NF-κB pathway as a molecular target for curcumin in diabetes mellitus treatment: Focusing on oxidative stress and inflammation.

Diabetes mellitus (DM) is a collection of metabolic disorder that is characterized by chronic hyperglycemia. Recent studies have demonstrated the crucial involvement of oxidative stress (OS) and inflammatory reactions in the development of DM. Curcumin (CUR), a natural compound derived from turmeric, exerts beneficial effects on diabetes mellitus through its interaction with the nuclear factor kappa B (NF-κB) pathway. Research indicates that CUR targets inflammatory mediators in diabetes, including tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6), by modulating the NF-κB signaling pathway. By reducing the expression of these inflammatory factors, CUR demonstrates protective effects in DM by improving pancreatic ß-cells function, normalizing inflammatory cytokines, reducing OS and enhancing insulin sensitivity. The findings reveal that CUR administration effectively lowered blood glucose elevation, reinstated diminished serum insulin levels, and enhanced body weight in Streptozotocin -induced diabetic rats. CUR exerts its beneficial effects in management of diabetic complications through regulation of signaling pathways, such as calcium-calmodulin (CaM)-dependent protein kinase II (CaMKII), peroxisome proliferator-activated receptor gamma (PPAR-γ), NF-κB, and transforming growth factor ß1 (TGFB1). Moreover, CUR reversed the heightened expression of inflammatory cytokines (TNF-α, Interleukin-1 beta (IL-1ß), IL-6) and chemokines like MCP-1 in diabetic specimens, vindicating its anti-inflammatory potency in counteracting hyperglycemia-induced alterations. CUR diminishes OS, avert structural kidney damage linked to diabetic nephropathy, and suppress NF-κB activity. Furthermore, CUR exhibited a protective effect against diabetic cardiomyopathy, lung injury, and diabetic gastroparesis. Conclusively, the study posits that CUR could potentially offer therapeutic benefits in relieving diabetic complications through its influence on the NF-κB pathway.

Exploring the detailed role of interleukins in cancer: A comprehensive review of literature.

The cancer cells that are not normal can grow into tumors, invade surrounding tissues, and travel to other parts of the body via the lymphatic or circulatory systems. Interleukins, a vital class of signaling proteins, facilitate cell-to-cell contact within the immune system. A type of non-coding RNA known as lncRNAs mediates its actions by regulating miRNA-mRNA roles (Interleukins). Because of their dual function in controlling the growth of tumors and altering the immune system's response to cancer cells, interleukins have been extensively studied concerning cancer. Understanding the complex relationships between interleukins, the immune system, the tumor microenvironment, and the components of interleukin signaling pathways that impact the miRNA-mRNA axis, including lncRNAs, has advanced significantly in cancer research. Due to the significant and all-encompassing influence of interleukins on the immune system and the development and advancement of cancers, lncRNAs play a crucial role in cancer research by modulating interleukins. Their diverse effects on immune system regulation, tumor growth encouragement, and tumor inhibition make them appealing candidates for potential cancer treatments and diagnostics. A deeper understanding of the relationship between the biology of interleukin and lncRNAs will likely result in more effective immunotherapy strategies and individualized cancer treatments.

Functionalization of porous silica with graphene oxide and polyethyleneimine, containing zinc copper ferrite nanoparticles for water treatment and antibacterial application.

The article discusses the removal of methylene blue (MB) dye, a common cationic dye used in the textile industry, from aqueous solutions through an adsorption process. The use of porous components as adsorbents are shown to facilitate complete separation after the process is completed. The substrate was synthesized by connecting zinc copper ferrite (ZnCuFe2O4), polyethyleneimine (PEI), and Graphene Oxide (GO) sheets to MCM-48, which is a mesoporous material. The surface of MCM-48 was modified using CPTMS, which created an O-Si-Cl bridge, thereby improving the adsorption rate. The substrate was shown to have suitable sites for electrostatic interactions and creating hydrogen bonds with MB. The adsorption process from the Freundlich isotherm (R2 = 0.9224) and the pseudo-second-order diagram (R2 = 0.9927) demonstrates the adsorption of several layers of dye on the heterogeneous surface of the substrate. The synthesized substrate was also shown to have good bactericidal activity against E. coli and S. aureus bacterial strain. Furthermore, the substrate maintained its initial ability to adsorb MB dye for four consecutive cycles. The research resulted that ZnCuFe2O4@MCM-48/PEI-GO substrate has the potential for efficient and economical removal of MB dye from aqueous solutions (R = 88.82%) (qmax = 294.1176 mg. g-1), making it a promising solution for the disposal of harmful industrial waste.

