A Review In Medical, Pharmacological and Industrial Importance of Roselle <em>Hibiscus sabdariffa</em> L.

Medicinal plants and plants occupy a major place in the world’s agricultural and industrial production as the main source of pharmaceutical drugs or as a source of active substances that are used in the preparation of medicine. The Roselle plant Hibiscus sabdariffa L.(Malvaceae Family) is known in Arabic as “karkade” and “Roselle”. The continental regions of Africa and Asia are the original home of the Roselle. The months of March and April and proceeds to reap the fruits during the months of October to the end of December. Recent researches and studies have pointed to the use of Roselle plant in the medical, food and industrial fields. It is used in the manufacture of jellies and jams. The syrup is added to some medical preparations. It is refreshing, moisturizing, and helps digestion. It is also a useful drink in the cases of bile. It causes urination and acts as an antifungal agent. and is used in the treatment of high blood pressure, It is also used in cancer treatment

The possible association between Chlamydia pneumoniae infection and asthma.

Background: Many etiological factors have been implicated in the pathogenesis of Asthma like; viruses, bacteria and Chlamydia pneumoniae. This study focuses on the role of Chlamydia pneumoniae in asthma pathogenesis. Patients and Methods: The detection of Anti-Chlamydia pneumoniae antibodies IgA, IgM and IgG in patients by ELISA, for 35 patients, 18 asthmatic patients, 12 patients with chest infection with no history of asthma, and 5 apparently healthy as control subjects. Results: The results showed that 80% and 70% of the patients were negative for anti- Chlamydia pneumonia antibodies IgA and IgM respectively, while significantly (p<0.05) high number (73%) of patients were positive for IgG, of which significant number (p<0.05) of them, 63% were asthmatic and 36% were non-asthmatic chest infection. Conclusion: this study may support the association between Chlamydia pneumoniae and asthma

Simulation of Drug Release in Expanding Hydrogels Containing Chitosan and Gelatin

Utilizing mathematical modeling of drug release is one method for accelerating the rate of drug diffusion and penetration in hydrogel-based systems. This method facilitates a greater comprehension of drug control mechanisms and their release. Hydrogels are expanding biomaterials that necessitate regulation for use in drug release. The current study's objective is to model drug release in swelling hydrogels containing combinations of chitosan and gelatin polymers; with the aid of this simulation, the release time and concentration of the drug can be predicted. This modeling examined changes in the concentration of drugs in various hydrogels. For this simulation, the governing equations of the drug release system in Python and the numerical solution method were utilized to determine the drug release mechanism in the hydrogel. Then, the graphs of the changes in drug concentration in each hydrogel were examined to evaluate the performance of hydrogels in drug release. Observations revealed that the swelling rate of the hydrogel increases as the concentration of chitosan relative to gelatin in the hydrogel composition rises and that the drug release rate in hydrogels with more significant swelling was also accelerated. Compared to Cs-Gel (1:4) hydrogel, the drug release time in Cs-Gel (4:1), Cs-Gel (3:2), Cs-Gel (2.5:2.5) and Cs-Gel (2:3) hydrogels decreased by 52, 44, 37, and 18%, respectively. In hydrogels with a high swelling rate, the drug concentration decreased rapidly, whereas in hydrogels with a low swelling rate, the duration of drug release increased. This is due to the significance of mass transfer via mass movement and inflation rate

Design of a Wide-Band Microstrip Filtering Antenna with Modified Shaped Slots and SIR Structure

This paper presents a new compact microstrip filtering antenna with modified shaped slots to improve the impedance bandwidth. The proposed microstrip filtering antenna consists of three parts: the monopole radiating patch antenna; the Stepped Impedance Resonator (SIR) filter; and the feeding microstrip line. The designed structure is achieved on one-sided glass epoxy FR-4 substrate with dielectric constant εr = 4.4 and thickness h = 1.6 mm. The design procedure of the proposed filtering antenna starts from the second-order Chebyshev low pass filter (LPF) prototype. The achieved results show an excellent performance of S11-parameter with broadside antenna gain on +z-direction. Having two transmission zeros at 5.4 GHz and 7.7 GHz, good skirt selectivity and a wide-band impedance bandwidth of about 1.66 GHz makes the designed filtering antenna suitable for high-speed data communications. Both the simulation results generated by using the Computer Simulation Technology (CST) software package and the measurement achieved by using a vector network analyzer (HP 8510C) and the anechoic chamber show good agreement

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Clinical presentation and outcomes of peripartum cardiomyopathy in the Middle East: a cohort from seven Arab countries

