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Abstract Background Neurofibromatosis type 1 (NF1) is a multisystem genetic disorder that commonly involves skin, nerves, and skeletal system with increased neoplastic predisposition. This disease has been rarely associated with multiple congenital anomalies. Herein, we describe an Egyptian child with NF1 and coexistent bilateral congenital glaucoma, giant congenital melanocytic nevi (GCMN), alopecia, and hypospadias. Case presentation A 2.5-year-old boy presented with developmental delay, back swelling, and multiple congenital anomalies. His father and two sisters were known to have NF1. The child was diagnosed with bilateral primary congenital glaucoma at the age of 3.5 months and underwent trabeculectomy with mitomycin C therapy. Examination at the age of 5 months revealed marked hypotonia, multiple GCMN, scanty café-au-lait macules, left upper eyelid plexiform neuroma and trichomegaly, hypertrichosis of left eyebrow, hypertelorism, depressed nasal bridge, left frontal scalp alopecia, and distal penile hypospadias. At the age of 8 months, brain imaging depicted a markedly dilated left lateral ventricle, and he underwent ventriculoperitoneal shunt surgery. The child developed back swelling at the age of 2.5 years, and a spinal magnetic resonance image showed bilateral multiple spinal neurofibromas in the paraspinal region with intraspinal extensions. A whole exome sequencing identified a heterozygous missense variant NM_001042492.3:c.1466A > G (NP_001035957.1:p.Tyr489Cys) in NF1 gene. Conclusions The present case report adds to the knowledge of the phenotypic spectrum and variability of NF1 by reporting the association of multiple unusual congenital anomalies. Importantly, such congenital anomalies could be the first presenting features in patients with NF1 since cafe´-au-lait macules and other typical diagnostic criteria may not be apparent in the neonatal period and early infancy. Accordingly, NF1 should be considered in newborns with congenital glaucoma, GCMN, scalp alopecia, and hypospadias.

Context: Homoeriodictyol is a flavonoid with known antioxidant, anti-inflammatory, and anti-tumor properties found in various plants. However, its potential analgesic effects have not been explored. Aims: To investigate the pain-relieving properties of homoeriodictyol using different mouse models of nociception. Methods: Various doses of homoeriodictyol (50, 100, 150, and 200 µg/kg) were administered to mice and evaluated using the acetic acid-induced writhing test, the hot plate test, and the formalin-induced paw licking assay. These effects were compared with those of mice treated with acetylsalicylic acid or morphine, both with and without naloxone, an opioid receptor antagonist. Additionally, capsaicin- and glutamate-induced paw-licking tests were conducted to assess the involvement of the vanilloid and glutamatergic systems, respectively. Results: Homoeriodictyol demonstrated a significant and dose-dependent reduction in nociceptive behavior in the acetic acid-induced writhing test, achieving a 52.4% inhibition at a dose of 200 µg/kg. It also substantially increased the latency period in response to the hot plate test (65.8% at 200 µg/kg) and significantly suppressed both the neurogenic and inflammatory phases in the formalin-induced paw-licking test. Notably, the effects of homoeriodictyol in the hot plate test and formalin-induced paw-licking test were significantly reversed by naloxone. Furthermore, homoeriodictyol effectively reduced neurogenic nociception induced by intraplantar injections of glutamate and capsaicin (57.8% and 76.9%, respectively, at a dose of 200 µg/kg). Conclusions: This study concludes that homoeriodictyol exhibits antinociceptive activity in mice, acting through both central and peripheral pathways.

The flavonoid compound Isorhamnetin (IRMN) is known for its considerable pharmacological properties, which include antioxidant and anti-inflammatory effects, as well as significant protective actions on heart health. However, the potential of IRMN to guard against heart damage caused by cisplatin (CP), a common chemotherapeutic agent, and the specific mechanisms involved, remain unexplored areas. This research was designed to investigate how IRMN counters CP-induced heart toxicity. In our study, mice were orally given IRMN at 50 or 150 mg/kg/day for a week, followed by CP injections (5 mg/kg/day) on the third and sixth days. The animals were euthanized under sodium pentobarbital anesthesia (50 mg/kg, intraperitoneally) on the eighth day to collect blood and heart tissues for further examination. Our findings reveal that IRMN administration significantly reduced the heart damage and the elevation of heart injury markers such as cardiac troponin I, creatine kinase, and lactate dehydrogenase induced by CP. IRMN also effectively lowered oxidative stress markers, including reactive oxygen species and malondialdehyde, while boosting ATP production and antioxidants like superoxide dismutase, catalase, and glutathione. The compound’s capability to diminish the levels of pro-inflammatory cytokines like tumor necrosis factor-alpha and interleukin-6, alongside modulating apoptosis-regulating proteins (enhancing Bcl-2 while suppressing Bax and Caspase-3 expression), further underscores its cardioprotective effect. Notably, IRMN modulated the p62–Keap1–Nrf2 signaling pathway, suggesting a mechanism through which it exerts its protective effects against CP-induced cardiac injury. These insights underscore the potential of IRMN as an effective adjunct in cancer therapy, offering a strategy to mitigate the cardiotoxic side effects of cisplatin.

Background: Major depressive disorder is prevalent across different societies, affecting individuals from various cultural and socioeconomic backgrounds. Dysregulation of the nitric oxide (NO) pathway and increased oxidative stress have been implicated as contributing factors. Purpose: This study aimed to explore the antidepressant potential of β-caryophyllene in a mouse model subjected to maternal separation stress, with a focus on its effects on oxidative stress and nitrite levels. Study Design: The research involved 40 male mice, which were divided into five groups. Methods: The control group received 1 ml/kg of normal saline, while the maternal separation (MS) groups were administered normal saline in conjunction with β-caryophyllene at doses of 10, 20, and 50 mg/kg. Various behavioral tests, including the open field test (OFT), forced swimming test (FST), and splash test, were employed to assess the impact of β-caryophyllene. Additionally, measurements of total antioxidant capacity (TAC), malondialdehyde (MDA), and nitrite levels in the hippocampus were conducted. Results: The findings demonstrated that maternal separation stress induced depressive-like behaviors in mice, as evidenced by increased immobility time in the FST and decreased grooming behavior in the splash test. Furthermore, MS was associated with elevated MDA and nitrite levels and reduced TAC in the hippocampus. However, administration of β-caryophyllene increased grooming activity in the splash test and decreased immobility time in the FST. Additionally, β-caryophyllene exhibited antioxidant properties, lowering MDA and nitrite levels while enhancing TAC in the hippocampus. Conclusion: These results suggest that β-caryophyllene may possess antidepressant-like effects in mice subjected to maternal separation, likely due to its antioxidant actions in the hippocampus.

