Mowat-Wilson Syndrome (MWS) is an autosomal dominant genetic syndrome caused by mutations in the ZEB2 gene. It is characterized by distinctive facial appearance, intellectual disability (ID), epilepsy, Hirschsprung disease (HSCR), and other congenital anomalies. The psychiatric symptoms, associated with MWS have rarely been reported. The following report highlights a case of schizoaffective disorder in a 24-year-old male with MWS and the challenges he encountered over his treatment course.After considering numerous diagnoses including bipolar disorder and psychosis secondary to a general medical condition, the patient was diagnosed with schizoaffective disorder. Various trials consisting of atypical antipsychotics and mood stabilizers were unsuccessful in managing his symptoms. Eventually, the patient stabilized on a medication regimen consisting of clozapine 300 mg once daily, topiramate 75 mg twice per day, and lithium 1800 mg once daily. This case report documents co-occurrence of MWS and Schizoaffective disorder.

One of the most important emerging pollutants is pharmaceutical active compounds, which may be responsible, for example, for ecotoxicological changes and microbiological resistance. Wastewater treatment plants are not adequately equipped to remove all of the emerging pollutants contained in the wastewater. The ultrafiltration process has been proven to be effective in traditional wastewater treatment, so it is important to assess the performance of such a technique in the partial elimination of pharmaceutical compounds to avoid contamination. In this work, an assessment of ultrafiltration process operating conditions for eliminating six pharmaceutical compounds: Ibuprofen, Acetaminophen, Naproxen, Diclofenac, Caffeine, and trimethoprim, present in different types of water is performed. Experimental design is a systematic and structured approach to conducting experiments, and its application can significantly improve the study of membrane technology, reducing the number of assays necessary to obtain meaningful results. The statistical principles application ensures that the results obtained are reliable and representative of the true effects of the variables being studied. Its application helps to obtain valid conclusions from the data and provides a solid basis for making decisions or recommendations regarding the tests and variables to take into account. Membrane processes can involve complex interactions between several factors. Experimental design helps to identify and understand these interactions, allowing researchers to discern the combined effects of different variables. This is crucial to accurately predict and optimize membrane performance.In this work, ANOVA analysis has been carried out in order to determine the influence of membrane cut-off, solution pH, and feed concentration, as well as their interactions, in permeate flux and the rejection index. The results obtained show similar behavior for Ibuprofen, Naproxen, Diclofenac, and Trimethoprim, being the pH the most important factor. However, no significant factors were found for the acetaminophen and the Caffeine.

This study conducted an elemental analysis and assessed heavy metal concentrations in five powdered milk samples (V1, L1, H1, G1, and D1) from Senegal, utilizing X-ray Fluorescence (XRF). The analysis focused on aluminum (Al), calcium (Ca), potassium (K), phosphorus (P), and chlorine (Cl). Aluminum was either undetected or found at negligible levels in all samples. Calcium levels consistently surpassed the Acceptable Maximum Level (AML) in all samples, with H1 exceeding the AML by approximately 11.1 times (27,745.06 ± 310.16 ppm). Potassium concentrations varied, with G1 exhibiting the highest levels, significantly exceeding the AML (51,058.15 ± 456.13 ppm), while V1 remained within acceptable limits. Chlorine concentrations generally complied with the AML, except for G1, which slightly exceeded the limit (3631.04 ± 31.23 ppm). Phosphorus concentrations in H1 were notably higher than the AML (13,750.94 ± 275.35 ppm). The non-uniformity in heavy metal concentrations among samples emphasizes the need for ongoing research and regulatory scrutiny to address potential risks and ensure the safety of powdered milk.

