International Journal of Nutrology

Nutrology of probiotics and nutrients in cancer patients: a systematic review

2026-07-10T01:12:38+00:00

Introduction: In the scenario of immunomodulation by regulatory T cells (Tregs), studies show that the increase in Bifidobacterium probiotics, in addition to colonizing the intestine, alters the intestinal microbiota, activating Treg cells, which produces anti-tumor effects. Objective: This was to establish, through a systematic review study, the main clinical studies that show the positive effects of probiotics and nutrients in stimulating regulatory T cells in cancer patients, to enable immunotherapy for the control, reduction, or even elimination of cancer cells. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from April to May 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 141 articles were found. A total of 40 articles were fully assessed and 31 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 26 studies with a high risk of bias and 24 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X²=67.8%>50%. It was concluded that probiotics, together with intestinal microbiota, have been increasingly proposed to improve immune checkpoint blockade treatments against cancer by activating Treg cells. Oral administration of butyrate, propionate, and acetate, individually or in combination, led to an increase in the number of Treg cells in the colon. Also, all-trans retinoic acid (atRA), a bioactive form of vitamin A, stimulates Treg cells in the human intestine.

Main clinical studies on the impact of nutrition on oral and endodontic health: a systematic review

2026-07-09T15:39:04+00:00

Introduction: In the context of endodontics, oral and periodontal diseases are predictors of various problems, primarily tooth loss in adults. Inflammatory processes are caused by bacteria, genetic factors, lifestyle, and nutrition. Periodontitis can cause alterations and severe damage to oral health and well-being. Numerous clinical and experimental studies highlight a strong association between periodontitis and certain systemic diseases. Objective: It was to conduct a systematic review presenting key clinical studies on the impact of nutrition on oral and endodontic health. Methods: The PRISMA guidelines for systematic reviews were followed. The search was conducted from February to May 2026 across the Scopus, PubMed, Science Direct, SciELO, and Google Scholar databases. Study quality was assessed using the GRADE instrument, and risk of bias was analysed according to the Cochrane tool. Results and Conclusion: A total of 135 articles were identified; 50 were evaluated in full, and 40 were included in this systematic review. Based on the Cochrane risk-of-bias tool, the overall assessment revealed 9 studies with a high risk of bias, while 5 studies failed to meet GRADE and AMSTAR-2 standards. Most studies lacked homogeneity in their results (X² = 75.2% > 50%). This review concluded that nutritional science is essential for oral and endodontic health. Nutrient deficiencies can affect oral health status. Nutritional science addresses nutritional needs and helps prevent diseases associated with a poor diet. A nutrient-deficient diet can accelerate the progression of oral cavity diseases by disrupting tissue homeostasis, reducing resistance to microbial biofilms, and impairing tissue healing, thereby compromising endodontic health and, consequently, systemic health.

Phytochemical screening and pharmacological activities of various fractions derived from Ephedra foeminea Forssk aerial parts

2026-06-16T19:09:36+00:00

Obesity is a major risk of chronic diseases such as metabolic syndrome, cardiovascular diseases and type-2 diabetes mellitus. These diseases are the leading causes of death worldwide. Therefore, it is necessary to search for anti-obesity therapeutics. This study aimed to investigate, in vitro, the anti-obesity effect of Ephedra foeminea Forssk. for the first time. To achieve our aim, acetone, hexane, aqueous and methanol fractions were derived from E. foeminea. It appeared that the four fractions had strong inhibitory effect against the activity of α-amylase enzyme with IC50 value range 13-15 μg/mL. Methanol fraction possessed the strongest inhibitory effect on glucosidase (IC50 117.5 μg/mL) and lipase enzymes activities (IC50 24.5 μg/mL). Furthermore, methanol fraction possessed the strongest antioxidant activity (IC50 14.5 μg/mL) and had no cytotoxic effect. This indicates that methanol fraction is a potential and safe source of therapeutically active compounds with anti-obesity and anti-diabetic potency.

Antioxidant, antimicrobial, and cytotoxic properties of four different fractions derived from the bulbs of Urginea maritima L.

2026-06-16T14:26:25+00:00

Introduction: Urginea maritima L. (U. maritima) has been utilized in traditional medicine, but in many cases, it is not based on scientific evidence due to limited studies, particularly in Palestine. Objective: This study aimed to assess the antioxidant, antimicrobial, and cytotoxic properties of four solvents fractions extracted from U. maritima bulbs collected from Palestine for the first time. Methods: The DPPH method was used to quantify antioxidant activity. Antimicrobial activity was tested employing the broth microdilution method. Anti-proliferative activity was evaluated utilizing colorimetric methods. Results: The DPPH free radical scavenging assay revealed that the U. maritima aqueous and methanol fractions demonstrated no antioxidant properties. In contrast, acetone and hexane fractions exhibited significant activity with IC₅₀ values of 24 and 10.33 μg/mL, respectively. Acetone and hexane fractions had a broader spectrum of antimicrobial activity (ranging from 0.8 to 6.3 mg/mL) compared to aqueous and methanol fractions. Aqueous fractions reduced cell viability by 50% within 24-48 h. Methanol and acetone fractions reduced cell viability by 40% after 4 and 24 h (p-value <0.0001), while prolonged exposure to methanol, acetone, and hexane fractions for 48 hresulted in a substantial decrease in cell viability by 70% to 90% (p-value <0.0001). Conclusion: Our findings have revealed that acetone and hexane fractions exhibited strong antioxidant, cytotoxic, and antimicrobial activities compared to the aqueous and methanol fractions. These observations offer significant insights into the potential therapeutic applications of U. maritima in combatting oxidative stress, microbial infections, and perhaps cancer. Further in vivo investigations are necessary to validate these findings in the future.

Major clinical considerations of nutrients and supplements in the treatment of periodontitis for dental implant success: a scoping review

2026-06-09T11:23:36+00:00

Introduction: With Brånemark's concept of osseointegration in 1960, dental implants have seen significant advancements, particularly in the structural and functional connection between bone and the implant surface. One of the main predictors influencing osseointegration is bone quality fostered by nutrients and the absence of periodontitis. Objective: This study aimed to analyze the clinical considerations of nutrients and supplements in the treatment of periodontitis for dental implant success. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from March to April 2026 in the Web of Science, Scopus, Embase, PubMed, Science Direct, SciELO, and Google Scholar databases. The quality of the studies was based on the GRADE instrument, and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneity in their results, with X²=83.5%>50%. A total of 101 articles were found and submitted for eligibility analysis, with 13 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. It was concluded that probiotic and prebiotic nutraceuticals, polyunsaturated fatty acids, and vitamins A, B, C, D, and E are the most commonly used in dentistry. Evidence suggests a positive relationship between adequate vitamin D levels and early osseointegration of dental implants. Regarding marginal bone changes and peri-implant soft tissue outcomes, the findings were consistent but statistically heterogeneous, with several studies indicating greater bone loss, thinner gingival phenotypes, or a more pro-inflammatory peri-implant environment in the presence of vitamin D deficiency.

Effect of cytokinin on growth parameters, yield, and medicinally active compounds of roselle (Hibiscus sabdariffa L.) under water stress conditions

2026-06-03T22:08:33+00:00

Introduction: Water stress significantly limits the agricultural and medicinal potential of roselle (Hibiscus sabdariffa L.). Exogenous plant growth regulators, such as cytokinins, may mitigate these adverse environmental effects and enhance overall plant productivity. Objective: To investigate the impact of cytokinin application and varying water stress levels on the vegetative growth, yield, and medicinally active compounds of roselle. Methods: A factorial field experiment using a Randomized Complete Block Design (RCBD) with three replications was conducted during the spring season of 2025 in Al-Mussaib, Iraq. Treatments consisted of three cytokinin levels (0, 50, and 100 mg L⁻¹) and four water stress levels (25%, 50%, 75%, and 100% of field capacity). Data were statistically analyzed using the Least Significant Difference (LSD) test. Results: The application of 100 mg L⁻¹ cytokinin significantly maximized plant height (95.08 cm), branches (9.20 plant⁻¹), leaves (106.70 plant⁻¹), capsules (38.83 plant⁻¹), and calyces’ dry weight (9.30 g). It also peaked the concentrations of vitamin C, quercetin, hibiscetin, and gossypetin. Similarly, irrigation at 75% field capacity produced the highest mean values for the same traits. Crucially, the interaction between 100 mg L⁻¹ cytokinin and 75% field capacity recorded the absolute highest values across all studied morphological, yield, and phytochemical parameters. Conclusions: Applying 100 mg L⁻¹ of cytokinin optimally enhances the growth, yield, and phytochemical composition of Hibiscus sabdariffa L., particularly when combined with

moderate water management (75% field capacity). This combination provides an effective agronomic strategy for cultivating this medicinal crop under constrained water conditions.

