Diabetic peripheral neuropathy: the potential role of vitamin D deficiency

Abstract Background Vitamin D is well known for its role in promoting calcium and phosphorus absorption and is recently associated with various neurological disorders. Objective To study the possible relation between vitamin D deficiency and diabetic peripheral neuropathy in a sample of patients recruited from Beni-Suef governorate, north Upper Egypt Methods A case-control study included 25 type 2 diabetic patients with diabetic peripheral neuropathy and 25 healthy controls. The patients included were subjected to clinical evaluation including Michigan Neuropathy Screening Instrument and nerve conduction study. And all patients and control were subjected to assessment of fasting and 2-h post prandial blood sugar, hemoglobin A1C, and serum vitamin D level. Results Serum vitamin D level was significantly lower in patients compared to control (P value = 0.008). For the patients group, females and patients with Michigan neuropathy screening instrument score more than 4 had statistically significant lower vitamin D level (P value = 0.003 and 0.006, respectively). No statistically significant difference in vitamin D level was found between patients below and above the age of 50 years, duration of diabetes less and more than 5 years, different types of diabetes medications, or patients with fair and poor control (P value = 0.525, 0.700, 0.881 and 0.252, respectively). No significant correlation was found between vitamin D level and the results of nerve conduction study. Conclusion Vitamin D deficiency was highly prevalent in diabetic peripheral neuropathy patients. Females and patients with severe form of neuropathy are more liable for lower vitamin D levels

Evaluation of transmasseteric anteroparotid approach to mandibular subcondylar fractures

Introduction: Different techniques employing, retromandibular, preauricular, or submandibular incisions have been used for the treatment of subcondylar and condylar fractures. The approaches listed above may lead to some disadvantages which include limited visibility, facial nerve damage, and problems associated with the parotid gland. Study objective: Clinically, case studies were performed to evaluate the efficacy of P-TMAP approach for open reduction and internal fixation (ORIF) of condylar and subcondylar fractures. The study comprised of 7 people within the condylar and subcondylar fractures group who were treated by ORIF. We analyzed the administrative hours, accessibility, and medical review on perioperative complications. A CT scan was done to confirm the site where condylar fractures were reduced. Findings: Visibility and accessibility were good. The patients underwent careful anatomical alignment and stabilization. These reported complications were limited and only lasted temporarily. The facial nerve (buccal branch) palsy of one patient was the only adverse event that was reported, and it resolved spontaneously in 3 months. No case of Frey's syndrome and sialocele was spotted. Conclusion: The P-TMAP method is an effective way of access for closing the reduction and fixing the condylar fractures. It facilitates retention, transference, relocation, and fixation of the condyle.&nbsp

Proceedings of IEEE - CiST14 - Third IEEE International Colloquium in Information Science and Technology (CIST)

The 3rd international IEEE Colloquium on Information Science and Technology (CIST\u2714) is part of the IEEE CONFERENCE SERIES that are held in Morocco, and is sponsored by the IEEE Morocco Section and the IEEE Morocco Computer & Communication Joint Chapter, and the UAE IEEE Student Branch. The 2014 edition was organized in collaboration with the Faculty of Sciences of Tetuan, the national school of applied sciences of Tetuan and the University of Abdelmalek Essaadi. IEEE CIST is emerging as a key annual event that aims to serve as a forum to promote the exchange of the latest advances achieved by IT researchers, IT decision makers, IT managers, application designers and software engineers in the domain of information science and related technology. Computing challenges, models, applications and IT solutions will be discussed from the perspectives of academia, industry and government. In addition to the main conference topics, IEEE CIST will also provide a platform for supporting innovative and original contributions in three complementary disciplines that are: Arabic natural language processing, Information and multimedia processing and Internet of Things. We would like to extend our most sincere thanks and gratitude to the keynote speakers of IEEE CIST\u2714 for their important added value to this edition and to the Scientific Committee Members who helped us in the review process. We would like also to express our thanks to the IEEE Computer Society for their support through their Distinguished Lecturers Programs. We are also very glad to express our most sincere gratitude for the organizing committee members for their full dedication and professional organization of this edition. The success of this colloquium will be mainly attributed to the authors who contributed with their posters and talks. We hope that CIST will continue to offer a privileged context for participants to develop new ways and methods to achieve our objectives in advancing our research and projects. We can together achieve more and face more efficiently the challenges of the current millennium

