Objective:To study the antidiabetic and antioxidant activities of nipa palm vinegar (NPV) used in traditional Malay medicine for treating diabetes.Methods:NPV was extracted using liquid-liquid extraction method and the obtained samples were subjected to antidiabetic studies using normal and streptozotocin-induced diabetic rat models whereas antidoxidant activities were investigated viain vitroantioxidant tests namely 2,2-diphenyl-1-picrylhydrazyl and 2,2’-azinobis-3-ethylbenzothiozoline-6-sulfonic acid free radicals scavenging activities and the reducing power assay.Results:Single administration of NPV and its extracts were not effective in both normal and diabetic rats. In intraperitoneal glucose tolerance test, NPV and its aqueous extract showed significant blood glucose lowering effect. In the sub-acute study, compared with the diabetic control, aqueous extract of NPV showed the most notable blood glucose lowering effect (56.6%) and a significant improvement in serum insulin levels (79.8%, P<0.05). To assess NPV’s antioxidant activity, threein vitro antioxidant tests were employed:2,2-diphenyl-1-picryhydrazyl and 2,2’-azinobis-3-ethylbenzothiozoline-6-sulfonic acid free radical-scavenging assays, and the reducing power assay. Ethyl acetate extract had the greatest antioxidant potential and content of phenolic and flavonoid compounds. A linear positive correlation between the antioxidant parameters was observed. Chemical profiling analysis of aqueous extract of NPV revealed the presence of acetic acid (35.25%), the main active constituent which significantly contributed to the observed antidiabetic activity.Conclusions:Aqueous extract of NPV possesses antihyperglycaemic activities comparable to the metformin, while the ethyl acetate extract precipitated significant antioxidant effects attributable to its high phenolic content. These findings suggest that antioxidant compounds of NPV do not contribute much towards the overall observed antidiabetic effect.

BACKGROUND: Early diagnosis is the cornerstone of management of acute myocardial infarction (AMI). We aimed to compare the diagnostic accuracy of high-sensitivity troponin T (hs-cTnT) with myeloperoxidase (MPO) and pregnancy-associated plasma protein A (PAPP-A) for early diagnosis of AMI in patients at the time of presentation to the emergency department (ED). METHODS: We enrolled 289 patients who presented at the ED of the National Institute of Heart Disease (NIHD) Rawalpindi, Pakistan, within 4 hr of onset of chest pain. Clinical assessment, electrocardiography (ECG), and angiography were carried out. Blood samples were collected at 0, 3, 6, and 12 hr. Analyses of plasma hs-cTnT, MPO, and PAPP-A were carried out using commercial kits. RESULTS: Out of 289 subjects who presented to the ED, we diagnosed 180 patients with coronary heart disease as having AMI (N=61) and 119 as without AMI (stable coronary artery disease, N=61; unstable angina, N=58). Compared to non-AMI patients, the patients with AMI had significantly higher levels (represented here as median [inter quartile range]) of plasma hs-cTnT (136 [39-370] vs. 12 [7-21] ng/L), MPO (906 [564-1,631] vs. 786 [351-1,299] pmol/L) and PAPP-A (5.78 [2.67-13.4] vs. 2.8 [1.8-4.9] mIU/L). Receiver operator characteristic curves (95% CI) for hs-cTnT (0.952 [0.909-0.978]) were significantly higher (P<0.001) than those for MPO (0.886 [0.830-0.929]) and PAPP-A (0.797 [0.730-0.854]), with AMI sensitivity and specificity percentages of 87% and 98% (hs-cTnT), 82% and 84% (MPO), and 65% and 87% (PAPP-A), respectively. CONCLUSIONS: The diagnostic performance of hs-cTnT was superior to that of MPO and PAPP-A for early triage and diagnosis of AMI among patients of coronary heart disease presenting with chest pain to the ED.
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Biological Markers/blood ; Coronary Angiography ; Early Diagnosis ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/blood/*diagnosis/radiography ; Peroxidase/*blood ; Pregnancy-Associated Plasma Protein-A/*analysis ; ROC Curve ; Time Factors ; Triage ; Troponin T/*blood