Aim This study explored Panduratin A’s protective effects against DSS-induced colitis in mice, focusing on reducing inflammation and oxidative stress in the colon.Methods Mice were treated with dextran sodium sulfate (DSS) and Panduratin A (3, 6, 18 mg/kg), and changes in body weight, colon length, Disease Activity Index (DAI), histopathology, inflammation markers including tumor necrosis factor- α (TNF-α), Interleukin-1 β (IL-1β), Myeloperoxidase (MPO), and oxidative stress, Malondialdehyde (MDA) were evaluated.Results Panduratin A significantly reversed DSS-induced symptoms, including body weight loss, colonic length shortening, and DAI increase, while reducing histopathological damage. It lowered inflammatory markers and oxidative stress, suppressed NF-κB activation, and enhanced Nrf2 and HO-1 expression.Conclusion Panduratin A shows promise as a colitis treatment, warranting further research for broader clinical application.

Background: Dysmenorrhea is wide spread gynecological disorder among that affect the quality of life of women world wide. The current study aims to examine whether war displacement, mental health symptoms, and other clinical factors are associated with dysmenorrhea severity. Methods: This is a cross-sectional case-control study recruiting two groups: displaced Syrian women and un-displaced local Jordanian women. Demographics and clinical details were recorded. The severity of dysmenorrhea was assessed using WaLIDD scale, the PHQ-9 scale was emplyed to assess depressive symptoms, anxiety was assessed using the GAD-7 scale, and insomnia was assessed using the ISI-A scale. Predictors of severe dysmenorrhea in females using multivariate binary logistic regression. Results: Out of 808 of the total participants, 396 (49%) were Syrian displaced war refugees, 424 (42.5%) reported using paracetamol, 232 (23.2%) were using NSAIDs, and 257 (25.9%) using herbal remedies. Severe dysmenorrhea was associated with war displacement (OR = 2.14, 95% CI = 1.49–3.08, p < 0.001), not using NSAIDs (OR = 2.75, 95% CI = 1.91–3.95, p < 0.001), not using herbal remedies (OR = 2.01, 95% CI = 1.13–3.60, p = 0.01), depression (OR = 2.14, 95% CI = 1.40–3.29, p < 0.001), and insomnia (OR = 1.66, 95% CI = 1.14–2.42, p = 0.009). Conclusions: War displacement, type of analgesic, depression, and insomnia are risk factors for severe dysmenorrhea.

Context: Salvia fruticosa, known as Greek sage, is a perennial shrub indigenous to the eastern Mediterranean. Historically, its leaves have been prized for their medicinal properties, particularly in traditional remedies for anti-inflammatory, antimicrobial, and digestive ailments. Aims: To evaluate the anti-inflammatory properties and possible mechanisms of action of Salvia fruticosa essential oil (EOSF). Methods: The essential oil was obtained from the aerial parts of the plant using hydrodistillation and then analyzed using gas chromatography and mass spectrometry. The anti-inflammatory effects of the essential oil were examined using established inflammation models, specifically carrageenan-induced paw edema and peritonitis. To investigate the anti-inflammatory effects of the essential oils, widely recognized inflammation models were employed, specifically carrageenan-induced paw edema and peritonitis. In addition, the essential oil’s antioxidant activity was evaluated by measuring its ability to scavenge nitric oxide radicals and inhibit lipid peroxidation. Results: The primary constituents of the EOSF were found to be 1,8-cineol (eucalyptol) (45.5%), β-caryophyllene (9.2%), and β-pinene (6.5%). The results of the study demonstrated that EOSF displayed a significant reduction in edema, peritonitis, myeloperoxidase activity, and NOx-peritoneal lavage concentration induced by carrageenan. Moreover, the essential oil exhibited notable inhibition of nitric oxide radical production stimulated by sodium nitroprusside. Additionally, EOSF demonstrated the ability to prevent lipid peroxidation caused by Fe2+ or Fe2+ plus H2O2. Conclusions: The findings indicate that EOSF possesses anti-inflammatory properties, potentially attributed to its antioxidant capacity.

Aim: The study aims to investigate the association between type 2 diabetes and adipokines, particularly resistin and adiponectin, in insulin resistance. It also explores the potential of the resistin to adiponectin ratio as an indicator for these conditions Methods: This research involved 198 participants, including 100 patients with type 2 diabetes and 98 controls. It focused on measuring various biochemical parameters like HbA1c, fasting plasma glucose, lipid profiles (low-density lipoprotein, oxidized low-density lipoprotein, triglyceride, total cholesterol), and adipokines (resistin and adiponectin). The study utilized the Homeostasis Model Assessment of Insulin Resistance and Triglyceride-Glucose index to evaluate insulin resistance. Results: Type 2 diabetic patients exhibited higher levels of HbA1c, fasting plasma glucose, lipid profiles, and resistin, but lower adiponectin levels compared to controls. Adiponectin showed a negative correlation with insulin resistance, while resistin demonstrated a positive correlation. Both adipokines significantly related to atherogenic markers, with adiponectin offering protection against atherosclerosis and resistin augmenting it. Conclusion: The findings underscore the complex roles of resistin and adiponectin in the pathophysiology of type 2 diabetes, insulin resistance. The resistin to adiponectin ratio could be a useful biomarker for insulin resistance. These insights suggest potential therapeutic strategies for treating diabetes and preventing its complications.

Objective: The Jordanian and the Palestinian communities are tightly related, hence, the current war on Gaza also has social and psychological impacts on Jordanians. Therefore, this study aims to identify the factors associated with severe insomnia and fatigue symptoms in a cohort of Jordanians during the Gaza War outbreak. Methods: This is a cross-sectional web-based questionnaire study. The Insomnia Severity Index-Arabic version (ISI-A), and the Brief Fatigue Inventory-Arabic (BFI-A) were employed, binary logistic and linear regression analyses was performed to identify predictors to severe insomnia and fatigue respectively. Data were collected between December 2023 and January 2024. Results: Data were analyzed from 477 participants, of which 315 (66 %) were females, 107 (22.4 %) reported having a family relative or a friend residing in Gaza, 365 (76.5 %) reported not using any sleep aid, 78 (16.4 %) reported using homeopathy herbal remedies for sleep, and only 52 (10.9 %) reported using over-the-counter sedating antihistamines. Severe insomnia was significantly associated with participants “younger than 30 years old” (OR = 1.81, 95 %CI = 1.22–2.66, p = 0.003), participants “using over-the-counter sedating antihistamines” (OR = 2.78, 95 % CI = 1.27–6.06, p = 0.01). Severe fatigue was significantly associated with “females” (B = 5.87, t = 2.78, p = 0.006), and “smokers” (B = 5.09, t = 2.52, p = 0.01). On the other hand, “not using sleep aids” demonstrated significantly lower odds for severe insomnia (OR = 0.41, 95 % CI = 0.24–0.68, p = 0.001), and fatigue (B = -10.84, t = -4.81, p