Stevia is a natural sweetener that has gained attention as a potential sugar substitute for glycemic control and weight management. Extensive research has shown that high sugar consumption is linked to obesity, dental caries, and other health issues. Stevia, derived from the Stevia rebaudiana plant, offers sweetness without calories and has a favorable glycemic profile. Studies have demonstrated its effectiveness in regulating blood glucose levels and reducing overall sugar and caloric intake. Consumer attitudes suggest a positive reception of Stevia as a sugar substitute among health-conscious individuals. However, further research is needed to understand its long-term effects and consumer sentiments. Future investigations should prioritize human clinical trials, targeted studies in diabetic populations, and exploration of Stevia’s interaction with gut microbiota, among other aspects. Stevia shows promise as a health-conscious alternative in glycemic control and weight management.

Background: Effective medication to manage diabetes mellitus-related organ complications with minimal adverse drug toxicity is still in pursuit by scientists worldwide. This study investigated the cardio-protective of Rida herbal bitter (RHB) in a high-fat diet/streptozotocin (STZ)-induced diabetic rats.Methods: Thirty-two matured male Wistar rats (250 ± 20g) were used. The animals were fed with high-fat diet (HFD) for 6 weeks before diabetes induction. A single dose of (35 mg/kgb.wt) freshly prepared STZ was injected intraperitoneally to induce diabetes. The animals were allocated into four groups, 8rats/group. Group I: control; Group II: HFD/STZ-induced diabetic rats; Groups III & IV: HFD/STZ-induced diabetic rats treated with 0.3 ml RHB & 200 mg/kgb.wt metformin respectively. At the end of the experiment, the animals were sacrificed, blood was sample collected via cardiac puncture and the heart was excised and homogenized. The blood samples and cardiac homogenates tissue were centrifuged to retrieve clear supernatant plasma for biochemical assay.Results: Diabetic rats exhibited significant (p < 0.05) elevated blood glucose, insulin, glycated hemoglobin (HbA1c), cardiac biomarkers, lipid profile, malondialdehyde (MDA), pro-inflammatory cytokines, food, and water intake levels with a reduction in body weight, cardiac antioxidant activity, and total protein. RHB administration significantly (p < 0.05) diminished the blood glucose, insulin, HbA1c, cardiac biomarkers, MDA, pro-inflammatory cytokines, lipid profile, food, and water intake, and improved the body weight cardiac antioxidant activity, and total protein.Conclusion: Rida herbal bitter possesses a cardio-protective effect from this study and could be a better alternative medication for managing diabetes and its related cardiovascular complications.

Introduction: Acute lower respiratory infection (ALRI) of viral etiology is a frequent consultation in pediatrics. Post-infectious bronchiolitis obliterans (PIBO) is a rare and potentially severe disorder following ALRI, characterized by partial or complete obstruction of the small airways by inflammatory tissue. There is evidence that macrolides reduce morbidity and mortality in diffuse panbronchiolitis, which may have similar inflammatory and obstructive components.We hypothesized that the effect of azithromycin (AZ) may improve lung function and reduce pulmonary exacerbations in PIBO.MethodsStudy design: A double-blind, randomized, placebo-controlled trial.Patients: We enrolled patients with PIBO followed-up at the Pulmonology department between 5 years to 18 years.Treatment regimen: The patients were randomized to receive active drug or placebo three times a week. Clinical evaluation: Clinical evaluation, pulse oximetry, lung function, and 6-min walk test were performed before and after study initiation and at 1, 3, and 6 months.CT scan and a quality of life questionnaire were performed at the beginning and the end of the Study.Results: 29 patients, 15 in G1 (10 males) and 14 in G2 (7 males) were included.There were no significant differences in FVC, FEV1, TLC, RV, or sGaw between the treatment group and controls. In addition, no significant differences were observed in exacerbations, quality of life questionnaire, or HRCT scan scores.Conclusion: No differences were observed between the groups. Further studies are necessary to allow us to find a better treatment, as azithromycin does not seem to be efficacious.

