European Journal of Clinical and Experimental Medicine
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description: <p style="box-sizing: border-box; margin: 0px 0px 1em; line-height: 20px; color: #010101; font-size: 14px; font-family: Lato, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: 0.1px; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> <p style="box-sizing: border-box; margin: 0px 0px 1em; line-height: 20px; color: #010101; font-size: 14px; font-family: Lato, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: 0.1px; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">GENERAL INFORMATION <p style="box-sizing: border-box; margin: 0px 0px 1em; line-height: 20px; color: #010101; font-size: 14px; font-family: Lato, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: 0.1px; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">The European Journal of Clinical and Experimental Medicine (Eur J Clin Exp Med) is an internationally recognized, peer-reviewed, open-access journal published by the Rzeszów University Press. The journal is issued quarterly in an online format and publishes exclusively in English. Submissions are accepted in English only, ensuring accessibility to a global …
publisher: Rzeszów University Press
language: en-US
publication name: European Journal of Clinical and Experimental Medicine
issn: 2544-2406
copyright: Our open access policy is in accordance with the Budapest Open Access Initiative (BOAI) definition: this means that articles have free availability on the public Internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from having access to the Internet itself. All articles are published with free open access under the CC-BY Creative Commons attribution license (the current version is CC-BY, version 4.0). If you submit your paper for publication by the Eur J Clin Exp Med, you agree to have the CC-BY license applied to your work. Under this Open Access license, you, as the author, agree that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. This facilitates freedom in re-use and also ensures that Eur J Clin Exp Med content can be mined without barriers for the research needs.
items: Rheumatic mitral stenosis in the perioperative setting ‒ an old acquaintance with new implications
items: Postoperative diagnosis of pulmonary actinomycosis in a patient with bronchiectasis ‒ a rare case
items: Self-injection of kerosene with chemical pneumonitis and abscess formation ‒ a case report and literature review
items: The comparative efficacy of FDA-approved drugs for management of alcohol use disorder ‒ a network meta-analysis
items: Harnessing therapeutic potential of vitamins and microelements to mitigate testicular damage caused by drugs or chemical toxins ‒ a review
items: Review of the therapeutic effect of alpha-tocopherol, ascorbic acid, and folic acid against ovarian toxicity induced by drugs and heavy metals
items: Harnessing the gut-brain axis in the treatment of type 2 diabetes mellitus and obesity
items: Doxorubicin-induced cell cycle arrest and apoptosis in HL-60 leukemia cells – a narrative review
items: Dipeptidyl peptidase-4 dysregulation and inflammatory cytokines as dual biomarkers in ulcerative colitis ‒ a case-control study
items: Evaluation of adrenomedullin, growth differentiation factor-15, and atrial natriuretic peptide in patients with rheumatoid arthritis
items: Exploring the role of B complex vitamins in reproductive health ‒ valuable insights and unresolved issues regarding premature ovarian failure
items: Frailty in liver cirrhosis ‒ insights into prevalence, determinants, and clinical impact from a tertiary center experience
items: Baicalein's neuroprotective effects in a lansoprazole-induced Alzheimer's model in Wistar rats
items: Comparison of clinical profile and outcomes in patients with carbapenem resistant and carbapenem sensitive gram-negative bacteraemia
items: Ezetimibe mitigates DNCB-induced mouse model of eczematous dermatitis
items: A retrospective study on sickle cell disease-associated cardiovascular anomalies
items: Zn and Se protect toxic metal mixture-mediated memory deficit by activation of Nrf2-hmox-1 signaling in the hippocampus of female rats
items: Elevated estrogen receptor beta and oxidative stress in postmenopausal women with ovarian cancer
items: Impact of multicomponent training on functional fitness among older adults in rural India
items: Aprocitentan mitigates ischemia reperfusion induced kidney injury in rats by attenuating inflammation and pyroptosis through suppressing NF-κB/NLRP3/caspase-1 signaling pathway
items: Apelin, C-reactive protein, and serum protein correlation with blood pressure ‒ a biomarker analysis
items: Evaluating tumor necrosis factor-alpha and interleukin 17 as plasma biomarkers for rheumatoid arthritis diagnosis
items: Evaluation of endothelin 1 and N-terminal pro-B-type natriuretic peptide in patients with rheumatoid arthritis
items: Neuroprotective effects of Vernonia amygdalina and Moringa oleifera in alloxan-induced diabetic Wistar rats
items: Association between handgrip strength and cognitive function in older adults living with cancer
items: Sex differences in hypertension prevalence and risk factors in India ‒ a comparative study based on National Family Health Survey IV and V
items: Serum leptin and glucagon-like peptide-1 levels in diabetic patients with end-stage renal disease on hemodialysis ‒ a cross-sectional study in Iraqi patients
items: Exploring the diagnostic potential of micro-RNA-320 and anti-Müllerian hormone in women with polycystic ovary syndrome ‒ a case-control study
items: Sotagliflozin prevents acute kidney injury by suppressing oxidative stress, inflammation, and apoptosis in renal ischemia/reperfusion rat model
items: The relationship between dry eye syndrome and serum fat-soluble vitamin levels
items: Postural, behavioural and cognitive effects of sit-stand desk use in primary school children – a crossover intervention pilot study

Rheumatic mitral stenosis in the perioperative setting ‒ an old acquaintance with new implications
type: item
creator: Cláudia Barreiros
creator: Marc Giménez-Milà
creator: Elena Sandoval
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 1102–1104
ending page: 1102–1104
doi: 10.15584/ejcem.2025.4.27

Postoperative diagnosis of pulmonary actinomycosis in a patient with bronchiectasis ‒ a rare case
type: item
description: Introduction and aim. Pulmonary actinomycosis is a rare chronic infection caused by Actinomyces species, often mimicking tuberculosis, malignancy, or other chronic lung diseases both clinically and radiologically. These similarities frequently lead to diagnostic delays. We present a rare case of pulmonary actinomycosis in a patient with long-standing bronchiectasis who developed acute hemoptysis during anticoagulant therapy. Description of the case. A 59-year-old woman with a ten-year history of bronchiectasis and recent mechanical aortic valve replacement presented with persistent hemoptysis while on warfarin. Thoracic computed tomography revealed bronchiectatic changes and opacities in the right middle lobe. Bronchoscopy showed bloody, encrusted material, but no definitive diagnosis was made. Due to ongoing symptoms and radiological suspicion of malignancy, an urgent right middle lobectomy was performed. Histopathological analysis confirmed pulmonary actinomycosis, revealing filamentous organisms via PAS, Gram, and Grocott’s staining. Conclusion. This case highlights the importance of considering pulmonary actinomycosis in patients with bronchiectasis and unexplained hemoptysis, particularly when standard treatment fails. Surgical resection may be essential for both diagnosis and treatment. The case underscores how structural lung disease and anticoagulant use can reveal rare infections otherwise masked by chronic symptoms.
creator: Muhammet Kertmen
creator: Kübra Cullu
creator: Gülsah Kolak Gözükücük
creator: Turkan Dubus
creator: Nur Büyükpınarbasili
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 1088
ending page: 1092
doi: 10.15584/ejcem.2025.4.11

Self-injection of kerosene with chemical pneumonitis and abscess formation ‒ a case report and literature review
type: item
description: Introduction and aim. Kerosene, a widely available household fuel in Sri Lanka, is a common cause of accidental poisoning, especially in children, and is occasionally used for self-harm, which can cause complications such as chemical pneumonitis, abscesses, and thrombosis. Its unsafe storage practices increase the risk of accidental exposure. Description of the case. A 16-year-old Sri Lankan male self-injected kerosene into the left cubital fossa. Although initially stable, he later developed chemical pneumonitis, left cephalic vein thrombosis, and a sterile abscess at the injection site. Conclusion. Early multidisciplinary intervention and close clinical monitoring led to a favorable outcome. A review of the literature reveals that intravenous hydrocarbon injection, although rare, can lead to significant local and systemic toxicities.
creator: Anura Wijesinghe
creator: Thilina Rathnasekara
creator: Hashini Sewwandi
creator: Prasanna Weerawansa
creator: Sisira Siribaddana
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 1093–1101
ending page: 1093–1101
doi: 10.15584/ejcem.2025.4.14

