Objective of the study was to find the association of vitamin D receptor (VDR) polymorphisms (Fokl, Taql and Apal) with vitamin D levels in diabetic foot ulcer (DFU) patients in South India. In this case-control study, plasma vitamin D levels and VDR genotype frequencies of 70 cases (DFU patients) were compared with 70 diabetic (diabetes mellitus [DM] [non-DFU]) patients and 70 apparently healthy controls (HC) from South India. Plasma vitamin D levels were measured using the ELISA technique, and genotyping of VDR polymorphisms was carried out using real-time polymerase chain reaction. Logistic regression was used to find the association between DFU versus HC and DFU versus DM traits. Association analysis was performed based on additive, dominant and recessive models with age and gender as covariates. A 45.7% of DFU patients have sufficient vitamin D levels than 48.6% and 40% of DM patients and HC, respectively. Linkage disequilibrium analysis for DFU versus HC and DFU versus DM traits shows that single nucleotide polymorphisms (SNPs) Taq1 (rs731236) and Apal (rs7975232) are in strong linkage disequilibrium in DFU patients. The alleles and genotype frequencies were similar in all three groups. Although the additive model does not show statistical significance, age and sex correlate with the three SNPs (Fokl, Taql and Apal). No association was found between VDR gene polymorphisms and vitamin D levels in DFU patients in Southern India. On the other hand, age and sex correlate with the three SNPs.

Aim: The systematic review summarizes the current evidence on the efficacy and safety of iron replacement in patients with pulmonary hypertension (PH). Methods: A systematic literature search was conducted in electronic databases like PubMed, Scopus, Web of Science, and Embase up to April 2024. Eligible studies investigating iron replacement therapy in pulmonary hypertension patients were included in the review. Quality assessment of included studies was performed using standardized risk of bias tools. Results: Five studies met the study-eligible criteria and were included for review. Out of all final selected five studies, one was a randomized control trial (RCT), two were non-RCT, and two were observational studies. We observed an improvement in the six-minute walk distance (6MWD) test, iron indices, peak oxygen intake, and anaerobic threshold after the iron replacement. In all included studies, the iron replacement was tolerated well with no serious adverse events. Conclusion: Regardless of the variation in the study design, positive effects were observed on multiple outcome measures like the 6MWD test, cardiopulmonary exercise test parameter, and iron indices upon iron replacement in PH patients with iron deficiency. Further controlled trials are needed to enable better treatment group comparisons. Exploring long-term impacts on comorbidities, mortality, and disease progression would provide valuable insights for managing pulmonary hypertension.

Background: Previous research has shown that seasonal variations in phytoconstituent levels eventually lead to alterations in the biological activities of the plant materials. The research assessed the effects of seasonal changes on b-sitosterol levels and the anti-fertility properties of two solvated bark extracts (ethanol and water) from Caesalpinia pulcherrima (CP) Linn. in female rats.Materials and methods: Soxhlet and hot reflux extraction with ethanol and water solvents were used to separate the active components from the barks. The phytochemical screening, characterization, and in-vivo antifertility activity in female rats were carried out to determine the presence of bioactive components. Two dosages of the extracts (200 and 400 mg/kg) were chosen based on the results of an acute toxicity investigation. Uterine tissue histopathology was performed to analyze the effects of various treatments. The data was statistically examined and p value less than 0.05 was considered to reflect the significance.Results: The extracts were characterized for the presence of beta-sitosterol using FT-IR, H1-NMR, and HR Mass. The animals were able to withstand a dose of up to 2000 mg/kg without exhibiting any toxicological signs or symptoms. Based on in vivo investigations, an ethanolic extract of the bark showed 88.93 % and 77.21 % anti-implantation action at 200 and 400 mg/kg, while an aqueous extract showed 78.31 and 70.52 % activity at the same doses. When compared to the control, the anti-implantation and estrogenic actions of both extracts were shown to be statistically significant (p<0.001). The abortifacient effect in the rainy season ethanolic extract was linear and dose-dependent, as compared to the control (p<0.001).Conclusion: The findings of this study suggest that the presence of the phytosterol beta Sitosterol in Caesalpinia pulcherrima (CP) Linn. is responsible for its post-coital antifertility effect. It appears that the amount of beta-sitosterol in the plant, which may have an antifertility effect, is greatly affected by seasonal change.(c) 2023 SAAB. Published by Elsevier B.V. All rights reserved.

