OBJECTIVE Leukemia is characterized by the uncontrolled proliferation of abnormal white blood cells, and although chemotherapy remains a standard treatment, toxicity, relapse, and drug resistance continue to pose major clinical challenges. These limitations draw attention to the need for safer and more effective therapeutic alternatives. Natural products have attracted considerable interest due to their diverse bioactive constituents and promising anti-cancer effects. Virgin coconut oil (VCO) has been reported to offer several health benefits, including antioxidant, anti- stress, anti-inflammatory, weight-reducing, and anti-cancer properties. This study was designed to investigate the capability of VCO to inhibit HL-60 (human promyelocytic leukemia) cell growth by inducing cell cycle arrest and apoptosis. METHODS VCO was analyzed using gas chromatography-mass spectrometry (GC-MS) analysis. Cell viability was assessed using the MTT assay; HL-60 cells were treated with various VCO concentrations for 48 hours. Additionally, cell cycle analysis was conducted by means of staining with propidium iodide, and an apoptosis assay was performed with Annexin V-FITC. RESULTS GC-MS analysis revealed that VCO contains lauric acid (LA), caprylic acid, capric acid, myristic acid, palmitic acid, linoleic acid, oleic acid, and stearic acid. After treatment, VCO exhibited cytotoxic effects in HL-60 cells with IC50 values between 269 and 300 µg/mL, and its activity was compared to commercial lauric acid (C-LA). Additionally, VCO was found to inhibit cell proliferation in a dose-dependent manner. Cell cycle analysis confirmed that VCO induced cell cycle arrest at the G1-phase. Furthermore, an apoptosis assay demonstrated that treatment with VCO induced apoptotic cell death in HL-60 cells. CONCLUSION These findings suggest that the anti-leukemic effect of VCO is associated with cell cycle arrest and reduced cell viability through apoptosis.
Pseudomonas putida is a Gram-negative, non-fermenting bacillus traditionally considered a low-virulence environmental organism, but increasingly recognized as an emerging opportunistic pathogen in healthcare settings. Infections are most often reported in immunocompromised patients, particularly those with end-stage renal disease (ESRD), diabetes, malignancies, or indwelling medical devices. We report a case of P. putida bacteremia in a 69-year-old female with ESRD on maintenance haemodialysis, type 2 diabetes mellitus, and hypertension, who presented with acute breathlessness, vomiting, diarrhea, and altered sensorium. Blood cultures performed using the BacT/Alert® system grew P. putida, confirmed by VITEK 2 Compact and MALDI-ToF. The isolate was resistant to trimethoprim/sulfamethoxazole but remained susceptible to ceftazidime, cefepime, carbapenems, aminoglycosides, and fluoroquinolones. Empiric meropenem therapy was continued upon identification, leading to marked clinical improvement within five days. Four cycles of haemodialysis were administered; however, the patient was discharged against medical advice due to financial constraints, and follow-up cultures could not be obtained. This case underscores the clinical significance of P. putida as an emerging nosocomial pathogen in patients with multiple comorbidities. Rapid identification, timely initiation of effective empiric therapy, and antimicrobial stewardship are essential to improve patient outcomes and mitigate complications, particularly as multidrug-resistant strains of P. putida are increasingly reported worldwide.
Pomegranate (Punica granatum), a natural antioxidant, may help reduce oxidative stress and inflammatory markers in thyroid eye disease (TED), an autoimmune disorder affecting approximately one-third of patients with thyroid disease. This systematic review evaluated its efficacy and safety in TED management. Following PRISMA 2020 guidelines, a comprehensive search of ScienceDirect, PubMed, and SagePub identified English-language full-text articles published from 2010 to 2024. Editorials and non-DOI reviews were excluded. From over 400 publications screened, eight met the inclusion criteria. Evidence suggests that quercetin, a key flavonoid in pomegranate, can neutralize superoxide anions, inhibit lipid peroxidation, and induce apoptosis in tumor cells. In-vitro studies further indicate that quercetin suppresses fibroblast proliferation and reduces hyaluronic acid secretion in TED. These findings support pomegranate’s potential as an adjunct therapy for TED; however, further clinical trials are needed to establish optimal dosage, formulation, and bioavailability for therapeutic use.
