Articles

Vildagliptin is an orally active, potent, and selective Dipeptidyl Peptidase-4 (DPP-4) inhibitor, shown to be effective and well tolerated in patients with Type 2 Diabetes Mellitus (T2DM) as either monotherapy or in combination with other anti-diabetic agents. Vildagliptin is used to treat type 2 diabetes mellitus, typically in conjunction with diet and exercise. Vildagliptin is usually administered orally, with a common dosing regimen of 50 mg twice daily. It can be taken with or without food; however, it is important to take it consistently at the same time each day for optimal effectiveness.This study focuses on the most recent advancements in analytical methods for determining the presence of Vildagliptin in different biological media, such as human plasma and urine, as well as in bulk and commercial dose forms. The following analytical techniques will be fully investigated in this paper: High-pressure Liquid Chromatography (HPLC), High Efficiency Thin Layer Chromatography (HPTLC), liquid chromatography coupled to a tandem mass spectrometry system (LC-MS), and electrophoresis. These techniques include several parameters, such as the following: matrix, dynamic phase composition, permanent phase RF value for sensing frequency, retention duration, DL, carrier gas, flow rate, capillary wavelength, separation voltage, temperature, and pressure.

Telemedicine has become widely used, primarily following or during the COVID pandemic. However, it was used a long time ago in specific cases, like submarines and space. Telemedicine has been developed to facilitate diagnosis and treatment in areas without physicians, either because the area is isolated without a medical doctor (as in submarines and space) or because we need expertise. This article is a review using studies selected via PubMed to collect generic knowledge on some technical details on both sides: Earth and Space, where telemedicine activity is regularly provided. The goal was to compare tools, data collected, and ways of improvement in each area. As experienced on both sides, indeed, the author has already worked in the spaceflight area with astronauts as well as doing teleconsultations with patients nowadays, which allows us to see how we could improve the way we are doing teleconsultation on Earth by teaching the users as done with the astronauts in the pre-flight period. It seems telemedicine will still be mandatory for a while because as seen in many countries even out of the scope of isolated area (or very difficult to be accessed (like mountains, desert …), more and more small cities and even bigger are lacking general practitioner (GP) as well as some specialists. Taking into account the time needed to have a functional doctor (for a GP mainly 8 years and for specialists longer, up to 12 years), telemedicine should improve and take a real place in the health system. This review gives a few definitions, also the term telehealth or e-health is widely used. It refers to the use of an internet communication system to transmit data, receive data, communicate in real time, and guide and provide healthcare services to the patient remotely. Improvements in technologies have mainly been done for Earth applications, and tools are becoming smaller and more resistant. The different purposes of using telemedicine are increasing nowadays, and it is not used only because of a lack of physicians but to teach remotely and avoid travel, as well as to have direct access /advice with a specialist. We can find a lot of reasons to use it. Living in space is a real challenge for the human body used to gravity. As explained in a lot of reviews, the body in space loses bone, muscle, and has changes in heart volume and excitability. All the body systems will suffer from microgravity. Other factors impacting the body in space are the high level of ionized radiation, plus isolation. This is why, since the beginning of space flight, the so-called flight surgeon (more GP of the astronaut than a surgeon) is using telemedicine with the astronauts to prevent disease and, in case a medical event happens, to help the astronaut receive a diagnosis and efficient treatment. The actual ISS, International Space Station, allows real-time communication with the astronauts. This will be used for direct discussion or conferences to check the medical/psychological/fitness status. In other cases, remote access can always be done to communicate pictures or movies to provide advice on health or science. Furthermore, some medical tests will be done to guide the astronauts because some tools need real expertise to be interpreted correctly. In that case, eye exam is a good example: an astronaut uses devices following the recommendation of the specialist based on the NASA Console in Houston. Of course, new improvements are needed to facilitate the next challenges of spaceflight, also going a step further beyond LEO (Low Earth Orbit), like doing an interplanetary trip and going to Mars. In that next scenario, to allow the mission where the Earth will not be seen anymore, when the real-time exchange will not be feasible, a new autonomy of the astronauts will be required. As on Earth, space with all technologies like satellite is not only used as for direct health care facility with the astronauts but also in a more preventive way. It is possible to follow changes on the ground, climate changes too, as a witness to a possible new epidemic, and another specific use is to help in locating people. Finally, we see how the way telemedicine is done in space could help improve telemedicine on the ground. First of all, we could improve telemedicine in many ways on Earth for classical consultation by increasing the utilization of simple tools like otoscope and… more in that case we need to train the patient like the astronauts are trained on ground before flying, this has a huge positive effect in allowing easier diagnostic and then better treatment for example when good pictures are provided. The new tools as Artificial Intelligence (AI) or Virtual Reality (VR), on trial if needed for long-duration missions and specifically for missions beyond low Earth orbit, should be beneficial as well on Earth. Maybe the big challenge for Earth’s Telemedicine is increasing the trust in practitioners who are still convinced that this way of providing medicine could be a competitor, and for that reason, they are reluctant to use it. Nowadays, it should become more and more obvious that we need to work on some specific weak points, like security, training in using tools to make sure telemedicine is efficient and useful, where we have a lack of physicians.

