Association of plasma folic acid, vitamin-B12 and homocysteine with recurrent pregnancy loss. "A case control study".

Objective: To investigate the relationship of serum homocysteine, folic acid, and vitamin-B12 levels with recurrent pregnancy loss (RPL). Methods: A case-control study was conducted in the Department of Gynecology and Obstetrics, Dr. Ruth Pfau Civil Hospital, Karachi from July 2021 to June 2022. Total 124 participants were recruited from gynecology outpatient department after taking informed consent. The participants included 62 non-pregnant females with two or more consecutive unexplained RPLs and 62 healthy women having at least two successful deliveries without any pregnancy loss. Serum folic acid and vitamin-B12 levels were measured by chemiluminescent method and serum homocysteine was measured by enzyme-linked immunosorbent assay (ELISA). Comparison of quantitative variables with RPL cases and control was done by Mann-Whitney U-test (for non-normally distributed data) and independent sample t-test (for normally distributed data), while Pearson's chi-square test was used for the association of qualitative variables with RPL cases and control. Correlation of homocysteine with vitamin-B12 and folic acid was assessed in RPL cases. Results: The median age of the study population was 27 (IQR 25-32) years. The median body mass index (BMI) was 26.25 (IQR 22-29) kg/m2. Cases had significantly lower serum folic acid (p-value=0.022), while vitamin-B12 was decreased in cases as compared to controls (p-value=0.295). Mean concentration of serum homocysteine was higher in RPL cases as compared to controls (p-value=0.094). There was significant association of serum vitamin B12 (p-value=0.001) and folic acid levels (p-value=0.004) with RPL. The homocysteine was not significantly correlated with vitamin-B12 (r=0.124, p=0.338) and folic acid (r=0.067, p=0.606) in the RPL group. Conclusion: Reduced level of serum folic acid and vitamin B12 was significantly associated with RPL cases, while homocysteine was marginally raised however the difference was not significant. Folic acid and vitamin B12 supplementation before next pregnancy in RPL patients is likely to be beneficial in improving pregnancy outcomes.

Efficacy of warm compresses in preserving perineal integrity and decreasing pain during normal labor: A systematic review and meta-Analysis.

The objective of the study was to assess the effect of warm compresses in preserving perineal integrity in women who delivered a single baby vaginally with cephalic presentation. We searched PubMed, Scopus, and the ISI Web of Science databases. Two researchers worked independently and conducted the study's search, selection, and extraction. We calculated the pooled risk ratio (R.R.)- for our categorical outcomes- and mean difference (M.D.)-for our continuous outcomes- using random or fixed-effect meta-analysis according to heterogenicity status. I2 test was used to detect heterogenicity. Studies were assessed for methodological quality using the Cochrane risk of bias assessment tool. Our study analyzed 13 controlled trials (n= 3947) to compare warm compresses versus not using it during vaginal delivery. The analysis revealed that warm compresses group had better outcomes regarding episiotomy, degree of perineal trauma (third and fourth degree), perineal trauma requiring suturing, and also in behavioral pain scales (severe muscle tense, being very restless, and constant grimacing) with the following R.R. and confidence intervals: (R.R.= 0.56, 95% C.I.[0.23, 1.37]), (R.R.= 0.69, 95% C.I.[0.54, 0.89], p= 0.004),( (R.R.= 0.37, 95% C.I.[0.18, 0.77], p= 0.004), and ( (R.R.= 0.42, 95% C.I.[0.23, 0.78], p= 0.006) respectively. We conclude that among primiparous women, warm compresses group showed better outcome in improving perineal comfort than a the good of women who did not receive warm compresses after delivery.

miR-363-3p/PTEN is involved in the regulation of lipid metabolism by genistein in HepG2 cells via ERß.