OBJECTIVE This study aims to evaluate whether gallic acid (GA) alleviates diabetic glomerulopathy in a type 2 diabetic mouse model.METHODS ICR mice were fed a high-fat diet (60% fat) and providing a 25% (w/v) fructose solution for 10 weeks and given multiple intraperi-toneal injections of streptozotocin (STZ) (35 mg/kg) to induce type 2 diabetes (T2D) and kidney injury. After diabetes onset, mice were treated with GA at 30 or 60 mg/kg/day for four weeks. Fasting glucose levels, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), renal malondialdehyde (MDA) levels, renal superoxide anion radicals (O2•–) for-mation, glomerular histology, and the expression of p47phox, a key regula-tor of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and transforming growth factor beta 1 (TGF-β1), were assessed.RESULTS Diabetic mice exhibited marked hyperglycemia, increased HOMA-IR, and elevated renal oxidative stress, as demonstrated by higher MDA levels, enhanced O2•–, and increased p47phox expression (p < 0.05 vs. controls). Histological analysis showed glomerular hypertrophy, enlarged glomerular volume, expanded Bowman’s space, thickening of the glo-merular basement membrane, and raised TGF-β expression (p < 0.05 vs. controls). Notably, GA treatment significantly reduced these pathological changes, with the 60 mg/kg/day dose being more effective than the 30 mg/kg/day dose. CONCLUSION GA effectively reduces oxidative stress and mitigates structural kidney alterations in a diabetic mouse model, highlighting its potential as an adjunct therapy for diabetes-induced kidney injury.
OBJECTIVE For the advancement of neuroscience and therapeutic appli-cations, it is crucial to understand how cerebral and subcortical volumes change across sexes. This study utilized magnetic resonance imaging (MRI) to investigate volumetric variations in various brain areas across different sexes.METHODS A cross-sectional study was conducted on 200 healthy par-ticipants (100 males and 100 females). High-resolution MRI scans were acquired using a 1.5T General Electric Signa scanner, and cortical seg-mentation was performed using a standardized semi-automated method. Statistical analyses were conducted using IBM SPSS, with independent sample t-tests employed to compare volumetric differences between sexes. Effect sizes were computed using Cohen’s d, and multiple compari-sons were adjusted via the Bonferroni method.RESULTS There were considerably greater volumes of total cerebral white matter (p < 0.001, d = -1.1), total cortex (p < 0.001, d = -0.635), and total cerebrum (p < 0.001, d = -1.352) in males. Males also had considerably bigger ventricular structures, such as the lateral (p < 0.001, d = -0.71) and third (p < 0.001, d = -1.229) ventricles, although there was no signifi-cant difference in the fourth ventricle (p = 0.171). Males had substantially greater volumes in the inferior temporal gyrus (p < 0.001, d = -0.58), middle temporal gyrus (p < 0.001, d = -0.55), and superior temporal gyrus (p < 0.001, d = -0.73) among cortical areas with low-density sex hormone receptors. Significant differences were seen in the occipital pole (p < 0.001, d = -1.342), thalamus (p < 0.001, d = -1.282), and postcentral gyrus (p < 0.001, d = -1.536) in areas with high-density sex hormone receptors. CONCLUSIONS This study confirms significant sex-based differences in brain volume, particularly in cortical and subcortical structures. These findings highlight the role of sex hormones in shaping neuroanatomy and provide insights for future research on sex-specific neurological and psy-chiatric conditions.
OBJECTIVE Stroke is a neurological condition with multiple complications, one of the most common being Unilateral Spatial Neglect (USN), where patients lose awareness of one side of their body. Both task-oriented mirror therapy and task-oriented therapy can aid in improving functional performance. The objective of the study was to compare the efficacy of task-oriented mirror therapy with task-oriented therapy in improving functional recovery among patients with USN. METHODS This was a comparative study of 30 individuals. Using the sealed envelope method, participants were randomly assigned into group A or group B with 15 individuals in each group as per the inclusion and exclusion criteria. Group A was administered task-oriented mirror therapy and group B was administered task-oriented therapy. The therapy sessions were conducted for 45 minutes daily, 5 times a week, over a span of 4 weeks. The outcome measures were evaluated using the Catherine Bergego Scale (CBS) and the Line Bisection Test. RESULTS Task-oriented mirror therapy had a greater impact on unilateral spatial neglect compared to task-oriented therapy without a mirror. A notable difference was found in the post-test mean and standard deviation values for CBS in group A [8.20 ± 2.624] and Group B [15.07 ± 3.105], as well as for line bisection test in group A [7.27 ± 1.534] and Group B [14.53 ± 2.973], both with a p < 0.001. CONCLUSION Task-oriented mirror therapy showed better improvement in functional outcomes for patients with unilateral spatial neglect compared to task-oriented therapy.
OBJECTIVE Cardiovascular diseases (CVDs), particularly coronary artery disease (CAD), remain among the leading causes of morbidity and mortality worldwide. Type 2 diabetes mellitus (T2DM) significantly accelerates the progression of CAD through metabolic disturbances, including dyslipidemia and elevated homocysteine levels. This study aimed to evaluate cardiovascular biomarkers and lipid profiles in diabetic patients undergoing coronary artery bypass grafting (CABG) surgery, compared to a non-diabetic control group. METHODS A total of 200 participants were included in this study, consisting of 100 patients with type 2 diabetes who had undergone CABG or angioplasty, and 100 age matched individuals with type 2 diabetes without any history of cardiovascular disease, who served as controls. RESULTS Homocysteine levels were elevated in 75.0% of diabetic patients versus 58.0% of controls (p = 0.03). Low high-density lipoprotein cholesterol (HDL-C) was observed in 93.0% of diabetics compared to 68.0% of controls (p = 0.01). No statistically significant differences were found in total cholesterol, low-density lipoprotein cholesterol (LDL-C), troponin, or CK-Mb levels between groups (p > 0.05). These findings suggest that hyperhomocysteinemia and low HDL-C are significantly associated with CAD in diabetic populations. The presence of elevated homocysteine in a substantial proportion of the control group may reflect subclinical metabolic dysfunction or undiagnosed risk factors, warranting further investigation. CONCLUSIONS These results underscore the potential utility of homocysteine and HDL-C as biomarkers in cardiovascular risk stratification. Their integration into routine screening protocols may enhance early detection and preventive strategies, particularly in high-risk or resource- limited settings.
OBJECTIVE This study aimed to develop a predictive model for low birth weight (LBW) using maternal history and the second trimester bio-chemical quadruple screening test in singleton pregnancies delivered at Sanpatong Hospital, Chiang Mai, Thailand.METHODS: This retrospective cohort study collected data from medical records of 873 singleton pregnancy women who underwent the quadruple test at 14-16 weeks of gestation and delivered at Sanpatong Hospital between October 1, 2016, and September 30, 2023. Data collected included maternal characteristics, quadruple test results, obstetric complications, and birth weight. Multivariable logistic regression was used to analyze associations between various factors and LBW. Model performance was evaluated using receiver operating characteristic (ROC) curve analysis.RESULTS: The incidence of LBW was 6.76% (59 out of 873 deliveries). Significant factors associated with LBW in multivariable analysis included maternal body mass index (BMI) (AOR = 0.924, p = 0.018), nulliparity (AOR = 0.524, p = 0.021), high-risk quadruple test for aneuploidy (AOR = 16.061, p = 0.006), preeclampsia (AOR = 3.573, p = 0.007), preterm labor (AOR = 36.526, p < 0.001), fetal growth restriction (AOR=45.726, p < 0.001), MoM of AFP (AOR = 2.598, p = 0.001), and MoM of β-hCG (AOR = 1.352, p = 0.003). Four predic-tive models were developed: history-only (AUC = 0.673), biochemical-only (MoM of AFP and β-hCG; AUC = 0.604), a combined model (history + bio-chemical; AUC = 0.707), and a full combined model (history + biochemical + complication; AUC = 0.902). The full combined model demonstrated superior performance in predicting LBW.CONCLUSIONS: The full combined model incorporating clinical history and quadruple test biochemical markers (AFP and β-hCG) effectively pre-dicts LBW. These findings suggest the potential for early identification of at-risk pregnancies, enabling timely interventions to improve maternal and neonatal outcomes.
