Neuromodulatory effects of green coffee bean extract against brain damage in male albino rats with experimentally induced diabetes.

Diabetes mellitus is an increasing metabolic disease worldwide associated with central nervous system disorders. Coffee is a widely consumed beverage that enriched with antioxidants with numerous medicinal applications. Accordingly, the present study aimed to investigate the therapeutic potential of orally administered green coffee bean water extract (GCBWE) against cortical damage induced by high fat diet (HFD) followed by a single injection of streptozotocin (STZ) in rats. Metformin (Met) was used as standard antidiabetic drug. Animals were allocated into six groups: control, GCBWE (100 mg/kg), HFD/STZ (40 mg/kg), HFD/STZ + GCBWE (50 mg/kg), HFD/STZ + GCBWE (100 mg/kg) and HFD/STZ + Met (200 mg/kg) which were treated daily for 28 days. Compared to control rats, HFD/STZ-treated rats showed decreased levels of cortical dopamine, norepinephrine and serotonin with marked increases in their metabolites. Further, HFD/STZ treatment resulted in notable elevations in malondialdehyde, protein carbonyl and total nitrite levels paralleled with declines in antioxidant markers (SOD, CAT, GPx, GR and GSH) and down-regulations of Sod2, Cat, GPx1 and Gsr gene expression. Neuroinflammation was evident in diabetic animals by marked elevations in TNF-α, IL-1ß and up-regulation of inducible nitric oxide synthase. Significant rises incaspase-3 and Bax with decline in Bcl-2 level were noticed in diabetic rats together with similar results in their gene expressions. Cortical histopathological examination supported the biochemical and molecular findings. GCBWE administration achieved noteworthy neuroprotection in diabetic animals in most assessed parameters. The overall results suggested that antioxidant, anti-inflammatory; anti-apoptotic activities of GCBWE restored the cortical neurochemistry in diabetic rats.

Serum ferritin and vitamin d in female hair loss: do they play a role?

AIM: Evaluation of serum ferritin and vitamin D levels in females with chronic telogen effluvium (TE) or female pattern hair loss (FPHL), in order to validate their role in these common hair loss diseases. METHODS: Eighty females (18 to 45 years old) with hair loss, in the form of TE or FPHL, and 40 age-matched females with no hair loss were included in the study. Diagnosis was based upon clinical examination as well as trichogram and dermoscopy. Serum ferritin and vitamin D2 levels were determined for each participant. RESULTS: Serum ferritin levels in the TE (14.7 ± 22.1 µg/l) and FPHL (23.9 ± 38.5 µg/l) candidates were significantly lower than in controls (43.5 ± 20.4 µg/l). Serum vitamin D2 levels in females with TE (28.8 ± 10.5 nmol/l) and FPHL (29.1 ± 8.5 nmol/l) were significantly lower than in controls (118.2 ± 68.1 nmol/l; p < 0.001). These levels decreased with increased disease severity. Serum ferritin cut-off values for TE and FPHL were 27.5 and 29.4 µg/l, respectively, and those for vitamin D were 40.9 and 67.9 nmol/l. CONCLUSION: Low serum ferritin and vitamin D2 are associated with hair loss in females with TE and FPHL. Screening to establish these levels in cases of hair loss and supplementing with them when they are deficient may be beneficial in the treatment of disease.

Knowledge, Attitude and Practice towards Dengue Fever: a Study among the Inhabitants of Cumilla Cantonment area of Bangladesh.

