Comparing the incidence of hypoglycemia episodes in patients with type 2 diabetes and chronic kidney disease treated with insulin or glibenclamide

Introduction. Hypoglycemia is one of the side effects of glibenclamide, which is administered orally in people with diabetes. Hypoglycemia may occur easily due to the reduced metabolism of this drug in patients with chronic kidney disease. The aim of this study was to compare the incidence of hypoglycemia in patients with chronic kidney disease who were treated with glibenclamide or insulin. Material and methods. In this study, 87 patients with type 2 diabetes and in stage 3–4 of chronic kidney disease (CKD) were examined. The patients were divided into two groups of glibenclamide (N = 44) and insulin (N = 43) based on the type of blood glucose-lowering therapy. Next, demographic data, serum creatinine level, number of hypoglycemic episodes over the last year and the amount of consumed drugs were recorded in the checklist. Finally, the data analysis was performed using the SPSS Software. Results. There was no significant difference between the two groups in terms of age, estimated glomerular filtration rate (eGFR), weight, duration of diabetes and blood glucose control. In addition, it was indicated that 38% of patients in the glibenclamide group and 32% of patients in the insulin group had at least one hypoglycemic episode. Also, in those two groups, there was no significant correlation between doses of the drug and the number of hypoglycemic episodes. Conclusions. This study showed that there was no significant difference between the patients with chronic kidney disease who were treated with insulin and those patients who were treated with glibenclamide in terms of number of symptomatic hypoglycemic episodes

Prevalence of Asymptomatic Brucellosis in Children 7 to 12 Years Old

Background. Brucellosis is one of the most common diseases of humans and animals and its clinical manifestations differ from asymptomatic infection to chronic illness associated with recurrence of symptoms. This study aimed to evaluate the prevalence of brucellosis in asymptomatic children 7 to 12 years old in Kahak, Iran. Methods. In this study, 186 children 7 to 12 years old were evaluated. Demographic data and exposure to the brucellosis agent were recorded and blood samples for the Wright, Coombs, and 2ME tests were collected. All the study subjects were followed up for one year about the appearance of symptoms. Results. The mean age was 10 ± 1.72 years and 51% were boys. Family history was positive for brucellosis in 15% of children. A total of 8 children were brucellosis seropositive and, in subsequent follow-up, 6 of them showed the disease symptoms. Conclusion. This study showed that approximately 4.3% of children in endemic areas can have asymptomatic brucellosis and many of these children may be symptomatic in short term

Porównanie częstości występowania epizodów hipoglikemii u chorych na cukrzycę typu 2 z przewlekłą chorobą nerek leczonych insuliną lub glibenklamidem

Wstęp. Hipoglikemia jest jednym z objawów ubocznych obserwowanych przy stosowaniu glibenklamidu — leku doustnego używanego w leczeniu cukrzycy. Hipoglikemia może występować częściej z powodu obniżonego metabolizmu tego leku u chorych z przewlekłą niewydolnością nerek. Celem pracy była ocena częstości występowania hipoglikemii u pacjentów z przewlekłą niewydolnością nerek leczonych glibenklamidem w porównaniu z chorymi otrzymującymi insulinę. Metody. Do badania zakwalifikowano 87 pacjentów z cukrzycą typu 2 i niewydolnością nerek w stadium 3.–4. Na podstawie zastosowanego leczenia hipoglikemizującego zostali oni podzieleni na dwie grupy: pacjentów otrzymujących glibenklamid (n = 44) oraz leczonych insuliną (n = 43). Następnie odnotowano dane demograficzne, poziom kreatyniny w surowicy krwi, liczbę epizodów hipoglikemii w ciągu ostatniego roku oraz dane dotyczące liczby zużytych leków. Analizę przeprowadzono za pomocą oprogramowania SPSS Software. Wyniki. Nie obserwowano znamiennej różnicy między badanymi grupami w odniesieniu do wieku i masy ciała pacjentów, poziomu wskaźnika filtracji kłębuszkowej (GFR), czasu trwania cukrzycy oraz jej wyrównania. Ponadto stwierdzono że u 38% pacjentów w grupie leczonych glibenklamidem oraz u 32% chorych z grupy otrzymujących insulinę wystąpił co najmniej jeden epizod hipoglikemii. W obu grupach nie było znamiennej korelacji między dawką przyjmowanego leku a liczbą incydentów hipoglikemii. Wnioski. Badanie wykazało brak istotnej różnicy w liczbie objawowych epizodów hipoglikemii między grupami pacjentów z cukrzycą i przewlekłą chorobą nerek leczonych glibenklamidem a grupą chorych z cukrzycą, i tym samym z powikłaniem, otrzymujących insulinę

