Supervised learning applied to classifying fallers versus non-fallers among older adults with cancer.

INTRODUCTION: Supervised machine learning approaches are increasingly used to analyze clinical data, including in geriatric oncology. This study presents a machine learning approach to understand falls in a cohort of older adults with advanced cancer starting chemotherapy, including fall prediction and identification of contributing factors. MATERIALS AND METHODS: This secondary analysis of prospectively collected data from the GAP 70+ Trial (NCT02054741; PI: Mohile) enrolled patients aged ≥70 with advanced cancer and ≥ 1 geriatric assessment domain impairment who planned to start a new cancer treatment regimen. Of ≥2000 baseline variables ("features") collected, 73 were selected based on clinical judgment. Machine learning models to predict falls at three months were developed, optimized, and tested using data from 522 patients. A custom data preprocessing pipeline was implemented to prepare data for analysis. Both undersampling and oversampling techniques were applied to balance the outcome measure. Ensemble feature selection was applied to identify and select the most relevant features. Four models (logistic regression [LR], k-nearest neighbor [kNN], random forest [RF], and MultiLayer Perceptron [MLP]) were trained and subsequently tested on a holdout set. Receiver operating characteristic (ROC) curves were generated and area under the curve (AUC) was calculated for each model. SHapley Additive exPlanations (SHAP) values were utilized to further understand individual feature contributions to observed predictions. RESULTS: Based on the ensemble feature selection algorithm, the top eight features were selected for inclusion in the final models. Selected features aligned with clinical intuition and prior literature. The LR, kNN, and RF models performed equivalently well in predicting falls in the test set, with AUC values 0.66-0.67, and the MLP model showed AUC 0.75. Ensemble feature selection resulted in improved AUC values compared to using LASSO alone. SHAP values, a model-agnostic technique, revealed logical associations between selected features and model predictions. DISCUSSION: Machine learning techniques can augment hypothesis-driven research, including in older adults for whom randomized trial data are limited. Interpretable machine learning is particularly important, as understanding which features impact predictions is a critical aspect of decision-making and intervention. Clinicians should understand the philosophy, strengths, and limitations of a machine learning approach applied to patient data.

The COVID-19 Pandemic and Mental Health Concerns on Twitter in the United States.

Background: During the COVID-19 pandemic, mental health concerns (such as fear and loneliness) have been actively discussed on social media. We aim to examine mental health discussions on Twitter during the COVID-19 pandemic in the US and infer the demographic composition of Twitter users who had mental health concerns. Methods: COVID-19-related tweets from March 5th, 2020, to January 31st, 2021, were collected through Twitter streaming API using keywords (i.e., "corona," "covid19," and "covid"). By further filtering using keywords (i.e., "depress," "failure," and "hopeless"), we extracted mental health-related tweets from the US. Topic modeling using the Latent Dirichlet Allocation model was conducted to monitor users' discussions surrounding mental health concerns. Deep learning algorithms were performed to infer the demographic composition of Twitter users who had mental health concerns during the pandemic. Results: We observed a positive correlation between mental health concerns on Twitter and the COVID-19 pandemic in the US. Topic modeling showed that "stay-at-home," "death poll," and "politics and policy" were the most popular topics in COVID-19 mental health tweets. Among Twitter users who had mental health concerns during the pandemic, Males, White, and 30-49 age group people were more likely to express mental health concerns. In addition, Twitter users from the east and west coast had more mental health concerns. Conclusions: The COVID-19 pandemic has a significant impact on mental health concerns on Twitter in the US. Certain groups of people (such as Males and White) were more likely to have mental health concerns during the COVID-19 pandemic.

Comprehensive Lichenometabolomic Exploration of Ramalina conduplicans Vain Using UPLC-Q-ToF-MS/MS: An Identification of Free Radical Scavenging and Anti-Hyperglycemic Constituents.

