk of all-cause dementia, suggesting an individualized approach is needed to address dementia disparities.

Abstract Background Magnetic resonance imaging (MRI) is a noninvasive diagnostic tool that is commonly used to visualize soft tissues and anatomical structures. Many patients who undergo MRI scans experience anxiety. This multicenter study was conducted to assess anxiety levels experienced by patients who underwent MRI scans in the Palestinian radiology departments and identify the risk factors associated with higher levels of anxiety experienced by the patients. Methods This multicenter cross-sectional study was conducted in the radiology departments of different hospitals in the West Bank of Palestine using a questionnaire. The questionnaire collected different demographic data of the patients. A 100-mm visual analog scale (VAS) was used to assess the level of anxiety experienced by the patients who received MRI scans. The data were analyzed using SPSS version 28. Results A total of 383 patients participated in this study. Of the patients, 255 (66.6%) reported experiencing low, moderate, or high anxiety levels during the MRI scan. The median anxiety was 20.0 with an interquartile range (IQR) of 0.0–50.0 as measured using the 100-mm VAS. Higher anxiety levels were reported by the patients who were female (p-value

Abstract Background Little studies were conducted to assess the prevalence of stress urinary incontinence among Palestinian women. This study was conducted to determine the prevalence of stress urinary incontinence symptoms, their impact on the quality of life, and the risk factors that were associated with stress incontinence symptoms among Palestinian women. Methods This study was conducted in a cross-sectional design from 2023 to 2024. The data were collected through an interviewer-administered questionnaire. The questionnaire collected the demographic and health characteristics of the women. Additionally, the questionnaire also contained the PRAFAB questionnaire (PRAFAB-Q). Moreover, the questionnaire included the Assessment of Quality of Life (AQoL)-8D scale. Results Data were collected from 386 Palestinian women (response rate = 85.8%). The mean age of women in this study was 37.1 ± 14.7 years. In this study, 104 (26.9%) reported stress urinary incontinence symptoms. Of the women, 102 (26.4%) reported urinary leakage during coughing, 100 (25.9%) reported urinary leakage during sneezing, and 94 (24.4%) reported urinary leakage during laughing. The women who had a family history of stress incontinence were 2.5-fold (95% CI: 1.2–5.2) more likely to have stress incontinence symptoms compared to the women who did not have a family history of stress incontinence. Similarly, the women who were overweight/obese were 2.0-fold (95% CI: 1.1–3.7) more likely to have stress incontinence symptoms compared to the women who were underweight or had a normal weight. PRAFAB-Q scores were predicted by place of residence, family history of stress incontinence, and being recruited from a hospital. Conclusion The study reported a high prevalence of stress urinary incontinence and identified the risk factors that were associated with stress incontinence symptoms among Palestinian women. The findings showed that the intensity of stress urinary incontinence symptoms was associated with deteriorated quality of life of the affected women. These findings could be used by urologists, gynecologists, obstetricians, and other healthcare providers caring for women to design ways to reduce the burden of stress urinary incontinence among Palestinian women and improve their quality of life.

Abstract Background This study was conducted to assess the prevalence of lower urinary tract symptoms (LUTS) among non-obese and obese Palestinians. The study also aimed to assess the effects of LUTS on the quality of life of obese and non-obese Palestinians. Methods This was a cross-sectional study that was conducted among normal-weight, overweight, and obese Palestinians using the King Health Questionnaire. The data collected from participants were entered and analyzed using SPSS (version 22). Results In this study, data were collected from 378 participants. The median age of the participants was 42.0 [30.0, 55.0] years, and the median body mass index was 27.1 [24.0, 30.8] kg/m2. Of the participants, 149 (39.4%) were overweight and 112 (29.6%) were obese. The prevalence of urinary hesitancy, incomplete emptying, urgency, nocturia, urgency, urge incontinence, stress incontinence, nocturnal enuresis, intercourse incontinence, bladder pain, number of urinations/24 h, and number of urinations/night was significantly higher among obese participants. Similarly, role limitations, physical/social limitation, personal relationships, emotions, and sleep/energy were affected significantly higher in obese compared to nonobese participants. Conclusion Higher prevalence of LUTS among obese patients compared to nonobese patients was observed among the Palestinians. Obese patients reported significantly higher deterioration of the quality of life as a result of LUTS compared to nonobese patients. Urologists, nutritionists, public health specialists, and other healthcare providers should consider measures to reduce LUTS among obese patients and improve their quality of life.