The comparative efficacy of FDA-approved drugs for management of alcohol use disorder ‒ a network meta-analysis
type: item
description: Introduction and aim. Alcohol use disorder (AUD) represents a significant and lasting public health challenge affecting millions of people around the world. Currently, the US FDA has approved naltrexone, disulfiram, and acamprosate for AUD; however, their comparative effectiveness remains uncertain. This study aimed to evaluate the comparative efficacy of FDA-approved medications for AUD. Material and methods. A comprehensive search of PubMed, the Cochrane Library, and Embase was performed up to January 2025. Eligible studies were randomized controlled trials of at least 12 weeks in duration, enrolling adults with AUD and investigating one or more FDA-approved medications, individually or in combination. The Cochrane Risk of Bias 2 (ROB 2) tool was used to assess study quality. A frequentist random-effects network meta-analysis (NMA) was performed. The primary and secondary outcomes were the return to any level of drinking and the return to heavy drinking, respectively. Analysis of the literature. Fifty-two trials were included. Compared to placebo, acamprosate (risk ratio, RR, 0.87 [95% CI, 0.82-0.92]), naltrexone (0.93 [0.88-0.99]) and a combination of acamprosate and naltrexone (NAAC) (0.52 [0.35-0.76]) all statistically significantly reduced the risk of return to any type of drinking. Based on SUCRA rankings, NAAC (SUCRA = 0.99) was ranked first for efficacy. For the secondary outcome, only naltrexone (RR, 0.87 [0.80-0.95]) was found to be effective. Conclusion. When combined with psychosocial interventions, naltrexone and acamprosate demonstrated superior efficacy compared to placebo. Furthermore, the combination of the two medications led to significantly better results.
creator: Suresh Kumar
creator: Suresh Shanmugham
creator: Fern Yee Tan
creator: Ashley Haze Zhi Xuan Kong
creator: Chen Xing Foong
creator: Jia En Chan
creator: Paul T. Antony
creator: Frederick Charles Smales
creator: Siew Mooi Ching
creator: Harsha Vadakkechalil
creator: Sajesh K. Veettil
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 1037–1046
ending page: 1037–1046
doi: 10.15584/ejcem.2025.4.15

Harnessing therapeutic potential of vitamins and microelements to mitigate testicular damage caused by drugs or chemical toxins ‒ a review
type: item
description: Introduction and aim. Exposure to drugs and chemical toxins has been a common cause of structural and functional impairment of the male gonad (or testis), often leading to male reproductive disorder and infertility. Health concerns due to drugs or chemical-induced testicular damage have increased the exploration of potential therapeutic agents including vitamins and microelements. This review summarizes therapeutic role of vitamins and microelements against drugs or chemical toxins in preclinical studies. Material and methods. Relevant articles published on scientific databases like PubMed, Google Scholar, Scopus, and Web of Science were retrieved and critically reviewed for this study. Analysis of the literature. The mitigating effect of essential vitamins (such as vitamin B2, vitamin B9, vitamin B12, vitamin B17, vitamin C, vitamin E) and microelements (such as zinc and selenium) has been demonstrated on testicular damage caused by exposure to drugs and chemical toxins in preclinical studies and associated with their antioxidant, anti-inflammatory and anti-apoptotic properties. This was further characterized with reparation of testicular histopathology, suppression of testicular oxidative damage, improved sperm parameters, elevated testicular antioxidants and testosterone level, upregulation of steroidogenic gene, inhibition of sperm DNA damage. Conclusion. Vitamins and microelements exert therapeutic effect against drugs and chemical-induced testicular damage.
creator: Dayo Rotimi Omotoso
creator: Oluwaseun Iwasokun
creator: Oluwasegun Davis Olatomide
creator: Tolulope Timothy Arogundade
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 1047–1059
ending page: 1047–1059
doi: 10.15584/ejcem.2025.4.18

Review of the therapeutic effect of alpha-tocopherol, ascorbic acid, and folic acid against ovarian toxicity induced by drugs and heavy metals
type: item
description: Introduction and aim. The ovaries are almond-shaped organs that produce the female gametes and reproductive hormones. They also play a critical role of ovulation under well-coordinated hormonal regulation. However, chemotherapy involving the application of drugs to combat chronic diseases (like cancer) results in toxicity to tissues like ovaries. Similarly, exposure to heavy metals has a toxic effect on the ovaries. Hence, potential therapeutic agents including vitamin antioxidants have been explored to combat ovarian toxicity caused by drugs or heavy metals. Material and methods. This review was based on previous articles archived on Web of Science, PubMed, Scopus and Google Scholar databases. After initial assessment, the relevant articles were selected for further critical assessment. Analysis of the literature. Induction of oxidative stress and activation of inflammo-apoptotic signaling were indicated as the major mechanisms of ovarian toxicity due to exposure to drugs and heavy metals. Moreover, vitamins such as alpha-tocopherol, ascorbic acid and folic acid demonstrated therapeutic effects against drug and heavy metal-induced ovarian toxicity based on their modulatory effect on the downstream mechanisms of the toxicity. Conclusion. Vitamins exert a therapeutic effect against ovarian toxicity caused by drugs or heavy metal exposure due to their antioxidant, anti-inflammatory and anti-apoptotic properties.
creator: Dayo Rotimi Omotoso
creator: Opemiposi Oreoluwa Alamu
creator: Olaoluwa Aderinto
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 1060–1068
ending page: 1060–1068
doi: 10.15584/ejcem.2025.4.23

Harnessing the gut-brain axis in the treatment of type 2 diabetes mellitus and obesity
type: item
description: Introduction and aim. The most common metabolic disorders include type 2 diabetes (T2DM) and obesity. Their prevalence has increased in recent years. Due to their widespread prevalence and the fact that they increase the risk of cardiovascular disease, morbidity, and mortality, they pose a significant economic burden to the healthcare system. In this review, we will focus primarily on the role of gut hormone signaling produced by enteroendocrine cells (EECs), which are part of the gut-brain axis. Furthermore we will summarize applications of these mechanisms in novel therapies for T2DM and obesity. Material and method. Literature data analysis was performed using the following databases: PubMed (MEDLINE), Scopus, Web of Science and Google Scholar. The review included articles in Polish and English published between 2000 and 2024. Analysis of the literature. EECs are specialized transepithelial cells present throughout the intestine. The best-studied EEC subtype is the L cell, which secretes glucagon-like peptide-1 (GLP-1). GLP-1 regulates insulin secretion and contributes to satiety by increasing insulin secretion and inhibiting glucagon secretion. Significant progress in the use of intestinal hormones in the treatment of T2DM and obesity has led to the development of effective therapies for both of these conditions, such as GLP-1 analogs. Conclusion. The growing understanding of biochemical processes, hormonal signaling, and the development of new technologies contribute to the continuation of research on new, more effective therapies that use mechanisms of action of the gut-brain axis. Despite these achievements, the need for new and more effective treatments is constantly growing, and requires innovative strategies and their potential combination with existing therapies.
creator: Kornela Kotucha
creator: Katarzyna Kapłon
creator: Magdalena Moś
creator: Jakub Fiegler-Rudol
creator: Alina Pietryszyn-Bilińska
creator: Klaudia Dynarowicz
creator: David Aebisher
creator: Rafał Wiench
creator: Aleksandra Kawczyk-Krupka
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 1069–1080
ending page: 1069–1080
doi: 10.15584/ejcem.2025.4.24