Graphical Abstract

Clinical studies on the interrelationship between gut microbiota and oral health for systemic homeostasis: a systematic review

2026-05-29T18:13:30+00:00

Introduction: The oral microbiota has shown important actions in the physical and mental health of human beings. Oral diseases related to oral dysbiosis are studied, as well as systemic degenerative inflammatory diseases. Objective: It was to present and discuss the main considerations and results of clinical studies on the interrelationship between gut microbiota and oral health for systemic homeostasis. Methods: The PRISMA Guidelines were followed. The search was conducted from January to February 2026 across the Web of Science, Scopus, Embase, PubMed, ScienceDirect, SciELO, and Google Scholar databases. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneous results, with X2=67.5% > 50%. A total of 112 articles were found and submitted for eligibility analysis, with 18 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 35 studies with a high risk of bias and 21 studies that did not meet GRADE and AMSTAR-2 standards. It was concluded that there are distinct causal relationships between the microbiota and acute and chronic gingivitis. Oral microbiota dysbiosis not only induces local inflammation and exacerbates inflammation associated with metabolic diseases, but can also trigger systemic inflammation, leading to metabolic and neuropsychiatric disorders. Clinical studies have shown the effectiveness of anti-inflammatory treatments of the gut and oral microbiota in reducing periodontal disease and cognitive decline. The integration of advanced microbiome analysis and neuroimaging techniques may help to elucidate the mechanisms linking gut health, systemic inflammation, and cognitive function.

Midwives practices regarding standardized guidelines for prevention of postpartum hemorrhage: a cross-sectional analysis

2026-05-26T08:36:07+00:00

Introduction: Postpartum Hemorrhage is still one of the greatest dangerous and significant problems that can happen during birth. Most Postpartum Hemorrhage cases can be prevented and managed with prompt intervention and standardized protocols. Objective: The research aim was to assess midwives’ level of practice regarding standardized guidelines for prevention of postpartum hemorrhage. Methods: To achieve the study's objectives, a descriptive crosssectional design was adopted. two tools were used to collect data. The first instrument was a selfadministered structured questionnaire that included questions about the demographic characteristics of midwives, and the second instrument was Observational Checklist for assess midwives' practices regarding guidelines for prevention of postpartum hemorrhage: It was an adopted from the World Health Organization's (WHO) guidelines updated in 2023, and The Iraqi Ministry of Health's guidelines for prevention of primary postpartum hemorrhage (PPH). The questionnaire was tested by professionals and showed good reliability (Cronbach alpha= 0.82). SPSS version 25 was used to code, input, and analyses questionnaire data. The chi-square test explored category variable relationships. Significant results had a p-value below 0.05. Results: the current findings reveal that (89.8%) of midwives had moderate practices in the prevention of postpartum hemorrhage (PPH) throughout 3rd stage of labor and immediate postpartum period. While (10.2%) had poor practices and (0.0%) had good practices, also its found that there was no correlation between the sociodemographic factors and the total level of midwives’ practice. Conclusion: The current study concluded that most midwives demonstrated a moderate level of practice regarding standardized guidelines for postpartum hemorrhage prevention during 3rd stage of labour and immediate post-partum period. To bridge these gaps, a monitoring system should be designed and implemented to regularly assess obstetric nurses' practices to ensure best practices and identify area for improvement.

Role of herbal bioactive compounds in the prevention of dental caries and periodontal diseases: a narrative review

2026-05-23T11:51:14+00:00

Introduction: Dental caries and periodontal diseases remain two of the most prevalent chronic non-communicable conditions worldwide, with substantial impact on systemic health and public health expenditure. Although fluoride, mechanical biofilm control, and chlorhexidine remain cornerstones of prevention, concerns regarding antimicrobial resistance, dysbiosis, staining, and altered taste have stimulated interest in herbal bioactive compounds as complementary agents. Objective: To critically synthesize current evidence on the role of herbal bioactive compounds, including polyphenols, flavonoids, terpenoids, alkaloids, and essential oils — in the prevention of dental caries and periodontal diseases, with attention to mechanisms of action, clinical efficacy, safety, and translational nutrological perspectives. Methods: A structured narrative review was conducted using PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library covering literature published between January 2000 and December 2025. In vitro studies, animal experiments, randomized controlled trials, systematic reviews, and meta-analyses published in English were eligible. Results: Multiple herbal bioactives demonstrate antibacterial, antibiofilm, anti-inflammatory, antioxidant, and matrix-stabilizing properties relevant to oral disease prevention. Camellia sinensis catechins (especially EGCG), curcumin, propolis flavonoids, pomegranate ellagitannins, grape-seed proanthocyanidins, Salvadora persica derivatives, Azadirachta indica extracts, aloe vera polysaccharides, and Glycyrrhiza glabra isoflavans show consistent activity against key cariogenic and periodontal pathogens. Clinical trials suggest that herbal mouthrinses, gels, and dentifrices achieve plaque and gingivitis reductions comparable to chlorhexidine, with fewer adverse effects. Conclusion: Herbal bioactive compounds represent a scientifically promising adjunct to conventional oral preventive strategies. However, methodological heterogeneity, lack of standardized formulations, and limited long-term safety data preclude their unqualified recommendation as monotherapies. Future research should prioritize adequately powered randomized controlled trials with standardized phytochemical preparations and integration with nutrological frameworks.

