Abstract Chocolate is a preferred food for children and adults. Micronutrient deficiencies are still prevalent worldwide. This study aims to manufacture and evaluate a type of sugar-free dark chocolate fortified with vitamins and minerals. Three types of chocolate were fortified with vitamin D3, vitamin B12, and iron and zinc. The fortified chocolate was evaluated in terms of chemical composition using FTIR and DSC methods, visco-mechanical, sensory and stability. The FTIR studies indicated that the spectrum of all fortified chocolates was similar to that of the control, unfortified chocolate. The DSC studies indicated that there were no characteristics differences in crystallinity and degree of crystallization between the fortified and the control products. The addition of vitamins and minerals to chocolate strengthened the structure, increased the melting point, didn’t cause significant variation in the rheological properties and had no significant effect on the overall sensation of the taste when compared with controlled chocolate. The stability results indicated that the fortified chocolate was stable for 9 months at room temperature. It was concluded that the fortified chocolate was a good vehicle for the vitamins and minerals with acceptable properties that may be used for supplementing vitamins and minerals.

Abstract The past two decades have witnessed prompt advances in aluminum alloy welding methods. Friction crush welding (FCW) has been recommended to be one of the key solutions to join these particular alloys with a range of plate thickness. This study aims to contribute to this welding technique by conducting several experiments to investigate the effect using three traverse speeds (120, 140, and 160 mm/min); and two rotational speeds (1400 and 1500 rpm) on the produces joint. These parameters were considered in a welding 1145 Aluminum sheets with 1mm thickness. The produced joints were evaluated using optical micrographs, micro-hardness, SEM, and tensile tests properties. The results showed that the best joint has 41 MPa tensile strength, 24 HV micro- hardness, and the best microstructure were obtained at 1400 rpm rotational speed and160 mm/min traverse speed.

Abstract Background: Social media can effectively mediate digital health interventions and thus, overcome barriers associated with face-to-face interaction. Objective: To assess the impact of patient-centered diabetes education program administered through WhatsApp on glycosylated hemoglobin (HbA1c) values, assess the correlation, if any, between health literacy and numeracy on intervention outcomes Methods: During an 'intervention phase' spread over six months, target diabetic patients (N=109) received structured education through WhatsApp as per the American Association of Diabetes Educators Self-Care Behaviors recommendations. The control group with an equal number of participants received 'usual care' provided by health professionals void of the social media intervention. Changes in HbA1c levels were recorded thrice (at baseline, 3 and 6 months) for the test group and twice (baseline and 6 months) for the control group. Change in HbA1c values were compared and statistical significance was defined at p<0.05. Baseline health literacy and diabetes numeracy were assessed for both groups (N=218) using the Literacy Assessment for Diabetes (LAD), and the Diabetes Numeracy Test (DNT), respectively, and values were correlated with HbA1c change p<0.05. Participants' satisfaction with the intervention was also assessed. Results: The average age of respondents was 41.98 (SD 15.05) years, with a diabetes history of 10.2 (SD 8.5) years. At baseline, the average HbA1c in the control and test groups were 8.4 (SD 1.06) and 8.5 (SD 1.29), respectively. After six months, a significant drop in HbA1c value was noticed in intervention group (7.7; SD 1.35; p= 0.001); with no significance in the control group (8.4; SD 1.32; p=0.032, paired t-test). Moreover, the reduction in HbA1c was more in the test group (0.7%) than the control group (0.1%) with a difference of 0.6% which is considered clinically significant. There was no significant correlation between LAD score and HbA1c at baseline (r=-0.203, p=0.064), 3 months (r=-0.123, p=0.266) and 6 months (r=-0.106, p= 0.337) Pearson correlation. A similar result was observed with DNT, where DNT score and HbA1c at baseline, 3 months and 6 months showed no correlation (r=0.112, 0.959 and 0.886; respectively) with HbA1c levels. Eighty percent of the respondents found the social media intervention 'beneficial' and suggested it be used long term. Conclusions: Diabetes education via WhatsApp showed promising outcomes regardless of the level of patients' health literacy or numeracy.

Abstract Objective: To clinically evaluate the retention and marginal discoloration of pit and fissure sealants applied to primary and permanent teeth. Material and Methods: The study population encompassed of 5-15 years-old children. After consenting, a light-curing sealant was applied to etched pits and fissures of occlusal surfaces of selected sound teeth. The retention rate and marginal discoloration were assessed, 3 months after application of the sealants based on the criteria proposed by Simonsen’s criteria (total retention: score 0, partial loss: score 1, and total loss: score 2). Each tooth was considered as an independent sample during analysis. Results: The achieved sample size was 43 children aged 5-15 years (mean age=10.0 years). Therefore, data of 100 teeth from 43 children were used for the final analysis. The percentage of completely retained sealants (59%) was higher than the percentage of partially retained sealants (23%) and completely missing sealants (18%) after 3 months follow up. Out of 100 sealed teeth, 60% were either had marginal discoloration or completely missing. Using the Mann-Whitney test, there was a statistically significant difference (p<0.05) between primary and permanent teeth in terms of retention. However, there was no statistical difference (p>0.05) between upper and lower teeth in terms of retention. Conclusion: The success rate of fissure sealants after 3 months follow-up was satisfactory.