Alzheimer’s disease, a major healthcare concern, lacks an effective pharmacological therapy to change its irreversible progression. In this work, we present Klotho, a protein associated with aging that is involved in the regulation of numerous physiological processes and is a serious candidate to be a pharmacological target to act on. Klotho’s mRNA has been found in neurons of a variety of brain regions (cortex, hippocampus). The best studied and prominent function of Klotho is as the co-receptor of fibroblast growth factor 23 (FGF23), through which Klotho controls renal phosphate excretion and vitamin D metabolism. Reduced serum levels of Klotho in mice have been associated with a shorter life expectancy and with numerous pathological conditions such as renal disease, vascular calcification, neurodegeneration, and others. Moreover, overexpression of Klotho leads to opposite effects resulting in increased survival rates. In this review we address different signaling pathways in which Klotho is involved in one way or another, focusing on those pathways that could serve as pharmacological targets to modify the evolution of Alzheimer’s disease. We describe how Klotho inhibits signaling cascades involved in cellular senescence, fibrosis, inflammation, and apoptosis all of which are mediated by tumor growth factor β (TGF- β), nuclear factor kappa K (NF- κ B), insulin-like growth factor 1 (IGF-1) or Wnt. We also highlight how Klotho is able to activate anti-inflammatory and antioxidant signaling pathways.  Although there are no drugs that act specifically on Klotho, compounds currently on the market such as hormone-based drugs, pravastatin, losartan, fosinopril, and rapamycin have been shown to increase the expression of this protein and are also discussed.

Background: Systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH) is characterized by pulmonary arterial remodeling resulting in right ventricular failure and death if untreated. Despite therapeutic advances, there is survival variability within the SSc-PAH population. The aim of this study was to delineate high-risk subgroups of SSc-PAH using readily available clinical parameters.Methods: We analyzed data from the PHAROS database, a prospective observational registry of incident SSc-PAH patients. Latent class modeling was performed based on trends in 6MWD over time. We compared survival between the clusters regarding baseline clinical parameters and changes in these parameters over time.Results: We identified four unique groups within 103 patients meeting our inclusion criteria, based on trajectories of 6MWD. Patients in Cluster 4 exhibited a decline in 6MWD over time and had the worst prognosis with a median survival of 3 years. Patients in Cluster 3, with the lowest baseline 6MWD, were associated with lower median survival (5 years) when compared to Clusters 1 and 2 (> 9 and 7 years, respectively), despite an improvement in 6MWD over time. There were no meaningful changes in SF-36 and WHO functional class between the clusters, but BNP trended higher over time in the higher-risk clusters. Conclusion: We identified high-risk subsets of SSc-PAH characterized by significantly worse survival. Incident SSc-PAH patients with a decline in 6MWD over time or low baseline 6MWD had worse survival when compared to SSc-PAH patients who demonstrated relatively stable or mild reduction in 6MWD over time.

The Canadian healthcare system, grappling with issues like systemic and intelligently established structural anti-black racism, including indigenous nations; even within Pathology and Laboratory Medicine Communities: and deteriorating outcomes, sees potential in AI to address challenges, though concerns exist regarding exacerbating discriminatory practices. In clinical pathology, AI demonstrates superior diagnostic accuracy compared to pathologists in a study, emphasizing its potential to improve healthcare. However, AI governance is crucial to navigating ethical, legal, and societal concerns. The Royal College of Physicians of Canada acknowledges the transformative impact of AI in healthcare but stresses the need for responsible AI tools co-developed by diverse teams. Despite positive attitudes towards AI in healthcare, concerns about patient safety, privacy, and autonomy highlight the necessity for comprehensive education, engagement, and collaboration. Legal concerns, including liability and regulation, pose challenges, emphasizing the need for a robust regulatory framework. AI application in healthcare is categorized as high-risk, demanding stringent regulation to ensure safety, efficacy, and fairness. A parallel is drawn to drug regulation processes, suggesting a similar approach for AI. The lack of transparency in AI-based decision-making raises ethical questions, necessitating measures to address biases and ensure patient privacy. Social accountability is crucial to prevent AI from exacerbating health disparities and harming marginalized communities. In conclusion, while AI offers potential benefits in clinical pathology, a cautious approach with comprehensive governance measures is essential to mitigate risks and ensure ethical AI integration into healthcare.

