Background: Diabetic foot ulcer (DFU) is considered a major social and economic problem, and it is also known as a leading cause of morbidity and mortality. Patients with DFUs frequently require amputation of the lower limbs, and in more than half of the cases, infection is the predominant factor. The aim of this systemic review is to highlight the risk factors such as age and gender associated with DFU infections, whether the infection is caused by single bacteria or polymicrobial infection and what is the most prevalent bacteria and their susceptibility pattern to currently used antibiotics. Methods: Three databases were searched from December 2020 to February 2021 including PubMed, Hinari, and Google Scholar. A total of 12 articles were included in the current meta-analysis. Results: Higher frequency of DFU in males than in females and maximum number of DFU mostly occur within the age group 40–60 years was reported. Monomicrobial infections in DFU were higher than monomicrobial infection. Escherichia coli, Pseudomonas, and Staphylococcus aureus were the most prominent microorganism. The higher grades of the DFUs were infected with more than one organism. High resistance rates of the isolated bacteria to the most commonly used antibiotics were documented and there were alarming growing resistance rate to Carbapenems which were considered the most effective Antibiotics nowadays. Conclusions: DFU infections are one of the major social and economic problems. There is an urgent need for continuous antibiotic sensitivity testing for the isolated bacteria to choose the appropriate antibiotics during the management and limit the spreading of multidrug-resistant bacteria and reduce the burden of health-care cost.

Osteoporosis is a chronic disorder in both men and women, where it decreases the bone quality and quantity, which may lead to a fall in bone mass density. It mostly occurs because of reduced peak bone mass or excessive formation or resorption during bone remodeling. Various degradation products of bone collagen are pyridinoline (Pyr), deoxypyridinoline, N-terminal telopeptides, and hydroxyproline (Hyp), which are excreted in the urine. Among that, Hyp is a crucial biomarker used to correlate osteoporosis condition. An overview of all the biomarkers and the signed note of Hyp with different analytical methods are provided in the current piece of work. To quantify amounts in biological samples, various methods have been developed for Hyp analysis, such as the colorimetric technique, gas chromatography, gas chromatography-mass spectrometry, and widely used high-performance liquid chromatography tests to detect the concentration of Hyp in different matrices. This review states the importance of biomarkers and Hyp's significance for detecting osteoporosis, clinical manifestation, and different analytical methods for Hyp. The study indicates that hydroxyproline is a unique biomarker used to detect osteoporosis. It is also showing the clinical manifestation of osteoporosis and discussed different analytical methods for hydroxyproline.

Oral cancer has high mortality and morbidity. The traditional treatment of oral squamous cell carcinoma (OSCC) is often a combination of surgery, chemotherapy, and radiation. Curcumin is a natural alkaloid used for centuries against various ailments including cancer. Nanotechnology has its profound application in the diagnosis/prognosis and for therapeutics in cancer. In therapeutics, nanotechnology can convey site-specific delivery of pharmaceutical agents by conferring new properties to the agents and only targeting the drugs to the tumor site, thus reducing systemic toxicity. The encapsulation of curcumin into polymeric nanoparticles seems to be beneficial, since it allows the administration of curcumin hydrophobic drug as an aqueous dispersion. Curcumin reports to inhibit cell proliferation and apoptosis in head-and-neck squamous cell carcinoma and suppresses OSCC cell growth. Most research studies conducted have focused on the anticancer properties of bulk curcumin and its application in adjuvant therapy. The challenge that bulk curcumin poses in terms of its limited uptake and permeability into tissues cannot be ruled out. The possible efficacy of nanocurcumin its effects on OSCC cell line has not been explored adequately. This study aims to review and assess the efficacy of nanocurcumin and its potential as a natural alkaloid against OSCC.

