Design, development and preclinical assessment of MENAVip-ICP, a new snake antivenom with potential coverage of species in the Middle East and North Africa regions.

Snakebite in the Middle East and North Africa (MENA) is a public health problem whose magnitude is not fully known. Several antivenoms are available in these regions, but these formulations are designed for restricted geographical settings. Many countries do not have local production of antivenoms and must access products whose clinical performance has not been demonstrated. We hypothesize that it is possible to unify the treatment for viperid snakebites of MENA in a single antivenom formulation. Hereby we describe the design, development and preclinical evaluation of an antivenom of broad geographical coverage for this region (MENAVip-ICP). We produced this antivenom from the plasma of horses immunized with eight medically important venoms of viperid snake species from MENA. For this, we used a strategy based on two stages: first, immunization of horses with North African (NA) venoms, followed by a second immunization stage, on the same horses, with MENA venoms. We purified antivenoms from both stages: the Anti-NA and the final product Anti-MENA (MENAVip-ICP). Anti-NA was considered as intermediate formulation and was purified with the intention to study the progression of the immunoglobulin immune response of the horses. Antivenoms from both stages neutralized lethal, hemorrhagic, and procoagulant activities of homologous venoms. Compared to Anti-NA, MENAVip-ICP improved the neutralization profile of intravenous lethality and in vitro procoagulant activities of venoms. A notable finding was the difference in the neutralization of lethality when MENAVip-ICP was assessed intraperitoneally versus intravenously in the murine model. Intraperitoneally, MENAVip-ICP appears more effective in neutralizing the lethality of all venoms. Furthermore, MENAVip-ICP neutralized the lethal activity of venoms of species from other regions of MENA, Central/East Asia, and Sub-Saharan Africa that were not included in the immunization protocol. Our results showed that MENAVip-ICP neutralizes the main toxic activities induced by viperid MENA venoms at the preclinical level. Consequently, it is a promising product that could be clinically assessed for the treatment of snakebite envenomings in this region.

Prevalence and associated risk factors of Helicobacter pylori infection in East Africa: a systematic review and meta-analysis.

BACKGROUND: Helicobacter pylori is the main cause of chronic gastritis, peptic ulcer, lymphoma, and gastric cancer in humans. The prevalence and factors associated with H. pylori infection are varied across countries. Thus, a comprehensive review has not been done on prevalence and associated factors in East Africa. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence and identify factors associated with H. pylori infection in East Africa. METHODS: Articles written in English language were retrieved from PubMed, Scopus, and Science Direct. Relevant articles were selected and screened using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Publication bias was assessed qualitatively and qualitatively using funnel plot symmetry and Egger's test, respectively. Heterogeneity was assessed using the I2 measure. Data were analyzed using Stata software, version 14, and the "metan" command. RESULTS: A total of 231 articles were retrieved from nineteen countries in East Africa. Of these, 70 articles were eligible for the review. The pooled prevalence of H. pylori in East Africa was 50.98% (95% CI: 45.05-56.90). The prevalence of H. pylori infection ranged from 7.7 to 94.5% in East African countries. The highest pooled prevalence was from Sudan (61.3%, 95% CI: 52.6-69.9), and the lowest prevalence was reported from Uganda (40.7%, 95% CI: 33-48.3). Persons with no formal education (OR: 2.03; 95% CI: 1.22-2.83), lack of hand washing habit after toilet (OR: 2.24; 95% CI: 1.45-3.02), having a history of dyspepsia (OR: 2.25; 95% CI: 1.31-3.18), living in rural areas (OR = 1.80; 95% CI: 0.38-3.23), and having unclean water source (OR = 1.5; 95% CI:0.45-3.45) were all associated with higher risk for H. pylori infection. CONCLUSION: More than half of the populations of East African countries were positive for H. pylori infection. Rural residence, source of water, and alcohol consumption were significantly associated with H. pylori infection. Therefore, healthcare workers could provide health education on the aforementioned risk factors, and the government and other stakeholders could improve the source of drinking water in East Africa.