Objective: To determine the factors influencing completion of DOTS in Tuberculosis treatment in the Bahamas.Methods: A quantitative, descriptive cross-sectional survey. Tuberculosis patients aged 18 years and above were considered regardless of the site or the smear status of their TB. The sample size was 40. Data analysis and interpretation were done using the statistical package for the social sciences software (SPSS version 24), through the exploration and calculation of descriptive (frequencies, percentages, means, standard deviations, and inferential (Anova) statistical methods. Statistical significance was determined to be a p < 0.05. Results: The mean age of the respondents, was 39.9 years, SD 11.65, and 73% of them were men. 63% of participants, 78% of whom were citizens of the Bahamas, reported having no annual income. Seventy-eight percent (31) of the participants said they had insufficient food and drink while they were unwell. More than half of the participants in the survey reported being on at least one pharmaceutical regimen, although 36% said they were not actively taking any of the prescription medications.Conclusion: Less than a third were noncompliant with DOTS, this was influenced by factors such as annual income, no family support, marital status, employment status, and educational level.

In this case report a 64-year-old male patient with recent past medical history of head injury complicated by zygomatic arc fracture and mild subarachnoid hemorrhage is studied. He had been presented to the Emergency Department because of progressive neurological symptoms and neurological deficits in the physical examination that could have been indicating subcacute subdural hemorrhage. However, the patient was reluctant to undergo diagnostic imaging due to concerns about radiation exposure. After several explanations, a CT scan was done, which revealed a bilateral subacute subdural hematoma. Neurosurgical management was initiated and intravenous corticosteroid therapy was administered to reduce local edema. The challenge of this case is based on the subtlety of symptoms that might cause patients to delay seeking medical attention. Additionally, patient reluctance to undergo diagnostic tests can complicate management, emphasizing the importance of patient education and therapeutic alliance. Multidisciplinary management involving Neurology and Neurosurgery is crucial for optimal patient care in such cases. This report underscores the significance of effective communication and collaborative decision-making between healthcare providers and patients to ensure timely and appropriate management of complex medical conditions.

Weight gain can be good or bad for health. Benefits include increased health for overweight people, disease or surgical recovery, and more. Health concerns, joint and musculoskeletal disorders, respiratory issues, metabolic abnormalities, cardiovascular health, psychological impact, reduced mobility, digestive troubles, hormonal changes, and cancer risk are negative impacts. Weight gain outcomes depend on heredity, weight distribution, and health. Maintaining a healthy weight needs a balanced diet, regular exercise, and stress management. A doctor or nutritionist can offer personalized weight management advice. Stress chemicals like cortisol trigger weight gain. ACTH stimulates adrenal glands to release cortisol, which increases hunger, fat storage, insulin resistance, and muscle loss. Understanding how stress hormones like cortisol affect weight gain is vital to reducing chronic stress’s health risks. Stress reduction, a balanced diet, regular exercise, proper sleep, social support, and professional treatment can mitigate these outcomes. Ultimately, stress hormones like cortisol can cause weight gain, but a holistic strategy tackling physical and psychological stress can help people maintain a healthy weight.