The forensic identification of nitrate ions in post-blast pit soil samples is crucial for investigating nitrate-based explosive incidents owing to environmental factors such as rainfall and monsoon conditions, which can significantly alter the concentration and distribution of nitrate residues at blast sites, as nitrate ions are completely soluble in water. This study investigated the influence of rainfall on the retention and detectability of nitrate ions in pit soil collected from spiked simulated explosive samples, replicating the topographical conditions of hilly regions frequently impacted by insurgent and terrorist activities. Ion Chromatography (IC), a highly sensitive and selective analytical technique, was employed to quantify nitrate ion concentrations within the soil matrix. This study aimed to elucidate the mobility, leaching behavior, and retention of nitrate ions in soils affected by blast under natural drizzling rainfall conditions.

Cytomegalovirus (CMV) colitis is classically seen in immunocompromised individuals, such as those with HIV, organ transplants, or receiving immunosuppressive therapy. It is exceedingly rare in immunocompetent patients and can pose a diagnostic challenge, especially when it presents as a mass-like lesion mimicking colon cancer. We report a case of a 78-year-old immunocompetent male who presented with hematochezia and was found to have a bleeding cecal mass initially suspicious for adenocarcinoma. Subsequent histopathology revealed CMV colitis. This case emphasizes the importance of considering CMV colitis in the differential diagnosis of colonic masses, even in immunocompetent hosts.

Objective: To provide a rigorous, multidisciplinary synthesis of the epidemiological, genetic, immunological, and environmental factors contributing to Premature Ovarian Failure (POF), with particular attention to regional disparities, occupational exposures, the impact of chemotherapy, the occurrence and recurrence of endometrosis, and emerging fertility preservation strategies. Design: A structured literature review with an emphasis on recent advances in genetic and immunological understanding.Setting: Academic research and clinical insights from multidisciplinary contributors.Patients: Individuals diagnosed with POF as reported in the literature.Interventions: Review of literature concerning epidemiology, genetic mutations, immunological disorders, and surgical outcomes linked to POF.Main outcome measures: Identification of both established and emerging risk factors, validation of genetic and immunological markers, and clarification of diagnostic and preventive clinical approaches.Results: The prevalence of POF varies globally, affecting 1% of women under 40. Genetic factors, particularly mutations in the FMR1 and BMP15 genes, play a significant role, alongside autoimmune diseases. Chemotherapy is a leading iatrogenic cause, while endometriosis and ovarian cyst surgeries significantly contribute to diminished ovarian reserve.Conclusion: POF is a multifactorial condition with rising incidence in specific subgroups. Improved early detection, standardized biomarker use, and expanded access to fertility preservation are essential. Targeted genomic and occupational risk screening may enable personalized interventions. Further genomic studies are needed to elucidate rare mutations and their impact.