Doxorubicin-induced cell cycle arrest and apoptosis in HL-60 leukemia cells – a narrative review
type: item
description: Introduction and aim. Doxorubicin is an anthracycline widely used in cancer therapy. Although the complete mechanism of action of doxorubicin is not fully understood, it is known to effectively destroy cancer cells by intercalating into DNA. This article aims to evaluate the anticancer effect of doxorubicin with particular emphasis on HL-60 leukemia cells and cell cycle/apoptosis. Material and methods. This narrative review contains a collection and evaluation of peer-reviewed publications on the anticancer properties and therapeutic applications of doxorubicin. It focuses on doxorubicin-induced cell cycle arrest and apoptosis in HL-60 leukemia cells, with particular emphasis on toxicity and resistance. A literature review was conducted using the following databases: PubMed and Google Scholar. Analysis of the literature. Doxorubicin exhibits potent anticancer activity against many cancer types. Unfortunately, due to serious side effects, primarily related to the cardiotoxicity of the drug, its potential cannot be fully exploited. Conclusion. In recent years, many approaches have been developed to circumvent the limitations of doxorubicin. Identifying all the pathways of doxorubicin action is important for planning combination therapy, mitigating side effects, and developing new drugs. However, further clinical studies are needed to determine their long-term safety and efficacy.
creator: Dominika Rzeszutek
creator: Ewelina Kuna
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 1081–1087
ending page: 1081–1087
doi: 10.15584/ejcem.2025.4.30

Dipeptidyl peptidase-4 dysregulation and inflammatory cytokines as dual biomarkers in ulcerative colitis ‒ a case-control study
type: item
description: Introduction and aim. Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) characterized by immune dysregulation and mucosal inflammation. Current UC biomarkers lack specificity, underscoring the need for novel diagnostic tools. Dipeptidyl peptidase-4 (DPP-4), a serine protease implicated in immune modulation and inflammation, and interleukin-7 (IL-7), a cytokine linked to mucosal immune dysregulation, may serve as dual biomarkers. This study aimed to evaluate the diagnostic utility of serum levels of DPP-4, C-reactive protein (CRP), and IL-7 to differentiate UC patients with UC from healthy individuals. Material and methods. This research conducted a case-control study involving 130 individuals, 65 diagnosed with UC and 65 apparently healthy individuals serving as the control group. Blood samples were obtained to measure DPP-4, IL-7, insulin and C-reactive protein levels. Results. The study demonstrated a significantly higher level of inflammatory markers compared to the healthy controls with a significantly higher CRP (23.38±17.76 vs. 2.38±0.89 mg/dL, p<0.001) and IL-7 concentrations (62.39±19.7 vs. 22.86±4.73 ng/L, p<0.001). and lower level of DPP-4 activity (1.33±0.19 vs. 2.37±0.35 U/L, p<0.001). ROC curve analysis revealed the excellent diagnostic performance of DPP-4 and IL-7 in identifying UC. Conclusion. Reduced serum DPP-4 levels and elevated levels of inflammatory markers (CRP and IL-7) highlight their utility as dual biomarkers for the diagnosis and monitoring of UC disease. DPP-4 expression is inversely correlated with inflammation. These biomarkers demonstrate diagnostic potential for UC; however, longitudinal studies are needed to assess their role in monitoring disease progression and response to treatment.
creator: Hamza Hussein Hamid
creator: Ban Mahmood Shaker
creator: Ali Jaber Almamory
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 828–834
ending page: 828–834
doi: 10.15584/ejcem.2025.4.1

Evaluation of adrenomedullin, growth differentiation factor-15, and atrial natriuretic peptide in patients with rheumatoid arthritis
type: item
description: Introduction and aim. Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by joint inflammation and systemic complications, including cardiovascular involvement. This study evaluated the diagnostic utility of angiotensinogen (AGT), serum amyloid A-4 protein (SAA4) and C-reactive protein (CRP) in RA, along with new cardiac biomarkers adrenomedullin (ADM), growth differentiation factor-15 (GDF-15), and atrial natriuretic peptide (ANP), to assess cardiac complications. Material and methods. This case-control study included 61 RA patients (divided into newly diagnosed, sDMARD-treated, and sDMARD/bDMARD-treated groups) and 27 healthy controls. Serum levels of AGT, SAA4, CRP, ADM, GDF-15, and ANP were measured using ELISA. Statistical analyses were performed using SPSS software. Results. RA patients exhibited significantly elevated levels of AGT (40.841±17.285 µg/mL), SAA4 (48.128±17.065 ng/mL), CRP (13.097±18.702 mg/L), ADM (96.295±19.424 pg/mL), GDF-15 (1247.049±854.335 pg/mL), and ANP (334.016±40.874 pg/mL) levels compared to controls (p≤0.001). No significant differences were observed between the treatment groups for AGT, SAA4, or CRP levels. Cardiac biomarkers (ADM, GDF-15, and ANP) remained elevated in all RA groups, with strong inter-parameter correlations (Spearman r>0.6). Conclusion. AGT, SAA4, and CRP demonstrate robust diagnostic value for RA. Persistent elevation of ADM, GDF-15, and ANP in all patient groups confirms significant cardiac involvement in RA.
creator: Ammar Ali Ahmed
creator: Abdulkareem M. Jewad
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 835–842
ending page: 835–842
doi: 10.15584/ejcem.2025.4.2

Exploring the role of B complex vitamins in reproductive health ‒ valuable insights and unresolved issues regarding premature ovarian failure
type: item
description: Introduction and aim. Premature ovarian failure (POF) is a condition distinguished by a decline in ovarian follicles in women under 40 leading to a disruption in the normal menstrual cycle and fertility. Vitamin B-6 (pyridoxine) and vitamin B-12 (cyanocobalamin) play an important role in ovarian health. The aim was to investigate the effects of vitamins B-6 and B-12, for predicting POF via the association of these vitamins with other biochemical parameters. Material and methods. A total of 80 participants with age ≤ 40 years, 40 POF women, and 40 fertile control women were recruited in this study from November 2023 to March 2024. Serum levels of prolactin (PRO), thyroid hormones, estradiol (E-2), progesterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), 17-alpha hydroxylase, and inhibin alpha (INH-α) were measured using the ELISA technique while vitamins B-6 and B-12 were measured by HPLC. Results. Serum levels of reproductive hormones (LH, E2, progesterone, and testosterone), vitamin B-6, B-12, T3, T4, 17-alpha hydroxylase, and INH-α were markedly reduced in POF patients, while levels of FSH, TSH, and PRO were significantly elevated compared to healthy controls. Conclusion. This study highlights the critical role of vitamins B-6 and B-12 in the pathophysiology of POF, suggesting their potential as biomarkers for diagnosis and prognosis.
creator: Dena A. Hashim
creator: Alaa Sh. Abdulbari
creator: Noor M. Ali
creator: Alaa Hussein J. Al-Qaisi
creator: Ahmed Rahmah Abu-Raghif Abu-Raghif
creator: Hayder Ridha-Salman
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 843–852
ending page: 843–852
doi: 10.15584/ejcem.2025.4.3