Abstract The use of natural fibers has seen a significant rise in the composites sector, resulting in the creation of polymer composites with exceptional strength. These environmentally-friendly alternatives offer a compelling substitute for synthetic composites. This study explores the use of date palm waste as reinforcement for the fabrication of polyvinyl chloride (PVC) composites. A surface modification method was essential for improving the binding interaction between palm fibers and PVC composites. The two-hour benzoyl chloride treatment at 140 °C played a crucial role. The study examined the effects of hydrothermal aging on mechanical properties of composites, using various techniques such as surface morphology analysis, Fourier Transform Infrared spectroscopy, and Thermogravimetric Analysis, on composites made of untreated fibers and those treated with benzoyl chloride. Although the treatment of palm fiber-reinforced composites with benzoyl chloride improved their mechanical properties, it is crucial to note that hydrothermal aging reduced their tensile strength by 10%. Despite this, these composites prove to be well-suited for applications requiring moderate strength and stiffness in mild environmental conditions. These composites, while utilizing benzoyl chloride for surface treatment, still represent a more sustainable alternative to traditional synthetic composites by incorporating renewable date palm waste and enhancing mechanical properties, which potentially reduces overall environmental impact.

Abstract Background S. pneumoniae (SPN) is the most common cause of pneumonia. The disease can be effectively prevented through immunisation. Since December 2020, the Malaysian Government has included the 10-valent pneumococcal conjugate vaccine (PCV10) for all infants born on or after 1 January 2020 as part of the National Immunisation Programme (NIP). However, the epidemiology of pneumonia remains poorly understood. To fill the knowledge gap, we established a multicentre surveillance study to understand the burden of pneumococcal pneumonia among young children in Peninsular Malaysia. Methods MY-Pneumo is a multicentre prospective case–control study conducted in three sentinel sites located in three different states of Peninsular Malaysia – Kuala Lumpur, Pahang, and Kelantan. A cohort of at least 500 incident cases and 500 controls is enrolled beginning in October 2021 and matched for age. Cases are hospitalised children

Sheep milk production is a complex process that is influenced by various factors. This study aims to investigate how the litter size (single vs. twins), birth type (male vs. female), age of the ewes and body weight affect the milk composition and fatty acid profile of milk fat. Milk samples were collected from 119 Najdi ewes that were the subject of this study. Gas chromatography-mass spectrometry (GC-MASS) was used to quantify the fatty acids (FAs). The results showed that the twins birth type (female/female) has a significant influence (P

Abstract Aims Right ventricular failure after left ventricular assist device (LVAD) implantation is a major concern that remains challenging to predict. We sought to investigate the relationship between preoperative pulmonary artery pulsatility index (PAPi) and mortality after LVAD implantation. Methods and results A retrospective analysis of the ASSIST‐ICD multicentre registry allowed the assessment of PAPi before LVAD according to the formula [(systolic pulmonary artery pressure − diastolic pulmonary artery pressure)/central venous pressure]. The primary endpoint was survival at 3 months, according to the threshold value of PAPi determined by the receiver operating characteristic (ROC) curve. A multivariate analysis including demographic, echographic, haemodynamic, and biological variables was performed to identify predictive factors for 2 year mortality. One hundred seventeen patients were included from 2007 to 2021. The mean age was 58.45 years (±13.16), with 15.4% of women (sex ratio 5.5). A total of 53.4% were implanted as bridge to transplant and 43.1% as destination therapy. Post‐operative right ventricular failure was observed in 57 patients (48.7%), with no significant difference between survivors and non‐survivors at 1 month (odds ratio 1.59, P = 0.30). The median PAPi for the whole study population was 2.83 [interquartile range 1.63–4.69]. The threshold value of PAPi determined by the ROC curve was 2.84. Patients with PAPi ≥ 2.84 had a higher survival rate at 3 months [PAPi

Abstract The preclinical study of atherosclerosis has traditionally centred around the use of small animal models, translating to large animal models, prior to first-in-man studies. We propose to disrupt this paradigm by designing an ex vivo pump perfused human limb model. The novel model consists of taking a freshly amputated limb and incorporating it into an ex situ pump-perfused bypass system (akin to extracorporeal membrane oxygenation), circulating warmed, oxygenated blood. The circuit incorporates an introducer sheath and guiding catheter for intravascular imaging and X-ray angiography. Regular monitoring is performed using blood gas analysis, aiming for physiological parameters. The model maintains oxygen saturations > 99% for the length of perfusion (up to 6-h). Clinical grade X-ray angiography, intravascular ultrasound and optical coherence tomography have been successfully performed. Indocyanine green, a near-infrared fluorescent dye that localises to atherosclerotic plaque, has been injected into the system and left to circulate for 90-min. Fluorescence reflectance imaging of the dissected arterial bed confirmed uptake in areas of calcific atherosclerotic plaque on intravascular imaging. This is the first demonstration of an ex vivo pump-perfused “living” limb experimental model of atherosclerosis, which shows promise for future studies in translational interventional imaging and molecular targeting.