Autophagy, the major cellular pathway, is known not only for the degradation and recovering in mammalian cells but also it maintains the cellular energy homeostasis and produces the building blocks. However, if the process starts destroying the essential ones other than the bad proteins, then the normal cellular control will be lost, and here, we see similar kinds of phenomena in cancer. It has been reported by previous papers related to this field that the novel pathway has paradoxical role in cancer, as it acts as both tumor promoter and suppressor. Therefore, autophagy could provide new resources for the improvement of antitumor drugs in near future. Here, in this review, we will know about the autophagy process in brief. We will also try to understand the contrasting role of autophagy in different cancers types, its significance as prognostic markers and its therapeutic implication for cancer treatment in the near future.

Corona virus-19 disease (COVID-19), caused by SARS-Cov-2. What was initially considered to be another worldwide flu epidemic mostly affecting the respiratory system has now emerged as a multi-organ disease, the most common extra-pulmonary involved organs include the blood vessels, eyes, heart, gastrointestinal tract, liver, skin, and kidneys. A growing number of case reports and series describe opportunistic fungal infections in COVID-19 patients. Co-morbidities such as diabetes mellitus, coupled with immune dysfunction and use of steroids, are hypothesized as the main causes. More recently, many cases of mucormycosis “black fungus” have been reported, particularly in Asian countries such as India. Mucormycosis is a rare angio-invasive illness caused by the fungi Mucorales, which is often seen in immunecompromised patients. Rhino-orbitocerebral, cutaneous, disseminated, gastrointestinal, and pulmonary forms of this unusual fungal infection exist. COVID-19 and Mucormycosis, Risks factors associated with Mucormycosis in COVID 19, Immune system response to mucormycosis, fungal pneumonias can resemble COVID-19, as well as prevention of these fungal will be discussed in this review.

Background: More recently, the human oral microbiota has attracted attention in epidemiological research on health and disease. Against this background, changes in the oral microbiota in acute diseases of the upper respiratory tract are of interest in modern pediatrics and epidemiology. The composition of the bacterial flora is one of the main premorbid backgrounds that determine the clinical course of acute tonsillitis in children. However, the prevalence of bacterial flora and its impact on the clinical course of patients with acute diseases remains unclear. Aims: The aims are to study the state of the oral cavity microbiota in children with acute tonsillitis. Methods: The microbiota of the oral cavity was studied in 221 children aged 3–14 years with acute tonsillitis. General clinical examinations and pharyngoscopy were performed. Bacteriological examination of the oral microbiota was carried out according to the standard method. Results: Colonization by the following was most frequently observed in patients: Staphylococcus aureus (42.2%), Streptococcus pneumoniae (32.0%), Haemophilus influenzae (24.2%), Haemophilus parainfluenzae (18.8%), Streptococcus anginosus (10.9%), Moraxella catarrhalis (9.4%), Streptococcus dysgalactiae ssp. equisimilis (8.6%), and Streptococcus agalactiae (3.1%), which most often occurred as symbionts. Conclusions: In children with acute tonsillitis, colonization of the tonsils by pathogenic bacterial flora increases, changing the composition of the oral microbiota. The most common causes of oral microbiota imbalance in children with acute tonsillitis were S. aureus, Streptococcus pyogenes, and H. influenzae, with varying relative proportions.

Background: The role of Lactobacillus casei on human health is well documented. However, little is known about their protein effects on food digestion. Therefore, in the present study, we aimed to investigate the efficacy of three proteins of L. casei on lipid and carbohydrate digestion that was identified at acidic pH in our previous study. Methods: Chaperonin (Ch), metal-dependent hydrolase (HYD), and lysozyme (LYS) proteins that were expressed by cultivated L. casei at pH 5 were extracted. HepG2 cell line was used to elucidate the effect of the considered three proteins on gene expression related to fat and glucose metabolism. The target genes were determined by Kyoto Encyclopedia of Genes and Genomes pathway analysis and extracted proteins were transfected into HepG2 cells. After 48 and 120 h, the mRNA expression of the following genes was analyzed using real-time polymerase chain reaction, insulin receptor substrate 2, (IRS-2), Protein kinase Bβ (AKT2), insulin-like growth factor 1, angiopoietin-like 4 (Angptl-4), and lipoprotein lipase (LPL). Results: The expression of all of the genes was significantly increased in comparison to control under the effect of Ch and metal-dependent HYDs after 48 h of culture. By increasing the duration of transfection from 48 h to 120 h, the expression of Angptl-4 from Ch and metal-dependent HYDs was reduced significantly, whereas the expression of LPL and Angptl-4 genes after 5 days was significantly increased in LYS compared to the last 3 days. Conclusions: L. casei secrets acidic proteins such as Ch, metal-dependent HYD, and LYS in bloodstream are involved in the digestion of carbohydrates and fats in the liver.