Promising approaches for simultaneous enhancement of medicinally significant benzylisoquinoline alkaloids in opium poppy

Benzylisoquinoline alkaloids (BIAs) produced in opium poppy have been evidenced to heal patients suffering from various diseases. They, therefore, hold an integral position in the herbal drug industry. Despite the adoption of several approaches for the large-scale production of BIAs, opium poppy remains the only platform in this purpose. The only disadvantage associated with producing BIAs in the plant is their small quantity. Thus, recruiting strategies that boost their levels is deemed necessary. All the methods which have been employed so far are just able to enhance a maximum of two BIAs. Thus, if these methods are utilized, a sizable amount of time and budget must be spent on the synthesis of all BIAs. Hence, the exploitation of strategies which increase the content of all BIAs at the same time is more commercially effective and time-saving, avoiding the laborious step of resolving the biosynthetic pathway of each compound. Exposure to biotic and abiotic elicitors, development of a synthetic auto-tetraploid, overexpression of a WRKY transcription factor, formation of an artificial metabolon, and suppression of a gene in the shikimate pathway and miRNA are strategies that turn opium poppy into a versatile bioreactor for the concurrent and massive production of BIAs. The last three strategies have never been applied for BIA biosynthetic pathways

Epidemiological and Clinical Aspects of COVID-19; a Narrative Review

There are significant misconceptions and many obstacles in the way of illuminating the epidemiological and clinical aspects of COVID-19 as a new emerging epidemic. In addition, usefulness of some evidence published in the context of the recent epidemic for decision making in clinic as well as public health is questionable. However, misinterpreting or ignoring strong evidence in clinical practice and public health probably results in less effective and somehow more harmful decisions for individuals as well as subgroups in general populations of countries in the initial stages of this epidemic. Accordingly, our narrative review appraised epidemiological and clinical aspects of the disease including genetic diversity of coronavirus genus, mode of transmission, incubation period, infectivity, pathogenicity, virulence, immunogenicity, diagnosis, surveillance, clinical case management and also successful measures for preventing its spread in some communities. Keywords:COVID-19; severe acute respiratory syndrome coronavirus 2; epidemiology; public health; communicable diseases; emergin

Association of Salivary Microbial, Fungal Population and Salivary Acidity with Obesity in Children

Background: Childhood obesity is an increasing global health concern associated with both systemic and oral complications. While studies suggest links between body mass index (BMI) and oral health markers, these relationships remain poorly defined.Purpose: This study evaluated the association between salivary microbial/fungal populations, salivary acidity, and obesity in children.Materials and Method: In this cross-sectional descriptive study (2021–2022), 90 children aged 8-12 from public schools in Qom, Iran, were categorized into three groups based on BMI: 30 children with normal weight, 30 overweight children, and 30 obese children. Demographic information, including parental education and occupation, was recorded. Unstimulated saliva samples were collected using the passive drooling method. A total of 0.5 ml of saliva was mixed with 5 ml of phosphate-buffered saline (PBS) and homogenized thoroughly by using a shaker. Microbiological analysis involved quantifying colonies of Streptococcus mutans, Lactobacillus, and Candida albicans and measuring salivary pH using a calibrated pH meter. Data were analyzed using appropriate statistical tests with significance set at p Value< 0.05.Results: No significant relationship was found between childhood obesity and parental education (father’s p= 0.051, mother’s p= 0.862) or occupation (father’s p= 0.224, mother’s p= 0.893). Salivary pH did not differ significantly between weight groups (p= 0.639). Overweight children had lower Lactobacillus levels (p= 0.857), and obese children had higher Streptococcus mutans levels (p=  0.777); though neither correlated significantly with BMI. Candida albicans colonies showed a significant negative correlation with childhood obesity (p= 0.046). Significant associations were also observed between Streptococcus mutans (p= 0.046) and Lactobacillus (p= 0.002) levels with Candida albicans levels.Conclusion: Although oral bacterial levels did not differ significantly across weight groups, fungal species, particularly Candida albicans, varied significantly. A negative association between obesity and Candida albicans counts suggests that obesity may impact the salivary microbial ecosystem, highlighting the need for further research into its systemic and oral health implications

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019 a systematic analysis for the global burden of disease study 2019

IMPORTANCE The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world. © 2022 American Medical Association. All rights reserved. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman" is provided in this record*

Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations