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Introduction: The management of the hospital observed that patients on appointment and those on the queue, at times show their discontentment with the long waiting time at the hospital. Sometimes, patients goes without treatment. Hence, present study is undertaken to find out the causes leading to increased patient waiting time. Material and Methods: The study has been conducted in order to systematically improve patient waiting time in dental hospital in Hyderabad city. Fishbone diagram has been used to study the cause and effects. Paired t - test is used to statistically analyze the obtained data. p value <0.05 is considered as significant value. Results: Data so obtained reported patients waiting time from entering the hospital to initiation of the treatment is obtained as 2.01± 1.02 hours. The causes for long waiting time attributed to patient and clinician factors, lack of pre-telephonic appointment system, lack of trained attendants and slow sterilization process. Conclusion: The present study concludes that dissatisfaction with waiting time in the clinic reveals an important problem that needs to be resolved, possibly through a proper channel of appointment system. [ABSTRACT FROM AUTHOR]

Introduction & Objective: Adiponectin exerts anti-tumor effect through connection to its receptor. Some studies have shown that polymorphism in Adipor1 results in insulin resistance, diabetic type 2 and colorectal cancer (CRC). The purpose of this study is to investigate the incidence mutant allele of adiponectin receptor 1 polymorphism rs2275738 and to examine the association of genetic variant in ADIPOR1 rs 2275738 with the risk of colorectal cancer. Materials & Methods: This study was a case-control type. Genotyping of adiponectin receptor 1 gene was determined in series of 106 colorectal cancer patients and 106 controls by the use of polymerase chain reaction and restriction fragment length polymorphism genotyping assay (PCR-RFLP). We calculated odd ratio and confidence interval (CI) of ADIPOR1 genotypes by SPSS 16 and χ2 to examine if this polymorphism is associated with colorectal cancer. Results: The frequency of TT,CT,CC genotype for adiponectin receptor polymorphism rs2275738 in the patients was 27.4, 50, 22.6 percents, respectively. Frequency of TT,CT,CC genotype in the controls was 40.6,22.6,36.8, respectively. Allele frequency of T,C was 41 and 59 percents in the controls respectively and 52.4 and 47.6 in the patients. Incidence of mutant allele among the patients and the controls shows significant differences (OR=1.57 CI=1.07-2.31 P=0.01). Conclusion: These findings suggest that polymorphism Adipor1 rs 2275738 is associated with increased risk of CRC.

The flavor of vanilla is a complex blend of compounds, with vanillin as the most prominent, along with vanillyl alcohol and 4-hydroxybenzoic acid. Natural vanillin extracted from vanilla beans is expensive, so researchers use heterologous synthesis to produce nature-identical vanillin in plant hosts. Consequently, alternative traditional farming and gathering methods are required to bridge the significant disparity between supply and demand. The current research successfully developed a method to induce hairy root formation from leaves. It integrated the Vanillin synthase (VpVAN) gene into transgenic hairy root lines of Beta vulgaris , synthesizing vanillin-related compounds. The presence of the VpVAN gene in transgenic roots was confirmed using PCR analysis. Additionally, RT-qPCR analysis demonstrated the expression of the VpVAN gene in the transgenic root lines. The transgenic hairy root clones H1, H2, and H5 showed enhanced vanillin production, vanillyl alcohol, and 4-hydroxybenzoic acid. Elicitation with methyl jasmonate (MJ) and salicylic acid (SA) further improved the production of these compounds in B. vulgaris hairy roots. The maximum hairy root biomass was observed after 60 days, with the maximum synthesis of vanillin and 4-hydroxybenzoic acid obtained from hairy root clones H5 and HR2, respectively. Vanillyl alcohol HR2 was obtained on the 45th day of cultivation. Elicitation with wound-associated hormone methyl jasmonate and salicylic acid enhanced the yield of vanillin, vanillyl alcohol, and 4-hydroxybenzoic acid, with a 215-fold increase in vanillin, a 13-fold increase in vanillyl alcohol, and a 21 fold increase in 4-hydroxybenzoic acid. The study results indicate that establishing transgenic hairy root cultures with the VpVAN gene is a promising alternative method for enhancing the production of vanilla flavor compounds such as vanillin, vanillyl alcohol, and 4-hydroxybenzoic acid. A cost-effective protocol has been developed to mass-produce phenolic compounds using a hairy root culture of B. vulgaris . This approach addresses the increasing demand for these substances while reducing the cost of natural vanillin production, making it suitable for industrial-scale applications., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Husain, Warsi, Khan, Mahendran, Afroz, Chandran, Kashyap, Khatoon, Parween, Tandon and Rahman.)

Objective: To compare the efficacy of foot reflexology and Benson's relaxation on anxiety and physiologic parameters after cesarean surgery., Design: Randomized controlled trial with three parallel arms., Setting: Gynecologic ward of the Persian Gulf Martyrs Hospital in Bushehr, Iran, in 2020., Participants and Interventions: Women undergoing cesarean surgery (n = 135) were selected by convenience sampling and divided via block randomization into three groups of foot reflexology, Benson's relaxation interventions, and control group (n = 45 in each group). Interventions were performed 2 hours after cesarean surgery., Measurements: Spielberger's State-Trait Anxiety Inventory, mercury sphygmomanometer, and pulse oximeter were used to collect the data. Anxiety was measured before and 30 minutes after the intervention. Physiologic parameters were measured before the intervention and immediately, 30 minutes, and 60 minutes after the intervention. Data were analyzed using inferential statistics., Results: The mean score of situational anxiety after the intervention was significantly lower than before the intervention in the reflexology (t = 6.171; 95% confidence interval [CI] [5.66, 11.14]) and Benson's relaxation groups (t = 7.362; 95% CI [5.91, 9.85]). However, changes in the control group were not significant (t = 1.674; 95% CI [-0.24, 2.55]). Decreases in anxiety scores were similar in the two intervention groups. After intervention, in most measurement times, respiratory rate and pulse rate decreased in the two intervention groups compared to the control group, and arterial oxygen saturation and systolic blood pressure increased., Conclusion: Considering the effect of both interventions on decreasing anxiety and improving most physiologic parameters, it seems that foot reflexology and Benson's relaxation can be recommended after cesarean surgery., (Copyright © 2024 AWHONN. Published by Elsevier Inc. All rights reserved.)

