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Objective To compare temporal inverted ILM flap (TIF) technique versus conventional ILM peeling (CILMP) technique in large idiopathic full-thickness macular hole (FTMH) regarding closure rate, and type of closure.Methods We conducted a randomized, interventional, prospective, comparative study. After informed consent, 40 eyes were included and were divided into 2 groups. Group 1 included 20 eyes that underwent Pars plana vitrectomy (PPV) with CILMP, and group 2 included 20 eyes that underwent PPV with the TIF technique in the period between December 2021 and July 2023. Pre and postoperative full ophthalmological assessment and OCT were done, with a follow-up period of 6 months after surgery.Results Macular hole (MH) closure was achieved in 80% of eyes in group 1 (16/20) and 90% of eyes in group 2 (18/20) after primary surgery. U-shaped foveal contour was achieved in 85%, 95%, and 100% of eyes in group 2 at 1,3 and 6 months respectively. However, it was recorded in 55% in group 1 at 1,3 and 6 months.Conclusion The MH closure rate achieved by the CILMP technique is comparable to that achieved by the TIF technique. However, the TIF technique achieves better foveal contour compared to the CILMP technique.

Objective To predict birth weight at various potential gestational ages of delivery based on data routinely available at the first antenatal visit.Design Individual participant data meta-analysis.Data sources Individual participant data of four cohorts (237 228 pregnancies) from the International Prediction of Pregnancy Complications (IPPIC) network dataset.Eligibility criteria for selecting studies Studies in the IPPIC network were identified by searching major databases for studies reporting risk factors for adverse pregnancy outcomes, such as pre-eclampsia, fetal growth restriction, and stillbirth, from database inception to August 2019. Data of four IPPIC cohorts (237 228 pregnancies) from the US (National Institute of Child Health and Human Development, 2018; 233 483 pregnancies), UK (Allen et al, 2017; 1045 pregnancies), Norway (STORK Groruddalen research programme, 2010; 823 pregnancies), and Australia (Rumbold et al, 2006; 1877 pregnancies) were included in the development of the model.Results The IPPIC birth weight model was developed with random intercept regression models with backward elimination for variable selection. Internal-external cross validation was performed to assess the study specific and pooled performance of the model, reported as calibration slope, calibration-in-the-large, and observed versus expected average birth weight ratio. Meta-analysis showed that the apparent performance of the model had good calibration (calibration slope 0.99, 95% confidence interval (CI) 0.88 to 1.10; calibration-in-the-large 44.5 g, −18.4 to 107.3) with an observed versus expected average birth weight ratio of 1.02 (95% CI 0.97 to 1.07). The proportion of variation in birth weight explained by the model (R2) was 46.9% (range 32.7-56.1% in each cohort). On internal-external cross validation, the model showed good calibration and predictive performance when validated in three cohorts with a calibration slope of 0.90 (Allen cohort), 1.04 (STORK Groruddalen cohort), and 1.07 (Rumbold cohort), calibration-in-the-large of −22.3 g (Allen cohort), −33.42 (Rumbold cohort), and 86.4 g (STORK Groruddalen cohort), and observed versus expected ratio of 0.99 (Rumbold cohort), 1.00 (Allen cohort), and 1.03 (STORK Groruddalen cohort); respective pooled estimates were 1.00 (95% CI 0.78 to 1.23; calibration slope), 9.7 g (−154.3 to 173.8; calibration-in-the-large), and 1.00 (0.94 to 1.07; observed v expected ratio). The model predictions were more accurate (smaller mean square error) in the lower end of predicted birth weight, which is important in informing clinical decision making.Conclusions The IPPIC birth weight model allowed birth weight predictions for a range of possible gestational ages. The model explained about 50% of individual variation in birth weights, was well calibrated (especially in babies at high risk of fetal growth restriction and its complications), and showed promising performance in four different populations included in the individual participant data meta-analysis. Further research to examine the generalisability of performance in other countries, settings, and subgroups is required.Trial registration PROSPERO CRD42019135045

