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Dagar M, Kumari P, Mirza AMW, Singh S, Ain NU, Munir Z, Javed T, Virk MFI, Javed S, Qizilbash FH, Kc A, Ekhator C, Bellegarde SB. The Hidden Threat: Endocrine Disruptors and Their Impact on Insulin Resistance. Cureus 2023; 15:e47282. [PMID: 38021644 PMCID: PMC10656111 DOI: 10.7759/cureus.47282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
The association between Insulin resistance, a global health issue, and endocrine disruptors (EDCs), chemicals interfering with the endocrine system, has sparked concern in the scientific community. This article provides a comprehensive review of the existing literature regarding the intricate relationship between EDCs and insulin resistance. Phthalates, commonly found in consumer products, are well-established EDCs with documented effects on insulin-signaling pathways and metabolic processes. Epidemiological studies have connected phthalate exposure to an increased risk of type 2 diabetes mellitus (T2DM). Perfluoroalkyl substances (PFAS), persistent synthetic compounds, have shown inconsistent associations with T2DM in epidemiological research. However, studies suggest that PFAS may influence insulin resistance and overall metabolic health, with varying effects depending on specific PFAS molecules and study populations. Bisphenol A (BPA), found in plastics and resins, has emerged as a concern for glucose regulation and insulin resistance. Research has linked BPA exposure to T2DM, altered insulin release, obesity, and changes in the mass and function of insulin-secreting β-cells. Triclosan, an antibacterial agent in personal care products, exhibits gender-specific associations with T2DM risk. It may impact gut microbiota, thyroid hormones, obesity, and inflammation, raising concerns about its effects on metabolic health. Furthermore, environmental EDCs like polycyclic aromatic hydrocarbons, pesticides, and heavy metals have demonstrated associations with T2DM, insulin resistance, hypertension, and obesity. Occupational exposure to specific pesticides and heavy metals has been linked to metabolic abnormalities.
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Affiliation(s)
- Mehak Dagar
- Internal Medicine, Himalayan Institute of Medical Sciences, New Delhi, IND
| | - Priya Kumari
- Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | | | - Shivani Singh
- Medicine, MediCiti Institute of Medical Sciences, Hyderabad, IND
| | - Noor U Ain
- Medicine, Mayo Hospital, Lahore, PAK
- Medicine, King Edward Medical University, Lahore, PAK
| | - Zainab Munir
- Emergency Department, Imran Idrees Teaching Hospital, Sialkot, PAK
| | - Tamleel Javed
- Emergency Department, Imran Idrees Teaching Hospital, Sialkot, PAK
| | | | - Saleha Javed
- Emergency Department, Sheikh Zayed Hospital, Rahim Yar Khan, PAK
| | | | - Anil Kc
- Medicine and Surgery, Patan Academy of Health Sciences, Kathmandu, NPL
- Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Chukwuyem Ekhator
- Neuro-Oncology, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA
| | - Sophia B Bellegarde
- Pathology and Laboratory Medicine, American University of Antigua, Coolidge, ATG
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Mohsin SN, Gapizov A, Ekhator C, Ain NU, Ahmad S, Khan M, Barker C, Hussain M, Malineni J, Ramadhan A, Halappa Nagaraj R. The Role of Artificial Intelligence in Prediction, Risk Stratification, and Personalized Treatment Planning for Congenital Heart Diseases. Cureus 2023; 15:e44374. [PMID: 37664359 PMCID: PMC10469091 DOI: 10.7759/cureus.44374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 09/05/2023] Open
Abstract
This narrative review delves into the potential of artificial intelligence (AI) in predicting, stratifying risk, and personalizing treatment planning for congenital heart disease (CHD). CHD is a complex condition that affects individuals across various age groups. The review highlights the challenges in predicting risks, planning treatments, and prognosticating long-term outcomes due to CHD's multifaceted nature, limited data, ethical concerns, and individual variabilities. AI, with its ability to analyze extensive data sets, presents a promising solution. The review emphasizes the need for larger, diverse datasets, the integration of various data sources, and the analysis of longitudinal data. Prospective validation in real-world clinical settings, interpretability, and the importance of human clinical expertise are also underscored. The ethical considerations surrounding privacy, consent, bias, monitoring, and human oversight are examined. AI's implications include improved patient outcomes, cost-effectiveness, and real-time decision support. The review aims to provide a comprehensive understanding of AI's potential for revolutionizing CHD management and highlights the significance of collaboration and transparency to address challenges and limitations.