In real life situation, it is often difficult to judge the relative importance of different parameters being considered for evaluating some alternatives. In the context of fuzzy sets, it is a situation where it is difficult to define precise membership grades for attribute values. Here we require more generalized type of fuzzy sets which have a greater representational power than ordinary fuzzy sets. For this purpose we use "interval type-2 trapezoidal fuzzy preference relations (IT2TrFPRs)" in this article as a generalization of fuzzy preference relations and consider the environment discussed above, where there is no information on priority weights. A collective decision matrix will be constructed on the basis of hybrid averages using weighted averaging and signed distance based OWA operation. Then a least deviation model will be employed in order to determine the priority weight vectors. Finally, the alternatives will be ranked on the basis of weighted normalized signed distance of each alternative from the ideal solution. Moreover, a real life example of location selection is illustrated to elaborate the effectiveness of the proposed scheme., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Key Message: Thchit42 constitutive expression for fungal resistance showed synchronisation with leaf augmentation and transcriptome analysis revealed the Longifolia and Zinc finger RICESLEEPER gene is responsible for plant growth and development. Pelargonium graveolens essential oil possesses significant attributes, known for perfumery and aromatherapy. However, optimal yield and propagation are predominantly hindered by biotic stress. All biotechnological approaches have yet to prove effective in addressing fungal resistance. The current study developed transgenic geranium bridging molecular mechanism of fungal resistance and plant growth by introducing cassette 35S::Thchit42. Furthermore, 120 independently putative transformed explants were regenerated on kanamycin fortified medium. Primarily transgenic lines were demonstrated peak pathogenicity and antifungal activity against formidable Colletotrichum gloeosporioides and Fusarium oxysporum. Additionally, phenotypic analysis revealed ~ 2fold increase in leaf size and ~ 2.1fold enhanced oil content. To elucidate the molecular mechanisms for genotypic cause, de novo transcriptional profiles were analyzed to indicate that the auxin-regulated longifolia gene is accountable for augmentation in leaf size, and zinc finger (ZF) RICESLEEPER attributes growth upregulation. Collectively, data provides valuable insights into unravelling the mechanism of Thchit42-mediated crosstalk between morphological and chemical alteration in transgenic plants. This knowledge might create novel opportunities to cultivate fungal-resistant geranium throughout all seasons to fulfil demand., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Although there have been reports of misbehavior and disrespectful maternal care by healthcare providers worldwide, there are few intervention studies aimed at promoting respectful care, particularly among midwives., Research Objectives: The aim of this study was to examine the effect of Moral Case Deliberation (MCD) on the of midwives' knowledge and practice in the field of respectful maternity care., Research Design and Methods: This semi-experimental study involved 46 midwives working in the maternity departments of two hospitals affiliated with Bushehr University of Medical Sciences in 2023. The two hospitals were randomly divided into control and intervention groups. All midwives from both hospitals were included in the study. The Dilemma Method of MCD was implemented for midwives of intervention hospital. The Midwives' Knowledge and Practice of Respectful Maternity Care scale was used for data collection. It was administered both before and two weeks after the intervention. Data were analyzed using SPSS (version 20)., Ethical Considerations: The study was approved by ethics committee of Bushehr University of Medical Sciences in Bushehr, Iran (ethics code: IR.BPUMS.REC.1402.017). All participants provided written informed consent., Findings: The intervention group showed a significantly greater increase in knowledge scores from pre-test to post-test compared to the control group ( p < .001). The intervention group had a significantly higher mean change score in practice self-assessment and practice peer evaluation, from pre-test to post-test, than in the control group ( p < .001)., Discussion: MCD based on the dilemma method can improve practice in the field of respect-oriented midwifery care by increasing knowledge and potentially changing attitudes., Conclusion: The Dilemma Method of MCD improved midwives' knowledge and practice regarding respectful maternity care. This method can be included in the midwifery care quality improvement program to promote respectful maternity care. It is necessary to develop methods for wider dissemination of MCD in the cultural context of Iran., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Many genes involved in triterpenoid saponins in plants control isoprenoid flux and constitute the precursor pool, which is channeled into various downstream pathways leading to the synthesis of triterpenoid saponins in C. asiatica. Full-length 1-Deoxy-D-Xylulose-5-Phosphate-Synthase (CaDXS) gene was isolated for the study from the previously annotated Centella asiatica leaves transcriptomic data. The CaDXS gene sequence was submitted to the NCBI databases with GenBank accession number MZ997832. The full-length CaDXS gene contained a 2244 base pair open reading frame that encoded a 747 amino acid polypeptide. The predicted molecular weight (MW) and theoretical pI of DXS are 76.28 kDa and 6.86, respectively. Multiple amino acid sequence alignment of amino acids and phylogenetic studies suggest that CaDXS shares high similarities with DXS from other plants DXS belonging to different families. A phylogenetic tree was constructed using Molecular Evolutionary Genetic Analysis (MEGA) version 10.1.6. Structural analysis provided fundamental information about the three-dimensional features and physicochemical parameters of the CaDXS protein. Quantitative expression analysis showed that CaDXS transcripts were maximally expressed in leaf, followed by petiole, roots, and node tissues. CaDXS was cloned into the expression vector pET28a, expressed heterologously in DH5α bacteria, confirmed by sequencing, and subsequently characterized by protein expression and functional complementation. The study focused on understanding the protein structure, biological significance, regulatory mechanism, functional analysis, and gene characterization of the centellosides biosynthetic pathway gene DXS for the first time in the plant. It would provide new information about the metabolic pathway and its relative contribution to isoprenoid biosynthesis., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Pogostemon cablin cultivation faces massive constraints because of its susceptability to drought stress that reduces patchouli propagation and oil yield. The present study has achieved an efficient and rapid direct regeneration system for the transgenic production of P. cablin using Agrobacterium-mediated genetic transformation. To establish an efficient regeneration protocol for fast in-vitro multiplication of patchouli plants, leaf, petiole, and transverse thin cell layer (tTCL) explants were used and inoculated on an MS medium supplemented with different combinations of phytohormones. A comparative study showed a maximum regeneration frequency of 93.30 ± 0.56% per explant was obtained from leaf segments on optimal MS medium fortified with 0.2mg/L BAP and 0.1mg/L NAA. Leaf and petiole explants took 25-35 days to regenerate while tTCL section showed regeneration in just 15-20 days on the same medium. Subsequently, productive genetic transformation protocol OD 600 0.6, AS 200µM, 30mg/L kanamycin, and infection time 5 min. was standardized and best-suited explants were infected at optimum conditions from the Agrobacterium tumefaciens (LBA 4404) strain harboring ACC deaminase to generate transgenic P. cablin Benth. (CIM-Samarth) plants. The investigation suggested that the optimized protocol provides a maximum transformation frequency of 42 ± 1.9% in 15-20 days from tTCL. The transgenic plants were shifted to the greenhouse with a 52.0 ± 0.8% survival frequency. A molecular docking study confirmed significant binding affinity of ligand ACC with ACC deaminase at the catalytic site, and ligand interactions showed four H-bonds at the binding pocket with amino acids Cys-196, Val-198, Thr-199, and Gly-200 that validate gene relative expression in transgenic plants. Among all transgenic acclimatized greenhouse-grown patchouli plants, line PT4 showed improved drought resistance under severe water stress as its RWC was 71.7 ± 2.3% to 75.7 ± 2.1% which is greater than the RWC of the control plant, 58.30 ± 0.21%. Analysis of the other physiological indicators, H 2 O 2 , chlorophyll content, and ROS result support drought resistance ability. Our study concluded that the first report on P. cablin , tTCL direct regeneration, and standardized transformation protocol created a new opportunity for genetic manipulation to achieve drought-resistant patchouli plants for cultivation in all seasons at the commercial level., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Warsi, Khatoon, Singh and Rahman.)