This study aimed to create a hoof lamellae model by combining the histomorphometric data of lamellae from animals with odd and even toes. The comparison study showed that odd-toed horses and donkeys have two unique types of epidermal lamellae (EL) in the innermost layer of the capsular wall, known as primary (PEL) and secondary epidermal lamellae (SEL). In contrast, even-toed cows and camels have only PEL. These lamellae form a complex and complicated dermo-epidermal connection by interlocking with the corresponding primary (PDL) and secondary dermal lamellae (SDL). The PEL were all the same shape, and cells made up the intertubular horn of the stratum medium. Animals with odd toes had SEL. A group of non-cornified basal cells and a central area with partially keratinized cells were composed of these Els. A distinct and straightforward connection between SEL and PEL was shown via connective tissue fibers. In both odd-toed and even-toed animals, the PEL originates from basal cells placed at the proximal extremity of the stratum internum. As the cells migrate towards the outermost edge, they undergo keratinization, contributing to the overall count of keratinized cells in the PEL. The results indicated significant differences in lamellae between those animals with odd-toed and even-toed feet. In addition, the current outcomes deliver a new perspective on the relationship between the architecture of hoof lamellae in animals with odd or even toes and their increased ability for keratin formation, which might explain the development of hoof diseases in the future.

This article presents two patients who were diagnosed with autoimmune liver disease (autoimmune hepatitis and primary biliary cholangitis overlap syndrome) during anti-tuberculosis therapy, which is a rarely reported occurrence. It highlights the challenges in distinguishing drug-induced liver injury from authentic autoimmune liver disease. It also points out the importance of considering autoimmune liver disease as a potential diagnosis revealed by the setting of drug-induced liver injury.

Abstract: This study aims to understand the role of algorithms in information misinformation by marginalizing media information, which in turn hinders media literacy. The rapid spread of artificial intelligence and algorithmic systems raises concerns due to their lack of transparency, complicating assessments of compliance with human rights and labor laws. Algorithms can exhibit bias based on the training data and their correlation with processed data features. This issue has spurred discussions within the scientific community about biases and the ethical, computational, and media effects of algorithms. Keywords : Algorithms, Misinformation, Media Literacy, Bias, Transparency

Abstract: The current study examined vowel identification among 72 phonetically trained and untrained Algerian students of English enrolled in Master 2 English Language and Letters and Mathematics courses, respectively, at Mentouri University of Constantine. The study used a multiple alternative forced choice (m-AFC) classification test to assess participants’ identification rates of isolated RP prototypic vowels across varying temporal manipulations. It was hypothesised that phonetically trained and untrained participants would use acoustic features of examined vowels differently to identify vowels, with phonetically trained participants showing higher identification rates compared to untrained ones. Analysis of results demonstrated that the use of temporal and spectral features of vowels varied non-significantly across phonetically trained and untrained participants. The results show that vowel identification may be subject to specific speech mechanisms and non-significantly affected by phonetic training, suggesting the limited role of explicit phonetic instruction in vowel perception among L2 learners and the need for more effective teaching methods. Keywords: vowel identification rate, acoustic, durational manipulations, phonetically trained, untrained

The environmental effects on the response of Date Palm Fiber (DPF) composites are explored through an in-depth analysis of water absorption behavior. This study comprehensively investigates the influence of fiber content, immersion time, and water type on mass gain. Rigorous experimentation and advanced statistical analyses quantify the percent contribution of each factor, emphasizing the dominant role of fiber content at 96.61%. While immersion time and water type contribute relatively smaller percentages (2.11% and 1.28%, respectively), their insights are invaluable for tailored composite design. The study extends to interaction effects, showcasing the combined influence of factors. Regression models, progressing from linear and reciprocal formulations to comprehensive global models, are developed. Meticulous examination of prediction accuracy, using diverse statistical metrics, highlights the superior performance of the global reciprocal model across different water types. This work provides essential insights for optimizing DPF composite design, fabrication, and application, empowering engineers and researchers to make informed decisions in industries demanding tailored water absorption behavior.

