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Objective: Since its discovery as an antioxidant, melatonin has been increasingly recognized for its therapeutic potential beyond sleep disturbances in neurodegenerative disorders. This study aims to evaluate efficacy of various melatonin doses, treatment durations, and formulations, in alleviating motor symptoms and sleep disturbances in Parkinson's disease, the second most common neurodegenerative disorder worldwide. Methods: PubMed, Cochrane Library, ClinicalTrials.gov and other databases were systematically searched to retrieve randomized controlled trials (RCTs) administrating melatonin to Parkinson's disease patients until June 10th, 2023. Outcomes including Unified Parkinson Disease Rating Scale (UPDRS) scores and Pittsburgh Sleep Quality Index (PSQI) scores, were pooled and reported as mean differences (MD) with 95% confidence intervals (CIs). Meta-analysis was performed using an inverse variance random-effects model in Review Manager 5.4 software. Trial Sequential Analysis was performed to avoid false-positive results from random errors. Results: Five RCTs with a total of 155 patients were included. Statistically significant reductions in UPDRS total scores were observed in groups receiving Melatonin ≥ 10 mg/day (MD = -11.35, 95% CI: -22.35 to -0.35, I² = 0%, p = 0.04) and immediate release formulations (MD = -11.35, 95% CI: -22.35 to -0.35, I² = 0%, p = 0.04). No significant effects on individual UPDRS II, III, and IV scores were observed, regardless of melatonin dosage and treatment duration. Moreover, significant improvements in PSQI scores were observed with only immediaterelease melatonin formulations (MD = -2.86, 95% CI: -4.74 to -0.97, I² = 0%, p = 0.003). Conclusion: Melatonin ≥ 10 mg/day for a minimum duration of ≥12 weeks in immediate-release formulations consistently demonstrated significant therapeutic potential in improving motor symptom and sleep disturbances in Parkinson disease. However, further trials are warranted to investigate its impact when initiated early in the disease course to fully explore its true therapeutic potential. [ABSTRACT FROM AUTHOR]

Aim: The aim of this research is to investigate the efficacy of ultrasonography as a diagnostic tool for determining the presence of carpal tunnel syndrome (CTS) in either the left or right upper limb of participants who have a suspicion that they may have the condition. Method: This research was conducted over the course of a year at the Mayo Hospital's radiology and neurology sections in Lahore. The research was cross-sectional in nature. The remaining 128 individuals were comprised of healthy volunteers (n=64) and patients (n=64), respectively. An examination of the nerve conduction was carried out on each and every patient (NCS). Initially, the diagnostic technique included measuring the median nerve's cross-sectional area near the carpal tunnel's opening. The results from the NCS and the ultrasound were then compared and contrasted. NCS testing in conjunction with a traditional medical evaluation was regarded as the gold standard. Results: The electro-diagnostic examinations correlated positively with the median nerve's cross-sectional area (r = 0.618, p = 0.001). This resulted in a Pearson correlation of 0.3913 between the two variables. A condition ranging from moderate to severe was present in over two-thirds of individuals who were diagnosed. In a similar vein, sixty percent of them had a crosssectional area that was more than 0.15 cm2. A paired t-test revealed that there was a substantial difference in the perimeters (p = 0.0001, confidence interval = 95%). This difference was shown to exist between the two groups. The following results were obtained with a cut-off CSA of > 0.09 cm2: sensitivity of 54 out of 64, specificity of 90 out of 64, positive predictive value of 54 out of 60, and negative predictive value of 58 out of 68. Conclusions: If the median nerve's cross-sectional area is more than 0.09 cm2, a diagnosis of carpal tunnel syndrome may be established. When a patient is suspected of having carpal tunnel syndrome, an ultrasound may prove to be a helpful new diagnostic technique for evaluating the median nerve. Diagnostic methods that may be helpful in determining whether or not a patient has Carpal Tunnel Syndrome include electrodiagnostic testing, nerve conduction studies, electromyography, and high-resolution ultrasonography. [ABSTRACT FROM AUTHOR]

The study examined the efficacy of various immunosuppressants in patients with chronic inflammatory demyelinating polyneuropathy. We compared the efficacy of Azathioprine and Methotrexate in the treatment of CIDP. Patients of either gender aged > 18 years having chronic polyneuropathy progressive for at least 8 weeks having no serum para protein or any genetic abnormality and fulfilling the Koski criteria. To measure the efficacy, Overall Neuropathy Limitation Scale (ONLS) was used. Group 1 was treated with a combination of oral steroids i.e., Prednisolone and Azathioprine while group 2 was treated with a combination of Prednisolone and Methotrexate. ONLS was statistically insignificant in the patient groups (AZA versus MTX) at the beginning of the therapy (from 1-3 months) in both groups. However, in the 4th month, the AZA group performed better than the MTX group. At the 12th month, the mean ONLS score of the patients in the AZA group was 3.69, while the mean ONLS score of the patients in the MTX group was 5.30 (p-value=0.001). We concluded that Azathioprine was more efficacious as compared to Methotrexate in the treatment of CIDP based on ONLS and should be considered as a first-line immunosuppressant in the treatment of CIDP in low-income countries like Pakistan. [ABSTRACT FROM AUTHOR]