Frailty in liver cirrhosis ‒ insights into prevalence, determinants, and clinical impact from a tertiary center experience
type: item
description: Introduction and aim. Frailty has emerged as a critical determinant of poor outcomes in patients with liver cirrhosis. This study aims to determine the prevalence and predictors of frailty in patients with liver cirrhosis and assess its clinical impact on disease severity. Material and methods. This cross-sectional study included 460 patients with liver cirrhosis were classified into frail Clinical Frailty Scale (CFS) >4 and non-frail (CFS≤4) groups. Results. The prevalence of frailty among the studied patients was 45.7%. Frail patients were significantly older (60.61±9.06 years), without gender predilection (43.7%, 47.9%). Patients with frailty exhibited significantly worse liver function; higher bilirubin (1.30 (0.90–2.0) vs 0.90 (0.66–1.30) mg/dL, p<0.001) and low albumin (3.9 (3.50–4.10) vs 3.2 (2.60–3.70) g/dL, p<0.001). Multivariate analysis identified age (OR=1.055, 95%CI: 1.023–1.088, p<0.001), body mass index (OR=9.803, 95%CI: 5.067–18.963, p<0.001), and high nutritional risk (OR=20.186, 95%CI: 8.456–48.191, p<0.001) as independent predictors of frailty. Conclusion. Frailty is a significant concern in patients with liver cirrhosis, particularly those with advanced age, diabetes, and severe hepatic dysfunction. Optimizing outcomes for this patient population requires a multi-faceted approach that considers liver disease management, routine frailty assessment, and interventions to enhance physical resilience and address co-morbidities.
creator: Omkolsoum Alhaddad
creator: Maha Elsabaawy
creator: Asmaa Abedelhai
creator: Gamal Badra
creator: Marwa Elfayoumy
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 853–858
ending page: 853–858
doi: 10.15584/ejcem.2025.4.4

Baicalein's neuroprotective effects in a lansoprazole-induced Alzheimer's model in Wistar rats
type: item
description: Introduction and aim. Alzheimer's disease (AD) is a devastating neurodegenerative disorder and the most frequently diagnosed type of dementia. Baicalein, a flavonoid found in the roots of Scutellaria baicalensis, was useful in preventing neuronal injury in various neurodegenerative models. The present study was designed to determine the neuroprotective effect of baicalein in lansoprazole-induced AD in Wistar rats. Material and methods. We used male Wistar rats randomly divided into six groups: control, vehicle, lansoprazole-induced, and baicalein+lansoprazole or baicalein treated. The lowest dose, lansoprazole (30 mg/kg), was administered orally for 28 weeks to induce AD-like pathology. Baicalein (10 mg/kg) was coadministered with lansoprazole in the treatment group. Cognitive functions were evaluated using a Morris water maze (MWM) and a novel object recognition test. Acetylcholinesterase (AChE) activity, determination of oxidative stress, including malondialdehyde, superoxide dismutas, and reduced glutathione levels, and inflammation-related cytokines such as tumor necrosis factor α were biochemically analyzed. We collected hippocampal sections to assess amyloid beta deposition and neuronal integrity histochemically. Results. Lansoprazole-induced rats showed marked cognitive decline accompanied by enhanced AChE activity, increased oxidative stress, and levels of pro-inflammatory cytokines compared to controls (p<0.01). Co-administration of Baicalein significantly improved cognitive performance, AChE activity was reduced to control levels, oxidative stress markers decreased to near-normal values in the brain and blood, and inflammatory cytokines were significantly lower compared to rats treated with the lansoprazole-treated rats (p<0.01). Baicalein treatment attenuated plaque deposition and neuronal injury, as revealed by histopathological analysis in vivo. Conclusion. Baicalein has a protective effect on lansoprazole-induced AD in Wistar rats. These appear to be d…
creator: Priti Sharma
creator: Aditi Giri
creator: Falguni Goel
creator: Sachchida Nand Rai
creator: Prabhash Nath Tripathi
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 859–873
ending page: 859–873
doi: 10.15584/ejcem.2025.4.5

Comparison of clinical profile and outcomes in patients with carbapenem resistant and carbapenem sensitive gram-negative bacteraemia
type: item
description: Introduction and aim. Carbapenem-resistant Gram-negative bacteraemia (CR-GNB), an emerging public health concern due to limited treatment options and high mortality rates. Carbapenems, face reduced efficacy against resistant strains, posing a significant challenge. The aim was to compare clinical profiles and outcomes between CR-GNB and carbapenem-sensitive (CS-GNB) and to identify factors influencing mortality among these patients. Material and methods. This prospective study was conducted at the tertiary care teaching hospital, enrolling 115 patients with GNB (55 CR-GNB and 60 CS-GNB). Following institutional approval and informed consent, patients underwent standardized testing (blood culture and susceptibility testing) with the VITEK method. Results. CR-GNB patients had significantly longer hospital stays (12.88 vs. 8.87 days, p=0.001), higher ICU admissions (90% vs 49.3%), and prolonged antibiotic use (8.7 vs 6.04 days, p=0.001). Pneumonia was more prevalent in CR-GNB (42.5%) while UTIs dominated in CS-GNB cases (64%). Kaplan-Meier analysis showed increased mortality risk in CR-GNB, with hazard ratios of 1.82 (day-14) and 2.12 (day-28). Conclusion. Thus, in our study CR-GNB posed a significant hazard for mortality risk. Thus, early identification, stringent infection control measures, and antimicrobial stewardship are crucial and to develop effective treatment strategies tailored to high-risk populations can enhance patient survival and limit the resistance.
creator: Amarnath Kavuri
creator: Sethuraj Selvaraj
creator: Vignessh Raveekumaran
creator: K.S. Chenthil
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 874–881
ending page: 874–881
doi: 10.15584/ejcem.2025.4.6

Ezetimibe mitigates DNCB-induced mouse model of eczematous dermatitis
type: item
description: Introduction and aim. Atopic dermatitis (AD) is a life-long inflammatory dermatosis that features dry, erythematous skin. Ezetimibe is a lipid-lowering agent with enhanced anti-inflammatory and anti-oxidative capacities. This work attempted to evaluate the anti-eczematous action of topically administered ezetimibe in a mouse prototype of 1-chloro-2,4-dinitrobenzene (DNCB)-evoked AD. To our knowledge, this is the first study to investigate the topical use of ezetimibe in an experimental model of AD. Material and methods. Thirty male Swiss albino mice were randomly allocated into five groups: healthy control, DNCB-induced model, vehicle, tacrolimus (0.1% ointment), and ezetimibe (2% ointment). Treatments were applied daily for 21 days. Clinical severity scores, total and differential leukocyte counts, histopathological changes, immunohistochemical expression of interleukin (IL)-4 and IL-13, and tissue levels of IgE, malondialdehyde (MDA), IL-17, IL-31, transforming growth factor-β (TGF-β), and tumor necrosis factor-α (TNF-α) were assessed. Results. DNCB increased dermatitis severity (EASI score 9.8±0.7 vs. 0.5±0.1 in controls, p<0.001), total leukocytes (14.2±1.6 ×10³/mL vs. 3.9±0.6 ×10³/mL, p<0.001), and IgE (356±42 ng/mL vs. 92±15 ng/mL, p<0.001). Ezetimibe treatment significantly reduced EASI scores (2.1±0.4, p<0.01 vs. DNCB), leukocytes (5.9±0.3 ×10³/mL, p<0.01 vs. DNCB), IgE (128±18 ng/mL, p<0.01 vs. DNCB), and MDA (2.3±0.4 µmol/L vs. 5.9±0.7 µmol/L in DNCB, p<0.001). Pro-inflammatory cytokines IL-4, IL-13, IL-17, IL-31, TGF-β, and TNF-α were also markedly decreased (all p<0.05), with effects comparable to tacrolimus. Conclusion. Topical ezetimibe significantly alleviated DNCB-induced AD-like lesions by reducing histopathological changes, leukocyte infiltration, IgE, oxidative stress, and key inflammatory cytokines. These findings support ezetimibe as a potential adjunctive topical therapy for immune-mediated dermatoses, warranting future clinical evaluation.
creator: Amnah Muntasser Shallal
creator: Ahmed Rahmah Abu-Raghif
creator: Hayder Ridha-Salman
creator: Worood Hameed Al-Zheery
creator: Ali Jihad Hemid Al-Athari
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 882–897
ending page: 882–897
doi: 10.15584/ejcem.2025.4.7