Synthesis, Crystal Structure, Antibacterial and In Vitro Anticancer Activity of Novel Macroacyclic Schiff Bases and Their Cu (II) Complexes Derived from S-Methyl and S-Benzyl Dithiocarbazate

A series of novel macroacyclic Schiff base ligands and their Cu (II) complexes were synthesised via reacting dicarbonyls of varying chain lengths with S-methyl dithiocarbazate (SMDTC) and S-benzyl dithiocarbazate (SBDTC) followed by coordination with Cu (II) ions. X-ray crystal structures were obtained for compound 4, an SBDTC-diacetyl analogue, and Cu7, an SMDTC-hexanedione Cu (II) complex. Anticancer evaluation of the compounds showed that Cu1, an SMDTC-glyoxal complex, demonstrated the highest cytotoxic activity against MCF-7 and MDA-MB-231 breast cancer cells with IC50 values of 1.7 µM and 1.4 µM, respectively. There was no clear pattern observed between the effect of chain length and cytotoxic activity; however, SMDTC-derived analogues were more active than SBDTC-derived analogues against MDA-MB-231 cells. The antibacterial assay showed that K. rhizophila was the most susceptible bacteria to the compounds, followed by S. aureus. Compound 4 and the SMDTC-derived analogues 3, 5, Cu7 and Cu9 possessed the highest antibacterial activity. These active analogues were further assessed, whereby 3 possessed the highest antibacterial activity with an MIC of <24.4 µg/mL against K. rhizophila and S. aureus. Further antibacterial studies showed that at least compounds 4 and 5 were bactericidal. Thus, Cu1 and 3 were the most promising anticancer and antibacterial agents, respectively

Development of canagliflozin nanocrystals sublingual tablets in the presence of sodium caprate permeability enhancer: formulation optimization, characterization, in-vitro, in silico, and in-vivo study

AbstractCanagliflozin (CFZ) is a sodium-glucose cotransporter-2 inhibitor (SGLT2) that lowers albuminuria in type-2 diabetic patients, cardiovascular, kidney, and liver disease. CFZ is classified as class IV in the Biopharmaceutical Classification System (BCS) and is characterized by low permeability, solubility, and bioavailability, most likely attributed to hepatic first-pass metabolism. Nanocrystal-based sublingual formulations were developed in the presence of sodium caprate, as a wetting agent, and as a permeability enhancer. This formulation is suitable for children and adults and could enhance solubility, permeability, and avoid enterohepatic circulation due to absorption through the sublingual mucosa. In the present study, formulations containing various surfactants (P237, P338, PVA, and PVP K30) were prepared by the Sono-homo-assisted precipitation ion technique. The optimized formula prepared with PVP-K30 showed the smallest particle size (157 ± 0.32 nm), Zeta-potential (−18 ± 0.01), and morphology by TEM analysis. The optimized formula was subsequently formulated into a sublingual tablet containing Pharma burst-V® with a shorter disintegration time (51s) for the in-vivo study. The selected sublingual tablet improved histological and biochemical markers (blood glucose, liver, and kidney function), AMP-activated protein kinase (AMPK), and protein kinase B (AKT) pathway compared to the market formula, increased CFZ’s antidiabetic potency in diabetic rabbits, boosted bioavailability by five-fold, and produced faster onset of action. These findings suggest successful treatment of diabetes with CFZ nanocrystal-sublingual tablets

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease

Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19. Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospital with COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients were randomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once per day by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatment groups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment and were twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants and local study staff were not masked to the allocated treatment, but all others involved in the trial were masked to the outcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) were eligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was 65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomly allocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall, 561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days (rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median 10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days (rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, no significant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilation or death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24). Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or other prespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restricted to patients in whom there is a clear antimicrobial indication. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research