In this study, we propose ultra-performance liquid chromatography coupled with quadrupole/time-of-flight mass spectrometry (UPLC-QToF-MS/MS)-guided metabolite isolation as a choice analytical approach to the ongoing structure−activity investigations of chemical isolates from the edible lichen, Ramalina conduplicans Vain. This strategy led to the isolation and identification of a new depside (5) along with 13 known compounds (1−4, 6−14), most of which being newly described in this lichen species. The structures of the isolates were established by detailed analysis of their spectral data (IR, NMR, and Mass). The acetone extract was further analyzed by UPLC-Q-ToF-MS/MS in a negative ionization mode, which facilitated the identification and confirmation of 18 compounds based on their fragmentation patterns. The antioxidant capacities of the lichen acetone extract (AE) and isolates were measured by tracking DPPH and ABTS free radical scavenging activities. Most isolates displayed marked radical scavenging activities against ABTS while moderate activities were observed against DPPH radical scavenging. Except for atranol (14), oxidative DNA damage was limited by all the tested compounds, with a marked protection for the novel isolated compound (5), as previously noted for the acetone extract (p < 0.001). Furthermore, compound (4) and acetone extract (AE) have inhibited intestinal α-glucosidase enzyme significantly (p < 0.01). Although some phytochemical studies were already performed on this lichen, this study provided new insights into the isolation and identification of bioactive compounds, illustrating interest in future novel analytical techniques.

Automated Deep Learning-based Single-Step Diameter Estimation of Carotid Arteries in B-mode Ultrasound.

Accurate measurement of blood vessel diameter on ultrasonic images is important in many vascular exams. In one of them, volumetric blood flow measurements, the volume flow rate is calculated by multiplying the time-averaged velocity with the cross-sectional area of the vessel (using diameter measured from B-mode images). Computation of lumen diameter is also vital for planning surgical procedures like carotid artery stenting and endarterectomy. More recently, several automated vessel diameter estimation methods employing deep learning have been proposed. In this paper, we propose a novel single-step automated deep learning-based vessel diameter estimation technique developed on B-mode images. Longitudinal images of the human common carotid artery were acquired by trained vascular sonographers in human subjects using a linear array probe. Ground truth measurements were obtained by a human expert to validate the proposed technique. 504 images (with augmentation) were divided into training, validation, and test sets. Three pre-trained deep learning networks were used for training, and the lumen diameter was predicted in a hold-out test set. The Mean Absolute Deviation (MAD) and Root Mean Square Error (RMSE) ranged from 0.22-0.65 mm and 0.32-0.82 mm, respectively, for the three networks. Furthermore, 5-fold cross-validation resulted in MAD and RMSE of 0.36±0.1 mm and 0.513±0.15 mm, respectively. Clinical Relevance- The results demonstrate that the technology can potentially be embedded in commercial scanners to make the workflow in vascular ultrasound more efficient.

Bombax ceiba calyx displays antihyperglycemic activity via improving insulin secretion and sensitivity: Identification of bioactive phytometabolomes by UPLC-QTof-MS/MS.

Vegetables are considered good food for the management of hyperglycemia. Bombax ceiba L. (family: Bombacaceae) calyces are part of traditional vegetables. This study evaluated its usefulness on various parameters responsible for the development of hyperglycemia and conducted phytometabolomic analysis to identify phytochemicals responsible for the observed activities. It was found that the aqueous methanol extract of its calyces (B. ceiba calyx extract, BCE) reduced (12.4%) significantly (p < 0.05) the development of sucrose-induced postprandial hyperglycemic load in rats. In-vitro studies revealed that BCE improved glucose-stimulated insulin secretory activity in MIN6 cells plausibly by decreasing ADP/ATP ratio. BCE also augmented concentration-dependent (5 µg, 10 µg, and 20 µg) increase in glucose uptake in hyperglycemic L6 myotubes both by non-insulin-dependent manner (35%, 68%, and 132%, respectively) and insulin-dependent manner (42%, 59%, and 172%, respectively). The insulin-stimulated GLUT4 translocation was compromised (34%) significantly (p < 0.05) under hyperglycemic condition; however, it was improved by 23% and 72% (p < 0.001) when L6 myotubes were primed with 10 and 20 µg of BCE, respectively. Hyperglycemia aggravated reactive oxygen species (ROS) generation in L6 myotubes. The ROS generation was significantly (p < 0.001) reduced by priming myotubes with BCE before challenging myotubes to hyperglycemic environment, possibly by preserving cellular antioxidant enzymes catalase, glutathione peroxidase, and reduced glutathione levels. Phytometabolomic analysis disclosed a number of phytochemicals present in B. ceiba calyces known to display these activities. This is the first study reporting antihyperglycemic activity in B. ceiba calyces, its mechanisms of action, and phytometabolomic profile applying UPLC-QTof-MS/MS technique. PRACTICAL APPLICATION: B. ceiba calyces are part of traditional vegetables. Our study finds that B. ceiba calyces contain phytochemicals possessing antihyperglycemic, insulin secretory, insulin sensitization properties, and potentials for preserving hyperglycemia-induced vitiations in cellular antioxidant defense. These observations provide foundation for exploring further possibilities of B. ceiba calyces to become valuable dietary inclusion in the diet of people suffering from metabolic disorders.

