Narrative review on nanoparticles based on current evidence: therapeutic agents for diabetic foot infection.

Diabetes's effects on wound healing present a major treatment challenge and increase the risk of amputation. When traditional therapies fail, new approaches must be investigated. With their submicron size and improved cellular internalisation, nanoparticles present a viable way to improve diabetic wound healing. They are attractive options because of their innate antibacterial qualities, biocompatibility, and biodegradability. Nanoparticles loaded with organic or inorganic compounds, or embedded in biomimetic matrices such as hydrogels, chitosan, and hyaluronic acid, exhibit excellent anti-inflammatory, antibacterial, and antioxidant properties. Drug delivery systems (DDSs)-more precisely, nanodrug delivery systems (NDDSs)-use the advantages of nanotechnology to get around some of the drawbacks of traditional DDSs. Recent developments show how expertly designed nanocarriers can carry a variety of chemicals, transforming the treatment of diabetic wounds. Biomaterials that deliver customised medications to the wound microenvironment demonstrate potential. Delivery techniques for nanomedicines become more potent than ever, overcoming conventional constraints. Therapeutics for diabetes-induced non-healing wounds are entering a revolutionary era thanks to precisely calibrated nanocarriers that effectively distribute chemicals. This review highlights the therapeutic potential of nanoparticles and outlines the multifunctional nanoparticles of the future that will be used for complete wound healing in diabetics. The investigation of novel nanodrug delivery systems has the potential to revolutionise diabetic wound therapy and provide hope for more efficient and focused therapeutic approaches.

Hesperidin Supplementation Improves Altered PON -1, LDL Oxidation, Inflammatory Response and Hepatic Function in an Experimental Rat Model of Hyperlipidemia.

In this study, we have examined the effect of hesperidin on rats fed on an experimental high-fat diet. Male Wistar rats were given a high-fat diet orally for one month for developing an HFD (High fat- diet) model. Rats were also supplemented with hesperidin (100 mg/kg body weight) for one month. We determined serum LDL (Low-density lipoprotein) oxidation, Paraoxonase-1 (PON-1) activity, and histopathological profile of the liver. Inflammatory cytokines levels were also measured in serum. HFD induced significant changes in LDL oxidation and PON-1 activity. Liver tissue histopathology and gene expression of inflammatory markers (Il-6(Interleukin-6), TNF- alpha (Tumor necrosis factor alpha), NF-KB (Nuclear factor kappa B) show that significant changes occur in the hyperlipidemic model of rats. We also show that hesperidin can effectively improve plasma antioxidant, LDL oxidation, and inflammatory cytokine expression in rats already subjected to hyperlipidemic stress. We conclude that hesperidin may protect the liver from oxidative stress by improving hepatic function.

Advanced glycation end product signaling and metabolic complications: Dietary approach.

Advanced glycation end products (AGEs) are a heterogeneous collection of compounds formed during industrial processing and home cooking through a sequence of nonenzymatic glycation reactions. The modern western diet is full of heat-treated foods that contribute to AGE intake. Foods high in AGEs in the contemporary diet include processed cereal products. Due to industrialization and marketing strategies, restaurant meals are modified rather than being traditionally or conventionally cooked. Fried, grilled, baked, and boiled foods have the greatest AGE levels. Higher AGE-content foods include dry nuts, roasted walnuts, sunflower seeds, fried chicken, bacon, and beef. Animal proteins and processed plant foods contain furosine, acrylamide, heterocyclic amines, and 5-hydroxymethylfurfural. Furosine (2-furoil-methyl-lysine) is an amino acid found in cooked meat products and other processed foods. High concentrations of carboxymethyl-lysine, carboxyethyl-lysine, and methylglyoxal-O are found in heat-treated nonvegetarian foods, peanut butter, and cereal items. Increased plasma levels of AGEs, which are harmful chemicals that lead to age-related diseases and physiological aging, diabetes, and autoimmune/inflammatory rheumatic diseases such as systemic lupus erythematosus and rheumatoid arthritis. AGEs in the pathophysiology of metabolic diseases have been linked to individuals with diabetes mellitus who have peripheral nerves with high amounts of AGEs and diabetes has been linked to increased myelin glycation. Insulin resistance and hyperglycemia can impact numerous human tissues and organs, leading to long-term difficulties in a number of systems and organs, including the cardiovascular system. Plasma AGE levels are linked to all-cause mortality in individuals with diabetes who have fatal or nonfatal coronary artery disease, such as ventricular dysfunction. High levels of tissue AGEs are independently associated with cardiac systolic dysfunction in diabetic patients with heart failure compared with diabetic patients without heart failure. It is widely recognized that AGEs and oxidative stress play a key role in the cardiovascular complications of diabetes because they both influence and are impacted by oxidative stress. All chronic illnesses involve protein, lipid, or nucleic acid modifications including crosslinked and nondegradable aggregates known as AGEs. Endogenous AGE formation or dietary AGE uptake can result in additional protein modifications and stimulation of several inflammatory signaling pathways. Many of these systems, however, require additional explanation because they are not entirely obvious. This review summarizes the current evidence regarding dietary sources of AGEs and metabolism-related complications associated with AGEs.

