Diversity, Ecology, and Environmental Significance of Foraminifera in Al Hamama and Susah Coastal Regions, Northeastern Libya: Insights from Holocene Sediments

This research initiative, conducted along the coastal zones of Al Hamama and Susah in northeastern Libya, aimed to enhance our understanding of Holocene benthic foraminifera assemblages and the paleoenvironmental parameters in the region. We meticulously gathered five sediment samples to analyze the composition of foraminifera populations within the unconsolidated sedimentary deposits adjacent to these locations. We successfully identified nine distinct benthic foraminifera species, including Amphistegina lobifera, Eliphidium crispum, Sigmoilinita tenuis, Sorites orbiculus, Stomatorbina concentrica, Peneroplis planatus, Pseudotriloculina rotunda, Pyrgoella sphaera, and Triloculina schreberiana. Notably, Eliphidium crispum and Amphistegina lobifera emerged as the most prevalent species. These foraminifera species exhibited distinct ecological preferences, shedding light on paleoenvironmental conditions and climatic fluctuations during the Quaternary Period in the Susah and Al Hamama coastal regions. The presence of Orbulina universa, a planktonic foraminifera species, further enriched our understanding of the paleoenvironment by providing insights into specific water depths and temperature ranges. This research significantly contributes to paleoceanography and environmental reconstruction, highlighting the invaluable use of foraminifera as proxies for exploring past environmental changes. Additionally, the study investigated the impacts of anthropogenic influences on benthic ecosystems in the Al Hamama and Susah coastal areas. These influences included reworked foraminifera specimens and the effects of karst formations, acid rain, and eutrophication. Notably, human-induced factors have visibly affected biogenic fauna and ecosystem dynamics in the study area. Consequently, this research provides valuable insights into paleoenvironmental conditions and ecological dynamics within the Susah and Al Hamama coastal regions, emphasizing the crucial role of foraminifera in reconstructing historical environmental fluctuations.

Predictors of vitamin D deficiency in inflammatory bowel disease and health: A Mississippi perspective

AIM To identify the predictors of vitamin D deficiency in patients with and without inflammatory bowel disease(IBD).METHODS Patients with ulcerative colitis(UC) or Crohn's disease(CD) related diagnostic codes who received medical care at University of Mississippi Medical Center between July 2012 and 2015 were identified. After thorough chart review, we identified patients with biopsy proven IBD who had also been tested for serum 25-hydroxyvitamin D [25(OH)D] concentration. We compared these patients to a previously studied cohort of healthy controls who also had vitamin D concentration checked. Logistic regression analysis was performed to determine the association between vitamin d deficiency and UC, CD, race, age, gender and body mass index(BMI).RESULTS We identified 237 patients with confirmed IBD. Of these, only 211 had a serum 25(OH)D concentrations available in the medical record. The group of healthy controls consisted of 98 individuals with available serum 25(OH)D concentration. 43% of IBD patients were African American(AA). Patients with CD were more likely to have vitamin D concentration checked. Bivariate analysis showed that AA(51% vs 21%, P= 0.00001), subjects with BMI > 30 kg/m^2(39% vs 23% P = 0.01) and CD(40% vs 26%, P = 0.04) were more likely to be vitamin D deficient than vitamin D sufficient. Those with Age > 65 were more likely to be vitamin D sufficient(46% vs 15%, P = 0.04). Multiple regression showed that only BMI > 30 kg/m^2 and AA race are associated with vitamin D deficiency. CONCLUSION BMI > 30 kg/m^2 and AA race are predictive of vitamin D deficiency. Gender, age and diagnosis of IBD are not predictive of vitamin D deficiency.