Dengue ruins a major public health challenge causing death among many people in Bangladesh. The magnitude of dengue-related illness and death has significantly increased over recent years. The study was conducted to assess the level of knowledge, attitude, and practices related to dengue fever. This cross-sectional type of descriptive study was conducted among a total of 250 respondents who consented to participate in this study. Respondents were included purposively from selected bushy Cumilla Cantonment area also classified as a stable dengue-prone region of Bangladesh from January 2023 to March 2023. The survey was carried out by face-to-face interviews using a pre-tested semi-structured questionnaire. The results reveal that 81.2% of respondents were below 40 years of age group, 74.8% of respondents were married and 72.8% of respondents were in the below monthly 35000tk income group. Only 77.0% of respondents had good knowledge scores and 61.0% had positive attitudes and 75.0% had good compliance with practices. Knowledge was not significantly associated with type of residence, marital status, income group and age group (p>0.05 in every aspect). Transmission of dengue about more than two-thirds (84%) reported that the Aedes aegypti was a vector mosquito for dengue transmission and 27(10.8%) were aware of the biting time of the mosquito. Most participants (81.6%) strongly agreed that dengue is a serious illness and less than half (40.8%) reported that it could be prevented with vector control strategies. The majority (98.4%) used mosquito nets as a preventive measure, while over two-thirds (87.6%) reported that they discarded waste, containers and non-used bottles across their yards that hold water. Although the respondents had quite a positive attitude toward preventive measures regarding dengue (61.0%) and a sizeable number (39.0%) did not put proper attitude into practice. Poorly planned urbanization combined with an explosive urban population in the Cumilla Cantonment area has brought the mosquito and the human host into close proximity. The government should launch health education programs on dengue prevention to educate the community members, addressing misconceptions about their preventive measures and how they could eliminate the risk factors related to practices.

Ferulic acid influences Nrf2 activation to restore testicular tissue from cadmium-induced oxidative challenge, inflammation, and apoptosis in rats.

Here, we examined the protective effect of ferulic acid (FA) on cadmium chloride (CdCl2 )-mediated reproductive toxicity in male rats. Animals were divided into four groups: control, FA (20 mg/kg), CdCl2 (6.5 mg/kg), and FA + CdCl2 . CdCl2 treatment evoked a significant increase in testis cadmium concentration in addition to obvious increase in testosterone, luteinizing hormone, and follicle-stimulating hormone levels. Moreover, CdCl2 -induced oxidative damage through exhausting the cellular defenses (superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, and glutathione) and downregulating the nuclear factor erythroid 2-related factor 2 (Nrf2) expression accompanied by increases of malondialdehyde and nitric oxide contents. Testicular inflammation was evident indicated by increased levels of interleukin-1ß and tumor necrosis factor-α in CdCl2 -treated rats. CdCl2 exposure also decreased the expression of the proliferating cell nuclear antigen and augmented apoptotic events associated with prominent histopathological alterations. However, FA coadministration mitigated the impaired hormonal level, apoptotic and inflammatory injuries elicited by CdCl2, and maintained the oxidant/antioxidant balance in testicular tissue via Nrf2 activation. PRACTICAL APPLICATIONS: Cadmium is an environmental toxicant and known to cause adverse effects including reproductive toxicity. However, antioxidant application has been found to protect against heavy metals-mediated toxic effects. Here, we examined the potential protective efficacy of ferulic acid against cadmium-mediated testicular impairments through estimating the amount of cadmium in the testis, hormonal profile, oxidative status, inflammatory response, apoptotic and proliferating markers in addition to the histopathological alterations. The obtained findings revealed that ferulic acid supplementation was able to abolish the testicular damages coupled with cadmium exposure. The protective efficiency of ferulic acid may correlated with its strong antioxidant, anti-inflammatory, and antiapoptotic activities; suggesting that ferulic acid may be used to ameliorate cadmium-induced testicular deficits.

Serum homocysteine concentration in patients with acute MI and chronic IHD.

This was an observational study carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka; with the active co-operation of Coronary Care Unit (CCU) of BSMMU & National Institute of Cardiovascular Disease (NICVD), Dhaka. This study was carried out from March 2002 to January 2003. Total seventy (70) subjects were studied. Out of them 20 were of Acute MI, 20 were Chronic ischemic heart disease (CHD) and 30 were age and sex matched healthy controls. Hospitalized diagnosed patients were selected by taking history, clinical examination and several investigations like ECG. Echocardiogram, Angiogram and several enzymes assay. Several studies in many countries showed that serum homocysteine (Hcy) was elevated in IHD Patient. Cardiovascular disease is alarmingly increasing in Bangladesh. So our aim and objective of the study was to find out the association of serum Hcy with Acute MI and chronic ischemic heart disease (CHD) patients in our population. Mean Hcy level of Acute MI were 21.16 +/- 4.56 (micromol/l), 27.55 +/- 10.40 (micromol/l) and that of control was 13.03 +/- 10.51(micromol/l). Serum Hcy was significantly higher in both cases than control. But insignificant difference was found between AMI vs CHD (P> 0.05). Quantitative measurement of serum Hcy was measured by fluorescence polarization Immunoassay (FPIA) in IMX analyzer (Abbott-USA).

Device-related nosocomial infection in intensive care units of Alexandria University Students Hospital.

We studied the magnitude and determinants of device-related nosocomial infections in intensive care units (ICU) and identified the predominant microorganisms involved. Sputum, urine, blood cultures and chest X-ray were taken from each patient on admission and on appearance of any sign/symptom of infection. Out of 400 patients admitted to 3 units during the study, 45 (11.3%) developed nosocomial infections. The most important determinants of infection were previous admission to an ICU, whether in the same or another hospital, and duration of stay. Overall, 38 patients developed 43 device-related nosocomial infections (1.13 episodes per patient). The main infectied association with invasive procedures were ventilator-associated pneumonia followed by catheter-related urinary tract infection and bloodstream infections.

Autoimmune vestibular dysfunction: preliminary report.

Since 1981, 28 patients have been diagnosed with autoimmune inner ear disease. This preliminary, retrospective study reviews clinical and laboratory manifestations of autoimmune vestibular dysfunction. Sixteen of 28 patients presented with dizziness (7 vertigo, 8 lightheadedness, 1 ataxia). Twelve of these patients presented with Meniere's syndrome. Seven of 16 dizzy patients underwent formal vestibular testing. Five had reduced vestibular response in the involved ear(s); one patient had positional nystagmus only; and one had normal results. Of 17 patients with adequate follow-up, 11 presented with dizziness. Hearing improved and dizziness resolved in two patients following treatment. Hearing stabilized and dizziness resolved in two. Hearing stabilized but lightheadedness (without vertigo) persisted in five. Hearing was lost and oscillopsia resulted in two patients. Preliminary conclusions are vestibular dysfunction in autoimmune inner ear disease is nonspecific; bilateral vestibular dysfunction is more common; Meniere's syndrome is relatively common; medical management usually is helpful; surgery at this time does not seem appropriate; vestibular treatment results tend to parallel auditory treatment results.

Clinical value of sinusoidal harmonic acceleration test results. Site of lesion and side of lesion.

Sinusoidal harmonic acceleration tests can be used reliably to determine site and side of lesion. Results from 6000 patients collected over the past 10 years have shown that the temporal pattern of asymmetry can be reliably used to differentiate peripheral from central vestibular dysfunction. Peripheral cases tend to have a high level of asymmetry, with temporal regression to normal range, and a high correlation with patient symptoms. Central cases tend to have a low level of variable asymmetry and variable symptoms. In either case, phase can be abnormal or normal and cannot be reliably used to differentiate peripheral from central dysfunction. By combining phase and symmetry, the side of the lesion can be reliably determined. When phase is abnormal, asymmetry is toward the side of the lesion in 92 per cent of cases, whereas when phase is normal, asymmetry cannot be reliably used to determine side of lesion. SHA testing has contributed significantly to our clinical ability to fully evaluate the vestibular system and has become an indispensable part of the complete vestibular laboratory. It requires a relatively large patient load as well as software and hardware support to become a cost-effective utility.

The metabolism of phenylalanine and leucine by a cell suspension of Eubacterium brachy and the effects of metronidazole on metabolism.

Degradation of phenylalanine and leucine by resting cells of Eubacterium brachy ATCC 33089 were studied under strict anaerobic conditions. The effects of metronidazole and air on the metabolism were also studied. The organism principally produced phenylpropionate and isocaproate from phenylalanine and leucine, respectively. Other products were cinnamate and phenylacetate from phenylalanine, and alpha-ketoisocaproate and isovalerate from leucine. The organism also produced hydroxylated end-products, i.e. phenyllactate from phenylalanine and hydroxyisocaproate from leucine. When metronidazole was added to the reaction mixture, the production of phenylpropionate, cinnamate, phenylacetate, isocaproate, alpha-ketoisocaproate and isovalerate was inhibited, while that of hydroxylated products was not, suggesting that the organism has metronidazole-sensitive and -tolerant pathways of metabolism. A similar inhibitory effect was also found when the reaction was done aerobically, suggesting that the inhibitory mode of metronidazole is similar to that of oxygen.

Classification of leprosy cases under field conditions in Bangladesh. I. Usefulness of skin-smear examinations.

In 2 non-governmental organization projects in Bangladesh 244 new leprosy patients were classified in the field according to clinical criteria. Skin smears were taken at 4 standardized sites and at the most active peripheral lesion, where a biopsy was also taken. Comparison of the clinical field classification with the results of the skin smears and biopsies gives a sensitivity of 92.1% for the clinical criteria, but a specificity of only 41.3%. The skin-smear results, on the other hand, have a sensitivity of 88.4% and a specificity of 98.1%. Thus, skin smears may contribute considerably to the operational classification of leprosy patients under field conditions. Quality control of the peripheral laboratory is essential. Appropriate site selection for the smear taking will also contribute to increased performance. Analysis of the skin-smear results suggests that the policy of taking smears at standardized sites should be abandoned in favour of the earlobes and active peripheral lesions.

Classification of leprosy cases under field conditions in Bangladesh. II. Reliability of clinical criteria.

In 2 non-governmental organization projects 244 new leprosy patients in Bangladesh were classified in the field according to clinical criteria i.e. number of skin lesions and number of enlarged nerves. Comparison of these classification results with the results of skin smears and biopsies yielded a sensitivity (for detection of a MB case) of 92.1%, but the 'unconfirmed MB rate' amounted to 52.6%. In order to improve the reliability of the operational classification, several additional clinical criteria were investigated. It was found that neither the presence of anaesthesia in the skin lesions nor the presence of grade 2 disabilities or peripheral anaesthesia or voluntary muscle testing (VMT) impairment contributed to an improved classification. Counting the number of body areas showing signs of leprosy, which had proven very useful in other programmes, did not result in a more reliable classification in the 2 projects in Bangladesh. The presence of clinical signs of lepromatous leprosy, more specifically nodules or diffuse infiltration, could be a useful addition to the classification criteria. If the sensitivity must remain higher than 90%, the lowest 'unconfirmed MB rate' obtainable in Bangladesh, using clinical criteria only, is 46.4%, for a sensitivity of 91.0%. However, the inclusion of skin-smear results in the classification criteria could improve the sensitivity to 96.6% and lower the 'unconfirmed MB rate' to 40.3%. A reduction in MB overclassification will result in more efficient and more cost-effective leprosy control programmes.

Determining side of vestibular dysfunction with rotatory chair testing.

Determining side of vestibular lesion remains a challenging task during neurotologic investigations, particularly if auditory lateralizing signs are absent. Traditionally, absent or decreased caloric response has been regarded as evidence of unilateral vestibular deficit. But, the inability of the chair test to detect side of lesion has been generally accepted because rotation stimulates both end organs. A retrospective study postulated and tested a hypothesis that low-frequency asymmetry of sinusoidal harmonic acceleration (SHA) testing can determine side of lesion when phase is abnormal. The present prospective, double-blind study was designed to further test the retrospective study hypothesis. Results showed that SHA asymmetry detects side of unilateral vestibular deficit when phase is abnormal in 97% of cases.

Vestibular and postural findings in the motion sickness syndrome.

The motion sickness syndrome constitutes varying degrees of subjective motion intolerance and three objective findings: hyperactive VOR (79%), hip sway strategy (60%), and positional nystagmus (42%). It is present in subjects who have a strong history of motion sickness. Vestibular rehabilitation appears to help control symptoms. The study also suggests an inheritance pattern, but a structured pedigree could not be constructed. Prospective studies are warranted to further establish the patterns of the motion sickness syndrome.

Vestibular evoked potentials in man: an overview.

Evoked potentials (EPs) have been used to detect auditory, visual, and somatosensory dysfunction. Evoked potentials are recorded by averaging an optimal number of responses (that are time-locked) to the same number of appropriate stimuli. Adequate stimulus levels and "minimal" response latency are necessary for recording evoked potentials. Vestibular evoked potentials have received considerably less attention because of the difficulty in providing appropriate stimuli, the relatively long latency of vestibular responses, and the adaptation of the vestibular system to repeated stimulation. Technological advances have made it possible to provide accurate stimuli by use of computer-controlled rotating chairs and computer-averaging procedures.

ENG-MRI correlates in cerebellar oculomotor dysfunction.

This study correlates ENG and MRI findings in six patients with cerebellar eye movements. For each subject, both tests independently support the presence of a cerebellar tract abnormality. In two patients, MRI studies confirmed the site of cerebellar dysfunction previously demonstrated by ENG. Although the number of patients is small, the strong correlation (100%) indicates that ENG remains a sensitive method for detection and localization of the origin of cerebellar eye movements. The physiologic information provided by ENG is supported anatomically by MRI. The cerebellar eye movement abnormalities are briefly reviewed.

Results of sinusoidal harmonic acceleration test in one thousand patients: preliminary report.

One thousand patients with dizziness were tested by sinusoidal harmonic acceleration with frequencies of .01, .02, .04, .08, and .16 Hz. Two hundred fifty (25% of data base) were randomly selected for this study. One hundred forty-eight diagnoses were confirmed: 66 (45%) patients had a clinical diagnosis of peripheral vestibular dysfunction, 28 (19%) had central vestibular dysfunction, and 53 (36%) had dizziness of undetermined cause. This preliminary study investigated the response patterns of phase (latency), asymmetry (slow phase preponderance), and gain (output/input) as they correlated with each of the above patient groups. The main response pattern was a varying degree of asymmetry with normal or abnormal latency. Persistent abnormal phase pattern indicated permanent vestibular damage and could not be used reliably to differentiate peripheral from central vestibular dysfunction. Asymmetry changed with time and correlated with patients' symptoms. The dynamic pattern of asymmetry could be used to differentiate peripheral from central vestibular dysfunction. Gain was a reliable and essential measure of the sensitivity of the vestibular system and the validity of the rotational response.

Autoimmune endolymphatic hydrops: five-year review.

This article reviews the authors' experience with autoimmune endolymphatic hydrops over the past 5 years. Twenty-seven of 52 patients with diagnosed autoimmune inner ear disease (52%) manifested endolymphatic hydrops, usually bilateral. Treatment consisted of low salt diet, diuretic, vestibular suppressant, and usually prednisone. Cytotoxic drugs and lymphocytoplasmapheresis were reserved for refractory cases. Audiometric followup (average, 23 months) was available in 12 patients. Using American Academy of Otolaryngology--Head and Neck Surgery guidelines, hearing improved or stabilized in at least one ear in nine patients and deteriorated bilaterally in three patients. Vestibular treatment results paralleled auditory treatment results. Autoimmune endolymphatic hydrops should be considered in the differential diagnosis when symptoms are bilateral and do not respond to conventional therapy or when immune laboratory tests are positive. In suspect patients, medical therapy with prednisone, and rarely cytotoxic drugs and lymphocytoplasmapheresis, should be recommended. Further research is needed to determine whether surgery should be performed in medically unresponsive cases.

Interlaboratory variability of rotational chair test results II: analysis of simulated data.

Standardization of rotational chair testing across laboratories has not been achieved because of differences in test protocol and analysis algorithms. The Interlaboratory Rotational Chair Study Group was formed to investigate these differences. Its first study demonstrated significant variability in calculated results using actual patient data files. No estimation of accuracy could be made, however, because the "true" values of response parameters were unknown. In this study we used simulated "patient" data files to further explore the differences among analysis algorithms. We found a high degree of agreement and accuracy across laboratories using automated analysis of high signal-to-noise/low-artifact data for gain, phase, and asymmetry. Variability increased significantly for the lower signal-to-noise ratio/higher artifact files. Operator intervention generally improved accuracy and decreased variability, but there were cases in which operator intervention reduced accuracy.