Objectives: Stroke is a leading cause of distress, disability, and death worldwide. The goal of reperfusion therapy for acute ischemic stroke (AIS) is the restoration of cerebral blood flow (CBF). If initiated too late, however, reperfusion therapy may paradoxically exacerbate tissue injury. Beyond a critical period, restoration of CBF may amplify already deranged inflammatory, apoptotic, and metabolic processes, increasing neurologic damage. This study was conducted to evaluate how timing of reperfusion therapy affects inflammatory, apoptotic, and metabolic responses after AIS. Materials and Methods: A total of 49 male Sprague-–Dawley rats were divided into four groups, either subject to 2- or 4-h of middle cerebral artery occlusion (MCAO) before reperfusion, 24 h of MCAO with no reperfusion, or a control group. Seven rats from each group were used for histological assay and for Western Blotting, respectively. Results: Infarction volumes were slightly decreased in the 2- and 4-h ischemia groups compared to the permanent ischemia group (49.5%, 49.3%, and 53.1%, respectively). No significant variation in neurological deficit scores was observed when comparing 2- and 4-h ischemia groups to the permanent ischemia group. Glucose metabolism protein (GLUT1 and GLUT3) expression was increased in all ischemia groups compared to the control group (P < 0.05). Expression of pro-inflammatory proteins (tumor necrosis factor α, interleukin-1 β, intercellular adhesion molecule-1, and vascular cell adhesion protein-1 was significantly increased in all ischemia groups compared to the control group at 24 (P < 0.05). There was significantly increased expression of pro-apoptotic proteins (caspase-3, cleaved caspase-3, and Bax) and significantly reduced anti-apoptotic protein (Bcl-2) expression in all the ischemia groups compared to the control group at 24 h (P < 0.05). Nuclear factor kappa (NF-κB) expression was significantly increased in all ischemia groups compared to the control group at 24 h (P < 0.05). Conclusion: The results of this study displayed relationships between the timing of reperfusion therapy and the multiple pathways discussed. There is potential utility in exploring and targeting components of the post-AIS inflammatory, apoptotic, and metabolic responses for neuroprotection against AIS and reperfusion injury.

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Introduction: Chronic kidney disease with uncertain etiology (CKDu) was first recognized in the 1990s in Sri Lanka. Considering the distribution of CKDu in the country, clusters of endemic and nonendemic areas can be identified. This study was carried out to compare the biochemical characteristics between CKDu endemic and nonendemic areas in Sri Lanka. Materials and Methods: A cross-sectional study was carried out among randomly selected males between the age category of 30 and 60 years in selected villages of Wilgamuwa (endemic) and Hanguranketha (nonendemic), located in the dry and wet zone, respectively. Results: The total participation percentage from the endemic area was 74.7% (224 out of 300 invitees). Out of 150 participants invited from the nonendemic area, only 100 participated in the study cohort. There was a striking difference between the two areas in serum creatinine levels (P = 0.001). When considering the behavioral patterns of the two study areas, the main occupation was farming and there was no significant difference between the behaviors of the people in the selected areas. A significant number of participants (n = 31, 13.8%) from the endemic area had high serum creatinine levels with a mean of 109 μmol/L (standard deviation [SD] = 66.41) (normal: 90–116 μmol/L). Whereas, in the nonendemic area, only 3 (3%) participants had elevated creatinine levels with a mean value of 85.41 μmol/L (SD = 18.78). A significant difference was observed in the two groups in the mean values of serum creatinine levels (P = 0.001). The mean value of random blood sugar (RBS) was 113.56 mg/dL (SD = 44.38) and 119.10 mg/dL (SD = 50.48) in endemic and nonendemic areas, respectively. There was no significant difference between the mean values of RBS (P = 0.2). The mean serum cholesterol was slightly higher in Wilgamuwa (119.26 mg/dl, SD = 45.31) compared to Hanguranketha (189.02 mg/dl, SD = 45.09). However, that was not statistically significant (P = 0.6). Conclusions: Serum creatinine is remarkably increased in CKDu endemic areas. RBS and serum cholesterol are less significant according to the endemicity of CKDu.

