Effect of hydroalcoholic Allium atroviolaceum L. on the pathology of testicular tissue in cyclophosphamide-treated mice

Background: The most important side effects of Cyclophosphamide, as an anticancer broad-spectrum drug, are the negative effects on the reproduction and fertility because of oxidative stress. Considering the antioxidant properties of medicinal plants, especially those of the Allium genus, this paper studied the effect of hydroalcoholic extract of Allium atroviolaceum L. on the pathology of testicular tissue in CP-treated mice. Methods: Groups of this experimental study consisted of normal saline recipients; three groups receiving A. atroviolaceum extract at 50, 100, 200 mg/kg; three groups receiving A. atroviolaceum extract at 50, 100, and 200 mg/g and 6.6 mg/kg of Cyclophosphamide; and a group given Cyclophosphamide at 1.6 mg/kg. All injections were performed intraperitoneally. After 30 days, the testicular histological profile as well as the number of spermatozoa, the number of primary and round spermatocytes, and the number of spermatogonia were investigated. Results: Cyclophosphamide treatment significantly reduced the lumen diameter, the seminiferous tubule diameter, the epithelial thickness, as well as decreased the quantity of spermatozoa and round and primary spermatocytes compared to the control group. Cyclophosphamide groups treated with A. atroviolaceum extract at 50, 100 and 200 mg/kg in a significant manner improved these variables (P < 0.001). Conclusion: A. atroviolaceum extract can significantly improve Cyclophosphamide-induced toxicity and pathological process on testicular tissue. It seems that this plant, with high antioxidant capacity, can be considered a complementary therapy for Cyclophosphamide to prevent undesirable effects on the reproductive system. Keywords:Cyclophosphamide; Allium atroviolaceum; Pathology; Testicular tissu

Ameliorative effect of Allium atroviolaceum on sperm quality in cyclophosphamide-treated mice

Background: Cyclophosphamide (CP) is an anti-neoplastic alkylating agent that is extensively used in different chemotherapy regimens. Adverse effects on the reproductive system, especially spermatogenesis, are one of the most important side effects of this drug. It is medically essential to use complementary and alternative drugs. Herbal drugs have long been used as a complementary treatment. Our purpose was to study the effect of hydroalcoholic Allium atroviolaceum L. extract on spermatogenesis in CP-treated mice. Results: CP affected a significant decrease in sperm count, motility, viability, and morphology. Sperm count was significantly higher in the all extract groups than in the group of control (p<0.001) and CP group (p<0.001, p<0.01). Sperm motility was significantly greater in the extract (100 and 200mg/kg) groups than in the group of control (p<0.05 and <0.001). Sperm immotility and rotational movement were significantly higher in the CP group than in the CP+extract groups (p<0.001). The sperm viability was significantly greater in the CP+extract (200mg/kg) group than in the CP group (p<0.001). The number of headless sperm, sperm with initial tail, with coiled tail, and sperm with curved body, was significantly lower in the CP+extract (200mg/kg) group than in the CP group (p<0.001). Conclusion: A. atroviolaceum extract treatment significantly improved CP-induced reproductive toxicity

Super-spreading social events for COVID-19 transmission: evidence from the investigation of six early clusters in Bahrain

IntroductionThis study aimed to characterize six early clusters of COVID-19 and derive key transmission parameters from confirmed cases that were traced between April and June 2020 in Bahrain.MethodsPairs of “infector-infectee” allowed us to map the clusters and estimate the incubation period serial interval as the secondary attack rate. The chi-squared test, with a p-value computed using the Monte Carlo test, measured associations between categorical variables. Statistical analysis was performed using R software and the “data.tree, tidyverse” libraries.ResultsFrom 9 April to 27 June 2020, we investigated 596 individuals suspected of COVID-19, of whom 127 positive cases were confirmed by PCR and linked in six clusters. The mean age was 30.34 years (S.D. = 17.84 years). The male-to-female ratio was 0.87 (276/318), and most of the contacts were of Bahraini citizenship (511/591 = 86.5%). Exposure occurred within the family in 74.3% (411/553), and 18.9% of clusters' cases were symptomatic (23/122 = 18.9%). Mapped clusters and generations increased after 24 May 2020, corresponding to “Aid El-Fitr.” The mean incubation period was 4 days, and the mean serial interval ranged from 3 to 3.31 days. The secondary attack rate was 0.21 (95% C.I.) = [0.17–0.24].ConclusionCOVID-19 transmission was amplified due to the high number of families mixing during “Aid El Fitr” and “Ramadhan,” generating important clusters. Estimated serial intervals and incubation periods support asymptomatic transmission

Integrating artificial neural network and scoring systems to increase the prediction accuracy of patient mortality and organ dysfunction

