Stroke and high-risk TIA outcomes with reduction of treatment duration when treatment initiated in emergency rooms (SHORTER-study).

BACKGROUND: Following transient ischemic attack (TIA) and minor stroke, the risk of recurrent stroke can be significantly reduced with short-duration dual antiplatelet therapy (DAPT). We wish to investigate whether 10 days of DAPT is as effective as 21 days' treatment. STUDY DESIGN: This is an open-label, randomized, parallel-group study comparing whether 10 days of DAPT treatment (ASA + clopidogrel) is non-inferior to 21 days of DAPT in patients with acute ischemic stroke (AIS) or high-risk TIA. In both groups, DAPT is started within 24 hours of symptom onset. This study is being conducted in approximately 15 study sites in the Kingdom of Saudi Arabia. The planned sample size is 1932. OUTCOMES: Non-inferiority of 10 days compared to 21 days of DAPT in the prevention of the composite endpoint of stroke and death at 90 days in AIS/TIA patients. The primary safety outcome is major intra-cranial and systemic hemorrhage. STUDY PERIOD: Enrolment started in the second quarter of 2023, and the completion of the study is expected in the fourth quarter of 2025. DISCUSSION: The trial is expected to show that 10 days of DAPT is non-inferior for the prevention of early recurrence of vascular events in patients with high-risk TIAs and minor strokes.

Impact of Sprouting Process on the Protein Quality of Yellow and Red Quinoa (Chenopodium quinoa).

The demand for plant-based proteins has increased remarkably over the last decade. Expanding the availability and variety of plant-based protein options has shown positive potential. This study aimed to investigate the qualitative and quantitative changes in amino acids of yellow and red quinoa seeds (YQ and RQ) during a 9-day germination period. The results showed that the germination process led to an increase in the total amino acids by 7.43% and 14.36% in the YQ and RQ, respectively. Both varieties exhibited significant (p < 0.05) increases in non-essential and essential amino acids, including lysine, phenylalanine, threonine, and tyrosine. The content of non-essential amino acids nearly reached the standard values found in chicken eggs. These results were likely attributed to the impact of the germination process in increasing enzymes activity and decreasing anti-nutrient content (e.g., saponins). A linear relationship between increased seeds' hydration and decreased saponins content was observed, indicating the effect of water absorption in changing the chemical composition of the plant. Both sprouts showed positive germination progression; however, the sprouted RQ showed a higher germination rate than the YQ (57.67% vs. 43.33%, respectively). Overall, this study demonstrates that germination is a promising technique for enhancing the nutritional value of quinoa seeds, delivering sprouted quinoa seeds as a highly recommended source of high-protein grains with notable functional properties.

Effects of Prenatal Exposure to Bisphenol A Substitutes, Bisphenol S and Bisphenol F, on Offspring's Health: Evidence from Epidemiological and Experimental Studies.

Pregnancy and lactation are critical periods for human well-being and are sensitive windows for pollutant exposure. Bisphenol A (BPA) is well demonstrated as a toxicant and has been replaced in the plastic industry with other bisphenol analogs that share similarities in structure and characteristics, most commonly Bisphenol S (BPS) and Bisphenol F (BPF). Maternal exposure to BPS or BPF can result in their accumulation in the fetal compartment, leading to chronic exposure and potentially limiting normal fetal growth and development. This review summarizes considerable findings of epidemiological or experimental studies reporting associations between BPS or BPF and impaired fetal growth and development. Briefly, the available findings indicate that exposure to the two bisphenol analogs during pregnancy and lactation can result in multiple disturbances in the offspring, including fetal growth restrictions, neurological dysfunctions, and metabolic disorders with the potential to persist throughout childhood. The occurrence of premature births may also be attributed to exposure to the two bisphenols. The possible mechanisms of actions by which the two bisphenols can induce such effects can be attributed to a complex of interactions between the physiological mechanisms, including impaired placental functioning and development, dysregulation of gene expression, altered hormonal balance, and disturbances in immune responses as well as induced inflammations and oxidative stress. In conclusion, the available evidence suggests that BPS and BPF have a toxic potential in a compartment level to BPA. Future research is needed to provide more intensive information; long-term studies and epidemiological research, including a wide scale of populations with different settings, are recommended. Public awareness regarding the safety of BPA-free products should also be enhanced, with particular emphasis on educating individuals responsible for the well-being of children.