A retrospective study on sickle cell disease-associated cardiovascular anomalies
type: item
description: Introduction and aim. Sickle cell disease (SCD), a chronic inherited hemolytic disorder prevalent in certain regions of India and globally, is associated with various cardiovascular complications that significantly impact morbidity and mortality. The objective is to assess the relationship among clinical, electrocardiographic, and echocardiographic findings in individuals diagnosed with sickle cell disease, and, as a secondary aim, to contrast these findings with those observed in patients with SCTtaking into account different age groups across both sexes. Material and methods. This study included thirty-four individuals previously diagnosed with sickle cell disease or SCTbased on hemoglobin electrophoresis. Clinical records were reviewed to obtain data from comprehensive examinations, including electrocardiographic and echocardiographic assessments. Cardiac function was evaluated, interpreted, and compared between the two groups using documented ECG and echocardiography results. Results. A total of 34 participants were enrolled, including 23 individuals with SCD and 11 with sickle cell trait (SCT). The mean age was 28.6±9.3 years in the SCD group and 30.2±8.7 years in the SCT group (p=0.57). Males predominated in both groups (SCD: 65.2%; SCT: 63.6%). Clinical examination revealed a statistically significant higher frequency of displaced apex beat in the SCD group (60.9%) compared to SCT (18.2%) (p=0.03). Electrocardiographic abnormalities such as left ventricular hypertrophy were more common in SCD (47.8%) than SCT (18.2%) (p=0.04). ST-T changes were seen in 56.5% of SCD vs. 9.1% of SCT (p=0.01). Echocardiographic findings demonstrated significantly elevated pulmonary artery systolic pressure (PASP) in the SCD group (38.6±6.2 mmHg) compared to SCT (28.4±5.7 mmHg) (p < 0.001). Mean pulmonary artery pressure (mPAP) was also higher in SCD (25.3±4.8 mmHg) vs. SCT (19.2±3.9 mmHg) (p=0.002). Tricuspid regurgitation velocity (TRV) was elevated in SCD (2.9±0.3 m/s) compare…
creator: Srikant Kumar Dhar
creator: Asif Dabeer Jafri
creator: Muktesh Singh
creator: Aniket Satale
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 898–905
ending page: 898–905
doi: 10.15584/ejcem.2025.4.8

Zn and Se protect toxic metal mixture-mediated memory deficit by activation of Nrf2-hmox-1 signaling in the hippocampus of female rats
type: item
description: Introduction and aim. Heavy metals mediate neurotoxicity by altering some signaling pathways. This work investigated the effect of two nutritional elements Zn and Se on neurotoxicity caused by toxic metals. Material and methods. Female Sprague Dawley rats (35) were divided in to 5 groups (7 rats/group), treated as follows: orally received deionized water (group I), heavy metals mixture HMM: 20 mg·kg -1; 0.40 mg·kg -1 of Hg; 0.56 mg·kg -1 of Mn; and 35 mg·kg -1 of Pb body weight; of Al (group II), HMM+Zn (zinc chloride; 0.80 mg·kg -1) (group III), HMM+Se (sodium selenite: 1.50 mg·kg -1) (group IV) and HMM+Zn+Se (group V). Before euthanasia of the rats, the Cincinnati Dry Maze, Barnes Maze, and Rotarod tests were performed. After euthanasia, the hippocampus was examined biochemically and histopathologically. Results. Treatment with HMM induced inflammation with increased concentration of interleukin 6 and tumor necrosis factor α (30.70±6.65, p<0.02 pg/mg protein and 14.20±4.81 pg/mg protein, p<0.0001) respectively, compromised antioxidants levels, potentiated lipid peroxidation (higher malondialdehyde at 0.94±0.04 nmol/g tissue, p<0.0001 and nitric oxide at 3.89±0.16 nmol/g tissue, p<0.0001 levels), disrupted Nrf2 signaling pathway, potentiated acetylcholinesterase activity and induced mild pathohistological alterations in the rat hippocampus. Conclusion. Supplementation with Zn and Se attenuated HMM mediated neurotoxicity.
creator: Chinyere S. Dike
creator: Chinna N. Orish
creator: Anthonet N. Ezejiofor
creator: Theresa C. Umeji
creator: Ana Cirovic
creator: Aleksandar Cirovic
creator: Orish E. Orisakwe
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 906–918
ending page: 906–918
doi: 10.15584/ejcem.2025.4.9

Elevated estrogen receptor beta and oxidative stress in postmenopausal women with ovarian cancer
type: item
description: Introduction and aim. Ovarian cancer in postmenopausal women is associated with hormonal dysregulation and oxidative stress. This study investigates the relationship between estrogen receptor beta (ERβ), selected reproductive hormones, and oxidative stress markers in women with ovarian cancer compared to healthy controls. To our knowledge, this is one of the first studies to evaluate these parameters in an integrated way, offering new insights into the pathophysiological mechanisms underlying postmenopausal ovarian cancer. Material and methods. Blood samples were collected from 45 postmenopausal women with ovarian cancer immediately after diagnosis to be compared with 45 healthy women. ERβ and some hormones were evaluated using an enzyme-linked immunosorbent assay. Chemiluminescence imunoassays and miniVIDAS, while spectrophotometric methods were used to evaluate variables associated with oxidative stress. Results. The results show a significant increase in beta estrogen receptor values for women with ovarian cancer 12.69±1.79 ng/mL, p<0.001 compared to healthy women 0.47±0.06 ng/mL. Furthermore, a significant increase was observed in the values of each estrogen (E2) 18.4±2.19 pg/mL vs. 16.20±3.45 pg/mL, p=0.001, anti-Müllerian hormone (AMH) 15.56±2.88 pmol/L vs. 1.22±0.29 pmol/L, p<0.001, and total oxidant status 2.93±0.63 µmol/L vs. 0.65±0.09 µmol/L, p<0.001. On the contrary, a significant decrease in total antioxidant capacity 3.22±0.72 mmol/L vs. 10.04±1.50 mmol/L, p<0.001. The results also show a positive correlation between the values of total oxidants and the hormones studied, compared to the negative correlation with total antioxidants. Conclusion. The significant increase in the values ​​of ERβ as well as the estrogen hormone that may be derived from adipose tissue in women with ovarian cancer in the postmenopausal stage, has multiple effects, for example, by altering some hormones such as progesterone, dehydroepiandrosterone sulfate, testosterone, and AMH.…
creator: Ali M. A. Al-Kufaishi
creator: Noor J.T. Al-Musawi
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 919–926
ending page: 919–926
doi: 10.15584/ejcem.2025.4.10

Impact of multicomponent training on functional fitness among older adults in rural India
type: item
description: Introduction and aim. In rural India, preserving functional fitness is crucial for older adults to maintain independence and perform daily activities without assistance. This study examines the effectiveness of multicomponent training (MCT) in improving functional fitness among older adults in rural India. Methods: Thirty participants (mean age 64.50±3.67 years) engaged in a structured low-to-moderate intensity exercise program three times per week for six weeks. Functional fitness was assessed at baseline, three weeks, and six weeks using the Senior Fitness Test (SFT). Results. In a short period of six weeks, significant improvements were observed in lower-body strength (p<0.001), endurance (p<0.001), flexibility (p<0.01), and overall functional fitness (p<0.001), with lower-body strength and endurance surpassing minimal detectable change thresholds. Females had lower baseline performance but showed greater improvement. Conclusion. MCT effectively enhances functional fitness in older adults. However, additional upper-body strength and balance exercises may be beneficial for comprehensive improvements.
creator: Krishnapriya K.
creator: Smitha Soman
creator: Jaison Jacob
creator: Anoop S. Nair
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 927–935
ending page: 927–935
doi: 10.15584/ejcem.2025.4.12