OBJECTIVE This study aims to synthesize and estimate the anti-bacterial, anti-fungal and anti-tubercular activity of novel N-pyridine/piperidine Mannich base derivatives (M1-M6). METHODS The novel N-pyridine/piperidine Mannich base derivatives were prepared through condensation reactions between pyridine/piperidine, furfuraldehyde and various aromatic/ aliphatic amines. The structures of the synthesised compounds were characterized using FTIR, ¹³C-NMR, ¹H-NMR, and mass spectroscopy. These derivatives were assessed for anti- bacterial, anti-fungal and anti-tubercular activity using in vitro methods such as paper disc diffusion and agar well diffusion methods. RESULTS The antimicrobial and antitubercular activities of the Schiff base Mannich derivatives (M1–M6) were systematically evaluated. Antimicrobial screening against bacterial strains (S. aureus, E. coli, S. epidermidis, and P. aeruginosa) and fungal strains (Aspergillus fumigatus and A. niger) demonstrated clear concentration-dependent activity. At a concentration of 100 μg/disc, compound M2 exhibited notable inhibition zones of 10.25 mm (S. aureus), 9.76 mm (E. coli), and 10.43 mm (A. fumigatus), while M4 showed comparable activity with 10.03 mm, 8.56 mm, and 9.87 mm, respectively. In contrast, M3 displayed the lowest activity, especially against P. aeruginosa and fungal strains, whereas M5 and M6 showed moderate effects. Standard drugs, ciprofloxacin and fluconazole, exhibited superior potency. In antitubercular assays, M2 and M4 showed dose-dependent inhibition of mycobacterium, with M2 demonstrating higher efficacy. Docking studies further supported these findings, as M2 and M4 showed strong binding affinities toward InhA and EthR proteins, correlating well with their biological activity. CONCLUSION These findings emphasize the therapeutic promise of Mannich base derivatives, particularly piperidine-containing compounds (M2, M4), as potential antimicrobial and antitubercular agents. Their higher basicity enhances molecular interactions with microbial targets. Further structural optimization of these scaffolds could improve potency, selectivity, and effectiveness against resistant bacteria, fungi, and Mycobacterium tuberculosis.
OBJECTIVE Melioidosis is a life-threatening infectious disease caused by Burkholderia pseudomallei. The clinical presentations are diverse with high mortality. The disease requires timely and appropriate antibiotics. Imaging studies play an important role in the diagnosis. This study evaluated clinical manifestations, risk factors, and imaging patterns of melioidosis. METHODS This retrospective study reviewed medical records and imaging studies of patients with melioidosis conclusively identified by cultures at Maharaj Nakorn Chiang Mai Hospital during 2017–2023. RESULTS Of 33 melioidosis patients, most were male (75.76%) and the mean age was 57. Fever (66.67%) and localized pain (48.48%) were the common symptoms, while septicemia occurred in 33.33% of cases. Diabetes mellitus (48.48%) was the predominant risk factor. Imaging studies, including chest radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography, detected infections in 90.90% of the patients, with lung involvement being the most frequent (39.39%). CT was particularly effective in identifying pulmonary and visceral abscesses, while MRI aided in diagnosing osteoarticular infections. Imaging successfully guided specimen collection in 78.57% of hemoculture-negative cases. CONCLUSIONS This study underscores the importance of imaging in diagnosing melioidosis, particularly in patients with risk factors, and highlights the need for tailored imaging strategies based on clinical features.
OBJECTIVE Breastfeeding offers numerous benefits for both mother and child. While many mothers attending follow-up visits at the Pediatrics outpatient center of a tertiary hospital in Thailand are still breastfeeding, the precise rate of exclusive breastfeeding (EBF) up to six months remains unclear. This study aims to assess the rate of 6-month EBF, maternal knowledge and attitudes toward breastfeeding, and risk factors for failure of EBF.METHODS This cross-sectional study included Thai mothers with babies over six months old who had consulted with our breastfeeding center between September 1, 2020, and December 31, 2022. Participating mothers completed a questionnaire covering personal and obstetric information, past and current breastfeeding patterns, breastfeeding problems, breast-feeding knowledge (good score ≥ 12 out of 15), and attitudes (good score ≥ 40 out of 50). EBF rates and factors related to failure of non-exclusive breastfeeding were studied.RESULTS The mean age of the 683 mothers in the study was 35.7 ± 3.5 years, with 62.8% being primiparous. Most babies were delivered full-term (98.2%). EBF was achieved in 87.7% of cases. The mean scores of knowledge and attitudes related to breast milk and breastfeeding were 14.5 ± 1.1 and 47.3 ± 2.5, respectively. The majority were assessed as having good knowledge (97.4%) and positive attitudes toward breastfeeding (98.8%). Significant risk factors for failure of EBF included age ≥ 40 years, separated/divorced status, multiparity, working more than 8 hours/day, contraception use, breastfeeding problems, failure of EBF with a previous child as well as low EBF knowledge and poor EBF attitude scores. Multiparity, contraception use, and breastfeeding problems were significantly associated with EBF in multivariable analysis. CONCLUSIONS This study showed a high rate of 6-month EBF. Most participating mothers had good knowledge and positive attitudes toward breastfeeding. Multiparity, contraceptive use, and breastfeeding problems were independent risk factors for failure to achieve EBF.
