Anti-Obesity Evaluation of Averrhoa carambola L. Leaves and Assessment of Its Polyphenols as Potential α-Glucosidase Inhibitors

Averrhoa carambola L. is reported for its anti-obese and anti-diabetic activities. The present study aimed to investigate its aqueous methanol leaf extract (CLL) in vivo anti-obese activity along with the isolation and identification of bioactive compounds and their in vitro α-glucosidase inhibition assessment. CLL improved all obesity complications and exhibited significant activity in an obese rat model. Fourteen compounds, including four flavone glycosides (1–4) and ten dihydrochalcone glycosides (5–12), were isolated and identified using spectroscopic techniques. New compounds identified in planta included (1) apigenin 6-C-(2-deoxy-β-D-galactopyranoside)-7-O-β-D-quinovopyranoside, (8) phloretin 3′-C-(2-O-(E)-cinnamoyl-3-O-β-D-fucopyranosyl-4-O-acetyl)-β-D-fucopyranosyl-6′-O-β-D fucopyranosyl-(1/2)-α-L arabinofuranoside, (11a) phloretin3′-C-(2-O-(E)-p-coumaroyl-3-O-β-D-fucosyl-4-O-acetyl)-β-D-fucosyl-6′-O-(2-O-β-D-fucosyl)-α-L-arabinofuranoside, (11b) phloretin3′-C-(2-O-(Z)-p-coumaroyl-3-O-β-D-fucosyl-4-O-acetyl)-β-D-fucosyl-6′-O-(2-O-β-D-fucosyl)-α-L-arabinofuranoside. Carambolaside M (5), carambolaside Ia (6), carambolaside J (7), carambolaside I (9), carambolaside P (10a), carambolaside O (10b), and carambolaside Q (12), which are reported for the first time from A. carambola L. leaves, whereas luteolin 6-C-α-L-rhamnopyranosyl-(1-2)-β-D-fucopyranoside (2), apigenin 6-C-β-D-galactopyranoside (3), and apigenin 6-C-α-L-rhamnopyranosyl-(1-2)-β-L-fucopyranoside (4) are isolated for the first time from Family. Oxalidaceae. In vitro α-glucosidase inhibitory activity revealed the potential efficacy of flavone glycosides, viz., 1, 2, 3, and 4 as antidiabetic agents. In contrast, dihydrochalcone glycosides (5–11) showed weak activity, except for compound 12, which showed relatively strong activity

Using Virtual Reality Pablo Gaming in the Post-Operative Rehabilitation of Breast Cancer Patients: Randomized Controlled Trial

Background/Objectives: Surgical treatment of breast cancer may lead to physical and psychological side effects. Exercises, especially those aided by virtual reality (VR), can improve both physical and psychological dysfunctions. To explore the effects of exercises using VR through Pablo games Technology on the function, grip strength, wrist ROM, fatigue, pain, activities of daily living (ADLs), and anxiety among post-operative breast cancer females. Methods: Forty post-operative breast cancer females participated in the current study: nineteen in the control group (CG), who received a standard treatment consisting of upper limb exercises plus intermittent compression therapy, and twenty-one participants assigned to the Pablo group (PG), who received the standard treatment plus additional training using the Pablo game training system. The intervention period was eight weeks long. The outcome measures were function, grip strength, wrist ROM, fatigue, pain, activities of daily living, and anxiety. Data were obtained at the baseline, after eight weeks, and at two months follow-up. Results: There were statistically significant declines in pain and fatigue, while there were statistically significant improvements in ADLs, grip strength, function, and ROM post-intervention and at two months follow-up in both groups (p < 0.001). Between-group comparisons demonstrated a statistically significant decrease in pain, anxiety, and fatigue and statistically significant improvements in function, ADLs, grip strength, and ROM in favor of the PG post-treatment and at the follow-up (p < 0.001). Conclusions: Adding VR using the Pablo game training system to the standard rehabilitation of post-surgical breast cancer patients can further improve their function, hand grip, wrist ROM, fatigue, pain, and ADLs

Cardiac repolarization abnormalities in children with familial Mediterranean fever

Abstract Background Familial Mediterranean fever (FMF) is an autoinflammatory disease that can have conduction disturbances and cardiac rhythm disorders as manifestations of cardiac involvement. The aim of the study is to assess the susceptibility of children with FMF to cardiac repolarization abnormalities and therefore arrhythmia in children with FMF. Methods A cross sectional study conducted on 60 children had FMF and 40 age and sex matched healthy controls. Cardiac repolarization markers, cardiac dimensions and functions were assessed by electrocardiogram (ECG) and conventional echocardiography in patients and controls. Results The mean ± SD age of the patients was 10.43 ± 3.472 years, corrected QT (QTc) and the ratio of peak to end T wave (Tpe) over QTc interval (Tpe /QTc) increased significantly in FMF patients more than healthy control (p value 0.023 and 0.022 respectively). P wave dispersion (Pd) was significantly higher in FMF patients with amyloidosis (p value 0.030). No significant difference was found in cardiac dimensions and functions between the two groups. We found a statistically negative correlation between Pd and age of patients at time of study, age of disease onset and age at diagnosis. On the other hand, we found a statistically significant positive correlation between Pd with number of attacks per year and disease severity score. Furthermore, Tpe/QTc ratio correlated with FMF 50 score, QTc correlated with 24 hours proteinuria. QT, JT intervals correlated with fibrinogen. Conclusions FMF Patients may have increased risk of arrhythmia and should be monitored on regular basis. Compliance to colchicine therapy and better disease control might play a role in decreasing this risk. </jats:sec