Long-term outcomes for epidemic viral pneumonia survivors after discharge from the intensive care unit: a systematic review

ABSTRACT Objective To review the long-term outcomes (functional status and psychological sequelae) of survivors of critical illnesses due to epidemic viral pneumonia before the COVID-19 pandemic and to establish a benchmark for comparison of the COVID-19 long-term outcomes. Methods This systematic review of clinical studies reported the long-term outcomes in adults admitted to intensive care units who were diagnosed with viral epidemic pneumonia. An electronic search was performed using databases: MEDLINE®, Web of Science™, LILACS/IBECS, and EMBASE. Additionally, complementary searches were conducted on the reference lists of eligible studies. The quality of the studies was assessed using the Newcastle-Ottawa Scale. The results were grouped into tables and textual descriptions. Results The final analysis included 15 studies from a total of 243 studies. This review included 771 patients with Influenza A, Middle East Respiratory Syndrome, and Severe Acute Respiratory Syndrome. It analyzed the quality of life, functionality, lung function, mortality, rate of return to work, rehospitalization, and psychiatric symptoms. The follow-up periods ranged from 1 to 144 months. We found that the quality of life, functional capacity, and pulmonary function were below expected standards. Conclusion This review revealed great heterogeneity between studies attributed to different scales, follow-up time points, and methodologies. However, this systematic review identified negative long-term effects on patient outcomes. Given the possibility of future pandemics, it is essential to identify the long-term effects of viral pneumonia outbreaks. This review was not funded. Prospero database registration: (www.crd.york.ac.uk/prospero) under registration ID CRD42021190296.

Prevalence of Salmonella infection in village chickens and determination of the tetracycline resistance genes in the Salmonella isolates in the Sistan region, Iran.

Recently, an increasing number of multi drug resistant Salmonella species have been emerged due to overuse of antibiotics in veterinary and human medicine which has adverse consequences on public health. The present study was conducted with the aim of investigating the prevalence of Salmonella infection in village chickens in Sistan region and determining the prevalence of the antibiotic resistance genes in Salmonella isolated from these birds. In this study, 100 chickens were randomly selected from five counties of Sistan region. A cloacal swab sample was taken from each bird and also information about age, gender, breed, proximity with other birds, proximity with waterfowl, proximity with livestock, and receiving different antibiotics especially tetracycline were obtained using a questionnaire. Conventional culture methods used for Salmonella detection and isolation. Then, amplification of invA gene by PCR was used to confirm Salmonella colonies. Finally, 27 samples were confirmed to be infected with Salmonella by both culture and PCR methods. Disk diffusion method was used to determine the sensitivity to 4 antibiotics including; tetracycline, gentamicin, cefepime, and difloxacin. The results of the present study showed that proximity to waterfowl (OR = 0.273) significantly mitigates the risk of Salmonella infection. For the isolates, the highest resistance was recorded against cefepime and the highest susceptibility was to difloxacin. The presence proportion of tetA and tetB in tetracycline resistant isolates was higher than that in susceptible ones but this difference was not statistically significant.

Rapid Epidemic Expansion of Chikungunya Virus East/Central/South African Lineage, Paraguay.

The spread of Chikungunya virus is a major public health concern in the Americas. There were >120,000 cases and 51 deaths in 2023, of which 46 occurred in Paraguay. Using a suite of genomic, phylodynamic, and epidemiologic techniques, we characterized the ongoing large chikungunya epidemic in Paraguay.

Narrative Review of the Evolution of COVID-19 Vaccination Recommendations in Countries in Latin America, Africa and the Middle East, and Asia.