Gout is a disease unique to humans, resulting from the evolutionary loss of functional uricase, the enzyme that converts uric acid to the more soluble allantoin. This loss causes elevation of serum uric acid (SUA). With sustained hyperuricemia, deposition of monosodium urate (MSU) crystals in and around joints and extra-articular tissues occurs. Clinically, gout manifests as recurrent episodes of acute inflammatory arthritis and, when untreated or undertreated, may progress to more frequent flares, tophus formation, and structural joint damage. Persistent hyperuricemia is also linked to nephrolithiasis, chronic kidney disease progression, and increased cardiometabolic burden. This review summarizes gout across the past, the present, and the future. Historical perspectives span early descriptions dating to the Egyptian period and extend through the period just prior to the discovery of light microscopy that led to enabling identification of MSU crystals. The modern era is reviewed through the development of classification criteria; mechanisms of MSU crystal-induced inflammation; genetic determinants of urate homeostasis; and the roles of renal and intestinal urate transport in hyperuricemia. Metabolomic signatures and gut microbiota are discussed alongside current approaches to urate- lowering therapy (ULT) and flare prevention. Future directions include precision, individualized medicine integrating clinical features with molecular and imaging data to improve risk stratification and guide therapy. They also include targeted anti-inflammatory strategies, newer ULT and uricosuric agents, and the application of metabolomics and microbiome science. Finally, the long-term possibility of uricase gene restoration as a transformative approach to reconstitute urate metabolism and potentially modify disease course is discussed.
OBJECTIVE Conjunctival hyperemia reflects the severity of various ocular conditions and is a common side effect of glaucoma medications, posing a significant concern for affected patients. Most existing clinical grading systems are subjective and rely heavily on individual physician interpretation, making interobserver comparison difficult. We developed an automated grading software to objectively and quantitatively assess conjunctival hyperemia. This study aimed to evaluate the repeatability and reproducibility of a newly developed automated software for quantitative assessment of conjunctival hyperemia in glaucoma patients in a pilot validation study. METHODS In this pilot study, glaucoma patients using at least one topical anti-glaucoma medication and exhibiting conjunctival hyperemia were enrolled. Each patient’s conjunctival hyperemia was assessed using the automated software, which segmented images into four regions: blood vessel area, strong red area, weak red area, and non-red area. An automatic region of interest (ROI) registration function was incorporated to enhance measurement consistency. Repeatability was assessed using two measurements from the same image, and reproducibility was tested using separate images of the same eye. RESULTS Eighty images from twenty glaucoma patients were analyzed (collected between December 1, 2016, and December 31, 2018). Following administration of 10% phenylephrine ophthalmic solution, the percentage of conjunctival hyperemia decreased significantly in all regions (p < 0.001). Spearman correlation coefficients for repeated measurements on the same image were 0.884 (blood vessel), 0.982 (strong red), and 0.932 (weak red). Corresponding values for repeated images of the same eye were 0.988, 0.992, and 0.995, respectively. The intraclass correlation coefficient (ICC) for clinical grading by ten ophthalmologists was 0.969 (95% CI: 0.952–0.981). CONCLUSION This pilot study demonstrates that the proposed automated software provides an objective and quantitative assessment of conjunctival hyperemia with excellent repeatability and reproducibility. The system shows high correlation with clinical grading and may serve as a reliable tool for monitoring conjunctival hyperemia changes in clinical practice.
