A case-control regression analysis of liver enzymes in obesity-induced metabolic disorders in South Asian females.

Excessive body weight may disrupt hepatic enzymes that may be aggravated by obesity-related comorbidities. The current case-control study was designed to evaluate the extent of liver enzyme alteration in obesity-related metabolic disorders. Obese females with BMI ≥ 30 suffering from metabolic disorders were grouped according to existing co-morbidity and their hepatic enzymes were compared with non-obese healthy females. The resultant data was subjected to analysis of variance and mean difference in liver enzymes were calculated at P = 0.05. Analysis of variance indicated that obese diabetic and obese hypertensive females had almost 96% and 67% increase in the concentration of gamma-glutamyl transferase than control, respectively (P<0.0001). The obese females suffering from diabetes and hypertension exhibited nearly 54% enhancement in alanine transaminase level (P<0.0001) and a 17% increase in aspartate aminotransferase concentration (P = 0.0028). Obesity along with infertility decline liver enzyme production and a 31% significant decline in aspartate aminotransferase was observed while other enzyme concentrations were not significantly altered. Regression analysis was performed on the resultant data to understand the association between liver enzyme alteration and the development of metabolic diseases. Regression analysis indicated that obese diabetic and obese diabetic hypertensive women had 20% production of normal liver enzymes and 80% enzymes produced abnormally. Obese hypertensive and obese infertile females had only 5% and 6% normal production of liver enzymes, respectively. This research leads to the conclusion that the ability of the liver to function normally is reduced in obesity-related diabetes and hypertension. This may be due to inflamed and injured liver and poses a serious threat to developing fatty liver disease and ultimately liver cirrhosis.

Correction: The Influence of Biological Sex on Presentation and Outcomes of Acute Myocarditis: A Systematic Review and Meta-Analysis.

[This corrects the article DOI: 10.7759/cureus.57325.].

The Influence of Biological Sex on Presentation and Outcomes of Acute Myocarditis: A Systematic Review and Meta-Analysis.

There is growing evidence of sex-related differences in the epidemiology and pathophysiology of cardiovascular diseases. This is the first systematic review and meta-analysis that aimed to highlight the sex-specific differences in the clinical features and outcomes of acute myocarditis. Electronic searches were performed on Scopus, Embase, and PubMed from inception up to June 2023 to identify studies comparing the clinical features and outcomes of acute myocarditis in males and females. Both qualitative and quantitative summaries were conducted. In this systematic review and meta-analysis of 11 studies involving 34,791 patients presenting with acute myocarditis. Male patients, who comprised 69.8% of the entire pooled population, presented at a markedly younger age (mean difference: -8.99 years; 95% CI: -13.60, -4.38; p=0.0001). They also had significantly lower rates of hypertension, diabetes mellitus, and coronary artery disease compared to female patients (p<0.01). Male patients were more likely to present with ST elevation (RR: 2.57 [1.38, 4.79]; p=0.003) and higher C-reactive protein levels (RR: 3.04 [2.75, 3.34]; p<0.00001) compared to female patients. This review underscores the crucial sex-specific evaluation in acute myocarditis, necessitating tailored approaches in assessment and diagnostic evaluation, and emphasizing the need for additional research in this domain.

Career Intentions and Their Influencing Factors Among Medical Students and Graduates in Peshawar, Pakistan: A Cross-Sectional Study on Brain Drain.

BACKGROUND AND OBJECTIVE:  Physician brain drain is of mounting concern worldwide, especially in lower-middle-income countries like Pakistan, where the healthcare sector is overworked, and the exodus of talented health professionals further deteriorates the country's health statistics. Our study's objective was to investigate the career and migration intentions of medical undergraduates and graduates in Peshawar. DESIGN, SETTINGS, AND PARTICIPANTS:  A cross-sectional self-structured questionnaire was distributed among 305 fourth- and final-year medical students and demonstrators at Khyber Medical College and graduates working as house officers, medical officers, and training medical officers at its conjugate hospital, Khyber Teaching Hospital, Peshawar. The questionnaire consisted of four sections designed to collect demographic details, determine participants' career and migration intentions, evaluate reasons for and against migration, and assess their reasons for establishing these intentions. The data were analyzed using IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. RESULTS:  67.5% of our respondents intended to migrate abroad, most of whom were men. The UK emerged as the top destination for those wishing to relocate. The most common reasons participants wanted to migrate were better quality of training and research, followed by a gain in professional skills over others, and lastly, better remuneration abroad. Most of those who wished to stay back chose family ties, a desire to serve the nation, and fixing flaws in the country's healthcare system as the most influential factors behind their decision to stay back. CONCLUSION:  The threat of brain drain is far-reaching and profound, putting Pakistan's people's health at risk. Policymakers must act to address the country's healthcare workers' concerns.