Exposure to Bisphenol A Substitutes, Bisphenol S and Bisphenol F, and Its Association with Developing Obesity and Diabetes Mellitus: A Narrative Review.

Bisphenol A, a well-known endocrine-disrupting chemical, has been replaced with its analogs bisphenol S (BPS) and bisphenol F (BPF) over the last decade due to health concerns. BPS and BPF are present in relatively high concentrations in different products, such as food products, personal care products, and sales receipts. Both BPS and BPF have similar structural and chemical properties to BPA; therefore, considerable scientific efforts have investigated the safety of their exposure. In this review, we summarize the findings of relevant epidemiological studies investigating the association between urinary concentrations of BPS and/or BPF with the incidence of obesity or diabetes. The results showed that BPS and BPF were detected in many urinary samples at median concentrations ranging from 0.03 to 0.4 µg·L-1. At this exposure level, BPS median urinary concentrations (0.4 µg·L-1) were associated with the development of obesity. At a lower exposure level (0.1-0.03 µg·L-1), two studies showed an association with developing diabetes. For BPF exposure, only one study showed an association with obesity. However, most of the reported studies only assessed BPS exposure levels. Furthermore, we also summarize the findings of experimental studies in vivo and in vitro regarding our aim; results support the possible obesogenic effects/metabolic disorders mediated by BPS and/or BPF exposure. Unexpectedly, BPS may promote worse obesogenic effects than BPA. In addition, the possible mode of action underlying the obesogenic effects of BPS might be attributed to various pathophysiological mechanisms, including estrogenic or androgenic activities, alterations in the gene expression of critical adipogenesis-related markers, and induction of oxidative stress and an inflammatory state. Furthermore, susceptibility to the adverse effects of BPS may be altered by sex differences according to the results of both epidemiological and experimental studies. However, the possible mode of action underlying these sex differences is still unclear. In conclusion, exposure to BPS or BPF may promote the development of obesity and diabetes. Future approaches are highly needed to assess the safety of BPS and BPF regarding their potential effects in promoting metabolic disturbances. Other studies in different populations and settings are highly suggested.

Phenolics and Volatile Compounds of Fennel (Foeniculum vulgare) Seeds and Their Sprouts Prevent Oxidative DNA Damage and Ameliorates CCl4-Induced Hepatotoxicity and Oxidative Stress in Rats.

Researchers recently focused on studying the nutritional and functional qualities of sprouts generated from seeds. The current study investigated the total phenolic content (TPC), total flavonoids (TF), total flavonols (TFL), antioxidant activity (AOA), specific phenolic acids, and volatile chemicals in fennel seeds (FS) and fennel seed sprouts (FSS). The oxidative DNA damage prevention activity of selected FS and FSS extracts against DNA was examined. Consequently, the antioxidative stress potential of FS and FSS extracts at 300 and 600 mg kg-1 on CCl4-induced hepatotoxicity and oxidative stress in rats weas investigated. The liver's functions and oxidative stress biomarkers in rat blood were examined. FSS exhibited rich phytochemical content such as TPC, TF, TFL, and AOA with altered phenolics and volatiles. HPLC identified nineteen compounds of phenolic acids and their derivatives in FS. Thirteen phenolics and six flavonoids were predominantly identified as Vanillic acid and Kaempferol, respectively. GC-MS analysis identified fifty and fifty-one components in FS and FSS, respectively. The predominant component was Benzene, [1-(2-propenyloxy)-3-butenyl] (trans-Anethole) (38.41%), followed by trans-Anethole (Benzene, 1-methoxy-4-(2-propenyl)) (23.65%), Fenchone (11.18%), and 1,7-Octadiene, 2-methyl-6-methylene- Cyclohexene (7.17%). Interestingly, α-Pinene, Fenchone, trans-Anethole (Benzene, 1-methoxy-4-(2-propenyl)), 4-Methoxybenzaldehyde (4-Anisaldehyde), Benzeneacetic acid, α-hydroxy-4-methoxy, and Nonacosane contents were increased. While Dillapiole, 7-Octadecenoic acid, and methyl ester were newly identified and quantified in FSS. The oxidative DNA damage prevention capability of FSS and FS extracts indicated remarkable DNA protection. Administrating FS and FSS extracts at 300 and 600 mg kg-1 ameliorated AST, ALT, and ALP, as well as GSH, CAT, MDA, and SOD, in a dose-dependent manner. The most efficient treatment of FS or FSS was using a dose of 600 mg Kg-1, which recorded an improvement rate of 20.77 and 24.17, 20.36 and 24.92, and 37.49 and 37.90% for ALT, AST, and ALP, respectively. While an improvement rate of 40.08 and 37.87%, 37.17 and 46.52%, 114.56 and 154.13%, and 66.05 and 69.69% for GSH, DMA, CAT, and SOD compared to the CCl4-group, respectively. The observed protection is associated with increased phenolics and volatiles in F. vulgare. Therefore, FS and FSS are recommended as functional foods with bioactive functionality, health-promoting properties, and desired prevention capabilities that may help prevent oxidative stress-related diseases.

Antioxidative potential and ameliorative effects of green lentil (Lens culinaris M.) sprouts against CCl4-induced oxidative stress in rats.

The present study is aimed to investigate the antioxidative potential and ameliorative effects of Lens culinaris Medikus sprouts hydroalcoholic extract (LSHE) on CCl4-induced oxidative stress in rats. The research has been carried out in two successive stages. Firstly, the highest phenolic content and antioxidant activity of L. culinaris sprouts were assessed at 20 ± 1°C and 90-93% RH during sprouting. Total phenolic content (TPC), total carotenoids (TC), total flavonoids (TF), total flavonols (TFL), DPPH-RSA, and vitamin C contents of L. culinaris seeds and 6-days sprouts were determined. Subsequently, phenolics by HPLC analysis of L. culinaris seeds, 3rd and 6th-day sprouts were identified and quantified. Results indicated that 6th-day sprouts contained considerable phenolics with superior antioxidant capacity, thus selected to be examined for biological activity in a rat's module consisting of five groups. G1, normal rats orally received distilled water. G2 received 1.0 mL kg-1 of CCl4 and olive oil (1:1) intraperitoneally (i.p.) twice a week. G3 received CCl4 (i.p.) and 50 mg GAE kg-1 of LSHE daily/orally. G4 received CCl4 (i.p.) 100 mg kg-1 of LSHE orally/daily. G5 (reference group) treated by intramuscular injection (i.m.) of vit. E+Selenium (Vit. E+Se, 50 mg kg-1 twice a week). The weight gain, relative weight of organs, hypoglycemic and hypolipidemic efficiencies, liver's and kidneys' functions, and antioxidant biomarkers were examined. LSHE enhanced the weight gain recovery % and significantly reduced fasting blood glucose. The hypolipidemic effect of LSHE was dramatically reduced triglycerides (TG), total cholesterol (CHO), high- and low-density lipoproteins (HDL-c and LDL-c), and very-low-density lipoproteins (VLDL-c). Administration of 50 and 100 LSHE mg kg-1 ameliorated liver and kidney function in dose-dependent manure. Intriguingly, LSHE considerably reduced malondialdehyde (MDA) while significantly raising reduced glutathione (GSH), superoxide dismutase (SOD), and catalase (CAT) in a dose-dependent manner. In conclusion, biochemical examinations confirmed the therapeutic efficacy of LSHE as a functional product. It encouraged us to recommend L. culinaris sprout production for attenuating hepatotoxicity and nephrotoxicity, as well as being beneficial and profitable for controlling oxidative stress complications.

Amygdalin: A Review on Its Characteristics, Antioxidant Potential, Gastrointestinal Microbiota Intervention, Anticancer Therapeutic and Mechanisms, Toxicity, and Encapsulation.