Abstract Background: Hormonal contraceptive pills have evolved as a common form of contraception worldwide. Pharmacists play a vital role in providing safe and effective access to these medicines. In many developing countries such as the United Arab Emirates (UAE), these medicines are available to the general public without the presentation of a prescription which requires the pharmacist to shoulder responsibility by assessing and educating patients to assure their appropriate use. Objectives: To evaluate community pharmacists’ current practice of dispensing and counseling on hormonal contraceptives Methods: Simulated patient methodology was used in this study. A single simulated patient visited community pharmacies requesting an oral contraceptive as per a preplanned scenario. Information from the visits were recorded on a data collection form including: pharmacist assessing patient eligibility to take hormonal contraceptives, selecting the appropriate oral contraceptive, providing complete counseling on how to use the pill, adherence, missed dose handlings and side effects of the medication. The Pharmacist was prompted by the simulated patient to provide the information if they did not provide spontaneous counseling. The quality of pharmacists’ counseling was rated and consequently coded as complete, incomplete or poor. Results: A total of 201 community pharmacies were visited. More than 92% of the pharmacists did not ask the simulated patient any question to assess their eligibility to use contraceptives. Twenty three pharmacists (11.4%) selected the proper product. One hundred seventeen (58.2%) of the pharmacists provided spontaneous counseling on how to use the pill, 17 of them had their counsel rated as complete, but none of the pharmacists provided spontaneous counseling regarding adherence or side effects of the medications. On prompting, 10 pharmacists (12%) provided complete counseling regarding how to use oral contraceptives, 14 pharmacists (7.0%) provided complete counseling on adherence and missing dose handling and five pharmacists (2.5%) provided complete counseling about expected side effects. Conclusions: Pharmacists’ practice regarding hormonal contraceptive dispensing and counseling was suboptimal in this study. Areas needing intervention were related to pharmacist assessment of eligibility for oral contraceptive use, choice of optimal oral contraceptive for patient-specific co-morbidities and provision of adequate counseling regarding proper use, adherence and missed dose handlings.

ABSTRACT BACKGROUND: There is a paucity of research on knowledge/attitudes regarding the dangers of exposure to secondhand smoking (SHS) among women. The relationship between exposure to SHS, socioeconomic status (SES) and knowledge/attitudes regarding the risks of SHS has often been ignored. We therefore aimed to examine (1) whether SES and exposure to SHS were independently associated with knowledge/attitudes regarding the risks of SHS; and (2) whether women with low SES and exposure to SHS were uniquely disadvantaged in terms of deficient knowledge and more dismissive attitudes towards the risks of SHS. DESIGN AND SETTING: Cross-sectional study in the Rajshahi district, Bangladesh. METHODS: A total of 541 women were interviewed. Knowledge of and attitudes towards the risks of SHS were the outcomes of interest. RESULTS: A majority of the respondents were exposed to SHS at home (49.0%). Only 20.1% had higher levels of knowledge, and only 37.3% had non-dismissive attitudes towards the risks of SHS. Participants in the low SES group and those exposed to SHS had lower odds of higher knowledge and their attitudes towards the risks of SHS were more dismissive. Regarding deficient levels of knowledge and scores indicating more dismissive attitudes, women in the low SES group and who were exposed to SHS were not uniquely disadvantaged. CONCLUSIONS: Exposure to SHS and low SES were independently associated with deficient knowledge and scores indicating more dismissive attitudes. Regarding knowledge/attitudes, the negative effect of exposure to SHS extended across all socioeconomic backgrounds and was not limited to women in either the low or the high SES group.

RESUMO Fundamento: A doença intestinal inflamatória é um distúrbio intestinal idiopático, crônico e inflamatório devido ao estilo de vida que requer medicamentos de longo prazo e cuidados. Objetivo do estudo: Avaliar o nível de adiponectina na doença intestinal inflamatória não classificada e sua relação com diferentes parâmetros, como o perfil lipídico e o índice de massa corporal. Tipo de estudo: Estudo de caso controle. Pacientes e métodos: O número total de grupos de estudos foi de 60 indivíduos, quarenta deles eram pacientes com doença intestinal inflamatória não classificada e o restante era de indivíduos saudáveis controle. Os soros foram examinados para detecção de perfil lipídico (colesterol, triglicerídeos, HDLP, LDLP (Humano-Alemanha), adiponectina (Humano-Alemanha). Resultados: Adiponectina, colesterol, triglicerídeos, LDL e LDL/HDL foram significativamente maiores no grupo de pacientes. Os resultados mostraram que havia uma correlação negativa entre adiponectina e altura (r = -0.071), relação cintura-quadril (r =-0.174), colesterol (r = -0.417), HDL (r = -0.039), LDL (r = -0.451) enquanto que para outros parâmetros há uma correlação positiva. Conclusões: Doença intestinal inflamatória não classificada apresenta um nível aumentado de adiponectina que está positivamente associado a índice de massa corporal e triglicerídeos. Está negativamente correlacionada com altura, relação cintura-quadril, colesterol, HDL e LDL.