Oxidative stress and inflammation are implicated in depression. While selective serotonin reuptake inhibitors (SSRIs) like escitalopram are commonly prescribed as first-line treatments, their inconsistent efficacy and delayed onset of action necessitates the exploration of adjunctive therapies. Isorhamnetin, a flavonol, has shown antioxidant and anti-inflammatory properties that makes exploring its antidepressant effect attractive. This study aims to investigate the adjuvant potential of isorhamnetin in combination with escitalopram to enhance its antidepressant efficacy in a lipopolysaccharide (LPS)-induced depression model using Swiss albino mice. Behavioral paradigms, such as the forced swim test and open field test, were employed to assess depressive symptoms, locomotion, and sedation. Additionally, enzyme-linked immunosorbent assays were utilized to measure Nrf2, BDNF, HO-1, NO, and IL-6 levels in the prefrontal cortex and hippocampus. The results demonstrate that isorhamnetin significantly improves the antidepressant response of escitalopram, as evidenced by reduced floating time in the forced swim test. Moreover, isorhamnetin enhanced antidepressant effects of escitalopram and effectively restored depleted levels of Nrf2, BDNF, and HO-1 in the cortex caused by LPS-induced depression. Isorhamnetin shows promise in enhancing the efficacy of conventional antidepressant therapy through antioxidant and anti-inflammatory effects.

Background and Objectives: Although physical health is always studied for women with diabetes, the mental health aspect is generally overlooked for this chronic disease. The present study aimed to examine the prevalence of psychosomatic symptoms, namely, fibromyalgia syndrome, depression, anxiety, and insomnia, and how these symptoms related to the medications used in a cohort of women diagnosed with type 2 diabetes (DM) in Jordan. Materials and Methods: This cross-sectional study recruited women diagnosed with type 2 diabetes, and validated scales (PSRS, PHQ-9, GAD-7, and ISI-A) for fibromyalgia syndrome, depression, anxiety, and insomnia were used. The associations between the different medications used and the dependent variables were examined using four separate multivariate logistic regression models. Results: Data were analyzed from 213 participants. Of them, 27.2% met the threshold for fibromyalgia syndrome diagnosis, 38% met the threshold for severe depression, 36.2% met the threshold for severe anxiety, and 39.9% met the threshold for severe insomnia. Fibromyalgia syndrome symptoms were significantly associated with glimepiride (OR = 1.92, CI = 1.00–3.68), β-blockers (OR = 2.21, CI = 1.03–4.70), diuretics (OR = 3.13, CI = 1.26–7.78), herbal remedies (OR = 2.12, CI = 0.98–4.55), and prescriptions for centrally acting medication (OR = 2.78, CI = 1.24–6.29). Significant associations were found between depression and diuretics (OR = 2.62, CI = 1.05–6.67), over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) (OR = 3.49, CI = 1.69–7.23), and herbal remedies (OR = 5.07, CI = 2.40–10.69). In addition, anxiety was significantly related to diuretics (OR = 2.48, CI = 1.02–6.02), and OTC NSAIDs (OR = 2.60, CI = 1.29–5.21). Significant associations were evident between insomnia and β-blockers (OR = 3.23, CI = 1.51–6.95), acetaminophen (OR = 2.09, CI = 1.06–4.08), NSAIDs (OR = 4.61, CI = 2.18–9.76), and herbal remedies (OR = 5.95, CI = 2.71–13.07). Conclusions: Medications are associated with high burden of fibromyalgia syndrome, depression, anxiety, and insomnia. These findings underscore the importance of revising and optimizing the pharmacotherapy of these vulnerable patients, performing close mental health monitoring and the implementation of non-pharmacological interventions by integrating mental health services for women with chronic diseases such as diabetes.

Aim: This study aimed to assess the anti-inflammatory activity and potential mechanisms of essential oil of Tamarix aphylla (EOTA). Methods: The essential oils were extracted from the plant’s aerial parts using hydrodistillation and analyzed through gas chromatography and mass spectrometry (GC/MS). The essential oils were assessed for their anti-inflammatory effects using well-established inflammation models, namely carrageenan-induced paw edema and peritonitis. To evaluate the antioxidant activity of the essential oil, measurements were taken for nitric oxide radical-scavenging activity and lipid peroxidation. Results: The predominant components of the EOTA were 6,10,14-Trimethyl-2-pentadecanone (20.2%), β-Ionone (20.1%), Dodecanoic acid (12.2%), and trans-β-Caryophyllene (10%.1). The study found that EOTA significantly reduced edema, peritonitis, myeloperoxidase activity, and NOx-peritoneal lavage concentration induced by carrageenan. Additionally, the essential oil exhibited significant inhibition of nitric oxide radical production triggered by sodium nitroprusside. Furthermore, EOTA demonstrated the ability to prevent lipid peroxidation induced by Fe+2- or Fe+2 plus H2O2. Conclusion: The findings suggest that EOTA possesses anti-inflammatory activity, potentially linked to its antioxidant capacity.

Background: Formononetin (FMN) is a flavonoid that has different pharmacological effects. Thus, the anti-diabetic effects of FMN has been investigated in a high-fat diet/Streptozotocin-(HFD/STZ)-induced diabetes mice model. Methods: Mice were fed with HFD followed by STZ. Diabetic mice were treated orally with FMN or metformin for 28 days before collecting plasma and soleus muscle for further analysis. Results: FMN reduced serum glucose (p>0.001) and increased serum insulin in diabetic group compared to the vehicle control. Additionally, FMN decreased homeostasis model assessment of insulin resistance (HOMA-IR). Fasting glucose level was also reduced with FMN during the intraperitoneal glucose tolerance test (IPGTT). GLUT4 and p-AMPK-α1 were upregulated following treatment with FMN. LDL, triglyceride, and cholesterol were reduced in diabetic mice treated with FMN. FMN reduced MDA, increased GSH levels , and reduced GSSG levels in diabetic mice. Conclusion: FMN could represent a promising therapeutic agent to treat T2D.