The Utility of the Galea in Scalp Reconstruction

Total scalp avulsion is a time-sensitive, catastrophic injury requiring quick, complex decision-making. Traditionally, these injuries were treated with split-thickness skin grafts. With advancements in microsurgery, treatments evolved to scalp replantation, becoming the standard of care in scalp reconstruction. Although the integrity of the scalp’s blood vessels is pivotal for successful replantation, the authors believe that scalp replantation should be considered at all costs. In the presented case, a 54-year-old female presented to the emergency room following an incident with an auger that completely avulsed her scalp. She was taken back to the operating room, where scalp replantation was performed. Following replantation, scalp necrosis led to serial debridings in the operating room, and eventually, all of the scalp was debrided down to healthy tissue. Surprisingly, the galea survived despite this, which provided a healthy base for skin grafts. Before definitive coverage was placed, it was decided to utilize a bilaminar acellular dermal matrix along with negative pressure wound therapy to create a more robust bed of granulation tissue. After three weeks of this treatment plan, the patient returned to the operating room, where a healthy, viable bed of granulating tissue was revealed beneath the dermal matrix. Split-thickness skin grafts were taken from her thighs bilaterally and sewn together in a quilt-like fashion to cover the wound bed. The entirety of the graft healed without complication except for one small area that required full-thickness skin grafting in an outpatient setting. Even though the replantation ultimately failed, it allowed the galea to survive, which saved the patient from undergoing a free tissue transfer and allowed her scalp to be reconstructed with split-thickness skin grafts. Even in the setting of polytrauma, the authors hope that anyone treating a scalp avulsion would consider scalp replantation at all costs.

Treatment and Maintenance of Interstitial Cystitis/Bladder Pain Syndrome in Female Patients with Cetirizine-Famotidine: A Case Series

Purpose: Interstitial cystitis/Bladder pain syndrome is an inflammatory disorder of the bladder, for which histamine has been implicated in the pathogenesis of the disease. The condition is often refractory to standard-of-care medical treatments, including the antihistamines hydroxyzine or cimetidine, and procedures. Herein we report a physician-sponsored proof-of-principle case series of four adult female patients with chronic painful bladder and frequent urination, who were treated once daily with a low dose H1 + H2 histamine receptor antagonist combination. Materials and Methods: Four adult females with Interstitial cystitis/Bladder pain syndrome were treated once daily with a compounded oral dosage form containing the H1 receptor antagonist-cetirizine 8 mg in combination with the H2 receptor antagonist-famotidine 22 mg. The case series consists of a retrospective review of the symptom severity prior to versus following H1 + H2 treatment. Results and Conclusions: The once daily dual histamine receptor antagonist therapy substantially reduced the pain and urination frequency, and prophylactically maintained all four patients long-term with substantially reduced disease severity. The reduction in symptom severity was achieved at amounts that do not exceed the US FDA approved and exceptionally safe daily doses for the two over-the-counter monotherapies. This case series provides proof-of-principle evidence that a dual antihistamine combination of cetirizine plus famotidine effectively treated and maintained female patients, who were previously refractory to standard-of-care medications and/or procedures.

Phytoremediation Strategies for Heavy Metal Contamination: A Review on Sustainable Approach for Environmental Restoration

Current globalization trends and important breakthroughs globally need a complete study of heavy metal contamination, its causes, its impacts on human and environmental health, and different remediation strategies. Heavy metal pollution is mostly produced by urbanization and industry, which threatens ecosystems and human health. Herein, we discuss a sustainable environmental restoration strategy employing phytoremediation for heavy metal pollution, the carcinogenic, mutagenic, and cytotoxic effects of heavy metals such as cadmium, copper, mercury, selenium, zinc, arsenic, chromium, lead, nickel, and silver, which may be fatal. Phytoremediation, which was prioritized, uses plants to remove, accumulate, and depollute pollutants. This eco-friendly method may safely collect, accumulate, and detoxify toxins using plants, making it popular. This study covers phytostabilization, phytodegradation, rhizodegradation, phytoextraction, phytovolatilization, and rhizofiltration. A phytoremediation process’s efficiency in varied environmental circumstances depends on these components’ complex interplay. This paper also introduces developing phytoremediation approaches including microbe-assisted, chemical-assisted, and organic or bio-char use. These advancements attempt to overcome conventional phytoremediation’s limitations, such as limited suitable plant species, location problems, and sluggish remediation. Current research includes machine learning techniques and computer modeling, biostimulation, genetic engineering, bioaugmentation, and hybrid remediation. These front-line solutions show that phytoremediation research is developing towards transdisciplinary efficiency enhancement. We acknowledge phytoremediation’s promise but also its drawbacks, such as site-specific variables, biomass buildup, and sluggish remediation, as well as ongoing research to address them. In conclusion, heavy metal pollution threatens the ecology and public health and must be reduced. Phytoremediation treats heavy metal pollution in different ways. Over time, phytoremediation systems have developed unique ways that improve efficiency. Despite difficulties like site-specificity, sluggish remediation, and biomass buildup potential, phytoremediation is still a vital tool for environmental sustainability.

Rapid transport of insulin to the brain following intranasal administration in rats

We previously reported that intranasal insulin protects substantia nigra dopaminergic neurons against6-hydroxydopamine neurotoxicity in rats. This study aimed to assess insulin pharmacokinetics in the rat brain following intranasal application. Recombinant human insulin(rh-Ins) or phosphate buffer solution was administered to both nostrils of rats. Animals were sacrificed at 15 minutes, 1, 2, and 6 hours to determine insulin levels in different brain regions by an ultrasensitive, human-specific enzyme-linked immunosorbent assay kit. For fluorescence tracing study, rats were administered with intranasal florescence-tagged insulin(Alex546-Ins), and brains were fixed at 10 and 30 minutes to prepare sagittal sections.rh-Ins was detected in all brain regions examined except the cerebral cortex. The highest levels were detected in the brainstem, followed by the cerebellum, substantia nigra/ventral tegmental area, olfactory bulb,striatum, hippocampus, and thalamus/hypothalamus. Insulin levels reached a peak at 15 minutes and then declined gradually overtime, but remained significantly higher than baseline levels at 6 hours in most regions.Consistently, widespread Alex546-Ins-binding cells were detected in the brain at 10 and 30 minutes, with the olfactory bulb and brainstem showing the highest while the cerebral cortex showing lowest fluorescence signals. Double-immunostaining showed that Alex546-Ins-bindings were primarily co-localized with neuronal nuclei-positive neurons. In the subtantia nigra, phospho-Akt was found to be activated in a subset of Alex546-Ins and tyrosine hydroxylase double-labeled cells, suggesting activation of the Akt/PI3 K pathway in these dopaminergic neurons. Data from this study suggest that intranasal insulin could effectively reach deep brain structures including the nigrostriatal pathways, where it binds to dopaminergic neurons and activates intracellular cell survival signaling. This study was approved by the Institutional Animal Care Committee at the University of Mississippi Medical Center(protocol 1333 A) on June 29, 2015.

Numerical simulation of solitary and random wave propagation through vegetation based on VOF method

A vertical two-dimensional numerical model has been applied to solving the Reynolds Averaged Navier- Stokes （RANS} equations in the simulation of current and wave propagation through vegetated and non- vegetated waters. The k-e model is used for turbulence closure of RANS equations. The effect of vegeta- tion is simulated by adding the drag force of vegetation in the flow momentum equations and turbulence model. To solve the modified N-S equations, the finite difference method is used with the staggered grid system to solver equations. The Youngs＇ fractional volume of fluid （VOF） is applied tracking the free sur- face with second-order accuracy. The model has been tested by simulating dam break wave, pure current with vegetation, solitary wave runup on vegetated and non-vegetated channel, regular and random waves over a vegetated field. The model reasonably well reproduces these experimental observations, the model- ing approach presented herein should be useful in simulating nearshore processes in coastal domains with vegetation effects.

Lean heart: Role of leptin in cardiac hypertrophy and metabolism

Leptin is an adipokine that has been linked with the cardiovascular complications resulting from obesity such as hypertension and heart disease. Obese patients have high levels of circulating leptin due to increased fat mass. Clinical and population studies have correlated high levels of circulating leptin with the development of cardiac hypertrophy in obesity. Leptin has also been demonstrated to increase the growth of cultured cardiomyocytes. However, several animal studies of obese leptin deficient mice have not supported a role for leptin in promoting cardiac hypertrophy so the role of leptin in this pathological process remains unclear. Leptin is also an important hormone in the regulation of cardiac metabolism where it supports oxidation of glucose and fatty acids. In addition, leptin plays a critical role in protecting the heart from excess lipid accumulation and the formation of toxic lipids in obesity a condition known as cardiac lipotoxicity. This paper focuses on the data supporting and refuting leptin's role in promoting cardiac hypertrophy as well as its important role in the regulation of cardiac metabolism and protection against cardiac lipotoxicity.

Sedimentary Characteristics of the Pleistocene Outwash Accumulation and their Implications for Paleoclimate Change in the Midstream of Dadu River,Southwestern China

Ancient outwash accumulations, deposited in Pleistocene with complicated sedimentary characteristics, are discovered in the midstream valley of Dadu River, Southwestern China. Their sedimentation characteristics are investigated for gaining a deep insight into the dependency of Paleoclimate changes in this area. This is achieved by means of detailed site investigation, sampling and laboratory tests （grain size distribution and Electron Spin Resonance dating tests） for two representative outwash accumulations. Based on the present study, several main conclusions are drown out as follows： 1） The accumulations are composed mainly of coarse soils （coarse fraction is over 50%） and very coarse soils （coarse fraction is about 20%-35%, and very coarse fraction is over 55%）; 2） The coarse soils are sub-rounded well-sorted and sub-stratified to well-stratified, while the very coarse soils exhibit sub-rounded to sub-angular and poorly-sorted; 3） The accumulations are postulated to have been intermittently deposited in three time periods. This is evidenced by two layers of weathered/ residual clay, purple to brick red in color; and 4） It is inferred that the temperature in the study area increased over three time periods, i.e., 280 ka B.P. to 120 ka B.P., 110 ka B.P. to 80 ka B.P. and 70 ka B. P. to 25 ka B.P., and declined twice at 120 ka B.P. and 77 ka B.P. respectively.

Dysregulation of neurogenesis by neuroinflammation:key differences in neurodevelopmental and neurological disorders

Embryonic neurogenesis is the process of generating neurons,the functional units of the brain.Because of its sensitivity to adverse intrauterine environment such as infection,dysregulation of this process has emerged as a key mechanism underlying many neurodevelopmental disorders such as autism spectrum disorders（ASD）.Adult neurogenesis,although is restricted to a few neurogenic niches,plays pivotal roles in brain plasticity and repair.Increasing evidence suggests that impairments in adult neurogenesis are involved in major neurodegenerative disorders such as Alzheimer＇s disease.A hallmark feature of these brain disorders is neuroinflammation,which can either promote or inhibit neurogenesis depending upon the context of brain microenvironment.In this review paper,we present evidence from both experimental and human studies to show a complex picture of relationship between these two events,and discussed potential factors contributing to different or even opposing actions of neuroinflammation on neurogenesis in neurodevelopmental and neurological disorders.

Combination of epidural electrical stimulation with ex vivo triple gene therapy for spinal cord injury:a proof of principle study

Despite emerging contemporary biotechnological methods such as gene-and stem cell-based therapy,there are no clinically established therapeutic strategies for neural regeneration after spinal cord injury.Our previous studies have demonstrated that transplantation of genetically engineered human umbilical cord blood mononuclear cells producing three recombinant therapeutic molecules,including vascular endothelial growth factor(VEGF),glial cell-line derived neurotrophic factor(GDNF),and neural cell adhesion molecule(NCAM)can improve morpho-functional recovery of injured spinal cord in rats and mini-pigs.To investigate the efficacy of human umbilical cord blood mononuclear cells-mediated triple-gene therapy combined with epidural electrical stimulation in the treatment of spinal cord injury,in this study,rats with moderate spinal cord contusion injury were intrathecally infused with human umbilical cord blood mononuclear cells expressing recombinant genes VEGF165,GDNF,NCAM1 at 4 hours after spinal cord injury.Three days after injury,epidural stimulations were given simultaneously above the lesion site at C5(to stimulate the cervical network related to forelimb functions)and below the lesion site at L2(to activate the central pattern generators)every other day for 4 weeks.Rats subjected to the combined treatment showed a limited functional improvement of the knee joint,high preservation of muscle fiber area in tibialis anterior muscle and increased H/M ratio in gastrocnemius muscle 30 days after spinal cord injury.However,beneficial cellular outcomes such as reduced apoptosis and increased sparing of the gray and white matters,and enhanced expression of heat shock and synaptic proteins were found in rats with spinal cord injury subjected to the combined epidural electrical stimulation with gene therapy.This study presents the first proof of principle study of combination of the multisite epidural electrical stimulation with ex vivo triple gene therapy(VEGF,GDNF and NCAM)for treatment of spinal cord injury in rat models.The animal protocols were approved by the Kazan State Medical University Animal Care and Use Committee(approval No.2.20.02.18)on February 20,2018.

Endosonography guided management of pancreatic fluid collections

The revised Atlanta classification of acute pancreatitis was adopted by international consensus, and is based on actual local and systemic determinants of disease severity. The local determinant is pancreatic necrosis(sterile or infected), and the systemic determinant is organ failure. Local complications of pancreatitis can include acute peri-pancreatic fluid collection, acute necrotic collection, pseudocyst formation, and walledoff necrosis. Interventional endoscopic ultrasound(EUS) has been increasing utilized in managing these local complications. After performing a Pub Med search, the authors manually applied pre-defined inclusion criteria or a filter to identify publications relevant to EUS and pancreatic collections(PFCs). The authors then reviewed the utility, efficacy, and risks associated with using therapeutic EUS and involved EUS devices in treating PFCs. Due to the development and regulatory approval of improved and novel endoscopic devices specifically designed for transmural drainage of fluid and necrotic debris(access and patency devices), the authors predict continuing evolution in the management of PFCs. We believe that EUS will become an indispensable part of procedures used to diagnose PFCs and perform image-guided interventions. After draining a PFC, the amount of tissue necrosis is the most important predictor of a successful outcome. Hence, it seems logical to classify these collections based on their percentage of necrotic component or debris present when viewed by imaging methods or EUS. Finally, the authors propose an algorithm for managing fluid collections based on their size, location, associated symptoms, internal echogenic patterns, and content.

Decoupling coefficients of dilatational wave for Biot's dynamic equation and its Green's functions in frequency domain

Green＇s functions for Blot＇s dynamic equation in the frequency domain can be a highly useful tool for the investigation of dynamic responses of a saturated porous medium. Its applications are found in soil dynamics, seismology, earthquake engineering, rock mechanics, geophysics, and acoustics. However, the mathematical work for deriving it can be daunting. Green＇s functions have been presented utilizing an analogy between the dynamic thermoelasticity and the dynamic poroelasticity in the frequency domain using the u-p formulation. In this work, a special term ＂decoupling coefficient＂ for the decomposition of the fast and slow dilatational waves is proposed and expressed to present a new methodology for deriving the poroelastodynamic Green＇s functions. The correct- ness of the solution is demonstrated by numerically comparing the current solution with Cheng＇s previous solution. The separation of the two waves in the present methodology allows the more accurate evaluation of Green＇s functions, particularly the solution of the slow dilatational wave. This can be advantageous for the numerical implementation of the boundary element method （BEM） and other applications.

Endoscopic ultrasound features of autoimmune pancreatitis: The typical findings and chronic pancreatitis changes

BACKGROUND Few studies have fully described endoscopic ultrasound(EUS)features of newly diagnosed autoimmune pancreatitis(AIP)involving both typical findings and chronic pancreatitis(CP)features.The typical EUS findings are prevalent in the diffuse type AIP but may not be as common for the focal type,and the differences between the diffuse and focal AIP need to be specified.AIM To demonstrate the EUS features of newly diagnosed AIP and the difference between diffuse and focal AIP.METHODS This retrospective single center study included 285 patients of newly diagnosed type 1 AIP following the international consensus diagnostic criteria,with the EUS procedures accomplished before corticosteroid initiation.We explored the EUS features and compared the typical AIP and CP features between the diffuse and focal AIP cases.The Rosemont criteria were employed for CP features definition and CP change level comparison.RESULTS For the typical AIP features,there were significantly more patients in the diffuse group with bile duct wall thickening(158 of 214 cases,73.4%vs 37 of 71 cases,52.1%,P=0.001)and peripancreatic hypoechoic margin(76 of 214 cases,35.5%vs 5 of 71 cases,7.0%,P<0.001).For the CP features,there were significantly more patients in the focal group with main pancreatic duct dilation(30 of 214 cases,14.0%vs 18 of 71 cases,25.3%,P=0.03).The cholangitis-like changes were more prevalent in the focal cases with pancreatic head involvement.The CP change level was relatively limited for newly diagnosed AIP cases in both groups.CONCLUSION This study demonstrated the difference in the typical AIP and CP features between diffuse and focal AIP and indicated the limited CP change level in newly diagnosed AIP.

Medicinal uses,phytochemistry and pharmacology of Picralima nitida(Apocynaceae) in tropical diseases:A review

Picralima nitida Durand and Hook,(fam.Apocynaceae)is a West African plant with varied applications in African folk medicine.Various parts of the plant have been employed ethnomedicinally as remedy for fever,hypertension,jaundice,dysmenorrheal,gastrointestinal disorders and malaria.In order to reveal its full pharmacological and therapeutic potentials,die present review focuses on the current medicinal uses,phytochemistry,pharmacological and toxicological activities of this species.Literature survey on scientific journals,books as well as electronic sources have shown the isolation of alkaloids,tannins,polyphenols and steroids from different parts of the plant,pharmacological studies revealed that the extract or isolated compounds from this species posses analgesic,anti-inflammatory,hypoglyceamic,hypotensive,antiplasmodial,antimicrobial,antiulcer and antitumorigenic activities.Results from various scientific investigations to date have revealed the potential of the extract from the plant or isolated compounds for use in the treatment and prevention of various kinds of human diseases.However,further studies on the extracts and pure compounds from this species is required to completely assess its phytoc-hemical,pharmacological and toxicological profile as well as the mechanism of action behind these pharmacological activities exhibited by the compounds isolated from this species.

Associations of renal function with diabetic retinopathy and visual impairment in type 2 diabetes: A multicenter nationwide cross-sectional study

BACKGROUND Diabetic retinopathy(DR) separately has been noted as a major public health problem worldwide as well. Currently, many studies have demonstrated an association between diabetic nephropathy and DR in type 1 diabetes mellitus(T1DM) patients, but this association is less strong in T2DM. The evidence for an association between renal function and DR and visual impairment among T2DM patients is limited, particularly in the Asian population.AIM To assess the association between glomerular filtration rate(GFR) and DR, severe DR, and severe visual impairment among T2DM patients in Thailand.METHODS We conducted a nationwide cross-sectional study based on the DM/HT study of the Medical Research Network of the Consortium of Thai Medical Schools. This study evaluated adult T2DM patients from 831 public hospitals in Thailand in the year 2013. GFR was categorized into ≥ 90, 60-89, 30-59 and < 30 mL/min/1.73 m^2.The association between GFR and DR, severe DR, and severe visual impairment were assessed using multivariate logistic regression.RESULTS A total of 13192 T2DM patients with available GFR were included in the analysis.The mean GFR was 66.9 ± 25.8 mL/min/1.73 m^2. The prevalence of DR,proliferative DR, diabetic macular edema, and severe visual impairment were 12.4%, 1.8%, 0.2%, and 2.1%, respectively. Patients with GFR of 60-89, 30-59 and <30 mL/min/1.73 m^2 were significantly associated with increased DR and severe DR when compared with patients with GFR of ≥ 90 mL/min/1.73 m^2. In addition,increased severe visual impairment was associated with GFR 30-59 and < 30 m L/min/1.73 m^2.CONCLUSION Decreased GFR was independently associated with increased DR, severe DR, and severe visual impairment. GFR should be monitored in diabetic patients for DR awareness and prevention.

Hepatic applications of endoscopic ultrasound:Current status and future directions

The diagnosis and staging of various gastrointestinal malignancies have been made possible with the use of endoscopic ultrasound, which is a relatively safe procedure. The field of endoscopic ultrasound is fast expanding due to advancements in therapeutic endoscopic ultrasound. Though various studies have established its role in gastrointestinal malignancies and pancreatic conditions, its potential in the field of hepatic lesions still remains vastly untapped. In this paper the authors attempt to review important and landmark trials, case series and case studies involving hepatic applications of endoscopic ultrasound, thus not only providing an overview of utilization of endoscopic ultrasound in various liver conditions but also speculating its future role.

Complementary roles of interventional radiology and therapeutic endoscopy in gastroenterology

Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient's work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping and complementary in the management of these complex conditions.

Prevalence and associated factors of hospitalization for dysglycemia among elderly type 2 diabetes patients: A nationwide study

BACKGROUND The prevalence of older individuals with type 2 diabetes mellitus (T2DM) is increasing due to the aging population and improved medical care. These patients are very susceptible to disease and treatment-related hospitalizations, resulting in higher health care costs, morbidity, and decreased quality of life. However, data of treatment-related complications, especially dysglycemiarelated hospitalizations, are lacking. AIM To assess the prevalence and associated factors for dysglycemia-related hospitalizations among elderly diabetic patients in Thailand using nationwide patient sample. METHODS T2DM patients aged ≥ 65 years who received medical care at public hospitals in Thailand in the year 2014 were included. The prevalence of hospitalization due to dysglycemia within one year was examined. Multivariable logistic regression was performed to assess the independent factors associated with hospitalization due to hypoglycemia and hyperglycemia RESULTS A total of 11404 elderly T2DM patients were enrolled in this study. The mean age was 72.9 ± 5.5 years. The prevalence of hospital admissions due to diabetic ketoacidosis, hyperosmolar hyperglycemic state, hyperglycemic dehydration syndrome, and hypoglycemia among elderly T2DM patients in the year 2014 was 0.1%, 0.1%, 1.7% and 3.1%, respectively. Increased hospitalization due to hypoglycemia was associated with older age, female sex, had hypertension, dementia, lower body mass index, elevated hemoglobin A1C (HbA1C), decreased kidney function, insulin use. Increased hospitalization due to hyperglycemia was associated with dementia, depression, lower body mass index, elevated HbA1C, and insulin use. CONCLUSION The prevalence of dysglycemia-related hospitalization in elderly T2DM patients in Thailand was 4.9%. Close monitoring of blood glucose should be provided in high-risk patients for prevention and early detection for these complications.

Isolation of antileishmanial,antimalarial and antimicrobial metabolites from Jatropha multifida

Objective:To investigate the antileishinanial,antimicrobial and antimalarial activities of the pure metabolites from Jatropha multifida used in African ethnomedicine.Methods:The methanolic stem bark extract of Jatropha multifida used in Nigerian folk medicine as remedy against bacterial infections was subjected to column chromatography and HPLC analyses lo obtain three known metabolites,microcyclic lathyrane dilerpenoids(1-3).Structures were confirmed by comparison of 1D and 2D spectral data with literature.Results:The three compounds exhibited inhibition of antileishmanial,antimalarial and antimicrobial actions against the tested organisms with compouds 2 and 3 active against Cryptococcus neoformans at IC_(50)of 82 and 8.7 μg/ml,respectively.Conclusions:The research lends support to the ethnomedicinal use of the plant in combating microbial infections,leishmaniasis and malarial infections.