Paraovarian tumors of borderline malignancy (PTBM) are exceedingly rare, with only slightly over 60 cases reported worldwide. This report presents the case of a 22-year-old nulliparous patient who incidentally discovered a left paraovarian mass during a routine abdominal ultrasound. Subsequent MRI revealed a 2.5×2.1 cm cystic lesion located in close proximity to, but outside of, the left ovary, with no other pathological findings. A laparoscopic cystectomy was performed with meticulous care to prevent tumor spillage, and the patient experienced an uneventful recovery. Histopathological examination unveiled irregularly shaped tissue measuring 2.2×1.2×1 cm, characterized by fibrous tissue/wall with spindle cell stroma and an epithelium displaying features consistent with a serous borderline tumor. Our multidisciplinary team recommended diligent follow-up. This case contributes to the existing literature on PTBM and highlights the imperative for additional cases to enhance our comprehension of the optimal management of these exceedingly rare tumors.

BackgroundType 2 diabetes mellitus is highly prevalent in the Arab Gulf countries. Despite this, limited culturally-adapted lifestyle intervention studies have been conducted in this region.MethodsIn this culturally adapted 12-month cluster randomized trial, 382 patients with type 2 diabetes, aged 20-70 years were recruited from 6 public healthcare centers (3 interventions and 3 controls) in Al Ain, United Arab Emirates. The primary outcome of this study was a change in hemoglobin A1c (HbA1c). The secondary outcomes were Body Mass Index (BMI), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, total cholesterol, dietary intake, and physical activity levels. A diet and physical activity intervention, guided by the social cognitive theory, was delivered individually and in group format to the intervention group. The control group continued receiving only their usual diabetes management care. The data were collected at baseline and 1 year after participation.ResultsThe mean baseline HbA1c levels of the control and the intervention groups were 7.45 ± 0.11% and 7.81 ± 0.11%, respectively. At the end of the 12-month intervention, there was no significant difference in the changes of mean HbA1c between the intervention and the control groups. On the other hand, BMI and daily caloric intake were significantly decreased in the intervention compared to the control group by 1.18 kg/m2 (95% CI: -1.78 - -0.60) and 246 kcal (95% CI: -419.52 - -77.21), respectively, after controlling for age, gender, education, marital status, duration since diabetes diagnosis, diabetes treatment, treatment clinic, and baseline values. Sitting time during the week-end was significantly lower, difference 52.53 minutes (95% CI: 93.93 - -11.14).ConclusionsThis community-based lifestyle intervention for patients with baseline HbA1c Trial registrationThis trial was registered on February 11, 2020 with Clinicaltrials.gov (NCT04264793).

Abstract Objective: This study aimed to measure urinary sodium and potassium as a measure of sodium and potassium intake concerning the knowledge, attitude and practice towards sodium intake among a group of healthy residents in the UAE. Design: A cross-sectional study on a sample of healthy adults in the UAE. In addition to the knowledge, attitude and practice questionnaire, sodium and potassium excretions and food records were taken. Setting: The UAE. Participants: A sample of 190 healthy individuals aged between 20 and 60 years. Results: The mean (± s d) age of the sample was 38·6 (± 12·5) years, and 50·5 % were females. The mean urinary sodium and potassium intake were 2816·2 ± 675·7 mg/d and 2533·3 ± 615 mg/d, respectively. The means were significantly different compared with the WHO recommendation of sodium and potassium (P < 0·001). About 65 % of the participants exceeded the WHO recommendations for salt intake, and participants’ knowledge classification for health-related issues was fair, while food-related knowledge was poor (P = 0·001). A two-stage stepwise multiple regression analysis revealed that knowledge, attitude and practice scores were negatively associated with urinary sodium excretion (r = –0·174; P = 0·017) and those older participants and females had lower urinary sodium excretion (P < 0·001). Conclusions: These findings may suggest an increase in the risk of hypertension in the UAE population. Moreover, these findings emphasise the need to establish education and public awareness programmes focusing on identifying the sodium contents of foods and establishing national regulations regarding food reformulation, particularly for staple foods such as bread.

