Assembling a Coculture System to Prepare Highly Pure Induced Pluripotent Stem Cell-Derived Neurons at Late Maturation Stages.

Generation of human induced pluripotent stem cell (hiPSC)-derived motor neurons (MNs) offers an unprecedented approach to modeling movement disorders such as dystonia and amyotrophic lateral sclerosis. However, achieving survival poses a significant challenge when culturing induced MNs, especially when aiming to reach late maturation stages. Utilizing hiPSC-derived motor neurons and primary mouse astrocytes, we assembled two types of coculture systems: direct coculturing of neurons with astrocytes and indirect coculture using culture inserts that physically separate neurons and astrocytes. Both systems significantly enhance neuron survival. Compared with these two systems, no significant differences in neurodevelopment, maturation, and survival within 3 weeks, allowing to prepare neurons at maturation stages. Using the indirect coculture system, we obtained highly pure MNs at the late mature stage from hiPSCs. Transcriptomic studies of hiPSC-derived MNs showed a typical neurodevelopmental switch in gene expression from the early immature stage to late maturation stages. Mature genes associated with neurodevelopment and synaptogenesis are highly enriched in MNs at late stages, demonstrating that these neurons achieve maturation. This study introduces a novel tool for the preparation of highly pure hiPSC-derived neurons, enabling the determination of neurological disease pathogenesis in neurons at late disease onset stages through biochemical approaches, which typically necessitate highly pure neurons. This advancement is particularly significant in modeling age-related neurodegeneration.

Protocol to image and quantify nucleocytoplasmic transport in cultured cells using fluorescent in situ hybridization and a dual reporter system.

Nucleocytoplasmic transport (NCT) plays critical roles in maintaining cellular homeostasis. Here, we present a protocol to measure NCT for both transcript and protein cargos in cultured cells. We first describe the fluorescent in situ hybridization (FISH) assay to measure the nuclear mRNA export. We then detail a dual reporter system to measure the protein NCT. This protocol also includes image analysis and data output using CellProfiler™. The combined approach can be used to unbiasedly analyze NCT activities in cultured cells. For complete details on the use and execution of this protocol, please refer to Ding et al. (2020, 2021).

Generation of highly pure motor neurons from human induced pluripotent stem cells.

Generation of human motor neurons (MNs) overcomes the inaccessibility to patient brain tissues and greatly facilitates the research in MN-related diseases. Here, we describe a protocol for generation of neural progenitor cells (NPCs) from human induced pluripotent stem cells (hiPSCs), followed by preparation of functional MNs. The optimized induction condition with the expression of three transcription factors in a single lentiviral vector significantly improved the yield and purity, making it possible to biochemically identify dysregulated factors in diseased neurons. For complete details on the use and execution of this protocol, please refer to Ding (2021), Ding et al. (2021), and Sepehrimanesh and Ding (2020).

OLGA- and OLGIM-Based Staging in the Patients with Gastritis and Endoscopy Indications.

BACKGROUND: Gastric cancer is one of the most common cancers with high mortality. In Iran, the high-risk regions include Northern and Northwestern parts. The aim of this study was to assess the operative link on gastritis assessment- and operative link on gastric intestinal metaplasia-based staging in patients with upper gastrointestinal symptoms. METHODS: Totally, 345 patients underwent upper gastrointestinal endoscopy. Also, the status of Helicobacter pylori infection was evaluated using rapid urease test and histological method. Moreover, histological changes were assessed using the Update Sydney System. The operative link on gastritis assessment- and operative link on gastric intestinal metaplasia-based stages of 0-II were considered as low-risk stages and stages III and IV were considered as high-risk stages. RESULTS: Most of the patients were lower than 60 years (245 patients, 71%), and 71.9% of our patients had H. pylori infection. The frequency of atrophic gastritis and intestinal metaplasia was 44.9% and 25.2%, respectively (P < .001). Eleven patients (73.7%) with gastric adenocarcinoma had a low risk and 2 patients with low-grade dysplasia had a high risk of operative link on gastritis assessment and operative link on gastric intestinal metaplasia. Almost, 62.5% of gastric cancer patients with an intestinal type of gastric adenocarcinoma were at low-risk stages. CONCLUSIONS: Although high stages of operative link on gastritis assessment and operative link on gastric intestinal metaplasia need further follow-up, lower stages of atrophy or intestinal metaplasia also require follow-up. Furthermore, operative link on gastritis assessment method in detecting a greater number of patients who need follow-up is more successful and profitable.

Direct conversion of adult fibroblasts into motor neurons.

Generation of patient-derived neurons provides an unprecedented approach in modeling neurological diseases. Here, we describe the direct conversion of adult fibroblasts into motor neurons via lentiviral delivery of transcription factors. Compared with iPSC-based approach, directly converted neurons from donors retain features associated with age, making them ideal systems for modeling age-related neurological diseases. Low yield is the major challenge of this protocol. High quality lentiviruses and optimized cell culture conditions are critical to improve the final yield. For complete details on the use and execution of this protocol, please refer to Ding et al. (2020), Ding et al. (2021), and Liu et al. (2016).

Nucleocytoplasmic Transport: Regulatory Mechanisms and the Implications in Neurodegeneration.

Nucleocytoplasmic transport (NCT) across the nuclear envelope is precisely regulated in eukaryotic cells, and it plays critical roles in maintenance of cellular homeostasis. Accumulating evidence has demonstrated that dysregulations of NCT are implicated in aging and age-related neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), Alzheimer's disease (AD), and Huntington disease (HD). This is an emerging research field. The molecular mechanisms underlying impaired NCT and the pathogenesis leading to neurodegeneration are not clear. In this review, we comprehensively described the components of NCT machinery, including nuclear envelope (NE), nuclear pore complex (NPC), importins and exportins, RanGTPase and its regulators, and the regulatory mechanisms of nuclear transport of both protein and transcript cargos. Additionally, we discussed the possible molecular mechanisms of impaired NCT underlying aging and neurodegenerative diseases, such as ALS/FTD, HD, and AD.

A study on the potential role of autophagy-related protein 10 as a biomarker for ulcerative colitis.

PURPOSE: Ulcerative colitis (UC) is a lifelong disease with unclear etiology and increasing prevalence worldwide. Autophagy has been reported to play roles in the pathogenesis and progression of UC. Here, we aimed to analyze the expression of autophagy related protein 10 (ATG10) and its regulator, micro-RNA (miR) 519a, in UC patients. METHODS: The level of ATG10 in the serum, stool, and colon biopsies from 15 UC patients and 30 non-UC healthy individuals (HC) group was measured by ELISA. Also, the blood level of miR-519a was investigated by quantitative real-time PCR. RESULTS: We found 13.63 ng/ml versus 0.99 ng/ml, 11.01 ng/ml versus 1.11 ng/ml and 6.41 ng/ml versus 3.21 ng/ml of ATG10 in the stool, colon tissue, and serum of UC and HC, respectively. There was no significant difference in the expression of miR-519a in the blood samples of UC and HC. CONCLUSIONS: ATG10 might be a potential non-invasive diagnostic biomarker for UC.

Epidemiologic profile of viral hepatitis B and C in North of Iran: results from PERSIAN Guilan Cohort Study (PGCS).

OBJECTIVE: Hepatitis B (HB) and C (HC) are two severe viral infectious diseases with a deleterious impact on global health. This study aimed to evaluate the prevalence of HB and HC in the Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study using immunological and molecular methods. RESULTS: The blood samples were obtained from 10,520 enrolled participants. Complete biochemical and hematological tests, as well as urine analysis, were assessed. The presence of HBsAg, anti-HBs, anti-HBc, and anti-HCV antibodies for all participant and HBeAg and anti-HBe antibodies for HB-positive patients were evaluated. Moreover, HB genomic DNA and HC genomic RNA were extracted from serum samples of HB-positive patients. The real-time PCR assay was employed to quantify the gene copies of hepatitis B and C viruses. HC genotyping was also performed. The prevalence of HB and HC was 0.24% (95% CI 0.16-0.35) and 0.11% (95% CI 0.06-0.19), respectively. Rural participants were significantly more HB-positive than the urban people (P = 0.045), while males were significantly more HC-positive than the females (P = 0.013). The prevalence of HB and HC in this area were lower than those of other geographical locations of Iran, which may be due to different lifestyles or other unknown reasons.

The Therapeutic Effect of Shark Liver Oil in a Rat Model of Acetic Acid-Induced Ulcerative Colitis.