Background: 2ʹ,3,3,5ʹ-Tetramethyl-4ʹ-nitro-2ʹH-1,3ʹ-bipyrazole (TMNB) is a novel bipyrazole compound that exhibited antidiabetic and anti-inflammatory properties. However, its analgesic effect has not been investigated. This study aimed to assess the antinociceptive activity of TMNB using different nociception mouse models. Methods: TMNB doses (50, 100, 150, and 200 µg/kg) were assessed in mice using the acetic acid-induced writhing test, hot plate test, and formalin-induced paw licking assay. The effects were compared to those of mice treated with acetylsalicylic acid or morphine in the presence or absence of naloxone. Capsaicin- and glutamate-induced paw-licking tests were also used to evaluate the involvement of the vanilloid and glutamatergic systems, respectively. Results: TMNB produced significant dose-dependent inhibition of nociceptive behavior in the acetic acid-induced writhing test, showing 66% inhibition at a dose of 200 µg/kg. TMNB also caused a significant increase in the latency period in response to the hot plate test (68.2% at 200 µg/kg), and significantly inhibited both the neurogenic and inflammatory phases in the formalin-induced paw-licking test. Naloxone significantly reverses the effect of TMNB in both the hot plate test and formalin-induced paw-licking test. Moreover, TMNB significantly inhibited the neurogenic nociception induced by intraplantar injections of glutamate and capsaicin (53% and 77.1%, respectively at a dose of 200 µg/kg). Conclusion: TMNB possesses antinociceptive activity in mice that is mediated through both central and peripheral pathways.

Abstract Background Ward rounds are a cornerstone in the educational experience of junior doctors and an essential part of teaching patient care. Here, we aimed to assess the doctors’ perception of ward rounds as an educational opportunity and to identify the obstacles faced in conducting a proper ward round in Sudanese hospitals. Method A cross-sectional study was conducted from the 15th to the 30th of January 2022 among house officers, medical officers, and registrars in about 50 teaching and referral hospitals in Sudan. House officers and medical officers were considered the learners, while specialist registrars were considered the teachers. Doctors’ perceptions were assessed using an online questionnaire, with a 5-level Likert scale to answer questions. Results A total of 2,011 doctors participated in this study (882 house officers, 697 medical officers, and 432 registrars). The participants were aged 26.9 ± 3.2 years, and females constituted about 60% of the sample. An average of 3.1 ± 6.8 ward rounds were conducted per week in our hospitals, with 11.1 ± 20.3 h spent on ward rounds per week. Most doctors agreed that ward rounds are suitable for teaching patient management (91.3%) and diagnostic investigations (89.1%). Almost all the doctors agreed that being interested in teaching (95.1%) and communicating appropriately with the patients (94.7%) make a good teacher in ward rounds. Furthermore, nearly all the doctors agreed that being interested in learning (94.3%) and communicating appropriately with the teacher (94.5%) make a good student on ward rounds. About 92.8% of the doctors stated that the quality of ward rounds could be improved. The most frequently reported obstacles faced during ward rounds were the noise (70%) and lack of privacy (77%) in the ward environment. Conclusion Ward rounds have a special value in teaching patient diagnosis and management. Being interested in teaching/learning and having good communication skills were the two major criteria that make a good teacher/learner. Unfortunately, ward rounds are faced with obstacles related to the ward environment. It is mandatory to ensure the quality of both ward rounds' teaching and environment to optimize the educational value and subsequently improve patient care practice.

Chemotaxonomy is a valuable tool for obtaining taxonomic insights, which are most effectively employed in combination with other forms of data to establish a system of classification that closely reflects natural connections. The utilization of plant secondary metabolites possessing diverse therapeutic qualities signifies the growing exploitation of natural products in the medical discipline. The objectives of the current study encompassed the identification of phytochemicals in the extracts of nine species of medicinal plants, the examination of their chemotaxonomic properties, and the assessment of the antibacterial and antioxidant capabilities exhibited by the extracts. GC-MS technology was employed for the identification of phytochemical compounds. The study utilized ClassyFire, an automated chemical classification system that incorporates an extensive and computable classification, to categorize chemicals. The chemical classification of plants was examined by the application of principal component analysis (PCA) and cluster analysis (CA). The bactericidal properties of plants were assessed against four harmful bacterial species using the disc diffusion technique. The antioxidant properties of plant extracts were assessed employing the DPPH free radical scavenging methodology, and the half maximal effective concentration (EC50) was determined using dose response models. The calculator being referred to is the Quest Graph™ EC50 Calculator. In the plant extracts, the analysis disclosed the occurrence of 160 phytochemicals, classified into 36 phytochemical classes. The results of CA and PCA demonstrated the proximity and associations among Asteraceae species, while indicating the divergence of the two Lamiaceae species. Achillea fragrantissima and Ducrosia flabellifolia demonstrated the most diversity in phytochemical classes, while Thymus vulgaris displayed the highest level of dominance. Pulicaria undulata and T. vulgaris had the most notable antibacterial activity. D. flabellifolia and P. incisa demonstrated the highest levels of antioxidant activity. Ethanol exhibited superior antibacterial efficacy compared to other solvents. The remarkable biological activities exhibited by these plant extracts can be ascribed to the copious presence of certain chemicals, predominantly sesquiterpenoids, monoterpenoids, benzene and its derivatives, naphthalenes, fatty acyls, and phenols. The susceptibility of Gram-positive bacterial species to plant extracts was shown to be higher in comparison to Gram-negative bacterial species.

Epigallocatechin gallate (EGCG) is a catechin, which is a type of flavonoid found in high concentrations in green tea. EGCG has been studied extensively for its potential health benefits, particularly in cancer. EGCG has been found to exhibit anti-proliferative, anti-angiogenic, and pro-apoptotic effects in numerous cancer cell lines and animal models. EGCG has demonstrated the ability to interrupt various signaling pathways associated with cellular proliferation and division in different cancer types. EGCG anticancer activity is mediated by interfering with various cancer hallmarks. This article summarize and highlight the effects of EGCG on cancer hallmarks and focused on the impacts of EGCG on these cancer-related hallmarks. The studies discussed in this review enrich the understanding of EGCG’s potential as a therapeutic tool against cancer, offering a substantial foundation for scientists and medical experts to advance scientific and clinical investigations regarding EGCG’s possibility as a potential anticancer treatment.

