Introduction. Although sulfonamide antibiotics are potent antimicrobial agents against bacterial infections, their water insolubility and toxicity at high doses limit their therapeutic efficacy. This study explores a potent anti-infection drug-delivery system using gold nanoparticles (gNPs) capped with ovotransferrin (OTf) as a targeting carrier and solubilising agent for sulfamethoxazole (SMZ) antibiotic. Materials and methods. The OTf was conjugated with sulfamethoxazole OTf(SMZ) at pH 9.0 for 24 h at 29°C. The conjugate (OTf(SMZ)) or free OTf was added to the gold chloride solution containing sodium citrate as a reducing agent, and then stirred for 24 h at 37˚C. The gold nanoparticle (GNP) formulations were purified by gel filtration. The gNP formulations and their individual components (free OTf, SMZ, and gNP tested separately) were evaluated against several microbial strains, including drug-resistant Salmonella, and against bacteria that infect human cells intracellularly. Results. The gold nanoparticle capped with OTf loaded with SMZ [OTf(SMZ)-gNP] showed superior microbicidal activity against several bacterial strains and the fungi Candida albicans compared to the activities of gNP capped with OTf alone [OTf-gNP] or the individual agents. The wild-type Salmonella enteritidis, which encodes the multidrug efflux channel TolC, becomes susceptible to both OTf(SMZ)-gNP and OTf-gNP nano-formulation but not to their separate components. However, the tolC-knockout Salmonella enteritidis mutant strain was susceptible only to the OTf(SMZ)-gNP, indicating the ability of this nanoformulation to deliver the antibiotic SMZ into bacterial cells through self-promoted uptake. The OTf(SMZ)-gNP efficiently killed pathogens intracellularly infecting human colon carcinoma cells. Conclusions. The results demonstrate that OTf(SMZ)-gNP nanomaterials can mediate the endocytosis of SMZ, making them suitable for targeting bacterial infections, including those that have acquired antibiotic resistance. The study highlights the potential of OTf-capped nanomaterials that can be engineered to enhance the potency of hydrophobic antibiotics for treating infectious diseases.

A healthy lifestyle is recommended for every person with type 1 diabetes. Unfortunately, the incidence of type 1 diabetes is steadily increasing. Many studies confirm that maintaining a balanced diet or incorporating physical activity helps to maintain good health over the long term. It helps to balance the diabetes metabolically and to prevent the development of excessive body weight. Making appropriate lifestyle modifications, as recommended by researchers and associations, will undoubtedly help with this. This study aims to analyse the impact of a healthy lifestyle, including a balanced diet, sleep hygiene, psychological conditions, insulin therapy and physical activity, on metabolic control and the prevention of excess body weight in patients with type 1 diabetes. The introduction and alignment of the described components in patients with type 1 diabetes contribute to better metabolic control of the disease and reduce the risk of excessive body weight.

Obesity in children, especially those with cancer, is a growing concern due to its impact on health outcomes. These children are at increased risk for neurological, renal, and cardiovascular complications, which can worsen their prognosis. This systematic review aims to examine the role of obesity in the development of these complications in children with cancer, highlighting the associated cardiovascular risk factors. A comprehensive literature search was conducted across databases such as PubMed, Scopus, Web of Science, Embase, and Google Scholar for studies published between 2014 and 2025. Eligible studies included interventional, cohort, case-control, and observational studies that examined the impact of cancer treatments on neurological and renal outcomes in obese pediatric patients. The review followed PRISMA guidelines to ensure methodological rigor, with quality assessment using validated tools such as the Newcastle-Ottawa Scale and STROBE checklist. Thirteen studies involving 14,723 participants met the inclusion criteria. Obesity was associated with poorer survival outcomes, particularly in children with ALL and CNS tumors, showing lower EFS and OS rates. Obese children undergoing chemotherapy had higher incidences of treatment-related toxicities, including hepatotoxicity, nephrotoxicity, and thrombotic events. Renal complications, including acute kidney injury and electrolyte imbalances, were more prevalent in obese patients. Obesity also increased cardiovascular risk, with higher rates of hypertension and insulin resistance. Additionally, it contributed to neurocognitive impairments and poor psychosocial outcomes. Lastly, obesity affected growth trajectories, with many survivors remaining obese long-term. Early weight management and personalized treatment strategies are crucial to mitigate these risks. Addressing obesity in pediatric cancer care is essential to improve treatment outcomes and long-term survivorship, with further research needed to develop effective interventions.

Introduction. The gut-brain axis is considered to be a crucial component of mental health, significantly influenced by the gut microbiota. This axis operates through neural (vagal nerve), hormonal (Hypothalamic-Pituitary-Adrenal axis), and immune pathways. Key mechanisms include microbial production of neurotransmitters like serotonin and gamma-aminobutyric acid, modulation of inflammatory responses and metabolic pathways involving short-chain fatty acids. Dysbiosis - a microbial imbalance - is associated with increased inflammation and neurotransmitter disruptions, both contributing to depressive symptoms.Material and methods. The search strategy was centered on gathering high-quality articles focusing on the gut-brain axis and its implications for mental health, particularly depression. Databases including PubMed, Scopus, and Google Scholar were searched using keywords such as "gut-brain axis," "microbiota and mental health," "depression and gut microbiome," "gut neurotransmitters," "probiotics," and "inflammation and mood disorders." Studies were selected with a focus on research published mainly within the last two years.Results. Potential interventions, such as administration of probiotics, prebiotics, dietary modifications, and innovative therapies like fecal microbiota transplantation and vagus nerve stimulation intend to restore the gut microbiota equilibrium.Conclusions. Despite the limitations of current research, such as reliance on animal models, small human sample sizes, and methodological inconsistencies, expanding these studies remains highly valuable. Conducting large-scale human trials with standardized protocols and deeper exploring the interactions of specific microbial species could create a foundation for new approaches to supporting the treatment of depression effectively.

Introduction. Heart failure is a diverse life-threatening condition with complex biology and demanding therapeutic goals. Even when anemic patients are excluded, up to 59% of heart failure patients have low ferritin levels, making them especially vulnerable to iron deficiency. We aim to explore the benefits and safety of intravenous iron therapy among patients with heart failure and iron deficiency. Material and methods. We have searched the literature on PubMed (MEDLINE), Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science (WoS), and EMBASE until 31st August, 2023. We used RevMan V. 5.4 to pool dichotomous data using a risk ratio (RR) with a 95% confidence interval (CI). This review has been registered and published in PROSPERO (CRD42023471419) Results. Fourteen randomized controlled trials with 6,626 patients were included. The intravenous iron group was favored over the control group in reducing hospital admissions for heart failure (first event) (RR= 0.83, 95% CI 0.71 to 0.97; p = 0.02) and (total events) (RR= 0.81, 95% CI 0.74 to 0.89; p < 0.0001). Also, the iron group had a 21% lower risk in terms of cardiovascular death and hospital admission for heart failure (number of events, rate per 100 patients in a year) (RR= 0.79, 95% CI 0.74 to 0.85; p < 0.00001). Concerning the adverse events, both ferric carboxymaltose and ferric derisomaltose showed a beneficial effect in reducing the cardiac disorder (RR= 0.81, 95% CI 0.76 to 0.87; p <0.0001), and (RR= 0.82, 95% CI 0.71 to 0.95; p = 0.009), respectively. Conclusions. Intravenous iron infusion in patients with heart failure has a favorable safety profile. It reduces total hospitalizations for heart failure and cardiovascular mortality, with no effect on all-cause mortality, cardiovascular mortality alone, or first-time hospitalization for heart failure.

Clove, the dried flower bud of the Syzygium aromaticum tree, has been used for thousands of years in traditional medicine for its medicinal properties. One of the most well-known properties of clove is its antimicrobial activity attributed to a compound called eugenol. Eugenol has been found to be effective against a wide range of microorganisms, including bacteria, viruses, fungi, and parasites. In addition to its antimicrobial activity, clove has also been found to have anti-inflammatory, antioxidant, and pain-relieving properties. These properties make it an ideal natural remedy for a wide range of conditions, including toothaches, sore throat, and skin infections. With this background a systematic review was conducted wherein we explored the articles relevant to the research questions through databases like PubMed, Scopus, Web of Science, etc. Out of 150 articles explored, 30 were selected through online and snowballing literature searches. Out of these, 19 were original research articles, 8 systematic reviews, and 3 books/online resources . The selected articles were further assessed on quality reporting. In the current scenario of increasing prevalence of bacterial infections and emergence of multidrug resistant strains it is essential to explore alternative options like herbal antimicrobials to combat this problem.