Purpose: To evaluate current practice patterns for Egyptian ophthalmologists in the diagnosis of diabetic retinopathy (DR) and explore potential implications of these approaches on management. Methods: Cross-sectional survey conducted in Egypt amongst practicing ophthalmologists. Results: The study had 203 responses (~6% of all Egyptian ophthalmologists). A majority of respondents were general ophthalmologists (78.2%), practicing for five to ten years (41.9%). In patients with DR and no diabetic macular edema (DME), 33.0% of respondents would use FA in patients with mild DR, 44.3% in patients with moderate DR and 51.2% in patients with severe non-proliferative diabetic retinopathy (NPDR). Color imaging (CI) was used by less than 1% as the sole imaging modality for any level of DR. Approximately 70% of respondents used fluorescein angiography (FA) to grade and base treatment decisions for DR, either alone or in conjunction with dilated eye exams and/or CI. Given the known more severe appearance of DR on FA than on standard color imaging upon which treatment guidelines are based, use of FA as the primary modality over a one-year period could result in PRP that would otherwise not be suggested in approximately 78,820 eyes at an additional cost of $10.1 million US dollars. These numbers are projected to double by 2045. Conclusion: Given that FA detects significantly greater pathology than CI, and that treatment and follow-up recommendations are based on CI, its use as the primary imaging modality in DR grading may result in apparently significantly higher DR severity, with subsequently increased procedures and associated costs.

Crohn’s disease is a multi-systemic chronic inflammatory disease that can affect various organs besides the gastrointestinal tract such as joints, uvea, and the skin. Vulvar Crohn’s disease is a rare entity occurring with vulvar lesions that show typical Crohn’s disease granulomatous inflammation but are not contiguous with the gastrointestinal involvement. Vulvar Crohn’s disease can be easily confused with other granulomatous diseases and awareness that such involvement may precede gastrointestinal symptoms must be raised. Few cases of vulvar Crohn’s disease have been reported in the literature to date. Here, we report a case of a 43-year-old woman with a 6-month history of a vulvar lesion; the patient was diagnosed with Crohn’s disease of the large bowel just over a year ago.

Objective: To compare temporal inverted ILM flap (TIF) technique versus conventional ILM peeling (CILMP) technique in large idiopathic full-thickness macular hole (FTMH) regarding closure rate, and type of closure. Methods: We conducted a randomized, interventional, prospective, comparative study. After informed consent, 40 eyes were included and were divided into 2 groups. Group 1 included 20 eyes that underwent Pars plana vitrectomy (PPV) with CILMP, and group 2 included 20 eyes that underwent PPV with the TIF technique in the period between December 2021 and July 2023. Pre and postoperative full ophthalmological assessment and OCT were done, with a follow-up period of 6 months after surgery. Results: Macular hole (MH) closure was achieved in 80% of eyes in group 1 (16/20) and 90% of eyes in group 2 (18/20) after primary surgery. U-shaped foveal contour was achieved in 85%, 95%, and 100% of eyes in group 2 at 1,3 and 6 months respectively. However, it was recorded in 55% in group 1 at 1,3 and 6 months. Conclusion: The MH closure rate achieved by the CILMP technique is comparable to that achieved by the TIF technique. However, the TIF technique achieves better foveal contour compared to the CILMP technique. [ABSTRACT FROM AUTHOR]

Pleurotus eryngii mushrooms are commercially cultivated and widely consumed due to their organoleptic properties, and the low caloric and high nutritional value. In addition, they contain various biologically active and health-promoting compounds; very recently, their genoprotective effect in Caco-2 cells after their fermentation by the human fecal microbiota was also documented. In the current study, the effect of P. eryngii pre- and post-fermentation supernatants in micronuclei formation was evaluated in human lymphocytes. In addition, the genoprotective properties of increasing concentrations of aqueous extracts from P. eryngii mushrooms (150, 300, 600 mg/kg) against the cyclophosphamide-induced DNA damage were studied in young and elderly female and male mice in bone marrow and whole blood cells. The ability of the highest dose (600 mg/kg) to regulate the main cellular signaling pathways was also evaluated in gut and liver tissues of female animals by quantifying the mRNA expression of NrF2, Nfkβ, DNMT1, and IL-22 genes. P. eryngii post-fermentation, but not pre-fermentation, supernatants were able to protect human lymphocytes from the mitomycin C-induced DNA damage in a dose-dependent manner. Similarly, genoprotection was also observed in bone marrow cells of mice treated by gavage with P. eryngii extract. The effect was observed in all the experimental groups of mice (young and elderly, male and female) and was more potent in young female mice. Overexpression of all genes examined was observed in both tissues, mainly among the elderly animals. In conclusion, P. eryngii mushrooms were shown to maintain genome integrity through protecting cells from genotoxic insults. These beneficial effects can be attributed to their antioxidant and immunomodulatory properties, as well as their ability to regulate the cell’s epigenetic mechanisms and maintain cell homeostasis.

Background: Breast fibromatosis is a very rare, locally infiltrative lesion, without metastatic potential that arises from either stromal fibroblasts or myofibroblasts of the breast or from the pectoral fascia, extending into the breast, with its cytological and histological features only rarely being described. Case Presentation: A 58-year-old woman, with no past medical/surgical or family history, was diagnosed on regular mammographic and ultrasound examination with a nodular tumor density, in the upper inner part of her right breast. There were no calcifications or apparent lymph nodes in the right axilla. The woman underwent FNA and US-guided biopsy and final resection biopsy under hook marking. We reviewed the cytological findings of fibromatosis of the breast, as they presented in FNAC aspirates of a non-palpable mammographic finding and the histological findings in both preoperative core-needle biopsy and excision specimen. The final diagnosis was of fibromatosis of the breast. No further actions were taken. The woman is well, without recurrence, more than four years afterwards. Conclusion: Our case can make the pathologists more acquainted with the cytological and pathologic features of a rare tumor entity and the clinicians with a rare breast lesion, which can mimic malignancy both clinically and radiologically. The diagnosis of fibromatosis of the breast is more reliable in excision specimens. Nevertheless, cytology can be an invaluable adjunct to histology, pre-operatively, as it can exclude cancer and help in the preoperative planning.

Dietary fibre analysis is expensive due to its reliance on enzymes such as α-amylase, protease, and amyloglucosidase. This study investigated whether enzymes are essential in analysing insoluble, soluble, and total dietary fibre (IDF, SDF and TDF) contents in dry fruits with very low starch and protein contents. The IDF, SDF, and TDF were measured in date fruits using the enzymatic gravimetric method AOAC 991.43 in the ANKOM dietary fibre analyser, with and without enzymatic digestion. The study analysed six date fruit varieties with a range of texture profiles. Our results highlighted agreement between both methods in the measured IDF, SDF, and TDF values. TDF values in date fruit varieties varied considerably, from 5.67% g/100 g to 10.33% g/100 g. Results from both methods also indicate that IDF constituted the bulk of dietary fibre content in all date fruit varieties (77.8% to 91.6%), while the proportion of SDF was between 8.4% and 22.2%. This study confirms that dates are a rich source of dietary fibre, and can be a valuable functional ingredient in foods that reduce the risk of chronic diseases. The study confirmed that the inexpensive non-enzymatic technique is a viable substitute for the enzymatic method for analysing dietary fibre in dry fruits.

Abstract Background To evaluate the safety and efficacy of intravitreal ziv-aflibercept (IVZ) in the management of vitreous hemorrhage (VH) in eyes with previously lasered proliferative diabetic retinopathy (PDR). Methods In a prospective multicenter study, previously lasered eyes who had dense VH from PDR underwent intravitreal injection of ziv-aflibercept (IVZ) (1.25 mg aflibercept). Demographic characteristics of the patients, baseline and final logMar visual acuity, number of injections, VH clearance time, and need for vitrectomy were recorded. Results Twenty-seven eyes of 21 patients were included in the study. Mean age of study patients was 61.3 ± 14.1 years with mean duration of diabetes mellitus of 22.6 ± 7.8 years. Mean logMAR BCVA at baseline was 1.41 ± 1.26 (Snellen equivalent 20/514) and at the last visit 0.55 ± 0.61 (Snellen equivalent 20/70) with a mean gain of 0.86 EDTRS line (paired student t test = 5.1; p ≤ 0.001). Mean number of IVZ 2.4 ± 1.6 (range 1–6). The mean follow-up time was 11.7 ± 11.1 months (range 1–34). Mean time for visual recovery and/or VH clearance was 5.7 ± 3.3 weeks. Eyes, which required multiple injections, the interval period between injections for recurrent VH was 6.4 ± 5.2 months. No subject required vitrectomy. No ocular or systemic adverse effects were noted. Conclusions IVZ injections had good short-term safety and efficacy for the therapy of new or recurrent VH in previously lasered eyes with PDR reducing somewhat the need for vitrectomy. Trial registration: NCT02486484