Background: The flux of isoprenoids and the total accumulation of triterpenoid saponins known as centellosides in C. asiatica are controlled by the key genes of the Mevalonate pathway (MVA). These genes were reported to have positive regulation of the pathway in providing isoprenoid moieties. Though, some information is available on the pathway and secondary metabolites. However, most of the pathway steps are not characterized functionally., Methodology and Results: For the study, full-length pathway gene Hydroxymethyl glutaryl-CoA-synthase (CaHMGS; GenBank accession number: MZ997833), was isolated from previously annotated transcriptome data of Centella asiatica leaves. HMGS has been successfully cloned and heterologously expressed in bacteria E. coli strain DH5α. The cloned gene has been sequenced and further characterized through in silico studies by different bioinformatics tools. Also, the gene sequences have been submitted in NCBI. In silico studies of isolated gene sequence revealed the nature, characteristics of genes. The ORF of HMGS is 1449 bp encoding 482 amino acids. Predicted molecular weight (MW) of HMGS was 48.09 kDa and theoretical pI was 5.97. Blast results and Multiple sequence alignments of the gene showing the similarity with HMGS of other plants of their respective families. The Molecular Evolutionary Genetic Analysis (MEGA) version 10.1.6 was used to construct a phylogenetic tree. Differential tissue-specific expression of different plant parts was also checked. Tissue expression patterns unveiled that the highest expression level of the CaHMGS had been seen in the roots and lowest in the node of the plant. Functional complementation experiment of the CaHMGS in Saccharomyces cerevisiae wild strain YSC1021 and haploid strain YSC1021 which lack HMGS protein confirmed that the CaHMGS gene encodes functional CaHMGS that catalyzed the biosynthesis of mevalonate in yeast., Conclusions: The gene was reported, cloned and characterized first time in Centella asiatica. Understanding this biosynthetic pathway gene will further help in the improvement of plants for enhanced secondary metabolites production., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

The present research work was aimed to develop and optimize the nanostructured lipid carrier (NLCs) of the antihypertensive drug lacidipine (LAC) for the improvement of oral bioavailability and antihypertensive activity. LAC-NLCs were successfully developed by the preemulsion probe sonication technique. The formulations were optimized by Box-Behnken design and assessed for particle size (PS), polydispersity index (PDI), entrapment efficiency (EE), drug loading (DL), drug release, ex vivo permeation, and in vivo study. The optimized LAC-NLCs showed nanometric PS (191.0 ± 5.89 nm), high EE (90% ± 3.69%) and DL (9.26% ± 1.89%), negative zeta potential (-28.9 ± 0.99 mV), and narrow size distribution (PDI of 0.074 ± 0.013) with spherical morphology. The drug release study revealed that a significantly ( p < 0.05) higher LAC release (88.49% ± 3.01%) was achieved from the optimized LAC-NLCs compared to LAC-dispersion (34.27% ± 3.01%). Moreover, the optimized LAC-NLCs showed significantly ( p < 0.05) higher intestinal permeation (692.04 ± 19.76 μg) than LAC-dispersion (23.83 ± 5.08 μg). After oral administration of a single dose of LAC, the optimized LAC-NLCs exhibited 3.45-fold higher relative oral bioavailability as well as a more prominent antihypertensive effect than LAC-dispersion. This might be due to the high penetration and absorption of the drug. Hence, NLCs might provide an efficient nano delivery for the management of hypertension and promising drug delivery systems for the bioavailability enhancement of LAC.

Introduction: Coronavirus illness 2019, commonly referred to as COVID-19, is a highly infectious disease brought on by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 was declared a universal pandemic in March 2020 by the World Health Organization and is a severe health issue with unprecedented morbidity and mortality rates. Both surgical and mediastinal emphysema have been seen in cases of critically ill COVID-19 patients in several hospitals in the Eastern Province of Saudi Arabia., Methods: This was a retrospective, cross-sectional, multicentric study involving several hospitals in the Saudi Arabian Eastern Province. Data were collected from intensive care units (ICUs) in these hospitals from March 2 to August 2, 2020. The inclusion criteria consisted of all patients who tested positive for SARS-CoV-2 and were admitted to a critical care unit., Results: Thirty patients required thoracic consultation and management, including 26 males (81.3%) and 4 females (12.5%) (1:0.15) who developed surgical and mediastinal emphysema requiring thoracic surgery intervention. Most of the patients were on high ventilation settings, and the mean duration of ventilator support was 16.50 ± 13.98 days. Two patients (6.3%) required reintubation. The median positive end-expiratory pressure (PEEP) was 12 ± 2.80 cmH 2 O with a median FiO2 of 70% ± 19.73. On average, thoracic complications occurred on day 3 (±6.29 days) postintubation. Ten patients (33.33%) experienced a pneumothorax associated with surgical emphysema (SE), 1 patient (3.33%) presented with only mediastinal emphysema; 17 patients (56.66%) with only SE, and 1 (3.33%) had mediastinal emphysema associated with SE. We noted a correlation between the duration of ventilator support, the length of ICU stay ( P < 0.001), and the total length of stay (LOS) in the hospital ( P < 0.001). Total length of hospital stay showed significant association with the onset of complications ( P = 0.045) and outcomes ( P = 0.006). A significant association between PEEP and the duration of ventilator support was also evident with a P value = 0.009 and the onset of complications ( P = 0.043). In addition, we found a significant association between the group with pneumothorax in combination with SE, and their outcomes, with a P = 0.002., Conclusion: Surgical and mediastinal emphysema in the critically ill patients are usually attributed to barotrauma and high ventilations settings. During COVID-19 pandemic, these entities were seen and the pathogenesis was revisited and some attributed its presence to the disease process and destruction on lung parenchyma. The associated with extended LOS and delayed recovery in addition to poor prognosis were seen. Their presence is an indicator to higher morbidity and mortality., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Annals of Thoracic Medicine.)

Petroleum refinery wastewater combined with domestic sewage were collected from the open channel in the vicinity of Mathura oil refinery, UP (India) and analysed by inductively coupled plasma optical emission spectrometry (ICP-OES) and gas chromatography-mass spectrometry (GC-MS) for elemental analysis and organic pollutants, respectively. Several potentially toxic and non-toxic elements were found to be present in the wastewater samples. GC-MS analysis revealed the presence of several organic contaminants including pesticides. Wastewater samples were extracted using amberlite XAD4/8 resins and liquid-liquid extraction procedures using different organic solvents. The extracts were tested for their cyto-genotoxic potential using bacterial ( Salmonella mutagenicity test, E. coli K-12 DNA repair defective mutants, Bacteriophage λ assay) and plant ( Vigna mungo phytotoxicity test, Allium cepa chromosomal aberration assay) systems. A significant increase was observed in the number of revertants of TA97a, TA98 and TA100 strains with the test samples and XAD concentrated samples were found to be more mutagenic than liquid-liquid extracts. Colony forming units (CFUs) of DNA repair defective mutants of E. coli K-12 recA , lexA and polA declined significantly as compared to their isogenic wild-type counterparts with the test samples. Significant reduction in plaque forming units (PFUs) of bacteriophage λ was also found on treatment with the solvent extracts. Presence of several toxic pollutants in the wastewater apply prohibitive action on the seed germination process. Germination rate of Vigna mungo seeds as well as radicle and plumule lengths were found to be affected when treated with different concentration of wastewater as compared to control. Present study also indicated concentration dependent reduction in mitotic index of A. cepa i.e., 16.38% at 5% and 9.74% at 100% wastewater and percentage of aberrant cells were highest at 100% effluent. Present findings indicated that mutagenicity/genotoxicity of wastewater is due to the mixture of genotoxins; poses serious hazards to the receiving waterbodies which require continuous monitoring and remedial measures for their improvement., Competing Interests: The authors declare no conflict of interest., (© 2021 The Authors.)