The rapid rollout of vaccines to combat the coronavirus disease 2019 (COVID-19) pandemic over the past 2 years has resulted in the use of various vaccine platforms and regional differences in COVID-19 vaccine implementation strategies. The aim of this narrative review was to summarize evolving COVID-19 vaccine recommendations in countries in Latin America, Asia, and Africa and the Middle East across various vaccine platforms, age groups, and specific subpopulations. Nuances in primary and booster vaccination schedules were evaluated, and the preliminary impact of such diverse vaccination strategies are discussed, including key vaccine effectiveness data in the era of Omicron-lineage variants. Primary vaccination rates for included Latin American countries were 71-94% for adults and between 41% and 98% for adolescents and children; rates for first booster in adults were 36-85%. Primary vaccination rates for adults in the included Asian countries ranged from 64% in the Philippines to 98% in Malaysia, with corresponding booster rates varying from 9% in India to 78% in Singapore; for adolescents and children, primary vaccination rates ranged from 29% in the Philippines to 93% in Malaysia. Across included African and Middle Eastern countries, primary vaccination rates in adults varied widely from 32% in South Africa to 99% in the United Arab Emirates; booster rates ranged from 5% in South Africa to 60% in Bahrain. Evidence from the regions studied indicates preference of using an mRNA vaccine as a booster on the basis of safety and effectiveness of observed real-world data, especially during circulation of Omicron lineages. Vaccination against COVID-19 remains of paramount importance to reduce the burden of disease; strategies to overcome vaccine inequity, fatigue, hesitancy, and misinformation and to ensure adequate access and supply are also important.

Hygiene Practices and Early Childhood Development in the East Asia-Pacific Region: A Cross-Sectional Analysis.

Poor hygiene might be a risk factor for early childhood development (ECD). This study investigated the associations of three hygiene practices ('wash hands before a meal,' 'wash hands after going to the toilet,' and 'brush teeth'), separately and combined, with ECD. Six thousand six hundred ninety-seven children (4 [0.8] years) from the East Asia-Pacific Early Child Development Scales validation study were included in this cross-sectional analysis. The hygiene variables were recoded to have comparable values as 'always,' 'sometimes,' and 'never.' These variables were then grouped to create combined categories. The binary outcome variables, poor ECD, were defined as a score < age-specific 25th centile. Modified Poisson regression models were used to analyse the associations. Data collection was performed between 2012 and 2014, and the analyses were conducted in April 2022. Compared with children who 'always' washed their hands before a meal, those who did it 'sometimes' (Prevalence Ratio [PR]: 1.30 [95% CI: 1.16-1.46]) or 'never' (PR: 1.35 [1.18-1.55]) had a higher likelihood of poorer overall development. Comparable results were identified for the other two hygiene practices and the other four domain-specific outcomes (p < 0.05). Compared with children who always followed the three hygiene practices, the likelihood of poor overall ECD increased as the combined hygiene practice decreased among children with poor hygiene practices (PRnever: 1.67 [1.40-2.00]; PRrarely: 1.49 [1.30-1.71]; PRsometimes: 1.30 [1.14-1.49]). Children who did not always follow good hygiene practices had a higher likelihood of poor ECD independently of sociodemographic factors. Considering these findings, future hygiene practice interventions and trials should consider including ECD outcomes.

Comparative Screening of Mexican, Rwandan and Commercial Entomopathogenic Nematodes to Be Used against Invasive Fall Armyworm, Spodoptera frugiperda.