OBJECTIVE This study aimed to determine the prevalence and characteristics of patients with acute acquired comitant esotropia (AACE) who had abnormal findings on neuroimaging. METHODS A retrospective review of data from patients diagnosed with AACE who had an onset age of greater than six months, cycloplegic refraction of less than +3.00 spherical diopters, and had undergone neuroimaging between 2014 and 2024 was conducted. RESULTS A total of 45 patients, 28 males (62.2%) were included in the study. The overall mean age was 10.2 years, and the mean angle of deviation was 36.11 prism diopters (PD) for distance and 36.1 PD for near. Of the 45 patients, 43 (95.6%) had normal neuroimaging and 2 (4.4%) had abnormal neuroimaging. Abnormal findings consisted of a small vascular anomaly in one patient and an arachnoid cyst in another. The mean age at onset was 5.5 years in the abnormal neuroimaging group and 8.8 years in the normal neuroimaging group (p = 0.46). The mean near angle of deviation was 27.5 PD versus 36.8 PD (p = 0.21) in patients with abnormal and normal neuroimaging, respectively. The mean distance deviation was 25 PD and 36.9 PD (p = 0.19) in the abnormal and the normal neuroimaging group, respectively. No patients demonstrated associated abnormal neurological symptoms or signs. CONCLUSIONS No predictive factors associated with abnormal neurological findings were identified as statistically significant. Despite the infrequency of abnormal neuroimaging findings in AACE and the absence of identified predictive factors, clinicians should remain aware of the possibility of underlying brain abnormalities.
OBJECTIVE Vitamin D is essential for the proper functioning of numerous organs, including the thyroid gland. For that reason, a deficiency in vitamin D is considered a potential risk factor for developing various thyroid disorders, particularly hypothyroidism. The present study aimed to evaluate the serum concentrations of vitamin D and calcium in individuals who have been diagnosed with primary hypothyroidism. METHODS The research was conducted on a cohort of 100 hypothyroid patients at the Department of Internal Medicine, Albayda Medical Center, in Albayda, Libya. Serum levels of vitamin D, calcium, and thyroid profiles (thyroid stimulating hormone (TSH), T3, and T4) were measured in all participants. A control group consisting of 100 healthy individuals was used for comparison. Statistical analysis was performed using SPSS software version 20.0 with independent t-tests and Pearson correlation analysis. RESULTS Our findings indicate that the serum levels of vitamin D and calcium were significantly lower among the hypothyroid group compared to the control group (12.21 ± 2.02 ng/mL and 4.40 ± 1.24 mg/dL vs 45.53 ± 10.51 ng/mL and 10.88 ± 1.45 mg/dL, p = 0.008 and 0.006, respectively). However, we noticed non-significant differences in changes in the serum levels of vitamin D and calcium between males and females in the hypothyroid group (p = 0.578 and 0.410, respectively). Pearson correlation analysis indicated that the TSH levels of the hypothyroid group had statistically significant negative correlations with the serum vitamin D and calcium levels (r = −0.144, p = 0.030 and r = −0.145, p = 0.029, respectively). CONCLUSIONS Based on these results, it is strongly advised that individuals with hypothyroidism be screened for vitamin D and calcium deficiencies and, if necessary, receive appropriate supplementation.
OBJECTIVE This research explores the prevalence of vitamin D deficiency among diabetic neuropathy patients in South India, highlighting the significant impact of this deficiency on health outcomes, particularly of the sensory-motor type. METHODS A cross-sectional study at Koonaseema Institute of Medical Science and Research Foundation (KIMS&RF) found a significant association between vitamin D deficiency and diabetic neuropathy, with factors such as sociodemographic, risk factors, treatment duration, treatment modality, DPN score, hyperalgesia, and neuropathic pain. RESULTS A study of 480 diabetic neuropathy patients found that 88.54% of them had a deficiency in vitamin D. Of those patients, 51.43% had insufficiency, while 37.11% had a more severe deficiency. The statistical analy-sis was conducted using Excel and the 16th edition of SPSS (Statistical Package for the Social Sciences). Literate individuals had lower vitamin D levels, while middle-class individuals were more likely. Obesity was linked to vitamin D insufficiency, with 65.60% of obese patients having insufficient vitamin D. Treatment modalities, sensory thresholds, and neuropathic pain symptoms were also associated with vitamin D deficiency. CONCLUSIONS This study in South India found that 88.54% of individuals, particularly those with diabetic neuropathy, were deficient in vitamin D. This is lower than in Egypt, but higher than in the UAE and China. Factors affecting vitamin D levels affect both males and females, with a higher impact on males. Complications from diabetic neuropathy are linked tovitamin D insufficiency. Further research is needed to validate these findings. KEYWORDS vitamin D, diabetic neuropathy, hyperalgesia, neuropathic pain