Background: The concept of burden of care came from the realm of behavioral sciences primarily in the context of looking after a psychiatrically ill person. Caregivers of schizophrenia and bipolar affective disorder (BPAD) have to take over the totality of patient care since most of these patients are treated at home. As a result of this, they are exposed to negative consequences of caregiving., Aim: This study aims to assess and compare the pattern of burden among the families having patients with schizophrenia and bipolar disorder., Materials and Methods: This cross-sectional, observational study was conducted on the outpatient department level at Ranchi Institute of Neuropsychiatry and Allied Science. This study included 30 patients with schizophrenia and equal number of age- and sex-matched patients with bipolar disorder. The diagnosis was made as per criteria of International Classification of Diseases 10 diagnostic criteria for research. Their caregivers who gave consent for their participation in the study and satisfy the inclusion and exclusion criteria were included in the study by purposive sampling. Tools administered were socio-demographic datasheet and family burden inventory schedule., Statistical Analysis Used: Chi-square test, Fisher's exact test, and Mann-Whitney U test., Results: Total caregiver burden, financial burden, disruption of routine family activities, family leisure, family interaction, and subjective burden felt by caregiver were significantly more in caregivers of schizophrenia patients compared to caregivers of BPAD. There was no significant difference in the two areas of burden, i.e., effect on physical health of the caregivers and effect on mental health of caregivers., Conclusion: Caregivers of schizophrenia patients have significantly higher family burden as compared to caregivers of subjects with BPAD., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Industrial Psychiatry Journal.)

Aim: In the current study, it was hypothesized that single nucleotide polymorphisms (SNPs) in the regulatory region of the IL-22 signaling pathway genes, including IL-22 and IL-22RA1 variants, may be associated with CRC susceptibility., Background: The important role of pro-inflammatory cytokines during tumorigenesis is well-established. In recent years, IL-22 has been linked with colorectal cancer (CRC) through a number of mechanistic and observational studies., Methods: The association of four polymorphisms in the IL-22 (rs1179251 and rs1179246) and IL-22RA1 (rs4648936 and rs10794665) genes with CRC risk were studied using a case-control design with 304 cases and 345 controls from the Iranian population. All 649 subjects were evaluated by PCR-RFLP method., Results: No significant difference was found in genotype and allele frequencies between the cases and controls for either IL-22 and IL-22RA1 gene variants or CRC risk before or after adjusting for confounders., Conclusion: The current findings do not present any significant evidence for associations between variants in IL-22 signaling pathway genes and CRC. Complementary studies with greater sample sizes may be necessary to fully elucidate the nature of these associations., Competing Interests: The authors declare that they have no conflict of interest., (©2021 RIGLD, Research Institute for Gastroenterology and Liver Diseases.)

Periodontitis, a major oral disease, affects a vast majority of the population but has been often ignored without realizing its long-fetched effects on overall human health. A realization in recent years of its association with severe diseases such as carditis, low birth weight babies, and preeclampsia has instigated dedicated research in this area. In the arena of periodontal medicines, the studies of past decades suggest a link between human periodontal afflictions and certain systemic disorders such as cardiovascular diseases, diabetes mellitus, respiratory disorders, preterm birth, autoimmune disorders, and cancer. Although, the disease appears as a locoregional infection, the periodontal pathogens, in addition their metabolic products and systemic mediators, receive access to the bloodstream, thereby contributing to the development of systemic disorders. Mechanism-based insights into the disease pathogenesis and association are highly relevant and shall be useful in avoiding any systemic complications. This review presents an update of the mechanisms and relationships between chronic periodontal infection and systemic disorders. Attention is also given to highlighting the incidence in support of this relationship. In addition, an attempt is made to propose the various periodonto-therapeutic tools to apprise the readers about the availability of appropriate treatment for the disease at the earliest stage without allowing it to progress and cause systemic adverse effects.

Background: Single umbilical artery (SUA) is found in 0.5-6% of all pregnancies worldwide. Although the association of SUA with some congenital malformations is mainly accepted, its effect on pregnancy/neonatal outcomes is still controversial., Objective: This is the first study aimed to approximate the SUA prevalence in southern part of Iran. SUA epidemiologic features accompanied by some of its effects on pregnancy/neonatal outcomes are investigated as well., Materials and Methods: In this cross-sectional study, data from two referral centers in Southern Iran were analyzed. In total, 1,469 pregnancies, fetuses, and neonates were examined for epidemiological features associated with SUA. SUA was confirmed by pathological examination, while congenital anomalies were diagnosed by clinical, ultrasound, and echocardiographical examinations. Data on pregnancy outcome were recorded based on the patients' medical records., Results: The prevalence of SUA was 3.47% (95% CI: 2.6-4.6%). Fetal anomalies including renal, cardiac, and other congenital anomalies, intrauterine fetal death, early neonatal death, low birth weight, low placental weight, and preterm birth were significantly higher in the SUA group (OR = 68.02, 31.04, 16.03, 3.85, 11.31, 3.22, 2.70, and 2.47, respectively). However, the maternal multiparity was lower in the SUA group (OR = 0.65; 95% CI: 0.44-0.98)., Conclusion: A significant association was observed between SUA and increased risk of intrauterine fetal death and early neonatal death, as well as low birth weight and preterm birth. Obstetrical history of the mother like parity was identified as an important predictor of SUA. Further investigations are suggested on risk stratification of neonates in this regard., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2021 Vafaei et al.)

Curcumin, resveratrol, and thymoquinone are the potential natural bio-actives reported with good anti-psoriatic activity. However, poor aqueous solubility and limited skin permeation of these natural bio-actives hinder their effective delivery and potential therapeutic outcome. In this regard, current research work focuses on the design and optimization of nanoemulsion (NE) gel formulation for the concurrent delivery of these three drugs. The NE system is consisting of oleic acid as oil phase, Tween 20 as surfactant, and PEG 200 as co-surfactant. The optimized formulation exhibited the droplet size 76.20 ± 1.67 nm, PDI of 0.12 ± 0.05, RI of 1.403 ± 0.007, and viscosity of 137.9 ± 4.07 mp. Carbopol 940 (0.5% w/v) was used as the gelling agent to prepare the NE gel which exhibited a good texture profile. The optimized formulation exhibited a higher % of growth inhibition on A-431 cells and demonstrated good anti-angiogenic activity in the HET-CAM test. Finally, in vivo studies in Balb/c mice model showed improved anti-psoriatic conditions which indicated that the triple natural bio-actives combination in nanoemulgel formulation is effective in the management of psoriasis.

Purpose: To study the changing indications for Penetrating keratoplasty in Bahrain and to compare them with published data., Patients and Methods: A Retrospective review of available records of patients who underwent penetrating keratoplasty at a tertiary center in Bahrain (1996-2015). The trend of each indication was analyzed. The study was subdivided into three periods for correlation purposes. Pearson Coefficient r and the p values were used for interpretation of data. The results were compared with similar studies., Results: A total of 298 patients underwent keratoplasty in the study period, which is from 1996 until 2015 (missing data 2009-2011). Keratoconus was found to be the leading indication, accounting for 33% of the total cases, followed by trachoma 27%, followed by aphakic and pseudophakic bullous keratopathies 13%. Trachoma showed a statistically significant decreasing trend (p < 0.001), Keratoconus had an increasing trend (p<0.001). Bullous keratopathy showed an increasing trend (p = 0.001) with an abrupt rise after 2012., Conclusion: Corneal scarring due to old trachoma was the leading indication for keratoplasty 20 years ago in Bahrain. However, due to improvement of health awareness, hygiene, and the socioeconomic status, this has regressed with keratoconus becoming the leading indication from 2002 onwards. A surge of bullous keratopathy was noted after 2012, placing it as the second commonest indication. This may be due to the introduction of phacoemulsification technique for cataract surgery, and perhaps because the nature of the institute being a teaching hospital. Keratoconus is the leading indication and showed an increasing trend. It is recommended to perform a keratoconus screening program for early detection and prevention., Competing Interests: The authors report no conflicts of interest in this work. They have no financial interest or other conflicts of interest. The abstract of this paper was presented in part at the 24th ESCRS winter meeting as a poster presentation., (© 2021 Al-Yousuf et al.)