Context Retinopathy of prematurity (ROP) is a vascular proliferative disease affecting premature infants. Aims The aim was to assess the extent of peripheral retinal vascular growth and recurrence rate in patients with type 1 ROP treated with ranibizumab. Settings and design Patients with ROP attending the pediatric eye clinic in the main university hospital in Alexandria Faculty of Medicine were recruited. Participants and methods This prospective study included 20 eyes of 10 patients showing type 1 ROP, treated with 0.25 mg ranibizumab intravitreal injection only. Patients were followed for 6 months, where peripheral vascularization and rate of recurrence were assessed through indirect ophthalmoscopy and RetCam imaging. Statistical analysis Data were fed to the computer and analyzed using IBM SPSS software package version 20.0. The tests used were χ2 test, Fisher’s exact test, and Student t test. Results A total of 16 (80%) eyes showed good peripheral vascularization and favorable anatomical outcome. The average timing for temporal zone III retinal vascularization was 15.71±2.09 weeks, with three eyes not reaching zone III after 6 months of injection. One eye showed retinal folding and macular ectopia. Three (15%) eyes showed signs of recurrence, with two eyes showing neovascularization at the initial vascular ridge by the fifth week after intravitreal ranibizumab injection (IVR), and one eye showing the recurrence of thick temporal ridge by the fourth months. Conclusions Ranibizumab is a potential effective treatment for patients with type 1 ROP. Delayed peripheral vascularization and disease recurrence mandate tailored long-term follow-up period according to individual response.

(1) Background: The present systematic study aimed to assess whether using esophageal speech (ES) as a method of vocal rehabilitation in patients after total laryngectomy enhances their quality of life (QoL) and vocal functionality based on patients' reports. (2) Methods: Data collection was conducted from PubMed, Google Scholar, and Speech Bite, and the PRISMA Flow Diagram tool was used to record different stages of the literature search process. In the review, nine studies were included, while a bias check was carried out using the Critical Appraisal Skills Programme (CASP) checklists. Survey analysis incorporated quantitative and qualitative data, including standardized questionnaires and audio analyses. (3) Results: A technique's effectiveness depends on the method's functionality and the patient's abilities. Furthermore, the findings revealed that ES use unexpectedly affects quality of life regarding patients. While statistical analysis of the studies showed that some patients reported improvement in quality of life and vocal functionality, others faced challenges such as difficulty in learning the technique, long-term intervention, and unsatisfactory phonetic performance. Some studies observed quantitative measures, such as improved Voice Impairment Index (VHI) scores and Voice-Related Quality of Life (V-RQOL) scores. However, results were not uniformly positive across studies, with a subset of patients reporting minimal improvement. (4) Conclusions: The limited literature on the effect of ES on patients' QoL appears to influence the results in different ways. However, research data support that patients' communication and psychological state seem to improve significantly compared to patients who have not been rehabilitated. The final assessment of the technique's effectiveness on quality of life must depend on many factors. [ABSTRACT FROM AUTHOR]

