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Background: Chronic kidney disease is a progressive loss in renal function that is more accepted as global public health importance and its magnitude is overgrowing in the least developed countries like Ethiopia. No data was found in Debre Birhan Central Ethiopia on the magnitude of chronic kidney disease among type 2 diabetes patients. Methods: Institution-based cross-sectional study was conducted among 327 at Debre Berhan Referral Hospital from March to June 2019 in Adult (≥ 18 years) type 2 diabetes follow-up patients who volunteered to give informed written consent were included in the study. Systematic random sampling was used. Data were collected by interviews using structured and pre-tested questionnaires. Descriptive statistics of the continuous and categorical variables were done. The bi-variable and multivariable logistic regression was done to show the net effect of explanatory variables on chronic renal disease. Results: A total of 327 study participants were involved in the final analysis. The Prevalence of CKD among type 2 diabetic patients was 15.9%. A significant association was found with age > 60 years [AOR 3.5 (95% CI 1.8-6.8)], alcoholic patients [AOR 2.4 (95% CI 1.2-5.1)], glycated hemoglobin levels above 7% [AOR 2.5 (95 CI 1.5-4.1)], higher level of LDL greater than 100 g/dl [AOR 2.7 (95% CI 1.9-4)] and lower level of HDL [AOR 2.9 (95% CI 1.4-6)].Conclusion: The magnitude of chronic kidney disease among type 2 diabetic follow-up patients was 15.9%. Estimated GFR should be determined for diabetic patients at regular intervals of time for earlier diagnosis of chronic kidney disease.

Indonesia is the fourth largest country in the world by population and has made considerable progress since the 1960s in terms of economic growth and structural transformation. But in recent years it has become apparent that the health of the nation is far from satisfactory. The purpose of this article is to review recent literature on health problems in Indonesia and to outline the policy challenges which face the government. Since 2001, the provision of primary health care has been decentralized to sub-provincial levels of government but they lack often lack the resources, and trained staff to provide adequate services to rural populations in particular. The literature suggests that while most health indicators have shown some improvement in recent years, there are still large variations by region and social class. The country is still far from achieving the goal of universal health coverage.

The pathogenesis of an ovarian disease is connected with PTN and its receptor protein tyrosine phosphatase receptor Z1 (PTPRZ1). Paclitaxel is the first-line drug for the therapy of ovarian cancer. With the increment of paclitaxel chemotherapy, paclitaxel obstruction happens in the late phase of therapy frequently. By treating A2780 and SKOV-3 cells with PTN, we found the development of the two cell lines was enhanced. Different concentrations of PTN were added to A2780 and SKOV-3 cells treated with paclitaxel and the results of MTT showed that the inhibitory effect of paclitaxel on these two cell lines was weakened. The results of apoptosis assays showed that PTN could slow down the rate of apoptosis and its concentration dependence in both cell lines. To further investigate the impact of PTN on the paclitaxel responsiveness of ovarian malignant growth cells, A2780 and SKOV-3 cells were transfected with sh-PTN-1, sh-PTN-2 and sh-NC plasmids. The results of PCR and Western Blot showed that both RNA-interfering plasmids could inhibit PTN in A2780 and SKOV-3 cells. The results of MTT showed that the inhibitory effect of paclitaxel on cells transfected with sh-PTN-1 expanded compared with the benchmark group. Apoptosis assays showed that the complete apoptosis pace of A2780 and SKOV-3 cells with sh-PTN-1 plasmid induced by paclitaxel was accelerated obviously compared with the benchmark group. To summarize, the results suggested that PTN could enhance the resistance to paclitaxel in ovarian cancer cells, which provides a groundwork for studying on drug resistance of cancer cells to paclitaxel and a new perspective for ovarian cancer therapy.

Oncological diseases are one of the most significant medical and social diseases in most countries of the world. Over the past decades, the search and development of new drugs, treatment regimens and methods of molecular diagnostics of malignant neoplasms remains relevant. In turn, an important goal of molecular genetic research is to suppress the expression of genes responsible for the development of tumors. The key targets taken into account in the development of antitumor drugs are proteins involved in carcinogenic changes in the cell. One of the promising molecular targets for the development of medicinal compounds in targeted therapy of tumor diseases is poly(ADP-ribose)polymerase 1 (PARP1). A potential way to inhibit PARP1 even at the stage of protein translation is RNA interference due to small interfering RNAs (siRNAs). For the penetration of siRNAs into the target cell, it is necessary to develop a method of their transportation controlled in space and time. An actual direction for solving this problem is the use of highly stable porous silicon-based nanoparticles. In the current study, in order to increase the functionality of nanoparticles, their surface was modified with various agents (functionalization), providing increased efficiency of drug loading and more uniform release. 

Disruption to contrast agent supply chains for radiology investigations has become an additional consequence of the COVID-19 pandemic. Various recommendations, including dose reductions and choices of alternative agents, have been made to help account for this limited availability. This case demonstrated how two separate CT venograms with different contrast agents, undertaken on the same day for the same patient, yielded different results; venous thromboses were more prominent in the subsequent scan. Although there was some evidence of venous sinus thrombosis on the first scan, repeat imaging was required to further characterize the lesions identified. The case exemplifies the notion that diagnostic imaging should always be guided by a detailed history and examination. It also raises the discussion point of whether more strict or uniform protocols should be developed to facilitate contrast administration for radiology investigations. It is important that appropriate doses are always administered to maximize diagnostic yield.

Monitoring the life cycle of physical assets (PA) implies addressing issues, such as PA’s energy efficiency and its replacement and definition of the most proper moment to renew. The goals of this article are: to present a characterization of energy sources and analyze the PA life cycle in a food sector company. First, it will be characterized the costs and the expenses of the organization’s energy sources, then, a study about the replacement of PA is presented; Traditional methods were used, such as economic life; The models that underlie it are discussed throughout the article, using actual data, for validation. Three methods for depreciation of PA are used: Linear Depreciation; Sum of Digits and Exponential. Other methods were used to determine the Economic Cycle for replacing PA: Uniform Annual Expenditure (MRAU); Minimizing the Average Total Cost (MCMT); and the MCMT-Reduced to Present Value (MCMT-RVP). The equipment of the study was bakery ovens (gas and electrical). Results and conclusions from the application of the methods used in the evaluation of these PAs are presented.

Every society organizes itself to reduce the complexity of living together in order to ensure relative peace of mind for its members. Major technological accidents such as the Chernobyl or Fukushima nuclear accidents are violent disruptions that affect the quality of life of tens of thousands of people and generate increased distrust and anxiety among them as well as the questioning of the state system’s ability to restore some peace of mind. Past experience has shown that the measurement of radiation and the development of local projects with the support of professionals and experts prove to be effective levers for those affected to regain the ability to make decisions for their protection and to assess the protective actions implemented collectively. It also showed that restoring confidence and restoring the dignity of these people, seriously impaired by the accident, takes time.

Objective: To study clinical and immunological characteristics of depressive patients with high clinical risk of schizophrenia.Materials and methods: We examined 30 depressive patients with attenuated positive symptoms (APS), which indicates a clinically high risk of schizophrenia, 20 depressive patients without APS and 27 healthy volunteers with no mental disorders. APS identified according to the presence of three or more scores on at least one of the following items on the Scale of Prodromal Symptoms (SOPS) positive symptoms subscale: P1 (Unusual thought content/Delusional ideas), P2 (Suspiciousness/Persecutory ideas) and P4 (Perceptual abnormalities/Hallucinations). The psychometric assessment was carried out on the Hamilton Depression Rating Scale (HDRS), SOPS, and the Scale for Assessment of Negative Symptoms (SANS). The activity of leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI), the autoantibodies to neoantigens S100B and myelin basic protein, and the ratio of LE and α1-PI activity or Leukocyte Inhibitory Index (LII) were determined. Results: The activity of inflammatory markers LE and α1-PI was increased in patients in both clinical groups compared with controls. In the total group of patients, the associations between LII and the score on the positive subscale SOPS, and between LII and the score on the negative subscale SOPS and SANS scale with the most pronounced association with the SANS subscales «Affective Flattening or Blunting» and «Alogia» were established. Conclusion: The identified correlations between immune response features and positive and negative symptoms in depressive patients may have prognostic value for establishing a high risk of schizophrenia.

Background: Healthcare-Associated Infections (HAIs) are the most common healthcare-associated complications, particularly in elderly patients. The aim of this study is to describe the prevalence of HAIs and associated risk factors in the IRCCS INRCA of Ancona.Methods: A cross-sectional study has been carried out. Data has been collected in accordance with the European Centre for Disease Prevention and Control (ECDC) Point Prevalence Survey 2022-2023 (PPS3) protocol in the IRCCS INRCA of Ancona in November 2022.Results: Out of the 128 patients included in our study, 75.0% were over 78 years old and 9.1% presented an active HAI on the day of the survey. The prevalence of HAIs varied based on the length of the hospital stay (OR 1.1, CI 95% 1.05 - 1.17, p < 0.001) and hospitalization > 7 days (OR 5.9, CI 95% 1.2 - 28.7, p = 0.02).Conclusion: It is clear from our findings that HAIs are associated with advanced patient age, prolonged hospital stay, and use of medical devices, especially in those patients that, due to their clinical situation, are more vulnerable. Although some of these infections can easily be treated, it is important to develop effective infection control strategies thanks to antimicrobial stewardship programs.

Purpose: Exercise has a positive regulatory effect on gut microbiota and is also involved in regulating multiple physiological functions of the human body. This article tested the effects of basketball exercises at different exercise intensities on the gut microbiota of college students. Methods: Athlete research subjects (male, aged 18 - 25) were selected from the basketball team and trained at different intensities to obtain a total of 101 fresh fecal samples. DNA was extracted by a DNA extraction kit and bacterial 16S rRNA gene V3-V4 region high-throughput sequencing using the Illumina Hiseq platform. The downstream data were spliced, filtered and de-trimerized and then used to study the difference in gut microbiota. Results: Key bacterial taxa in the gut that responded to exercise intensity differed among athletes of different exercise intensities but most belonged to Firmicutes. With increasing exercise intensity, Butyricicoccus, Anaerostipes, Oxalobacter and Clostridium_IV in basketball players enrich. Further analysis of the functional prediction revealed that carbohydrate metabolism, amino acid metabolism, metabolism of xenobiotics and glycans and metabolism were significantly expressed in the gut microbiota of basketball athletes with high intensity. Conclusion: The study demonstrated that after long-term professional training, the gut microbiota of athletes adapts to exercise stimulators and can quickly respond to changes in exercise intensity. In high-intensity training, the organism is protected from harm by enriching some beneficial bacteria.

Background: The clinical manifestations of Corona Virus Disease of 2019 (COVID-19) varied from patient to patient with evidence of multi-organ involvement. Many patients continue to have a wide range of symptoms for variable periods of time. The long-term effects of COVID-19 infection (post-COVID-19 illness or syndrome) are not yet been fully explored.This study aims to highlight the clinical manifestations of the acute COVID-19 infection and the longer-term manifestations of the disease among the attendants to a private GP clinic in the Urban Amman Area, Jordan.Methods: A clinical case-series study was conducted on a sample of 300 COVID-19-positive cases among patients attending my private GP clinic in the Urban Amman Area, Jordan. We used the structured questionnaire based mainly on World Health Organization (WHO) Case Report Form (CRF) verified tool for post-COVID-19. All patients with COVID-19 were included in the study. Data collection was conducted through phone calls and analyzed using the Statistical Package for Social Sciences (SPSS) software. Results: The incidence of COVID-19 among patients attending the clinic during the period of this study was 25%. Females were 135 (45%) of the study population and males were 165 (55%). The mean (SD) of age was 34.2 (5.0) years. Most of the infected staff (90%) were symptomatic and developed acute COVID-19 symptoms. Fever, Cough, Fatigue, joint pain and loss of smell and taste were the most common symptoms. 72% of the study population had fully recovered from the infection, while 28% of them continued to suffer from many long symptoms. Fatigue (28%), shortness of breath on activity (18%), Social withdrawal (18%), anxiety (17%), forgetfulness (16%), trouble concentrating (15) and depressed mood (14%) were the most frequently reported long symptoms.Conclusion: The prevalence of Post COVID-19 illness was 28% with a high public health burden calling for the public health system to address the medical and psychological needs of affected persons. Mental health and psychosocial support are recommended elements for the management of patients.

Background: Autologous hematopoietic stem cell transplants (HSCT) is the standard of care for transplant-eligible patients with newly diagnosed multiple myeloma (MM) and patients with relapsed and refractory Hodgkin lymphoma (R/R-HL) who achieve chemosensitivity after salvage therapy. Although autologous HSCT is routinely performed in an  inpatient setting, the procedure can safely be performed in an  outpatient setting.Methods and materials: A retrospective study of patients with MM and R/R- HL who received outpatient autologous HSCT at King Fahad Specialist Hospital (KFSH) in Dammam, Saudi Arabia between the first of April 2017 and the 31st of January 2022 was performed.Results: Over the study period of 4 years and 10 months, a total of 90 outpatient autologous HSCTs were performed for 79 patients (54 patients with MM; 4 of them received planned tandem autografts and 7 other myeloma patients received second autologous HSCTs for relapsed or progressive disease; and 25 patients with R/R-HL) at our institution. The median ages of patients with MM and those with R/R-HL at HSCT were 50.4 years and 27.8 years respectively.At the presentation of their MM, the following high-risk (HR) features were encountered: stage II and III diseases according to the revised international scoring system (RISS) in 53.7%; adverse cytogenetics in 42.6% and extensive bone involvement in 53.7% of patients. In patients with HL at presentation, 48% of patients had stage IV disease according to Ann Arbor staging classification and 84% of patients had B symptoms.Survival for 100 days post-HSCT for all patients with MM and HL who received outpatient autologous transplants was 100%. For patients with MM, the overall survival (OS) rates at 3 years and 4 years post-HSCT were 80% and 67%, while the progression-free survival (PFS) rates over 3 years and 4 years were 58% and 38% respectively. For patients with HL, the OS at 6 years post-HSCT was 95% while the PFS rates at 3 years and 6 years post-HSCT were 84% and 62% respectively.Conclusion: Outpatient autologous HSCT for patients with MM and HL is safe, and feasible and can lead to short-term as well as long-term outcomes that are comparable to autologous transplantation performed in an  inpatient setting. Additional benefits of outpatient autologous include saving beds and reducing hospital costs.

Information regarding the effects of the novel coronavirus on human reproduction is currently limited. The objective of our work was to assess whether, in women who have passed the disease, there was a variation in the ovarian reserve through the determination of AMH levels. During May-June 2020, women performing an Assisted Reproductive treatment and who had a positive IgG for SARS-CoV-2 were included in the study; this group of women had a previous AMH determination of no more than 6 months. Women were stratified into two groups, according to their previous AMH levels: low responders (AMH<1 ng/ml) or normal-high responders (AMH ≥ 1 ng/ml) Statistical analyses were performed using the Statistical Package for Social Sciences 19.0 (IBM Corporation, Armonk, NY, USA). A total of 46 patients were included in the study; 16 women were diagnosed as having low ovarian reserve (AMH < 1 ng/ml), with an average age of 38.6 years, whereas 30 were classified as having normal ovarian reserve (AMH ≥ 1 ng/ml), with an average age of 34.7 years. Generally, the data show no variation in AMH levels before and after SARS-CoV-2 infection (1.73 ng/ml vs. 1.61 ng/ml, respectively). However, when we analyzed these differences according to the study groups, the results were consistent with the patient's ovarian status. It is possible to conclude that the fact of having passed the disease does not affect the ovarian reserve status but the degree of the variation of AMH levels depending on the patient was a low or high responder.

Introduction: Self-harm and depression are two related mental health issues that often co-occur and can have serious impacts on individuals and their well-being. Major Depressive Disorder (MDD) is a complex and multifaceted mental health condition that is prevalent among young adults. It is a significant public health concern that affects individuals, families and society as a whole, contributing to considerable social, economic, and health-related costs. Despite the high prevalence of depression in young adults, there is a lack of understanding of its etiology, risk factors, and optimal treatment strategies. Self-harm behavior is a concerning manifestation of MDD that can have serious consequences, including injury, infection, or even death.Methods: In this article, we report a case of an MDD patient with self-harm behavior and discuss the assessment method and treatment options. Our aim is to raise awareness of these pathologies among psychiatrists and the general population and to highlight the importance of early diagnosis and effective treatment in reducing the risk of self-harm behavior and suicide.Conclusion: In light of the case presented, it is evident that early detection and targeted intervention are crucial in mitigating the risk of self-injurious behavior in MDD patients. The utilization of a comprehensive assessment methodology, inclusive of a thorough review of the patient’s clinical history and utilization of standardized rating scales, proved indispensable in the tailoring of an individualized treatment regimen. The amalgamation of pharmacotherapy and psychotherapy proved to be a successful strategy in the amelioration of depressive symptoms and consequent self-harm behavior. As such, we trust that this case report will serve to sensitize clinicians to the importance of early identification and prompt management of these pathologies, in the quest for enhanced mental health outcomes.

Background: Hemp seed (Cannabis sativa L.) is an annual herbaceous plant of the Cannabis genus that contains a large amount of protein, iron, and fatty acids, including linoleic, α-linolenic, and γ-linolenic acid. These compounds are involved in a number of biological activities, including immunity enhancement, hyperlipidemia, and inflammation reduction. Here, we investigated the antioxidant effects of hemp seed on human cognitive function.Methods: The test was administered to 34 healthy volunteers aged ≥ 20 years. Participants were selected according to age and sex and were administered 10 g of hemp seed three times daily (30 g/day) for 45 days. The outcome measurements were recorded using a survey, computerized neurocognitive tests, and artificial intelligence.Results: Survey analysis determined that both the Beck Anxiety Inventory and Beck Depression Inventory measurements decreased significantly after hemp seed consumption when compared to measurements taken before consumption (p < 0.05). Additionally, significant results were observed in the Stroop and Tower of London tasks (p < 0.05). The prediction performance for the antidepressant effect was 0.83 for the area under the curve in the random forest algorithm, which was superior to that of other machine learning methods. Conclusion: These results suggest that hemp seeds have a beneficial effect on cognitive impairment.

Hereditary spherocytosis is a common inherited type of hemolytic anemia that results from abnormal morphology of erythrocytes. It has a high occurrence in North Americans and northern Europeans with a prevalence of 1/2000. There is a wide range in age and symptoms at presentation with some individuals being asymptomatic and others having severe diseases requiring blood transfusions. Based on the severity of symptoms, management may vary from simple observation to frequent blood transfusions, cholecystectomy for gallstones, and splenectomy. Timely diagnosis may be critical to minimize complications. Diagnostic tests have been available with varying degrees of accuracy. However new diagnostic tests with greater specificity and sensitivity are now available for more accurate diagnosis of Hereditary Spherocytosis in individuals of all ages including newborns. Illustrative cases are presented that show the variability in presentation, symptoms, complications, and care. Information is presented updating diagnostic testing that allows earlier diagnosis of children with hereditary spherocytosis. Additionally, the hematologic findings suspicious and consistent for this diagnosis are presented, serving as a guide when testing should be initiated.

The biochemical model explains the intricate mechanisms of psychobiological life. He still cannot explain what the transition from inanimate to living matter is all about. Where is the threshold and what is its essence, what role do biochemical processes play in the coherence of the soma with consciousness and its impact on the soma and vice versa? A similar problem is with other mental processes, their nature does not fit into the biochemical model of life and is inexplicable on the basis of biochemical interactions, again it is much easier to describe it in the light of quantum processes - including wave physics. It is similar to the functioning of the heart or other organs, where only the biochemical processes of the cell are considered, ignoring the bioelectronic processes. Man is not only a purely biological construct but also contains the basis of biochemical, bioelectronic, information, and cybernetic processes that are responsible for shaping the psychobiological processes of man. Contemporary biosystems in science are considered at the level of corpuscular structures, ignoring energy and information structures. By shifting the cognitive emphasis towards energy and information structures, the organism can be perceived as a quantum generator of information: electromagnetic, soliton, acoustic, spin and bioplasma. This bioelectronic construction creates homo electronics with his electronic personality.

In the past, natural pigments derived from plant-biomass wastes had been widely used for coloring purposes (e.g. fabrics/batik), before finally getting pushed aside by the imported synthetic/inorganic pigments. Thorough attempts to revive the use of such natural pigments then deserve carrying out. Relevantly, conducting storage of liquid/wet or dry natural coloring pigments, extracted from wood wastes; and use of fixatives for batik fabrics intended to impart fabric-color variations. Wood wastes (i.e. leaves and barks) were obtained from nine plant species (Acacia mangium Willd, Avicenia marina L, Caesalpinia sappan L, Ceriop tagal Perr. CB. Rob, Pelthophorum ferruginum Benth, Rhyzophora mucronata Lamk, Tectona grandis Linn.f., Terminalia catappa L and Xylocarpus granatum KD Koenig.), prevalently growing on plain/lowland areas; and their wood portions commonly utilized by wood industries, which generate similar wastes enormously. The pigments in liquid/wet and then in dry forms were produced from those wastes. The production process of pigments adopted traditions by local batik crafters in Bogor. Variations occurring in fabric colors could be due to fixatives, i.e. lime (CaCO3), ferrous sulphate/tunjung (FeSO4); and various wastes. Six-month storage insignificantly changed the coloring qualities of natural coloring pigments applied to fabrics, compared to those of corresponding initially produced pigments. Leaf wastes always contained green-colored compounds, while bark wastes appeared aptly brownish in color. Color performances of bark extracts at fabrics with ferro-sulfat fixative brought about strong grey colors, and with lime fixative produced brown colors. Coloring of fabrics using leaf waste extracts with ferro-sulfat fixative aptly exhibited greenish grey; while with lime fixative became reddish brown. Testing results on the leaching resistance of pigment-colored and fixative-treated fabrics against rubbing and exposure to sunlight revealed a very good category (4-5), but against detergent, washing was very low (2-3).

Today, there are said to be some 590 million people of all ages around the world, who are suffering from a range of swallowing problems – probably about 4 million in the UK. Either living at home or as residents in some 20,000 Care Homes, with perhaps another 25,000 as patients in hospitals every day.Professor David Smithard, of the Lewisham and Greenwich NHS Trust, has been leading a national campaign for some years to raise general awareness of Dysphagia and to improve the treatment of patients with varying conditions. He and his team at the Queen Elizabeth Hospital have now completed a detailed Review of the use of carbonated water (CW) in the treatment of Dysphagia, which has just been published and can be accessed here: https://www.mdpi.com/2308-3417/8/1/6The Review concludes that further evidence-based research is essential before CW can be adopted as standard in clinical practice – but that although the amount of evidence is small, there is a suggestion that swallows are safer and that secretion management improves, and consequently until further studies are undertaken, Carbonated Water should be limited to individual patient use.My experience as a Dysphagia sufferer is that the use of CW has resulted in life-changing benefits, and this paper is devoted to describing how CW worked for me, and what the practical requirements are, so that many others may be able to benefit as I have done. The paper has three sections: My Personal Experience, Practical Considerations, and Conclusions.

Parkinson’s disease is a progressive and debilitating neurodegenerative disorder affecting millions of people worldwide. The disease is characterized by motor symptoms such as tremors, rigidity and postural instability, as well as non-motor symptoms such as depression and cognitive impairment. While there is no cure for Parkinson’s disease, there are various treatments available to manage symptoms and improve quality of life for patients.This case study examines a 65-year-old retired accountant, Mr. John Smith, who was diagnosed with Parkinson’s disease five years ago. Mr. Smith has been treated with a combination of medications, including levodopa and carbidopa and physical therapy to manage his symptoms. However, his symptoms have not significantly improved.This literature review explores the current research on Parkinson’s disease, including its pathophysiology, diagnosis and treatment. Parkinson’s disease is caused by the degeneration of dopamine-producing neurons in the brain, leading to a depletion of dopamine and the accumulation of alpha-synuclein protein, oxidative stress and inflammation. Diagnosis is based on clinical symptoms, neurological examination and response to dopaminergic therapy. Treatment focuses on managing symptoms, with medications and non-pharmacological interventions such as exercise and physical therapy. Deep brain stimulation is a surgical treatment option that has been shown to be effective in managing motor symptoms.While there is currently no cure for Parkinson’s disease, ongoing research into its pathophysiology and treatment holds promise for improving outcomes for patients. This case study highlights the importance of early diagnosis and personalized treatment plans for patients with Parkinson’s disease.