Ulcerative colitis (UC) is one of the most well-known types of inflammatory bowel disease that manifests as recurrent inflammation of rectum and colon. The goal of this study is to evaluate the protective effects of shark liver oil (SLO) on acetic acid-induced ulcerative colitis in rats. Eighty induced UC rats were randomly divided into ten equal groups and received the following treatments for seven days: 1 ml of normal saline rectally, 1 ml of gel base (carboxymethyl cellulose) rectally, 10 mg/kg of Asacol rectally, 10 mg/kg of mesalazine orally, 5% gel form of SLO rectally, 10% gel form of SLO rectally, 200 mg of SLO orally, and 400 mg of SLO orally. We examined the oxidative stress indices, histopathological features, and body weight changes, as well as the function of the liver and kidneys at the end of treatment. Administration of 10% rectal and 400 mg oral SLO resulted in a significant weight gain. Also, glutathione peroxidase activity was significantly higher in 5% and 10% SLO-treated groups, and elevated superoxide dismutase activity in rats that received 5% SLO was observed compared to negative control and Asacol groups. While no significant changes were observed in most of the kidney and liver function markers, higher levels of aspartate aminotransferase were detected in the group that received 400 mg SLO orally compared to negative control and Asacol groups. Many histopathological signs of improvement were observed in mesalazine, Asacol, and SLO groups. There were no significant changes detected in the mean rank among different groups. Our data indicate that SLO supplementation could improve the amelioration of acetic acid-induced UC in rats due to its antioxidant effects.

Naproxen, isosorbide dinitrate and co-administration cannot prevent post-endoscopic retrograde cholangiopancreatography pancreatitis: Randomized controlled trial.

BACKGROUNDS/AIMS: Acute pancreatitis is the most widespread complication of endoscopic retrograde cholangiopancreatography. Here, we investigated the efficacy of rectal suppository naproxen, sublingual isosorbide dinitrate and their co-administration in the prevention of post-ERCP pancreatitis. METHODS: This double-blind randomized clinical trial carried out from June 2015 to February 2016 at the Gastrointestinal and Liver Diseases Research Center in Rasht, Iran. A total of 585 patients were selected from candidates for diagnostic or therapeutic ERCP by using the simple sampling method. Patients divided into three groups. Group A received 500 mg naproxen, group B took 5 mg isosorbide dinitrate, and group C was co-administrated both agents before ERCP. The primary outcome measure was the development of pancreatitis onset of pain in the upper abdomen and increase of serum amylase activity more than 3 times over the upper normal limit (60-100 IU/L) within first the 24 h post-ERCP. RESULTS: Totally, 80 patients developed PEP included 29 (4.9%), 24 (4.1%), and 27 (4.6%) patients in groups A, B, and C, respectively (p=0.845). Longer ERCP time (p=0.041), using diazepam (p=0.033), a higher number of pancreatic ducts cannulation (p＜0.001), pancreatic duct injection (p=0.013), and using pancreatic stent (p=0.004) were the predisposing factors for PEP. CONCLUSIONS: Our findings indicated that prophylactic naproxen suppository or isosorbide dinitrate sublingually or co-administration had no significant difference in the prevention and severity of PEP, however, enhancing the endoscopist's skills can be effective. Departments and educational hospitals should develop their assessment and quality assurance measures for the training of fellows' not only technical training but also an understanding of the diagnostic and therapeutic roles of the procedure.

Generation and optimization of highly pure motor neurons from human induced pluripotent stem cells via lentiviral delivery of transcription factors.

Generation of neurons from human induced pluripotent stem cells (hiPSCs) overcomes the limited access to human brain samples and greatly facilitates the progress of research in neurological diseases. However, it is still a challenge to generate a particular neuronal subtype with high purity and yield for determining the pathogenesis of diseased neurons using biochemical approaches. Motor neurons (MNs) are a specialized neuronal subtype responsible for governing both autonomic and volitional movement. Dysfunctions in MNs are implicated in a variety of movement diseases, such as amyotrophic lateral sclerosis (ALS). In this study, we generated functional MNs from human iPSCs via lentiviral delivery of transcription factors. Moreover, we optimized induction conditions by using different combinations of transcription factors and found that a single lentiviral vector expressing three factors [neurogenin-2 (NGN2), insulin gene enhancer 1 (ISL1), and LIM/homeobox 3 (LHX3)] is necessary and sufficient to induce iPSC-derived MNs (iPSC-MNs). These MNs robustly expressed general neuron markers [microtubule-associated protein 2 (MAP2), neurofilament protein (SMI-32), and tubulin ß-3 class III (TUBB3)] and MN-specific markers [HB9 and choline acetyltransferase (ChAT)] and showed electrical maturation and firing of action potentials within 3 wk. This approach significantly improved the neuronal survival, yield, and purity, making it feasible to obtain abundant materials for biochemical studies in modeling movement diseases.