Maturity-onset diabetes of the young (MODY) is a rare form of diabetes that is different from both type 1 and type 2 diabetes and runs strongly in families, with autosomal dominant inheritance. Currently, there are 14 different types of MODY depending on the gene disorder. Glucokinase-related MODY (MODY 2) is a common form of this disorder. Mutations in the gene are associated with gestational diabetes and deviation of the average fetal birth weight. The main features of MODY are: (1) diabetes developing before the age of 25 years, (2) family history, (3) diabetes treated by diet or less often by tablets, and (4) absence of obesity (although overweight or obese people can get MODY) or other problems associated with type 2 diabetes or metabolic syndrome. We present the case of a 35-year-old Caucasian primigravida with a medical and family history of MODY type 2, who attended our unit due to fetal growth restriction (FGR) and increased umbilical artery (UA) Doppler pulsatility index (PI) at 28 weeks of gestation and delivered at 36+6 weeks. Management of such cases requires specific knowledge and a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Date seeds are a by-product of the date fruit processing industry with minimal human use; however, they are a rich source of polyphenols with a range of potential biological properties. The current study investigates the cytotoxicity of date seed polyphenols against cancer cell lines, its ability to combat hyperglycemia, its antioxidant potential and its anti-adipogenic effect. The present work aimed to establish the usefulness of date seeds in the food industry as a functional ingredient. The anti-tumour activity of DSE was tested in a panel of cell lines such as MCF-7, MDA-MB-231, Hep-G2, Caco-2, and PC-3 by measuring cell viability and cleaved PARP. Lipid accumulation and effect on the differentiation of 3T3-L1 cells (adipocytes) were tested with date seed extract treatments. The influence of date seed polyphenols on glucose uptake was studied in 3T3-L1 cells and C2C12 cells (muscle cells). The antioxidant activity of the polyphenols from date seed products such as date seed extract (DSE), date seed powder (DSP), and date seeds fortified bread (DSB) was tested following in-vitro digestion to study their stability in the gastrointestinal milieu. DSE treatment resulted in significantly reduced viability in MCF-7 and Hep-G2 cells with 48-h treatments. Glucose uptake increased in the adipocytes with DSE treatments; moreover, it inhibited adipocyte differentiation and lipid accumulation. DSE decreased the expression levels of PPAR-γ, C/EBPα, adiponectin and upregulated GLUT-4, and phospho-AMPK. This study also found that date seed samples retained antioxidant activity in the digestive milieu and concludes that the date seed polyphenols remain active in the digestive milieu and exhibit potential anti-hyperglycemic and anti-adipogenic activity.

Background: Silicone lymphadenopathy is a recognized complication of silicone implant rupture. It occurs when silicone droplets migrate from breast implants to lymph nodes, resulting in the formation of granulomas (known as siliconoma) and lymph node enlargement. The ipsilateral axillary lymph nodes are most commonly involved but it can also affect contralateral axillary, supraclavicular, internal mammary and mediastinal lymph nodes. Case presentation: A 60-year-old woman with a history of left breast cancer who had undergone modified radical mastectomy (MRM) followed by left breast reconstruction with implant (30 years ago) presented with right axillary lymph nodes enlargement. An excisional biopsy of the two larger lymph nodes was performed to rule out malignancy. Pathologic examination showed features of silicone lymphadenopathy. Further examination with Ultrasound and MRI confirmed breast implant rupture. Conclusion: Silicone lymphadenopathy following breast augmentation and reconstruction primarily affects the ipsilateral axillary nodes. Contralateral lymph node involvement is rare and may occur several years after breast cancer diagnosis and can be the first sign of breast implant rupture. Although, the need to exclude malignancy in such cases is of outmost importance, silicone lymphadenopathy should also be considered in the differential diagnosis.