Aims: Published data on the clinical presentation of peripartum cardiomyopathy (PPCM) are very limited particularly from the Middle East. The aim of this study was to examine the clinical presentation, management, and outcomes of patients with PPCM using data from a large multicentre heart failure (HF) registry from the Middle East. Methods and results: From February to November 2012, a total of 5005 consecutive patients with HF were enrolled from 47 hospitals in 7 Middle East countries. From this cohort, patients with PPCM were identified and included in this study. Clinical features, in-hospital, and 12 months outcomes were examined. During the study period, 64 patients with PPCM were enrolled with a mean age of 32.5 ± 5.8 years. Family history was identified in 11 patients (17.2%) and hypertension in 7 patients (10.9%). The predominant presenting symptom was dyspnoea New York Heart Association class IV in 51.6%, class III in 31.3%, and class II in 17.2%. Basal lung crepitations and peripheral oedema were the predominant signs on clinical examination (98.2% and 84.4%, respectively). Most patients received evidence-based HF therapies. Inotropic support and mechanical ventilation were required in 16% and 5% of patients, respectively. There was one in-hospital death (1.6%), and after 1 year of follow-up, nine patients were rehospitalized with HF (15%), and one patient died (1.6%). Conclusions: A high index of suspicion of PPCM is required to make the diagnosis especially in the presence of family history of HF or cardiomyopathy. Further studies are warranted on the genetic basis of PPCM.Gulf CARE is an investigator-initiated study conducted under the auspices of the Gulf Heart Association and funded by Servier, Paris, France, and (for centres in Saudi Arabia) by the Saudi Heart Association [The Deanship of Scientific Research at King Saud University, Riyadh, Saudi Arabia (Research Group Number RG-1436-013)]. This does not alter our adherence to policies on sharing data and materials, and the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Investigation into the controversial association of Streptococcus gallolyticus with colorectal cancer and adenoma

Background: The seroprevalence of IgG antibodies of Streptococcus gallolyticus subspecies gallolyticus, CIP 105428, was evaluated to investigate the controversial association of S. gallolyticus with colorectal carcinoma and adenoma in attempt to investigate the nature of such association if any, by exploring the mRNA expression of NF-κB and IL-8. Moreover, the serological behavior of S. gallolyticus IgG antibodies was compared to that of an indicator bacterium of bowel, Bacteroides fragilis. Methods: ELISA was used to measure IgG antibodies of S. gallolyticus and B. fragilis in sera of 50 colorectal cancer, 14 colorectal adenoma patients, 30 age- and sex- matched apparently healthy volunteers (HV) and 30 age- and sex- matched colonoscopically-proven tumor-free control subjects. NF-κB and IL-8 mRNA expression was evaluated in tumorous and non-tumorous tissue sections of carcinoma and adenoma patients in comparison with that of control subjects by using in situ hybridization assay. Results: Colorectal cancer and adenoma patients were associated with higher levels of serum S. Gallolyticus IgG antibodies in comparison with HV and control subjects (P 0.05). ELISA cutoff value for the seropositivity of S. gallolyticus IgG was calculated from tumor-free control group. The expression of NF-κB mRNA was higher in tumorous than non-tumorous tissue sections of adenoma and carcinoma, higher in carcinoma/adenoma sections than in control subjects, higher in tumorous sections of carcinoma than in adenoma patients, and higher in S. gallolyticus IgG seropositive than in seronegative groups in both tumorous and non-tumorous sections (P < 0.05). IL-8 mRNA expression in tumorous sections of adenoma and carcinoma was higher than in non-tumorous sections, higher in carcinoma/adenoma than in control subjects, and higher in S. gallolyticus IgG seropositive than in seronegative groups in tumorous rather than non-tumorous sections (P < 0.05). Conclusion: S. gallolyticus most likely plays an essential role in the oncogenic progression of normal colorectal mucosa to adenoma and to CRC. This promoting/propagating role of S. gallolyticus might take place by utilizing certain inflammatory, anti-apoptotic, and angiogenic factors of transformation including NF-κB and IL-8.Ahmed S Abdulamir, Rand R Hafidh, Layla K Mahdi, Tarik Al-jeboori and Fatimah Abubake

The PROVENT-C19 registry: A study protocol for international multicenter SIAARTI registry on the use of prone positioning in mechanically ventilated patients with COVID-19 ARDS

Background The worldwide use of prone position (PP) for invasively ventilated patients with COVID-19 is progressively increasing from the first pandemic wave in everyday clinical practice. Among the suggested treatments for the management of ARDS patients, PP was recommended in the Surviving Sepsis Campaign COVID-19 guidelines as an adjuvant therapy for improving ventilation. In patients with severe classical ARDS, some authors reported that early application of prolonged PP sessions significantly decreases 28-day and 90-day mortality. Methods and analysis Since January 2021, the COVID19 Veneto ICU Network research group has developed and implemented nationally and internationally the "PROVENT-C19 Registry", endorsed by the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care. . .'(SIAARTI). The PROVENT-C19 Registry wishes to describe 1. The real clinical practice on the use of PP in COVID-19 patients during the pandemic at a National and International level; and 2. Potential baseline and clinical characteristics that identify subpopulations of invasively ventilated patients with COVID-19 that may improve daily from PP therapy. This web-based registry will provide relevant information on how the database research tools may improve our daily clinical practice. Conclusions This multicenter, prospective registry is the first to identify and characterize the role of PP on clinical outcome in COVID-19 patients. In recent years, data emerging from large registries have been increasingly used to provide real-world evidence on the effectiveness, quality, and safety of a clinical intervention. Indeed observation-based registries could be effective tools aimed at identifying specific clusters of patients within a large study population with widely heterogeneous clinical characteristics. Copyright

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics