World Health Organization Reports Research Articles

Penyuluhan tentang Cara Mengatasi Dismenorea pada Remaja Puteri di SMA Takwa Palembang

Dysmenorrhea is considered a normal complaint experienced during menstruation. Pain arises due to contractions that occur in the uterus. These contractions function to shed menstrual blood that sticks to the uterine wall. The World Health Organization (WHO) reports globally that the incidence of dysmenorrhea is still very high. The incidence of dysmenorrhea in young women was 16.8-81% in 2018. The results of Riskesdas (2018) showed that the number of dysmenorrhea cases was 64.25%. It is estimated that as many as 90% of women in Indonesia experience menstrual pain, but do not report it to health services. The aim of this activity is to increase the knowledge of SMA Takwa Palembang students about how to deal with complaints of menstrual pain. The results of the activity showed that the average knowledge of young women had increased after the counseling activities, namely 34.8. On average, participants said they experienced menstrual pain on the first day of menstruation with varying duration of pain. It is hoped that young women will practice the knowledge gained in this activity when they feel menstrual pain.

Differences between non-obese and obese patients with hypertension according to gender

Abstract Introduction In recent years, obesity has escalated markedly, emerging as a one of major worldwide health issue. The frequency of obesity in both adults and children is rising at an alarming rate, leading to severe consequences for public health. The World Health Organization (WHO) reports that as much as 13% of the global population is grappling with obesity. Numerous research studies have established that obesity not only heightens the risk of cardiovascular diseases (CVD) including hypertension, coronary heart disease, and heart failure, but also exacerbates complications in individuals already suffering from these conditions. Purpose The aim of this study was to retrospectively analyze the differences between non-obese and obese patients admitted to the cardiology department due to hypertension according to gender. Methods We performed a retrospective analysis of 486 medical records of patients who had been admitted to the Institute of Heart Diseases of the University Clinical Hospital in Wroclaw (Poland) between January 2017 and June 2021. The study group was divided in two ways. The division of patients was into one of two groups based on the following cut-off BMI values: non-obese (BMI < 30) and obese (BMI ≥ 30). The study was conducted following the principles of the Declaration of Helsinki and approved by the independent Bioethics Committee of Wroclaw Medical University, protocol no. KB-837/2022. The significance level for all statistical tests was set to 0.05. R 4.3.0. was used for computations. Results Women accounted for 53% of the study group and were significantly older than men (64.7±12.8 vs. 60.5±11.8, p=0.466). Women with obesity had significantly higher triglycerides (TG), high-sensitivity C-reactive protein and thyroid-stimulating hormone concentrations and significantly lower high-density lipoprotein (HDL) concentrations than women who were not affected by obesity. Men with obesity had significantly higher TG levels, lower HDL levels, more more frequent to have diabetes (DM) and less frequent stroke in the past compared to men without obesity. (Table 1 and 2) Conclusions This study highlights important differences between patients with hypertension without and with obesity, with notable gender differences. Women with obesity showed differences only in laboratory test results, while men with obesity showed differences in laboratory test results and comorbidities. These findings emphasize the need for gender-specific management strategies and research in hypertension and obesity, underscoring the distinct cardiovascular risks associated with obesity in both genders.

CRISPR-Cas9 Gene Editing Therapy, a Curative Hope for Sickle Cell in Nigeria, West Africa

Sickle cell anaemia is one of the haemoglobin abnormalities resulting from a genetic mutation— it is caused by inheriting two faulty genes that result in an abnormal substitution of glutamate for valine on the beta chain of haemoglobin, which causes haemoglobin molecules to stick together. According to a World Health Organization (WHO) report, 20 out of every 1,000 births suffer from sickle-cell anaemia, and 24% of Nigerians are carriers of this mutant gene. Scientists have suggested several solutions, including stem cell transplantation and gene therapies, but these have faced opposition due to ethical beliefs, high cost, and the ensuing immune issues. Research is now centered on advancing genome editing techniques for gene therapy. Ongoing studies have proven that genetic differences can be corrected methodically by modifying the genome at specific sites instead of introducing a new copy of the affected gene into the cells; due to the effectiveness of this method, scientists are testing its applications in manipulating genes in various systems. This review correlates a few studies that used the recently developed technique—CRISPR-Cas9—as a novel approach to gene therapy, dissecting the different clinical studies about sickle cell origin to point out many of its ethical and medical limitations, the consequences of these limitations, and the advancements this technology has made possible.

Screening Tests for the Interaction of Rubus idaeus and Rubus occidentalis Extracts with Antibiotics against Gram-Positive and Gram-Negative Human Pathogens.

WHO (World Health Organization) reports from recent years warn about the growing number of antibiotic-resistant bacterial strains. Therefore, there is an urgent need to constantly search for new substances effective in the fight against microorganisms. Plants are a rich source of chemical compounds with antibacterial properties. These compounds, classified as secondary metabolites, may act independently or support the action of currently used antibiotics. Due to the large number of metabolites isolated from the plant kingdom and new plant species being studied, there is a need to develop new strategies/techniques or modifications of currently applied methods that can be used to select plant extracts or chemical compounds isolated from them that enter into positive, synergistic interactions with currently used antibiotics. One such method is the dual-disk synergy test (DDST). It involves the diffusion of active compounds in the agar environment and influencing the growth of microorganisms grown on it. The method was used to assess the interaction of extracts from the fruit and shoots of some cultivated varieties of Rubus idaeus and Rubus occidentalis with selected antibiotics. The research was conducted on strains of bacteria pathogenic to humans, including Staphylococcus aureus, Corynebacterium diphtheriae, Escherichia coli, Pseudomonas aeruginosa, Helicobacter pylori, and Candida albicans, showing synergy, antagonism, or lack of interaction of the tested substances-plant extract and antibiotic. As a result, it was found that the diffusion method is useful in screening tests to assess the impact of antibiotic-herbal substance interactions on Gram-positive and Gram-negative microorganisms.

Exploring the competency and confidence levels of physiotherapists in the management of patients diagnosed with life-limiting illnesses

Background Globally, palliative care services do not meet demand. The World Health Organisation reports that 14% of people who need palliative care currently receive it. Moreover, the increase in chronic disease prevalence will result in the need for services to continue to grow. In Ireland, to help manage this demand, it is recommended that all physiotherapists should be able to deliver basic palliative care to patients diagnosed with life-limiting illnesses. Objective To explore the competency and confidence levels of physiotherapists in the management of patients with life-limiting conditions. Methods An anonymous, cross-sectional online questionnaire was designed and administered to physiotherapists working across various settings in Ireland. Results There were 90 respondents (response rate = 4.2%). A significant majority (93%, n = 84) agreed that most patients with life-limiting conditions can participate in physiotherapy. Just over half (56%, n = 50) felt confident in their ability to prescribe exercise for this cohort. Less than one-third (29%, n = 26) felt that the role of physiotherapy in palliative care was understood by the multi-disciplinary team. The majority (76%, n = 68) did not agree that their undergraduate training prepared them for work in this area. The ability to access mentorship from specialist palliative care physiotherapists was deemed as a facilitator in providing patient care. Conclusion This study highlights the demand for greater palliative care education, the need for a better understanding among the wider multi-disciplinary team so that patients receive timely access to physiotherapy, and the importance of establishing strong links between specialist physiotherapists and their generalist counterparts.

OPTIMIZING AN EXPERT SYSTEM FOR DIAGNOSING A DEPRESSION DISORDER USING A CASE BASED REASONING METHOD

According to data from the World Health Organization (WHO), 3.7% of the population in Indonesia experiences depression. Depression can impact both the mental and physical conditions of an individual. WHO reports that every year, approximately 800,000 people die by suicide, with depression being one of the causes. Depression treatment is handled by a professional, and in the field, the process of diagnosing depression disorders is still generally done manually by them. This creates many opportunities for errors, despite the fact that each level of depression disorder requires different handling. Inadequate treatment can hinder the patient's recovery and may potentially worsen their condition. A precise and efficient method is needed to diagnose depression disorders. An expert system can reduce the risk of errors that occur with manual calculations. The implemented case-based reasoning method can classify depression disorders. Testing was conducted using 30 datasets as initial knowledge, with 20 sample data points for testing, randomly selected from the population through questionnaires. The classification accuracy for depression disorders reached up to 90%.

Bedaquiline: An Insight Into its Clinical Use in Multidrug-Resistant Pulmonary Tuberculosis.