BACKGROUND: Genistein (GEN) is one of the most well-known phytoestrogens identified in various legumes. Although increasing evidence shows GEN has a potential use in phytotherapy to regulate lipid metabolism, its therapeutic mechanisms have not yet been completely elucidated, especially epigenetic alterations of miRNAs to alleviate lipid accumulation in the liver remains unknown. PURPOSE: To clarify how GEN modulates the miRNA profile in HepG2 cells and investigate molecular mechanisms of the modulated miRNA on regulating hepatic lipid metabolism. METHODS: The miRNA microarray was performed to compare the miRNAs expression patterns, followed by determining principal miRNA and its target gene associated with hepatic lipid metabolism modulated by GEN. miR-363-3p mimics (mi) and phosphatase and tensin homolog (PTEN)-siRNA were transfected into HepG2 cells and GEN was further treated with the cells for 24 h RESULTS: GEN induced downregulation of miR-363-3p and upregulation of PTEN, which was a target mRNA of miR-363-3p. The miR-363-3p mi led to an upregulation of sterol-regulatory element-binding protein-1c (SREBP-1c) and its downstream lipid synthesis-related factors in HepG2 cells. In addition, the inhibition of PTEN led to an increase of lipogenesis, which was associated with the AKT/mTOR signal regulation. However, GEN treatment could abrogate the lipogenic effects of miR-363-3p mi or PTEN siRNA. The modulation was associated with estrogen receptor ß (ERß). CONCLUSION: We discerned a new mechanism that GEN regulated hepatic lipid metabolism by inhibiting miR-363-3p, which could be mediated via ERß and by targeting PTEN in HepG2 cells. Additionally, GEN reduced hepatic lipid accumulation by regulating PTEN-AKT/mTOR signal. It implicated a protective role of GEN by elucidating its epigenetic modification of the miRNA modulated by ERß on improving hepatic lipid metabolism and provided novel evidence of the mechanism on targeting miR-363-3p/PTEN in treating hepatic lipid disorders.

Industrial Application and Health Prospective of Fig (Ficus carica) By-Products.

The current review was carried out on the industrial application of fig by-products and their role against chronic disorders. Fig is basically belonging to fruit and is botanically called Ficus carica. There are different parts of fig, including the leaves, fruits, seeds and latex. The fig parts are a rich source of bioactive compounds and phytochemicals including antioxidants, phenolic compounds, polyunsaturated fatty acids, phytosterols and vitamins. These different parts of fig are used in different food industries such as the bakery, dairy and beverage industries. Fig by-products are used in extract or powder form to value the addition of different food products for the purpose of improving the nutritional value and enhancing the stability. Fig by-products are additive-based products which contain high phytochemicals fatty acids, polyphenols and antioxidants. Due to the high bioactive compounds, these products performed a vital role against various diseases including cancer, diabetes, constipation, cardiovascular disease (CVD) and the gastrointestinal tract (GIT). Concussively, fig-based food products may be important for human beings and produce healthy food.

Chia seeds (Salvia hispanica L.): A therapeutic weapon in metabolic disorders.

The growth of functional components containing agricultural foods is enhancing because these components aid the human body against different chronic diseases. Currently, chia seeds basically belong to the mint family and are edible seeds of Salvia hispanica. These seeds are composed of different functional components including fiber, polyphenols, antioxidants, omega-3 fatty acid vitamins, minerals, and peptides. Besides, these seeds are also a good source of vegetable protein, unsaturated fat, carbohydrates, and ash. Chia seed components are helpful in cardiovascular disease (CVD) by reducing blood pressure, platelet aggregation, cholesterol, and oxidation. In GI-tract-related diseases like diabetes and constipation, chia fiber reduces the blood glucose level and provides bulk to stool. However, antioxidants and polyphenols are protected beta cells of the pancreas from inflammation. These components are protected from the cell damage of the different body parts, which can provide help in different types of cancer including breast, colorectal, liver, and pancreatic. Conclusively, some pervious studies approved that chia seed components are played important role in chronic diseases.

Crocin: Functional characteristics, extraction, food applications and efficacy against brain related disorders.

Crocin is a bioactive compound that naturally occurs in some medicinal plants, especially saffron and gardenia fruit. Different conventional and novel methods are used for its extraction. Due to some control conditions, recent methods such as ultrasonic extraction, supercritical fluid extraction, enzyme-associated extraction, microwave extraction, and pulsed electric field extraction are widely used because these methods give more yield and efficiency. Crocin is incorporated into different food products to make functional foods. However, it can also aid in the stability of food products. Due to its ability to protect against brain diseases, the demand for crocin has been rising in the pharmaceutical industry. It also contain antioxidant, anti-inflammatory, anticancer and antidepressant qualities. This review aims to describe crocin and its role in developing functional food, extraction, and bioavailability in various brain-related diseases. The results of the literature strongly support the importance of crocin against various diseases and its use in making different functional foods.