Pathophysiological role of Atg5 in human ulcerative colitis.

BACKGROUND/AIMS: Ulcerative colitis (UC), along with Crohn's disease, is one of the main types of inflammatory bowel disease (IBD). On the other hand, deregulated autophagy is involved in many chronic diseases, including IBD. In this study, we aimed to investigate the role of Atg5 and microRNA-181a (miR-181a) in the pathophysiology of UC. METHODS: Colon biopsy, stool, and blood samples of 6 men and 9 women were confirmed for UC. Also, 13 men and 17 women were selected as healthy control (HC). Enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry were used to measure the Atg-5 content of the colon biopsies. Besides, the serum and stool levels of Atg5 were measured using ELISA. Moreover, the total RNA of blood cells was extracted and evaluated for the expression of miR-181a. RESULTS: We found 1.2 ng/mL versus 0.46 ng/mL, 0.34 ng/mL versus 0.24 ng/mL, and 0.082 ng/mL versus 0.062 ng/mL of Atg5 in stool, intestinal tissue, and serum of UC and HCs, respectively. There was no significant difference in the expression of miR-181a in the blood samples of UC and HCs. Immunohistochemistry showed high positivity without any significant difference between the 2 groups in the quantitative analysis. CONCLUSIONS: The significant difference observed between the stool Atg5 content of the HCs and UC patients may provide new insight into using this protein as a diagnostic biomarker, however, considering the small size of our studied population further studies are needed.

Association Between Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome with Gallstone Disease, South Iran: A Population-Based Study.

AIM: Gallstone disease (GSD), non-alcoholic fatty liver disease (NAFLD), and metabolic syndrome (MetS) are common problems. The aim of this study was to investigate the association between NAFLD, MetS and its components with GSD. MATERIALS AND METHODS: This cross-sectional study was conducted as a part of the Kavar Cohort Study (KCS) affiliated to Shiraz University of Medical Sciences, Shiraz, Iran between January 2012 and January 2018. A total of 2239 participants of the general population of the KCS were selected randomly. Ultrasonography for GSD and NAFLD diagnosis and clinical and laboratory assaying for MetS evaluation were performed for the participants. The National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP-III) and Criteria for Clinical Diagnosis of MetS in Iranian Adults (CCDMIA) were used for diagnosis of MetS. RESULTS: Overall, 59 patients with GSD and 177 age- and sex- matched participants without gallstones as a comparison group were enrolled. According to GSD groups, NAFLD was observed in 42.4% and 22.6% of patients with and without GSD, respectively, and the difference between the two groups was statistically significant (P = 0.003). MetS was present in 33.9% and 39.0% of GSD subjects, compared with 32.8% and 33.3% of the non-GSD group, based on NCEP/ATPIII and CCDMIA, respectively. Although the mean of all components of MetS except HDL-cholesterol were higher in the GSD group than in the non-GSD group,  the difference was only significant in waist circumference (P = 0.041). CONCLUSION: The present study found an obvious association between NAFLD and GSD. This study also showed a significant association between increasing waist circumference and risk of GSD. We recommend that patients with GSD should be evaluated for the likelihood of NAFLD and its treatment in addition to lifestyle changes to gain proper weight. However, further researches are needed to clarify the relationship between the nature of GSD, NAFLD, and obesity.

Validity and inter-observers reliability of blood pressure measurements using mercury sphygmomanometer in the PERSIAN Guilan cohort study.