Adherence, in a healthcare context, refers to the extent to which a person’s behavior aligns with recommendations from a healthcare provider. This can involve taking medication as prescribed, following a specific diet, or adhering to lifestyle changes. Although it is known that adherence is critical and requires a special approach to health, in Mexico, there are few studies on this issue. We confirm the information collected from 786 patients using an original questionnaire (AFEC) in Spanish, previously validated. Perfect adherence was detected in only 179 (22.8%), good adherence in 334 (42.5%), and nonadherence in 452 (57.5%). The age, obesity, and number of comorbidities were significantly associated with non-adherence (p < 0.05). Special strategies to approach this critical problem in health need to be reconsidered in Mexico. Non-adherence may help explain the low control rate of Mexican patients and the high rate of cardiovascular mortality.

Fish are important organisms as they indicate the ecological and environmental processes and the producer-consumer interactions. The fish samples of Cirrhinus mrigala and Oreochromis niloticus were collected from the Yamuna River at Allahabad (now Prayagraj), India, from August 2011 to July 2012. During the study period, 335 specimens of Cirrhinus mrigala and 516 specimens of Oreochromis niloticus were examined for the estimation of the age pyramid. The age groups varied from 0+ to 10+, and a heavy bottom or broad-based age pyramid was recorded in C. mrigala. The age groups varied from 0+ to 6+, and Urn shaped age pyramid was recorded in O. niloticus. The age group 2+ dominated by virtue of numbers in the lower stretch of the Yamuna River in both species of stock.

Background: Acute Respiratory Distress Syndrome (ARDS) is a clinically, radiologically, and biologically heterogeneous condition. This variability contributes to diagnostic challenges and inconsistent responses to therapy. Identifying homogeneous subgroups or phenotypes within ARDS may enhance precision medicine and therapeutic targeting.Objective: This review evaluates the utility of decision tree–based supervised machine learning (ML) algorithms—specifically CART, Random Forest, and AdaBoost—in phenotyping ARDS using clinical, radiological, and biological data.Methods: A comprehensive literature search was conducted between December 2023 and March 2024 using PubMed and Google Scholar. Search terms included ‘decision tree in ARDS’, ‘phenotype in ARDS’, and ‘ML in hypo- and hyperinflammatory ARDS’. Twenty-six relevant articles were included, comprising original studies and reviews.Results: Decision tree–based models have demonstrated significant potential in classifying ARDS subtypes using routine clinical variables, radiographic features, and biomarker profiles. These algorithms have shown strong predictive performance in differentiating inflammatory phenotypes, forecasting mortality, and enabling early ARDS prediction.Conclusion: Decision tree algorithms offer a promising approach to ARDS phenotyping by leveraging routinely available data. Their interpretability and predictive accuracy may aid in translating complex biological insights into bedside clinical decision-making, advancing personalized care in critical illness.

Background: This study explored whether emotional distress, coping, and/or resilience contributed to return to driving (RTD) following experienced mild traumatic brain injury, and whether these variables of interest differed among those who had and had not RTD.  Methods: The present study evaluated de-identified archival data of 65 patients with mTBI following an MVA. Patients were either the driver, passenger, /or pedestrian struck by a motor vehicle, and aged 22 to 69 years. The sample consisted of 36 men and 29 women with an average education. The mean months elapsed between the accident and the assessment was 16.82 months. Pearson correlations were used to test for associations between all explanatory and outcome variables. Separate linear and hierarchical regressions were carried out to evaluate whether variables of interest were significant predictors of RTD.  Results: Findings revealed that the presence of depressive symptoms was associated with coping, irrespective of style, resilience, driving-related anxiety, and RTD. Moreover, RTD was related to driving-related anxiety, too, and in fact, anxiety (considering the presence of depressive symptoms) appeared to be an even greater limiting factor when considering RTD in this population. Age, gender, and education did not influence RTD. Conclusion: The present study revealed that depressive symptoms and driving-related anxiety in particular contribute to whether patients with mTBI RTD, irrespective of time since injury, age, and gender. Coping styles and resilience did not predict RTD. Further work is warranted to address the paucity of research investigating RTD parameters that contribute to and/or hinder RTD among mTBI sufferers.