The parental rotavirus strain 116E (G9P[11]) used to generate Rotavac® vaccine was isolated in 1986 in New Delhi. Thenceforward, there is no comprehensive report on diversity of G9 rotavirus strains from 116E; therefore, the present study evaluates the VP7 gene sequence diversity of G9 strains (retrieved from GenBank) from different geographical regions (1987-2016). Additionally, 22 recently collected G9 strains from Himachal Pradesh and Delhi (2013-2016) were included in the phylogenetic analysis. Interestingly, unlike 116E which belong to lineage-II all other G9 rotavirus including these 22 samples clustered together in a separate lineage (III). Further, six amino acid substitutions including one novel, K143M (epitope 7-2) different from 116E were detected mostly in the neutralization epitopes of VP7 protein (neutralization escape mutants). Overall, the accumulation of identified substitutions in VP7 epitopes and evolution of G9 strains in India may have impact on Rotavac® efficacy., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

A core-shell hybrid of ZnO and nitrogen-doped carbon (ZnO@C:N) is designed as a long-cycling anode for LIBs. The ZnO@C:N hybrid has a high initial capacity of 1116 mA h g-1 and a reversible capacity of 608 mA h g-1 after 500 cycles at 0.1 A g-1. The unique core-shell structure, high conductivity due to nitrogen doping, and uniform solid electrolyte interphase (SEI) film formed in the electrode are revealed to result in the remarkable electrochemical performances of the ZnO@C:N electrodes.

Wastewater were collected from the effluent channel in the vicinity of Mathura oil refinery, U.P. (India) and analysed for physicochemical characteristics, heavy metals as well as organic compounds including PAHs. The interaction of PAHs and heavy metals with various group of microorganisms revealed the viable count of aerobic heterotrophs, asymbiotic nitrogen fixers, actinomycetes and fungi were found to be 2.38 × 10 6 , 1.89 × 10 4 , 2.20 × 10 4 CFU/mL and 8.76 × 10 3 CFU/mL respectively. We have selected and screened 50 bacterial isolates for their resistance/tolerance to heavy metal and PAHs. Out of 25 multi-metal resistant isolates, 6 were able to tolerate PAHs at the concentration of 5000 μg/mL (50μg/disc) to naphthalene, anthracene, phenanthrene and pyrene. The PAH degradation efficiency of the isolates was assessed using spectrophotometer with 100 μg/mL of phenanthrene and observed different degree of degradation ranging from 34-66% after 96 h of incubation. One of the bacterial isolates KWB3 (identified as Enterobacter ludwigii by 16S rDNA sequencing) exhibited maximum degradation efficiency (66%) was further tested for phenanthrene degrading ability in the presence and absence of a co-substrate (glucose) in a mineral salt medium; and a number of metabolites were produced and detected by GC-MS which revealed the presence of benzocoumarin, phthalic acid, catechol and several low molecular weight compounds. The DNA derived from multi-metal and PAHs tolerant bacteria were PCR amplified using Inc specific primers and positive PCR products were obtained with oriT and trfA2 of the IncP group; indicates that these bacteria have gene-mobilizing capacity., (© 2019 The Authors.)

FeSe2-carbon nanotube (FeSe2-CNT) hybrid microspheres are investigated as anode materials for lithium ion batteries (LIBs), exhibiting a high specific capacity of 571.2 mA h g-1 at 0.5 A g-1 with excellent rate performance and cycling stability. The FeSe2-CNT hybrid LIBs could withstand the high-voltage pulse of triboelectric nanogenerators (TENGs) and be charged by TENGs directly for harvesting energy with high stability.

Aim: To assess the possible correlation between single nucleotide polymorphisms (SNPs) of two members of TNF ligand superfamily genes, tumor necrosis factor-α (TNF-α) and lymphotoxin-α (LTA), and HCV chronic disease., Background: The causes of disease progression from hepatitis C virus (HCV) infection to chronic liver disease still remains unclear. Abnormal production of the cytokines alleged to be contributed to progression of the disease or viral persistence. Regulatory mechanisms that control the production of cytokines including genetic polymorphisms, especially at coding/regulatory regions of genes, may affect expression and secretion of the cytokines., Methods: In this case-control investigation, 258 individuals with serologically proven chronic HCV infection and 277 healthy controls were studied. Genotyping of rs1799964 variant of TNF-α and rs909253 intronic variant in LTA gene were performed. To confirm the results of genotyping, 10% of the specimens analyzed again by sequencing approach., Results: In this investigation, a significant association was observed between the TNF-α TC genotype and chronic HCV infection (P = 0.035). Moreover, the frequency of C allele was significantly different between control subjects in comparison with chronic HCV patients (P=0.02). On the other hand, no association was found between LTA gene polymorphism and susceptibility to chronic HCV infection., Conclusion: These findings indicate that genetic variants like single nucleotide polymorphism in TNF-α rs1799964, could be a host factor associated with susceptibility to HCV chronic infection. However, further large scale investigations are needed to confirm this finding., Competing Interests: The authors declare that they have no conflict of interest.

In view of high mortality associated with coronary artery disease (CAD), development of an early predicting tool will be beneficial in reducing the burden of the disease. The database comprising demographic, conventional, folate/xenobiotic genetic risk factors of 648 subjects (364 cases of CAD and 284 healthy controls) was used as the basis to develop CAD risk and percentage stenosis prediction models using ensemble machine learning algorithms (EMLA), multifactor dimensionality reduction (MDR) and recursive partitioning (RP). The EMLA model showed better performance than other models in disease (89.3%) and stenosis prediction (82.5%). This model depicted hypertension and alcohol intake as the key predictors of CAD risk followed by cSHMT C1420T, GCPII C1561T, diabetes, GSTT1, CYP1A1 m2, TYMs 5'-UTR 28 bp tandem repeat and MTRR A66G. MDR and RP models are in agreement in projecting increasing age, hypertension and cSHMTC1420T as the key determinants interacting in modulating CAD risk. Receiver operating characteristic curves exhibited clinical utility of the developed models in the following order: EMLA (C = 0.96) > RP (C = 0.83) > MDR (C = 0.80). The stenosis prediction model showed that xenobiotic pathway genetic variants i.e. CYP1A1 m2 and GSTT1 are the key determinants of percentage of stenosis. Diabetes, diet, alcohol intake, hypertension and MTRR A66G are the other determinants of stenosis. These eleven variables contribute towards 82.5% stenosis. To conclude, the EMLA model exhibited higher predictability both in terms of disease prediction and stenosis prediction. This can be attributed to higher number of iterations in EMLA model that can increase the prediction accuracy.