The fall armyworm (FAW), Spodoptera frugiperda Smith (Lepidoptera: Noctuidae) is an important pest of maize originating from the Americas. It recently invaded Africa and Asia, where it causes severe yield losses to maize. To fight this pest, tremendous quantities of synthetic insecticides are being used. As a safe and sustainable alternative, we explore the possibility to control FAW with entomopathogenic nematodes (EPN). We tested in the laboratory whether local EPNs, isolated in the invasive range of FAW, are as effective as EPNs from FAW native range or as commercially available EPNs. This work compared the virulence, killing speed and propagation capability of low doses of forty EPN strains, representing twelve species, after placing them with second-, third- and sixth-instar caterpillars as well as pupae. EPN isolated in the invasive range of FAW (Rwanda) were found to be as effective as commercial and EPNs from the native range of FAW (Mexico) at killing FAW caterpillars. In particular, the Rwandan Steinernema carpocapsae strain RW14-G-R3a-2 caused rapid 100% mortality of second- and third-instar and close to 75% of sixth-instar FAW caterpillars. EPN strains and concentrations used in this study were not effective in killing FAW pupae. Virulence varied greatly among EPN strains, underlining the importance of thorough EPN screenings. These findings will facilitate the development of local EPN-based biological control products for sustainable and environmentally friendly control of FAW in East Africa and beyond.

Molecular mechanisms for the modulation of blood pressure and potassium homeostasis by the distal convoluted tubule.

Epidemiological and clinical observations have shown that potassium ingestion is inversely correlated with arterial hypertension prevalence and cardiovascular mortality. The higher the dietary potassium, the lower the blood pressure and mortality. This phenomenon is explained, at least in part, by the interaction between salt reabsorption in the distal convoluted tubule (DCT) and potassium secretion in the connecting tubule/collecting duct of the mammalian nephron: In order to achieve adequate K+ secretion levels under certain conditions, salt reabsorption in the DCT must be reduced. Because salt handling by the kidney constitutes the basis for the long-term regulation of blood pressure, losing salt prevents hypertension. Here, we discuss how the study of inherited diseases in which salt reabsorption in the DCT is affected has revealed the molecular players, including membrane transporters and channels, kinases, and ubiquitin ligases that form the potassium sensing mechanism of the DCT and the processes through which the consequent adjustments in salt reabsorption are achieved.

Fruit and vegetable consumption during the COVID-19 lockdown in Sri Lanka: an online survey.

Purpose: The COVID-19 pandemic has drastically altered the dietary patterns of individuals. This study aimed to investigate the changes in the purchase and consumption of fruit and vegetables in Sri Lanka during the COVID-19 pandemic. Methods: An online cross-sectional survey assessed the self-reported changes in fruit and vegetable consumption and purchase using Google forms. Logistic regression analyses were performed to assess the association between decreased consumption of imported fruits and increased home-grown food intake with socio-demographic variables. Results: Among the 3621 survey respondents, 63.0% and 43.3% reported a decreased intake of imported and local fruits purchased from the market, respectively. Although the overall vegetable consumption has declined, the leafy vegetable consumption has increased by 40.7%. Imported fruit intake has significantly reduced among youngsters, males, respondents living in municipal areas, employed, and those with lower monthly incomes. Among the respondent, 48.9% declared an increased consumption of home-grown fruits or vegetables. Responders living away from Colombo and rural areas were more likely to report a higher intake of home-grown fruits and vegetables (OR 2.021; 95% CI, 1.762-2.318, P < 0.001). Employed males residing in municipal areas were less likely to report an increased intake (OR 0.689; 95% CI, 0.574-0.827, P < 0.001). Conclusion: Purchase of imported and local fruits from the market has reduced. Although the overall vegetable consumption was decreased, there has been an increase in the consumption of leafy vegetables. Furthermore, consumption of home-grown fruits and vegetables has increased considerably. Well-established food distribution programs are essential in future pandemics to promote healthy eating.

DNA methylation level of gene SIRT1 in ram spermatozoa and relationship with fertilizing ability according to breed and age

