Background: Thyroid hormones (THs) regulate growth, development and function of different tissues. Hypothyroidism is a common clinical disorder characterized by deficiency in THs and adversely affects the development and functions of several organs. This work aimed to investigate the ameliorative effect of eltroxin (ELT), a hypothyroidism medication, and hesperidin (HSP), a flavonoid, against testicular and renal toxicity in hypothyroid rats. Twenty-four rats were divided into four groups and treated orally for 12 weeks. Group I (control), group II (hypothyroidism) received 20 mg/kg carbimazole (CBZ), group III received CBZ and 0.045 mg/kg ELT, and group IV received CBZ and 200 mg/kg HSP. Results: CBZ administration induced biochemical and histopathological changes in testis and kidney. Co-administration of ELT or HSP significantly (P < 0.05) ameliorated THs, reduced urea and creatinine while raised follicle stimulating hormone (FSH), Luteinizing hormone (LH), and testosterone in serum. Testicular and renal malondialdehyde level as a lipid peroxidation indicator, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were significantly (P < 0.05) decreased while glutathione content, glutathione peroxidase, and glutathione-s-transferase activities were significantly (P < 0.05) increased. The histopathological changes were also diminished. Decreased mRNA and protein expressions of nuclear factor erythroid 2–related factor 2 (Nrf2), heme oxygenase-1 (HO-1), and peroxisome proliferator-activated receptor gamma(PPARγ) in hypothyroid rats were up-regulated after ELT or HSP treatment. Conclusions ELT and HSP showed antioxidant and anti-inflammatory effects against CBZ-induced testicular and renal toxicity, and these effects may be promoted via activating Nrf2/HO-1 and PPARγ signaling pathways.

Objective: To analyze how Pilates exercises affect standing, walking, and balance in children with diplegic cerebral palsy throughout a 10-week program. Methods: We included 40 children aged 7–9 years with diplegic cerebral palsy, and randomly allocated them into two groups of the same size: conventional therapy group (group A) and conventional therapy+Pilates group (group B). We administered the same conventional physical therapy program to both groups for 45 minutes, with group B receiving additional Pilates exercises for 45 minutes. Both groups attended the intervention program three times/week for 10 weeks. We used the Growth Motor Function Measure Scale (GMFM-88) to evaluate standing and walking (Dimensions D and E), and the Pediatric Balance Scale to evaluate balance function before and after treatment. Results: Comparison of the average values of all measured variables before and after therapy showed a statistically significant difference (p<0.05) between the two groups. All measured variables showed a significant difference between groups A and B, in favor of group B (p<0.05). Conclusion Pilates exercise in addition to conventional therapy is more effective in improving balance and gross motor function in children with diplegic cerebral palsy than the conventional therapy alone.

Purpose: This study aims to investigate the safety, efficacy and feasibility of sutureless trabeculectomy using a porous collagen matrix that contains a connected porous structure (Ologen) in the control of intraocular pressure (IOP) in glaucoma patients . Methods: The study includes 25 eyes from 24 patients that met the inclusion criteria. All eyes underwent trabeculectomy with the Ologen implant that provides a space with a dynamic and physiological aqueous reservoir system. The operation was considered successful if IOP is <15 mmHg without need of IOP-lowering drops at 18 months of follow-up. Results: The target IOP was achieved in 21 out of the 25 eyes (84%), the remaining four eyes all had an IOP of 16 mmHg at 18 months. Short-term complications consisted of seven cases of bleb leakage treated with bandage contact lens and one case of mild choroidal effusion which resolved after observation alone. Conclusions We can conclude that this technique can provide safety, effectiveness and short learning curve for ophthalmology trainees with lower incidence of perioperative and postoperative complications. Further studies may be required to prove stability and long-term efficacy in management of glaucoma patients.