Background: The aim of this work was to evaluate the narrow anterior chamber angle (ACA) in Chinese patients by anterior segment optical coherence tomography (As-OCT)., Methods: Eighty right eyes of 80 consecutive patients with a shallow peripheral anterior chamber but no peripheral anterior synechia were enrolled in this study. The ACA was observed by noncompression gonioscopy and classified according to the Shaffer grading system. The iridotrabecular contact (ITC) and trabecular-iris angle (T-I angle) were assessed by As-OCT examination., Results: Gonioscopic grade 0 and ITC were observed more frequently in the superior quadrant than the other quadrants (p < 0.02). The T-I angle was significantly smaller superiorly and inferiorly than nasally and temporally (p < 0.01). The frequency of the ITC and T-I angle significantly declined when the gonioscopic grade was from 0 to 2 (p < 0.01). Logistic analysis showed that the axial length and refraction were related to the presence of ITC in more than two quadrants (p < 0.03)., Conclusions: ITC was common in eyes with a shallow peripheral anterior chamber (superiorly, gonioscopic grade 0). Sites with wider gonioscopic grading tended to have a larger T-I angle. Axial length and refraction significantly impacted on the frequency of ITC., (© 2016 S. Karger AG, Basel.)

Introduction: Dysentery is an intestinal inflammation which is created by the microorganisms attacking intestine mucus. Knowing the prevalence of this disease in different societies paves the way for programming and providing treatment and preventive measures. The main purpose of this study is to investigate the epidemiologic pattern and geographical distribution of dysentery based on GIS., Method: This was a cross-sectional and analytical study. The dysentery cases were gathered from the section of contagious diseases in health chancellery of Mazandaran University of medical sciences through a checklist during the years 2008 to 2013. In order to analyze the data, we made use of chi-square test. Then, the GIS software was used to recognize the geographical distribution of the disease., Findings: There was reported about 653 cases affected by dysentery and the disease proportion was equal for both men and women. Most of the persons with dysentery was city dwellers. The highest rate of incidents was reported to be in Fereidunkenar in 2011, and the disease was mostly found among farmers, students, and college students., Conclusion: Since dysentery is a disease transmitted from water and food, and in this study, it was found out that the disease sources included using polluted water, vegetables, and lack of appropriate personal hygiene. Therefore, it is essential to take into consideration the health issues. Moreover, the suitable conditions of the geographical area which has the highest rate of incident have paved the way for dysentery occurrence. In addition, using geographic information system (GIS) as a visual instrument can help the stakeholders and officials to elaborate on the death trend and recognize the areas for optimal use of the available resources., Competing Interests: • Conflict of interest: none declared.

Background: Colorectal cancer (CRC) is the fourth leading cause of cancer-related death around the world and accumulated evidence indicates the association between CRC and obesity and insulin resistance., Objectives: Regarding the role of adiponectin in obesity and insulin resistance, we explored whether genetic variants in adiponectin (ADIPOQ) and adiponectin receptor 1 (ADIPOR1) are associated with CRC risk., Materials and Methods: ADIPOQ (rs2241766) and ADIPOR1 (rs2275738) gene variants were genotyped in 261 cases with CRC and 339 controls using PCR-RFLP method., Results: In this study, no significant difference was observed for ADIPOQ gene rs2241766 variant between the cases and controls. However, carriers of the ADIPOR1 (rs2275738) "CC + CT" genotype compared with "TT" genotype occurred more frequently in the cases with CRC than the controls, and the difference remained significant after adjustment for age, BMI, sex, smoking status, NSAID use, and family history of CRC (P = 0.048; OR = 1.49, 95%CI = 1.01-2.20). Interestingly, after adjustment for confounding factors the ADIPOR1 "CC + TC" genotype compared with "TT" genotype was also associated with an increased risk for obesity in the cases (P = 0.040; OR = 1.86, 95%CI = 1.03-3.36)., Conclusions: Our findings suggest for the first time that the - 106 C > T (rs2275738) variant of ADIPOR1 gene may be a genetic contributor to CRC and obesity risk in the cases with CRC. However, further studies with bigger sample size are needed to validate these findings.

Background: Given the major role of obesity and insulin resistance (IR) in colorectal cancer (CRC), we investigated whether genetic variants in ghrelin (GHRL), resistin (RETN) and insulin receptor substrate 1 (IRS1) were associated with CRC risk., Methods: This study was conducted as a case-control study, and 750 subjects, including 438 controls and 312 patients with CRC, were enrolled and genotyped using the PCR-RFLP method., Results: No significant differences were observed for GHRL (rs696217), RETN (rs3745367) and IRS1 (rs1801278, Gly972Arg or G972R) gene variants between the cases and controls. However, the IRS1 G972R R allele compared with the G allele and the G972R RR+GR genotype compared with the GG genotype appeared to be markers of decreased CRC susceptibility in the overweight/obese subjects (p = 0.024; odds ratio [OR] = 0.42, 95% confidence interval [95% CI], 0.20-0.91; and p = 0.048; OR = 0.42, 95% CI, 0.17-0.99, respectively). Furthermore, the R allele and RR+GR genotype were also associated with decreased risks for obesity in the patients with CRC (p = 0.007; OR = 0.35, 95% CI, 0.15-0.77; and p = 0.015; OR = 0.35, 95% CI, 0.15-0.72, respectively)., Conclusions: In accordance with previous studies, our findings suggest that the IRS1 G972R R allele and RR+GR genotype have protective effects for CRC in overweight/obese patients and for obesity in patients with CRC. Nevertheless, further studies are required to confirm these findings.

Background: Interleukin-16 (IL-16) is an immunomodulatory cytokine, which plays an important role in some inflammatory and autoimmune diseases such as hepatitis B, which is a major health concern worldwide., Objectives: In this study, we aimed to investigate the plausible association between IL-16 polymorphism and chronic HBV susceptibility in an Iranian population., Patients and Methods: In a case-control study, we analyzed rs1131445 polymorphism in the microRNA binding site of the IL-16 gene in 262 patients with chronic hepatitis B and 269 healthy controls, using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method and DNA sequencing technology to confirm our results., Results: Altogether, in this investigation, a significant association was observed between the IL-16 TC genotype compared with the TT genotype (OR = 0.696, 95% CI: 0.485 - 0.997, P = 0.048), after adjustments for confounders including age and gender., Conclusions: These findings show that immunogenetic factors, such as single nucleotide polymorphism in IL-16, could be a risk factor for susceptibility to chronic HBV infection. However, further investigations are needed to verify these results.

Given the role of insulin resistance in colorectal cancer (CRC), we explored whether genetic variants in insulin (INS), insulin receptor (INSR), insulin receptor substrate 1 (IRS1), insulin receptor substrate 2 (IRS2), insulin-like growth factor 1 (IGF1), and insulin-like growth factor binding protein 3 (IGFBP3) genes were associated with CRC risk. A total of 600 subjects, including 261 cases with CRC and 339 controls, were enrolled in this case-control study. Six polymorphisms in INS (rs689), INSR (rs1799817), IRS1 (rs1801278), IRS2 (rs1805097), IGF1 (rs5742612), and IGFBP3 (rs2854744) genes were genotyped using PCR-RFLP method. No significant difference was observed for INS, INSR, IRS1, IRS2, IGF1, and IGFBP3 genes between the cases and controls. However, the INSR rs1799817 "TT + CT" genotype and "CT" genotype compared with "CC" genotype occurred more frequently in the women with CRC than women controls (P = 0.007; OR = 1.93, 95 %CI = 1.20-3.11 and P = 0.002, OR = 2.15, 95 %CI = 1.31-3.53, respectively), and the difference remained significant after adjustment for confounding factors including age, BMI, smoking status, NSAID use, and family history of CRC (P = 0.018; OR = 1.86, 95 %CI = 1.11-3.10 and P = 0.004, OR = 2.18, 95 %CI = 1.28-3.71, respectively). In conclusion, to our knowledge, this study indicated for the first time that the INSR rs1799817 TT + CT genotype and CT genotype compared with the CC genotype had 1.86-fold and 2.18-fold increased risks for CRC among women, respectively. Furthermore, this finding is in line with previous studies which found significant associations between other variants of the INSR gene and CRC risk. Nevertheless, further studies are required to confirm our findings.