Background: Effect of the epigenetic factors on the male fertility is well proofed. Sperm acts as a carrier of genetic material, and its DNA methylome can affect maternal pregnancy rate and offspring phenotype. However, the research on the DNA methylation in the spermatozoids of livestock males, in particular rams, is still limited. To best of our knowledge the data about as a global as well as gene specific DNA methylation in ram spermatozoa from different breeds and ages are missed in the scientific literature. The present study was designed to analyze the relationship between methylation levels of the important for spermatogenesis gene SIRT1 in spermatozoa and fertilizing ability of sperm in rams from different breeds and ages. Materials, Methods & Results: The ejaculates of 16 rams from Lacaune, East Friesian and Assaf breeds at age between 18 to 96 months were evaluated. The kinematic parameters of 2 semen samples from each animal were estimated by CASA. The separated spermatozoa were used for DNA extraction followed by bisulfite conversion. The DNA methylation of SIRT1 was detected through quantitative methylation-specific PCR using 2 sets of primers designed specifically for bisulfite-converted DNA sequences to attach methylated and unmethylated sites. The breed and age effect on the gene SIRT1 methylation by ANOVA was estimated. Experimental females included 393 clinically healthy milk ewes (Lacaune, n = 131; East Friesian sheep, n = 100 and Assaf, n = 162) in breeding season. Reproductive performances (conception rate at lambing, lambing percentage and fecundity) of ewes, inseminated by sperm of the investigated rams, were statistically processed. ANOVA showed that the animal breed influences significantly on the level of DNA methylation of gene SIRT1 in ram spermatozoa (P = 0.002) An average value of DNA methylation of SIRT1 in ram sperm from Lacaune breed was significantly higher than in Assaf and East Friesian (81.21 ± 15.1% vs 36.7 ± 14.2% and 38.3 ± 18.6 respectively, P < 0.01). The highest percent of SIRT1 methylation was observed in old animals compared to the young and middle-age. Moderate and strong correlations (r from 0.44 to 0.71, P < 0.05) between the methylation level of the SIRT1 gene in rams' sperm and reproductive parameters of inseminated ewes in all breeds were established. Discussion: Our data are the first message about the effect of breed on the specificity of DNA methylation of gene SIRT1 in ram spermatozoa. These results demonstrated an existence of the sheep breeds with high and low level of DNA methylation of gene SIRT1 in ram sperm. Although the effect of age on the methylation level in sperm is still discussable, our results showed a moderate correlation between age and methylation level of SIRT1 in spermatozoa of rams. Taking into account that DNA methylation in sperm is stabilized with puberty onset and is a heritable epigenetic modification, it can be a promising marker of sperm quality in animal breeding. In all investigated breeds the rams with relatively high level of DNA methylation of gene SIRT1 in spermatozoa (50-68%) demonstrated a high conception rate at lambing (> 70%). In conclusion, the DNA methylation level of the SIRT1 gene in ram spermatozoa is determined by both the breed and the age of the animals and correlates with fertilizing ability of sperm.

Monogeneans from Catfishes in Lake Tanganyika. I: Two new species of Bagrobdella (Dactylogyridae) from Auchenoglanis occidentalis (Siluriformes: Claroteidae)

In the framework of the study of Siluriform fish monogeneans of Lake Tanganyika, we described two new species of Bagrobdella Paperna, 1969 from Auchenoglanis occidentalis (Valenciennes, 1840). Bagrobdella vanhovei sp. nov. is characterized by the morphology of its MCO which is unique among its congeners, presenting a non-terminal opening, whereas the other species have a terminal opening, and Bagrobdella vansteenbergei sp. nov. characterized by the size of its hooks, which are almost all of the same size, and its male copulating organ with a unique shape: a sub-terminal opening and no membrane surrounding. The Multivariate analysis done on morphometrical characters shows that the new and already described species are well individualized, except for Bagrobdella parauchenoglanii Akoumba, Pariselle, Tombi & Bilong Bilong, 2017 and Bagrobdella fraudulenta Euzet & Le Brun, 1990 (but these two species are easily distinguishable by their morphology), and that B. vanhovei sp. nov. has a great intra-specific morphometrical variation.

