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Diabetes mellitus (DM) is characterized by an absolute decline in insulin secretion and peripheral resistance and is the most prevalent metabolic and endocrine disorder. However, the pathogenesis of DM also includes adipocyte insulin resistance, increased glucagon secretion, increased renal glomerular glucose absorption, and neurotransmitter dysfunction. Although there is a wide spectrum of therapeutics available for glycemic control, owing to the identification of various pathogenic determinants of DM, management of DM remains challenging and complex. Current therapeutic interventions against DM focus mostly on glycemic control without considering the other pathological determinants that eventually lead to treatment failure and the progression of DM. Furthermore, long-term use of these conventionally available anti-diabetic drugs leads to various side effects, henceforth development of novel drugs against DM remains an unending search strategy for researchers. Various studies conducted in various parts of the world have proposed that these novel therapeutic interventions target multiple and alternate pathogenic hotspots involved in DM. The current review article discusses novel therapeutic options that hold particular promise to support their safety and discuss the side effects resulting from their use so that these novel candidate drugs can be effectively fabricated into potential drugs for the treatment of DM.

Diabetes mellitus (DM) is characterized by an absolute decline in insulin secretion and peripheral resistance and is the most prevalent metabolic and endocrine disorder. However, the pathogenesis of DM also includes adipocyte insulin resistance, increased glucagon secretion, increased renal glomerular glucose absorption, and neurotransmitter dysfunction. Although there is a wide spectrum of therapeutics available for glycemic control, owing to the identification of various pathogenic determinants of DM, management of DM remains challenging and complex. Current therapeutic interventions against DM focus mostly on glycemic control without considering the other pathological determinants that eventually lead to treatment failure and the progression of DM. Furthermore, long-term use of these conventionally available anti-diabetic drugs leads to various side effects, henceforth development of novel drugs against DM remains an unending search strategy for researchers. Various studies conducted in various parts of the world have proposed that these novel therapeutic interventions target multiple and alternate pathogenic hotspots involved in DM. The current review article discusses novel therapeutic options that hold particular promise to support their safety and discuss the side effects resulting from their use so that these novel candidate drugs can be effectively fabricated into potential drugs for the treatment of DM. [ABSTRACT FROM AUTHOR]

A prospective study on 193 patients through 3 years from February 2020 till January 2023 patients complain of colorectal carcinoma in different locations. 43 patients (23%) had a history of open or laparoscopic cholecystectomy since a different time ranging from 9 to more than 30 years, who have no family history of colorectal cancer or inflammatory bowel diseases, adenomatous polyps, and no history of familial adenomatous polyposis, (predisposing factors of colorectal cancer). most common location of malignancy for those patients with a history of cholecystectomy in the RT side of the colon 21 patients (48.8%) and the least location in the ano-rectum region one patient (2.4%). The most common time that we diagnosed colorectal carcinoma after 21 to 25 years from the time of cholecystectomy which occurred in 18 patients (41.9%) and the least after 9 years only one patient (2.4). While the microscopic appearance of colorectal cancer in patients with a history of cholecystectomy is, adenocarcinoma occurs in 38 patients (88.4%) and squamous carcinoma occurs in 5 patients (11.6%). While the macroscopic appearance of colorectal cancer occurs most commonly in ulcerative types in 29 patients (67.5%) and least annular type 5 patients (11.6%) and the most common age occur between the age of 60 and 69 years in 24 patients (55.8%) and leas occur at the age of 40 to 49 years only 2 patients (4.6%), about the grading of the tumor moderate differentiated type, is the most common type in 67.5% Aim of the study to know the incidence of colorectal carcinoma after cholecystectomy, locations of tumors, and related time. [ABSTRACT FROM AUTHOR]

Endothelial dysfunction is closely linked to the development of atherosclerosis. This systematic review and meta-analysis reviewed the evidence on the effect of weight loss, achieved by dietary-based interventions, on biomarkers of endothelial function (EF). Two databases (Medline, Embase) were searched from inception until November 2022 for studies that met the following criteria: 1) adult subjects (≥ 18 years) without exclusion for health status, 2) dietary interventions for weight loss, and 3) measurements of changes in EF biomarkers. Random-effect meta-analysis and meta-regression were performed. Thirty-seven articles including 1449 participants were included in the systematic review. Study duration ranged from 3-52 weeks. Overall, weight loss significantly improved biomarkers of EF [standardised mean difference (SMD):0.65; 95%CI:0.49,0.81; P < 0.001;I2 = 91.9%]. Subgroup analyses showed weight loss significantly improved levels of E-selectin (P < 0.001), intercellular adhesion molecule-1 (ICAM-1) (P < 0.001), vascular cell adhesion molecule-1 (VCAM-1) (P < 0.001), nitrite/nitrate (NOx) (P < 0.001) and vascular endothelial growth factor (VEGF) (P < 0.001). Conversely, there was no significant improvement for von Willebrand Factor (vWF). Meta-regression analysis revealed that changes in EF biomarkers were not affected by age, BMI, quality of the studies or the amount of weight lost. A significant heterogeneity was observed for the effects of weight loss on changes in EF biomarkers. Dietary-induced weight loss may be associated with biomarkers changes indicating an improvement of EF, and it may represent a potential strategy to reduce atherosclerotic risk. [ABSTRACT FROM AUTHOR]

Background and objectivesPhysical activity is associated with lower cardiovascular and all-cause mortality. However, the effects of different exercise modalities on arterial stiffness are currently unclear. Our objectives were to investigate the effects of exercise modalities (aerobic, resistance or combined) on pulse wave velocity (PWV) and augmentation index (AIx), and to determine whether the effects on these indices differed according to the participants' or exercise characteristics.MethodsWe searched the Medline, Embase and Cochrane Library databases from inception until April 2014 for randomized controlled trials lasting ≥ 4 weeks investigating the effects of exercise modalities on PWV and AIx in adults aged ≥ 18 years.ResultsForty-two studies (1627 participants) were included in this analysis. Aerobic exercise improved both PWV (WMD: -0.63 m/s, 95% CI: -0.90, -0.35) and AIx (WMD:-2.63%, 95% CI: -5.25 to -0.02) significantly. Aerobic exercise training showed significantly greater reduction in brachial-ankle (WMD: -1.01 m/s, 95% CI: -1.57, -0.44) than in carotid-femoral (WMD: -0.39 m/s, 95% CI: -0.52, -0.27) PWV. Higher aerobic exercise intensity was associated with larger reductions in AIx (β: -1.55%, CI -3.09, 0.0001). In addition, aerobic exercise had a significantly larger effect in reducing PWV (WMD:-1.0 m/s, 95% CI: -1.43, -0.57) in participants with stiffer arteries (PWV ≥ 8 m/s). Resistance exercise had no effect on PWV and AIx. There was no significant effect of combined exercise on PWV and AIx.ConclusionsWe conclude that aerobic exercise improved arterial stiffness significantly and that the effect was enhanced with higher aerobic exercise intensity and in participants with greater arterial stiffness at baseline.Trial registration prosperoDatabase registration: CRD42014009744.

This paper presents a novel hybrid algorithm based on particle swarm optimization (PSO) and noising metaheuristics for solving the single-source shortest-path problem (SPP) commonly encountered in graph theory. This hybrid search process combines PSO for iteratively finding a population of better solutions and noising method for diversifying the search scheme to solve this problem. A new encoding/decoding scheme based on heuristics has been devised for representing the SPP parameters as a particle in PSO. Noising-method-based metaheuristics (noisy local search) have been incorporated in order to enhance the overall search efficiency. In particular, an iteration of the proposed hybrid algorithm consists of a standard PSO iteration and few trials of noising scheme applied to each better/improved particle for local search, where the neighborhood of each such particle is noisily explored with an elementary transformation of the particle so as to escape possible local minima and to diversify the search. Simulation results on several networks with random topologies are used to illustrate the efficiency of the proposed hybrid algorithm for shortest-path computation. The proposed algorithm can be used as a platform for solving other NP-hard SPPs.

Hemorrhoid is the commonest disease of the lower gastrointestinal tract, the worldwide incidence between 2.9% and 27.9%. The name referred to symptomatic anal cushions and the term should only be used when patients have symptoms referable to them. The treatment options have varied, which may depend on the degree of the hemorrhoids which ranged from dietary and lifestyle modification in the first degree to excision for a fourth-degree, more than one kind of treatment used for the same degree of hemorrhoid. Carbon dioxide laser used for excision of hemorrhoids because of its characteristics, thin depth, thin collateral thermal effect zone and seal lymphatic, blood vessels and nerve ending, result in operation bloodless field, less edema, and pain. The objective of our study to evaluate the usage of carbon dioxide laser in hemorrhoidectomy and post-operative pain. In our study, there were 150 patients complain of hemorrhoids (2nd, 3rd & 4th) degrees. There were 114 males (76%), and 36 females (24%), with age between 25 and 55-year-old with mean of age were 40-year-old. The most common presentation was bleeding, prolapse of the mucosa, or constipation, although patients used conservative treatment but no improvement. We used Carbon dioxide laser for hemorrhoidectomy. The operative time and postoperative pain were less than conventional operation for hemorrhoids. 60% of patients had no pain, while 30% had mild to moderate pain which required simple analgesia and severe pain in 10% in the first postoperative day. From this study concluded hemorrhoidectomy with carbon dioxide 10600nm laser is safe (in well-trained hands in laser surgery), less post-operative pain compares with conventional hemorrhoidectomy or another kind of hemorrhoidectomy. [ABSTRACT FROM AUTHOR]

Ageing is a multifactorial process associated with reduced function and increased risk of morbidity and mortality. Recently, nine cellular and molecular hallmarks of ageing have been identified, which characterise the ageing process, and collectively, may be key determinants of the ageing trajectory. These include genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion and altered intercellular communication. Healthier dietary patterns reduce the risk of age-related diseases and increase longevity and may influence positively one or more of these hallmarks. The Mediterranean dietary pattern (MedDiet) is a plant-based eating pattern that was typical of countries such as Greece, Spain, and Italy pre-globalisation of the food system and which is associated with better health during ageing. Here we review the potential effects of a MedDiet on each of the nine hallmarks of ageing, and provide evidence that the MedDiet as a whole, or individual elements of this dietary pattern, may influence each hallmark positively-effects which may contribute to the beneficial effects of this dietary pattern on age-related disease risk and longevity. We also highlight potential avenues for future research. [ABSTRACT FROM AUTHOR]

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Summary: Osteoporosis is more common than most feared non-communicable diseases in the Middle East. This justifies the need to place osteoporosis as a health priority in the region. Introduction: Osteoporosis is a common disease associated with severe debilitating consequences. The objective of this study is To evaluate and compare disease burden from osteoporosis and other non-communicable diseases (NCDs) in Lebanon. Methods: We assessed the prevalence of osteoporosis and other NCDs, such as obesity, diabetes, hypertension, dyslipidemia, and cardiovascular diseases, based on a published population-based study of Lebanese ≥ 65 years. We compared incidence rates of hip fractures and major osteoporotic fractures (MOF) (spine, hip, humerus, and forearm) to the five commonest cancers in women ≥ 50 years. Rates were based on the national hip fracture and cancer registry data, provided by the Lebanese Ministry of Public Health. MOF incidence rates were derived from national hip fracture incidence rates and MOF/hip fractures incidence rate ratios from the literature. Results: Over 70% of elderly Lebanese had osteoporosis defined by densitometric criteria or prevalent morphometric vertebral fractures. This by far exceeded the prevalence of other NCDs, such as hypertension (53%), diabetes (21%), dyslipidemia (31%), and cardiovascular diseases (30%). Morphometric vertebral fractures (grades 2 and 3) were present in 19% of women and 12% of men. The incidence rates for MOF were 1.6 times greater than those for breast cancer, and 7.4–9.9 folds higher than those for the next commonest cancers of the lungs, colon, and ovaries. Hip fracture incidence rates were lower than those of breast cancer but were 2.1–2.8 folds higher than those of the above-mentioned cancers. Conclusion: This first of its kind study in the Middle East demonstrates that osteoporosis is a common disease, more common than most feared NCDs. Our findings are comparable to those in western populations and justify placing osteoporosis on the top of NCDs' priority list in our country and possibly the region. [ABSTRACT FROM AUTHOR]

Background and Aims: Worldwide, cardiovascular diseases (CVDs) remains as the main cause of mortality. Observational studies supports an association between intake of tomato products or lycopene with a reduced CVDs risk. Our aim was to undertake a systematic review and meta-analysis of the evidence on the topic.Methods: Medline, Web of Science, and Scopus were searched from inception until July 2017. We included longitudinal and cross-sectional studies reporting associations between lycopene and tomato consumption and cardiovascular morbidity and mortality among adult subjects. Random-effects models were used to determine the pooled effect sizes.Results: Twenty-eight publications met our inclusion criteria and 25 studies provided quantitative data for meta-analysis. Results showed that individuals in the highest consumption category of, or with the highest serum concentration of, lycopene had significantly lower risk of stroke (hazard ratio (HR) 0.74, 0.62-0.89, p = 0.02; I2 = 32) and CVDs (HR 0.86, 0.77-0.95, p = 0.003; I2 = 0). In addition, individuals categorised in the highest serum concentration of lycopene also had significantly lower risk of mortality (HR 0.63, 0.49-0.81, p<0.001; I2 = 46). Lycopene was not significantly associated with myocardial infarction, while scarce evidence on the association of lycopene with atherosclerosis, congestive heart failure, or atrial fibrillation was evident. Evidence from three studies suggested that higher intakes of tomato were associated with non-significantly lower stroke, CVDs and CHD.Conclusions: This comprehensive meta-analysis suggests that high-intakes or high-serum concentration of lycopene are associated with significant reductions in the risk of stroke (26%), mortality (37%) and CVDs (14%). [ABSTRACT FROM AUTHOR]

CVD are characterised by a multi-factorial pathogenesis. Key pathogenetic steps in the development of CVD are the occurrence of endothelial dysfunction and formation of atherosclerotic lesions. Reduced nitric oxide (NO) bioavailability is a primary event in the initiation of the atherosclerotic cascade. NO is a free radical with multiple physiological functions including the regulation of vascular resistance, coagulation, immunity and oxidative metabolism. The synthesis of NO proceeds via two distinct pathways identified as enzymatic and non-enzymatic. The former involves the conversion of arginine into NO by the NO synthases, whilst the latter comprises a two-step reducing process converting inorganic nitrate into nitrite and subsequently NO.Inorganic is present in water and food, particularly beetroot and green leafy vegetables. Several investigations have therefore used the non-enzymatic NO pathway as a target for nutritional supplementation ( salts) or dietary interventions (high- foods) to increase NO bioavailability and impact on cardiovascular outcomes. Some studies have reported positive effects of dietary on systolic blood pressure and endothelial function in patients with hypertension and chronic heart failure. Nevertheless, results have been inconsistent and the size of the effect appears to be declining in older individuals. Additionally, there is a paucity of studies for disorders such as diabetes, CHD and chronic kidney failure. Thus, whilst dietary supplementation could represent an effective and viable strategy for the primary and secondary prevention of age-related cardiovascular and metabolic diseases, more large-scale, robust studies are awaited to confirm or refute this notion. [ABSTRACT FROM AUTHOR]

Accidental hanging is rare. The circumstances of death are sometimes so strange and bizarre. It represents a differential diagnosis with suicidal hanging and even criminal hanging. We report two cases of accidental hanging. The first one occurred with a 7-year-old girl playing with a curtain rope. The second with a thief who was found head-trapped between two bars of a metal outer-door. We summarize the findings of the death scene examination, the forensic autopsy and the world literature concerning death by accidental hanging. [ABSTRACT FROM AUTHOR]