Background: Anemia in pregnancy which may be mild, moderate, or severe is a common physiological disorder that can lead to poor pregnancy outcome which may be primary or secondary to problems associated with hepatic, renal, and immune system which may be indicated by alterations in packed cell volume (PCV), alanine transaminase, albumin, tumor necrosis factor-alpha (TNF-α), and creatinine. This work is, therefore, designed to determine inflammatory response, plasma albumin, creatinine, alanine aminotransferase (ALT), and PCV in relationship with the degree of anemia and gestational age in anemic pregnant women. Methods: Two hundred (200) HbAA anemic pregnant women and 100 nonanemic pregnant women were recruited as test and control subjects, respectively. All subjects were negative to HIV-Ag-Ab, acid-fast bacillus (AFB)-Ziehl–Neelsen, Plasmodium, anti-hepatitis C virus (HCV), and hepatitis B envelope antigen (HBeAg) tests. HIV-Ag-Ab, TNF-α, anti-HCV, and HBeAg were determined by enzyme-linked immunosorbent assay; AFB by Ziehl–Neelsen staining; Plasmodium by thick-film Giemsa staining; hemoglobin types by hemoglobin electrophoresis; albumin, creatinine, and ALT by auto-chemistry analysis using COBAS C11; and PCV by microhematocrit tube method. Results: Eighteen percent (36) of the anemic pregnant women had severe anemia whereas 82% (164) had moderate anemia. The results obtained showed a significant increase in the plasma value of TNF-α and a decrease in the PCV in anemic pregnant women compared with the results obtained in the nonanemic pregnant women (P < 0.05). There was a significant increase in plasma TNF-α in severe anemia compared with the anemic pregnant women with moderate anemia (P < 0.05). Conclusions: This work revealed a significant increase in plasma TNF-α and a decrease in PCV in anemic pregnant women which was more intense in anemic pregnant women with severe anemia while the pattern of anemia showed that 18% (36) of the anemic pregnant women had severe anemia whereas 82% (164) had moderate anemia.

Background and Aim: Detection of early-stage pancreatic cancer (PaC) patients can decrease the mortality rate through surgical resection thanks to a screening approach of high-risk and asymptomatic individuals. Up to 80% of PaC patients are either hyperglycemic or diabetic at the time of diagnosis. Diabetes mellitus (DM) identification as an early manifestation of PaC may lead to detection of this malignancy at early and presymptomatic stages. Therefore, the current study aims to identify common molecular factors between DM and PaC to shed light on a potential screening for DM as a diagnostic approach for PaC. Methods: The study was divided into three steps including dataset selection and identification of key genes, quantitative real-time polymerase chain reaction (qRT-PCR) to validate these genes, and enrichment analysis of their target genes. Results: Using GEO2R analysis, conducted on microarray dataset (GSE15932), SPI1 and Yin Yang 1 (YY1) genes were found to be expressed in peripheral blood mononuclear cells of PaC, DM, and PaC + DM patients. Moreover, qRT-PCR results in validation of microarray data showed a significant increment of these two genes among all patient groups. Furthermore, enrichment analyses of SPI1 and YY1 target genes revealed that they are mainly expressed in hematopoietic cells and associated with immune responses as well as immune signaling pathways. Discussion: We speculate that this study on SPI1 and YY1 genes and their targets can result in a successful strategy to investigate diabetes as a screening step for better management of PaC screening using standard serologic tests.