Rumah sakit sebagai lembaga sosial bertujuan untuk memberikan pelayanan kesehatan yang bermutu kepada setiap masyarakat. Untuk memenuhi standar pelayanan yang bermutu rumah sakit harus membelanjakan Obat dan Bahan Medis Habis Pakai (BMHP) secara bijak sehingga menghasilkan kinerja yang baik. Penelitian ini bertujuan untuk membandingkan tingkat efektivitas dan efisiensi realisasi belanja Obat dan Bahan Medis Habis Pakai (BMHP) terhadap Jumlah Kunjungan Pasien Tahun 2021 dan 2022 pada BLUD RSUD dr. Zainoel Abidin. Penelitian ini menggunakan metode analisis deskriptif dengan teknik pengumpulan data sekunder berupa catatan atau dokumentasi, penelitian kepustakaan dan publikasi pemerintah dari Laporan Realisasi Anggaran berupa belanja obat-obatan dan belanja Bahan Medis Habis Pakai (BMHP), serta kunjungan pasien yang dianalisa menggunakan perhitungan rasio efektivitas dan efisiensi dan disimpulkan dalam bentuk deskriptif. Penelitian dilaksanakan dari Juli sampai September Tahun 2023. Berdasarkan hasil penelitian menunjukkan bahwa rasio efektivitas belanja obat-obatan dan BMHP tahun 2021 sebesar 97,18% dan untuk Tahun 2022 sebesar 106.59%. Tingkat efektivitas belanja obat-obatan dan BMHP mengalami peningkatan dari tahun 2021 ke tahun 2022 dari kategori efektif menjadi sangat efektif. Hal ini juga sejalan dengan peningkatan jumlah kunjungan pasien yang meningkat dari tahun 2021 ke tahun 2022. Rasio efisiensi belanja obat-obatan dan BMHP tahun 2021 sebesar 102,90% dan untuk Tahun 2022 sebesar 93,83%. Tingkat efisiensi belanja obat-obatan dan BMHP mengalami peningkatan dari kategori tidak efisien menjadi kurang efisien

MM is non-curable cancer that arises from plasma cells and is the second most common type of blood cancer. Drug-refractory relapses are inevitable, making it essential to sustain long-lasting remissions as part of therapy. Lenalidomide maintenance until progression is a standard of care for transplant-eligible newly-diagnosed patients. However, poor outcomes of high-risk patients and the risk of secondary primary malignancies associated with maintenance underline the need for novel approaches. Significant changes in frontline treatment maintenance are expected, with the increasing importance of minimal residual disease monitoring and the development of novel drug combinations for maintenance. This article explores current standards and prospects for maintaining response after upfront in ASCT in MM.

The complex interactions of genetic, environmental, and behavioral factors that contribute to obesity, a pervasive global health issue, continue to be a severe concern for people all over the world. This manuscript examines the field of obesogen research, seeking to understand the mechanisms by which certain environmental chemicals contribute to the development of obesity. We explore the obesogenic effects by focusing on pathways such as inflammation, hormone interference, and the activation of peroxisome proliferator-activated receptors (PPARs). The text focuses on the significance of PPAR isoforms, especially PPARγ, and how they play a role in adipose tissue growth. We examine how obesogens such as tributyltin (TBT) and bisphenol A (BPA) influence these receptors. Additionally, we examined the impact of obesogens on hormonal regulation, including disruptions to leptin and adiponectin, and investigated the intricate relationship between chronic inflammation and obesity. In the methodology of our study, we utilized a systematic search to identify peer-reviewed articles of relevance. This search spanned various model systems, including in vitro, in vivo, and epidemiological studies, providing insights into the distinct advantages and limitations associated with each. Epigenetic modifications and the influence of obesogens on the development of adipose tissue, metabolism, and appetite control further enrich our understanding of this complex field. Finally, we assess the role of endocrine disruptors in amplifying the risk of obesity, emphasizing the heightened susceptibility during crucial developmental periods. This comprehensive review aims to contribute to the ongoing discourse surrounding obesogens, paving the way for targeted interventions and a more profound comprehension of the global obesity epidemic.

Background. Despite the promising results of autologous bone marrow transplantation (BMT) in patients with lymphoma, infectious complications limit its positive outcomes. This study evaluated the incidence and associated factors of febrile neutropenia (FN) following BMT in patients with lymphoma. Materials and methods. The study consecutively included 147 patients with lymphoma who were candidates for BMT. Clinical and laboratory results were recorded, and after BMT, the occurrence of FN was investigated through the daily evaluation of neutrophil count and body temperature. Results. On average, FN occurred in 91 patients (61.9%) after 12.77 ± 2.45 days after BMT. Lower fluid balance was associated with a higher risk of FN (lowest adjusted odds ratio [OR] at day -2 = 0.602, 95% confidence interval [CI] = 0.299 – 0.870, p-value = 0.007). The higher uric acid level was associated with a higher risk of FN (highest adjusted OR at day -10 = 1.617, 95% CI = 1.328 – 1.963, p-value = 0.035). LDH was also positively correlated with FN (highest adjusted OR at day 0 = 1.501, 95% CI = 1.198 – 2.104, p-value = 0.004). Conclusions. Adequate hydration of the patients is of paramount importance for preventing FN in patients who receive BMT. Furthermore, uric acid and LDH could be considered in future studies for the risk stratification of FN.