Background: In Ramadan, most of the dosing schedules for the patients are changed, and to ensure patient compliance to medications and to healthy life among patients, appropriate guidelines and educations are needed. This can be achieved by pharmacy personnel in all clinical settings who are recognized as biopharmaceutical experts and integral educators of medications. Aims: This study aimed to identify the perspective knowledge of pharmacy personnel about effect of medication route and medical procedure on nullifying fasting in Ramadan and to determine the predictors of this knowledge. Methods: A cross-sectional study was conducted in Jordan during March-April 2022. An internet-based self-administrated questionnaire on knowledge, and views was distributed using social media groups to the pharmacy personnel among different geographical areas in Jordan. A descriptive and univariate analysis were performed. Binary logistic regression was conducted to determine the predictors of knowledge including all variables with p

Buildings use a significant amount of the world’s total primary energy, particularly in heating and cooling systems. Energy consumption of air conditioning systems can be lowered by installing energy-efficient systems that take into account piping thermal insulation. The objective of this research is to calculate the optimal thickness of insulation for piping networks with variable refrigerant flow and to investigate the environmental and economic impacts of using the optimal insulation thickness. The case study of this research is An-Najah Child Institute. The research is based on the current cost over the life cycle of the insulation, which is assumed to be 15 years, to determine the optimal thickness of the common insulation types (rock wool, extruded polystyrene, and flexible foam) for different pipe diameters and different refrigerant flow rates. The research results show that the optimum insulation thicknesses for pipe diameters from 12.7 to 50.8 mm using Rockwool are 32 to 44 mm, 28 to 38 mm for extruded polystyrene, and 11to 13 mm for flexible foam insulation. The reduction in energy losses from the optimal Rockwool insulation thickness in the case study piping system ranges from 78.5% to 81.6% compared to the uninsulated insulated piping system. In addition, the carbon emission saving by the optimal Rockwool insulation thickness is 1737, 1541, 1033, and 1160 kg CO2 for coal, oil, natural gas, and LPG fuel used in electricity generation, respectively. In addition, the study found that the physical parameters of the refrigerant, such as quality and flow rate, do not affect the optimal insulation thickness for all insulation types studied. And the thermal power saved corresponds to only 1.2% of the total system capacity

Background: Lysionotin, a natural flavonoid extracted from Lysionotus pauciflorus Maxim (Gesneriaceae), has several pharmacological effects including anti-bacterial, anti-hypertensive and anti-inflammatory effects. However, its analgesic effect has not been investigated. This study aimed to assess the antinociceptive activity of lysionotin using chemically and thermally induced nociception in a mouse model. Methods: The antinociceptive effects of various lysionotin doses (50, 100, 150, and 200 μg/kg) were assessed in mice using the acetic acid-induced writhing test, hot plate test, and formalin-induced paw licking assay. The effects were compared to those of mice treated with acetylsalicylic acid or morphine in the presence or absence of naloxone (an opioid receptor antagonist). Capsaicin- and glutamate-induced paw licking tests were also used to evaluate the involvement of the vanilloid and glutamatergic systems, respectively. Results: Lysionotin produced significant dose-dependent inhibition of nociceptive behavior in the acetic acid-induced writhing test, showing 60% inhibition at a dose of 200 μg/kg. Lysionotin also caused a significant increase in the latency period in response to the hot plate test (76.4% at 200 μg/kg), and significantly inhibited both the neurogenic and inflammatory phases in the formalin-induced paw licking test. Naloxone significantly reverses the effect of lysionotin in both hot plate test and formalin-induced paw licking test. Moreover, lysionotin significantly inhibited the neurogenic nociception induced by intraplantar injections of glutamate and capsaicin (57% and 67.2%, respectively at a dose of 200 μg/kg). Thus, lysionotin exhibited peripheral and central antinociception through the modulation of vanilloid receptors, opioid receptors, and the glutamatergic system. Conclusion: Lysionotin possesses antinociceptive activity on adult mice that is mediated through both central and peripheral pathways.

Pain is a common undertreated worldwide complaint. The need to explore the antinociceptive potential of alternative herbal products is essential. Although used as a mild sedative, limited evidence focused on the potential antinociceptive effect of valerian and hops combination. The present study was carried out to evaluate the in vivo anti-nociceptive effect of the valerian-hops combination to justify its use as an effective and safe analgesic agent. Anti-nociceptive effects of valerian-hops combination (50, 100, and 200 mg/kg) were assessed in swiss albino mice for performing the acetic acid-induced writhing test, the paw licking test using formalin, the paw licking test using glutamate, and the tail immersion test. The effects were compared to those of diclofenac or morphine in the presence or absence of the opioid receptor antagonist naloxone. Valerian-hops” extract of 100 and 200 mg/kg demonstrated a significant reduction in the number of writhing episodes induced by acetic acid compared to the control (p

Radio access network (RAN) technologies continue to evolve, with Open RAN gaining the most recent momentum. In the O-RAN specifications, the RAN intelligent controllers (RICs) are software-defined orchestration and automation functions for the intelligent management of RAN. This article introduces principles for machine learning (ML), in particular, reinforcement learning (RL) applications in the O-RAN stack. Furthermore, we review the state-of-the-art research in wireless networks and cast it onto the RAN framework and the hierarchy of the O-RAN architecture. We provide a taxonomy for the challenges faced by ML/RL models throughout the development life-cycle: from the system specification to production deployment (data acquisition, model design, testing and management, etc.). To address the challenges, we integrate a set of existing MLOps principles with unique characteristics when RL agents are considered. This paper discusses a systematic model development, testing and validation life-cycle, termed: RLOps. We discuss fundamental parts of RLOps, which include: model specification, development, production environment serving, operations monitoring and safety/security. Based on these principles, we propose the best practices for RLOps to achieve an automated and reproducible model development process. At last, a holistic data analytics platform rooted in the O-RAN deployment is designed and implemented, aiming to embrace and fulfil the aforementioned principles and best practices of RLOps.