Objective Real-life management of patients with hypertension and chronic kidney disease (CKD) among European Society of Hypertension Excellence Centres (ESH-ECs) is unclear : we aimed to investigate it. Methods A survey was conducted in 2023. The questionnaire contained 64 questions asking ESH-ECs representatives to estimate how patients with CKD are managed. Results Overall, 88 ESH-ECS representatives from 27 countries participated. According to the responders, renin-angiotensin system (RAS) blockers, calcium-channel blockers and thiazides were often added when these medications were lacking in CKD patients, but physicians were more prone to initiate RAS blockers (90% [interquartile range: 70–95%]) than MRA (20% [10–30%]), SGLT2i (30% [20–50%]) or (GLP1-RA (10% [5–15%]). Despite treatment optimisation, 30% of responders indicated that hypertension remained uncontrolled (30% (15–40%) vs 18% [10%–25%]) in CKD and CKD patients, respectively). Hyperkalemia was the most frequent barrier to initiate RAS blockers, and dosage reduction was considered in 45% of responders when kalaemia was 5.5–5.9 mmol/L. Conclusions RAS blockers are initiated in most ESH-ECS in CKD patients, but MRA and SGLT2i initiations are less frequent. Hyperkalemia was the main barrier for initiation or adequate dosing of RAS blockade, and RAS blockers’ dosage reduction was the usual management.

Background Epidural analgesia has emerged as one of the best methods that can be used to reduce labour pain. This study was conducted to assess awareness, attitudes, and practices of pregnant women who visited maternity and antenatal healthcare clinics about epidural analgesia during normal vaginal birth.Methods This multicentre study was conducted in a cross-sectional design among pregnant women using a pre-tested questionnaire. The study population in this study was pregnant women who visited maternity and antenatal healthcare clinics in Palestine.Results In this study, a total of 389 pregnant women completed the questionnaire. Of the pregnant women, 381 (97.9%) were aware of the existence of epidural analgesia, 172 (44.2%) had already used epidural analgesia, and 57 (33.1%) experienced complications as a result of epidural analgesia. Of the pregnant women, 308 (79.2%) stated that epidural analgesia should be available during vaginal birth. Of the pregnant women, 243 (62.5%) stated that they would use epidural analgesia if offered for free or covered by insurance. Multivariate logistic regression showed that women who were younger than 32 years, who have used epidural analgesia, and those who stated that epidural analgesia should be available during vaginal birth were 2.78-fold (95% CI: 1.54–5.04), 4.96-fold (95% CI: 2.71–9.10), and 13.57-fold (95% CI: 6.54–28.16) more likely to express willingness to use epidural analgesia, respectively.Conclusions Pregnant women had high awareness of the existence, moderate knowledge, and positive attitudes towards epidural analgesia for normal vaginal birth. Future studies should focus on educating pregnant women about all approaches that can be used to reduce labour pain including their risks and benefits.

ABSTRACT In this study, the thermal and mechanical characteristics of bamboo fiber-reinforced greenpoxy matrix composites were evaluated by varying the fiber loading from 30wt.% to 60wt.% during the compression molding process. The thermal behavior using dynamic mechanical analysis (DMA) and thermogravimetric analysis (TGA) and their impact and flexural properties of the composites were studied. The results indicate that thermal characterization, the highest peak E’ was observed: B-40 > B-60 > B-30 > B-50, while the peak E’‘ was found to be B-40 > B-30 > B-60 > B-50. The order for tan delta was B-30 > B-40 > B-50 > B-60. The TGA results indicated improved thermal stability with increasing fiber loading, as evidenced by higher residue % and lower weight loss %. Regarding the mechanical properties the impact strength of the composites increased with increasing fiber loading, with the maximum value of 8435.33 J/m2 at 50wt.%. The composite with a 60wt.% fiber loading showed the highest flexural modulus (4.70GPa), while the flexural strength improved at 40wt.%. The SEM analysis of fractured specimens from flexural tests of composite materials with varying fiber volume fractions revealed that an optimal balance between fiber and matrix resin enhanced mechanical properties.