Probing the Mechanism of Action of Bis(phenolato) Amine (ONO Donor Set) Titanium(IV) Anticancer Agents.

The need for anticancer therapies that overcome metallodrug resistance while minimizing adverse toxicities is targeted, herein, using titanium coordination complexes. Octahedral titanium(IV) trans,mer-[Ti{R1N(CH2-2-MeO-4-R1-C6H2)2}2] [R1 = Et, allyl, n-Pr, CHO, F, CH2(morpholino), the latter from the formyl derivative; R2 = Me, Et; not all combinations] are attained from Mannich reactions of commercial 2-methoxyphenols (27-74% overall yield, 2 steps). These crystalline (four X-ray structures) Ti(IV)-complexes are active against MCF-7, HCT-116, HT-29, PANC-1, and MDA-MB-468 cancer cell lines (GI50 = 0.5-38 µM). Their activity and cancer selectivity (vs nontumor MRC-5 cells) typically exceeds that of cisplatin (up to 16-fold). Proteomic analysis (in MCF-7) supported by other studies (G2/M cell cycle arrest, ROS generation, γH2AX production, caspase activation, annexin positivity, western blot, and kinase screens in MCF-7 and HCT-116) suggest apoptosis elicited by more than one mechanism of action. Comparison of these data to the modes of action proposed for salan Ti(IV) complexes is made.

Histopathological Tracing of HPV Genotypes 6 and 11 in Pediatric Patients in Medical City with Chronic Palatine and Pharyngeal Tonsillitis.

BACKGROUND: HPVs are considered to have high-oncogenic risk. These genotypes have been proven to have a causal link to cancers, in pediatric and youth patients, with high rates of HPV presence in the tonsillar tissues. OBJECTIVE: A prospective case-control research for determining HPV 6/11 genotypes in tonsillar specimens of children who underwent operations in the otolaryngology departments of the Medical City Complex, Baghdad, Iraq, for their non-oncologic palatine and pharyngeal tonsillar hypertrophies. METHODS: This study enrolled 102 tonsillar tissues, 82 from pediatric patients aged from 4 to 12 years and who underwent tonsillectomies for non-oncologic palatine and pharyngeal tonsillar hypertrophies; 38 specimens were from single operations while 22 were multiple specimens from the same pediatric patients, represented as a total of 44 tissues). In addition, trimmed nasal tissues from 20 patients, with unremarkable pathological changes, were included as the control group. For HPV 6/11 DNA detection, specific DNA probes were used for the chromogenic in situ hybridization (CISH) technique. RESULTS: In the palatine tonsillar hypertrophied tissue group, 26.2% of the tissues revealed positive CISH signals for HPV 6/11 DNA. Regarding the pharyngeal tonsillar hypertrophied tissues, 22.5% of the specimens expressed positive CISH reactions. Among the 22 pediatric patients who had combined pharyngeal and palatine tonsillectomies, in 22.7% both sites expressed positive signals. No positive-CISH reactions were documented in the control nasal tissues. Statistically a significant difference was seen when compared to the control group. CONCLUSIONS: Significant rates of HPV were observed which pointed to the spread of HPV, among other STIs, and in mothers of at least this studied pediatric group. Also, this represented a critical mark as reservoir tissue sites, allowing transmission to other mucosal tissue localizations, playing part in their pathogenesis.

Fluorescence Resonance Energy Transfer (FRET)-Based Sensor for Detection of Foodborne Pathogenic Bacteria: A Review.

Sensitive and rapid determination of foodborne pathogenic bacteria is of practical importance for the control and prevention of foodborne illnesses. Nowadays, with the prosperous development of fluorescence assays, fluorescence resonance energy transfer (FRET)-derived diagnostic strategies are extensively employed in quantitative analysis of different pathogenic bacteria in food-related matrices, which displays a rapid, simple, stable, reliable, cost-effective, selective, sensitive, and real-time way. Considering the extensive efforts that have been made in this field so far, we here discuss the up-to-date developments of FRET-based diagnostic approaches for the determination of key foodborne pathogens like Staphylococcus aureus, Escherichia coli, Vibrio parahaemolyticus, Salmonella spp., Campylobacter spp., and Bacillus cereus in complex food-related matrices. Moreover, the principle of this technology, the choosing standards of acceptor-donor pairs, and the fluorescence properties are also profiled. Finally, the current prospects and challenges in this field are also put forward.