Tacrolimus-Induced Neurotoxicity in Early Post-Liver Transplant Saudi Patients: Incidence and Risk Factors.

BACKGROUND Tacrolimus is a calcineurin inhibitor (CNI) commonly used as an immunosuppressant to prevent the rejection of organ transplants. After liver transplantation, it can cause early neurological complications, known as early calcineurin inhibitor-induced neurotoxicity (ECIIN). Its management requires CNI withdrawal, a measure that can affect post-transplant outcomes, primarily allograft rejection. In addition, it can negatively impact the quality of life. The incidence and risk factor of ECIIN has not been reported in the Saudi population. We investigated the incidence and risk factors of ECIIN after liver transplant in Saudi patients. We also looked at the length of stay in the Intensive Care Unit, hospital, and 30-day mortality as secondary endpoints. MATERIAL AND METHODS This was a retrospective cohort study of adult patients on tacrolimus with mild, moderate, or severe neurological events within the first month after liver transplantation at a single center of patients who meet the inclusion criteria and were over age 14 years. A total of 338 patients were included in the analysis, and the sample size was calculated based on a pilot study. RESULTS Among 338 liver transplantation patients, 63 patients (19%) developed ECIIN. Forty-eight percent of patients had seizures, 23% had agitation, 21% had psychosis, 10% had severe tremors, 13% had confusion, and 6% developed coma. The median time of the incident to develop ECIIN was 9 (IQR: 5-13.5) days after transplant. Thirty-eight patients were managed by switching to cyclosporine, 12 required a reduction in the dose, and 3 were managed temporarily by discontinuing therapy. Autoimmune hepatitis as an underlying liver disease was one of the statistically significant risk factors (P=0.0311). The median length of hospital stay was 31 (IQR: 21-75.5) days, ICU length of stay was 10 (IQR: 5-20.5) days, and 8 patients died within 30 days after transplant. CONCLUSIONS The incidence of ECIIN in Saud Arabia was similar to that reported in other populations with similar risk factors. Electrolyte imbalance, mainly hyponatremia, was significantly associated with developing ECIIN. Therefore, ECIIN may potentially increase hospital and ICU length of stay.

Prevalence of overweight and obesity and their associated factors among health sciences college students, Saudi Arabia.

CONTEXT: The healthcare sciences college students have a lifestyle with low physical activity and disordered eating habits, which exposes them to a higher risk of obesity. Health science college students were the target group of particular interest in this study as they are future physicians. If they are overweight or obese, they will carry the wrong impression to the general population. AIM: To assess the prevalence of overweight and obesity among healthcare science college students at private university in Saudi Arabia. Also, it assesses the relationship between the sociodemographic characteristics and risk of overweight and obesity in this population. METHODS: A cross-sectional study was conducted among healthcare science college students. A validated, structured, closed-ended questionnaire was self-administered through the Monkey survey. All data were analyzed using SPSS. RESULTS: 401 students participated, in which 33.4% were male and 66.6% were female students; and the mean age was 22 years. The study showed that 23.7% of participants were overweight, and 11% were obese. The prevalence of obesity was higher among males. Family history of obesity and fatigue were risk factors for obesity. CONCLUSION: The healthcare Science College students showed a high prevalence of obesity and overweight. This is strengthening the need to encourage a healthy lifestyle, healthy food habits, and physical activities to avoid obesity-related complications.

Medical students' perceptions of their educational environment in an integrated curriculum in Saudi Arabia.

OBJECTIVE: To measure medical students' perceptions of their educational environment and to determine the potential differences in those perceptions with regard to gender and the year of study. METHODS: The cross-sectional study was conducted at the College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia, in 2018-19, and comprised medical students enrolled at the college. Data was collected using the Dundee Ready Educational Environment Measure scale. Data was analysed using SPSS 22. RESULTS: Of the 262 students approached, 191(73%) responded. The total mean score was 122.49±21.50. Perception of educational environment was higher for male students and advanced-level students (p<0.05). CONCLUSIONS: The findings illustrated a healthy educational environment.

Development and validation of a Smartphone Impact Scale among healthcare professionals.

OBJECTIVES: Smartphone overuse is prevalent among healthcare professionals. There is no standard scale that can measure the impact of smartphone usage on healthcare professionals. This study aimed to develop and validate a tool, the Smartphone Impact Scale (SIS), that can effectively measure the use of smartphone among healthcare professionals. METHODS: We developed a generic instrument to study the impact of smartphone usage among healthcare professionals. A total of 1436 healthcare professionals from various regions of KSA participated in this study through an online questionnaire-based survey. The psychometric properties of the SIS were developed using content validity index (CVI), factor analysis, internal consistency, and test-retest reliability analysis. RESULTS: A 23-item scale was selected for reliability and validity analysis. The average CVI was found to be 0.824. The internal consistency with Cronbach's alpha value was 0.91, and test-retest reliability was 0.85. The Cronbach's alpha values for Factors 1 and 2 were 0.875 and 0.803, respectively. The confirmatory factor analysis indices were as follows: root mean square of approximation = 0.0710, comparative fit index = 0.861, Tucker-Lewis index = 0.845, and the coefficient of determination = 0.969. The correlation between two factors was 0.66. After factor analysis, we developed a final questionnaire with 23 items. CONCLUSIONS: Our SIS showed a three-factor structure and appropriate psychometric characteristics. Due to its adequate reliability and validity, SIS can be conveniently used to evaluate the impact of smartphone usage on healthcare professionals.

Human papillomavirus and its vaccination: Knowledge and attitudes among female university students in Saudi Arabia.

CONTEXT: College students worldwide have low levels of knowledge on human papillomavirus (HPV)-related diseases, highlighting the lack of awareness about HPV infection. To date, no study has examined the level of knowledge of cervical cancer and the HPV vaccine in the northern region of Saudi Arabia. AIM: This study aimed to assess the level of knowledge of cervical cancer and its risk factors, as well as HPV vaccine acceptance among female students in Saudi Arabia enrolled in health colleges. METHODS: A descriptive cross-sectional survey was conducted using a valid and reliable self-administered questionnaire. The questionnaire was completed by 966 female students enrolled at the University of Hail, northern region of Saudi Arabia, with a response rate of 83.5%. The main outcome measure was the identification of the knowledge gap pertaining to HPV infection and its prophylactic vaccine. RESULTS: The findings highlighted a lack of knowledge about cervical cancer, Pap smears, and HPV vaccine among most female university students. The knowledge score positively correlated to the duration of education. Students enrolled in applied medical science and medical colleges showed significantly higher knowledge scores, as did students in their senior academic years. Vaccine uptake barriers included concerns about its side effects and a lack of information. CONCLUSIONS: Our findings can be used to formulate effective future awareness programs in the northern region of Saudi Arabia. A larger number of educational programs are required to enlighten Saudi women about cervical cancer and its prophylactic vaccine, including the benefits of screening programs and prevention strategies.