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Background: The prevalence of the metabolic syndrome (MetS) is high among Chinese patients with type 2 diabetes. There is limited evidence in understanding the relationships between individual-level clinical indicators of MetS and diabetes complications among Chinese patients with Type 2 diabetes. Aims and Objectives: This study described the characteristics of patients with Type 2 diabetes in terms of the prevalence of MetS and clinical factors related to the common diabetes complications. Materials and Methods: Patients (n = 402) with Type 2 diabetes admitted to a tertiary hospital in Beijing were included in the study. Using patients' retrospective data, logistic regression was applied to determine the associated clinical factors of common diabetic complications. Results: In this sample, the prevalence of MetS was 84.3%, with the prevalence of diabetic peripheral neuropathy, microvascular, and macrovascular complications being 59.7%, 63.4%, and 61.7%, respectively. Our results showed that the diastolic blood pressure was significantly associated with diabetic retinopathy, while the levels of C peptide and fasting glucose were significantly related to diabetic nephropathy. Meanwhile, the regression also showed that the waist to hip ratio (WHR) is a significant indicator for the development of macrovascular complications. A 0.1 increase in the WHR will increase the chances of having carotid artery disease by 1.29 folds. Conclusion: The current study demonstrates that the prevalence of MetS and the common diabetic complications are relevantly high in this sample. Our findings suggest that reducing the WHR, controlling blood pressure, and improving glycemic control following clinical guidelines are essential to prevent or slow the progression of diabetes complications among patients with Type 2 diabetes.

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Objective: The objective of the study is to evaluate the impact of cardiac catheterization laboratory (CCL) activation by WeChat in community hospitals transfer for primary percutaneous coronary intervention (PCI) bypassing emergency department (ED) on time delay in ST-segment elevation myocardial infarction (STEMI) patients. Methods: This was a retrospective, cohort study of STEMI patients who were transferred from community hospitals to Luhe Hospital for primary PCI. Patients were divided into two groups: in CCL group, electrocardiogram (ECG) was transmitted through WeChat in the community hospital and the patients were transferred directly to CCL by emergency medical services (EMS) (n = 43); in control group, patients without ECG transmission were transferred by EMS to ED before CCL arrival (n = 57). The primary endpoint was median first medical contact (FMC)-to-device (FMC2D) times. The secondary endpoint was door-to-device (D2D) times. Results: The baseline clinical data and angiographic features among the two groups were similar (all P > 0.05. There was no difference in the symptom onset-to-FMC time (median interquartile range [IQR] min, 100.00 [74.50–247.00] vs. 105.00 [70.00–180.00], P > 0.05) between the two groups. Compared to control group, CCL group had shortened FMC2D times (median IQR min, 95.00 [72.60–160.58] vs. 160.79 [124.72–205.50], P < 0.001) and shortened D2D time (median IQR min, 17.18 [13.77–21.15] vs. 49.27 [40.26–64.90], P < 0.001). Achievement of the FMC2D time goal of <120 min rose from 29.82% in the control group to 76.74% in the CCL group (P < 0.001). Conclusion: CCL activated by WeChat can reduce reperfusion time of STEMI patients who are transferred for PCI from community hospitals.

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The ongoing coronavirus disease-2019 (COVID-19) pandemic continues to disrupt the health-care services, including the essential ones, even after the detection of the novel viral infection 2 years back. The population group comprising mothers, antenatal women, newborns, children, adolescents, and elderly people is a vulnerable one. The COVID-19 pandemic has significantly accounted for the disruption of services targeting the above population groups, especially in low- and middle-income nations. COVID-19 pandemic has resulted in a wide range of problems targeting the above population groups, which has indirectly impacted the delivery of care and services. There arises the need to take specific measures to reduce the impact of the potential problems that have emerged. To conclude, the COVID-19 pandemic has resulted in significant interruptions in the health-care services aimed for the welfare of mothers, antenatal women, newborns, children, adolescents, and elderly people. However, as these are vital population groups, we have to adopt a multisectoral approach involving different stakeholders and move forward toward improving the reach of health-care services.

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The 2022 monkeypox outbreak in nonendemic nations has emerged as a cause of concern for the public health authorities and international welfare agencies. The outbreaks of monkeypox in the endemic nations of the African region have been reported on a regular basis. However, the outbreak, which started on May 13, 2022, as a single case in the United Kingdom has become a cause of global concern. Moreover, the sudden detection of cases that has been distributed worldwide indicates undetected transmission for quite some time, and this is a cause of concern for public health professionals. It has been identified that children possess a higher risk to develop severe symptoms when compared with population groups of adolescents or adults. To conclude, the monkeypox outbreak in 2022 has been reported in both endemic and nonendemic nations. The outbreak in nonendemic nations has been quite atypical, with variable clinical presentation, and the absence of a history of travel to endemic nations. The need of the hour is to take prompt steps to spread awareness about the disease and interrupt the chain of transmission through the implementation of preventive measures.

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