Every year, the World Health Organization reports 500,000 new cases of drug-resistant tuberculosis (TB), which poses a serious global danger. The increased number of XDR-TB and MDR-TB cases reported worldwide necessitates the use of new therapeutic approaches. The main issues with the antitubercular medications now in use for the treatment of multidrug-resistant tuberculosis are their poor side effect profile, reduced efficacy, and antimicrobial resistance. One possible remedy for these problems is bedaquiline. The need for better treatment strategies is highlighted by the strong minimum inhibitory concentrations that bedaquiline (BDQ), a novel anti-TB medicine, exhibits against both drug-resistant and drug-susceptible TB. Bedaquiline may be able to help with these problems. Bedaquiline is a medication that is first in its class and has a distinct and particular mode of action. Bedaquiline is an ATP synthase inhibitor that is specifically directed against Mycobacterium tuberculosis and some nontuberculous mycobacteria. It is metabolized by CYP3A4. Bedaquiline preclinical investigations revealed intralesional drug biodistribution. The precise intralesional and multi-compartment pharmacokinetics of bedaquiline were obtained using PET bioimaging and high-resolution autoradiography investigations. Reduced CFU counts were observed in another investigation after a 12-week course of therapy. Meta-analyses and systematic reviews of phase II trials on bedaquiline's efficacy in treating drug-resistant tuberculosis in patients reported higher rates of cure, better culture conversion, and lower death rates when taken in conjunction with a background regimen. Here is a thorough medication profile for bedaquiline to aid medical professionals in treating individuals with tuberculosis.

The Philosophical and Sociological exposition of Suicide in Lesotho

One of the philosophical problem is the phenomenon of suicide. In the Kingdom of Lesotho as many nations the nature of suicide can be understood from the philosophical and sociological lenses. Among the countries in the world with the highest suicide rate is Lesotho. How come? This research article delves into the complex relationship between individual agency and social factors in context of the existence of suicide in Lesotho, drawing upon philosophical and sociological approaches. The main philosophical and sociological positions of suicide in this paper are presented. A qualitative method has been applied in this paper, secondary data has been subscribed from electronic database from various reliable sources such as World Health Organization (WHO) reports, government and private documents related to suicide and mental affairs reports. A comparative analysis of philosophical and sociological perspectives, the article seeks to deepen our understanding of the factors contributing to suicidal behaviours and their implications for prevention and intervention strategies. This paper also discusses the richness of Durkheim’s insight on suicide and four etiological types of suicide. This paper concludes by putting forward that young people in Lesotho who have serious mental illnesses at an early age have a higher risk of suicide.

Clinical and laboratory parameters as predictors of mortality in patients with chronic liver disease presenting to emergency department- a cross sectional study

BackgroundThe World Health Organization (WHO) reports that Asia and Africa have the highest Chronic Liver Disease (CLD) mortality rate. Cirrhosis, responsible for 22.2 fatalities per 100,000 people, is India’s 10th most common cause of mortality. The increasing prevalence of chronic liver disease necessitates a study to identify predictive factors for patients who visit the emergency department. Identifying elements that enhance the predictive value of mortality in unstable patients with CLD complications is important in emergency departments. This study aims to determine Clinical and Laboratory Parameters as mortality predictors in adult chronic liver disease patients.MethodologyThe study was conducted at the emergency department of a tertiary healthcare center in Northern India. Patients with chronic liver disease above 18 years of age who satisfied the inclusion criteria were clinically evaluated. Clinical and demographic details were collected, and data was analyzed.ResultsTwo hundred thirty-six patients were enrolled. The mean age was 50.77 ± 14.26 years. 78.4% of the participants were men. Abdominal distension, affecting 59.7% of patients, was the most common presenting ailment, followed by melena and hematemesis, affecting 41.9% and 32.6%, respectively. The mean stay in the emergency department was 10.29 ± 8.10 h. Refractory septic shock, the leading cause of mortality, accounts for 69.2% of all deaths, alongside grade 4 hepatic encephalopathy and massive Upper Gastrointestinal (UGI) bleeding, as identified in our study. Factors such as altered mental sensorium, high respiratory rate, low SpO2, increased heart rate, low systolic blood pressure, low diastolic blood pressure, and low Glasgow Coma Scale (GCS) on Emergency Department (ED) arrival are significantly associated with mortality.ConclusionsChronic liver disease, a prevalent condition in India, most commonly seen in middle aged men and lower socioeconomic groups. The parameters independently associated with mortality in our study were presence of altered mental sensorium, Glasgow coma scale, Child Pugh class and need for ICU admission. Understanding the presentation pattern, and mortality predictors can help ED physicians in managing acute events and follow-ups.

MOF-Based Platform for Kidney Diseases: Advances, Challenges, and Prospects.

Kidney diseases are important diseases that affect human health worldwide. According to the 2020 World Health Organization (WHO) report, kidney diseases have become the top 10 causes of death. Strengthening the prevention, primary diagnosis, and action of kidney-related diseases is of great significance in maintaining human health and improving the quality of life. It is increasingly challenging to address clinical needs with the present technologies for diagnosing and treating renal illness. Fortunately, metal-organic frameworks (MOFs) have shown great promise in the diagnosis and treatment of kidney diseases. This review summarizes the research progress of MOFs in the diagnosis and treatment of renal disease in recent years. Firstly, we introduce the basic structure and properties of MOFs. Secondly, we focus on the utilization of MOFs in the diagnosis and treatment of kidney diseases. In the diagnosis of kidney disease, MOFs are usually designed as biosensors to detect biomarkers related to kidney disease. In the treatment of kidney disease, MOFs can not only be used as an effective adsorbent for uremic toxins during hemodialysis but also as a precise treatment of intelligent drug delivery carriers. They can also be combined with nano-chelation technology to solve the problem of the imbalance of trace elements in kidney disease. Finally, we describe the current challenges and prospects of MOFs in the diagnosis and treatment of kidney diseases.

Environmental sensitivity in the 27 National Roma Integration Strategies of the European Union member states

ABSTRACT The Roma people, particularly in Central and Eastern European countries, often live ethnically segregated in inadequate housing or without access to basic services (water, sewage system, electricity). Exposure to these harmful environmental factors jeopardizes their health and hinders their social integration. This study delves into the sensitivity of the National Roma Integration Strategies (NRIS) (2012–2020) regarding the environmental factors that affect the Roma population. Previous studies have explored gender or identity in the strategies, but few have analysed environmental sensitivity. Based on World Health Organization (WHO) reports, we consider the following environmental factors: housing, access to basic services, urban environment, working environment and injuries at home. The sensitivity of the 27 NRIS to these factors was quantified in all crucial areas (housing, health, education, employment). An inductive analysis of the operational content (measures, actions) was conducted on nine NRIS. The Member States in the southeast of the European Union were more environmentally sensitive than their counterparts in the northwest. The salient environmental factors were housing and basic services. The nine NRIS analysed show two approaches (western/eastern) in addressing the environmental conditions of the Roma population. Finally, although we identified environmental factors in the NRIS, this issue was not systematically addressed.

Eutectic mixtures containing the active pharmaceutical ingredient ezetimibe: Phase diagrams, solid state characterization and dissolution profiles

Cardiovascular disease represents the leading cause of death worldwide, according to the World Health Organization (WHO) report. One of the treatment strategies is the use of the drug ezetimibe (EZT). This drug is a cholesterol absorption inhibitor with low aqueous solubility, which affects its therapeutic efficacy. The purpose of this paper was to obtain eutectic materials of EZT with methylparaben (MPB), salicylic acid (SCA) and nicotinamide (NTM) coformers, and to study their phase diagrams, dissolution properties and hygroscopicity to assess possible enhancements. Phase and Tamman diagrams were constructed using differential scanning calorimetry (DSC) results. The eutectic materials were characterized by powder X-ray diffraction (PXRD) and polarized light optical microscopy (OM). The hygroscopicity of the materials was assessed at different relative humidities (RH) through dynamic vapor sorption (DVS). The dissolution study was conducted with the materials in powder form, with paddle dissolution, rotating at 50 rpm, in 900 mL of aqueous buffer solution at pH 6.8 and 37 °C. The phase diagrams demonstrated that EZT formed eutectic systems with eutectic molar fractions of 0.59, 0.67 and 0.69 for EZT-SCA, EZT-NTM and EZT-MPB, respectively. The three eutectic materials are characterized as microcrystalline conglomerates of their components. In terms of the hygroscopic behavior of EZT at different RHs, eutectic materials demonstrated lower susceptibility to monohydrate formation compared to the anhydrous form. In dissolution studies, EZT-SCA and EZT-MPB solubilized EZT in amounts 22 % higher than the pure drug in 15 min. On the other hand, EZT-NTM eutectic suppressed the dissolution of EZT down to 56 % at the same time. The results indicated the possibility of obtaining materials with enhanced properties using eutectic mixtures, with improved dissolution rates and hygroscopic stability.