Dietary caffeine intake is associated with favorable metabolic profile among apparently healthy overweight and obese individuals.

BACKGROUND: Recent studies have revealed some conflicting results about the health effects of caffeine. These studies are inconsistent in terms of design and population and source of consumed caffeine. In the current study, we aimed to evaluate the possible health effects of dietary caffeine intake among overweight and obese individuals. METHODS: In this cross-sectional study, 488 apparently healthy individuals with overweight and obesity were participated. Dietary intake was assessed by a Food Frequency Questionnaire (FFQ) and the amount of dietary caffeine was calculated. Body composition was determined by bioelectrical impedance analysis (BIA). Enzymatic methods were used to evaluate serum lipid, glucose, and insulin concentrations. RESULTS: Those at the highest tertile of dietary caffeine intake had lower percentage of fat mass, higher fat free mass and appetite score (P < 0.05). Also, lower total cholesterol (TC) and low density lipoprotein cholesterol (LDL-c) was observed in higher tertiles of dietary caffeine intake compared with lower tertiles. In multinomial adjusted models, those at the second tertile of dietary caffeine intake were more likely to have higher serum insulin (P = 0.04) and lower homeostatic model assessment of insulin resistance (HOMA-IR) values compared with first tertile (P = 0.03) in crude model. While, in the age, body mass index (BMI), sex, physical activity, socio-economic status (SES) and energy intake -adjusted model (Model III), those at the third tertile of dietary caffeine intake were more likely to have low serum LDL concentrations [odds ratio (OR) = 0.957; CI = 0.918-0.997; P = 0.04]. With further adjustment to dietary vegetable, fiber and grain intake, those at the third tertile of dietary caffeine intake were more likely to have low systolic blood pressure (SBP), LDL and high HDL levels compared with those at the first tertile (P < 0.05). CONCLUSION: High intakes of dietary caffeine was associated with lower LDL, SBP, insulin resistance and higher HDL concentrations among overweight and obese individuals. However, due to observational design of the study, causal inference is impossible and further studies are warranted to confirm our findings.

Immunohistochemical Detection of the Expressed BRCA1 and BRCA2 Proteins in Microenvironment of Malignant Breast Cancerous Tissues Infected with Human Mammary Tumor Virus.

OBJECTIVE: The objective of the study was to examine the prevalence of HMTV infection, its associations with breast malignant tissues, and the expression of BRCA1 and BRCA2 proteins. METHODS: One hundred archival breast tissues, 40 biopsies from female patients with breast cancer (BC), and 20 healthy breast tissues from the control group were used in the study. Immunohistochemical analysis was conducted to detect the expressed BRCA1 and BRCA2 proteins. Digoxigenin-labeled HMTV probes were used in chromogenic in situ hybridization for the identification of HMTV in breast tumor tissues. The complementary sequence sites of the HMTV probe sequences were stained by NBT/BCIP as blue signals. RESULTS: There were 12 out of 40 (30%) benign breast tumorous tissues and 14 out of 40 (35%) BC tissues, while healthy control breast tissues were 10% (2 out of 20 tissues). Positive immunohistochemical (IHC) reactions for BRCA2 protein were observed in 12 out of 40 BC tissues (30.0%), 25% of benign breast tumorous tissues, and 5% of the control group. A significant (p < 0.05) statistical difference in the percentages of HMTV in the studied groups was found. CONCLUSION: HMTV might contribute to the development of subsets of benign and malignant breast tumors. The observed rates of defective or mutated BRCA1 and BRCA2 genes in healthy tissues indicate a role in the development of breast tumors.

Current Trends in Nanomaterials-Based Electrochemiluminescence Aptasensors for the Determination of Antibiotic Residues in Foodstuffs: A Comprehensive Review.