Background:Hyperlipidemia is one of the major risk factors for coronary heart disease and stroke. Triphala, a polyherbal Ayurvedic formulation made from dried fruits of Haritaki (Terminalia chebula Retz.), Bibhitaki (Terminalia bellirica Roxb.), and Amalaki (Phyllanthus emblica Gaertn.) has been suggested to be useful in mitigating hyperlipidemia. In the Ayurveda texts, depending on the patient's condition and body type, Triphala is formulated and used in one of the two combination (1:1:1 and 1:2:4 of individual constituents) forms.Aims:The present study aimed at evaluating the efficacy of two combinations (1:1:1 and 1:2:4 of individual constituents) of Triphala against high fat diet induced-hyperlipidemia in rats.Materials and method:Hyperlipidemia was induced in Spraque-Dawley albino rats by feeding them with high fat diet. The animals were concomitantly administered with graded dose of one of the two combination (combination of Haritaki, Bibhitaki, and Amalaki in ratio of 1:1:1 or 1:2:4, respectively) of Triphala (250, 500, or 1000 mg/kg body wt.) or atorvastatin. The animals were sacrificed on day 22 and serum was processed for lipid profile and the liver for lipid peroxidation. The statistical analysis was performed by the mean analysis of variance followed by Dunnet's test.Results:The results indicated that when compared to placebo group, levels of serum total cholesterol, and triglyceride were significantly lower, while high-density lipoprotein cholesterol increased in both the Triphala combination and atorvastatin groups. Of the two groups of Triphala, the formulation having 1:2:4 ratio was better than the 1:1:1. The group having highest drug dose (1000 mg/kg body wt.) of 1:2:4 formulation was better than atorvastatin in rectifying high fat diet-induced dyslipidemia and the atherogenic index was equal to that of atorvastatin.Conclusions:The results of the study indicate that of the two Triphala formulations, the 1:2:4 ratio was better than the 1:1:1 ratio for anti-hyper-lipidemic effects.

Background Diabetic foot ulcers (DFU) are a major complication of diabetes mellitus (DM). Nutrient deficiencies are among the major risk factors in DFU development and healing. In this context, we aimed to investigate the possible association between micronutrient status and risk of DFU. Methods A systematic review (Prospero registration: CRD42021259817) of articles, published in PubMed, Web of Science, Scopus, CINAHL Complete, and Embase, that measured the status of micronutrients in DFU patients was performed. Results Thirty-seven studies were considered, of which thirty were included for meta-analysis. These studies reported levels of 11 micronutrients: vitamins B9, B12, C, D, E, calcium, magnesium, iron, selenium, copper, and zinc. DFU, compared to healthy controls (HC) had significantly lower vitamin D (MD: -10.82 14 ng/ml, 95% CI: -20.47, -1.16), magnesium (MD: -0.45 mg/dL, 95% CI: -0.78, -0.12) and selenium (MD: -0.33 µmol/L, 95% CI: -0.34, -0.32) levels. DFU, compared to DM patients without DFU, had significantly lower vitamin D (MD: -5.41 ng/ml, 95% CI: -8.06, -2.76), and magnesium (MD: -0.20 mg/dL, 95% CI: -0.25, -0.15) levels. The overall analysis showed lower levels of vitamin D [15.55ng/ml (95% CI:13.44, 17.65)], vitamin C [4.99µmol/L (95% CI:3.16, 6.83)], magnesium [1.53mg/dL (95% CI:1.28, 1.78)] and selenium [0.54µmol/L (95% CI:0.45, 0.64)]. Conclusion This review provides evidence that micronutrient levels significantly differ in DFU patients, suggesting an association between micronutrient status and risk of DFU. Therefore, routine monitoring and supplementations are warranted in DFU patients. We suggest that personalized nutrition therapy may be considered in the DFU management guidelines. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=259817 , identifier CRD42021259817.

IntroductionInfections are becoming more difficult to treat, at least partly on account of microbes that produce biofilms. Reports suggest that decreased levels of antimicrobial peptides like cathelicidin, elevated levels of inflammatory cytokines, and biofilm formation are all associated with vitamin D deficiency, making vitamin D - deficient individuals more susceptible to infection. Infections attributable to biofilm-producing microbes can be managed by adjuvant therapy with vitamin D because of its immunomodulatory role, particularly because of the ability of vitamin D-pathway to induce the antimicrobial peptides like cathelicidin and decrease proinflammatory cytokines.Areas coveredThis narrative review covers biofilm formation, infections associated with biofilm due to vitamin D deficiency, putative role of vitamin D in host protection and the effect of vitamin D supplementation in biofilm-associated infections. A comprehensive literature search in PubMed and Google Scholar utilizing suitable keywords at multiple time points extracted relevant articlesExpert OpinionAlthough vitamin D deficiency has been associated with infections by biofilm producing microbes, comprehensive clinical trials in various ethnicities are required to understand the likely relationships between vitamin D receptor gene expression, cathelicidin levels, and infection outcome. Current evidence hypothesizes that maintaining normal vitamin D level can help prevent and treat these infections.

Introduction:: Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus, as it can physically and emotionally impact the person. Its management can be challenging and expensive, depending on the severity of the wound and the presence of infection. Background:: The fat-soluble molecule, vitamin D, has gained great importance ever since its pleiotropism has been recognized. Its efficacy could be attributed to the presence of vitamin D receptors in most of the body tissues. Vitamin D plays a significant role in cell proliferation, differentiation, and immune modulation. It modulates the T and B cells resulting in the suppression of the immunoglobulins, autoimmunity, and inflammation. Methods:: We performed a literature search with the objective to highlight the role of vitamin D in peripheral vascular disease and peripheral neuropathy, which are the major risk factors for DFU, as well as evidences of its role in wound healing and management of DFU. Results:: Preclinical and clinical studies have shown that vitamin D influences multiple phases of wound healing and thereby accelerates the process. It modulates various cells involved in proliferation and remodelling phases. Vitamin D also enhances the expression of antimicrobial peptides that help to eliminate the microbes, as well as suppress the proinflammatory responses while enhancing the anti-inflammatory responses. Conclusion:: This review concludes vitamin D to have a protective role in the immune and vascular system, improve glycaemic outcomes, and wound healing. Therefore, vitamin D could be a preferred adjuvant in the management of DFU.

The free radicals and neuroinflammatory processes are thought to underlie various neurodegenerative diseases such as Alzheimer's disease (AD) as the brain is highly susceptible to oxidative damage. Docosahexaenoic acid, choline, folate, vitamin B12, vitamin C, vitamin E, and copper were found to be significantly lower in the brain of AD patients. Nutritional therapy, which includes vitamin D and other antioxidants, has shown a potential effect in the prevention and treatment of AD through acting on various biological pathways. Nutrition is an essential lifestyle factor that can modify the risk of several neurodegenerative disorders. The free radicals and neuroinflammatory processes are thought to underlie various neurodegenerative diseases such as Alzheimer's disease as the brain is highly susceptible to oxidative damage. Prevention of dementia is a major concern as there exists a lack of a permanent cure. The Food and Nutrition Board at the Institute of Medicine of the National Academies has been given the Recommended Dietary Allowance of vitamin D.