Aprocitentan mitigates ischemia reperfusion induced kidney injury in rats by attenuating inflammation and pyroptosis through suppressing NF-κB/NLRP3/caspase-1 signaling pathway
type: item
description: Introduction and aim. Renal ischemia-reperfusion (I/R) injury is a primary cause of acute kidney injury (AKI). The NF-κB/NLRP3/caspase-1 signaling system is crucial for I/R-induced kidney damage, which leads to inflammation, pyroptosis, and tissue damage. Aprocitentan has anti-inflammatory and vasoprotective properties, suggesting its potential nephroprotective advantages. The aim of this investigation was to evaluate the protective advantages of aprocitentan against renal I/R injury in rat models. This was achieved by evaluating the impact of aprocitentan on inflammation, pyroptosis, and kidney function by altering the NF-κB/NLRP3/Caspase-1 pathway. Material and methods. Using twenty-four adult male Sprague-Dawley rats, four separate groups were formed: sham group, I/R control group, dimethyl sulfoxide group (DMSO) and aprocitentan group (10 mg/kg). Renal ischemia/reperfusion was induced by a period of forty minutes of bilateral ischemia, which was followed by two hours of reperfusion. To evaluate the renoprotective effect of aprocitentan urea, creatinine, neutrophil gelatinase-associated lipocalin (NGAL), phosphorylated nuclear factor kappa B p65 (NF-κB p65), NOD-like receptor protein 3 (NLRP3), and cysteine-aspartic protease-1 (caspase-1), were measured, along with histopathological examination. Results. Compared to the sham group, the I/R control group had significantly increased concentrations of urea, creatinine, NGAL, NF-κB p65, NLRP3, as well as caspase-1. These signs decreased in the aprocitentan group, leading to enhanced renal function, reduction of inflammation, and inhibition of pyroptosis. Histology showed a decrease in tubular inflammation and necrosis in the aprocitentan group. Conclusion. Aprocitentan decreases inflammation and inhibits pyroptosis by suppressing the NF-κB/NLRP3/Caspase-1 pathway. These results illustrate its promising potential to prevent ischemic renal diseases, including acute kidney injury.
creator: Layla Ameen Rasheed Alfatli
creator: Thu-Alfeqar R. Tweij
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 936–946
ending page: 936–946
doi: 10.15584/ejcem.2025.4.13

Apelin, C-reactive protein, and serum protein correlation with blood pressure ‒ a biomarker analysis
type: item
description: Introduction and aim. Hypertension is a major global health burden and a leading cause of cardiovascular disease and premature death. This study aimed to evaluate the association between serum apelin, inflammatory markers, and protein metabolism parameters in hypertensive patients compared to normotensive controls. This study uniquely explores the interplay between inflammatory and protein metabolism biomarkers using advanced multivariate models in hypertensive adults, a combination not previously examined in this population Material and methods. Two hundred adults aged 35–65 years were divided into hypertensive (n=100) and normotensive (n=100) groups. Serum apelin and C-reactive protein (CRP) levels were measured using enzyme-linked immunosorbent assay, while albumin and total protein were assessed via spectrophotometry. Statistical analyses included t-tests, multiple regression, structural equation modeling (SEM), and Cox regression. Results. Hypertensive patients had significantly higher blood pressure (p<0.001), CRP (7.52±4.21 vs. 1.35±0.51 mg/L; p<0.001), globulin (3.4±1.0 vs. 1.8±0.9 g/dL; p<0.001), and total protein, but lower apelin (2386.2±401.7 vs. 2873.4±572.8 pg/mL; p<0.001) and albumin levels. SEM revealed a direct association between CRP and systolic blood pressure (β=0.45, p<0.001), and a negative association between apelin and systolic pressure (β=−0.20, p=0.03). CRP (HR=1.75, p=0.005) and systolic BP (HR=1.52, p<0.001) were independent predictors of cardiovascular events. Conclusion. The findings suggest that systemic inflammation and dysregulation of serum protein metabolism are significantly associated with hypertension and cardiovascular risk. Apelin may play a protective role by mitigating the impact of inflammation on blood pressure.
creator: Zahraa Ahmed Mutaeb
creator: Usama H. Ramadhan
creator: Ekhlas Qanber Jasim
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 947–954
ending page: 947–954
doi: 10.15584/ejcem.2025.4.16

Evaluating tumor necrosis factor-alpha and interleukin 17 as plasma biomarkers for rheumatoid arthritis diagnosis
type: item
description: Introduction and aim. Rheumatoid arthritis (RA) is a complex chronic inflammatory autoimmune disease with significant global health implications. In this study, our aim was to evaluate the clinical utility of plasma tumor necrosis factor-alpha (TNF-α) and interleukin-17 (IL-17) along with immunological parameters as diagnostic biomarkers for patients with RA. Material and methods. A case-control study was conducted involving 75 RA cases and 75 age- and sex-matched controls. Plasma levels of TNF-α and IL-17 were measured using ELISA kits. Statistical analyses included receiver operating characteristic (ROC) curve analysis and correlation tests to evaluate the diagnostic accuracy, predictive value, and associations with disease activity parameters. Results. RA patients exhibited significantly elevated TNF-α (275.5±99.9 vs. 46.2±8.4 pg/mL, p<0.001) and IL-17 (313.8±95.4 vs. 42.2±10.96 pg/mL, p<0.001) compared to controls. Patients with a family history of RA had higher TNF-α (p=0.019) and IL-17 (p=0.03) levels. ROC analysis revealed perfect diagnostic accuracy for both biomarkers (100% sensitivity and specificity) at cut-offs >65.2 pg/mL (TNF-α) and >83 pg/mL (IL-17). Conclusion. There was a positive correlation between serum levels of IL-17 and TNF-α. Therefore, these biomarkers distinguish rheumatoid arthritis patients from healthy controls.
creator: Alaa H. Abd Ali
creator: Farah Majid Kharbat
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 955–961
ending page: 955–961
doi: 10.15584/ejcem.2025.4.17

Evaluation of endothelin 1 and N-terminal pro-B-type natriuretic peptide in patients with rheumatoid arthritis
type: item
description: Introduction and aim. Rheumatoid arthritis (RA) is a chronic disease characterized by synovial inflammation and joint destruction. This study evaluated the novel biomarkers vitamin D binding protein (VDBP), retinol-binding protein 4 (RBP4), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and endothelin-1 (ET-1) for RA diagnosis. To our knowledge, this is the first study to simultaneously assess these biomarkers across different treatment stages in RA, linking systemic inflammation with subclinical cardiovascular involvement. Material and methods. A case-control study enrolled 61 RA patients [G1 (newly diagnosed, untreated, n=10)], G2 [3 months csDMARDs, n=22], G3 [≥6 months biologic+csDMARDs, n =29]), 27 age/sex-matched healthy controls. The serum levels of VDBP, RBP-4, CRP, NT-proBNP, and ET-1 measured using enzyme-linked immunosorbent assay. Results. All evaluated biomarkers were significantly elevated in RA patients compared to controls (p<0.0001): RBP-4 (49.172±21.935 vs. 14.006±3.988 ng/mL), VDBP (12.091±3.334 vs. 2.882±1.136 ng/mL), NT-proBNP (1341.787±626.068 vs. 11.452±3.260 pg/mL), ET-1 (14.246±4.031 vs. 3.932±1.422 pg/mL). Subgroup analysis revealed a significantly higher VDBP in newly diagnosed untreated patients (G1:14.455±4.126 ng/mL) than in treated groups (G2:11.379±2.632; G3:11.816±3.269 ng/mL; p<0.05). NT-proBNP peaked in G1 (1789.2±710.81 pg/mL), decreased in csDMARD-treated (G2: 1154.0±537.58 pg/mL), biologic-treated (G3: 1329.96±601.18 pg/mL) group. Conclusion. VDBP, RBP-4, CRP are effective diagnostic biomarkers of RA. Significant elevations in NT-proBNP and ET-1 levels associated with cardiac complications, correlated with disease activity, and improved with therapy.
creator: Ammar A. Ahmed
creator: Abdulkareem M. Jewad
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 962–968
ending page: 962–968
doi: 10.15584/ejcem.2025.4.19