Bioactive amygdalin, found in high concentrations in bitter almonds, has been recognized as a symbol of the cyanogenic glycoside chemical organic substance, which was initially developed as a pharmaceutical for treating cancer after being hydrolyzed to hydrogen cyanide (HCN). Regrettably, research has shown that HCN can also damage normal cells, rendering it non-toxic to the human body. Extreme controversy surrounds both in vivo and in vitro studies, making its use risky. This review provides an extensive update on characteristics, antioxidant potential, gastrointestinal microbiota intervention, anticancer therapeutic, mechanisms, toxicity, and encapsulation of amygdalin. Antioxidant, anti-tumor, anti-fibrotic, antiatherosclerosis, anti-inflammatory, immunomodulatory, and analgesic characteristics, and the ability to improve digestive and reproductive systems, neurodegeneration, and cardiac hypertrophy are just some of the benefits of amygdalin. Studies verified the HCN-produced amygdalin to be harmful orally, but only at very high doses. Although intravenous treatment was less effective than the oral method, the oral route has a dose range of 0.6 to 1 g daily. Amygdalin's toxicity depends heavily on the variety of bacteria in the digestive tract. Unfortunately, there is currently no foolproof method for determining the microbial consortium and providing a safe oral dosage for every patient. Amygdalin encapsulation in alginate-chitosan nanoparticles (ACNPs) is a relatively new area of research. Amygdalin has an enhanced cytotoxic effect on malignant cells, and ACNPs can be employed as an active drug-delivery system to release this compound in a regulated, sustained manner without causing any harm to healthy cells or tissues. In conclusion, a large area of research for a substance that might be the next step in cancer therapy is opened up due to unverified and conflicting data.

Targeting SARS-CoV-2 main protease by teicoplanin: A mechanistic insight by docking, MM/GBSA and molecular dynamics simulation.

First emerged in late December 2019, the outbreak of novel severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) pandemic has instigated public-health emergency around the globe. Till date there is no specific therapeutic agent for this disease and hence, the world is craving to identify potential antiviral agents against SARS-CoV-2. The main protease (MPro) is considered as an attractive drug target for rational drug design against SARS-CoV-2 as it is known to play a crucial role in the viral replication and transcription. Teicoplanin is a glycopeptide class of antibiotic which is regularly used for treating Gram-positive bacterial infections, has shown potential therapeutic efficacy against SARS-CoV-2 in vitro. Therefore, in this study, a mechanistic insight of intermolecular interactions between teicoplanin and SARS-CoV-2 MPro has been scrutinized by molecular docking. Both monomeric and dimeric forms of MPro was used in docking involving blind as well as defined binding site based on the known inhibitor. Binding energies of teicoplanin-MPro complexes were estimated by Molecular Mechanics/Generalized Born Surface Area (MM/GBSA) computations from docking and simulated trajectories. The dynamic and thermodynamics constraints of docked drug in complex with target proteins under specific physiological conditions was ascertained by all-atom molecular dynamics simulation of 100 ns trajectory. Root mean square deviation and fluctuation of carbon α chain justified the stability of the bound complex in biological environments. The outcomes of current study are supposed to be fruitful in rational design of antiviral drugs against SARS-CoV-2.

Patients concerns about spinal surgery in Hafr Al Batin, Saudi Arabia.

BACKGROUND: The aim of the research to study the concerns about spine surgery in patients who attending to neurosurgery clinic in Central Hospital and King Khalid General Hospital in hafar Al-Batin. OBJECTIVE: The objective is to determine the concern of patients about spine surgery and to detect the reasons of rejection of the surgery with tying to compare the concerns with the social factors and to know the source of their knowledge. MATERIAL AND METHOD: A cross-sectional study on sample of 91 from the patients who attending neurosurgery clinic who could be suffering from any spinal diseases such as tumors, degenerative, and trauma. A standardized survey questionnaire distributed manually and responses were collected and analyzed. RESULTS: The majority of the survey respondents were suffering from trauma (48.4%). The satisfaction rate among persons undergone spine surgery was 20.9%. A negative correlation between age and level of education; rejection of spine surgery or exploring for alternative treatment because of risk of surgery was observed. The patient feedback revealed that if advised for spine operation was 46.2% will accept, 29.7% will delay surgery and looking to alternatives, while 23.1% will reject because of concerns. CONCLUSION: It is recommended that awareness campaigns are required about the importance of spine surgery and to provide the correct information about the complications of spine surgery and finally give more attention to the correct diagnosis.