Efficacy of oral insulin nanoparticles for the management of hyperglycemia in a rat model of diabetes induced with streptozotocin.

Insulin is the cornerstone of treatment in type 1 diabetes mellitus. However, because of its protein structure, insulin has to be administered via injection, and many attempts have been made to create oral formulations, especially using nanoparticles (NPs). The aim of this study was to compare the hypoglycemic effect of insulin-loaded NPs to that of subcutaneous insulin in an in vivo rat model of diabetes. We used biodegradable D-α-tocopherol polyethylene glycol succinate-emulsified, chitosan-capped poly(lactic-co-glycolic acid) NPs loaded with soluble human insulin in a dose of 20 IU/kg body weight, and examined the physical characteristics of NPs in vivo and in vitro. Serum glucose levels were reduced after 6 h, but the difference was not significant compared to subcutaneous insulin; at 12 h and 24 h, insulin levels were significantly higher in rats treated with NPs than in rats treated with subcutaneous insulin. There was no significant difference in serum insulin levels at 12 h and 24 h compared to non-diabetic rats. Our findings suggest that chitosan-based NPs are able to maintain good glycemic control for up to 24 h and can be considered a potential carrier for oral insulin delivery.

Insulin-induced lipodystrophy and predisposing factors in children and adolescents with type 1 diabetes mellitus (T1DM) in a tertiary care Egyptian center.

BACKGROUND: Lipodystrophy (LH) is one of the most common complications of subcutaneous insulin injection. Many factors are incriminated in the evolution of LH in children with diabetes type 1 (T1DM). LH may affect insulin absorption in the skin areas involved, resulting in a negative impact on blood glucose levels and glycemic variability. PATIENTS AND METHODS: We calculated and evaluated the prevalence of LH in relation to possible clinical factors associated with the development of LH in a cohort of children (n =115) with T1DM using insulin pens or syringes and we studied possible predisposing factors including their age, duration of T1DM, injection technique, insulin dose/kg, degree of pain perception, and HbA1c level. RESULTS: In our cross-sectional study, 84% of patients were using pens for insulin injection and 52.2 % of them were rotating the site of injection on daily basis. 27 % did not experience pain during an injection while 6 % had the worst hurt. 49.5 % had clinically detectable LH. Those with LH had higher HbA1c levels and more unexplained hypoglycemic events compared to those without LH (P: 0.058). The hypertrophied site was related to the preferred site of injection which was the arms in 71.9 % of the cases. Children who had LH were older with a longer duration of T1DM, rotating sites of injection less frequently, and were more frequently reusing needles compared to children without LH (P: < 0.05). CONCLUSION: Improper insulin injection technique, older age, and longer duration of T1DM were associated with LH. Proper education of patients and their parents must include correct injection techniques, rotating injection sites, and minimal reuse of needles.

miRNAs as potential game-changers in renal cell carcinoma: Future clinical and medicinal uses.

Renal cell carcinoma (RCC) has the highest mortality rate of all genitourinary cancers, and its prevalence has grown over time. While RCC can be surgically treated and recurrence is only probable in a tiny proportion of patients, early diagnosis is crucial. Mutations in a large number of oncogenes and tumor suppressor genes contribute to pathway dysregulation in RCC. MicroRNAs (miRNAs) have considerable promise as biomarkers for detecting cancer due to their special combination of properties. Several miRNAs have been proposed as a diagnostic or monitoring tool for RCC based on their presence in the blood or urine. Moreover, the expression profile of particular miRNAs has been associated with the response to chemotherapy, immunotherapy, or targeted therapeutic options like sunitinib. The goal of this review is to go over the development, spread, and evolution of RCC. Also, we emphasize the outcomes of studies that examined the use of miRNAs in RCC patients as biomarkers, therapeutic targets, or modulators of responsiveness to treatment modalities.

Recent advances and applicable flexibility potential of electrochemical processes for wastewater treatment.

This study examined >140 relevant publications from the last few years (2018-2021). In this study, classification was reviewed depending on the operation's progress. Electrocoagulation (EC), electrooxidation (EO), electroflotation (EF), electrodialysis (ED), and electro-Fenton (EFN) processes have received considerable attention. The type of action (individual or hybrid) for each electrochemical procedure was evaluated, and statistical analysis was performed to compare them as a new manner of reviewing cited papers providing a massive amount of information efficiently to the readers. Individual or hybrid operation progress of the electrochemical techniques is critical issues. Their design, operation, and maintenance costs vary depending on the in-situ conditions, as evidenced by surveyed articles and statistical analyses. This work also examines the variables affecting the elimination efficacy, such as the applied current, reaction time, pH, type of electrolyte, initial pollutant concentration, and energy consumption. In addition, owing to its efficacy in removing toxins, the hybrid activity showed a good percentage among the studies reviewed. The promise of each wastewater treatment technology depends on the type of contamination. In some cases, EO requires additives to oxidise the pollutants. EF and EFN eliminated lightweight organic pollutants. ED has been used to treat saline water. Compared to other methods, EC has been extensively employed to remove a wide variety of contaminants.

Linear growth and prevalence of the different components of the metabolic syndrome (MetS) in young obese nondiabetic children (below 5 years) in comparison to older obese children (6-12 years).

BACKGROUND: In Qatar, the prevalence of metabolic syndrome (MetS) in children and adults is increasing in parallel with the markedly increasing trends in obesity rates. OBJECTIVE: The aim of our study was to assess the prevalence of different components of MetS, measure plasma atherogenic indexes (AIP), and to evaluate linear growth in young obese nondiabetic children (< 5 years) in comparison to older obese children (6-12 years).  Methods:  We analysed the anthropometric and biochemical profile of 135 random sample obese children who attended to the Paediatric Clinic of Hamad Medical Centre (HGH) in Doha (Qatar) from January 2018 to December 2019. RESULTS: A large proportion of children presented with obesity, around the age of 5 years, were obese at the end of their first year of life (63.8%) and more were obese at the 2 years of age (82.6%). Significantly rapid gain in weight and linear growth occurred during the first 6 months of postnatal life. Moreover, some metabolic risk factors and high AIP occurred more frequently in older obese children compared to young obese children. CONCLUSIONS: This study documented the early occurrence of different components of the MetS in young obese children and the progressive increase of their prevalence in older prepubertal children. Most of obese children who presented at or below 5 years of age had significant obesity and rapid linear growth during the first two years (infancy). These two findings pointed out to the necessity to impose early detection and preventive measures on a national scale.

Can electrocoagulation technology be integrated with wastewater treatment systems to improve treatment efficiency?

Considerable amounts of domestic and industrial wastewater that should be treated before reuse are discharged into the environment annually. Electrocoagulation is an electrochemical technology in which electrical current is conducted through electrodes, it is mainly used to remove several types of wastewater pollutants, such as dyes, toxic materials, oil content, chemical oxygen demand, and salinity, individually or in combination with other processes. Electrocoagulation technology used in hybrid systems along with other technologies for wastewater treatment are reviewed in this work, and the articles reviewed herein were published from 2018 to 2021. Electrocoagulation is widely employed in integrated systems with other electrochemical technologies or conventional methods for effective removal of different pollutants with less cost and sometimes over shorter durations of operation. It has also been observed that the hybrid effects besides increasing the removal efficiency can overcome the disadvantages of using electrocoagulation alone, such as less sludge formation, high cost of operation and increased life of the used electrodes, and stable flux of water with longer periods of operation. More than 20 types of other technologies have been combined efficiently with electrocoagulation.

Review Nutritional interventions during adolescence and their possible effects.

Nutrition is one of the most important factors affecting pubertal development. Increasing demands for energy proteins and micronutrients are necessary to cope with the rapid linear pubertal growth and development, change in body composition, and increased physical activity. Adequate nutrition is a key permissive factor for the normal timing and tempo of pubertal development. Severe primary or secondary malnutrition also can adversely delay the onset and progression of puberty. The higher incidence of anorexia nervosa and bulimia in adolescents imposes a nutritional risk on pubertal development. Here we provide an overview of nutritional requirements (macronutrients and micronutrients) necessary to cope with these changes. In addition, we discuss possible nutritional interventions trials and their effects on several aspects of growth and development in undernourished and stunted adolescents, in low- and middle-income countries (LMIC), who require nutritional rehabilitation. This mini-review sums up some important findings in this important complex that links between nutrition, nutritional interventions, and pubertal development.

The association between juvenile autoimmune hepatitis and HLA-DRB1 alleles: Iraqi tertiary center experience.

AIM OF THE STUDY: To highlight the impact of the human leukocyte antigen (HLA) allele on susceptibility and prevention of autoimmune hepatitis (AIH) in Iraqi children. MATERIAL AND METHODS: We conducted a prospective study from children attending the Gastroenterology and Hepatology Clinic of Children's Welfare Teaching Hospital over five years from the first of September 2015 to the thirty-first of August 2020. It included 19 patients with AIH; their age (at time of diagnosis) ranged between 3 and 16 years, with a female predominance of 78.9%. The diagnosis was made by clinical, serological, and histological features. In addition, 20 age- and sex-matched unrelated subjects of the same ethnic background were selected randomly from healthy individuals undergoing checkup as controls. RESULTS: 19 patients diagnosed with AIH were included in this study, and 20 age- and sex-matched healthy controls, with a female predominance of 78.9%. The commonest autoantibodies found were smooth muscle antibody (SMA) in 13 (68.4%), antinuclear antibody (ANA) in 11 (57.9%). In AIH type 1, PCR showed higher frequencies among patients with HLA-DRB1*03, HLA-DRB1*04, HLA-DRB1*13 alleles in patients with AIH; moreover DRB1*11 and DRB1*15 were less frequent than in the control group. Frequency of HLA-DRB1*04 was 28% and HLA-DRB1*13 was 20% in AIH type 2 patients; HLA-DRB1*13 and HLA-DRB5 showed frequency of 25% for both and HLA-DRB4 frequency was 18.7%. CONCLUSIONS: HLA-DRB1*13, DRB1*04, and DRB1*03 are susceptibility alleles for the development of AIH type 1, while HLA-DRB1*13, HLA-DRB4 and DRB5 are susceptibility alleles for the development of AIH type 2 in Iraqi children.

Electrocoagulation treatment of high saline oily wastewater: evaluation and optimization.

The present work provides to treat real oily saline wastewater released from drilling oil sites by the use of electrocoagulation technique. Aluminum tubes were utilized as electrodes in a concentric manner to minimize the concentrations of 113400 mg TDS/L, 65623 mg TSS/L, and the ions of 477 mg HCO3/L, 102000 mg Cl/L and 5600 mg Ca/L presented in real oily wastewater under the effect of the operational parameters (the applied current and reaction time) by making use of the central composite rotatable design. The final concentrations of TDS, TSS, HCO3, Cl, and Ca that obtained were 93555 ppm (17.50%), 11011 ppm (83.22%), 189ppm (60.38%), 80000ppm (22%), and 4200 ppm (25%), respectively, under the optimum values of the operational parameters (1.625 Amps and 40 min). In spite of the low removal percentages of some pollutants, the present study proved the ability of this novel designed reactor for treating high saline real oily wastewater in accordance with the operational parameters. This prove the capability of the use of it as a pre-treatment of other conventional methods.

Long-term prednisone versus hydrocortisone treatment in children with classic Congenital Adrenal Hyperplasia (CAH) and a brief review of the literature.

BACKGROUND: Debate still exist about the safety of long-term use of prednisone (PD) versus hydrocortisone (HC) for treating children with congenital adrenal hyperplasia -21OH D (CAH). Despite recent developments in congenital adrenal hyperplasia -21OH D (CAH), several issues related to patient growth and final height remain unsolved. Debate still exist about the safety of long-term use of PD versus HC for treating children with CAH. The mechanism by which glucocorticoid therapy interferes with growth is complex and multifactorial. Relatively slight supra-physiologic levels may be enough to blunt growth velocity. An increased risk of developing obesity is another possible consequence of hyper-cortisolism in children with CAH. OBJECTIVES OF THE STUDY: To evaluate the anthropometric and biochemical effects of long-term PD versus HC treatment in children with CAH-21OHD. A brief review of the literature is also reported. PATIENTS AND METHODS: This retrospective study evaluated linear growth and biochemical data of thirty children with classic CAH (19 females and 11 males), who were on PD (n=22) or HC (n=8) treatment, since their first diagnosis. Clinical data included age, gender, duration of therapy, dose of HC and or equivalent dose of HC in the PD group, blood pressure, height (Ht) and weight. Ht-SDS and BMI were also calculated. Biochemical data included measurement of 17- OH progesterone, cholesterol, triglycerides (TG), HDL, LDL, fasting glucose, and insulin concentrations. HOMA-IR was calculated. Carotid intima-media thickness (CIMT) was measured using high-resolution B-mode ultrasonography. Thirty normal age matched children were used as controls for the anthropometric and CIMT data. RESULTS: The age of children and duration of treatment did not differ among the two treatment groups. After a mean of 6 years of treatment, the Ht-SDS and BMI did not differ between the three groups of children. The equivalent hydrocortisone dose of children on prednisone was significantly higher than the dose for the hydrocortisone group. Both systolic and diastolic blood pressures (BP) of children on PD was slightly higher compared to those on hydrocortisone group. However, the BP of the 2 treatment groups was not different compared to control children. Fasting blood glucose, homeostatic model assessment insulin resistance (HOMA-IR), plasma TG, HDL, and cholesterol did not differ among the two treatment groups. LDL levels were significantly higher in the PD group versus the HC group. The mean CIMT did not differ among the two treatment groups but was significantly higher in the treated groups versus controls. There was a significant linear correlation between BMI-SDS and CIMT (r=0.37, p=0.047). CONCLUSIONS: Children with CAH-21OHD who were kept on PD therapy for 6.4±2.7 years, since the beginning of diagnosis, have maintained normal linear growth. No difference in BMI, HOMA-IR, or CIMT was detected among the two treated groups. The efficiency, safety and convenience of a single daily dose of PD could be a good and relatively safe alternative to HC for the continuing medical treatment of patients with CAH-21OHD. However, more prospective studies across childhood and adolescence are necessary to draw definitive conclusions.