OBJECTIVE Dentin repair and regeneration pose significant challenges in restorative dentistry due to its hierarchical structure and susceptibility to demineralization. Traditional approaches often fail to restore the naturalarchitecture and functionality of dentin. The aim of this study was to develop and characterize a biomimetic polycaprolactone (PCL)/nanohydroxyapatite (nHA)/serine (Ser) scaffold to enhance dental mineralization and support tissue regeneration. The inclusion of serine, known for its ability to bind calcium and phosphate ions and guide hydroxyapatite crystal formation, could enhance nucleation and cell attachment, making the scaffold a promising biomaterial for dentin repair. METHODS Nanofibrous scaffolds were fabricated using PCL, nHA, and Ser by the electrospinning method. The structural and functional properties of the scaffold were characterized through scanning electron microscopy (SEM), energy-dispersive x-ray spectroscopy (EDX), x-ray diffraction (XRD), and fourier transform infrared spectroscopy (FTIR). SEM and EDX were used to evaluate the morphology, porosity, and elemental composition. XRD analyzed the crystalline and amorphous phases, while FTIR analyzed chemical interactions among the components. RESULTS SEM analysis revealed a uniform fibrous structure with interconnected porosity, mimicking the extracellular matrix. EDX confirmed the successful incorporation of calcium and phosphorus, indicating the presence of nHA. XRD analysis demonstrated a combination of crystalline and amorphous phases, highlighting the scaffold’s structural stability and bioactivity. FTIR spectroscopy identified characteristic peaks corresponding to PCL, nHA, and Ser, validating their successful integration and interaction within the scaffold matrix. CONCLUSIONS The nanofibrous scaffold exhibited structural and compositional properties, confirming the presence of PCL, nHA and Ser. The properties analyzed support its potential for biomineralization and tissue regeneration. The inclusion of Ser could enhance hydroxyapatite nucleation and cell attachment, making the scaffold a promising biomaterial for dentin repair. Further in-vitro and in-vivo studies are recommended to validate its clinical application. KEYWORDS biomineralization, dentin regeneration, nanohydroxyapatite, polycaprolactone, serine, scaffolds, tissue engineering
OBJECTIVE Inflammation plays an essential role in the development of insulin resistance and type 2 diabetes. The objective of this study was to evaluate the effects of inflammatory markers (hs-CRP and fetuin-A) on glycemic control in Iraqi women patients with type 2 diabetes, and to examine the correlation of these markers with indices of glycemic control. METHODS This case-control study included 45 Iraqi type 2 diabetic female patients and 44 non-diabetic Iraqi female patients matched for age and sex as control subjects. For both patients and controls hs-CRP and fetuin-A were measured using ELISA, HbA1c by the turbidimetric immunoassay, FBG and lipid profile measures using the spectrophotometer method. RESULTS High levels of both fetuin-A and hs-CRP were observed in diabetic patients compared to the healthy controls. hs-CRP was significantly higher in the diabetic group 3.1 ± 0.59 mg/dL than the control 1.22 ± 0.66 mg/dL and was statistically significantly correlated with the marker of glycemic control (p < 0.001). The serum level of fetuin-A in the diabetic group (768.7 ± 173.03 µg/mL) was also significantly higher than that of control (311.95 ± 94.13 µg/mL) (p < 0.001). A strong positive correlation was observed between fetuin-A concentrations with serum hs-CRP concentrations in the diabetic individuals but not in the controls. CONCLUSIONS Diabetic Iraqi women have higher inflammatory markers (fetuin-A and hs-CRP) than non-diabetic women. A strong association was observed for these inflammatory biomarkers and glycemic control in diabetic subjects. KEYWORDS inflammatory biomarkers, type 2 diabetes, fetuin-A, high sensitivity C-reactive protein