Background: Obesity remains a global epidemic with over 2.8 million people dying due to complications of being overweight or obese every year. The low-carbohydrate and high-fat ketogenic diet has a rising popularity for its rapid weight loss potential. However, most studies have a maximal 2-year follow-up, and therefore long-term adverse events remain unclear including the risk of Atherosclerotic Cardiovascular Disease (ASCVD).Results: Based on current evidence on PubMed and Google Scholar, there is no strong indication ketogenic diet is advantageous for weight loss, lipid profile, and mortality. When comparing a hypocaloric ketogenic diet with a low-fat diet, there may be faster weight loss until 6 months, however, this then appears equivalent. Ketogenic diets have shown inconsistent Low-Density Lipoprotein (LDL) changes; perhaps from different saturated fat intake, dietary adherence, and genetics. Case reports have shown a 2-4-fold elevation in LDL in Familial hypercholesterolaemic patients which has mostly reversed upon dietary discontinuation. There is also concern about possible increased ASCVD and mortality: low (< 40%) carbohydrate intake has been associated with increased mortality, high LDL from saturated fats, high animal product consumption can increase trimethylamine N-oxide, and cardioprotective foods are likely minimally ingested.Conclusion: Ketogenic diets have been associated with short-term positive effects including larger weight reductions. However, by 2 years there appears no significant differences for most cardiometabolic risk markers. Therefore, this raises the question, excluding those who have a critical need to lose weight fast, is this diet worth the potentially higher risks of ASCVD and mortality while further long-term studies are awaited?

Background: This case study explores an integrated approach to managing a complex cardiac condition, presenting a comprehensive single-session intervention. This includes balloon valvuloplasty using a Nucleus 18 mm balloon, complex angioplasty with rotational atherectomy (rotablator) targeting calcified lesions in the left main and left anterior descending artery, and Transcatheter Aortic Valve Implantation (TAVI) with a 23 mm Sapien 3 valve, all performed on an 81-year-old woman. Furthermore, this report underscores the strategic left atrial appendage closure conducted three months post-procedure due to the patient’s elevated hemorrhagic risk.Case presentation: Facing critical coronary and valvular pathologies, the patient underwent a meticulously planned, single-session intervention. The process began with a balloon valvuloplasty using a Nucleus 18 mm balloon to address the aortic stenosis. This was followed by a high-risk angioplasty, during which the Impella CP device provided hemodynamic support and rotational atherectomy was employed to address the calcified coronary artery disease effectively. The same session saw the successful execution of TAVI using a 23 mm Sapien 3 valve. The comprehensive approach notably diminished procedural complications, illustrating the benefits of an integrated treatment pathway in managing high-risk patients. Three months later, the patient underwent a left atrial appendage closure, a critical move considering her high risk of hemorrhage. This procedure also provided an opportunity to assess the favorable outcomes of the previous angioplasty.Conclusion: This case validates the feasibility and efficacy of performing multiple advanced percutaneous interventions in a single session for high-risk cardiac patients. It underscores the crucial role of innovative and personalized treatment strategies in improving patient outcomes, particularly in complex clinical scenarios. Moreover, the case exemplifies the essential relationship between immediate, comprehensive intervention and subsequent follow-up procedures in ensuring optimal long-term patient care.

Millets are physiologically and therapeutically healthy with high nutritious value and are in rising demand in emerging markets like India, China, Africa, and other developing countries including the Western world. Germinated Millets have high digestibility and are used as healthy food for children’s growth and development. Climate change resilience technology, high nutritional value, and the announcement of the year 2023 as “International Millet Year” have made it very popular. Bakery items based on Millet, particularly cookies, are becoming more popular in both urban and rural areas. Jaggery is raw sugar prepared from sugarcane juice and is considered superior to white sugar. It offers numerous nutritional and therapeutic benefits, including anti-carcinogenic with antitoxic actions. Hence, this study aimed to prepare healthy food items with germinated finger and pearl Millets for better nutritional quality that are attracting the attention of health-conscious people on a worldwide scale. Cookies made from blends of germinated wheat flour (GWF), germinated finger millet flour (GFMF), and germinated pearl millet flour (GPMF) were examined for their physicochemical qualities, in vitro digestibility, antioxidant activity, and overall acceptability by consumers. In vitro protein digestibility (62.24-82.34%), starch digestibility (47.48-62.41%), total phenolic content (11.45–49.12 mg GAE/100 g), and antioxidant activities significantly increased as the proportion of GFMF and GPMF flour increased in the cookie samples, whereas total starch, dietary fiber, carbohydrate, and phytic acid decreased. The physical qualities of the cookies were also improved by the addition of GFMF and GPMF flours. Cookies with acceptable sensory properties, including taste, aroma, appearance, mouthfeel, crispiness, and overall acceptability, were produced by blending 60% GWF, 20% GFMF, and 20% GPMF (T2). This study demonstrated that GFMF and GPMF flour blends may be used as functional ingredients to create superior goods.