An insight into predominance of pulmonary complications on right side in supracostal percutaneous nephrolithotomy.

PURPOSE: To analyse pulmonary complications following supracostal percutaneous nephrolithotomy especially after right sided supracostal punctures, both in initial and relook PCNL. MATERIAL AND METHODS: From February 2016 till date, 90 patients underwent PCNL in Government Medical College, Jammu through supracostal puncture - 53 on right side and 37 on left side. All supracostal punctures were made about 7-8.5 cm from midline. Tract dilatation was done using metal dilators and calculi were fragmented using pneumatic lithotripsy. Patients with supracostal superior calyceal punctures were evaluated for chest complications intraoperatively by fluoroscopy, X-ray chest on evening of postoperative day 0 and repeated thereafter on third and seventh postoperative days. RESULTS: Stone configuration included complete staghorn in 16, partial staghorn in 23, multiple stones in 16 and pelvic stone in 35 cases. Age range of patients was 07-76 years. There was 14.4% (13 out of 90) incidence of early or delayed chest complications - 20.8% (11 out of 53) on right side and 5.4% (2 out of 37) on left side. CONCLUSION: Pulmonary complications in supracostal punctures; especially on right side should not be underestimated. There are always chances of delayed hydrothorax after supracostal puncture. A chest X-ray should be repeated after 1 week in patients with supracostal PCNL punctures.

Analysis of causes of failure of medical treatment in patients undergoing surgery for benign prostate enlargement.

BACKGROUND: To analyse causes of failure of medical management in benign prostate enlargement (BPE) in patients who undergo surgery following medical treatment and to elucidate parameters which warrant for early surgical treatment. METHODS: Records of 747 patients who underwent surgery for BPE were reviewed for prostate volume, median lobe enlargement, post void residual urine, duration and type of medical treatment given for BPE. We used univariate and multivariate analysis to find out significant parameters for medical treatment failure. RESULTS: A total of 601 patients (80.45%) received medical treatment for their lower urinary tract symptoms (LUTS), for a duration ranging between 3 months and 2 years. Statistically significant difference was found between age, prostate volume, intravesical projection, PSA and acute urinary retention with failure of medical treatment. CONCLUSIONS: BPE patients with failure to respond with medical management within 3-6 months and/or associated with large size prostate, intravesical projection and raised serum PSA should better be offered surgical treatment.

Epidermal Fatty Acid‒Binding Protein Mediates Depilatory-Induced Acute Skin Inflammation.

Depilatory creams are widely used to remove unwanted body hair, but people with sensitive skin are subject to depilatory-induced skin burn/inflammation. It remains unknown what makes their skin more sensitive than others. In this study, we show that epidermal fatty acid‒binding protein (E-FABP) expressed in the skin plays a critical role in promoting depilatory-induced acute skin inflammation in mouse models. Although a depilatory cream removed hair by breaking down keratin disulfide bonds, it activated cytosolic phospholipase A2, leading to activation of the arachidonic acid/E-FABP/peroxisome proliferator-activated receptor ß signaling pathway in keratinocytes. Specifically, peroxisome proliferator-activated receptor ß activation induced downstream targets (e.g., cyclooxygenase 2) and chemokine (e.g., CXCL1) production, which systemically mobilized neutrophils and recruited them to localize in the skin for acute inflammatory responses. Importantly, E-FABP deletion by CRISPR-Cas9 reduced cytosolic phospholipase A2/peroxisome proliferator-activated receptor ß activation in keratinocytes, and genetic deletion of E-FABP protected mice from depilatory cream-induced neutrophil recruitment and skin inflammation. Our findings suggest E-FABP as a molecular sensor for sensitive skin by triggering depilatory-induced, lipid-mediated skin inflammatory responses.

Availability of prices for shoppable services on hospital internet sites.

OBJECTIVES: A regulation from CMS required that, starting January 1, 2021, all US hospitals publicly display the cash price and minimum and minimum negotiated charge for 300 "shoppable services." We evaluated compliance with CMS requirements among highly respected US hospitals. STUDY DESIGN: We conducted a cross-sectional study of hospital websites. METHODS: We evaluated the public websites of the 20 hospitals listed in the 2020-2021 US News & World Report honor roll between February 1 and February 14, 2021. We selected 2 imaging studies (brain MRI and abdominal ultrasound) and 3 hospital services (cardiac valve surgery, total joint replacement, and vaginal childbirth). For each service and hospital, we determined whether the discounted cash price and minimum negotiated charge were displayed and, if displayed, what the prices were. RESULTS: Among our 20 hospitals, 13 (65%) displayed the cash prices for the MRI and ultrasound, 8 (40%) for valve surgery, 10 (50%) for joint replacement, and 10 (50%) for childbirth. Only 1 (5%) displayed the minimum negotiated price for the 2 imaging studies and none for any of the hospital services. The mean (range) cash price for MRI was $3793 ($464-$6215) and for ultrasound was $767 ($136-$1391). The mean (range) cash price for cardiac surgery was $236,125 ($72,250-$349,782); for joint replacement, $46,008 ($22,170-$71,985); and for childbirth, $19,568 ($7314-$29,068). CONCLUSIONS: In an early assessment, a significant percentage of US hospitals were not in compliance with new price transparency legislation. Moreover, there is wide variation in prices among hospitals for identical services. These price differences suggest the potential for significant cost savings for patients.

Public Perception of COVID-19 Vaccines on Twitter in the United States.

Background: COVID-19 vaccines play a vital role in combating the COVID-19 pandemic. Social media provides a rich data source to study public perception of COVID-19 vaccines. Objective: In this study, we aimed to examine public perception and discussion of COVID-19 vaccines on Twitter in the US, as well as geographic and demographic characteristics of Twitter users who discussed about COVID-19 vaccines. Methods: Through Twitter streaming Application Programming Interface (API), COVID-19-related tweets were collected from March 5 th , 2020 to January 25 th , 2021 using relevant keywords (such as "corona", "covid19", and "covid"). Based on geolocation information provided in tweets and vaccine-related keywords (such as "vaccine" and "vaccination"), we identified COVID-19 vaccine-related tweets from the US. Topic modeling and sentiment analysis were performed to examine public perception and discussion of COVID-19 vaccines. Demographic inference using computer vision algorithm (DeepFace) was performed to infer the demographic characteristics (age, gender and race/ethnicity) of Twitter users who tweeted about COVID-19 vaccines. Results: Our longitudinal analysis showed that the discussion of COVID-19 vaccines on Twitter in the US reached a peak at the end of 2020. Average sentiment score for COVID-19 vaccine-related tweets remained relatively stable during our study period except for two big peaks, the positive peak corresponds to the optimism about the development of COVID-19 vaccines and the negative peak corresponds to worrying about the availability of COVID-19 vaccines. COVID-19 vaccine-related tweets from east coast states showed relatively high sentiment score. Twitter users from east, west and southern states of the US, as well as male users and users in age group 30-49 years, were more likely to discuss about COVID-19 vaccines on Twitter. Conclusions: Public discussion and perception of COVID-19 vaccines on Twitter were influenced by the vaccine development and the pandemic, which varied depending on the geographics and demographics of Twitter users.

Phytometabolomic analysis of boiled rhizome of Nymphaea nouchali (Burm. f.) using UPLC-Q-TOF-MSE, LC-QqQ-MS & GC-MS and evaluation of antihyperglycemic and antioxidant activities.

Phytometabolomic analysis of Nymphaea nouchali (Burm. F.) boiled rhizome was carried out utilizing UPLC-Q-TOF-MSE, LC-QqQ-MS and GC-MS techniques and evaluated for antihyperglycemic and antioxidative stress potentials. Metabolomic analysis revealed presence of multiple antidiabetic and antioxidant compounds. Boiled rhizome powder exhibited potent antihyperglycemic activity against sugar-induced postprandial hyperglycemia in rats plausibly due to the presence of intestinal α-glucosidase inhibitory and augmenting cellular glucose uptake activities. It also prevented hyperglycemia-induced hemoglobin and insulin glycation. Rhizome displayed potent reducing power, effectively scavenged various reactive oxygen species. It displayed antioxidative stress potential in assuaging H2O2 induced erythrocyte hemolysis and antioxidant activity by inhibiting membrane lipid peroxidation. Boiled rhizome was also found to preserve the loss of cellular antioxidants under H2O2 induced oxidative stress and disturbances caused to mitochondrial membrane potential. This is the first research reporting boiled N. nouchali rhizome as an ideal food material to manage the cause of hyperglycemia and resultant oxidative stress.

Social distancing merely stabilized COVID-19 in the United States.

Social distancing measures have been imposed across the United States in order to stem the spread of COVID-19. We quantify the reduction in the doubling rate, by state, that is associated with this intervention. Using the earlier of K-12 school closures and restaurant closures, by state, to define the start of the intervention, and considering daily confirmed cases through April 23, 2020, we find that social distancing is associated with a statistically-significant (p < 0.01) reduction in the doubling rate for all states except for Nebraska, North Dakota, and South Dakota, when controlling for false discovery, with the doubling rate averaged across the states falling from 0.302 (0.285, 0.320) days-1 to 0.010 (-0.007, 0.028) days-1. However, we do not find that social distancing has made the spread subcritical. Instead, social distancing has merely stabilized the spread of the disease. We provide an illustration of our findings for each state, including estimates of the effective reproduction number, R, both with and without social distancing. We also discuss the policy implications of our findings.

Bombax ceiba (Linn.) calyxes ameliorate methylglyoxal-induced oxidative stress via modulation of RAGE expression: identification of active phytometabolites by GC-MS analysis.

Non-enzymatic reactions between proteins and methylglyoxal (MG) result in the formation of advanced glycation end products (AGEs). These AGEs play a vital role in the development of diabetic complications by stimulating oxidative stress and acting upon their receptor RAGE (Receptor for Advanced Glycation End products). This study examined the effect of aqueous methanol extract of Bombax ceiba L. calyxes (BCCE) on MG induced protein glycation and oxidative stress, followed by the identification of phytometabolites present in the calyxes using gas chromatography-mass spectrometry (GC-MS). The study revealed that priming of bovine serum albumin protein with the BCCE inhibited MG induced AGE formation in vitro and restrained AGE-induced RAGE up-regulation in HEK-293 cells. The BCCE significantly (p < 0.001) reduced the MG induced increase in reactive oxygen species (ROS), NADPH oxidase (NOX), and mitochondrial dysfunction. Improvements in the levels of antioxidant enzymes such as Mn and Cu/Zn-superoxide dismutase and glutathione reductase were also observed in HEK-293 cells. Furthermore, the decrease in primary cellular defense against AGEs, the glyoxalase 1 (Glo-1) activity, due to MG treatment was restored in BCCE treated cells. GC-MS analysis revealed the presence of antioxidant and antiglycation compounds such as myo-ionisitol, scopoletin, d-sedoheptulose, succinic acid, and xylitol in B. ceiba calyxes. The observed beneficial effect in our study might be attributed to the presence of these compounds in B. Ceiba calyxes. This is the first report presenting the antioxidant and antiglycation activities of B. ceiba calyxes and GC-MS analysis of active phytometabolites. These observations show that B. ceiba calyxes may become a potent and promising functional food to manage/control the development of diabetic complications.

Pyeloduodenal fistula: A rare case report.

Pyeloduodenal fistula is a rare entity, with very few cases reported in the world literature so far. Commonly found in three disease entities - chronic renal inflammatory disease secondary to renal calculi, renal tuberculosis and renal malignancies in order of frequency; this disease entity is a rare to diagnose and treat.

Management of Genitourinary Fistulas Following Benign Gynecological and Obstetric Procedures: A Single Surgeon Experience.