OBJECTIVE: Accurate measuring of blood pressure is a vital step in both clinical and para-clinical settings. The aims of the present study were to evaluate the validity and inter-observer reliability of measured blood pressures by two trained observers and one expert supervisor in the PERSIAN Guilan cohort study (PGCS). PARTICIPANTS AND METHODS: In a quasi-experimental study, two trained observers and one expert supervisor measured systolic and diastolic blood pressures (SBP and DBP) in 85 included participants. All measurements were done using Riester mercury sphygmomanometer as duplicate for each people. RESULTS: Lack of validity in the total SBP (P = 0.017), DBP in age <50 years (P = 0.039), and DBP in BMI >25 (P=0.019) of first observer and total SBP (P = 0.045), SBP of male (P = 0.019), both SBP and DBP in age >50 years (P = 0.034, P = 0.012) and DBP in BMI <25 (P = 0.001) of second observer were seen. In addition, total inter-rater reliability was found as 12.2% and 27.2% in SBP and DBP, respectively. Age, sex and BMI categorized inter-observer reliability were not more than 15% in SBP of BMI <25 kg/m and 31.6% in DBP of female. The final inter-observer agreement after educational course was higher than 0.7 totally and in all categorical evaluations. CONCLUSION: Based on lack of validity in some conditions and low level of reliability, education of all observers to measure both SBP and DBP accurately is needed. This is more necessary to done before performing the high population surveys.

Serum levels of interleukin-23 and 35 in patients with and without type 2 diabetes mellitus and chronic periodontitis.

BACKGROUND: Type 2 diabetes mellitus (DM) and chronic periodontitis (CP) show common pathophysiological features. We investigated the serum levels of IL-23 and IL-35 in people with type 2 DM and CP. METHODS: In a cross-sectional study, 72 patients were divided into four equal groups: group A, participants without type 2 DM and CP; group B, patients with type 2 DM without CP; group C, patients with CP and without type 2 DM; and group D, patients with type 2 DM and CP. Demographic data were obtained and periodontal conditions including clinical attachment loss, bleeding on probing, plaque index, gingival index, and probing depth was evaluated on all existing teeth. Fasting blood sugar (FBS) levels, hemoglobin (Hb) A1c, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were assessed. In addition, serum levels of IL-23 and 35 were measured using enzyme-linked immunosorbent assay. RESULTS: The serum levels of IL-23 and 35 showed no significant differences between all groups (P>0.05). A significant positive correlation between the serum concentration of IL-23 and clinical attachment loss in the control group (r: 0.548, P=0.019) was detected. A significant negative correlation between IL-35 and the plaque index in group B (r: -0.578, P=0.012), plus significant negative correlations between IL-23 with ESR (r: -0.487, P=0.040) and CRP (r: -0.498, P=0.035) in groups C and D were also detected. CONCLUSION: Despite significant associations of serum concentration of IL-23 and 35 with certain periodontal and inflammatory indices, neither type 2 DM nor CP differentially affects serum levels of these two cytokines.

Prevalence of pre-cancerous colon lesions in referred patients under patronage of a local relief foundation in Guilan province.

Colon cancer is the most commonly diagnosed gastrointestinal cancers in developed countries with varied incidence and the onset age of disease worldwide. Overall, 161 participants who were under patronage of a local relief foundation and referred to the endoscopy ward of Razi Hospital affiliated to the Guilan University of Medical Sciences. These patients have been aged more than 50 or more than 40 years with history of colorectal cancer in their first-degree family were enrolled from March 2016-March 2017. Demographic information were collected. Colonoscopy was performed and histopathological evaluation of observed lesions and polyps was done. Most of participants were female (113 individuals, 70.2%) and aged 50-60 years (83 individuals, 51.6%). Seventy-four (46%) had certain lesions. Most of colonoscopy findings were observed in the ascending colon in which depressed polyps and diverticulum were most frequent. However, rectum showed the most histological findings. All polyps of descending and ascending colons were neoplastic, while most of rectal polyps were non-neoplastic. Male patients, who were aged more than 60 years and smokers had significant higher percentage of both lesions and polyps in their colon (p<0.05). Moreover, significant positive association was detected between exposure to harmful industries and having polyps (p=0.01). We found male gender, higher age, smoking, and exposure to harmful industries as important risk factors for having colorectal lesions, which must be confirmed in further studies.

Prevalence of non-alcoholic fatty liver disease in patients with diabetes mellitus, hyperlipidemia, obesity and polycystic ovary syndrome: A cross-sectional study in north of Iran.

