Association between diabetes distress and sociodemographic and/or socioeconomic factors among adults: A cross-sectional study.

Diabetes-related distress (DRD) is a psychological syndrome with worsened prognosis in uncontrolled diabetic patients. The current study aimed to assess the factors contributing to DRD among the Lebanese population using the Diabetes Distress Scale (DDS-17) score and its sub-scores. A cross-sectional analysis was conducted between March and September 2021 enrolling. 125 diabetic from six Lebanese governorates through an online survey. The survey included two parts: the first section gathered sociodemographic data sociodemographic and socioeconomic data and the second one focused on assessing the Diabetes Distress Scale (DDS-17) score. Participants 30 years old and above had higher emotional distress compared to younger patients, (65.2 % versus 45.5 %). Those with a primary educational level showed significantly higher emotional distress than those with a secondary and tertiary level of education (72.5 %, versus 66.7 % and 46.4 %). Participants who were treated with both insulin and non-insulin medications or had a diastolic blood pressure of more than 90 mmHg showed significantly moderate to high distress (63.6 % or 53.8 %). Participants who lived in rural areas showed higher distress (35.6 %). Obese and overweight had significant moderate to high distress (64.1 %, and 48.0 %). The same results were found in non-married (divorced or widowed) and married participants (76.9 % and 51.3 %). The association between medical history with total distress showed that participants with glycemic store HbA1c of more than 6.5 followed by those who had HbA1c between 5.7 and 6.4 showed moderate to high total distress (45.9 % and 40.0 %). It is concluded that the prevalence of DRD is high in Lebanon, more common among rural residents, and among participants high HbA1c, low educational level, unmarried and on complex treatment regimens. Screening for DRD and providing better support can optimize clinical outcomes.

Assessment of Tocilizumab (Humanized Monoclonal Antibody) for Therapeutic Efficacy and Clinical Safety in Patients with Coronavirus Disease (COVID-19).

Background and objectives: COVID-19 patients exhibit a broad range of manifestations, presenting with a flu-like respiratory tract infection that can advance to a systemic and severe disease characterized by pneumonia, pulmonary edema, severe damage to the airways, and acute respiratory distress syndrome (ARDS, causing fatality in 70% of COVID-19 cases). A 'cytokine storm' profile is found in most severely influenced COVID-19 patients. The treatment protocol of the disease also includes tocilizumab, which is a humanized monoclonal antibody used to treat autoimmune and inflammatory conditions. This study was designed (1) to assess the role of tocilizumab in COVID-19 patients regarding therapeutic efficacy through evaluation of cytokine release syndrome (CRS) resolution and anticoagulant effect, analyzing clinical safety via monitoring of associated adverse effects profile; and (2) to compare the clinical safety and therapeutic efficacy of institutional treatment regimen (alone) versus tocilizumab added to an institutional treatment module in COVID-19 patients. Materials and Methods: In this study, the endpoints parametric assessment of severely diseased patients of COVID-19 was performed (total n = 172, control group (institutional protocol treatment provided), n = 101 and test group (tocilizumab provided), n = 71) at the Khyber Teaching Institution, MTI, Peshawar. The assessments were compared using non-parametric analyses at baseline and after a follow-up of 12−18 days until the patient discharged or expired. Results: Results of the study revealed an insignificant difference among the control vs. test group in resolving inflammatory parameters (C-reactive protein (CRP) 21.30 vs. 50.07; p = 0.470, ferritin 482.9 vs. 211.5; p = 0.612, lactate dehydrogenase (LDH) 29.12 vs.18.8; p = 0.0863, and D-dimer 464 vs.164.4; p = 0.131). However, a statistically significant difference was found between the control group and test group regarding coagulation parameters (international normalized ratio (INR) 0.12 vs. −0.07; p ≤ 0.001; activated partial thromboplastin time (aPTT) 0.42 vs. −1.16; p ≤ 0.001; prothrombin time (PT) 0.31 vs. −0.96; p ≤ 0.001; platelet count −12.34 vs. −1.47; p = 0.012) and clinical survival rate (89.10 vs. 90.14; p < 0.001). Furthermore, there was significantly higher infection rates and raised alanine aminotransferase (ALT) and alkaline phosphatase (ALP) associated with the tocilizumab group as compared to those receiving institutional treatment (bacterial infections: 0.99% vs. 15.49%; p ≤ 0.01, ALT: 3.96% vs. 28.16%; p ≤ 0.01, ALP: 1.98% vs. 22.53%; p ≤ 0.01). Conclusions: From this study, it was concluded that tocilizumab can be a better drug of choice in terms of efficacy, particularly in resolving coagulopathy in severe COVID-19 patients.

GC/MS Analyses of the Essential Oils Obtained from Different Jatropha Species, Their Discrimination Using Chemometric Analysis and Assessment of Their Antibacterial and Anti-Biofilm Activities.

The essential oils of Jatropha intigrimma, J. roseae and J. gossypifolia (Euphorbiaceae) were analyzed employing GC/MS (Gas Chromatography coupled with Mass Spectrometry) analyses. A total of 95 volatile constituents were identified from J. intigrimma, J. gossypifolia and J. roseae essential oils, accounting for 91.61, 90.12, and 86.24%, respectively. Chemometric analysis using principal component analysis (PCA) based on the obtained GC data revealed the formation of three discriminant clusters due to the placement of the three Jatropha species in three different quadrants, highlighting the dissimilarity between them. Heneicosane, phytol, nonacosane, silphiperfol-6-ene, copaborneol, hexatriacontane, octadecamethyl-cyclononasiloxane, 9,12,15-Octadecatrienoic acid, methyl ester and methyl linoleate constitute the key markers for their differentiation. In vitro antibacterial activities of the essential oils were investigated at doses of 10 mg/mL against the Gram-negative anaerobe Escherichia coli using the agar well diffusion method and broth microdilution test. J. gossypifolia essential oil showed the most potent antimicrobial activity, demonstrating the largest inhibition zone (11.90 mm) and the least minimum inhibitory concentration (2.50 mg/mL), followed by the essential oil of J. intigrimma. The essential oils were evaluated for their anti-adhesion properties against the Gram-negative E. coli biofilm using a modified method of biofilm inhibition spectrophotometric assay. J. intigrimma essential oil showed the most potent biofilm inhibitory activity, demonstrating the least minimum biofilm inhibitory concentration (MBIC) of 31.25 µg/mL. In silico molecular docking performed within the active center of E. coli adhesion protein FimH showed that heneicosane, followed by cubebol and methyl linoleate, displayed the best fitting score. Thus, it can be concluded that the essential oils of J. gossypifolia and J. intigrimma leaves represent promising sources for antibacterial drugs with antibiofilm potential.