BACKGROUND: Genitourinary fistula results in lot of anxiety in the suffering females. Scant literature regarding the comprehensive management of genitourinary fistula i.e. VVF and UVF is available. OBJECTIVE: The aim of the study was to review a single surgeon experience in dealing with these complex situations. MATERIAL AND METHODS: We conducted a retrospective, institutional review board approved chart review of patients who underwent genitourinary fistula repair from Jan 2014 till Dec 2019. Of all the fistulas VVF accounted for 18 and UVF for 12 cases. Pre-operative diagnosis in these patients was based predominantly on the history, local examination and cystoscopy. Of the 18 VVF 12 were managed laparoscopically and 6 by open O'Connor's repair. Of the 12 UVF, 8 were managed laparoscopically and 4 by open ureteric reimplants. All were followed up for three months post operatively. RESULTS: A total of 30 patients were treated since 2014 till December 2019. Average age for the VVF was 54.72 ≤ 10.9 years and that for UVF repair was 59.9 ≤ 7.6 years. Hysterectomies for benign diseases accounted for 66.66% of VVF and 91.6% of UVF. Of the VVF patients one required a ureteric reimplantation, remaining were managed with O'Connors' repair. We had one failure which was successfully repaired after 6 weeks. None of our patients with UVF repairs had a failure at three months follow-up. CONCLUSION: Genitourinary fistulas are a debilitating problem in females but a comprehensive approach regarding diagnosis and treatment can cure these patients.

Isolation, semi-synthesis, free-radicals scavenging, and advanced glycation end products formation inhibitory constituents from Parmotrema tinctorum.

Bioassay-guided separation of acetone extract from lichen Parmotrema tinctorum (Delise ex Nyl.) Hale led to the isolation of six major phenolic constituents (1-6). Compounds structures were established using NMR and mass spectral techniques. Further, to develop libraries on these scaffolds, a series of semi-synthetic derivatives were prepared (1a-1f, 2a-2b, 3a, 5a) and investigated for their free-radicals (2,2-diphenyl-1-picrylhydrazyl and 2,2'-azinobis(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS)) scavenging and advanced glycation end products (AGEs) formation inhibitory activities. Amongst tested derivatives, 1a, 1d, 1e, 2a, and 5a showed strong ABTS scavenging potentials comparable to Trolox. In addition, these derivatives also manifested moderate AGEs formation inhibitory activities. [Formula: see text].

Corrigendum to "Antidiabetic, antioxidant and antimicrobial activities of extracts of Tephrosia bracteolata leaves" [Heliyon 5 (8) (August 2019) e02275].

[This corrects the article DOI: 10.1016/j.heliyon.2019.e02275.].

Antidiabetic, antioxidant and antimicrobial activities of extracts of Tephrosia bracteolata leaves.

AIMS: Plant extracts have long been used for the ethnomedical treatment of diabetes, microbial infections and as a source of antioxidant. This study was aimed at investigating the antidiabetic, antioxidant, and antimicrobial activities of the n-hexane and ethyl acetate extract of Tephrosia bracteolata leaves (TBL) as associated with the ethnobotanical knowledge of the local people of Nigeria. MAIN METHODS: The phytochemical composition of the n-hexane and ethyl acetate extract of the leaves of T. bracteolata were determined following standard procedures in literature, and it's in vitro inhibitory activities against α-glucosidase enzyme. 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS.+) and 1,1-diphenyl-2-picrylhydrazyl (DPPH+) antioxidant activities were also examined. Well diffusion method was employed in evaluating the antimicrobial property of the extracts. KEY FINDINGS: The ethyl acetate extract of T. bracteolata leaves had the greatest inhibitory effect on α-glucosidase, followed by the n-hexane with IC50 43.95 µg/ml and IC50 ˃50 µg/ml respectively. The ethyl acetate also exhibited significant DPPH+ and ABTS.+ antioxidant activity with IC50 of 24.96 µg/ml and 6.48 µg/ml as compared to Ascorbic acid and Trolox (12.24 µg/ml and 5.91 µg/ml) respectively. The zones of inhibition of the ethyl acetate extract of T. bracteolata leaves ranges from 10 - 25 mm at a concentration of 6.25-200 mg/ml, and it showed a greater antibacterial activity than the n-hexane extract, having a zone of inhibition from 10 - 20 mm at concentration of 12.5-200 mg/ml when compared to the standard Gentamycin. Similarly, the ethyl acetate extract of T. bracteolata showed a better anti fungi activity at concentration range 12.5-200 mg/ml than the n-hexane extract at concentration range of 25-200 mg/ml with reference to Tioconazole. These results indicated for the first time that the ethyl acetate extract of T. bracteolata leaves extracts exerted potent inhibitory effects against α-glucosidase, actively scavenge DPPH+ and ABTS.+ free radicals and successfully inhibits the proliferation of Gram positive and Gram negative microorganism. SIGNIFICANCE: TBL is an important source of antidiabetic, antimicrobial and antioxidant agent.