Effects of fasciatherapy versus fascial manipulation on pain, range of motion and function in patients with chronic neck pain.

BACKGROUND: Neck pain is among the common musculoskeletal problem that hinders a person's daily activities. Fascial tightness is a familiar cause of chronic neck pain that is often neglected and can further cause neck disability and a limited range of motion. OBJECTIVE: The purpose was to compare the effects of fascia therapy and fascial manipulation on pain, range of motion and function in patients with chronic neck pain. METHODS: A randomized clinical trial was conducted from February to August 2022 in the Riphah Rehabilitation Centre, Lahore, Pakistan. Fifty-two participants of both genders, aged 18-40 years with chronic neck pain of at least 3-6 months were included. Group A (n = 26) received fascia therapy along with a conventional physical therapy protocol of hot pack, strengthening and stretching, while group B (n = 26) received the fascial manipulation treatment with conventional physical therapy. All the participants were assessed at baseline and after 3 weeks (3 sessions per week). Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI) and Goniometer (range of motions) were the outcome measures. SPSS 25 was used for the data analysis and normality of the data through the Shaphiro-Wilk test (p > 0.05), and parametric tests were applied. RESULTS: The mean age of group A was 24.82 ± 2.64 years, and group B was 24.17 ± 2.20 years. The independent t-test result showed no significant difference (p ≥ 0.05) in all parameters except in cervical extension and right-side bending (p < 0.05). At the same time, the pair-wise comparison showed significant results (p < 0.05) for all outcome measures in both groups. CONCLUSION: DBM fascia therapy improved cervical extension and side bending (right) more than the fascial manipulation group.It is concluded that DBM fascia therapy shows more improvement as compared to other group. TRIAL REGISTRATION NUMBER: This study was registered at ClinicalTrials.gov ID: NCT05272111 on 09/03/2022.

High level of lactate dehydrogenase and ischaemia-reperfusion injury regulate the multiple organ dysfunction in patients with COVID-19.

BACKGROUND: Multiple organ damage has been observed in patients with COVID-19, but the exact pathway is not known. Vital organs of the human body may get affected after replication of SARS-CoV-2, including the lungs, heart, kidneys, liver and brain. It triggers severe inflammation and impairs the function of two or more organ systems. Ischaemia-reperfusion (IR) injury is a phenomenon that can have disastrous effects on the human body. METHODS: In this study, we analysed the laboratory data of 7052 hospitalised patients with COVID-19 including lactate dehydrogenase (LDH). A total of 66.4% patients were men and 33.6% were women, which indicated gender difference as a prominent factor to be considered. RESULTS: Our data showed high levels of inflammation and elevated markers of tissue injury from multiple organs C reactive protein, white blood cell count, alanine transaminase, aspartate aminotransferase and LDH. The number of red blood cells, haemoglobin concentration and haematocrit were lower than normal which indicated a reduction in oxygen supply and anaemia. CONCLUSION: On the basis of these results, we proposed a model linking IR injury to multiple organ damage by SARS-CoV-2. COVID-19 may cause a reduction in oxygen towards an organ, which leads to IR injury.

Complete Genome Sequences of Cluster F1 Mycobacteriophages Akhila and MilanaBonita.

Akhila and MilanaBonita are mycobacteriophages that were isolated from soil in New York using Mycobacterium smegmatis. Both phages have genomes that are 56,251 bp long and contain 99 genes; the genomes differ by only 1 nucleotide. Based on gene content similarity to phages in the Actinobacteriophage Database, both phages are assigned to cluster F1.

Life cycle assessment of a shrub willow evapotranspiration cover compared with conventional clay and geosynthetic covers in Upstate New York.

The establishment of landfill covers consumes substantial amounts of fuels and materials that contribute to greenhouse gas emissions and fossil fuel depletion (FFD). This study compared the global warming impact (GWI) and FFD of a shrub willow evapotranspiration (ET), conventional clay, and geosynthetic cover using life cycle assessment (LCA). The willow ET cover is a carbon-negative system with a total GWI of -13,206 kgCO2eq ha-1 over 30 years, while the GWI of clay (194,916 kgCO2eq ha-1) and geosynthetic covers (260,212 kgCO2eq ha-1) were substantial. Willow's ability to store carbon in coarse roots and stools creates the opportunity for negative carbon emissions. The FFD impact of the willow ET cover (75,303 MJ surplus ha-1) is 4.7 times lower than the clay cover and 7.7 times lower than the geosynthetic cover. Sensitivity and uncertainty analyses indicated that the GWI of the willow ET cover was less than zero for all scenarios, and the GWI and FFD of the geosynthetic cover were the highest. Willow ET covers can protect human health and the environment, reduce greenhouse gas emissions by sequestering carbon, and provide a source of wood chips that could be used for renewable energy or other applications.