Purposes: Obesity is associated with an increased risk of colorectal cancer (CRC), and ghrelin (GHRL) and resistin (RETN) are thought to be related to obesity. Our aim was to investigate whether GHRL and RETN gene variants are associated with CRC risk., Materials and Methods: All 414 subjects, including 197 cases with CRC and 217 controls, were genotyped for the GHRL (rs26802) and RETN (rs1862513) or -420 C>G gene variants using the PCR-RFLP method., Results: Our findings indicated that the RETN -420 C>G "CC" genotype, compared with the "GG" and "GC" genotypes, was a marker of decreased CRC susceptibility; the difference remained significant after adjustment for age, BMI, gender, smoking status, NSAID use, and family history of CRC (p=0.020; OR=0.52, 95% CI=0.30-0.90). Furthermore, after adjustment for confounding factors, the -420 C>G "CC" genotype, compared with the "GG" genotype, was associated with a decreased risk for CRC (p=0.044; OR=0.53, 95% CI=0.29-0.98). In addition, no significant difference was observed for the GHRL (rs26802) gene variant., Conclusions: To our knowledge, this is the first study suggesting that the RETN -420 C>G "CC" genotype is a marker of decreased CRC susceptibility. This observation is relevant from a scientific perspective and deserves further investigations.

Background: Substantial evidence from epidemiological studies has suggested that increased levels of calcium may play a protective role against colorectal cancer (CRC). Given the vital role of calcium sensing receptor (CaSR) and parathyroid hormone (PTH) in the maintenance of calcium homeostasis, we explored whether the rs1801725 (A986S) variant located in exon 7 of the CaSR gene and the rs6256 variant located in exon 3 of PTH gene might be associated with CRC risk., Materials and Methods: In this study 860 subjects including 350 cases with CRC and 510 controls were enrolled and genotyped using PCR-RFLP methods., Results: We observed no significant difference in genotype or allele frequencies between the cases with CRC and controls for both CaSR and PTH genes either before or after adjustment for confounding factors including age, BMI, sex, smoking status, and family history of CRC. Furthermore, no evidence for effect modification of any association of rs1801725 and rs6256 variants and CRC by BMI, sex, or tumor site was observed. In addition, there was no significant difference in genotype and allele frequencies between the normal weight (BMI<25 kg/m2) cases and overweight/ obese (BMI≥25 kg/m2) cases for the two SNPs., Conclusions: These data indicated that the CaSR gene A986S variant is not a genetic contributor to CRC risk in the Iranian population. Furthermore, our results suggest for the first time that PTH gene variant does not affect CRC risk. Nonetheless, further studies with larger sample size are needed to validate these findings.

Purpose: With regard to the protective effect of vitamin D against colorectal cancer (CRC), we evaluated genetic variants that might influence vitamin D metabolism: vitamin D receptor (VDR), vitamin D binding protein (GC), vitamin D 25-hydroxylase (CYP2R1), and vitamin D 25-hydroxy 1-alpha hydroxylase (CYP27B1)., Materials and Methods: A total of 657 subjects, including 303 cases with CRC and 354 controls were enrolled in this case-control study. All 657 were genotyped for the four gene variants using PCR-RFLP methods., Results: In this study, no significant difference was observed for VDR (rs2238136), GC (rs4588), CYP2R1 (rs12794714), and CYP27B1 (rs3782130) gene variants in either genotype or allele frequencies between the cases with CRC and the controls and this lack of difference remained even after adjustment for age, BMI, sex, smoking status, NSAID use, and family history of CRC. Furthermore, no evidence for effect modification of the variants and CRC by BMI, sex, or tumor site was observed., Conclusions: Our findings do not support a role for VDR, GC, and CYP27B1 genes in CRC risk in our Iranian population. Another interesting finding, which to our knowledge has not been reported previously, was the lack of association with the CYP2R1 gene polymorphism. Nonetheless, our findings require confirmation and possible roles of vitamin D metabolism-related genes in carcinogenesis need to be further investigated.

Background: Several epidemiological studies have shown associations between colorectal cancer (CRC) risk and type 2 diabetes and obesity. Any effects would be expected to be mediated through the insulin pathway. Therefore it is possible that variants of genes encoding components of the insulin pathway play roles in CRC susceptibility. In this study, we hypothesized that polymorphisms in the genes involving the insulin pathway are associated with risk of CRC., Materials and Methods: The associations of four single nucleotide polymorphisms (SNPs) in IGF-I (rs6214), IGFBP-3 (rs3110697), INSR (rs1052371), and IRS2 (rs2289046) genes with the risk of CRC were evaluated using a case-control design with 167 CRC cases and 277 controls by the PCR-RFLP method., Results: Overall, we observed no significant difference in genotype and allele frequencies between the cases and controls for the IGF-I, IGFBP-3, INSR, IRS2 gene variants and CRC before or after adjusting for confounders (age, BMI, sex, and smoking status). However, we observed that the IRS2 (rs2289046) GG genotype compared with AA+AG genotypes has a protective effect for CRC in normal weight subjects (p=0.035, OR=0.259, 95%CI= 0.074-0.907)., Conclusions: These findings do not support plausible associations between polymorphic variations in IGF-I, IGFBP-3, INSR, IRS2 genes and risk of CRC. However, the evidence for a link between the IRS2 (rs2289046) variant and risk of CRC dependent on the BMI of the subjects, requires confirmation in subsequent studies with greater sample size.

Vitamin D appears to have anti-tumor activities in the large bowel. Our aim was to investigate whether -4817 G>A (rs2238136) polymorphism located at 5'-untranslated region (5'-UTR) of the human vitamin D receptor (VDR) gene was associated with colorectal cancer (CRC) risk. We conducted a case-control study and VDR genotypes, determined by Bpu10I restriction endonuclease digestion of PCR-amplified DNA, were performed on 327 cases with CRC and 327 controls. The distribution of VDR -4817 G>A genotypes and alleles differed significantly between cases with CRC and controls even after adjustment for confounding factors such as age, BMI, sex, and smoking status. Individuals carrying the "AA" genotype had a 2.09-fold increased risk compared with those with "GG" genotype (P = 0.016, OR = 2.09, 95% CI = 1.15-3.78) and a 1.87-fold increased risk compared with those with "GG and GA" genotypes (P = 0.033, OR = 1.87, 95% CI = 1.05-3.33) for CRC. Furthermore, the VDR "A" allele was significantly overrepresented in cases with CRC than controls (P = 0.044; OR = 1.28, 95% CI = 1.01-1.63). Interestingly, the analysis of the SNP revealed that all these associations were stronger for women subjects than for all subjects combined. These data indicated for the first time a direct association between "AA" genotype of VDR gene -4817 G>A polymorphism and CRC, with a stronger association for female subjects. However, our findings remain to be confirmed in other populations.