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Affiliation(s)
| | | | - Chukwuyem Ekhator
- Neuro-Oncology, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, USA
| | - Noor U Ain
- Medicine, Mayo Hospital, Lahore, PAK
- Medicine, King Edward Medical University, Lahore, PAK
| | | | - Mavra Khan
- Medicine and Surgery, Mayo Hospital, Lahore , PAK
| | - Chad Barker
- Public Health, University of South Florida, Tampa, USA
| | | | - Jahnavi Malineni
- Medicine and Surgery, Maharajah's Institute of Medical Sciences, Vizianagaram, IND
| | - Afif Ramadhan
- Medicine, Universal Scientific Education and Research Network (USERN), Yogyakarta, IDN
- Medicine, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University, Yogyakarta, IDN
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Ain NU, Muhammad N, Dianatpour M, Baroncelli M, Iqbal M, Fard MAF, Bukhari I, Ahmed S, Hajipour M, Tabatabaie Z, Foroutan H, Nilsson O, Faghihi MA, Makitie O, Naz S. Biallelic TMEM251 variants in patients with severe skeletal dysplasia and extreme short stature. Hum Mutat 2021; 42:89-101. [PMID: 33252156 DOI: 10.1002/humu.24139] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/19/2020] [Accepted: 11/01/2020] [Indexed: 11/07/2022]
Abstract
Skeletal dysplasias are a heterogeneous group of disorders ranging from mild to lethal skeletal defects. We investigated two unrelated families with individuals presenting with a severe skeletal disorder. In family NMD02, affected individuals had a dysostosis multiplex-like skeletal dysplasia and severe short stature (<-8.5 SD). They manifested increasingly coarse facial features, protruding abdomens, and progressive skeletal changes, reminiscent of mucopolysaccharidosis. The patients gradually lost mobility and the two oldest affected individuals died in their twenties. The affected child in family ID01 had coarse facial features and severe skeletal dysplasia with clinical features similar to mucopolysaccharidosis. She had short stature, craniosynostosis, kyphoscoliosis, and hip-joint subluxation. She died at the age of 5 years. Whole-exome sequencing identified two homozygous variants c.133C>T; p.(Arg45Trp) and c.215dupA; p.(Tyr72Ter), respectively, in the two families, affecting an evolutionary conserved gene TMEM251 (NM_001098621.1). Immunofluorescence and confocal studies using human osteosarcoma cells indicated that TMEM251 is localized to the Golgi complex. However, p.Arg45Trp mutant TMEM251 protein was targeted less efficiently and the localization was punctate. Tmem251 knockdown by small interfering RNA induced dedifferentiation of rat primary chondrocytes. Our work implicates TMEM251 in the pathogenesis of a novel disorder and suggests its potential function in chondrocyte differentiation.
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Affiliation(s)
- Noor U Ain
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niaz Muhammad
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan
| | - Mehdi Dianatpour
- Department of Medical Genetics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Stem Cell Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marta Baroncelli
- Division of pediatric endocrinology and Center for Molecular Medicine, Department of Women's and Children's Health, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - Muddassar Iqbal
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan
| | | | - Ihtisham Bukhari
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan
| | - Sufian Ahmed
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan
| | | | | | - Hamidreza Foroutan
- Laparoscopy research center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ola Nilsson
- Division of pediatric endocrinology and Center for Molecular Medicine, Department of Women's and Children's Health, Karolinska Institutet and University Hospital, Stockholm, Sweden
- School of Medical Sciences, Örebro University and Örebro University Hospital, Örebro, Sweden
| | | | - Outi Makitie
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Institute of Genetics, Helsinki, Finland
| | - Sadaf Naz
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan
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Haider MH, Ain NU, Abrar S, Riaz S. blaOXA, blaSHV-, and blaTEM- extended-spectrum β-lactamases in Gram-negative strains from burn patients in Lahore, Pakistan. J Infect Dev Ctries 2020; 14:1410-1417. [PMID: 33378283 DOI: 10.3855/jidc.12828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/06/2020] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Gram-negative bacterial pathogens are associated with complications of post-burn infections that showed significant association with different genotypic variants of extended-spectrum β-lactamases. In this study, we aimed to determine the distribution of ESBL gene variants among bacterial pathogens from post-burn infections. METHODOLOGY Cephalosporin-resistant isolates were collected from Jinnah Burn and Reconstructive Surgery Centre, Lahore. Phenotypic testing: double-disk synergy test, combination disk test, multiplex PCR for blaOXA, blaTEM, and blaSHV genes were performed. RESULTS Of the 53.5% cephalosporin-resistant isolates, 50.7% were community-acquired and 49.3% were nosocomial pathogens. Seventy-two percent of post-burn infections were found in males (p-value = 0.92, OR = 1.04). The age of burn victims ranged from 4 to 85 years (mean = 28.9, SD = 15.6). Pseudomonas aeruginosa was most predominant at a rate of 49%. There were 83.3% multidrug-resistant isolates, which showed susceptibility to meropenem, imipenem, and amikacin in 28.7%, 25.3%, and 26% respectively. In phenotypic tests 16% ESBLs detected by the DDST and 14% confirmed by the CDT. Molecular detection proved effective for the detection of 79.7% blaTEM, 37.7% blaOXA, and 18.8% blaSHV isolates. blaTEM genes were confirmed in 18.1% CDT-positive isolates, with 62.6% diagnostic accuracy (95% CI = 54.7-70) and 88% specificity (95% CI = 80.4-93.4). CONCLUSIONS The antimicrobial resistance associated with the ESBL-producing Pseudomonas spp. and Enterobacteriaceae is becoming a challenge for the treatment and survival of burn patients. The high rate blaTEM, blaOXA, and blaSHV genes confirm the need to improve the management of burn patients in order to prevent post-burn infections.
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Affiliation(s)
- Muhammad H Haider
- Department of Microbiology and Molecular Genetics, University of Punjab, Lahore, Pakistan
| | - Noor U Ain
- Department of Microbiology and Molecular Genetics, University of Punjab, Lahore, Pakistan
| | - Samyyia Abrar
- Department of Microbiology and Molecular Genetics, University of Punjab, Lahore, Pakistan
| | - Saba Riaz
- Department of Microbiology and Molecular Genetics, University of Punjab, Lahore, Pakistan.
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