Potential Role of Phytochemical Extract from Saffron in Development of Functional Foods and Protection of Brain-Related Disorders.

The present review is designed to measure the effects of saffron extract in functional foods and its pharmacological properties against various disorders. Saffron is a traditional medicinal plant used as a food additive. The stigma of saffron has bioactive compounds such as safranal, crocin, crocetin, picrocrocin, kaempferol, and flavonoid. These bioactive compounds can be extracted using conventional (maceration, solvent extraction, soxhlet extraction, and vapor or hydrodistillation) and novel techniques (emulsion liquid membrane extraction, ultrasound-assisted extraction, enzyme-associated extraction, pulsed electric field extraction, microwave-assisted extraction, and supercritical fluid extraction). Saffron is used as a functional ingredient, natural colorant, shelf-life enhancer, and fortifying agent in developing different food products. The demand for saffron has been increasing in the pharma industry due to its protection against cardiovascular and Alzheimer disease and its antioxidant, anti-inflammatory, antitumor, and antidepressant properties. Conclusively, the phytochemical compounds of saffron improve the nutrition value of products and protect humans against various disorders.

Mechanism of Astragalus membranaceus Alleviating Acquired Hyperlipidemia Induced by High-Fat Diet through Regulating Lipid Metabolism.

Astragalus membranaceus (AM) is a food and medicinal homologous plant. The current research is aimed to investigate the beneficial effects and mechanisms of AM in treating acquired hyperlipidemia. The network pharmacology and bioinformatics analysis results showed 481 AM-related targets and 474 acquired hyperlipidemia-associated targets, and 101 candidate targets were obtained through the intersection, mainly enriched in endocrine resistance, AGE-RAGE in diabetic complications and p53 signaling pathways. Quercetin, kaempferol, calycosin, formononetin and isorhamnetin were determined as the candidate active components of AM in the treatment of acquired hyperlipidemia. Moreover, key targets of AM, namely, AKT serine/threonine kinase 1 (AKT1), vascular endothelial growth factor A (VEGFA), cyclin D1 (CCND1) and estrogen receptor 1 (ESR1), were screened out, which were closely related to adipogenesis, fatty acid metabolism and bile acid metabolism. The subsequent animal experiments showed that AM extract treatment improved the lipid profiles of the high-fat diet (HFD)-fed mice by reducing lipogenesis and increasing lipolysis and lipid ß-oxidation, which were associated with the downregulating of AKT1 and CCND1, and the upregulating of VEGFA and ESR1 in liver and adipose tissue. Overall, AM alleviated acquired hyperlipidemia through regulating lipid metabolism, and AKT1, VEGFA, CCND1 and ESR1 might be the key targets.

Hematology and serum biochemistry of captive Sunda pangolin (Manis javanica) in Wildlife Reserves Singapore.

The Sunda pangolin (Manis javanica) faces threat of extinction due to illegal trafficking of its scales for the purpose of traditional medicine in the Asian region. Ex-situ captive breeding and reintroduction programs have been identified to be a key effort in the conservation of the species. The establishment of blood parameters for captive Sunda pangolins are vital to assess the health in these animals during health assessments. The objective of this study is to establish blood parameters for captive Sunda pangolins and compare the blood parameters with the established blood reference ranges for rescued wild Sunda pangolins in Singapore. Blood parameters for hematology and serum biochemistry were established from 13 clinically normal captive Sunda pangolins. Male captive Sunda pangolins were found to have significantly (P<0.05) higher potassium compared to the female captive Sunda pangolins. Captive Sunda pangolins were found to have significantly (P<0.05) lower white blood cell count (WBC), neutrophil counts, alanine phosphatase (ALP) and phosphorus and significantly (P<0.05) higher PCV, TP, globulin and blood urea nitrogen (BUN) when compared with rescued wild Sunda pangolins from the previous study.

Pharmacological effects of oral vitamin D intake on pulmonary function Test and Interleukin-17 in adult asthmatic patients in Karachi.

Vitamin D is an anti-inflammatory and immuno-modulatory secosteroid. Previous studies showed strong link between childhood and adult onset asthma with vitamin D. Interleukin 17 is an inflammatory cytokine and plays a major role in the worsening of asthma. The aim of this study is to compare the effects of serum vitamin D on serum IL 17 and pulmonary function test (FVC, FEV1, FEV1/FVC) before and after oral vitamin D supplementation. Fifty severe asthmatic patients were selected from out patient department of Chest Medicine Ward, Jinnah post graduate medical center, Karachi. Spirometry was performed by vitalograph compact. Baseline values were as follows: serum vitamin D=13.19±2.37ng/ml, IL-17=20.70±2.13ng/ml, FVC=2.31±0.40L, FEV1=1.40±0.28L,FEV1/FVC=60.15±4.61%. Subjects were given 1000 IU of oral vitamin D capsule per day for six weeks. After this trial all values were found as serum vitamin D=19.03±1.26ng/ml (p<0.001), IL 17=15.40ng/ml (p<0.001), FVC=2.90±0.60 L (p<0.001), FEV1=2.01±0.10L (p<0.001), FEV1/FVC=63.79% ±1.45 (p<0.001). It may be concluded that improvement in serum vitamin D levels improves the status of lung functions, decreases the airway inflammation and hence may decrease the asthma severity.

Hematology and serum biochemistry parameters for rescued common palm civets (Paradoxurus hermaphroditus) in different age groups.

Currently, there are no complete parameters established for serum biochemistry and hematology for the determination of health status of rescued common palm civets (Paradoxurus hermaphroditus). In this study, blood samples were obtained from 18 adults and 15 juvenile civets caught on Singapore Main Island. Significant age-related differences (P<0.05) were noted in the hemoglobin, erythrocyte count, packed cell volume (PCV), total serum protein and globulin concentration in the adult civets showing higher values compared with the juvenile civets. The mean corpuscular volume (MCV), the alkaline phosphatase (ALP) and the phosphorus concentrations were significantly higher (P<0.05) in juveniles compared with adult civets.

Cyclosporine induced nephrotoxicity in renal transplant recipients: clinical significance of fractional excretion of sodium, potassium and magnesium.

OBJECTIVE: Evaluation of fractional excretion of Sodium, Potassium and Magnesium as indicators of cyclosporine (CsA) toxicity in de-novo renal transplant recipients. METHODS: A prospective study was conducted on 59 live related renal allograft recipients. Fractional excretion(FE) of sodium (Na+), potassium (K+) and magnesium (Mg2+) were calculated on day 1, 3, 5 and 10 post transplant. Graft dysfunctions were evaluated by colour-Doppler, CsA levels and renal biopsy. Normal ranges were determined on 30 healthy subjects. RESULTS: The mean creatinine on day 1 was 3.1 +/- 1.3 mg/dl and declined to 1.6 +/- 1.2 on day 10. FE of Na+, K+ and Mg2+ were 12 +/- 9%, 34 +/- 20% and 13 +/- 10% respectively on day 1 and reduced to 2.2 +/- 2%, 11 +/- 14% and 11 +/- 14% on day 10. Of the 59 recipients, 38 (64%) had uneventful recovery (group A), 21(36%) had graft dysfunction [6 acute rejection (group B) and 15 either acute tubular necrosis or high CsA(group C)]. In group A, on day 1, FENa+, FEK+ and FEMg2+ were 5 +/- 4%, 24 +/- 12% and 6.6 +/- 3% respectively and these declined to 1.2 +/- 0.6%, 4.6 +/- 0.7% and 6 +/- 3% respectively on day 10. Compared to group A, group C had significantly high values on day 1, FENa+ 15 +/- 8%, FEK+ 36 +/- 24% and FEMg2+ 21 +/- 10% (p < 0.0001) and on day 10, FENa+ 3.7 +/- 2.7%, FEK+ 20 +/- 15% and FEMg2+ 15 +/- 8% (p < 0.05). In the group B, day 1 and day 10 levels were FENa+ 6 +/- 3%, FEK+ 26 +/- 13% and FEMg2+ 7 +/- 2.8% and FENa+ 1.2 +/- 0.7%, FEK+ 4.2 +/- 0.5%, FEMg2+ 7 +/- 4% respectively. CsA levels and AUC did not correlate with CsA toxicity. CONCLUSION: FE of magnesium is a useful marker of CsA toxicity independent of CsA blood levels. FE studies can supplement renal biopsy findings.