Background: This study investigates the effects of rosiglitazone (a peroxisome proliferator-activated receptor-gamma) on the histological parameters of the dorsal root ganglion (DRG) and the recovery potential of the injured sciatic nerve in rats using stereological methods., Methods: The rats were divided into four groups including control, sham-operated, sciatic nerve crush (SNC), and SNC + rosiglitazone treatment (5 mg/kg body weight/day). The sciatic functional index (SFI) was used to evaluate functional recovery. The main DRG neurons were defined as either A cells (the larger cell with a central nucleolus in the nucleus and granulated cytoplasm) or B cells (the smaller cell with multiple peripherally located nucleoli and homogenous cytoplasm). Satellite cells (supporting) surround the neuron cell body., Results: The volume and surface of A and B cells decreased in the SNC group compared to the sham-operated group. In the SNC + rosiglitazone group, the volume of A and B cells decreased to a lesser extent, and was 30% and 48% higher in comparison with the SCN group. In the SNC + rosiglitazone rats the surface of the A and B cells decreased to a minor extent, and was 45% and 21% higher in comparison with the SNC animals. In rosiglitazone-treated rats the number of the A, B, and satellite cells decreased less, and was 38%, 34%, and 29% higher than in the SNC rats. The SFI score improved in SNC + rosiglitazone rats in comparison with non-treated animals., Conclusion: Rosiglitazone has an ameliorative effect on the DRG and enhances the functional recovery after SNC in rats.

Depressed skull fracture is an inward buckling of the skull bones, often because of direct blow to a small surface area of the skull with a blunt object. Monoparesis is often among its clinical presentations, but midline depressed skull fracture presenting as motor weakness of both lower limbs (Paraperesis) has not yet been reported. We report the case of 55 year old male admitted to emergency department with alleged history of hit on head by a wooden rod. He had pain, mild swelling and a small cut over scalp without any symptoms & signs of neurological deficit. On day two of admission patient developed weakness of both lower limbs. On CT scan patient had bilateral depressed skull fracture of high parietal bone on either side of midline. Patient was managed conservatively, made remarkable recovery and was discharged after 2 weeks.

Epidemiological evidence suggests the protective effect of vitamin D against colorectal cancer (CRC) and the polymorphisms in vitamin D receptor (VDR) gene may influence the development of CRC. In this study the possible association of VDR FokI and BsmI gene polymorphisms with CRC risk was examined. A total of 904 subjects, including 452 cases with CRC and 452 controls were enrolled in this study. All 904 subjects were genotyped for VDR FokI and BsmI gene polymorphisms by PCR-RFLP method. We observed no significant difference in genotype and allele frequencies between the cases with CRC and controls for the both FokI and BsmI polymorphisms either before or after adjustment for confounding factors including age, BMI, sex, and smoking status. Furthermore, no evidence for effect modification of the association VDR gene FokI and BsmI variants and CRC by BMI, sex, or tumor site was observed. In addition, there was no significant difference in genotype and allele frequencies between the normal weight (BMI <25 kg/m(2)) cases with CRC and overweight/obese (BMI ≥25 kg/m(2)) cases with CRC for the two SNPs. Our results do not lend support to the hypothesis that VDR gene FokI and BsmI polymorphisms are associated with the risk of CRC. However, further studies are required to confirm this finding.

Aim: Leptin is a 16 kDa polypeptide hormone which secreted by adipose tissue and has an important role in energy balance, insulin pathway and inflammation, because of that it may play an important role in colorectal cancer (CRC). Leptin exerts its effect through the leptin receptor (LEPR) a member of the class I cytokine receptor family., Background: We have investigated whether glutamine to arginine substitution (Gln223Arg) in exon 6 of the leptin receptor gene, has implications for susceptibility to CRC., Patients and Methods: Polymerase chain reaction (PCR) and restriction enzyme digestion (RFLP) was performed to evaluate the association between the Gln223Arg polymorphism of the LEPR and CRC risk in a case-control study in 346 subjects involving 173 cases with CRC and 173 controls., Results: There was no statistically evidence of significant difference in genotype and allele frequencies between the cases with CRC and controls for the Gln223Arg polymorphism of LEPR, before or after adjusting for confounders (age, BMI, sex, and smoking status). Furthermore, no significant difference was observed between the CRC cases and controls by BMI, sex and smoking status., Conclusion: Our findings suggest that the LEPR Gln223Arg polymorphism is not associated with the risk of CRC in Iranian population.

The aim of this study was to investigate the histological changes in the dorsal root ganglion (DRG) and the sciatic nerve in rats after sciatic nerve crush (SNC) and treatment with rosiglitazone. The rats were divided into four groups, each including seven animals, and underwent the following intervention. Group I: control animals which received carboxy methyl cellulose (0.5 w/v, p.o.). Group II: sham operated animals whose skin of the posterior thigh was opened, closed and the animals received the vehicle (carboxy methyl cellulose). Group III: SNC animals; the animals received the vehicle. Group IV: SNC with rosiglitazone (5 mg/kg body weight/day) dissolved in the vehicle. On the 28th day the fifth lumbar DRG and sciatic nerve were removed. Volume of the dorsal root ganglion, total volume and number of cells (A and B cells) of DRG, total surface area of the cells, and total number, diameter and cross-sectional area of the myelinated nerve fibres were estimated using stereological techniques. No change was observed in volume of the DRG, but all of the other parameters were decreased after nerve crush. In SNC+ rosiglitazone treated rats, the parameters decreased but to a lesser extent in comparison with the non-treated SNC group. It can be concluded that rosiglitazone has a protective effect on the DRG cells and sciatic nerve after crush in rats.

Background & Aims: Corticosteroids alone or in conjunction with azathioprine (AZA) is the standard treatment in autoimmune hepatitis (AiH). Individual variations in thiopurine (TP) metabolism may affect both drug efficacy and toxicity. Our aim was to investigate the utility of thiopurine methyltransferase (TPMT) as well as thioguanine nucleotide (TGN) and methylthioinosine monophosphate (meTIMP) metabolite measurements with regard to clinical outcome., Methods: Two hundred thirty-eight patients with AiH were included in this cross-sectional study. TPMT status was assessed in all patients, while TGN and meTIMP were measured in patients with ongoing TP medication. Clinical outcome was evaluated by liver tests and the ability to withdraw steroids., Results: TPMT genotyping (n=229) revealed 207 (90.4%) wild-type and 22 heterozygous patients. One hundred forty-three patients had ongoing TP therapy with AZA (n=134) or mercaptopurine (MP; n=9); response was judged as complete response (CR) in 113 patients and partial response (PR) in 30 patients. Both TP dose (1.64 vs 1.19 mg/kg; p=0.012) and TPMT activity (14.3 vs 13.5; p=0.05) were higher in PR, resulting in similar TGN levels (PR: 121 pmol/8 x 10(8) red blood cells [RBC]; CR: 113 pmol/8 x 10(8) RBC; p=0.33) but higher meTIMP levels in PR (1350 vs 400 pmol/8 x 10(8) RBC; p=0.004). Patients able to withdraw steroids or who were using 5 mg prednisolone daily were treated with lower TP doses than patients on higher steroid doses (1.15 vs 1.18 vs 1.82 mg/kg; p<0.001)., Conclusions: TP metabolite measurements are of clinical value in AiH patients who do not respond to standard TP treatment and for the identification of a shifted metabolism, which may demand an alternative treatment strategy.