Aim: This study aimed to identify the perspective knowledge, attitudes, and barriers of community pharmacists in promoting breast cancer health. Methods: An internet-based self-administrated questionnaire was distributed using social media groups to the community pharmacists in Jordan. Results: A 76.7% of the pharmacists had insufficient knowledge score of breast cancer and 92.7% had positive attitude. Access to breast cancer educational materials was the major barrier to pharmacists. A significant association was found between pharmacists' knowledge and breast cancer educational materials being given to patients (p

Background: Herbal medicine use is widespread among patients, as community pharmacies may provide such products. Therefore, pharmacy practitioners should be aware of potential herbal products’ adverse effects and herb-drug interactions, particularly with medications for comorbid diseases, such as cardiovascular drugs, in which pharmacy practitioners need to have good knowledge to provide patients with relevant advice to get optimal and safe therapeutic outcomes. Accordingly, the study is designed to assess the knowledge and awareness of pharmacy practitioners regarding herbal product dispensing and cardiovascular drug interaction in Jordan and view their role in patients’ counselling to set up safe and effective drug use. Methods: A cross-sectional study was conducted in Jordan using an online formatted questionnaire distributed to pharmacy practitioners working in community pharmacies. Descriptive and analytical statistics were performed for the responses using the Statistical Package for the Social Sciences (SPSS) software, version 26. Results: Out of 508 participants, 41.7% had medium knowledge of herbal products pertaining mainly to university education (68.1%); 55.1% of participants dispensed herbal products without prescriptions for obesity and weight reduction (72.8%) and gastrointestinal problems (70.9%); this is because respondents agreed that herbal remedies are safe (28.5%) and effective (38.4%). Whilst the knowledge level of respondents about herbal medicine interaction with cardiovascular medication was medium, with a mean of 1.94, as this interaction may result in potentially serious consequences, 40.7% of respondents strongly agreed to gain more knowledge about the side effects of herbal products and medicine interactions through educational courses. Conclusions: The pharmacy practitioners had medium knowledge of herbal products; however, more attention should be paid to herb-drug interactions in the pharmacy educational curriculum. Additionally, pharmacy practitioners need to refresh their knowledge by attending periodic educational courses and by using reliable resources for information about herbal products in order to provide effective and competent pharmaceutical care.

Background: Ceratonia siliqua L. (Leguminosae) has neuroprotective, mutagenic, hypotensive, anti-bacterial, hypoglycaemic, and anti-inflammatory effects through extracts from its leaves. Therefore, the aim of this study is to assess the anti-nociceptive activity of ethanol extracts of Ceratonia siliqua leaves. Methods: Ethanol extract of Ceratonia siliqua leaves were studied using well-established animal models of inflammation and pain. A hot plate latency assay (55 °C) was used to assess the analgesic effect of 10, 31.6, 100, and 316 mg/kg doses of ethanol extracts in addition to paw licking time in early and late phase using a formalin-induced paw licking assay test. Paw oedema induction using carrageenan and cotton pellet granuloma assays were used to assess the anti-inflammatory effect of 10, 31.6, 100, and 316 mg/kg doses of ethanol extract. Results: The ethanol extract of Ceratonia siliqua leaves reduces paw licking time in early and late phase after formalin injection. The same effect was also observed when the hotplate test was performed. Ethanol extract of Ceratonia siliqua leaves caused dose dependent inhibition in paw oedema after the injection of carrageenan and cotton pellet granuloma in mice. These effects were not antagonized when opioid receptors were blocked by naloxone (5 mg/kg). The preliminary phytochemical analysis of the ethanol extract of Ceratonia siliqua leaves showed the presence of tannins, alkaloids, flavonoids and terpenoids. Conclusion: The present data indicate that ethanol extract of Ceratonia siliqua leaves might possess anti-inflammatory and anti-nociception properties and should be considered for further therapeutic research.

Background: Sodium/glucose cotransporter 2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs which improve glycaemic control in type 2 diabetes mellitus (T2DM) by preventing the kidney from reabsorbing glucose back to blood. Community pharmacists have long-term relationships with most of their chronic patients, so they play a key role in care for people with diabetes. Therefore, the objective of this study was to assess pharmacists’ knowledge and practice towards SGLT2 inhibitors. Methods: A cross-sectional study was conducted to meet the study objectives. A convenience sample of 348 community pharmacists in Jordan was recruited. knowledge and practice were assessed using a self-administered questionnaire created for the purpose of this study. Results: A total of 400 community pharmacists were reached, of whom 348 answered the survey (response rate 87%). The results indicated that SGLT2 inhibitors knowledge score among community pharmacists in Jordan was 6.61 (out of 12). Factors like age, gender, location of the pharmacy, years of pharmacists’ experience had no effect on knowledge score; however, pharmacists who attended training courses on diabetes had higher knowledge scores. Additionally, pharmacists’ dispensing practice toward SGLT2 inhibitors had insufficient knowledge, such as lack of knowledge about the superiority of SGLT2 inhibitors over other anti-diabetics and inability to give the best advice to patients. Conclusions: Our findings reflect a moderate knowledge among community pharmacists about SGLT2 inhibitors which may negatively affect the patients’ outcome; thus, continuous education for the pharmacists is essential.

Background: Sodium/glucose cotransporter 2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs which improve glycaemic control in type 2 diabetes mellitus (T2DM) by preventing the kidney from reabsorbing glucose back to blood. Community pharmacists have long-term relationships with most of their chronic patients, so they play a key role in care for people with diabetes. Therefore, the objective of this study was to assess pharmacists’ knowledge and practice towards SGLT2 inhibitors. Thus, improving pharmacists’ knowledge about this group of medications could improve the treatment outcome of people with diabetes. Methods: A cross-sectional study was conducted to meet the study objectives. A convenience sample of 348 community pharmacists in Jordan was recruited. knowledge and practice were assessed using a self-administered questionnaire created for the purpose of this study. Results: A total of 400 community pharmacists were reached, of whom 348 answered the survey (response rate 87%). The results indicated that SGLT2 inhibitors knowledge score among community pharmacists in Jordan was 6.61 (out of 12). Factors like age, gender, location of the pharmacy, years of pharmacists’ experience had no effect on knowledge score; however, pharmacists who attended training courses on diabetes had higher knowledge scores. Additionally, pharmacists’ dispensing practice toward SGLT2 inhibitors had insufficient knowledge, such as lack of knowledge about the superiority of SGLT2 inhibitors over other anti-diabetics and inability to give the best advice to patients. Conclusions: Our findings reflect a moderate knowledge among community pharmacists about SGLT2 inhibitors which may negatively affect the patients’ outcome; thus, continuous education for the pharmacists is essential.