Background: Hepatitis C virus (HCV) is highly distributed in Egypt. Moreover, parasitic diseases such as schistosomiasis, toxoplasmosis, or amebiasis are frequent in Egypt. Dual infections of HCV and each of these parasitic diseases are possible and associated with bad clinical consequences. The present study was done to monitor the clinical, biochemical, and hematological changes in Toxoplasma gondii, Entamoeba histolytica, and/or Schistosoma co-infection in the HCV-infected patients from Menoufia Province, Egypt. Methods: One hundred and nine blood samples, HCV monoinfected patients and co-infected with T. gondii, E. histolytica, and/or Schistosoma, were monitored and subjected to clinical chemistry and hematological examinations Results: Liver cirrhosis in patients with concomitant multiple parasites during chronic HCV infections showed a high percentage compared to HCV mono-infected patients. Moreover, significant increases in the level of alpha-fetoprotein, aspartate transaminase, prothrombin time, and the relative monocyte count were demonstrated in patients with concomitant multiple parasites during chronic HCV infections compared to HCV mono-infected patients. Changes in the levels of platelets and relative lymphocytes/neutrophils count were detected during dual or multiple infections. Conclusions: Schistosomiasis, toxoplasmosis, or amebiasis had unpropitious effects on HCV-infected patients and it is recommended to screen these parasitic diseases among HCV patients to reduce the HCV clinical outcome.

Background: Brown adipose tissue (BAT) has an essential role in regulating energy, metabolism, and thermogenesis in mammals. BAT activation is often detected in winter, especially in the female gender and in individuals with normal body mass index (BMI) by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) modality. It has been reported to be associated with some factors such as age, plasma glucose, and outdoor temperature. Therefore, in this study, we aimed to investigate the characteristics of demographic, metabolic, and other variables of patients with FDG uptake in activated BAT on 18F-FDG PET/CT imaging in patients diagnosed with various types of cancer. Methods: 15752 patients diagnosed with various types of cancer who underwent whole-body 18F-FDG PET/CT imaging for routine diagnosis, staging, or follow-up between March 2017 and April 2019 were screened, and a total of 188 BAT-positive patients were included in this retrospective study. In addition to demographic patient characteristics such as age, height, and weight, data were collected such as BMI, date of birth, date and season of PET/CT imaging, laboratory findings, injection, and PET/CT imaging time, and the average outdoor temperature on the day of PET imaging and evaluated statistically. Results: A total of 188 BAT-positive patients (142 females [75.5%] and 46 males [24.5%]) were included in this study. The mean age of the patient group was 43.89 ± 13.67 years, and the mean BMI was 24.12 ± 3.56. About 103 patients (54.7%) with positive BAT were at normal weight (BMI 18.5–24.9), 49 patients (26.2%) were overweight (BMI 25–30), and 36 patients (19.1%) were obese (BMI >30). The injection time was 76.6% in the afternoon hours, whereas 77.1% of the imaging was performed in the afternoon hours. The mean fasting blood glucose (FBS) was 106.93 ± 14.28 mg/dl, and 61.7% (n = 116) of the patients were hyperglycemic. However, we found no significant relationship between BAT activation and the date of birth, place of birth, PET imaging season (relative to the northern hemisphere), and outdoor temperature. Conclusions: In our study, while BAT FDG uptake was not increased with cold exposure before PET scan and seasonally, female gender, younger age, and mean low BMI are the significant predictive value of BAT activation. Therefore, we aimed to emphasize that BAT activation should be considered to prevent the masking of the image and prevent false-positive involvement, especially in tumor tissue in risky groups.

Background: Salsola vermiculata is an annual plant which is broadly distributed in southwest of Asia. Due to the lack of data regarding the biological properties of different parts of S. vermiculata, the present research focused on their biological activities. Methods: Different parts of plant were harvested, and phytochemical assay of S. vermiculata parts was performed to determine the presence of phenols, flavonoids, alkaloids, fixed oils, and volatile oils. Then, their antioxidant and cytotoxicity activities of the extracts and fractions were evaluated according to DPPH and MTT assay, respectively. Furthermore, the antimicrobial activities of the extracts and fractions were determined by the disk diffusion and minimum inhibitory concentration methods. Results: According to the results, the antioxidant activity and the phenolic contents in leaves and flowers crude extracts of S. vermiculata were high, and their ethyl acetate fractions had higher activities compared to other fractions. The cytotoxic study indicated that the seeds and roots crude extracts significantly exhibited cytotoxic activities with IC₅₀ values of 33.88, 42.92 μg/mL, respectively, and only the fixed oil fractions had cytotoxic activity. Antibacterial activity showed that the fixed oil fraction of roots had the highest activity against Staphylococcus aureus, followed by fixed oil fraction of seeds and volatile oil fraction of the roots. Conclusions: Different parts and fractions of S. vermiculata contain various bioactive compounds with different biological activities, and the results of this study could provide useful information to guide the application of S. vermiculata parts in food and pharmaceutical fields.

Background: According to the World Health Organization, the prevalence of colorectal cancer (CRC) is the third-most common cancer in Iran. The population of Escherichia coli strains of the B2 phylogenetic group as one of the components of gut microbiota is increased in the gut of people with CRC and can also play a role in the process of cancerous intestinal cells or malignancy. The most common concern about treating infections and their association with cancer is multidrug resistance (MDR). Methods: In this study, stool samples of 20 patients with CRC were examined for sensitivity to 9 antibiotics and their genotypes were determined. Results: More than 90% of the isolates were MDR. Although among 20 isolates of E. coli gut flora in CRC patients, 11 (55%), 7 (35%), 0 (0%), and 2 (10%) strains belonged to phylogenetic groups B2, D, B1, and A, respectively. Conclusions: There was no significant relationship between the B2 phylogenetic group and MDR. Furthermore, the closeness of the species based on >90% similarity, seven clusters were observed that among five clusters, similarities were observed in terms of the phylogenetic group.

Introduction: Leishmania major causes mucocutaneous leishmaniasis which is characterized by chronic skin sores. In L. major, some proteins are classified as hypothetical proteins (HPs). These proteins are chains of amino acids whose existence is predicted by sequencing organisms, but their functions remain unknown. They could further be analyzed, functionally annotated, and structurally predicted to open the doors to various applications. Methods: In this study, the HP AKK31191.1 from L. major was selected from the National Center for Biotechnology Information database. Various tools were used for one-dimensional (1D), 2D structural prediction followed by predicting the 3D protein structure via ab initio and homology modeling. The structure was analyzed and validated using various in silico tools. Results: A detailed information on the physicochemical analysis of the protein was achieved. It was found that this particular HP could be located in the cytoplasm. 2D structural analysis showed that the protein consisted of random coils at a higher amount succeeded by extended strands and alpha-helix. These data were validated through a Ramachandran plot. Subsequently, the 3D structure of the protein was visualized in UCSF Chimera which portrayed the random coils, extended strands, and the alpha-helix in different colors. Conclusions: This study focused on finding the characteristic features of the HP, predicting the 3D structure, functionally annotating the protein, and finding another similarity sequence. Through structural prediction, disease-associated mutations can be identified, and other functionally significant sites can be facilitated by determining the spatial positions of active sites and other critical residues.

Background: Clopidogrel and proton-pump inhibitors (PPIs) are inert drugs that need cytochrome P450 enzymes to switch chemically to their active forms. The aim of this research is to evaluate the influences of three different types of PPIs on platelet restraining effect of clopidogrel. Methods: This study consecutively enlisted 100 patients (30 females and 70 males), ranging from 45 to 60 years with coronary artery disease from Ibn Al-Nafees Hospital. The patients randomly divided into four groups and each group consists of 25 patients. One of them treated with clopidogrel tablet (75 mg daily) alone. Others treated with clopidogrel (75 mg daily) and pantoprazole (20 mg daily), or esomeprazole (20 mg daily), or rabeprazole (20 mg daily) for a period of 10 days. Light transmission aggregometry instrument was used for the estimation of maximal platelet aggregation percent (MPA%). Results: The statistical outcomes after 10 days of treatments demonstrated that high inhibition of platelet aggregation was achieved in patients on clopidogrel alone 52.5% and low inhibition of platelet aggregation was confirmed in patients on clopidogrel and rabeprazole 43.3%. Conclusions: Even each drug of PPIs that used in this study changed the MPA% as compared to clopidogrel alone, but rabeprazole had an appreciable impact on MPA% and thereby on clinical adequacy of clopidogrel as platelets aggregation preventer drug.

Background: Biomedical field has gained a lot of interest from active researchers today. Treating various diseases prevailing among the world has believed to bring huge insight in the today's research world. Second, advancement in technology has eased the work of researchers to justify their work. Machine learning (ML) is an approach being used by bioengineers today to predict diseases and to even aid them in drug discovery. Methods: Considering both the points, one of the most serious diseases, that is breast cancer here, is predicted using ML approaches. Breast cancer is classified as either benign or malignant which is to be predicted with the help of ML classifiers. A very famous dataset Wisconsin Breast Cancer Dataset is used here and is trained by three classifiers mainly support vector machine, general linear model, and neural network (NNET) against testing dataset. Testing the breast cancer prediction was carried out keeping in mind the accuracy of each of the classifiers. Results: This study is involving a generic code in R language. Conclusions: The study intends to show the usage of NNETs in breast cancer prediction using single-layered structure.

Background: To enhance the therapeutic index of drugs, various targeted drug delivery systems have been developed in recent decades. Among different drug carrier systems, albumin-based nanocarriers have acquired much attention due to its nonimmunogenic, biodegradable, biocompatible, and nontoxic nature. The present investigation deals with the development of a stable carboxyl functionalized bovine serum albumin (FBSA) nanoparticles through surface modification with chloroacetic acid. Methods: FBSA nanoparticles were synthesized by ground dispersion using ethanol as a desolvating agent; the stabilization of nanoparticles was done by glutaraldehyde. Various process modalities, namely glutaraldehyde concentration, FBSA concentration, pH, ethanol addition rate, and agitation speed, were tested to obtain stable nanoparticles of suitable size. Results: The nanoparticles of average diameter 100–120 nm with − 30 mV zeta potential and 0.1 polydispersity index were obtained in neutral and alkaline medium. Particle size and surface charge are very less influenced by varying the FBSA in 10–200 mg/ml concentration range. pH of the medium strongly influences the surface charge and particle diameter of the FBSA nanoparticles. No significant effect on particle diameter was noticed on varying the ethanol addition rate, stirring rate, and glutaraldehyde amount in the studied range. The scanning electron microscopy monochrome image and dynamic light scattering image of FBSA display that nanoparticles are of around 100 nm size. Conclusions: The present study proposes the preparation of more stable bovine serum albumin nanoparticles through surface modification. The synthesized nanoparticles will be capable to deliver the cancer drugs more effectively to the targeted tumor site.

Background: Advanced glycation end products (AGE) are heterogeneous groups of molecules formed from the nonenzymatic reaction of reducing sugars with free amino groups of proteins, lipids, and nucleic acids. Activation of receptor for advanced glycation end products (RAGE) by ligands in a variety of cell types and tissues may play a role in oral-systemic associations. The aim of the study is to estimate the salivary-soluble RAGE (sRAGE) levels in betel chewers and compare with salivary sRAGE levels of chronic periodontitis and normal healthy controls. Methods: Detailed case history and clinical examination was done for the study participants based on the inclusion and exclusion criteria. Study participants were grouped as Group I (chewers), Group II (chronic periodontitis), and Group III (normal controls). Unstimulated saliva samples were collected and salivary sRAGE levels were calculated using the sandwich ELISA technique. Results: Individuals with pan chewing habits have demonstrated increase in salivary sRAGE compared to chronic periodontitis and normal controls. Conclusions: Understanding AGE formation and biochemistry, cellular receptors for AGE, and AGE-induced effects on extracellular and intracellular functions will serve to expedite the process of finding effective therapies that block the excessive accumulation of these species and their interaction with the signal transduction receptor RAGE.