Neuroprotective effects of Vernonia amygdalina and Moringa oleifera in alloxan-induced diabetic Wistar rats
type: item
description: Introduction and aim. Diabetes mellitus is a metabolic disorder that affects multiple organs, including the hippocampus, a key region involved in memory. This study aimed to investigate the neuroprotective and antidiabetic effects of Vernonia amygdalina and Moringa oleifera in an alloxan-induced diabetic rat model. Materials and methods. Thirty-five adult Wistar rats were randomized into seven groups and treated with aqueous extracts of V. amygdalina, M. oleifera, their combination, or glibenclamide for 30 days following alloxan-induced diabetes. Fasting blood glucose (FBG), hippocampal acetylcholinesterase (AChE) activity, cognitive performance (Morris Water Maze test) and histopathological changes in the hippocampus were evaluated. Results. Alloxan significantly increased FBG (20.68±1.04 mmol/L), AChE activity (40.40±0.40 nmol/mL), and escape latency (51.75±4.39 sec), and reduced hippocampal cell density. Treatment with V. amygdalina and M. oleifera reduced FBG (8.29±0.93 mmol/L), AChE activity (34.50±0.30 nmol/mL), and escape latency (3.39±0.45 sec), and improved hippocampal histoarchitecture. Conclusion. V. amygdalina and M. oleifera demonstrated neuroprotective and antidiabetic effects in diabetic rats. These results support their potential as adjunct agents to prevent diabetes-induced cognitive dysfunction.
creator: Acharaike Amarachi Chidimma
creator: Uzozie Chikere Ofoego
creator: Damian Nnabuihe Ezejindu
creator: Paul Matthew Demshimeno
creator: Makuachukwu Francisca Obinwa
creator: Benedict Nzube Obinwa
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 969–977
ending page: 969–977
doi: 10.15584/ejcem.2025.4.20

Association between handgrip strength and cognitive function in older adults living with cancer
type: item
description: Introduction and aim. Handgrip strength (HGS) serves as a key indicator of muscle performance and may reflect cognitive status in older cancer patients. We examined whether handgrip strength was associated with cognitive function in this group of patients. Material and methods. For this study, a cross-sectional design was used, analyzing data from patients aged 60 years and older diagnosed with cancer, collected through Comprehensive Geriatric Assessments (CGAs). The information included demographics, HGS levels, and Mini-Mental State Examination (MMSE) scores. Results. Among 352 participants (average age 75.7 years), HGS showed a moderate positive correlation with cognitive function, stronger in females (r=0.36, p<0.001) than in men (r=0.22, p=0.005). Each 1 kg increase in HGS was associated with a 0.29-point increase in MMSE scores in women and 0.13 points in males. Conclusion. Higher HGS appears to better cognitive outcomes in older adults with cancer. As muscle strength is potentially modifiable, future research should explore whether HGS-targeted interventions could preserve or enhance cognitive health. Implementing regular handgrip strength assessments in geriatric oncology could help to detect patients who are vulnerable to cognitive decline.
creator: Teodoro J. Oscanoa
creator: Edwin Cieza-Macedo
creator: Roman Romero-Ortuno
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 978–983
ending page: 978–983
doi: 10.15584/ejcem.2025.4.21

Sex differences in hypertension prevalence and risk factors in India ‒ a comparative study based on National Family Health Survey IV and V
type: item
description: Introduction and aim. Hypertension is increasing universally, mainly in developing countries like India. This study analyzed sex differences in hypertension using data from National Family Health Survey (NFHS) rounds IV and V, with a focus on prevalence trends and associated risk factors. Material and methods. This study utilized data from NFHS rounds IV and V, focusing on males and females aged 15–49 years. The samples included 103,525 males and 667,258 females in NFHS-IV, and 93,267 males and 695,707 females in NFHS-V. Univariate, bivariate, and multivariate analytical techniques were employed to address the study’s objectives. Results. The NFHS-IV and V data revealed a notable increase in hypertension prevalence across India, with significantly higher odds observed among individuals in the older reproductive age group (45–49 years) for both sexes. Hypertension occurred 4.85 times higher among male in the age group 45‒49 compared to 15-24 age group, which rose to 5.23 in NFHS-V. Among female, the odds increased from 5.39 in NFHS-IV to 6.40 in NFHS-V. Remarkably, illiterate male showed lower odds of hypertension linked to their educated peers in both survey rounds, while female with only primary education showed higher odds. Regional disparities were also evident, with both male and female from the Northeast showing elevated odds ‒ particularly female, who had an odds ratio of 1.47 in NFHS-IV. Conclusion. The observed sex-specific variations in hypertension and its risk factors indicate a need for public health strategies to designed for each gender. Tailored interventions addressing education, lifestyle behaviors, and regional disparities are essential to effectively manage and prevent hypertension in India’s diverse population.
creator: Jang Bahadur Prasad
creator: Ganapati Sabhahit
creator: Rajeshwari A. Biradar
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 984–993
ending page: 984–993
doi: 10.15584/ejcem.2025.4.22

Serum leptin and glucagon-like peptide-1 levels in diabetic patients with end-stage renal disease on hemodialysis ‒ a cross-sectional study in Iraqi patients
type: item
description: Introduction and aim. Diabetic kidney disease (DKD), a common complication of type 2 diabetes mellitus, is the leading cause of end-stage renal disease (ESRD). This study aimed to evaluate differences in serum leptin and glucagon-like peptide-1 (GLP-1) levels between diabetic ESRD patients undergoing hemodialysis and healthy controls. Material and methods. A cross-sectional observational study was conducted involving 65 participants: 31 type 2 diabetic patients with ESRD on hemodialysis and 34 healthy controls. Serum leptin and GLP-1 concentrations were measured using enzyme-linked immunosorbent assays. Results. Patients with ESRD exhibited significantly higher serum leptin levels (1.7±1.0 ng/mL) compared to controls (1.4±0.7 ng/mL; p=0.001), and significantly lower GLP-1 levels (19.6±11.2 pmol/L vs. 37.0±25.7 pmol/L; p=0.001). Conclusion. Elevated leptin levels and reduced GLP-1 concentrations in diabetic ESRD patients suggest a potential role of these biomarkers in renal injury and metabolic regulation. The findings highlight the therapeutic promise of GLP-1 receptor agonists in this population.
creator: Haneen Husham Fadhil
creator: Rana Dawood Salman
creator: Jubran Khaleel Hasan
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 994–999
ending page: 994–999
doi: 10.15584/ejcem.2025.4.25