The aim of this study was to develop and compare techniques to increase the prediction accuracy of patient mortality and organ dysfunction in the Intensive Care Units (hereinafter ICU) of hospitals. Patient mortality was estimated with two models of artificial neural network (ANN)-backpropagation (BP) and simplified acute physiology score (SAPS). Organ dysfunction was predicted by coupled ANN self-organizing map (SOM) and logistic organ dysfunction score (LODS) method on the basis of patient conditions. Input dataset consisted of 36 features recorded for 4,000 patients in the ICU. An integrated response surface methodology (RSM) and genetic algorithm(GA) was developed to achieve the best topology of the ANN-BP model. Although mortality prediction of the best ANN-BP (MSE = 0.0036, AUC = 0.83, R-2 = 0.81) was more accurate than that of the SAPS scoremodel (MSE = 0.0056, AUC = 0.82, R-2 = 0.78), the execution time of the former (=45min) was longer than that of the latter (=20 min). Therefore, the principal component analysis (PCA) was used to reduce the input feature dimensions, which, in turn, reduced the execution time up to 50%. Data reduction also helped to increase the network accuracy up to 90%. The likelihood of organ dysfunction determined by coupled ANN and scoring method technique can be much more efficient than the LODS model alone because the SOM could successfully classify the patients in 64 classes. The primary patient classification plays a major role in increasing the efficiency of an estimator

Cobalamin Status In Patients With Type 2 Diabetes Mellitus At Primary Health Care Centers In Bahrain - A Cross-Sectional Study

Background and Objectives: Cobalamin, also known as vitamin B12, is essential for DNA synthesis and neurological functioning. Deficiency results in hematological and neurocognitive manifestations. One risk factor for vitamin B12 deficiency is the use of metformin, a common oral hypoglycemic agent. This study was conducted to determine cobalamin status in patients with type 2 diabetes mellitus at primary health care centers in Bahrain. Methods: This cross-sectional study was conducted in five randomly selected health centers in Bahrain. Vitamin B12 levels below 148 pmol/L were categorized as deficient, levels ranging from 148 to 221 pmol/L were considered borderline, and levels exceeding 221 pmol/L were classified as normal. Results: A total of 691 participants were included in the study, with a mean age of 58.7 years. The most common comorbid condition among our cohort was hypertension (63.1%), followed by dyslipidemia (53.1%). Analysis of the glycemic control showed that only 40% of the participants achieved control targets. Nearly 10% (9.4%, n=65) of the cohort had low levels of vitamin B12, and 31% had borderline values. A significant association was seen between low vitamin B12 levels and Bahraini nationality (P<0.001), and patients who engaged in weekly exercise (P=0.007). Furthermore, the analysis revealed that the use of metformin (P=0.037) and alcohol (P=0.012) was significantly associated with low levels of vitamin B12. Conclusion: Although the overall prevalence of B12 deficiency among patients with type 2 diabetes in Bahrain was low, patients at high risk of B12 deficiency, including metformin users and alcohol consumers, should be periodically screened to prevent the associated neurological and hematological sequela. Keywords: Bahrain, Cobalamin, Diabetes Mellitus, Primary Health Care, Vitamin B1

Characteristics, glycemic control and outcomes of adults with type-2 diabetes mellitus attending specialized clinics in primary healthcare centers in Bahrain—A cross-sectional study

Introduction: Diabetes mellitus is a global health challenge that requires continuous and multidisciplinary management. Suboptimal diabetes management results in serious complications that impose a huge burden on patients and the healthcare system. This study aimed to assess the characteristics, glycemic control and outcomes of patients with type-2 diabetes attending primary healthcare centers in Bahrain according to the new American Diabetes Association (ADA) guidelines. Materials and Methods: A cross-sectional study was conducted among adult patients with type-2 diabetes mellitus attending diabetic clinics in Bahrain. A multi-stage sampling technique was adopted. The data collection tool consisted of three parts: baseline and sociodemographic data, the physical measures of the patients and the most recent laboratory results. An A1C of less than 7% was indicative of good glycemic control. Results: A total of 721 patients with type-2 diabetes mellitus were included with an average age of 58.4 years. Most patients were hypertensive (n = 457, 63.4%), and half of them were hyperlipidemic (n = 373, 51.7%). Around 57% (n = 402) of the patients adopted lifestyle modifications, 14.8% adopted diet control measures and around half performed weekly regular exercises. More than 92% of the cohort were on metformin, 52.0% (n = 375) were on Sulphonylurea medications and 41% (n = 298) were on insulin formulations. While only 40% of the patients had controlled diabetes (n = 283, 39.3%) and hypertension (n = 298, 41.3%), most patients achieved adequate cholesterol and low-density lipoprotein levels (83.2% and 76.6%, respectively). Non-Bahraini (P ≤ 0.001), young (P = 0.027) and obese patients (P = 0.003) had lower glycemic control measures. Adequate cholesterol levels were seen more in patients with a controlled glycemic index (P = 0.015). Conclusion: Considering the new glycemic targets, glycemic and hypertension control was poor among diabetic patients, especially non-Bahraini, obese and young patients. Urgent interventions by policymakers, physicians and caregivers are needed to improve the outcomes of diabetes