Veterinary pharmaceuticals have been recently recognized as newly emerging environmental contaminants. Indeed, because of their uncontrolled or overused disposal, we are now facing undesirable amounts of these constituents in foodstuff and its related human health concerns. In this context, developing a well-organized environmental and foodstuff screening toward antibiotic levels is of paramount importance to ensure the safety of food products as well as human health. In this case, with the development and progress of electric/photo detecting, nanomaterials, and nucleic acid aptamer technology, their incorporation-driven evolving electrochemiluminescence aptasensing strategy has presented the hopeful potentials in identifying the residual amounts of different antibiotics toward sensitivity, economy, and practicality. In this context, we reviewed the up-to-date development of ECL aptasensors with aptamers as recognition elements and nanomaterials as the active elements for quantitative sensing the residual antibiotics in foodstuff and agriculture-related matrices, dissected the unavoidable challenges, and debated the upcoming prospects.

Diagnosis and management of pituitary apoplexy: a Tunisian data.

BACKGROUND: Pituitary apoplexy (PA) is defined as the hemorrhage or the infraction of a pituitary adenoma. Aiming to determine the epidemiological, clinical, paraclinical characteristics as well as management and outcomes of PA in our population, we conducted this cross-sectional study. METHODS: This cross-sectional study was conducted at the Department of Endocrinology of Hedi chaker university hospital, Sfax. Data was collected from medical charts of patients with pituitary apoplexy admitted in our department between 2000 and 2017. RESULTS: We included 44 patients with PA. Their mean age was 50 ± 12.6 years. Among them, 31.8% had a known pituitary adenoma, and it was in all cases a macroadenoma, predominantly a prolactin secreting tumor (42.8%). A triggering factor of PA was encountered in 31.8% of cases and it was mainly: head trauma, dopamine antagonists, and hypertension. The clinical presentation of PA encompassed headaches (84.1%), visual disturbances (75%), and neurological signs (40.9%). Gonadotropin deficiency was the most frequent form of hypopituitarism noted (59.1%), followed by corticotropin deficiency (52.3%), thyrotropin deficiency (47.7%), and somatotropin deficiency (2.3%). Hormonal assessment at PA onset, concluded that 23 had a secreting adenoma: 18 prolactinomas, 3 ACTH-secreting adenomas, and 2 GH-secreting adenomas. In the 21 remaining cases, the tumor was non-functioning (47.7%). Pituitary MRI was performed in 42 cases (95.5%), revealing infraction and or hemorrhage in the pituitary gland in 33 cases; a heterogenous signal or a fluid level within the adenoma, in nine cases. Urgent administration of intra venous hydrocortisone was required in 19 cases. Mannitol administration was mandatory in a patient who had severe intracranial hypertension. Surgical management of the PA was imperative in 24 patients (54.5%): 15 suffered from severe visual impairment, 4 had an intracranial hypertension, 2 cases demonstrated an impaired consciousness, 2 patients experienced a tumor enlargement and one case had a severe Cushing's disease. Operative complications found were rhinorrhea attributable to cerebral spinal fluid leakage, insipidus diabetes associated with rhinorrhea, isolated insipidus diabetes, and hydrocephalus in one case each. Long-term follow-up concluded that headaches persisted in five cases, owing to the tenacity of a macroprolactinoma regardless of cabergoline treatment in one case, the recurrence of an adenoma in two cases and its persistence despite the medical and the surgical treatment in two patients. Concerning the visual acuity defects, only two patients had persistent diminished visual acuity at long-term follow-up. Among 25 patients, 13 were diagnosed with definitive thyrotropin deficiency. Similarly, 14 patients had persistent corticotropin deficiency (CD). Additionally, CD was de novo diagnosed in two patients. Otherwise, gonadotropin deficiency prevailed in all cases. Persistent prolactin deficiency was seen in two patients. Disappearance of the pituitary tumor was encountered in 11 out of 24 cases at long-term follow-up. Overall, surgery was associated with better outcome than conservative management. Pituitary apoplexy is a challenging condition due to its variable course, its diagnosis difficulty and management, as gaps remain to determine the best approach to treat this condition. CONCLUSIONS: To conclude, pituitary apoplexy is a challenging condition due to its variable course, its diagnosis difficulty and management, as gaps remain to determine the best approach to treat this condition. Further studies are thus needed.

Impact of salicylic acid and calcium chloride on quality attributes of peach stored at refrigeration temperature.

