Numerous studies have implicated oxidative stress in the development of complications of diabetes. During hyperglycemia, production of oxidant agents such as reactive oxygen species and reactive nitrogen species increases. This process, along with a decrease in the activity of antioxidant enzymes, induces oxidative stress in the body. This redox imbalance causes damage to vital biomolecules such as proteins, lipids and DNA and results in the generation of harmful products for the body. Mechanisms associated with the creation of oxidative stress conditions and subsequently complications of diabetes are explained through several pathways such as flux through the polyol pathway, intracellular production of advanced glycation end products precursors, protein kinase-C activation, and increased activities of the hexosamine pathway. On the other hand, the study of polymorphism in the antioxidant enzymes genes indicates that some of the gene polymorphisms reduce the antioxidant power of the enzymes. This article aims to review various studies to demonstrate the effect of oxidative stress on the pathogenesis of diabetes and the positive role of antioxidants on diabetic complications.

Objective: To investigate the prevalence of cercarial infections in freshwater snails from several water sources in Nakhon Nayok, Nonthaburi, and Pathum Thani provinces of Central Thailand, and to reconstruct a phylogenetic tree for improved understanding of the relationships in the cercarial stage. Methods: The snail specimens were collected from 34 total sampling sites and investigated for cercarial infections using the crushing method. The cercarial specimens were classified and used for the phylogenetic tree analysis using the Internal Transcribed Spacer 2 (ITS2). Results: A total of 1 921 snail specimens were classified into five families and seven species. The results showed that four snail species were identified as intermediate hosts of the larval stages of trematodes, with an overall prevalence of infection of 2.45% (47/1 921). The infected snail specimens included five groups of the cercarial type: cercariaeum cercariae, echinostome cercaria, megalurous cercaria, parapleurolophocercous cercaria, and xiphidiocercariae. This is particularly true of xiphidiocercariae, which was found to be the dominant type among cercarial infections in bithyniid snails by approximately 38.00%. With regard to molecular identification, the phylogenetic tree was reconstructed using the neighbor-joining method with 10 000 bootstraps and separated the trematodes into three clades: Echinostomatoidea, Microphalloidea and Opisthorchioidea. Conclusions: The study reveals a high prevalence of cercarial infection for each cercarial type and maturation into a definite trematode genus and delineates morphological characteristics and evolutionary trends among each larval trematode in Nakhon Nayok, Nonthaburi and Pathum Thani provinces. In addition, the ITS2 sequence data of cercariae could be used to examine classification of these species at the family level.

Objective: To determine the significance of temperature, rainfall and humidity in the seasonal abundance of Anopheles stephensi in southern Iran. Methods: Data on the monthly abundance of Anopheles stephensi larvae and adults were gathered from earlier studies conducted between 2002 and 2019 in malaria prone areas of southeastern Iran. Climatic data for the studied counties were obtained from climatology stations. Generalized estimating equations method was used for cluster correlation of data for each study site in different years. Results: A significant relationship was found between monthly density of adult and larvae of Anopheles stephensi and precipitation, max temperature and mean temperature, both with simple and multiple generalized estimating equations analysis (P<0.05). But when analysis was done with one month lag, only relationship between monthly density of adults and larvae of Anopheles stephensi and max temperature was significant (P<0.05). Conclusions: This study provides a basis for developing multivariate time series models, which can be used to develop improved appropriate epidemic prediction systems for these areas. Long-term entomological study in the studied sites by expert teams is recommended to compare the abundance of malaria vectors in the different areas and their association with climatic variables.

Objective: To investigate the neuroprotective efficacy of pomegranate and ellagic acid on the histopathological changes in the hippocampus of an aluminium chloride (AlCl₃) induced rat model of Alzheimer’s disease. Methods: Sprague Dawley rats were divided into 4 groups (n=10 each): Group I : serving as negative control; Group II, Alzheimer model, induced by administration of 17 mg/kg bw AlCl₃; Group III, administered the same dose of AlCl₃ with 50 mg/kg of pomegranate peel extract and Group IV : administered ellagic acid (50 mg/kg) in addition to the same dose of AlCl₃. The medication given to all groups continued for 28 days. All were given the compounds by gastric gavage. Radial arm maze test, hippocampus antioxidant markers, histopathology of the dentate gyrus, and CA3 of the hippocampus were evaluated. Results: Rats treated with pomegranate peel extract exposed to radial arm maze test showed less number of errors and reduced time needed to reach the criterion. There was an increase in the levels of glutathione, catalase, and total antioxidant capacity and decreased lipid peroxidation products. Histopathological features in dentate gyrus and CA3 as apoptosis and chromatolysis of pyramidal cells and granular layer, respectively, were decreased. Alzheimer characteristic neurofibrillary tangles and senile plaques were reduced. Treatment with ellagic acid ameliorated the pathological results but to a statistically lower level. Conclusions: Pomegranate peel extract alleviates memory deficit and restores antioxidant homeostasis following degenerative changes in the hippocampus induced by aluminium chloride in rats.

Objective: To evaluate the performance of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution. Methods: A cross-sectional study was conducted in HIV-infected patients aged 5-18 years receiving antiretroviral treatment with CD4 T-lymphocytes >25% or >500 cells/mm³ for at least 6 months. QuantiFERON-TB Gold, T-SPOT.TB, and tuberculin skin test were performed in each patient. Results: A total of 50 patients were enrolled with median age of 13.7 years, CD4 counts of 753 (IQR: 587-989) cells/mm³. Among 27 patients with tuberculosis (16) or tuberculosis exposure (11), 8 (29.6%) were positive to at least one test, 2 (7.4%) were positive QuantiFERON-TB Gold, 3 (11.1%) positive T-SPOT.TB, and 7 (25.9%) had tuberculin skin test ≥5 mm. Among 23 patients without history of tuberculosis or exposure, all had negative interferon gamma release assays, while 2 (8.7%) had positive tuberculin skin test. Conclusions: All tests had low sensitivity despite immune reconstitution.

Rationale: Haemophagocytic lymphohistiocytosis is a rare complication of malaria, which is often misdiagnosed. Patient concerns: A 30-year-old male was admitted to our department for persistent fever, which began after returning from a stay in Guinea-Conakry. The laboratory investigations revealed a pancytopenia and an elevated C-reactive protein. Peripheral smear examination showed Plasmodium falciparum, therefore confirming the diagnosis of malaria. The laboratory tests showed a worsening pancytopenia. Bone marrow aspiration and biopsy revealed images of hemophagocytosis. Diagnosis: The diagnosis of haemophagocytic lymphohistiocytosis complicating malaria infection was established. Interventions: The patient was treated with artemether-lumefantrine. No immunosuppressant treatment was delivered to the patient. He received antipyretic and antimalarial treatment only. Outcomes and lessons: We report a case of haemophagocytic lymphohistiocytosis trigged by malaria infection and we review all reported cases secondary to Plasmodium falciparum malaria by searching PubMed publications till October 2019. Haemophagocytic lymphohistiocytos secondary to malaria should be suspected even in non-severe cases of malaria.