Purpose: This study aims to investigate the safety, efficacy and feasibility of sutureless trabeculectomy using a porous collagen matrix that contains a connected porous structure (Ologen) in the control of intraocular pressure (IOP) in glaucoma patients . Methods: The study includes 25 eyes from 24 patients that met the inclusion criteria. All eyes underwent trabeculectomy with the Ologen implant that provides a space with a dynamic and physiological aqueous reservoir system. The operation was considered successful if IOP is <15 mmHg without need of IOP-lowering drops at 18 months of follow-up. Results: The target IOP was achieved in 21 out of the 25 eyes (84%), the remaining four eyes all had an IOP of 16 mmHg at 18 months. Short-term complications consisted of seven cases of bleb leakage treated with bandage contact lens and one case of mild choroidal effusion which resolved after observation alone. Conclusions We can conclude that this technique can provide safety, effectiveness and short learning curve for ophthalmology trainees with lower incidence of perioperative and postoperative complications. Further studies may be required to prove stability and long-term efficacy in management of glaucoma patients.

The NS2B/NS3 protease is crucial for the pathogenesis of the DENV. Therefore, the inhibition of this protease is considered to be the key strategy for the development of new antiviral drugs. In the present study, malabaricones C (3) and E (4), acylphenols from the fruits of Myristica cinnamomea King, have been respectively identified as moderate (27.33 ± 5.45 μM) and potent (7.55 ± 1.64 μM) DENV-2 NS2B/NS3 protease inhibitors, thus making this the first report on the DENV-2 NS2B/NS3 protease inhibitory activity of acylphenols. Based on the molecular docking studies, compounds 3 and 4 both have π-π interactions with Tyr161. While compound 3 has hydrogen bonding interactions with Gly151, Gly153 and Tyr161, compound 4 however, forms hydrogen bonds with Ser135, Asp129, Phe130 and Ile86 instead. The results from the present study suggests that malabaricones C (3) and E (4) could be employed as lead compounds for the development of new dengue antivirals from natural origin.

Through the regional control programme, Malaysia has been successfully reducing the incidence of Plasmodium falciparum and Plasmodium vivax infections. However, the incidence of zoonotic malaria Plasmodium knowlesi infection is increasing and now has been the major cause of malaria in Malaysia especially Malaysian Borneo. The emergence of knowlesi infection has threatened the malaria elimination programme which the government aims to reduce the overall malaria infections by 2020. Unlike other benign human Plasmodium spp., P. knowlesi can cause fatal infections. The aim of this study was to determine the incidence and distribution of five human malaria parasites including P. knowlesi in Peninsular Malaysia and Malaysian Borneo. A total of 112 blood samples were collected from seven states and district hospitals in Peninsular Malaysia and Malaysian Borneo from year 2015 to 2016. The samples were examined by microscopy and further confirmed by nested PCR assay targeting 18S rRNA gene of Plasmodium spp. Following the nested PCR assays, a total of 54 (48.2%) samples were positive for P. knowlesi infections, 12 (10.7%) cases were positive for P. vivax infections, followed by 7 (6.3%) cases of P. falciparum and 4 (3.5%) cases of P. malariae. There were 3 cases (2.7%) of mixed infections (P. knowlesi/P. vivax). However, no cases were identified as P. ovale. A total of 32 (28.6%) cases were found as negative infections. LoopMediated Isothermal Amplification Assay (LAMP) was performed to confirm inconclusive results produced by microscopy and nested PCR. P. knowlesi showed the highest prevalence in Sarawak (n= 30), Sabah (n=13), Pulau Pinang (n=5) and Pahang (n=6). PCR and LAMP was not able to detect a large number of microscopy positive samples due to DNA degradation during storage and shipping. Among all the states involved in this study, the highest prevalence of P. knowlesi infection was found in Sabah and Sarawak.