Associations of motor neuron disease research productivity and socioeconomic factors in Southeast Asia: a bibliometric analysis / Associações entre produtividade em pesquisa sobre doenças do neurônio motor e fatores socioeconômicos no sudeste asiático: uma análise bibliométrica

ABSTRACT Background: Scientific productivity on motor neuron disease (MND) research has been hypothesized to be low in Southeast Asia (SEA). Objective: To investigate the scientific productivity of SEA countries on MND and the associations between research metric indices and various country-specific socioeconomic parameters. Methods: We searched electronic databases for relevant articles from SEA on MND from the earliest indexed record to June 30, 2020. We obtained the following research productivity indices: bibliometric (number of publications in journals with impact factor (IF) and Scopus citations) and altmetric indices (PlumX metrics). We also collected data from published literature and reliable sources on the following socioeconomic variables: population, gross domestic product (GDP), GDP per capita, %GDP allocated for research and development (R&D) and the number of neurologists per country. Results: We included 196 articles that satisfied our inclusion criteria. Amyotrophic lateral sclerosis studies comprised the majority of the articles (n = 112; 57.1%). The top three countries in terms of the numbers of publications in journals with IF and in PlumX metrics were Singapore (n = 129), Malaysia (n = 26), and Thailand (n = 18). GDP per capita, %GDP for R&D and number of neurologists per one million population had strong positive correlations with the bibliometric and altmetric indices. Conclusions: This study highlights that although the scientific productivity of MND research in SEA has been low, it is continuously growing. This also emphasizes the imperative to improve economic indices and the number of neurologists in SEA to enhance scientific output on MND.

Resumo Antecedentes: A produtividade científica em pesquisa sobre doenças do neurônio motor (DNM) tem sido considerada baixa no sudeste asiático. Objetivo: Investigar a produtividade científica sobre DNM em países do sudeste asiático e as associações entre os índices métricos de pesquisa e vários parâmetros socioeconômicos específicos de cada país. Métodos: Foram consultadas bases de dados eletrônicas em busca de artigos relevantes sobre DNM provenientes do sudeste asiático, partindo do registro indexado mais antigo até 30 de junho de 2020. Obtivemos os seguintes índices de produtividade em pesquisa: bibliométrico (número de publicações em periódicos com fator de impacto (FI) e citações na base Scopus) e índices altmétricos (métrica PlumX). Também coletamos dados da literatura publicada e fontes confiáveis ​​sobre as seguintes variáveis ​​socioeconômicas: população, produto interno bruto (PIB), PIB per capita, % do PIB alocada para pesquisa e desenvolvimento (P & D) e o número de neurologistas por país. Resultados: Selecionamos 196 artigos que atenderam aos nossos critérios de inclusão. Estudos sobre esclerose lateral amiotrófica representaram a maioria dos artigos (n = 112; 57,1%). Os três principais países em termos de número de publicações em periódicos com FI e em métricas PlumX foram Cingapura (n = 129), Malásia (n = 26) e Tailândia (n = 18). O PIB per capita, a % do PIB para P & D e o número de neurologistas por um milhão de habitantes tiveram fortes correlações positivas com os índices bibliométricos e altmétricos. Conclusões: Embora a produtividade científica em pesquisa sobre DNM no sudeste asiático ainda seja baixa, este estudo mostra que ela vem crescendo continuamente. Isto também enfatiza a necessidade de melhorar os índices econômicos e o número de neurologistas na região para aumentar a produção científica sobre o assunto.

Who Can Buffer Marginalization Risk? Affect Experience, Affect Valuation, and Social Marginalization in Japan and Brazil.