Metabolic Management of Cancer Disease – A Review

The US National Cancer Institute (NCI) define cancer as a disease in which some of the body’s cells are growing uncontrollably and are also spreading to other parts of the body. Cancer disease is a major cause of deaths worldwide and from the World Health Organization (WHO) report, in year 2020 alone, cancer caused about 10 million deaths globally. Also from a WHO report, cancer disease is responsible for 1 out of every 4 to 5 deaths worldwide. Conventionally, the treatment of cancer is based on three major approaches, viz; chemical therapy, surgery and radiation therapy. But, the outcome and prognosis of the conventional treatment of cancer disease is limited in its effectiveness, so there is an urgent need for more research based therapies that can effectively treat and manage cancer disease. With that, the treatment outcome and the survival rate of cancer will likely increase. Meanwhile, the term tumour was originally applied to the swelling caused by inflammation and there are two types of tumours; benign tumours and malignant tumours. Cancer is the common term for malignant tumours and the normal progression of most malignant tumours can be divided into four phases, which are; malignant change in the target cells, growth of the changed cells, local invasion of the surrounding tissues and organs by the changed cells, and distant metastases of the changed cells to other organs. In the clinical diagnosis of cancer disease, systems have been developed to express the level of differentiation of cancer within a patient (grade) and also the extent of spread of cancer within a patient (stage). The staging of cancers is based on the; size of the primary lesion, its extent of spread to regional lymph nodes, and the presence or absence of blood-borne metastases. Two major staging systems are quite common and the first was developed by the America Joint Committee (AJC) on Cancer Staging, while the second was by the Union Internationale Contre Cancer (UICC). The UICC employs a classification called the TNM system. Normal cells use the sophisticated process of respiration for their cellular energy production, but cancer cells use the primitive process of fermentation. However, no cell in its right conditions would ever use fermentation when there is enough oxygen, especially considering that fermentation does not produce as much energy as respiration, and it also creates toxic by-products. So, fermentation is primitive and wasteful. But, surprisingly, cancer cells use fermentation even when there is plenty of oxygen around. That very observation is the basis of the explanation for the Warburg effect, which is considered to be the metabolic signature of most cancer cells. From the meta-analysis research done on cancer at the University of Cambridge, UK, it was concluded that cancer is a mitochondrial disease and one of the effective ways of managing it is through diets. So, it was concluded from the meta-analysis that cancer growth and progression can be managed through a whole body transition from fermentable metabolites made up of basically glutamine and glucose, to respiratory metabolites made up of majorly ketone bodies.

Potentially Toxic Metals: Their Effects on the Soil-Human Health Continuum

As the foundation of nutritious foods lies in the soil, the consumption of crops grown in contaminated soils may pose an elevated risk of health issues through the soil-plant-human pathway. The impact of heavy metals (HMs) and metalloids on the physiological and biochemical responses of plants can have adverse effects on both growth and yield. The excessive accumulation of these substances in plant tissues poses a significant challenge to public health. HMs possess the capability not only to function as carcinogens but also to act as co-carcinogens, thereby activating specific chemical compounds. According to the World Health Organization (WHO) reports, the target values, representing the desirable maximum concentrations of HMs in the soil, follow the order: Cr>Pb>Zn>Cu>Ni>Cd. This implies that Cd poses the highest potential risk, given its target value of 0.8 mg/kg, while Cr carries the lowest potential risk, with a target value of 100 mg/kg. Various agricultural management practices are recognized as significant pathways that induce the accumulation of metals in the soil and the surrounding environment. Hence, understanding the origin and status of HMs in the environment, along with assessing their potential risks and developing strategies to mitigate these risks, becomes crucial. This study aims to evaluate different facets of the soil-human health continuum concerning potentially toxic metals.

THE ANTICANCER POTENTIAL OF VAN LAKE BASIN PLANTS

Abstract: For centuries, people have used plants in their environment for food and various needs, as well as for treating diseases. The main reason for the increasing demand for herbal resources in recent years is that synthetic drugs cause negative consequences that can damage various organs of the body while treating diseases. The World Health Organisation (WHO) reports that 80% of the world's population primarily uses medicinal plants to prevent and cure diseases. Cancer, a disease with a rapidly increasing incidence and mortality rate, is currently second only to cardiovascular diseases. The toxicity of modern chemotherapy and the resistance of cancer cells to anticancer agents have led the scientific world to search for new treatments and prevention methods for this insidious disease. The therapeutic properties of plants, which generally do not have significant side effects, are associated with biologically active organic compounds, and the geochemical composition of the region where they grow. Van Lake Basin has a rich plant diversity thanks to its climate, geographical features, and soil content. This region is home to many medicinal plant species that are used by the people but have not yet been investigated and their phytochemical structure is not fully understood. Although the plants in this region have been used for centuries by the people, as seen from their ancestors, studies need to prove their therapeutic effects in vivo and in vitro. This study presents the anticancer potentials of some crucial plants (Eryngium billardieri Delar., Cichorium intybus, Bongardia chrysogonum (L.) Spach, Bryonia multiflora Boiss. & Heldr., Euphorbia macroclada Boiss., Scutellaria orientalis L., Plantago major L., and Primula auriculata Lam.) reported to be used in treating various diseases in the Van Lake Basin by analyzing the in vitro and in vivo anticancer studies conducted with the same plants in the literature.

Amino Acid Biosynthesis Inhibitors in Tuberculosis Drug Discovery.

According to the latest World Health Organization (WHO) report, an estimated 10.6 million people were diagnosed with tuberculosis (TB) in 2022, and 1.30 million died. A major concern is the emergence of multi-drug-resistant (MDR) and extensively drug-resistant (XDR) strains, fueled by the length of anti-TB treatment and HIV comorbidity. Innovative anti-TB agents acting with new modes of action are the only solution to counteract the spread of resistant infections. To escape starvation and survive inside macrophages, Mtb has evolved to become independent of the host by synthesizing its own amino acids. Therefore, targeting amino acid biosynthesis could subvert the ability of the mycobacterium to evade the host immune system, providing innovative avenues for drug discovery. The aim of this review is to give an overview of the most recent progress in the discovery of amino acid biosynthesis inhibitors. Among the hits discovered over the past five years, tryptophan (Trp) inhibitors stand out as the most advanced and have significantly contributed to demonstrating the feasibility of this approach for future TB drug discovery. Future efforts should be directed at prioritizing the chemical optimization of these hits to enrich the TB drug pipeline with high-quality leads.

A Study For: Socio-cultural Environment and the Microinsurance

The poor are much more exposed to the dangers from their surroundings. They live in unhealthy environment where even proper sanitation is not available. Natural calamities like floods, drought, earth quake etc. hit them the hardest. An unfortunate event like Illness or death in the family can change the living standard of the poor for the worse. Cost of medical care being prohibitive, s/he consumes lots of (already diminished) resources from the family. Since they do not have adequate savings, such an episode drives them to either sell their assets or borrow money from local money lenders at high interest rates. According to World Health Organization report (2006), out of total health expenditure in India, 73% happens through out-of pocket spending. This is a very precarious situation as it exposes the poor household to sudden spurt in unplanned and unexpected medical expenses. So, how do we ensure that the poor, or the ‘excluded’ face this ever-threatening risk to their lives and livelihood? Insurance as a concept was introduced in 19th century to do exactly that - protect the poor! But over a period of time, it became a financial tool for the rich. Affordability being one of the prime reasons but exposure and access being other important reason for low penetration in this segment.

Effects of Gluteal Muscle Strengthening Exercise-Based Core Stabilization Training on Pain and Quality of Life in Patients with Chronic Low Back Pain.