Microscopic, phytochemical and pharmacological profiles are required for correct identification of a plant material to ensure consistent efficacy and safety. But such data are not available for the leaf of an important medicinal plant, Zizyphus oxyphylla Edgew. (Family: Rhamnaceae). Therefore, the current study aimed to investigate leaves of the plant for microscopic, phytochemical and antibacterial studies. Powdered material was subjected to microscopy, proximate analyses and estimation of total primary metabolites. Then, different types of extracts prepared using various solvents in order of increasing polarity were screened for antibacterial activity against seven standard strains. The most active extract was hydrolyzed and aglycone enriched fraction was extracted and screened for antibacterial activity. The powder microscopy indicated the presence of vascular bundles filled with cuboidal calcium oxalate crystals, anisocytic stomata and xylary vessels with reticulate and scalariform thickenings. Proximate features and primary metabolites provided characteristic identifying patterns. The most active extract (methanol) upon acidic hydrolysis exhibited higher activity against B. bronchiseptica (26.01±0.01 mm), S. aureus (26.00±0.00 mm), P. aeruginosa (24.03±0.02 mm) and M. luteus (24.02± 0.00 mm). The results of the current study provide identifying microscopic and phytochemical profiles that may be useful for correct identification of leaves of the plant. Aglycone enriched extract is having remarkable antibacterial activity hence may be used for activity-guided isolation. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis is a chronic inflammatory autoimmune disease that affects every aspects of quality of life and varies with disease severity especially among females. Objective: To assess quality of life (QOL) in female rheumatoid arthritis patients and its relationship with disease activity. Methods: It was a cross sectional analytical study with 140 rheumatoid arthritis female patients recruited through convenient sampling from October 2018 to January 2019 from the Rheumatology out-patient department of Shaikh Zayed Hospital, Lahore. World Health Organization Quality of Life questionnaire (WHOQOL-BREF) was used to assess quality of life and Disease Activity Score (DAS - 28) to assess activity of disease. Data was entered and analyzed by using SPSS version 20.0. Mean ± Standard Deviation (SD), median, frequency and percentages were used to describe various variables. The effect of sociodemographic and disease factors on four health domains of WHOQOL-BREF scores was examined by using multiple linear regression models with backward removal method. P-value ? 0.05 was considered statistically significant. Results: All patients were female with an average age of 36.4±5.4 years, 21.4% were obese, mostly unemployed. The DAS-28 was 2.9 ± 0.7, with 39.3% of the patients in remission phase. On the 0 - 100 scale WHOQOL-BREF physical score was minimum, social and environmental scores have the highest median value. Education, being married and being employed had a positive effect on various scores while high DAS had a negative effect on all scores. [RESULT NOT DISCUSSED IN ABSTRACT AS ADVISED, AS THE WORD COUNT OF ABSTRACT OTHERWISE EXCEED] Conclusion: Physical health domain of WHOQOL-BREF is most affected in Pakistani female rheumatoid arthritis patients. Increasing activity of disease worsens the QOL. Education, marital status, and employment has a positive effect on QOL. [ABSTRACT FROM AUTHOR]

Pongamia pinnata (L.) Pierre (Family: Fabaceae) is a famous traditional medicinal plant, the flowers of which are used for treating diabetes, however, the active constituent(s) is yet unidentified. Therefore, the present study aimed to carry out antidiabetic activity-guided isolation of extracts of flowers. Hexane extract being the most active (EC50, 900 µg/mL) was fractionated by partitioning and the most active hexane fraction (EC50, 570 µg/mL) was subjected to column chromatography which gave three isomers of compound 1 (4-Methoxy-7-phenyl-5H-furo [3,2-g][1] benzopyran-5-one), a furanoflavonoid. All the isomeric forms have equal antidiabetic activity (83.24%) with EC50 at 300 µg/mL. The activity of the isolated compound was found to be higher as compared to standard drug acarbose (43.46%). Molecular docking studies of the compound indicated higher binding energy scores with antidiabetic targets as compared to the standard drug acarbose. The results of the present study indicate that the isolated compound may be developed into an antidiabetic drug. [ABSTRACT FROM AUTHOR]

This study investigated the significance of difference between presence and absence of different neurological findings in COVID-19, in relation with the biochemistry. Various significant correlations in connection with the disease severity and clinical factors were also identified. 351 COVID-19 patients were included. Different laboratory/clinical findings were investigated. Correlations Kendall's tau and Pearson Chi-Square were applied to find the correlations between severity and clinical findings. The Mann-Whitney Test was applied for a comparison between two types of neurological groups for each biochemistry parameter. Headache was reported in 28% and dizziness in 13% patients. The impaired smell and impaired taste were reported in 28.5% and 36.2% patients, respectively. The muscle pain was present in 39% patients. 80% patients had low lymphocytes & 70% had high neutrophils. 54.5% were found with high ALP. LDH was elevated in 73%. Severity was found significantly correlated with decreased oxygen saturation, age and raised levels of urea, creatinine and LDH. The groups (with/without CNS involvement) were statistically different in ALP, groups (with/without PNS involvement) in WBC, lymphocytes, neutrophils, ALP, urea, creatinine, CK, CKMB and LDH and groups (with/without MSK involvement) in WBC. Oxygen saturation, age, urea, creatinine and LDH are significant indicators of disease severity in COVID-19. The altered levels of different biochemistry can impact the neurological states of COVID-19 patients. [ABSTRACT FROM AUTHOR]