The rising prevalence of chronic diseases and the aging population globally are diminishing the overall quality of life, especially for those with demanding daily routines. As medical advancements extend lifespans, the proportion of individuals over 60 is set to double by 2050, necessitating societal shifts toward health-responsible citizenship. Despite longer lifespans, evidence suggests that older age often accompanies mental health challenges such as anxiety, depression, and substance misuse. Social isolation and loneliness further compound these issues, affecting both physical and mental well-being. Digital wellness empowers individuals to take charge of their health, promoting proactive care and literacy to foster health-conscious citizenship. This paper explores the intersection of mental health, aging populations, preventive wellness initiatives, and health literacy, emphasizing their significance within the Health 5.0 framework, especially for older adults. Traditionally, health regulators offer static workflows for adopting standard procedures in health and well-being, reflecting a reactive approach. However, the evolving landscape of wearable and mobile devices connecting to healthcare IT systems through secure online networks necessitates a shift. Technology now facilitates remote patient monitoring and telemedicine service subscriptions and empowers individuals to manage their health proactively.The BE4YOU project, conducted in Portugal, serves as a case study, facilitating individual maintenance of health and well-being through intelligent and dynamic workflows, which are defined based on analytical models considering each person’s risk profile. By facilitating data sharing, promoting healthy lifestyles, and enabling early detection of mental health issues, the project leverages technology to support personalized monitoring and enhance overall health outcomes. Through technology-driven empowerment, individuals and healthcare professionals are better equipped to assess risks and ensure ongoing wellness monitoring, underscoring the role of technology in fostering personal health and supporting healthcare effectiveness.

Oral Cancer (OC) or squamous cell carcinoma of the oral cavity accounts for approximately 3% of all cancers worldwide, with increased incidence in developing countries. The use of tobacco is directly associated with approximately 80% of oral cancers, especially in older men over 40 years of age. As nearly one-third of the Indian population over 15 years consume smokeless tobacco in one or the other forms, a recent increase has been observed in OC incidence among women and young adults. Lately, the sexual behaviors of young & homosexuals have resulted in the emergence of oropharyngeal cancers due to infection with HPV 16. About 60% of oral cancer cases in India have a five-year survival rate, and this can be improved to 70% to 90% by mere early detection in stages I and II and with various treatment modalities. Despite the well-known benefits of oral cancer screening for the whole population in developing countries remains controversial. It is imperative to address the cultural barriers and societal norms, which limit the acceptability and participation in screening programs in India and many developing countries. This unique challenge of increasing OC morbidity in India and developing countries requires horizontal integration of the health systems with new services focused on cancer control, which gives the best chance for long-term survival, improved outcomes, and affordable care!This article is based on the author’s experience of overseeing 1 case of early detection and 2 cases of delayed diagnosis, outcomes and relevant literature review, and current guidelines for the management of OC.