BACKGROUND: Early diagnosis is the cornerstone of management of acute myocardial infarction (AMI). We aimed to compare the diagnostic accuracy of high-sensitivity troponin T (hs-cTnT) with myeloperoxidase (MPO) and pregnancy-associated plasma protein A (PAPP-A) for early diagnosis of AMI in patients at the time of presentation to the emergency department (ED). METHODS: We enrolled 289 patients who presented at the ED of the National Institute of Heart Disease (NIHD) Rawalpindi, Pakistan, within 4 hr of onset of chest pain. Clinical assessment, electrocardiography (ECG), and angiography were carried out. Blood samples were collected at 0, 3, 6, and 12 hr. Analyses of plasma hs-cTnT, MPO, and PAPP-A were carried out using commercial kits. RESULTS: Out of 289 subjects who presented to the ED, we diagnosed 180 patients with coronary heart disease as having AMI (N=61) and 119 as without AMI (stable coronary artery disease, N=61; unstable angina, N=58). Compared to non-AMI patients, the patients with AMI had significantly higher levels (represented here as median [inter quartile range]) of plasma hs-cTnT (136 [39-370] vs. 12 [7-21] ng/L), MPO (906 [564-1,631] vs. 786 [351-1,299] pmol/L) and PAPP-A (5.78 [2.67-13.4] vs. 2.8 [1.8-4.9] mIU/L). Receiver operator characteristic curves (95% CI) for hs-cTnT (0.952 [0.909-0.978]) were significantly higher (P<0.001) than those for MPO (0.886 [0.830-0.929]) and PAPP-A (0.797 [0.730-0.854]), with AMI sensitivity and specificity percentages of 87% and 98% (hs-cTnT), 82% and 84% (MPO), and 65% and 87% (PAPP-A), respectively. CONCLUSIONS: The diagnostic performance of hs-cTnT was superior to that of MPO and PAPP-A for early triage and diagnosis of AMI among patients of coronary heart disease presenting with chest pain to the ED.
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Biological Markers/blood ; Coronary Angiography ; Early Diagnosis ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/blood/*diagnosis/radiography ; Peroxidase/*blood ; Pregnancy-Associated Plasma Protein-A/*analysis ; ROC Curve ; Time Factors ; Triage ; Troponin T/*blood

Objective: This study aimed to compare the predicted and achieved labiolingual inclinations of the maxillary central incisors in adult Class II division 2 malocclusions treated with clear aligners using Power Ridges® and composite attachments. Methods: This retrospective study included 24 patients (mean age, 26.5 ± 3.3 years). The patients had Class II division 2 malocclusion and were treated with non-extraction with Invisalign® clear aligners with either Power Ridges® or composite attachments to enhance the predictability of required change in labiolingual inclination for the maxillary central incisors.Before treatment, treatment prediction and final digital models were exported as stereolithography files and superimposed using the eModel 9.0 “Compare” software. The predicted and achieved labiolingual incisor inclinations were compared. Results: The mean accuracies of the achieved inclination of the central incisors were 68.3% in the Power Ridges® group and 71.6% in the attachments group. No statistically significant differences in predictability were found between the groups (P > 0.05). A low positive correlation was observed between the predicted inclination change and the average absolute difference between the predicted and achieved inclinations (r = 0.19). Conclusions Predicted labiolingual inclination is not fully achieved with clear aligners in both the Power Ridges® and attachment groups. Clinicians must take measures to counteract this limitation, specifically in Class II division 2 cases.

Objective: This study aimed to compare the predicted and achieved labiolingual inclinations of the maxillary central incisors in adult Class II division 2 malocclusions treated with clear aligners using Power Ridges® and composite attachments. Methods: This retrospective study included 24 patients (mean age, 26.5 ± 3.3 years). The patients had Class II division 2 malocclusion and were treated with non-extraction with Invisalign® clear aligners with either Power Ridges® or composite attachments to enhance the predictability of required change in labiolingual inclination for the maxillary central incisors.Before treatment, treatment prediction and final digital models were exported as stereolithography files and superimposed using the eModel 9.0 “Compare” software. The predicted and achieved labiolingual incisor inclinations were compared. Results: The mean accuracies of the achieved inclination of the central incisors were 68.3% in the Power Ridges® group and 71.6% in the attachments group. No statistically significant differences in predictability were found between the groups (P > 0.05). A low positive correlation was observed between the predicted inclination change and the average absolute difference between the predicted and achieved inclinations (r = 0.19). Conclusions Predicted labiolingual inclination is not fully achieved with clear aligners in both the Power Ridges® and attachment groups. Clinicians must take measures to counteract this limitation, specifically in Class II division 2 cases.