This study aimed to diagnose the incidence of restless leg syndrome (RLS) in patients with diabetes mellitus (DM) type-2, thorough artificial intelligence based multilayer perceptron (MLP). 300 cases of diabetes mellitus type-2, of age between 18-80 years were included. Point-biserial correlation/Pearson Chi-Square correlations were conducted between RLS and risk factors. We trained a backpropagation MLP via. supervised learning algorithm to predict clinical outcome for RLS. Majority of the patients were having hypertension (63%) and with peripheral neuropathy (69%). Two mostly reported scaled parameters were: 18% 'tiredness' and 14%, 'impact on mood'. A significant correlation was found in RLS with smoking, hypertension and chronic renal failure (CRF). MLP model achieved more than 95% accuracy in predicting the outcome with cross entropy error 0.5%. Following scaled symptomatic variables: 'need/urge to move' (100%) achieved the highest normalized importance, followed by 'relief by moving' (85.7%), 'sleep disturbance' (62%) and 'impact on mood' (51.3%). Artificial intelligence based models can help physicians to identify the pre diagnose RLS, so that active measures can be taken in time to avoid further complications. [ABSTRACT FROM AUTHOR]

Frozen food chemicals contain neurotoxins which disturb electrolyte levels. Altered electrolyte levels can induce mental illnesses. This study was focused on finding the prevalence of depression, dementia, intake of antidepressants and electrolytic alterations in brain cancer (BC) patients and in control group (CG) who were taking frozen and canned food. The levels of electrolytes were compared in both groups through Mann-Whitney U test. The Odds Ratio (OR) and Relative Risks (RR) were calculated of having a specific occurrence or condition of brain cancer patients vs. controls. Majority (41.42%) patients were from the age group 33-57 years. There were 52% male and 47% female patients. There was more occurrence of dementia (41%) and depression (6%) in patients as compared to CG. 94% patients were found with dementia. 32% patients were having low levels of sodium and 43% were having low levels of potassium. High levels of potassium (26%) were found in CG. 76% patients and 73% controls were taking canned food in moderation. 69% patients and 50% controls were taking frozen food in moderation. The potassium levels (p value: 0.00001) and sodium levels (p value: 0.01468) were found at significant difference in brain cancer patients and control group. Statistically significantly higher odds of outcome (OR>1) and increased relative risks (RR) were reported in dementia, depression and intake of anti-depressants for BC vs. CG. This epidemiological study reports hyponatremia as a significantly different parameter between brain cancer patients and controls. Food's chemicals induce hyponatremia, which can disturb mental states to develop different neurological conditions. [ABSTRACT FROM AUTHOR]

Movie posters are multimodal forms of advertisements that are meant for promoting a movie through a combination of visual and verbal elements. For linguistic and visual analysis, this paper analyses posters of three Academy Award winning animated movies, namely, Toy Story 3 (2010), Frozen (2013), and Zootopia (2016). Each one of the posters was comprehensively analyzed using Kress and Leeuwen's (2006) three meanings: representational, interactive and compositional, as explicated by Chen and Gao (2013). The findings of the study deduced that various linguistic and visual modalities employed in movie posters converge together to give an apt representation of the theme of the movie. This article recommends the study of various multimodal pieces of discourse using Multimodal Discourse Analysis (MDA) as a means to exploit multiple semiotic modes to reach to a comprehensive meaning of social processes. [ABSTRACT FROM AUTHOR]

The systematic review investigates the impact of different nutrients and dietary patterns on metabolism and immunity to answer the research question: "Can personalized nutritional approaches boost immunity?" The importance of diet in supporting the immune system has come to light in today's environment, where a strong immune system is crucial for protection against infectious illnesses, as highlighted by the COVID-19 pandemic. This systematic review adhered to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. Four databases were screened for relevant data published in 2022-2023: PubMed, PubMed Central (PMC), MEDLINE, and Cochrane Library. Inclusion and exclusion criteria were utilized, and 13 papers were finalized after screening and employing the quality appraisal tool Cochrane Bias assessment for randomized controlled trials (RCT). Personalized nutrition can strengthen immunity and enhance overall health by adjusting dietary recommendations and following a person's genetic makeup, lifestyle, and health state. An adequate supply of vitamins, minerals, proteins, and fatty acids as well as an optimum caloric intake are essential for immune health, and individual requirements can vary significantly due to genetic factors, lifestyle choices, and underlying health conditions. Personalized nutrition considers these factors, enabling tailored dietary recommendations to address specific nutrient needs and optimize nutrient intake, leading to better health outcomes. The review concludes that personalized nutrition is more effective than a one-size-fits-all approach in boosting immunity, and its potential impact on health and immune function is highly important., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Paulsingh et al.)