Salicylic acid (SA) in different concentration were used to assess its individual effect as well as combined impact with 3% calcium chloride (CaCl2) on Swat No. 8 variety of peach stored at refrigerated temperature (6 ± 2 °C) for 21 days. Interestingly, the results revealed that applying 2 mmol L-1 SA with 3% CaCl2 maintained maximum nutritional value and least decay percent (44.1%) as compared to other treatments during storage. Moreover, this combination also exhibited significant weight loss and chilling injury at 6 ± 2 °C whereas increased levels of total phenolic, flavonoids, tannin, alkaloid, ascorbic acid, and antioxidant activity were observed as compared to other treatments. The combination treatment (2 mmol L-1 SA with 3% CaCl2) maintained other sensory attributes of peach fruit during refrigerated storage, therefore, its commercial use was recommended to store peach fruit for up to three weeks without any significant nutritional and physical loss.

Modeling and Optimal Operating Conditions of Hollow Fiber Membrane for CO2/CH4 Separation.

In this work, the capture of carbon dioxide using a dense hollow fiber membrane was studied experimentally and theoretically. The factors affecting the flux and recovery of carbon dioxide were studied using a lab-scale system. Experiments were conducted using a mixture of methane and carbon dioxide to simulate natural gas. The effect of changing the CO2 concentration from 2 to 10 mol%, the feed pressure from 2.5 to 7.5 bar, and the feed temperature from 20 to 40 °C, was investigated. Depending on the solution diffusion mechanism, coupled with the Dual sorption model, a comprehensive model was implemented to predict the CO2 flux through the membrane, based on resistance in the series model. Subsequently, a 2D axisymmetric model of a multilayer HFM was proposed to simulate the axial and radial diffusion of carbon dioxide in a membrane. In the three domains of fiber, the CFD technique was used to solve the equations for the transfer of momentum and mass transfer by using the COMSOL 5.6. Modeling results were validated with 27 experiments, and there was a good agreement between the simulation results and the experimental data. The experimental results show the effect of operational factors, such as the fact that temperature was directly on both gas diffusivity and mass transfer coefficient. Meanwhile, the effect of pressure was exactly the opposite, and the concentration of CO2 had almost no effect on both the diffusivity and the mass transfer coefficient. In addition, the CO2 recovery changed from 9% at a pressure equal to 2.5 bar, temperature equal to 20 °C, and a concentration of CO2 equal to 2 mol%, to 30.3% at a pressure equal to 7.5 bar, temperature equal to 30 °C, and concentration of CO2 equal 10 mol%; these conditions are the optimal operating point. The results also manifested that the operational factors that directly affect the flux are pressure and CO2 concentration, while there was no clear effect of temperature. This modeling offers valuable data about the feasibility studies and economic evaluation of a gas separation unit operation as a helpful unit in the industry.

Radiotherapy-associated sensorineural hearing loss in pediatric oncology patients.

During the radiotherapeutic treatment of pediatric oncology patients, they would be at a latent risk of developing ionizing radiation-induced ototoxicity when the cochlea or auditory nerve is located within the radiation field. Sensorineural hearing loss (SNHL) is an irreversible late complication of radiotherapy, and its incidence depends on various factors such as the patient's hearing sensitivity, total radiation dose to the cochlea, radiotherapy fractionation regimen, age and chemoradiation. Importantly, this complication exhibits serious challenges to adult survivors of childhood cancer, as it has been linked to impairments in academic achievement, psychosocial development, independent living skills, and employment in the survivor population. Therefore, early detection and proper management can alleviate academic, speech, language, social, and psychological morbidity arising from hearing deficits. In the present review, we have addressed issues such as underlying mechanisms of radiation-induced SNHL, audiometric findings of pediatric cancer patients treated with radiotherapy, and management and protection measures against radiation-induced ototoxicity.

Investigation ways of causes needle sticks injuries, risk factors affecting on health and ways to preventive.