Objective: This study aimed to compare the predicted and achieved labiolingual inclinations of the maxillary central incisors in adult Class II division 2 malocclusions treated with clear aligners using Power Ridges® and composite attachments. Methods: This retrospective study included 24 patients (mean age, 26.5 ± 3.3 years). The patients had Class II division 2 malocclusion and were treated with non-extraction with Invisalign® clear aligners with either Power Ridges® or composite attachments to enhance the predictability of required change in labiolingual inclination for the maxillary central incisors.Before treatment, treatment prediction and final digital models were exported as stereolithography files and superimposed using the eModel 9.0 “Compare” software. The predicted and achieved labiolingual incisor inclinations were compared. Results: The mean accuracies of the achieved inclination of the central incisors were 68.3% in the Power Ridges® group and 71.6% in the attachments group. No statistically significant differences in predictability were found between the groups (P > 0.05). A low positive correlation was observed between the predicted inclination change and the average absolute difference between the predicted and achieved inclinations (r = 0.19). Conclusions Predicted labiolingual inclination is not fully achieved with clear aligners in both the Power Ridges® and attachment groups. Clinicians must take measures to counteract this limitation, specifically in Class II division 2 cases.

Diaphragmatic fibromatosis is an exceptionally rare condition, with only 2 previously reported cases in the literature. We present the case of a 23-year-old woman with a left hypochondrial swelling measuring 19×18×13 cm on computed tomography. An endoscopic ultrasound-guided biopsy indicated low-grade papillary proliferation. Surgical exploration revealed a large mass originating from the left hemidiaphragm. Complete excision of the mass and reconstruction of the diaphragm with double-layer mesh were performed.Microscopic examination of the mass revealed a bland-looking spindle cell proliferation.Immunohistochemical staining showed a positive nuclear reaction in tumor cells for β-catenin, a focal positive reaction for SMA, and negative reactions for S100, CD34, and desmin.Diaphragmatic fibromatosis is an extremely rare tumor for which complete excision and reconstruction of the diaphragm is the best suggested modality of treatment.

Diaphragmatic fibromatosis is an exceptionally rare condition, with only 2 previously reported cases in the literature. We present the case of a 23-year-old woman with a left hypochondrial swelling measuring 19×18×13 cm on computed tomography. An endoscopic ultrasound-guided biopsy indicated low-grade papillary proliferation. Surgical exploration revealed a large mass originating from the left hemidiaphragm. Complete excision of the mass and reconstruction of the diaphragm with double-layer mesh were performed.Microscopic examination of the mass revealed a bland-looking spindle cell proliferation.Immunohistochemical staining showed a positive nuclear reaction in tumor cells for β-catenin, a focal positive reaction for SMA, and negative reactions for S100, CD34, and desmin.Diaphragmatic fibromatosis is an extremely rare tumor for which complete excision and reconstruction of the diaphragm is the best suggested modality of treatment.

Objective: This study aimed to compare the predicted and achieved labiolingual inclinations of the maxillary central incisors in adult Class II division 2 malocclusions treated with clear aligners using Power Ridges® and composite attachments. Methods: This retrospective study included 24 patients (mean age, 26.5 ± 3.3 years). The patients had Class II division 2 malocclusion and were treated with non-extraction with Invisalign® clear aligners with either Power Ridges® or composite attachments to enhance the predictability of required change in labiolingual inclination for the maxillary central incisors.Before treatment, treatment prediction and final digital models were exported as stereolithography files and superimposed using the eModel 9.0 “Compare” software. The predicted and achieved labiolingual incisor inclinations were compared. Results: The mean accuracies of the achieved inclination of the central incisors were 68.3% in the Power Ridges® group and 71.6% in the attachments group. No statistically significant differences in predictability were found between the groups (P > 0.05). A low positive correlation was observed between the predicted inclination change and the average absolute difference between the predicted and achieved inclinations (r = 0.19). Conclusions Predicted labiolingual inclination is not fully achieved with clear aligners in both the Power Ridges® and attachment groups. Clinicians must take measures to counteract this limitation, specifically in Class II division 2 cases.

Diaphragmatic fibromatosis is an exceptionally rare condition, with only 2 previously reported cases in the literature. We present the case of a 23-year-old woman with a left hypochondrial swelling measuring 19×18×13 cm on computed tomography. An endoscopic ultrasound-guided biopsy indicated low-grade papillary proliferation. Surgical exploration revealed a large mass originating from the left hemidiaphragm. Complete excision of the mass and reconstruction of the diaphragm with double-layer mesh were performed.Microscopic examination of the mass revealed a bland-looking spindle cell proliferation.Immunohistochemical staining showed a positive nuclear reaction in tumor cells for β-catenin, a focal positive reaction for SMA, and negative reactions for S100, CD34, and desmin.Diaphragmatic fibromatosis is an extremely rare tumor for which complete excision and reconstruction of the diaphragm is the best suggested modality of treatment.