OBJECTIVE The fundamental aim of periodontal therapy is to promote the regeneration of tissues affected by the disease. In recent times, there has been a rising trend in using guided tissue regeneration (GTR) membranes. These membranes are increasingly relied upon to direct the growth of gingival tissue away from the root surface. Both resorbable and non-resorbable membranes presently in use serve as physical barriers, hindering the infiltration of connective and epithelial tissues into the defect area, thus fostering periodontal tissue regeneration. This study aims to develop a polymeric membrane reinforced with carrageenan and zinc oxide nanoparticles and assess its potential for periodontal regeneration. METHODS 3g of dried Kappaphycus was mixed with 100 mL of distilled water in a container and autoclaved for 15 minutes at 121 degrees Celsius. After cooling, the mixture was blended thoroughly for carrageenan extraction. Then, 1.5 g of PEG 6000 was added as a plasticizer. Zinc oxide nanoparticles (ZnO) were added and homogenized into the carrageenan extract. The mixture was microwave-boiled for 2 minutes, poured onto a petri dish, and air-dried for 24 hours. Further drying at 50 degrees Celsius for 2 hours ensured complete moisture removal. Finally, the membrane was carefully peeled from the petri dish for testing and use. The membrane underwent SEM, tensile strength, Fourier transform infrared, and antimicrobial activity analysis. RESULTS Scanning electron microscopy analysis revealed a densely packed and moderately rough surface in the ZnO-incorporated membrane, with a broader particle size distribution (1.28 ± 3.67 µm) compared to the smoother carrageenan-only membrane (1.15 ± 1.68 µm). Tensile testing showed improved mechanical strength in the ZnO composite (6.89 MPa) relative to the plain carrageenan membrane (5.39 MPa). FTIR spectra confirmed successful integration of ZnO nanoparticles through characteristic Zn–O peaks, along with preserved polysaccharide functional groups. Antimicrobial activity, evaluated via OD600 measurements over 4 hours, demonstrated time- and size-dependent bacterial inhibition against S. mutans, with the 4 cm² membrane showing superior performance, comparable or superior to chloramphenicol at later time points. CONCLUSIONS The developed membrane reinforced with carrageenan and zinc oxide nanoparticles exhibited adequate tensile strength and sufficient antimicrobial properties, suggesting its suitability for utilization in periodontal therapy as an effective regenerative material. KEYWORDS biomaterials, carrageenan, guided tissue regeneration, nanoparticles
OBJECTIVE This study aimed to cross-culturally translate and evaluate the psychometric properties of the Thai version of the Barthel Index Self-Report (BI-SR-TH) for Thai people with spinal cord injury (SCI). METHODS A descriptive cross-sectional validation and reliability study was conducted at the Maharaj Nakorn Chiang Mai Hospital, involving 109 Thai people aged 18 or older with either traumatic or non-traumatic SCI. The English postal version of the Barthel Index was translated into Thai following standard cross-cultural procedures, including forward and backward translation. Participants completed both the BI-SR-TH and the Thai EuroQoL (EQ-5D-5L) questionnaires via self-report and clinician assessment using the Barthel Index. The BI-SR-TH was re-administered to the participants one week later. Psychometric evaluation included assessments of internal consistency (Cronbach’s alpha), concurrent validity (Spearman’s correlation with clinician-rated BI), construct validity (convergent and discriminant validity assessed by correlations with relevant and distinct EQ-5D-5L domains), and test-retest reliability (intraclass correlation coefficient, ICC). The agreement between the BI-SR-TH and BI scores was assessed using ICC and the Bland-Altmand Altman analysis. Item-level agreement was assessed using the Kappa statistic. RESULTS The BI-SR-TH demonstrated good internal consistency (Cronbach’s alpha = 0.836) and excellent concurrent validity with a clinician-rated BI (r = 0.884). In terms of construct validity, the BI-SR-TH showed strong negative correlations with relevant EQ-5D-5L domains, e.g., mobility, self-care, and usual activities (r = –0.67 to –0.81, p < 0.01), demonstrating convergent validity. In contrast, correlations with unrelated domains such as anxiety and pain were weak or nonsignificant, indicating discriminant validity. The total score agreement between BI-SR-TH and the clinician BI was high (ICC = 0.916), and Bland-Altman analysis indicated a small mean difference. Most BI-SR-TH items showed good agreement with clinician ratings (Kappa 0.61–0.72) with the exception of the bowels and bladder items which showed only fair agreement (Kappa = 0.34 and 0.35, respectively). Test-retest reliability was also high (ICC = 0.924). CONCLUSIONS The BI-SR-TH is a valid and reliable tool for assessing functional independence in Thai people with SCI. However, the bowels and bladder items require further refinement for this population KEYWORDS Barthel Index, self report, functional status, spinal cord injury, reliability and validity