BACKGROUND AND AIM: The aim of this study was to describe the frequency of non-alcoholic fatty liver disease (NAFLD) in patients with diabetes mellitus (DM), hyperlipidemia, obesity and polycystic ovaries syndrome (PCOS). METHODS: In a cross-sectional study, 333 patients who had one of the certain diagnosis of DM, hyperlipidemia, obesity or PCOS were enrolled. Information about demographics, anthropometric, nutritional habitude, smoking history, medical history and physical activity were recorded. Liver ultrasound examination and routine biochemistry analysis were performed. RESULTS: Among 333 patients with one of the four above-mentioned diseases. 199 patients (59.8%) had NAFLD. Male were more likely to have NAFLD than female (72.8% vs. 50.8% respectively, P < 0.001). About, 80.7% of patients through 41-50 years age had NAFLD. The frequency of abnormal fasting blood glucose, alanine aminotransferase (ALT), triglyceride, and total cholesterol were significantly higher in patients with NAFLD (P < 0.05). Subjects with NAFLD had a higher body mass index than non-NAFLD (33.6 ±â€¯7.9 kg/m2 vs. 31.1 ±â€¯5.0 kg/m2 respectively, P = 0.002). Patients with DM, hyperlipidemia, hypertension, and hypothyroidism were more likely to have NAFLD (P < 0.05). Patients with consumption of supper, high-fat diet, enjoy of eating and smoking were more likely to have NAFLD and patients with fruit and vegetable uptake and physical activity were less likely to have NAFLD (P < 0.05). CONCLUSIONS: As most patients with NAFLD are asymptomatic, employed individuals with higher education levels, with a history of smoking and unhealthy diet along with DM, hyperlipidemia, PCOS and obesity seriously have to be followed and educated for lifestyle modification.

Only serum pepsinogen I and pepsinogen I/II ratio are specific and sensitive biomarkers for screening of gastric cancer.

Purpose We aimed to determine optimal cut-off points of plasma levels of ghrelin and serum levels of pepsinogen I, II, and their ratio for screening of gastric cancer (GC). Methods Blood samples were taken from 41 patients with confirmed gastric cancer along with 82 patients without malignancy. Serum levels of pepsinogen I and II, plus plasma levels of acylated ghrelin were measured using commercial ELISA kits. Results The case group had significant lower plasma levels of ghrelin, pepsinogen I, and pepsinogen I/II ratio in comparison to the control group (P<0.001). In the control group, there was significant higher serum pepsinogen I (P=0.028) and pepsinogen II (P=0.003) and lower pepsinogen I/II ratio (P=0.020) in males versus females; significantly higher serum pepsinogen II (P=0.047) and lower pepsinogen I/II ratio (P=0.030) in overweight compared to normal weight patients; and significantly lower pepsinogen I/II ratio (P=0.030) in smokers versus non-smoker. In the case group, there was only significantly lower pepsinogen I (P=0.006) in males versus females, and significantly lower plasma ghrelin (P=0.017) in overweight compared to normal weight patients. The characteristic curve analysis indicated that pepsinogen I at a cut-off of 70.95 µg/L and pepsinogen I/II ratio at cut-off of 2.99, had good sensitivity and specificity. Conclusions Just serums levels of pepsinogen I and the ratio of pepsinogen I/II can be used as biomarker to screen GC.

The First Report about the Laparoscopic Sleeve Gastrectomy-Induced Lactose Intolerance.

The impact of laparoscopic sleeve gastrectomy (LSG) on the lactose intolerance (LI) remains unclear. We checked 8 men and 34 women with mean body mass index (BMI) of 43.94 ± 5.89 kg/m2 for LI using hydrogen breath test and clinical examination before LSG and at 3 months postoperation. In addition to appropriate weight loss (34.30 ± 5.51 kg/m2), 1 man and 3 women, who had not LI at starting, were suffered from LI at 3 months postoperation. Among these four patients, the most and least LI was seen in women who had the lowest and highest percentage of excess BMI loss. It seems LSG can induce LI which must be monitored in postoperative follow-ups.

Date Palm (Phoenix dactylifera): Novel Findings and Future Directions for Food and Drug Discovery.

Phoenix dactylifera is a useful traditional medicinal plant, mainly the fruit is used, which is the edible part of the plant (Ajwa date). It is now considered to be a valuable source of natural medicinal products against various diseases. Phytochemical investigations have shown that the fruit contains anthocyanins, phenolics, sterols, carotenoids, and flavonoids. The fruits are a rich source of carbohydrates, vitamins, and proteins. P. dactylifera is considered as a complete diet because it also contains different fatty acids, amino acids, proteins, and steroidal substances. This review highlights the phytochemical composition, nutritional significance, and potential health benefits of P. dactylifera and discusses its potential as a functional food for disease prevention, management, and treatment.