Exploring the diagnostic potential of micro-RNA-320 and anti-Müllerian hormone in women with polycystic ovary syndrome ‒ a case-control study
type: item
description: Introduction and aim. Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder characterized by hormonal imbalance, insulin resistance, and reproductive dysfunction. Due to its heterogeneous clinical presentation, diagnosis remains challenging. MicroRNA-320a-3p and anti-Müllerian hormone (AMH) have recently emerged as promising biomarkers. This study aimed to assess their diagnostic potential in women with PCOS. Material and methods. A case-control study was performed in 90 women aged 18–40 years, including 45 patients with polycystic ovary syndrome and 45 age- and body mass index-matched healthy controls. Hormonal and metabolic markers were measured using standard immunoassays, and the expression of microRNA-320a-3p was quantified using real-time polymerase chain reaction. Results. Patients with polycystic ovary syndrome demonstrated significantly higher levels of luteinizing hormone (9.45±6.0 vs 5.09±2.2 mIU/mL), increased luteinizing hormone to follicle-stimulating hormone ratio (1.64±0.87 vs 0.76±0.3), and elevated fasting blood glucose (105.5±14.7 vs 94.3±13.5 mg/dL), all with p<0.001. Contrary to expectations, insulin and homeostatic model assessment for insulin resistance values were lower in the polycystic ovary syndrome group, possibly reflecting a predominance of non-obese phenotypes. AMH levels were also reduced (2.27±1.0 vs 3.34±1.1 ng/mL, p<0.001). Expression of microRNA-320a-3p was significantly downregulated (0.61±1.27 vs 2.81±5.03-fold, p=0.0009). MicroRNA-320a-3p expression correlated positively with luteinizing hormone levels and the luteinizing hormone to follicle-stimulating hormone ratio, while AMH was associated with insulin resistance. The combined use of both markers improved diagnostic differentiation between groups. Conclusion. MicroRNA-320a-3p and AMH show promise as diagnostic biomarkers in polycystic ovary syndrome. Their integration with traditional clinical markers may enhance diagnostic accuracy and provide deeper insig…
creator: Zainab Mohammed Talib
creator: Khwam R. Hussein
creator: Hasan Abd Ali Khudhair
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 1000–1010
ending page: 1000–1010
doi: 10.15584/ejcem.2025.4.26

Sotagliflozin prevents acute kidney injury by suppressing oxidative stress, inflammation, and apoptosis in renal ischemia/reperfusion rat model
type: item
description: Introduction and aim. Acute kidney injury (AKI) is a life-threatening condition with limited effective pharmacological options. Although sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown renal protective effects, the potential role of the dual SGLT1/2 inhibitor sotagliflozin in ischemia/reperfusion injury (IRI) has not been previously investigated. We aimed to evaluate its nephroprotective properties in a rat model of renal IRI. Material and methods. Twenty-four male Sprague-Dawley rats were randomized into four groups (sham, control, dimethyl sulfoxide [DMSO], sotagliflozin). Renal IRI was induced by 40 min ischemia followed by 2 h reperfusion. Rats received either DMSO or sotagliflozin (10 mg/kg, intraperitoneally) 24 h and 1 h before surgery. Kidney function (urea, creatinine, neutrophil gelatinase-associated lipocalin [NGAL]), oxidative stress (8-iso-prostaglandin F2α [8-iso-PGF2α]), inflammation (tumor necrosis factor-alpha [TNF-α]), apoptosis (caspase-3), and histopathology were assessed. Results. In the control group, serum urea (106.5±2.9 mg/dL), creatinine (1.52±0.09 mg/dL), and NGAL (64.5±3.6 ng/mL) were significantly higher than in the sham group (32.6±5.3, 0.89±0.06, 49.5±3.8, respectively; p<0.0001). Tissue 8-iso-PGF2α (63.8±5.9 pg/mL), TNF-α (186±7 pg/mL), and caspase 3 (120.3±6.5 pmol/L) were also elevated vs. sham (35.6±3.6, 137±7, 92.3±4.9; p<0.0001). Sotagliflozin pretreatment reduced urea (53.8±2.8 mg/dL), creatinine (1.04±0.07 mg/dL), NGAL (49.6±6.4 ng/mL), 8-iso-PGF2α (41.3±3.9 pg/mL), TNF-α (140±6.6 pg/mL), and caspase 3 (89.7±2.4 pmol/L; all p<0.0001 vs. control). Histological injury scores improved from 4.0 in control to 1.0 in the sotagliflozin group (p<0.05). Conclusion. Sotagliflozin significantly improved renal function and histopathological damage in rats with renal IRI by attenuating oxidative stress, inflammation, and apoptosis. These findings support its potential as a candidate for further investigation in the prevention o…
creator: Nisreen Abd Alhassan Hamza Alshimary
creator: Thu-Alfeqar Razzaq Tweij
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 1011–1020
ending page: 1011–1020
doi: 10.15584/ejcem.2025.4.28

The relationship between dry eye syndrome and serum fat-soluble vitamin levels
type: item
description: Introduction and aim. Dry eye syndrome (DES) is a multifactorial ocular surface disease in which nutritional deficiencies, including fat-soluble vitamins, may play a role. This study aimed to investigate the relationship between serum levels of vitamins A, D, E, and K and DES. Material and methods. A total of 70 eyes from 35 patients with DES and 70 eyes from 35 healthy controls were examined. Dry eye evaluation included tear osmolarity (TO), tear break-up time (TBUT), Schirmer I test, and the Ocular Surface Disease Index (OSDI). Serum vitamin levels (A, D, E, K) were measured using HPLC, LC-MS/MS, and chemiluminescence immunoassay. Results. Patients with DES had significantly higher TO (312.7±4.9 vs. 295.2±6.5 mOsm/L, p<0.001) and OSDI scores (39.8±19.4 vs. 17.2±11.0, p<0.001), and significantly lower Schirmer I (7.0±1.8 vs. 17.3±1.3 mm, p<0.001) and TBUT values (7.3±0.8 vs. 16.1±0.7 s, p<0.001) compared with controls. Serum vitamin A (331.8±87.2 vs. 523.6±109.1 ng/mL, p<0.001) and vitamin D (14.8±6.9 vs. 34.6±14.9 ng/mL, p<0.001) levels were significantly lower in DES patients, whereas vitamin E and K did not differ between groups. Conclusion. Deficiencies in vitamins A and D are associated with impaired tear film parameters and symptoms of DES. These findings suggest that assessing and correcting vitamin A and D deficiency may have clinical relevance in managing DES.
creator: Ceren Gürez
creator: Suat Hayri Küçük
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 1021–1026
ending page: 1021–1026
doi: 10.15584/ejcem.2025.4.29

Postural, behavioural and cognitive effects of sit-stand desk use in primary school children – a crossover intervention pilot study
type: item
description: Introduction and aim. This study explores the effects of implementing stand-biased desks in a classroom setting on physical posture, cognitive performance, and attention in elementary school students aged 11 to 12 years old. Material and methods. The study group consisted of 51 boys from 5th and 6th grades. A crossover intervention design was employed, where students alternated between using traditional and sit-stand desks over the course of the study lasting three months. Anthropometric measurements, posture assessments, and cognitive tests (the d2 Test of Attention and Stroop), were conducted at three intervals (T1/T2/T3): initial, mid-intervention, and post-intervention. Results. During the intervention, significant changes were observed in anthropometric parameters, except for a decrease in body fat percentage. Cognitive testing revealed significant improvements in attentiveness and cognitive control when using the sit-stand desks. Specifically, the d2 test indicated enhanced concentration performance and test effectiveness, particularly when conducted in a standing position. The Stroop test also showed improvements in both time and corrected errors between the second and third assessments. Conclusion. The findings suggest that sit-stand desks may associate with better weight distribution and improved posture, with positive effects on attentiveness and cognitive performance of schoolchildren.
creator: Piotr Matłosz
creator: Jarosław Herbert
creator: Liliya Morska
rights: Copyright (c) 2025 European Journal of Clinical and Experimental Medicine https://creativecommons.org/licenses/by/4.0
license: https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
volume: 23
number: 4
starting page: 1027–1036
ending page: 1027–1036
doi: 10.15584/ejcem.2025.4.31