Endometriosis is a chronic debilitating inflammatory condition characterized by the presence of endometrial tissues outside the uterine cavity. Pelvic soreness and infertility are the usual association. Due to the poor effectiveness of the hormone therapy and the high incidence of recurrence following surgical excision, there is no single effective option for management of endometriosis. Mesenchymal stem cells (MSCs) are multipotent stromal cells studied for their broad immunoregulatory and anti-inflammatory properties; however, their efficiency in endometriosis cases is still a controversial issue. Our study aim was to evaluate whether adipose tissue-derived MSCs (AD-MSCs) could help with endometriosis through their studied anti-inflammatory role. Methods: Female Wistar rats weighting 180 to 250 g were randomly divided into two groups: group 1, endometriosis group; established by transplanting autologous uterine tissue into rats’ peritoneal cavities and group 2, stem cell treated group; treated with AD-MSCs on the 5th day after induction of endometriosis. The proliferative activity of the endometriosis lesions was evaluated through Ki67 staining. Quantitative estimation of interferon γ, tumor necrosis factor-α, interleukin (IL)-6, IL-1β, IL-10, and transforming growth factor β expression, as well as immunohistochemical detection of CD68 positive macrophages, were used to assess the inflammatory status. Results: The size and proliferative activity of endometriosis lesions were significantly reduced in the stem cell treated group. Stem cells efficiently mitigated endometriosis associated chronic inflammatory reactions estimated through reduction of CD68 positive macrophages and the expression of the proinflammatory cytokines. Conclusion: Stem cell therapy can be considered a novel remedy in endometriosis possibly through its anti-inflammatory and antiproliferative properties.

Objective: Dural arteriovenous fistula (DAVF) is a rare pathological vascular lesion with variable clinical manifestations. Since 1968, several articles have been published to address spinal and cranial DAVFs. The aim of this study is to identify, analyse, and review the pertinent literature of the top-100 most cited articles on DAVFs published to date. Methods: A title-specific, keyword-based search with no time restriction was performed in June 2020. The Scopus database was used to identify the top-100 most cited articles on DAVFs. The term “dural arteriovenous fistula” was used as a search keyword. The search results were arranged in descending order based on the total citation count. The top-100 articles were categorized into ten categories. Results: Between 1968 and 2020, a total of 2298 articles were published on DAVFs. The top-100 most cited articles were published between 1983 and 2012. The total number of citations for the top-100 articles was 12393 (123 citations/article). Most articles (34%) were investigating the clinical aspect of DAVFs. The country contributing to the most impactful and highest volume of publications (46%) was the United States. The Mayo Clinic was the most active institute in contribution. Most articles (29%) were published by the Journal of Neurosurgery. Conclusions In the top-100 most cited articles on DAVF, most studies were published in neurosurgeryeuroradiology-dedicated journals. This bibliometric analysis identifies the publication trends and provides a comprehensive overview of the most influential articles addressing DAVFs.

Objective: Dural arteriovenous fistula (DAVF) is a rare pathological vascular lesion with variable clinical manifestations. Since 1968, several articles have been published to address spinal and cranial DAVFs. The aim of this study is to identify, analyse, and review the pertinent literature of the top-100 most cited articles on DAVFs published to date. Methods: A title-specific, keyword-based search with no time restriction was performed in June 2020. The Scopus database was used to identify the top-100 most cited articles on DAVFs. The term “dural arteriovenous fistula” was used as a search keyword. The search results were arranged in descending order based on the total citation count. The top-100 articles were categorized into ten categories. Results: Between 1968 and 2020, a total of 2298 articles were published on DAVFs. The top-100 most cited articles were published between 1983 and 2012. The total number of citations for the top-100 articles was 12393 (123 citations/article). Most articles (34%) were investigating the clinical aspect of DAVFs. The country contributing to the most impactful and highest volume of publications (46%) was the United States. The Mayo Clinic was the most active institute in contribution. Most articles (29%) were published by the Journal of Neurosurgery. Conclusions In the top-100 most cited articles on DAVF, most studies were published in neurosurgeryeuroradiology-dedicated journals. This bibliometric analysis identifies the publication trends and provides a comprehensive overview of the most influential articles addressing DAVFs.