Vitamin D supplementation as a fall prevention method: A systematic review

BackgroundFalls are ‎common occurrences events leading to ‎remarkable morbidity and ‎mortality. Vitamin D supplementation is often recommended to prevent falls, although vitamin D trials‎ conclude contradictory results.AimsThis review aimed to summarize the available RCTs that studied the effect of ‎vitamin ‎D administered on falls in older adults.Methods Pub Med, ‎Google Scholar, and EBSCO ‎ databases were systematically search for relevant articles. The terms ‎ vitamin D, falls, ergocalciferols, 25-hydroxy vitamin D, and ‎‎1, ‎‎25-dihydroxy vitamin D‎ were used. out of Three hundred and four, only ‎eleven fulfilled ‎the inclusion criteria.Results In the majority of the randomized control trial, vitamin D supplementation provides protection against falls among the elderly population.ConclusionThe majority of the studies concluded that vitamin D alone or ‎in ‎combination with calcium was a ‎successful fall ‎reduction method among the ‎elderly

Endogenous endophthalmitis due to Serratia marcescens secondary to late‐onset empyema Post‐Cardiac surgery in an End‐Stage renal disease patient on peritoneal dialysis

Abstract Endogenous bacterial endophthalmitis results from bacterial seeding of the eye during bacteremia. A diagnosis of endogenous bacterial endophthalmitis requires clinical findings such as vitritis or hypopyon along with positive blood cultures. Serratia marcescens is the second most common pathogen causing hospital‐acquired ocular infections. This report describes a case of endogenous bacterial endophthalmitis caused by S. marcescens in an older adult with end‐stage renal disease (ESRD) on peritoneal dialysis, who had late‐onset pleural empyema secondary to coronary artery bypass grafting (CABG). A 61‐year‐old gentleman presented with a two‐day history of cloudy vision, black floaters, pain, swelling, and gradual vision loss in his right eye. There was no history of trauma, ocular surgeries, or previous similar episodes. He had myocardial infarction treated with CABG 3 months back. Examination showed a 3 mm hypopyon in the anterior chamber. He had classic signs of endophthalmitis with positive blood cultures for S. marcescens. He was treated with high‐dose intravenous meropenem and intravitreal ceftazidime without vitrectomy. Endophthalmitis progressed to complete vision loss in his right eye, requiring evisceration. Endophthalmitis caused by S. marcescens is rare, but long‐term outcomes can be severe, causing complete vision loss in about 60% of the patients. It is usually hospital‐acquired, and the source can be late‐onset empyema several months after cardiac surgery, in an immunocompromised patient. Systemic antibiotics should be supplemented with intravitreal agents with or without pars plana vitrectomy

Warfarin-Rifampin-Gene (WARIF-G) Interaction: A Retrospective, Genetic, Case–Control Study

Warfarin is extensively metabolized by cytochrome P450 2C9 (CYP2C9). Concomitant use with the potent CYP2C9 inducer, rifampin, requires close monitoring and dosage adjustments. Although, in theory, warfarin dose increase should overcome this interaction, most reported cases over the last 50 years have not responded even to high warfarin doses, but some have responded to modest doses. To investigate the genetic polymorphisms' impact on this unexplained interpatient variability, we performed genotyping of CYP2C9, VKORC1, and CYP4F2 for warfarin and rifampin concomitant receivers from 2016 to 2022 at Hamad Medical Corporation, Doha, Qatar. We identified and included 36 patients: 22 responders and 14 nonresponders. Warfarin-responders were significantly more likely to have one or more warfarin-sensitizing CYP2C9/VKORC1 alleles than nonresponders (odds ratio = 23.2, 95% confidence interval = 3.2–195.6; P = 0.0001). The mean genetic-based pre-interaction calculated dose was significantly lower for responders than for nonresponders (P < 0.001); and was negatively correlated with warfarin sensitivity index (WSI) (r = −0.58; P = 0.0002). The median percentage time in therapeutic range and mean WSI were significantly higher in the warfarin-sensitizing CYP2C9/VKORC1 alleles carriers than noncarriers (P = 0.017 and 0.0004, respectively). Whereas the warfarin-sensitizing CYP2C9/VKORC1 genotypes were associated with modest on-rifampin warfarin dose requirements, the noncarriers would have required more than double these doses to respond. Warfarin-sensitizing CYP2C9/VKORC1 genotypes and low genetic-based warfarin calculated doses were associated with higher warfarin sensitivity and better anticoagulation quality in patients receiving rifampin concomitantly.The cost for the materials and the genetic testing procedures was provided by Hamad Medical Corporation (HMC) to Qatar University (QU) as per a reimbursement Research Collaboration Agreement. The publication of this article was funded by Qatar National Library (QNL)

Secondary Metabolites, Biological Activities, and Industrial and Biotechnological Importance of <em>Aspergillus sydowii</em>

Marine-derived fungi are renowned as a source of astonishingly significant and synthetically appealing metabolites that are proven as new lead chemicals for chemical, pharmaceutical, and agricultural fields. Aspergillus sydowii is a saprotrophic, ubiquitous, and halophilic fungus that is commonly found in different marine ecosystems. This fungus can cause aspergillosis in sea fan corals leading to sea fan mortality with subsequent changes in coral community structure. Interestingly, A. sydowi is a prolific source of distinct and structurally varied metabolites such as alkaloids, xanthones, terpenes, anthraquinones, sterols, diphenyl ethers, pyrones, cyclopentenones, and polyketides with a range of bioactivities. A. sydowii has capacity to produce various enzymes with marked industrial and biotechnological potential, including α-amylases, lipases, xylanases, cellulases, keratinases, and tannases. Also, this fungus has the capacity for bioremediation as well as the biocatalysis of various chemical reactions. The current work aimed at focusing on the bright side of this fungus. In this review, published studies on isolated metabolites from A. sydowii, including their structures, biological functions, and biosynthesis, as well as the biotechnological and industrial significance of this fungus, were highlighted. More than 245 compounds were described in the current review with 134 references published within the period from 1975 to June 2023

Predictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis

BACKGROUND: Predictive markers represent a solution for the proactive management of severe dengue. Despite the low mortality rate resulting from severe cases, dengue requires constant examination and round-the-clock nursing care due to the unpredictable progression of complications, posing a burden on clinical triage and material resources. Accordingly, identifying markers that allow for predicting disease prognosis from the initial diagnosis is needed. Given the improved pathogenesis understanding, myriad candidates have been proposed to be associated with severe dengue progression. Thus, we aim to review the relationship between the available biomarkers and severe dengue. METHODOLOGY: We performed a systematic review and meta-analysis to compare the differences in host data collected within 72 hours of fever onset amongst the different disease severity levels. We searched nine bibliographic databases without restrictive criteria of language and publication date. We assessed risk of bias and graded robustness of evidence using NHLBI quality assessments and GRADE, respectively. This study protocol is registered in PROSPERO (CRD42018104495). PRINCIPAL FINDINGS: Of 4000 records found, 40 studies for qualitative synthesis, 19 for meta-analysis. We identified 108 host and viral markers collected within 72 hours of fever onset from 6160 laboratory-confirmed dengue cases, including hematopoietic parameters, biochemical substances, clinical symptoms, immune mediators, viral particles, and host genes. Overall, inconsistent case classifications explained substantial heterogeneity, and meta-analyses lacked statistical power. Still, moderate-certainty evidence indicated significantly lower platelet counts (SMD -0.65, 95% CI -0.97 to -0.32) and higher AST levels (SMD 0.87, 95% CI 0.36 to 1.38) in severe cases when compared to non-severe dengue during this time window. CONCLUSION: The findings suggest that alterations of platelet count and AST level—in the first 72 hours of fever onset—are independent markers predicting the development of severe dengue

Association between pet ownership and cardiovascular risks and mortality: a systematic review and meta-analysis

The aim of the study was to determine the association between pet ownership and cardiovascular risk factors and mortality. Electronic search was conducted through nine databases including PubMed for relevant publications reporting cardiovascular events and mortality among pet owners. Meta-analysis was used to pool the results. Of a total of 2818 reports screened, 26 studies were included in our systematic review and meta-analysis. Higher survival rate was observed in the pet owners group after pooling nonadjusted and adjusted hazard ratios for cardiovascular mortality at 0.73 [95% confidence interval (CI) 0.62–0.86] and 0.81 (0.68–0.97), respectively. A similar trend was observed for the pooled nonadjusted hazard ratio for overall mortality 0.73 (0.62–0.87) but not the adjusted hazard ratio 0.40 (0.04–3.78). Cat owners have a reduction in cardiovascular mortality but not overall mortality after pooling the adjusted hazard ratio 0.79 (0.63–0.99) and 1.04 (0.90–1.21), respectively. However, no significant association between dog owners and survival rate was observed for overall and cardiovascular-specific mortality. Pet owners had significantly lower heart rate (mean difference 95% CI: −2.32 (−3.07 to −1.57), mean arterial pressure −2.60 (−4.25 to −0.95) and SBP −1.69 (−3.06 to −0.31) but not DBP −0.23 (−1.05 to 0.60). No significant difference was observed between pet owners and nonpet owners in prevalence of hypertension. Our study draws attention to the beneficial effects of the human--pet bond; therefore, we recommend pet acquisition for better cardiovascular outcomes after controlling for zoonotics and pet-induced allergies

Efficacy and resistance of different artemisinin-based combination therapies: a systematic review and network meta-analysis

Background: Malaria parasites have developed resistance to most of the known antimalarial drugs in clinical practice, with reports of artemisinin resistance emerging in South East Asia (SEA). We sort to find the status of artemisinin resistance and efficacy of different modalities of the current artemisinin-based combination therapies (ACTs). Methods: We carried out a systematic search in 11 electronic databases to identify in vivo studies published between 2001 and 2017 that reported artemisinin resistance. This was then followed by A network meta-analysis to compare the efficacy of different ACTs. Quality assessment was performed using the Cochrane Risk of Bias (ROB) tool for randomized controlled trials and National Institute of Health (NIH) tool for cross-sectional studies. The study protocol was registered in PROSPERO under number CRD42018087574. Results: With 8400 studies initially identified, 82 were eligible for qualitative and quantitative analysis. Artemisinin resistance was only reported in South East Asia. K13 mutation C580Y was the most abundant mutation associated with resistance having an abundance of 63.1% among all K13 mutations reported. Although the overall network meta-analysis had shown good performance of dihydroartemisinin piperaquine in the early years, a subgroup analysis of the recent years revealed a poor performance of the drug in relation to recrudescence, clinical failure and parasitological failure especially in the artemisinin resistant regions. Conclusion: With report of high resistance and treatment failure against the leading artemisinin combination therapy in South East Asia, it is imperative that a new drug or a formulation is developed before further spread of resistance.Parasitology International, 74, art. no. 101919; 201