Background and objectives: Community pharmacists play an important role in ensuring the patient’s adherence to medications, thus achieving therapeutic outcomes. The present study had two aims: to measure the extent of knowledge that community pharmacists had about psychotropic medications and to determine the factors associated with higher knowledge scores. Methods: A cross-sectional design was employed, using a structured online questionnaire. The study instrument assessed demographics, general practice characteristics related to psychotropics and a battery of factual questions that assessed the knowledge of pharmacists about psychotropic medications using closed-ended responses. A total knowledge score consisting of the sum of correct responses was calculated; the passing score was 75%. A total of 676 pharmacists completed the survey. Results: Only 20% passed the threshold score (75%) for the factual knowledge questions, and only (11.0%) were very comfortable with their knowledge of psychotropic agents. A total of 49.0% of the respondents felt that they had been adequately trained to counsel patients on psychotropic agents. According to the regression model, pharmacists who reported higher knowledge were more experienced (0.63, (0.26–1.0), p < 0.001), reported studying the topic in the pharmacy school (0.77 (0.27–1.26), p = 0.002) holding a Doctor of Pharmacy (Pharm D) degree (0.24 (0.05–0.43), p = 0.01), and reported a higher perceived knowledge (0.29 (0.01–0.38), p = 0.038). Conclusion: Community pharmacists reported poor knowledge of psychotropic medications, and continuous medical and professional education programs are mandatory.

Abstract Background Until now, diabetes during pregnancy has been associated with a high risk of maternal, fetal, and neonatal morbidities and mortalities. The main aim of this study was to evaluate the risk factors of hypoglycemia in infants of diabetic mothers (IDMs) and to study the relationship between umbilical cord (UC) C peptide levels and the risk of developing hypoglycemia. Material and methods UC blood C-peptide and serial serum blood glucose measurements were done for all included singleton newborns born to diabetic mothers during the study period. Maternal and neonatal data such as gestational age, maternal age, maternal weight, types of diabetics and its control, maternal glycated hemoglobin (HbA1C), birth weight, Apgar score, and neonatal complete blood picture were collected. Results In total, 83 IDMs met the inclusion criteria. Fifty-four (65.06%) developed hypoglycemia and 29 (34.94%) remained normoglycemic. However, there were no significant differences between hypoglycemic and normoglycemic IDMs in terms of types of maternal diabetics (P value = 0.41), its duration (P value = 0.43). The hypoglycemia peak occurred within the first 3 h of life, with 33.11 ± 8.84 mg/dl for the hypoglycemia group and 54.10 ± 6.66 mg/dl for the normoglycemic group (P value

INTRODUCTION: Personalized and tumor-informed circulating tumor DNA (ctDNA) testing is feasible and allows for molecular residual disease (MRD) identification in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: In this retrospective analysis of commercial cases from multiple US institutions, personalized, tumor-informed, whole-exome sequenced, and germline-controlled ctDNA levels were quantified and analyzed in patients with PDAC. Plasma samples (n = 1329) from 298 clinically validated patients were collected at diagnosis, perioperatively (MRD-window; within 2-12 weeks after surgery, before therapy), and during surveillance (>12 weeks post-surgery if no ACT or starting 4 weeks post-ACT) from November 2019 to March 2023. RESULTS: Of the initially diagnosed patients with stages I-III PDAC who went for resection, the median follow-up time from surgery was 13 months (range 0.1-214). Positive ctDNA detection rates were 29% (29/100) and 29.6% (45/152) during the MRD and surveillance windows, respectively. Positive ctDNA detection was significantly associated with shorter DFS within the MRD window (median DFS of 6.37 months for ctDNA-positive vs 33.31 months for ctDNA-negative patients; HR: 5.45, P

Background: Isorhamnetin is a flavonoid that is found in medical plants. Several studies showed that isorhamnetin has anti-inflammatory and anti-obesity effects. This study aims to investigate the anti-diabetic effects of isorhamnetin in a high-fat diet and Streptozotocin-(HFD/STZ)-induced mice model of type 2 diabetes. Materials and Methods: Mice were fed with HFD followed by two consecutive low doses of STZ (40 mg/kg). HFD/STZ diabetic mice were treated orally with isorhamnetin (10 mg/kg) or (200 mg/kg) metformin for 10 days before sacrificing the mice and collecting plasma and soleus muscle for further analysis. Results: Isorhamnetin reduced the elevated levels of serum glucose compared to the vehicle control group (p < 0.001). Isorhamnetin abrogated the increase in serum insulin in the treated diabetic group compared to the vehicle control mice (p < 0.001). The homeostasis model assessment of insulin resistance (HOMA-IR) was decreased in diabetic mice treated with isorhamnetin compared to the vehicle controls. Fasting glucose level was significantly lower in diabetic mice treated with isorhamnetin during the intraperitoneal glucose tolerance test (IPGTT) (p < 0.001). The skeletal muscle protein contents of GLUT4 and p-AMPK-α were upregulated following treatment with isorhamnetin (p > 0.01). LDL, triglyceride, and cholesterol were reduced in diabetic mice treated with isorhamnetin compared to vehicle control (p < 0.001). Isorhamnetin reduced MDA, and IL-6 levels (p < 0.001), increased GSH levels (p < 0.001), and reduced GSSG levels (p < 0.05) in diabetic mice compared to vehicle control. Conclusions: Isorhamnetin ameliorates insulin resistance, oxidative stress, and inflammation. Isorhamnetin could represent a promising therapeutic agent to treat T2D.

2′,3,3,5′-Tetramethyl-4′-nitro-2′H-1,3′-bipyrazole (TMNB) is a novel bipyrazole compound with unknown therapeutic potential in diabetes mellitus. This study aims to investigate the anti-diabetic effects of TMNB in a high-fat diet and streptozotocin-(HFD/STZ)-induced rat model of type 2 diabetes mellitus (T2D). Rats were fed HFD, followed by a single low dose of STZ (40 mg/kg). HFD/STZ diabetic rats were treated orally with TMNB (10 mg/kg) or (200 mg/kg) metformin for 10 days before terminating the experiment and collecting plasma, soleus muscle, adipose tissue, and liver for further downstream analysis. TMNB reduced the elevated levels of serum glucose in diabetic rats compared to the vehicle control group (p < 0.001). TMNB abrogated the increase in serum insulin in the treated diabetic group compared to the vehicle control rats (p < 0.001). The homeostasis model assessment of insulin resistance (HOMA-IR) was decreased in the diabetic rats treated with TMNB compared to the vehicle controls. The skeletal muscle and adipose tissue protein contents of GLUT4 and AMPK were upregulated following treatment with TMNB (p < 0.001, < 0.01, respectively). TMNB was able to upregulate GLUT2 and AMPK protein expression in liver (p < 0.001, < 0.001, respectively). LDL, triglyceride, and cholesterol were reduced in diabetic rats treated with TMNB compared to the vehicle controls (p < 0.001, 0.01, respectively). TMNB reduced MDA and IL-6 levels (p < 0.001), and increased GSH level (p < 0.05) in diabetic rats compared to the vehicle controls. Conclusion: TMNB ameliorates insulin resistance, oxidative stress, and inflammation in a T2D model. TMNB could represent a promising therapeutic agent to treat T2D.