Neurodegenerative disorders (NDDs) pose a significant global health challenge, impacting millions with a gradual decline in neurons and cognitive abilities. Presently, available NDD therapies focus on symptom management rather than altering the disease trajectory. This underscores the critical necessity for groundbreaking treatments capable of addressing the root causes of neurodegeneration, offering both neuroprotection and neuro-restoration. This in-depth review delves into the forefront of emerging NDD therapies, encompassing gene therapy, stem cell therapy, immunotherapy, and neurotrophic factors. It sheds light on their potential advantages, hurdles, and recent advancements gleaned from both preclinical and clinical studies. Additionally, the document outlines existing NDD treatments, spanning pharmacological and non-pharmacological interventions, along with their inherent limitations. The overarching conclusion emphasizes the immense potential of emerging therapies in NDD treatment, yet underscores the imperative for continued research and optimization to ensure their safety, efficacy, and specificity.

Introduction: Hypoglycemia affects patient safety and glycemic control during insulin treatment of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). It is still a major clinical problem in the treatment of type 1 diabetes that impairs metabolic control. This study aimed to assess hypoglycemia and associated factors among type 1 diabetes mellitus patients attending the outpatient clinics of Debra–Tabor Comprehensive and Specialized Hospital, in 2021.Method: institutional-based cross-sectional study design was conducted among 204 selected type I DM, from June 1/2021 to August 30/2021. The study participants were selected by systematic sampling method from monthly follow-up lists and lists of registration. Data were cleaned and entered into Epi Data and then exported into SPSS version 20 for analysis. Data were presented with texts, graphs, diagrams, and tables but an analytic form of findings will be presented by text form of the odds ratio. Bivariable and multivariable binary logistic regression models were fitted to identify factors associated with hypoglycemia p – value < 0.05 was considered statistically significant and reported as a 95% confidence interval (CI).Results: A total of 204 participants participated with a response rate of 100%, and prevalence of self-reported hypoglycemia was 88.7% (95%, CI: 83.8-92.6) and the prevalence of hypoglycemia was significantly associated with occupation [AOR: 4.01 (95% CI:1.86-9.35)], higher educational status [AOR: 2.13 (95% CI:1.92-13.15)], diabetic duration < 1 [AOR: 3.80 (95% CI:1.32-9.28)], poor knowledge [AOR: 4.91 (95% CI:1.09-11.06)] and favorable attitude [AOR: 5.86 (1.10-6.07)]. The current study revealed that the knowledge, attitude, and practice of respondents were 81.9% (95%, CI, 76-86.8), 73% (95% CI, 66.7-78.9), and 91.2% (95% CI, 86.8-94.6) respectively.Conclusion and recommendation: Hypoglycemia was highly prevalent among diabetic patients treated at Debra-Tabor Comprehensive and Specialized Referral Hospital. To reduce the higher prevalence of hypoglycemia the health professionals working in the hospital had better provide appropriate patient advice about, BGL monitoring, medication adherence, self-injection as well as oral hypoglycemic agent administrations.

Introduction: Spaced fiber bundles, less evident cell striations, deposition of collagen fiber bundles, and increased presence of fibroblasts in the cardiac tissue of rats that voluntarily and chronically ingested ethanol were observed by our research group. In addition, we observed increased proliferation and cell death of cardiomyocytes. To find out whether these changes lead to impaired heart functionality, some clinical tests were performed. Aim: to investigate whether chronic ethanol decreases the left ventricular performance assessed by exercise testing, electrocardiogram, and echocardiogram of male and female UChB strain rats. Material and methods: ten adult males and ten adult females, Wistar strain rats, named UChB (University of Chile), spontaneous high ethanol drinkers (consumption greater than 2 g ethanol / Kg body weight/day), and ten male UChB rats and ten adults female UChB rats, not exposed to ethanol, UChBC rats (controls) were used. Cardiac performance was evaluated by the stress test, electrocardiogram, and echocardiogram. Results: Exposed females showed ventricular morphological changes in the heart. The exposed females and males had the highest heart relative weight with females being larger than males. The exposed females showed altered electrocardiogram and echocardiogram. Conclusion: Chronic ethanol decreases the left ventricular cardiac performance in rats. Females are more sensitive to changes in cardiac electrical conduction.