Needle sticks injuries (NSIs) has caused many health concerns, including the widespread infection disease. Needle sticks injuries can have high threaten health human especially, all those who are in contact with health and medical centers. The purpose of this review study was the determination the effects of needle sticks injuries (NSIs) on health care worker and patents. In this a review study of literature studied conducted on international databases included Google Scholar, ISI/WOS (Web of Science), Springer, Scopus, Medline/PubMed. The literature signs a notable undesirable affect from potential needle sticks injuries related to ways to preventive and risks factors among patents and health care worker. The literature was shown needle stick injuries can cause with a variety of ways including needle recapping, non-standard safety boxes, thin gloves, and inadequate personal protective equipment. According to the result this study, needle stick injuries can transfer infectious disease (Human Immunodeficiency viruses [HIV], Hepatitis C virus [HCV]) and increase risk health on health care worker and patients. According to research related to the subject, the ways to prevent reduce needle sticks include personal protective equipment, holding retraining courses for medical staff in the direction to raise awareness can significantly reduce cases of needle sticks injuries. Further research using more sophisticated methodology is warranted.

Synthesis of efficient cobalt-metal organic framework as reusable nanocatalyst in the synthesis of new 1,4-dihydropyridine derivatives with antioxidant activity.

Efficient cobalt-metal organic framework (Co-MOF) was prepared via a controllable microwave-assisted reverse micelle synthesis route. The products were characterized by SEM image, N2 adsorption/desorption isotherm, FTIR spectrum, and TG analysis. Results showed that the products have small particle size distribution, homogenous morphology, significant surface area, and high thermal stability. The physicochemical properties of the final products were remarkable compared with other MOF samples. The newly synthesized nanostructures were used as recyclable catalysts in the synthesis of 1,4-dihydropyridine derivatives. After the confirmation of related structures, the antioxidant activity of derivatives based on the DPPH method was evaluated and the relationship between structures and antioxidant activity was observed. In addition to recyclability, the catalytic activity of Co-MOF studied in this research has remarkable effects on the synthesis of 1,4 dihydropyridine derivatives.

Synthesis of Bioactive Yttrium-Metal-Organic Framework as Efficient Nanocatalyst in Synthesis of Novel Pyrazolopyranopyrimidine Derivatives and Evaluation of Anticancer Activity.

Novel Yttrium-metal-organic framework (Y-MOF) was synthesized under optimal conditions of microwave with a power of 20 W, the temperature of 30 degrees of centigrade, and time duration of 10 min. The products were characterized by SEM (morphology and size distribution), TGA (thermal stability), BET technique (surface area), and FTIR (characterization of the related group). The Yttrium-metal-organic framework (Y-MOF) synthesized in this study, after identifying and confirming the structure, was used as an efficient and recyclable catalyst in the synthesis of new pyrazolopyranopyrimidine derivatives. Following the study of the properties and applications of Y-MOF, its anticancer properties on breast cancer cells based on the MTT method were evaluated, and significant results were observed. In addition, the anticancer properties of the pyrazolopyranopyrimidine derivatives were investigated.

What is the influence of grape products on liver enzymes? A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: This systematic review and meta-analysis were aimed to determine the effects of grape products on liver enzymes in adults. METHODS: Databases including PubMed/Medline, Cochrane Library, ISI Web of Science, and Scopus were searched up to February 2021. Randomized clinical trials (RCTs) investigating the effect of grape products on serum concentrations of liver enzymes were included. Data were pooled using the random-effects model and weighted mean difference (WMD) was considered as the summary effect size. RESULTS: Eight RCTs enrolling 291 participants met the inclusion criteria for this meta-analysis. The overall effect illustrated no significant change in serum levels of alanine aminotransferase (ALT) (WMD: - 2.04; 95 % CI: - 5.50 to 1.42; P = 0.24; I2 = 72.5 %), and aspartate aminotransferase (AST) (WMD: - 1.40; 95 % CI: - 3.80 to 0.99; P = 0.25; I2 = 76.0 %) in intervention group compared with the control group. Subgroup analyses revealed that the effect of grape products on ALT (WMD: - 4.97; 95 % CI: - 8.73 to - 1.21; P = 0.01) and AST (WMD: - 2.89; 95 % CI: - 5.69 to - 0.08; P = 0.04) levels was significant when the intervention period was equal or more than 12 weeks. CONCLUSION: Overall, grape products had no significant effect on liver enzymes in adults. However, due to the low number of included studies, these findings must be interpreted with great caution. Larger, well-designed RCTs are still needed to further evaluate the capacity of the grape products as a complementary treatment to improve liver enzymes.

Ramadan fasting: recommendations for patients with cardiovascular disease.

Ramadan fasting is observed by most of the 1.8 billion Muslims around the world. It lasts for 1 month per the lunar calendar year and is the abstention from any food and drink from dawn to sunset. While recommendations on 'safe' fasting exist for patients with some chronic conditions, such as diabetes mellitus, guidance for patients with cardiovascular disease is lacking. We reviewed the literature to help healthcare professionals educate, discuss and manage patients with cardiovascular conditions, who are considering fasting. Studies on the safety of Ramadan fasting in patients with cardiac disease are sparse, observational, of small sample size and have short follow-up. Using expert consensus and a recognised framework, we risk stratified patients into 'low or moderate risk', for example, stable angina or non-severe heart failure; 'high risk', for example, poorly controlled arrhythmias or recent myocardial infarction; and 'very high risk', for example, advanced heart failure. The 'low-moderate risk' group may fast, provided their medications and clinical conditions allow. The 'high' or 'very high risk' groups should not fast and may consider safe alternatives such as non-consecutive fasts or fasting shorter days, for example, during winter. All patients who are fasting should be educated before Ramadan on their risk and management (including the risk of dehydration, fluid overload and terminating the fast if they become unwell) and reviewed after Ramadan to reassess their risk status and condition. Further studies to clarify the benefits and risks of fasting on the cardiovascular system in patients with different cardiovascular conditions should help refine these recommendations.

Assessing the effect of oral diseases on oral health related quality of life of institutionalized elderly using Oral Health Impact Profile (OHIP-14) questionnaire: a pilot study.

BACKGROUND: India establishes a geriatric population of about 80 million which is 7.2% of the total population. The geriatric population is often faced by a negative impact on their quality of life due to poor oral health. OBJECTIVES: To assess the impact of oral disease on daily activities and quality of life among the institutionalized elderly in Kanpur, India. MATERIALS AND METHOD: A total of fifty-six patients were purposively selected from two old age homes through convenience sampling technique. To assess the oral health status WHO basic oral health survey form (1997) was used. Short version of Oral Health Impact Profile (OHIP - 14) questionnaire was used to assess the Oral Health Related Quality of Life (OHRQoL). Independent t-test and ANOVA test was done to determine the relationship between the groups. RESULTS: Presence or absence of grossly decayed teeth, chronic periodontitis, based on edentulism and remaining sound teeth status produced no significant differences in any of the domains. In comparison with males, females experienced greater impact of oral diseases with respect to mean OHIP-14 score; however, it was non - significant (p=0.45). CONCLUSION: Oral health status of the institutionalized subjects in Kanpur city is poor, with edentulism and periodontitis. The effect of oral diseases on the lives of elderly is comparatively low and is non-significant.

Frequency of genomic mutations mediating resistance of Mycobacterium tuberculosis isolates to rifampicin in Northern Morocco.

Drug resistant tuberculosis (DR-TB) is challenging particularly in developing countries. As such, a previous investigation gave the first insight into the mutational status of the Rifampicin Resistance Determining Region (RRDR) of rpoB gene among a restricted number of MTB patients' residents in the Northern Morocco. The purpose of this study was to investigate rpoB mutation types and frequencies associated with resistance to Rifampicin in a larger panel of MTB patients and to evaluate the usefulness of these mutations to improve the diagnosis of resistance to Rifampicin. A panel of 301 consecutive sputum samples belonging to patients suscpected of having TB from Northern Morocco was collected at the Pasteur Institute of Tangier between 2014-2017. Samples were subjected to conventionel microbiological tests. Evaluation of rpoB muational status was assessed by PCR amplification and sequencing of the RRDR of the rpoB gene. DST results showed that 26.4% of strains were MDR. Sequencing results reported single point mutations in 36 of 65 RIFR isolates of which two had two mutations. Aminoacid substitutions in the codon Ser531Leu occurred at the highest frequency (34.46%). Overall, 10 aminoacid substitutions have been registered, and the H526S substitution was reported for the first time. The present study highlighted that resistance to RIF is a reliable marker of MDR-TB, the common mutations successfully detected in the rpoB 531, rpoB526 and rpoB516 codons provide a foundation for the implementation of molecular approaches such as Hain and GeneXpert as a routine tests to detect DR-TB. However, considerable work is still necessary to identify extensive mutations associated with DR-TB.