Previous research has associated social marginalization with the rejection of mainstream cultural values. Since cultural values reflect affect valuation, the present research investigates the relationships between social marginalization and ideal/actual affect in two different non-WEIRD cultures, Brazil and Japan. As a social marginalization index, we used the NEET-Hikikomori Risk Scale (NHR). We predicted that cultural differences would emerge in the valuation of affective states. Affect valuation theory suggests that in East Asia, individuals are encouraged to pursue and value low arousal positive emotions (LAP: e.g., calmness, serenity) over high arousal positive emotions (HAP: e.g., excitement, elation, etc.) as they can harm social relationships in these societies. In contrast, Latin American cultures value HAP over LAP, because social relationships are promoted through vibrant positive emotional expression in these cultures. Hence, we hypothesized that individuals' ideal affect, actual affect, and the discrepancy between ideal and actual affect would be associated with higher risk of social marginalization. Participants from Japan (N = 54) and Brazil (N = 54) reported their ideal affect and actual affect and completed the NEET-Hikikomori Risk Scale (NHR). Regression analyses showed that actual HAP and the discrepancy between ideal and actual HAP were negatively associated with NHR in Brazil, but no association was found in the Japanese data. The other variables, including ideal affect, were only minorly or not significantly associated with NHR. Though the study has limitations regarding its small sample size, we can explore future perspectives and discuss the relationships between emotion and cultural marginalization. Socioecological factors that promote actual HAP in Brazilians may encourage other mainstream cultural ideals, which buffers against cultural marginalization.

Anticoronavirus and Immunomodulatory Phenolic Compounds: Opportunities and Pharmacotherapeutic Perspectives.

In 2019, COVID-19 emerged as a severe respiratory disease that is caused by the novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). The disease has been associated with high mortality rate, especially in patients with comorbidities such as diabetes, cardiovascular and kidney diseases. This could be attributed to dysregulated immune responses and severe systemic inflammation in COVID-19 patients. The use of effective antiviral drugs against SARS-CoV-2 and modulation of the immune responses could be a potential therapeutic strategy for COVID-19. Studies have shown that natural phenolic compounds have several pharmacological properties, including anticoronavirus and immunomodulatory activities. Therefore, this review discusses the dual action of these natural products from the perspective of applicability at COVID-19.

Research in the Middle East into the Health Benefits of Curcumin.

The Middle East is known as the cradle of civilization. It was the crossroads of ancient empires and the birthplace of major world religions. Today, it is the center of many world issues due to economic, religious, and political reasons. Although it has lagged behind many other regions of the world in medicinal research, this has increased dramatically in recent years with increasing numbers of relevant publications. Much of this research has focused on increasing our understanding of the aging process and attempting to identify biomarkers and natural products to improve the human health span. This review provides a brief overview of the research conducted in the Middle East on the health benefits of curcumin, a phytochemical derived from the famous spice turmeric. These efforts have been mainly spearheaded by Iran.

Plants and Natural Products with Activity against Various Types of Coronaviruses: A Review with Focus on SARS-CoV-2.

COVID-19 is a pandemic disease caused by the SARS-CoV-2 virus, which is potentially fatal for vulnerable individuals. Disease management represents a challenge for many countries, given the shortage of medicines and hospital resources. The objective of this work was to review the medicinal plants, foods and natural products showing scientific evidence for host protection against various types of coronaviruses, with a focus on SARS-CoV-2. Natural products that mitigate the symptoms caused by various coronaviruses are also presented. Particular attention was placed on natural products that stabilize the Renin-Angiotensin-Aldosterone System (RAAS), which has been associated with the entry of the SARS-CoV-2 into human cells.

Colitis ulcerosa: a propósito de un caso pediátrico / Ulcerative colitis: about a pediatric case / Colite ulcerativa: sobre um caso pediátrico

RESUMEN Se presentó el caso de un paciente masculino de 8 años de edad con antecedentes de salud anterior, referido a la consulta externa de Gastroenterología del Hospital Nacional Guido Valadares, de Timor Oriental, por episodios recurrentes de diarreas mucosanguinolentas acompañadas de dolor abdominal en hipogastrio de cuatro meses de evolución. Se realizaron exámenes de laboratorio, ultrasonido abdominal y videocolonoscopia con citología y biopsia de la mucosa del colon. El estudio endoscópico informó una colitis ulcerativa extensa y la histología arrojó el diagnóstico de una enfermedad inflamatoria crónica intestinal del tipo colitis ulcerosa. La colitis ulcerosa es un proceso inflamatorio intestinal de origen desconocido que causa inflamación crónica, difusa y continua, en la mucosa y submucosa. Su incidencia en los niños está aumentando y afecta, incluso, a los lactantes. Se indicó tratamiento dietético y medicamentoso. Actualmente se encuentra asintomático y lleva seguimiento mensual en la consulta de Digestivo.

ABSTRACT The case of an 8-year-old male patient with a previous health history was presented, referred to the Gastroenterology outpatient clinic of the Guido Valadares National Hospital, East Timor, for recurrent episodes of mucosanguineous diarrhea accompanied by abdominal pain in the hypogastrium with four months of evolution. Laboratory tests, abdominal ultrasound and video colonoscopy with cytology and biopsy of the colon mucosa were performed. The endoscopic study reported extensive ulcerative colitis and the histology gave the diagnosis of a chronic inflammatory bowel disease of the ulcerative colitis type. Ulcerative colitis is an inflammatory intestinal process of unknown origin that causes chronic, diffuse and continuous inflammation in the mucosa and submucosa. Its incidence in children is increasing and affects even infants. Dietary and drug treatment was indicated. He is currently asymptomatic and undergoes monthly follow-up in the Digestive Clinic.

RESUMO Foi apresentado o caso de um paciente do sexo masculino, 8 anos, com antecedentes de saúde, encaminhado ao ambulatório de Gastroenterologia do Hospital Nacional Guido Valadares, Timor Leste, por episódios recorrentes de diarreia mucosanguínea acompanhada de dor abdominal em hipogástrio de quatro meses de evolução. Foram realizados exames laboratoriais, ultrassonografia abdominal e videocolonoscopia com citologia e biópsia da mucosa do cólon. O estudo endoscópico relatou colite ulcerativa extensa e a histologia deu o diagnóstico de doença inflamatória intestinal crônica do tipo colite ulcerativa. A colite ulcerosa é um processo inflamatório intestinal de origem desconhecida que causa inflamação crônica, difusa e contínua na mucosa e na submucosa. Sua incidência em crianças está aumentando e afeta até mesmo bebês. Foi indicado tratamento dietético e medicamentoso. Ele atualmente é assintomático e tem acompanhamento mensal na consulta Digestiva.

Use of real-world evidence for oncology clinical decision making in emerging economies.

Real-world evidence (RWE) can provide insights into patient profiles, disease detection, treatment choice, dosing strategies, treatment sequencing, adverse event management and financial toxicity associated with oncology treatment. However, the full potential of RWE is untapped in emerging economies due to structural and behavioral factors. Structural barriers include lack of regulatory engagement, real-world data availability, quality and integrity. Behavioral barriers include entrenched healthcare professional behaviors that impede rapid RWE understanding and adoption. These barriers can be addressed with close collaboration of healthcare stakeholders; of whom, regulators need to be at the forefront given their ability to facilitate use of RWE in healthcare policy and legislation.

Lay abstract Traditionally, randomized clinical trials have been used to provide insights on new medical therapies and continue to remain the gold standard for approval. The-increasing availability of patient level data in the real-world, it is now possible to generate evidence regarding the usage and potential benefits or risks of a medical therapy derived from analysis of real-world data. This evidence is collectively referred to real-world evidence (RWE). randomized clinical trials and RWE are complementary and the area of Oncology especially benefits from RWE to guide clinical decision making across the patient journey. Key benefits include cancer screening and diagnosis, optimal treatment choices (including personalized medicine) and disease management such as dosing and treatment of side effects. In recent times, RWE generation in oncology has been prolific in the USA and western Europe. With expansive biopharmaceutical investments into infrastructure harnessing patient-level data and greater local regulatory guidance, oncology patients in emerging economies may now also have the opportunity to benefit from clinical decision making informed by RWE.