The perturbation in plasma free amino acid metabolome has been observed previously in diabetes mellitus, and is associated with insulin resistance as well as the onset of cardiovascular disease in this population. In this study, we investigated, for the first time, changes in the amino acid profile in a group of people with and without type 2 diabetes (T2D) with normal BMI, from Jordan, who were only managed on metformin. Twenty one amino acids were evaluated in plasma samples from 124 people with T2D and 67 healthy controls, matched for age, gender and BMI, using amino acids analyser. Total amino acids, essential amino acids, non-essential amino acids and semi-essential amino acids were similar in T2D compared to healthy controls. Plasma concentrations of four essential amino acids were increased in the presence of T2D (Leucine, p < 0.01, Lysine, p < 0.001, Phenylalanine, p < 0.01, Tryptophan, p < 0.05). On the other hand, in relation to non-essential amino acids, Alanine and Serine were reduced in T2D (p < 0.01, p < 0.001, respectively), whereas Aspartate and Glutamate were increased in T2D compared to healthy controls (p < 0.001, p < 0.01, respectively). A semi-essential amino acid, Cystine, was also increased in T2D compared to healthy controls (p < 0.01). Citrulline, a metabolic indicator amino acid, demonstrated lower plasma concentration in T2D compared to healthy controls (p < 0.01). These amino acids were also correlated with fasting blood glucose and HbA1c (p < 0.05). Glutamate, glycine and arginine were correlated with the duration of metformin treatment (p < 0.05). No amino acid was correlated with lipid profiles. Disturbances in the metabolism of these amino acids are closely implicated in the pathogenesis of T2D and associated cardiovascular disease. Therefore, these perturbed amino acids could be explored as therapeutic targets to improve T2D management and prevent associated cardiovascular complications.

Diabetes in pregnancy is associated with adverse pregnancy outcomes including preterm birth. Although the mechanisms leading to these pregnancy complications are still poorly understood, aberrant angiogenesis and endothelial dysfunction play a key role. FKBPL and SIRT-1 are critical regulators of angiogenesis, however, their roles in pregnancies affected by diabetes have not been examined before in detail. Hence, this study aimed to investigate the role of FKBPL and SIRT-1 in pre-gestational (type 1 diabetes mellitus, T1D) and gestational diabetes mellitus (GDM). Placental protein expression of important angiogenesis proteins, FKBPL, SIRT-1, PlGF and VEGF-R1, was determined from pregnant women with GDM or T1D, and in the first trimester trophoblast cells exposed to high glucose (25 mM) and varying oxygen concentrations [21%, 6.5%, 2.5% (ACH-3Ps)]. Endothelial cell function was assessed in high glucose conditions (30 mM) and following FKBPL overexpression. Placental FKBPL protein expression was downregulated in T1D (FKBPL; p

Abstract Background Pre-gestational and gestational diabetes mellitus are common complications in pregnancy affecting one in six pregnancies. The maternity services are under significant strain managing the increasing number of complex pregnancies. This has an impact on patients’ experience of antenatal care. Therefore, there is a clear need to address pregnancy care. One possible solution is to use home-based digital technology to reduce clinic visits and improve clinical monitoring. Methods The aim of this study was to evaluate the antenatal services provided to pregnant women with diabetes who were monitored at the joint metabolic and obstetric clinic at the Southern Health and Social Care Trust in Northern Ireland. Results The questionnaires were completed by sixty-three women, most of whom had gestational diabetes mellitus. Most of the participants were between 25 and 35 years of age (69.8%), had one or more children (65.1%) and spent over 2 h attending the clinics (63.9%); 78% of women indicated that their travel time to and from the clinic appointment was over 15 min. Over 70% of women used smartphones for health-related purposes. However, only 8.8% used smartphones to manage their health or diabetes. Less than 25% of the women surveyed expressed concerns about using digital technology from home to monitor various aspects of their health in pregnancy. Conclusions Overall, pregnant women who had or developed diabetes in pregnancy experience frequent hospital visits and long waiting times in the maternity clinics. Most of these pregnant women are willing to self-manage their condition from home and to be monitored remotely by the healthcare staff.

Abstract Background Optimising breast cancer treatment remains a challenge. Resistance to therapy is a major problem in both ER- and ER+ breast cancer. Tumour recurrence after chemotherapy and/or targeted therapy leads to more aggressive tumours with enhanced metastatic ability. Self-renewing cancer stem cells (CSCs) have been implicated in treatment resistance, recurrence and the development of metastatic disease. Methods In this study, we utilised in vitro, in vivo and ex vivo breast cancer models using ER+ MCF-7 and ER- MDA-MB-231 cells, as well as solid and metastatic breast cancer patient samples, to interrogate the effects of FKBPL and its peptide therapeutics on metastasis, endocrine therapy resistant CSCs and DLL4 and Notch4 expression. The effects of FKBPL overexpression or peptide treatment were assessed using a t-test or one-way ANOVA with Dunnett’s multiple comparison test. Results We demonstrated that FKBPL overexpression or treatment with FKBPL-based therapeutics (AD-01, pre-clinical peptide /ALM201, clinical peptide) inhibit i) CSCs in both ER+ and ER- breast cancer, ii) cancer metastasis in a triple negative breast cancer metastasis model and iii) endocrine therapy resistant CSCs in ER+ breast cancer, via modulation of the DLL4 and Notch4 protein and/or mRNA expression. AD-01 was effective at reducing triple negative MDA-MB-231 breast cancer cell migration (n ≥ 3, p

Blunt abdominal trauma is a rare cause of intra-hepatic arterio-biliary fistula and pseudo-aneurysm. Surgery often indicated in cases that fail transcatheter arterial embolization (TAE). In this report we present a case of post-traumatic arterio-biliary fistula with intra-hepatic pseudo-aneurysm in a 10-year-old female patient. She presented with two episodes of massive hematemesis/melena and severe colicky epigastric pain of 5 days duration. Following informed consent from guardians, intra-operative ultrasound-guided selective clamping and ligation of liver segment 4 arterial and portal branches was performed. In conclusion, blunt abdominal trauma to liver can results in life-threatening arterio-biliary fistula and/or peudo-aneurysm. Selective ligation of pseudo-aneurysm feeders under intra-operative ultrasound guidance is recommended in resource–limited settings when interventional radiology is not available.