Purpose. To compare the efficacy of pars plana vitrectomy (PPV) versus intravitreal injection (IVI) of ranibizumab (RBZ) in the treatment of diabetic macular edema (DME) associated with vitreomacular interface abnormalities (VMIA). Methods. The records of patients presenting with DME and VMIA throughout 2016 to 2018 were retrospectively analyzed. The patients were divided into 2 groups: group I received IVIs of RBZ and group II underwent PPV with internal limiting membrane peeling. The main outcome measures were the change in the LogMAR corrected distance visual acuity (CDVA) and central subfield thickness (CSFT) on optical coherence tomography over 6 months. Results. At 6 months, mean CDVA improved by 0.22 ± 0.21 in group I patients p

Background: Type 2 diabetes mellitus is highly prevalent in the Arab Gulf countries. Despite this, limited culturally-adapted lifestyle intervention studies have been conducted in this region. Methods: In this culturally adapted 12-month cluster randomized trial, 382 patients with type 2 diabetes, aged 20–70 years were recruited from 6 public healthcare centers (3 interventions and 3 controls) in Al Ain, United Arab Emirates. The primary outcome of this study was a change in hemoglobin A1c (HbA1c). The secondary outcomes were Body Mass Index (BMI), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, total cholesterol, dietary intake, and physical activity levels. A diet and physical activity intervention, guided by the social cognitive theory, was delivered individually and in group format to the intervention group. The control group continued receiving only their usual diabetes management care. The data were collected at baseline and 1 year after participation. Results: The mean baseline HbA1c levels of the control and the intervention groups were 7.45 ± 0.11% and 7.81 ± 0.11%, respectively. At the end of the 12-month intervention, there was no significant difference in the changes of mean HbA1c between the intervention and the control groups. On the other hand, BMI and daily caloric intake were significantly decreased in the intervention compared to the control group by 1.18 kg/m2 (95% CI: -1.78 − -0.60) and 246 kcal (95% CI: -419.52 − -77.21), respectively, after controlling for age, gender, education, marital status, duration since diabetes diagnosis, diabetes treatment, treatment clinic, and baseline values. Sitting time during the week-end was significantly lower, difference 52.53 minutes (95% CI: 93.93 − -11.14). Conclusions: This community-based lifestyle intervention for patients with baseline HbA1c <8% did not result in a significant decrease of HbA1c but reduced caloric intake, body weight, and weekend inactivity after controlling for the covariates. Trial registration: This trial was registered on February 11, 2020 with Clinicaltrials.gov (NCT04264793). [ABSTRACT FROM AUTHOR]

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Abstract Background Antioxidant and anti-inflammatory properties of honey have been largely recognized by various studies. Almost all of the potential benefits are associated with polyphenol content. Honey varieties from the arid region are reported to be rich in polyphenols, but data related to its bioactivity in vitro is greatly lacking. This study aimed at establishing the antioxidant and anti-inflammatory properties of arid region honey. Four honey varieties from arid region (H1, H2, H3, and H4) and two popular non-arid region honey (H5 and H6) were tested in vitro in this study. Methods The erythrocyte membrane protection effect of honey varieties were measured by hemolysis assay after exposing erythrocytes to a peroxide generator. The subsequent production of MDA (malondialdehyde) content in erythrocytes was measured. Immunomodulatory effect of the honey varieties was tested in prostate cancer cells PC-3 and PBMC (peripheral blood mononuclear cells) by measuring the IL-6 (interleukin 6) and NO (nitric oxide) levels in cell culture supernatant after incubation with the honey varieties. PC-3 cell viability was assessed after incubation with honey varieties for 24 h. Results Arid region honey exhibited superior erythrocyte membrane protection effect with H4 measuring 1.3 ± 0.042mMTE/g and H2 measuring 1.122 ± 0.018mMTE/g. MDA levels were significantly reduced by honey samples, especially H4 (20.819 ± 0.63 nmol/mg protein). We observed a significant decrease in cell population in PC-3 after 24 h in culture on treatment with honey. A moderate increase in NO levels was observed in both cultures after 24 h at the same time levels of IL-6 were remarkably reduced by honey varieties. Conclusion The results demonstrate the antioxidant effect of arid region honey due to its erythrocyte membrane protection effect and subsequent lowering of oxidative damage as evident from lower levels of lipid peroxidation byproduct MDA. Arid region honey varieties were as good as non-arid region types at decreasing cell viability of prostate cancer cells. The moderate increase in NO levels in PC-3 and PBMCs were not significant enough to elicit any pro-inflammatory response. However, IL-6 secretion was remarkably reduced by all honey varieties in a comparable level indicating the potential anti-inflammatory property of arid region honey.