High-Value Components and Bioactives from Sea Cucumbers for Functional Foods—A Review

Sea cucumbers, belonging to the class Holothuroidea, are marine invertebrates, habitually found in the benthic areas and deep seas across the world. They have high commercial value coupled with increasing global production and trade. Sea cucumbers, informally named as bêche-de-mer, or gamat, have long been used for food and folk medicine in the communities of Asia and Middle East. Nutritionally, sea cucumbers have an impressive profile of valuable nutrients such as Vitamin A, Vitamin B1 (thiamine), Vitamin B2 (riboflavin), Vitamin B3 (niacin), and minerals, especially calcium, magnesium, iron and zinc. A number of unique biological and pharmacological activities including anti-angiogenic, anticancer, anticoagulant, anti-hypertension, anti-inflammatory, antimicrobial, antioxidant, antithrombotic, antitumor and wound healing have been ascribed to various species of sea cucumbers. Therapeutic properties and medicinal benefits of sea cucumbers can be linked to the presence of a wide array of bioactives especially triterpene glycosides (saponins), chondroitin sulfates, glycosaminoglycan (GAGs), sulfated polysaccharides, sterols (glycosides and sulfates), phenolics, cerberosides, lectins, peptides, glycoprotein, glycosphingolipids and essential fatty acids. This review is mainly designed to cover the high-value components and bioactives as well as the multiple biological and therapeutic properties of sea cucumbers with regard to exploring their potential uses for functional foods and nutraceuticals

Improving Orthopaedic Assessment in a Physiotherapy Department

The writer’s physiotherapy department has 36 therapists who graduated from 12 different national and international universities. This has caused diversity in assessment and documentation procedures. A literature review showed that professional and standardised documentation is vital for the creation of patient care plans, enhances communication, and is a legal requirement. In addition, the generated data can be used for research purposes. Moreover, research has shown that the use of forms is associated with significantly higher documentation rates. The World Confederation for Physical Therapy published the Core Standards of Physiotherapy Practice and recognised the importance of developing assessment forms that suit the prevailing circumstances in organisations. This change project used a modified HSE change model. The in-service team formulated seven orthopaedic assessment forms and conducted training lectures to enhance employees’ knowledge and skills. The post-change audit revealed a compliance rate of 38% in the use of the forms. Furthermore, the subjective and objective documentation rates significantly improved after training sessions. The organisation is working to computerise the documentation of the assessment forms to further improve the documentation and assessment procedures

A Comprehensive Electroencephalogram Audit in A Tertiary Care Center in Pakistan: Demographic Distribution, Referral Indications and Findings

Background and Objective: Electroencephalography (EEG) is a widely employed non-invasive technique for recording brain electrical activity, pivotal for diagnosing various neurological conditions. The study aims to provide insight into demographic distribution, referral indications, and EEG findings in a tertiary care hospital in Pakistan. Methods: A retrospective cross-sectional analysis was conducted involving 2,924 patients who underwent routine EEG evaluations over a three-year period. Data was collected from the EEG records after approval from the ethical review committee. Demographic variables, referral reasons, and EEG findings were recorded and analyzed using descriptive statistics. Results: The study revealed a gender distribution of 41.35 % females and 58.65 % males, aligning with broader epidemiological trends. Participants were categorized into different age groups and most of the patients in our study belonged to the five to 18 years of age group. Most common indication was a suspected seizure disorder (78.32 %), followed by subclinical seizures (7.38 %) and medication adjustment (6.81 %). Notably, encephalopathy was the most common abnormal EEG finding (31 %), with temporal epilepsies being predominant within the focal seizure category. Conclusion: The descriptive nature of the study contributes novel insights. The study’s contribution provides valuable guidance for healthcare professionals, enhancing their comprehension of neurological conditions and refining diagnostic and treatment strategies