Gel electrophoresis is essential in molecular biology and biochemistry for separating and analyzing DNA, RNA, and proteins. UV sensitivity and compatibility have led to the use of ethidium bromide stains. Mutagenic and toxic, ethidium bromide poses health and environmental risks, requiring strict handling and disposal procedures. This has led to safer, more eco-friendly staining options like SYBR Safe and patented plant-based dyes with reduced toxicity and improved sensitivity. Modern dyes meet rigorous laboratory safety standards and are compatible with safer visualization methods like blue light, improving user safety. We compare the efficacy, cost, and environmental impact of commercial electrophoresis stains in this review. These comparisons suggest using SYBR-safe or plant-based dyes, which stain well in safer lab conditions. These alternatives improve electrophoresis sustainability and safety without compromising analytical quality.

This study aimed to characterize the cervical cancer diagnosis experience of Kenyan women undergoing treatment for cervical cancer. We analyzed qualitative interviews with 29 women living in rural Kenya who were currently undergoing cervical cancer treatment at Machakos Cancer Care and Research Centre at Machakos Level 5 Referral Hospital in eastern Kenya. Semistructured qualitative interviews were conducted in Kiswahili and English and then de-identified and translated to English during transcription. The main themes generated were identified through an inductive approach to determine how women experienced cervical cancer symptoms and their process of navigating healthcare. Three themes emerged from the qualitative interviews: (1) delaying seeking care, (2) misinterpreting or misdiagnoses, and (3) grappling with the costly diagnosis process. Women misattributed early signs of cervical cancer to benign conditions. Women sought care only after experiencing severe symptoms. When they sought care, women reported facing lengthy and costly screening processes before receiving a cervical cancer diagnosis. There is a need to educate women on the early symptoms of cervical cancer and to increase the institutional capacity and availability of cervical cancer screening resources in healthcare facilities.

Congenital hiatal hernia is a rare congenital defect and often occurs at a sporadic basis, but familial cases have also been reported. Here, we report on a 3-year-old male patient of Middle-Eastern descent, diagnosed at 5 months of age patient presenting with a congenital hiatal hernia, vermis hypoplasia manifested by axial hypotonia and horizontal nystagmus, preauricular tag, and dysmorphic features with negative genetic mutations, not fitting any reported association or syndrome, suggesting the potential existence of a novel disease entity and highlighting the necessity for further exploration into rare genetic conditions for comprehensive patient care and syndrome characterization.

IntroductionCarrot (Daucus carota) is a nutrient-dense root vegetable, and carrot pomace is a by-product of the juice extraction procedure, which is recognized a source of phytochemicals and functional components. Almonds (Prunus dulcis) are packed with a decent amount of nutrients and bioactives.MethodsThis study investigates the utilization of carrot pomace powder (CPP) and almond powder (AP) as partial substitutes for straight grade white flour (SGWF) in cakes to enhance their nutritional value and sensory appeal, while reducing waste from carrot processing. The aim is to assess the effects of incorporating CPP (at 5%, 10%, and 15%) and AP (at 5%) on the chemical composition and properties of cakes.Results and discussionComparative analysis reveals that AP is rich in fat (13.8 ± 0.6%) and protein (31 ± 0.6%), while CPP excels in ash (5.0 ± 0.5%) and fiber (43.3 ± 3.3%) content. Furthermore, SGWF exhibits the highest moisture content. Water holding capacities for CPP and AP are 5.2 ± 0.2% and 5.0±0.1%, respectively, and oil holding capacities are 1.3 ± 0.1% and 1.8 ± 0.2%, respectively. Additionally, CPP contains higher levels of sodium, potassium, and calcium, while AP contains higher levels of magnesium, iron, and zinc compared to SGWF. The addition of CPP and AP increases the ash, fat, fiber, and protein contents of the cakes. Notably, cakes containing 80% SGWF, 15% CPP, and 5% AP show significantly higher total phenolic content (TPC) (125.5 ± 3.8 mg GAE/100 g), total flavonoid content (TFC) (58.4 ± 1.4 mg QE/100 g), and DPPH activity (17.6 ± 2.7%) compared to control cakes. Furthermore, a significant increment in mineral content is observed in cakes with high levels of CPP and AP. Sensory evaluations reveal high acceptance of cakes containing 15% CPP and 5% AP. In conclusion, this study suggests that the incorporation of CPP and AP into cakes can improve their nutritional profile, antioxidant activity, and sensory characteristics, offering a sustainable approach to bakery product development.

Background Peripartum cardiomyopathy (PPCM) outcomes have been previously linked to demographic and social factors. The social vulnerability index (SVI) is a measure of social vulnerability in the United States. We explored PPCM disparities and the impact of SVI on PPCM mortality. Methods and Results Mortality from 1999 to 2020, SVI, and demographic data were obtained from CDC databases. County‐specific SVI rankings were linked to PPCM age‐adjusted mortality rates (AAMRs), allowing for a comparative analysis of AAMRs across both cumulative populations and subpopulations to identify disparities. All US counties were then stratified into low‐ and high‐SVI groups, facilitating comparison of SVI rankings by estimation of excess‐deaths per 1 000 000 person‐years attributable to greater social vulnerability and rate ratios (RR) through univariable Poisson regression. We identified a total of 1026 deaths related to PPCM between 1999 and 2020. Overall AAMR increased from 0.180 in 1999 to 0.326 in 2020. Black populations (AAMR: 1.081) and Southern US counties (AAMR: 0.444) had the highest AAMRs compared with other racial and US census groups, respectively. Higher SVI accounted for 0.172 excess deaths per 1 000 000 person‐years (RR=1.800). Among Black and White populations, higher SVI also accounted for 0.248 and 0.071 excess deaths per 1 000 000 person‐years, respectively. Similar impacts of greater social vulnerability were observed when comparing the US census regions (Northeast RR=1.609, Midwest RR=1.819, South RR=1.934, West RR=1.776). Conclusions PPCM mortality disparities exist across racial and geographic populations in the United States. A greater burden of social vulnerability is associated with higher PPCM mortality on a national level.

BackgroundWith the increasing global prevalence of type 2 diabetes (T2D) and obesity, there is a pressing need for novel therapeutic interventions. Lavandula stoechas, a medicinal plant traditionally used for various ailments, holds promise as a potential agent for T2D management, particularly in Morocco, where it is commonly used to treat diabetes. This study aims to evaluate the pharmacological potential of L. stoechas aqueous extract (AqLs) by assessing its lipase inhibition antioxidant and anti-inflammatory activities, identifying phenolic compounds, and examining its efficacy in reducing diabetic complications.MethodsThe pharmacological potential of L. stoechas aqueous extract was investigated using in vitro assays. The inhibitory effect on pancreatic lipase, antioxidant power (FRAP), and anti-inflammatory activity (albumin denaturation method) was assessed. High-performance liquid chromatography (HPLC) analysis identified phenolic compounds. Additionally, albumin glycation was evaluated by estimating fructosamine, carbonyl groups, and amyloid β-structures to assess efficacy in mitigating diabetic complications.ResultsThe extract demonstrated concentration-dependent inhibition of pancreatic lipase (IC50 = 0.132 ± 0.006 mg/mL), potent antioxidant activity (IC50 = 604.99 ± 1.01 μg/mL), and dose-dependent anti-inflammatory effects (IC50 = 207.01 ± 34.94 mg/mL). HPLC analysis revealed phenolic compounds: naringin (38.28%), syringic acid (25.72%), and cinnamic acid (15.88%) were the most abundant, with 4-hydroxybenzoic acid, hydrated catechin, and catechin ranging from 9.60% to 5.24%, and p-coumaric acid (1.73%). Furthermore, the extract inhibited albumin glycation and fructosamine production, suggesting efficacy in mitigating diabetic complications.ConclusionThese findings highlight the multifaceted pharmacological potential of L. stoechas aqueous extract in T2D management, suggesting that this plant can be highly beneficial for diabetic individuals.

Chronic asymptomatic retention of an intragastric foreign body can pose a life-threatening scenario. In the event of migration, it may result in perforation, as shown in our unique case of pericardial perforation through the fundus. Beyond illustrating a rare condition, this case prompts us to engage in a debate about whether to retain or remove asymptomatic foreign bodies in the gastrointestinal tract. It is a 28-year-old male patient, a prisoner, with a history of recurrent foreign body ingestion leading to five previous interventions, presented a year ago to our emergency department after ingesting four metal rods. Despite recommendations, the patient refused the intervention. After 1 year, he presented to our emergency department for respiratory distress. On examination, he had tachycardia, cardiac auscultation revealed a high-pitched sound signing a pericardial knock and abdominal palpation revealed epigastric tenderness. An abdominal X-ray revealed the presence of metallic foreign bodies located in the gastric area. An electrocardiogram showed a low voltage. Given these findings, there was a strong suspicion of rod migration from the stomach to the thoracic cavity with a cardiac tamponade. An emergency CT scan revealed that the rod had pierced through the stomach and pericardium, causing pericardial effusion. The patient was promptly transported to the operating room to discover the tip of the rod out of the stomach and penetrating the left diaphragm and the pericardial layer. The foreign body was removed.