Background: The World Health Organization reports that back pain is a major cause of disorder worldwide. It is the most common musculoskeletal disorder with limited pain, muscle tension, and stiffness, and 70-80% of all individuals experience it once in their lifetime, with higher prevalence in women than in men. This study aimed to investigate the effects of gluteal muscle strengthening exercise- based core stabilization training (GSE-based CST) on pain, function, fear-avoidance patterns, and quality of life in patients with chronic back pain. Methods: This study included 34 patients with non-specific chronic low back pain. Seventeen individuals each were included in GSE-based CST and control groups. The GSE-based CST group performed GSE and CST for 15 min, three times a week for four weeks, and the control group performed CST for 30 min a day, three times a week for four weeks. The numeric pain rating scale was used to evaluate pain before and after treatment, Roland-Morris disability questionnaire was used to evaluate function, fear-avoidance beliefs questionnaire was used to evaluate fear-avoidance patterns, and quality of life was measured using the short form-36. Results: In this study, pain, function, and fear-avoidance pattern decreased significantly in both groups (All p < 0.05). During the evaluation of quality of life, both groups showed significant increase in physical and mental factors (p < 0.05). There were significant differences in pain and quality of life (p < 0.05) between the GSE-based CST and control groups. Conclusions: Therefore, GSE-based CST can be used as a basis for effective intervention to enhance pain, function, fear-avoidance patterns, and quality of life, emphasizing the need for gluteal muscle strengthening exercises in patients with non-specific chronic back pain in the future.

Assessment of three antibiotic combination regimens against Gram-negative bacteria causing neonatal sepsis in low- and middle-income countries

Gram-negative bacteria (GNB) are a major cause of neonatal sepsis in low- and middle-income countries (LMICs). Although the World Health Organization (WHO) reports that over 80% of these sepsis deaths could be prevented through improved treatment, the efficacy of the currently recommended first- and second-line treatment regimens for this condition is increasingly affected by high rates of drug resistance. Here we assess three well known antibiotics, fosfomycin, flomoxef and amikacin, in combination as potential antibiotic treatment regimens by investigating the drug resistance and genetic profiles of commonly isolated GNB causing neonatal sepsis in LMICs. The five most prevalent bacterial isolates in the NeoOBS study (NCT03721302) are Klebsiella pneumoniae, Acinetobacter baumannii, E. coli, Serratia marcescens and Enterobacter cloacae complex. Among these isolates, high levels of ESBL and carbapenemase encoding genes are detected along with resistance to ampicillin, gentamicin and cefotaxime, the current WHO recommended empiric regimens. The three new combinations show excellent in vitro activity against ESBL-producing K. pneumoniae and E. coli isolates. Our data should further inform and support the clinical evaluation of these three antibiotic combinations for the treatment of neonatal sepsis in areas with high rates of multidrug-resistant Gram-negative bacteria.

Development in the Inhibition of Dengue Proteases as Drug Targets.

Viral infections continue to increase morbidity and mortality severely. The flavivirus genus has fifty different species, including the dengue, Zika, and West Nile viruses that can infect 40% of individuals globally, who reside in at least a hundred different countries. Dengue, one of the oldest and most dangerous human infections, was initially documented by the Chinese Medical Encyclopedia in the Jin period. It was referred to as "water poison," connected to flying insects, i.e., Aedes aegypti and Aedes albopictus. DENV causes some medical expressions like dengue hemorrhagic fever, acute febrile illness, and dengue shock syndrome. According to the World Health Organization report of 2012, 2500 million people are in danger of contracting dengue fever worldwide. According to a recent study, 96 million of the 390 million dengue infections yearly show some clinical or subclinical severity. There is no antiviral drug or vaccine to treat this severe infection. It can be controlled by getting enough rest, drinking plenty of water, and using painkillers. The first dengue vaccine created by Sanofi, called Dengvaxia, was previously approved by the USFDA in 2019. All four serotypes of the DENV1-4 have shown re-infection in vaccine recipients. However, the usage of Dengvaxia has been constrained by its adverse effects. Different classes of compounds have been reported against DENV, such as nitrogen-containing heterocycles (i.e., imidazole, pyridine, triazoles quinazolines, quinoline, and indole), oxygen-containing heterocycles (i.e., coumarins), and some are mixed heterocyclic compounds of S, N (thiazole, benzothiazine, and thiazolidinediones), and N, O (i.e., oxadiazole). There have been reports of computationally designed compounds to impede the molecular functions of specific structural and non-structural proteins as potential therapeutic targets. This review summarized the current progress in developing dengue protease inhibitors.