Association Of Raised Serum Triglycerides With Incidence Of Pre-Eclampsia

Background: Pre-eclampsia, a serious multi-systemic pregnancy complication is estimated to occur in 5-10% of pregnancies worldwide. Objective: To determine the frequency of pre-eclampsia in pregnant females with hyper-triglyceridemia and to study its associations. Methodology: This Cross-sectional study was conducted at Gynecology Dept. Poly Clinic Hospital, Islamabad (March - Sept. 2022). Pregnant females of age 15-40 years, gestational age 13-20th weeks and singleton pregnancy were included. Known hypertensives, receiving lipid-lowering or anti-hypertensives, chronic kidney or liver disease, teenage pregnancies, primigravida, history of CVA, IHD, epilepsy or endocrine disorders were excluded. After the detailed clinical evaluation, fasting serum triglyceride levels were checked. A total of 225 cases with elevated serum triglycerides were finally selected and evaluated for the presence of pre-eclampsia by monitoring the blood pressure, cardiovascular, gynaecological examination and urine for the presence of proteinuria. Patients were followed till the development of pre-eclampsia or completion of pregnancy.  Results: Among 225 pregnant females with raised serum triglycerides, the mean age was 24.28+5.5 years. Pre-eclampsia was observed in 47(20.89%) of patients.  The Chi-square tests of association between pre-eclampsia and each of parity, residential status, and socio-economic status were insignificant while BMI and Gestational age were significant.  Conclusion: There is a high prevalence of pre-eclampsia in pregnant women with hypertriglyceridemia. Serum triglyceride levels may predict the women at risk for pre-eclampsia. The risk of preeclampsia in women with hyper-triglyceridemia is independent of parity, and socioeconomic or residential status. Hypertriglyceridemia may predispose to pre-eclampsia even at lower BMI levels. The development of hypertriglyceridemia in early gestation may be an additional risk factor. Early screening of women at risk may lead to better outcomes

A Review of Eviction Protections in Dallas, Texas

The Institute for Urban Policy Research partnered with the Texas Tenants Union to better understand the impact of eviction remediation programs on the plight of tenants in the City of Dallas. In Dallas, roughly three of every five households rent their home; programs aimed at preventing eviction are pertinent to most of Dallas's population (U. S. Census Bureau, 2020). Financial impacts of the Coronavirus pandemic threatened many households in Dallas and the early days of the pandemic saw multiple policy and procedure interventions, including court closures and the CARES Act. Dallas City Council was among the first localities to act, pass an eviction ordinance to protect renters from losing their homes.In this study, we pursue a mixed-methods approach, embracing both qualitative and quantitative research tools. Working with Dallas County, whose Justice of the Peace courts are the courts of original jurisdictions for evictions in Texas, we secured case filing data for January through June of 2019 and 2020. This data was used to perform a series of regression analyses comparing the volume of evictions in Dallas and surrounding cities. Next, we randomly sampled cases filed in one Dallas County Justice of the Peace court, including portions of Dallas and surrounding communities. We conducted a systematic record review of the entire case file for each of the randomly sampled cases. Finally, we engaged a purposive sample of local government and non-profit leaders, as well as affected tenants, in a focus group setting to understand their experiences with eviction in Dallas.While the quantitative results do suggest some impact of these policy responses, the findings are not encouraging. First, the milieu of policies enacted offered no universal protection to any broad segment of renting households. Second, many of those protected by these policies did not know their status, and efforts to educate them were not universally deployed. Finally, even when protected tenants were aware of their protection, their attempts to assert their rights were met by a system often confused on how to respect them

The impact of coronary perforation in percutaneous interventions involving the left main stem coronary artery in the United Kingdom 2007-2014: Insights from the British Cardiovascular Intervention Society database

Background Percutaneous coronary intervention (PCI) is increasingly utilized for treatment of coronary disease involving the unprotected left main stem (ULMS). However, no studies to date have examined the outcomes of such interventions when complicated by coronary perforation (CP). Methods Using the British Cardiovascular Intervention society (BCIS) database, data were analyzed on all ULMS‐PCI procedures complicated by CP in England and Wales between 2007 and 2014. Multivariate logistic regressions were used to identify predictors of ULMS CP and to evaluate the association between this complication and outcomes. Results During 10,373 ULMS‐PCI procedures, CP occurred more frequently than in non‐ULMS‐PCI (0.9 vs. 0.4%, p < .001) with a stable annual incidence. Covariates associated with CP included number of stents used, female gender, use of rotational atherectomy and chronic total occlusion (CTO) intervention. Adjusted odds of adverse outcomes for ULMS‐PCI complicated by CP were higher for peri‐procedural complications including cardiogenic shock, tamponade, side‐branch loss, DC cardioversion, in‐hospital major bleeding, transfusion requirement, and peri‐procedural myocardial infarction. There were also significantly increased odds for in‐hospital major adverse cardiac events (MACCE, OR 8.961, 95% CI [4.902–16.383]) and 30‐day mortality (OR 5.301, 95% CI [2.741–10.251]). Conclusions CP is an infrequent event during ULMS‐PCI and is predicted by female gender, rotational atherectomy, CTO interventions or number of stents used. CP was associated with significantly higher odds of mortality and morbidity, but at rates similar to previously published all‐comer PCI complicated by CP

Proximate and Sensory Analysis of Wheat Bread Supplemented with Onion Powder and Onion Peel Extract

In current era, the agro-waste production is tremendously increasing which strongly influences the stability of the ecosystem and ultimately the human health. Onion is among one of the most commonly consumed vegetables worldwide, but its peel is generally regarded as waste, which is rich in various phytonutrients. Wheat bread is consumed as a staple food by large number of populations hence this study was aimed at improving the nutritional quality of bread by supplementing it with onion peel extract (OPE) and onion powder (OP). A control bread was synthesized using standard formulation while breads supplemented with OPE and OP were prepared by substituting wheat flour with OPE and OP at 1%, 3% and 5%, 7% respectively. Proximate analysis of five types of bread (A, B, C, D, E) presented that addition of onion peel extract significantly (p <0.05) improved the moisture content (21.06-21.79%) of breads while incorporation of onion powder brought significant improvement in fiber (0.24-0.32%), protein (9.80-10.35%) and ash content (1.55-1.94%). Sensory analysis of the breads was done by a semi- trained panel constituting of 7 members. Significant differences were reported among the five treatments for appearance, texture, taste, odor and overall acceptability. Maximum score for all the above- mentioned attributes was obtained by 1% OPE fortified bread while the 7% onion powder fortified bread attained the lowest scores. The sensory attributes of OPE makes it a good flavoring ingredient for baked items.Peer reviewe

Two-year real-world outcome data from a single tertiary centre shows reduced ustekinumab persistence in a non-bio-naïve Crohn's disease cohort with penetrating disease, -ostomies and sarcopenia

BACKGROUND: Ustekinumab was approved in 2016 for the treatment of moderate-severe Crohn's disease (CD). Clinical trials and real-world studies have suggested ustekinumab to be a safe and effective treatment; however, studies to date infrequently use imaging techniques to predict response to biologics in CD. OBJECTIVES: We assessed the 2-year real-world effectiveness and safety of ustekinumab in a tertiary CD cohort with the use of novel imaging techniques. DESIGN: Retrospective cohort study. METHODS: Retrospective data were collected between 2016 and 2021. Study end points included ustekinumab persistence, biological and/or clinical response and remission at 12, 18 and 24 months. Statistical analysis included demographic and inferential analyses. RESULTS: In all, 131 CD patients [57.3% female, median age of 26.0 (21.0-37.0)] were included. Patients were non-bio naïve, and the majority received ustekinumab as third- or fourth-line treatment. At 24 months, 61.0% (80/131) persisted with ustekinumab [52.7% (69/131) steroid free]. Clinical response was reported in 55.2% (37/67), clinical remission in 85.7% (57/67), biological response in 46.8% (22/47) and biological remission in 31.9% (15/47) of patients at 24 months. The low outcome numbers were attributable to missing data. Improvements in routine disease markers, including C-reactive protein and Harvey-Bradshaw Index, were also reflected in magnetic resonance imaging-derived disease scores. The presence of penetrating CD, an -ostomy and sarcopenia were all predictors of poorer ustekinumab outcomes (p < 0.05). CONCLUSION: Ustekinumab is effective in non-bio-naïve CD patients with non-stricturing, non-penetrating disease with an unremarkable safety profile but may be less effective in those with penetrating disease, -ostomies and sarcopenia