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Abstract Mouth is the gateway to the total body wellness. Accordingly, oral microbiome influences overall health of an individual. Oral microbiome plays a key role in shaping up the host’s health profile. Obvious differences have been reported between patients with gastrointestinal diseases and healthy controls. The oral and gut microbiome profiles are well-segregated due to the oral–gut barrier. However, the oral microbiota can translocate to the intestinal mucosa in conditions of the oral–gut barrier dysfunction. Oral bacteria can disseminate to the distal gut via enteral or hematogenous routes. The translocation of oral microbes to the gut may give rise to a variety of gastrointestinal diseases including Helicobacter-induced diseases, irritable bowel syndrome, inflammatory bowel disease, celiac disease, and colorectal cancer. Understanding the role of the oral-to-gut microbial translocation in the pathogenesis will contribute to precise diagnosis and effective treatment. In this review, we aim to highlight the role of oral microbiota dysfunction in various gastrointestinal disorders.

This is a case of remarkable alpha-fetoprotein in a female patient with known cryptogenic liver cirrhosis. Both ultrasound and triphasic computed tomography (CT) abdomen cannot diagnose or exclude hepatocellular carcinoma (HCC). It turns out to be a case of portal vein thrombosis and hepatic pseudo-infarction. It is better to postpone the therapeutic intervention, whether surgical or chemotherapeutic, in cases not confirmed to be HCC for at least 3 months to avoid misdiagnosis of hepatic pseudo-infarction.

Carbon stock and diversity of species together address the two most pressing concerns for successful ecosystem functioning and management, namely climate change and biodiversity loss. Understory vegetation is a significant indicator of plant biodiversity, contributing to forest carbon storage, sustaining species, and providing many ecological services. However, little research has been done about the contribution of the understory carbon stock in the forests, most likely because these understory components only make up a small portion of the total carbon stock of the forest ecosystem. To fill this knowledge gap, the current study sought to study the baseline understory (shrub and herb) diversity and carbon stock from the Zabarwan Mountain Range. Data on the characteristics of the understory vegetation in five different forest types were gathered using a random sample method. Using the Pearson method, we calculated the correlation coefficient between the diversity parameters and the carbon stock. The calculated average total carbon stock in the understory was determined to be 3.93 Mg C/ha (1.55–9.2 Mg C/ha). The shrub layer contributed a maximum value of 82 % of carbon stock. The increasing trends in total understory carbon were Parrotiopsis forest Broad-leaved forest > Acacia forest > Pinus forest > Parrotiopsis forest. Overall, the data show that coniferous-dominated woodlands had higher understory carbon stocks than other kinds of woodlands. The data acquired highlights the importance of shrub carbon stock storage in the understory layer in this Himalayan region. The current research on understory vegetation provides strong evidence for maintaining forest management practices that enable and encourage the planting of multiple layers of vegetation in landscape restoration as approaches to improve biodiversity while increasing resistance to climate change.

Abstract Background Diabetic foot is one of the significant complications of diabetes mellitus, associated with a high risk of morbidity and mortality. Patients' knowledge of, and willingness to practice, good footcare are essential and may decrease these risks. This study was conducted to assess adult diabetic patients' knowledge of footcare and willingness to put their knowledge into practice. Method A cross‐sectional observational study was conducted on adult diabetic patients in the central area of the Jazan Region using patients' responses to a questionnaire. Descriptive statistics were calculated for study variables, and the Pearson chi‐squared test was used to compare categorical data. Results A total of 410 diabetic patients were included in this study. The mean age of the participants was 56.7 years. The mean duration of their diabetes mellitus (DM) to date was 9.2 years, and 63% had complications of diabetes. For the questionnaire, 56% of the patients gave incorrect responses to the knowledge of the footcare section and 81% to the willingness to practice footcare section. Highly educated patients have better knowledge and practice of diabetic footcare than those who are less educated (77% vs. 23%, p

DNA metabarcoding is widely used for diet characterization and is becoming increasingly important for biodiversity conservation, allowing the understanding of trophic networks and community assemblies. However, to our knowledge, few studies have used this approach to investigate trophic interactions for whole communities and none for reptiles. In particular, few studies have examined the diet composition of Saudi Arabian reptiles, and all have used classical methods only. Therefore, in this work, a non-invasive approach using DNA metabarcoding of faecal pellets was implemented to investigate the diet composition of the reptile community of Wadi Ashar, in AlUla County, north-western Saudi Arabia Kingdom. In the overall diet composition of the community, arthropods were present in 90% of the samples, and plants were present in 63%, revealing the unforeseen importance of plants to this community as a secondary, but also a primary dietary item. For some species, this is the first time that plants have been reported in their diet. A significant effect of reptile body size on diet composition was also demonstrated, indicating its strong influence on prey selection and resource partitioning in the community. This study highlights the importance of community assessments and the power of combining these with non-invasive DNA metabarcoding to accurately assess biodiversity and feeding habits, revealing unknown ecological interactions of often neglected groups. This revolutionary tool for conservation and management provided rapid and holistic information at relatively low costs, allowing to inform local authorities about which elements are central to the sustainable management of the Wadi Ashar community.

Background: Diabetes mellitus [DM] is the well-known endocrine problem where the body either doesn't deliver sufficient insulin or has a resistance to the circulating insulin. Atherosclerotic cardiovascular disease stays the chief reason of death and disability among diabetic patients, particularly in type II DM patients. Aim of the work: To correlate between glycated Hemoglobin [HBA1C], carotid, peripheral and coronary artery disease in type II DM patients.Patients and methods: This is an observational study of 122 type II DM patients who were admitted to National Institute of Diabetes and Endocrinology. A full history, a full clinical examination, 12 lead-ECG, Echocardiography, Carotid duplex, Ankle-brachial index [ABI] measurement, HbA1C and Invasive non emergent coronary angiography were done.Results: Carotid intima-media thickness [IMT] in patients with HbA1C >7% was significantly higher than those with HbA1C7% compared to those with HbA1C7% compared to those with HbA1C>7%, ABI had a significant negative correlation with number of diseased coronary vessels and IMT had a significant positive correlation with number of diseased coronary vessels in patients with higher HbA1C >7% with no significant correlation in those with HbA1C

The transmission of infections through gastrointestinal endoscopy is a vital issue. The main problem lies in the use of duodenoscopes due to mechanical aspects of the scope design. Even with high-level disinfection, sterilization of the scope can fail. Hence, the Food and Drug Administration has encouraged a shift to single-use endoscopes. Available options include endoscopes with single-use components (mainly single-use endcaps), fully single-use duodenoscopes (SUDs), and even those with a disposable elevator mechanism. Clinical trials revealed that both reusable and single-use scopes have the same efficacy, while single-use scopes have benefits in terms of infection control, economic considerations, and ease of reprocessing. A few drawbacks are left to be dealt with. Reusable duodenoscopes with removable/disposable endcaps are satisfactory except in specific situations where SUDs are better to use.

Background & Objective: Colorectal cancer is the third most common cause of cancer death worldwide. Stanniocalcin 2 (STC2) is a glycoprotein hormone over-expressed in many human cancers where it regulates tumor progression and invasion. Evaluating its expression in colorectal cancer and its relation with different clinicopathological parameters can provide valuable information about its role in colorectal cancer progression and behavior.Methods: This retrospective study was conducted on tissue samples of colorectal cancer. The STC2 immunohistochemical expression was detected and evaluated in 60 cases of colorectal cancer tissue samples of formalin-fixed and paraffin-embedded blocks. Then statistical analysis was performed to assess the relationship between its expression level and several clinicopathological parameters in the studied cases.Results: Statistically significant associations were found between the high level of STC2 immunohistochemical expression and histological tumor grade (P

The feral donkey (Equus asinus L.) is an invasive species in Saudi Arabia and can cause severe damage to natural and cultural heritage. Over the last 30 years, feral donkeys have become a serious problem, as their abundance and geographic distribution has increased drastically. The impacts of feral donkeys are not well documented, and information about their abundance and distribution is lacking, certainly in Saudi Arabia, which hampers the implementation of effective management plans. Accordingly, we used the minimum population number approach (MPN) to determine the number of feral donkeys in this part of northwest Saudi Arabia. A total of 1135 feral donkeys were encountered in the region. The area around Khaybar harbors ~25% (n = 338) of the feral donkey population, whereas Tayma and AlGhrameel nature reserves were the least-inhabited sites (almost absent). The average population density of feral donkeys was estimated as 1.03 (0.19 SE) donkey/km2. We documented the negative ecological impact of feral donkeys on natural resources, which constituted overgrazing that resulted in habitat fragmentation and competition for resources with native species. We propose urgent actions to control the presence of feral donkeys in the region and suggest humane eradication as the most efficient and applicable to significantly reduce the negative impacts of feral donkeys.

BackgroundData is still lacking about the expediency of umbilical cord milking (UCM) in preterm neonates born to mothers with placental insufficiency (PI).ObjectiveTo study the effect of UCM in preterm neonates who had ante-natal evidence of placental insufficiency on peripheral blood cluster of differentiation 34 (CD34) percentage, hematological indices, and clinical outcomes.MethodsPreterm neonates,

Background and Objectives: Sickle cell anemia (SCA) is a hereditary monogenic disease due to a single β-globin gene mutation that codes for the production of sickle hemoglobin. Its phenotype is modulated by fetal hemoglobin (HbF), a product of γ-globin genes. Exploring the molecules that regulate γ-globin genes at both transcriptional and translational levels, including microRNA (miRNA), might help identify alternative therapeutic targets. Materials and Methods: Using next-generation sequencing we identified pre-miRNAs and mature miRNA expression signatures associated with different HbF levels in patients homozygous for the sickle hemoglobin gene. The involvement of identified miRNAs in potential SCD-related pathways was investigated with the DIANA TOOL and miRWalk 2.0 database. Results: miR-184 were most highly upregulated in reticulocytes. miR-3609 and miR-483-5p were most highly downregulated in sickle cell anemia with high HbF. miR-370-3p that regulates LIN28A, and miR-451a which is effective in modulating α- and β- globin levels were also significantly upregulated. miRNA targeted gene pathway interaction identified BCL7A, BCL2L1, LIN28A, KLF6, GATA6, solute carrier family genes and ZNF genes associated with erythropoiesis, cell cycle regulation, glycosphingolipid biosynthesis, cAMP, cGMP-PKG, mTOR, MAPK and PI3K-AKT signaling pathways and cancer pathways. Conclusions: miRNA signatures and their target genes identified novel miRNAs that could regulate fetal hemoglobin production and might be exploited therapeutically.

Objectives:To evaluate the pupillary light reflex responses in patients with unilateral strabismic and anisometropic amblyopia using dynamic pupillometry.Materials and Methods:A total of 102 eyes of 51 patients with unilateral amblyopia were included in this cross-sectional study. Of the 51 patients, 37 (72.5%) had strabismic amblyopia and 14 (27.5%) had anisometropic amblyopia. All patients underwent complete ophthalmological examination, and pupillary light reflex responses were measured using a computerized dynamic pupillometry system (MonPack One; Metrovision, France). Initial pupil diameter; the amplitude, latency, duration, and velocity of pupil contraction; and the latency, duration, and velocity of pupil dilation were recorded. Results obtained from the patients’ amblyopic and normal fellow eyes were compared using paired-samples t-test and Wilcoxon signed rank test.Results:The mean age of the patients was 11.9±6.0 years. Amblyopic eyes had longer contraction latency (p=0.009), shorter contraction duration (p=0.002), and higher dilation velocity (p=0.033) compared to fellow eyes, while other parameters did not show significant differences. In subgroup analysis, eyes with strabismic amblyopia had longer contraction latency (p=0.006) and shorter contraction duration (p=0.017), while eyes with anisometropic amblyopia had shorter contraction duration (p=0.030) when compared with fellow eyes.Conclusion:In this study, the objective records obtained by dynamic pupillometry showed that pupillary light reflex responses are affected in amblyopic eyes. This finding may shed light on unclear aspects of the pathophysiology of amblyopia.

The study aimed to examine the effect of the alcoholic extract of the flaxseed on naphthalene-induced hepatotoxicity in the Syrian hamsters and to identify some of the resulted biochemical and histological changes. This study has been conducted on 32 hamster in the four equal groups. The animals of the first group (control) / the group I / have been immunized with the physiological solution NACL at a concentration of (0.9%). However, the second group / the group II/ have been extracted with the alcoholic extract of the flaxseed only in dose of (30 mg / 100 g) once daily for three weeks. also, the third group/ the group III/ have been dosed with naphthalene (100 mg / 100 g) daily for three weeks, the Group IV have been administered simultaneously with the alcoholic extract of the flaxseed and naphthalene at the same level in terms of the dose and treatment duration. The results of the biochemical study showed a significant increase (P

Cancer cells escape immune recognition by exploiting the programmed cell-death protein 1 (PD-1)/programmed cell-death 1 ligand 1 (PD-L1) immune checkpoint axis. Immune checkpoint inhibitors that target PD-1/PD-L1 unleash the properties of effector T cells that are licensed to kill cancer cells. Immune checkpoint blockade has dramatically changed the treatment landscape of many cancers. Following the cancer paradigm, preliminary results of clinical trials in lymphoma have demonstrated that immune checkpoint inhibitors induce remarkable responses in specific subtypes, most notably classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma, while in other subtypes, the results vary considerably, from promising to disappointing. Lymphomas that respond to immune checkpoint inhibitors tend to exhibit tumor cells that reside in a T-cell-rich immune microenvironment and display constitutive transcriptional upregulation of genes that facilitate innate immune resistance, such as structural variations of the PD-L1 locus, collectively referred to as T-cell-inflamed lymphomas, while those lacking such characteristics are referred to as noninflamed lymphomas. This distinction is not necessarily a sine qua non of response to immune checkpoint inhibitors, but rather a framework to move the field forward with a more rational approach. In this article, we provide insights on our current understanding of the biological mechanisms of immune checkpoint evasion in specific subtypes of B-cell and T-cell non-Hodgkin lymphomas and summarize the clinical experience of using inhibitors that target immune checkpoints in these subtypes. We also discuss the phenomenon of hyperprogression in T-cell lymphomas, related to the use of such inhibitors when T cells themselves are the target cells, and consider future approaches to refine clinical trials with immune checkpoint inhibitors in non-Hodgkin lymphomas.

En Abstract Background Laryngeal cancer is the most common malignant tumor of the upper aerodigestive tract. Surgical treatment of advanced laryngeal cancer often requires a total laryngectomy (TL), resulting in a permanent tracheostomy and potential difficulties with a patient’s speech and communication. Objectives The aim of this study was to assess post-treatment voice changes, swallowing, and quality of life (QoL) of patients with carcinoma of the larynx treated with different treatment modalities. Patients and methods A total of 100 patients with laryngeal cancer treated with different treatment modalities were included in the present study. The primary treatment modality included TL (n = 46), partial laryngectomy (PL) (n = 7), transoral cordectomy (n = 9), radiotherapy (Rx) (n = 29), or combined treatment during the last 10 years with radiation after TL (TL and Rx, n = 9). Patients were subjected to full history taking, complete ENT examination, and assessment of: global QoL, voice, and acoustic parameters using the computerized speech lab at the outpatient clinic of Tanta University Hospitals (TUH). Evaluation of swallowing was carried out using a modified Arabic version of the QoL questionnaire called the Sydney Swallow Questionnaire. Patients having problems with swallowing were further evaluated using fiberoptic endoscopic evaluation of swallowing, at the outpatient clinic of TUH. Respiratory function of the larynx was evaluated by applying a modification of St George’s Respiratory Questionnaire. Results Results of voice analysis showed that the best voice was evident in patients who had undergone cordectomy, followed by those who had received radiotherapy. There was no significant difference in voice characteristics between patients using voice prosthesis, esophageal voice, or electrolarynx after TL and those using these aids after PL. Worst voice as well as swallowing was seen in patients who had undergone combined TL and postoperative radiotherapy. The best results of swallowing were seen in patients who had undergone cordectomy. Patients who had undergone TL or radiotherapy alone showed similar swallowing results, but better than those who had undergone PL, especially those who had undergone supracricoid laryngectomy. Assessment of respiratory function showed best results in patients who had undergone cordectomy, followed by those who had undergone TL and radiotherapy. Poorest results were seen in patients with combined surgery and Rx, and those who had been treated with PL. Conclusion Our study revealed that the best significant performance results were seen in patients who had undergone transoral cordectomy, followed by patients who had received radiotherapy only. This was followed by patients who had undergone TL and PL, with no significant difference between the two groups. The worst results were seen in patients who had undergone combined surgery and radiotherapy as the primary treatment modality.

This study was performed to investigate the effect of aqueouse extract of tobacco leaves on blood parameters 15 Males Hamster were used in this study , they were divided into three groups : control , and two experimental groups ( five hamster in each ) , the control group was given distilled water , while the experimental groups were received oral doses of aqueouse extract of tobacco leaves 5.8 mg / kg of body weight and 11.8 mg / kg of body weight daily for (24)day . The Results showed a significant decrease (P

This article describes an unusual case of Riedel's thyroiditis and discusses its imagery, pathology, and treatment.

Recently, the multi-bit flip-flop (MBFF) technique was introduced as a method for reducing the power consumption and chip area of integrated circuits (ICs) during the physical implementation stage of their development process. From the perspective of the consumer, the main requirements for such an optimization method are high performance, low power usage and small area (PPA). Therefore, any new optimization technique should improve at least one, if not all, of these requirements. This paper proposes a new low-power methodology, applying a MBFF merging solution during the physical implementation of an IC to achieve better power consumption and area reduction. The aim of this study is to prove the benefit of this methodology on the power saving capability of the system while demonstrating that the proposed methodology does not have a negative impact on the circuit performance and design routability. The experimental results show that MBFF merging of 76% can be achieved and preserved throughout the entire physical implementation process, from cell placement to the final interconnection routing, without impacting the system’s performance or routability. Moreover, the clock wirelength, nets and buffers needed to balance the clock network were reduced by 11.98%, 3.82% and 9.16%, respectively. The reduction of the clock tree elements led to a reduction of the power consumption of the clock nets, registers and cells by 22.11%, 20.84% and 12.38%, respectively. The total power consumption of the design was reduced by 2.67%.

Epidemiological differences exist between Mycobacterium africanum (Maf)- and Mycobacterium tuberculosis (Mtb)-infected patients, but to date, contributing host factors have not been characterised. We analysed clinical outcomes, as well as soluble markers and gene expression profiles in unstimulated, and ESAT6/CFP-10-, whole-Maf- and Mtb-stimulated blood samples of 26 Maf- and 49 Mtb-HIV-negative tuberculosis patients before, and after 2 and 6 months of anti-tuberculosis therapy. Before treatment, both groups had similar clinical parameters, but differed in few cytokines concentration and gene expression profiles. Following treatment the body mass index, skinfold thickness and chest X-ray scores showed greater improvement in the Mtb- compared to Maf-infected patients, after adjusting for age, sex and ethnicity (p = 0.02; 0.04 and 0.007, respectively). In addition, in unstimulated blood, IL-12p70, IL12A and TLR9 were significantly higher in Maf-infected patients, while IL-15, IL-8 and MIP-1α were higher in Mtb-infected patients. Overnight stimulation with ESAT-6/CFP-10 induced significantly higher levels of IFN-γ and TNF-α production, as well as gene expression of CCL4, IL1B and TLR4 in Mtb- compared to Maf-infected patients. Our study confirms differences in clinical features and immune genes expression and concentration of proteins associated with inflammatory processes between Mtb- and Maf-infected patients following anti-tuberculosis treatment These findings have public health implications for treatment regimens, and biomarkers for tuberculosis diagnosis and susceptibility.

Abstract Introduction Lymphoepithelial carcinoma of the maxillary sinus is a very rare malignancy and it can be difficult to make a pre-operative diagnosis. Case presentation A 72-year-old Caucasian woman presented to our facility with an isolated right-side epistaxis that had been present for three months, with the results of a computed tomography scan showing a soft tissue mass in the right maxillary sinus with an impacted tooth. The results of a transnasal endoscopic biopsy were compatible with a lymphoepithelial carcinoma, following which our patient underwent a radical excision of the mass. The final histology results revealed lymphoepithelial carcinoma of the maxillary sinus with negative assays for Epstein-Barr virus. Our patient was given post-operative external radiotherapy and has remained disease-free at three-year follow-up. Conclusions This report details the diagnosis and management of a case of lymphoepithelial carcinoma of the maxillary sinus, which is a very rare malignant tumor with very little mention in the literature. Only a strong suspicion with systematic use of various patho-immunological tests helps to arrive at a definitive diagnosis by excluding other better-known tumors.

Abstract Background Emergency Care Practitioners (ECPs) have recently been deployed to provide out-of-hours primary care home visits – a practice development that has been supported by policy makers. The aim of the study was to evaluate the care provided to patients receiving out-of-hours home visits from ECPs in London from the patients' perspective and to assess their wellbeing following the visit. Methods A bespoke telephone-administered questionnaire was designed to survey all patients who had received out-of-hours care in Bromley Primary Care Trust from ECPs during a ten week period in 2005 (n = 174). Results Sixty three patients (36.2%) were excluded because: no telephone number was available; they had a diagnosis of dementia; or had not received a study information sheet. The remainder (n = 111) were contacted 3–5 days after the home visit, and 81 of these (73.0%) completed the survey. Of those respondents treated at home who gave unequivocal answers (n = 60), all but one (8.3%) reported that they felt that their treatment had been 'right' and/or had followed any advice given. However, overall only 86.4% reported that they had been clear about their ECP's assessment, and only 58.0% reported that their health was now 'better'. Those who reported that they were not clear about their assessment were less likely to report that their health was 'better' (p = 0.03) and more likely to have subsequently used hospital-based health services (p = 0.03). Conclusion Most patients treated at home by ECPs appeared satisfied and compliant with the care provided, according to the measures used in this study. However, it appears that a sizeable minority of patients were unclear about ECP assessments and it remains to be seen whether these patients had pre-existing health complaints which made them less likely to recover and more likely to seek hospital care, or whether the lack of clarity about their assessment undermined their subsequent recovery and necessitated hospital care. Further research is required to establish if the assessments provided by ECPs are less clear than those provided by other practitioners, and whether it is possible to ensure that all such assessments are clear to all patients. Patients hold a mainly positive view of out-of-hours home visit care provided by ECPs, although a lack of clarity about their assessment was evident, with a possible impact on their continuing health.