ABSTRACT Background: Inflammatory bowel disease (IBD) is a lifestyle idiopathic, chronic, and inflammatory intestinal disorders that required long-term medications and care. Aim of the study: Assess the level of adiponectin in IBDU and its relation with different parameters like lipid profile and Body Mass Index (BMI). Type of the study: A case-controlled study. Patients and methods: The total number of study groups was sixty individuals, forty of them were patients with inflammatory bowel disease unclassified and the rest were control healthy subjects. Serums were examined for lipid profile (cholesterol, triglyceride, HDLP, LDLP (Human-Germany), adiponectin (Human-Germany). Results: Adiponectin, cholesterol, triglyceride, LDL and LDL/HDL were significantly higher in patient group. The results showed that there was a negative correlation between adiponectin and height (r = -0.071), waist to hip ratio (r = -0.174), cholesterol (r = -0.417), HDL (r = -0.039), LDL (r = -0.451) while other parameters there are positive correlation. Conclusions: IBDU is associated with increased level of adiponectin which is positively associated with BMI and triglyceride. It is negatively correlation with height, waist to hip ratio, cholesterol, HDL and LDL.

ABSTRACT Acetaminophen (APAP) is a widely-used analgesic, while toxic doses of which induce liver injury. Inducible cyclooxygenase-2 (COX-2) is derived prostaglandins which play an anti-inflammatory role in acetaminophen-induced hepatotoxicity. Selective activation of vascular endothelial growth factor (VEGFR1, flt -1) on endothelial cells increased mRNA levels of hepatocyte mitogens (IL-6) and hepatocyte growth factor leading to prosurvival effects on hepatocytes. The aim of this study was to compare the hepatoprotective effect of N-acetylcysteine (NAC; the antidote for APAP) with that of α-Lipoic acid (ALA) and/or Thymoquinone (THQ) either alone or in combination on liver injury induced by APAP. APAP administration elevated most of the previously measured parameters and decreased GSH, SOD, and total protein levels compared with the control group. Liver sections of H&E demonstrate liver injury characterized by centrilobular hepatocellular necrosis, COX-2, and flt-1 expressions were also increased. Treatment with all fore mentioned antioxidants ameliorated most of the altered parameters compared to APAP-treated group. Treatment with the combination of ALA and THQ was the most effective therapy in the attenuation of liver injury assessed by a decrease in ALT and ALP activities and down-regulation of COX-2 and flt-1 expression. Section of liver from rat received APAP, ALA and THQ shows a marked improvement of hepatic degeneration which restricted to few hepatocytes with mild vacuolation of their cytoplasm while the nuclei appear normal mimic to control cells. It was concluded that the natural antioxidants such as ALA and THQ, may be considered as a potential antidote in combating liver injury induced by APAP.

Two tirucallane triterpenes, namely flindissol (1) and 3-oxotirucalla-7,24-dien-21-oic-acid (2), were isolated from the dichloromethane extract of the stem of Luvunga scandens (Roxb.) Buch-Ham ex Wight & Arn, Rutaceae. This is the first report of their isolation from this plant. Their structures were constructed by high resolution mass and 2D NMR spectroscopic data. The cytotoxic potential of the two pure compounds 1 and 2 were determined by MTT assay against human breast adenocarcinoma cell line (MCF-7). Compounds 1 and 2 showed potent cytotoxicity against MCF-7 cell line with IC50 values of 13.8 μM and 27.5 μM, respectively. This result suggested their potential activity as antitumor agents.

In tropical countries like Bangladesh, persons are bitten by snakes every day and a considerable number of patients die en route to the hospital. An event of consecutive neurotoxic bites on two men by a single snake was observed in the Snake Bite Study Clinic (SBSC) of the Chittagong Medical College Hospital (CMCH). Two brothers, working in their semi-pucca restaurant, were successively bitten by the same cobra on their lower limbs. Within an hour, they were taken to the CMCH. Few minutes after admission, both developed symptoms of neurotoxicity: ptosis, nasal voice, dysphagia, broken neck sign, etc. They received polyvalent antivenom (Haffkine Bio-Pharmaceuticals Company, India) and other auxiliary treatment immediately. Within few hours, neurotoxic features were completely absent. Later, the snake was captured in the restaurant kitchen and identified as monocellate cobra (Naja kauthia) by the SBSC. The elder brother developed significant antivenom reactions and both presented necrosis and ulceration at the bite sites. In these cases, immediate arrival to the hospital and early administration of antivenom resulted in successful recoveries.