Graphical Abstract

Comparison of cesarean section rates and Robson Group 5 proportions before and after non clinical intervention (focus group discussion) at Jombang District Hospital

2026-05-21T13:45:19+00:00

Introduction: Global cesarean section (CS) rates continue rising without corresponding maternal/neonatal mortality reductions. WHO recommends 10-15% ideal rates, yet Indonesia reports 17.6% (Riskesdas 2018) to 36% (BPJS 2019). Jombang District Hospital showed 38.9% CS rate in 2023, predominantly Robson Group 5 (16.9%). Objective: To compare CS rates and Robson Group 5 proportions before and after interventions at Jombang District Hospital in 2024, and evaluate management changes for women with prior CS history. Methods: Quasi-experimental study compared a pre-intervention period (January-June 2024: n=1,341) and a post-intervention period (July-December 2024: n=1,142) across a total of 2,483 deliveries. Hospital delivery records were analyzed utilizing the Robson classification. Chi-square tests assessed differences in CS proportions with a significance level of p<0.05. Results: The overall CS rate was 44.8% (1,113/2,483), increasing nonsignificantly from 43.3% to 46.6% (p=0.113). Robson Group 5 CS rates remained persistently high, shifting from 92.0% pre-intervention to 93.5% post-intervention (p=0.624). Vaginal birth after cesarean (VBAC) success was limited to 8-12%. Conclusion: Non-clinical focus group discussions among healthcare providers failed to reduce CS rates, highlighting the limitations of single-component interventions. Multifaceted strategies are essential, including mandatory second opinions for elective CS, standardized VBAC protocols, and intensive antenatal education.

Education and training needs for enhancing rural women’s participation in sustainable farming systems in Iraq: a cross-sectional study

2026-05-10T13:11:06+00:00

Introduction: Strengthening rural women’s participation in sustainable farming is essential for Iraq’s agricultural development, yet their specific educational and training requirements remain insufficiently defined to guide effective programming. Objective: The study assessed the education and training requirements needed to strengthen rural women’s participation in sustainable farming systems in Iraq. Methods: A cross-sectional descriptive survey design was adopted. Using purposive selection and proportional allocation, 150 respondents were drawn from ministries, research institutions, and development organizations involved in women-in-agriculture and agricultural extension programming. Data were collected via interview-administered structured questionnaires and analyzed using means (x̄), percentages, and rank order. Results: The most critical needs identified were specialized educational programmes (x̄ = 4.54; 90.00%), field schools (x̄ = 4.54; 89.06%), and knowledge-sharing platforms (x̄ = 4.43; 88.66%). Preferred delivery modalities focused on participatory and accessible formats, particularly local learning platforms and follow-up support. Key extension agendas included training in organic farming, waste recycling, soil/water management (x̄ = 4.40; 88.13%), and the integration of sustainability concepts into rural curricula (x̄ = 4.33; 86.66%). Conclusions: Participation of rural women in sustainable agriculture in Iraq is contingent upon the provision of locally accessible, practice-oriented, and continuous extension education tailored to their specific technical needs.

Graphical Abstract

A systematic review on marine-derived fucoidan as a nutritional therapeutic in periodontal disease

2026-05-09T18:18:38+00:00

Introduction: Fucoidan is a naturally occurring sulfated polysaccharide derived from brown seaweeds such as Fucus vesiculosus, Laminaria japonica, and Undaria pinnatifida. As a nutritive agent, fucoidan modulates tsystemic health through its bioactive components that influence metabolic, immune, and cellular functions. Its anti-inflammatory properties have a promising role in mitigating chronic low-grade inflammation, which underlies many systemic and oral diseases. Fucoidan is recently reported to possess significant antibacterial activity and the evidence regarding its use for periodontal diseases is scattered. Objective: Critical evaluation of the efficacy of fucoidan on periodontal pathogens using the existing evidence. Methods: Literature search was done on PubMed, Cochrane, Scopus, etc, according to PRISMA guidelines. Relevant articles were collected and evidence was tabulated. Results: The collected evidence indicated that fucoidan shows multifaceted therapeutic potential regarding periodontal diseases through multiple mechanisms like modulation of microbial virulence, reduction of inflammation, and boosting host–pathogen balance. Conclusion: Fucoidan exhibited promising antimicrobial, antibiofilm, and anti-inflammatory properties against periodontal pathogens.

Micronutrient supplementation and cognitive aging in Brazil: evidence, challenges, and policy directions

2026-05-07T14:57:32+00:00

Introduction: Brazil is undergoing rapid population aging, with individuals aged 60 and above comprising 15.6% of the population in 2023. This demographic shift poses significant publichealth challenges, particularly the rising prevalence of cognitive decline, compounded by widespread micronutrient deficiencies. Objective: To synthesize evidence on the relationship between micronutrient status, supplementation, and cognitive decline in older Brazilian population, and to identify barriers to implementing nutritional strategies into public health and clinical practice. Methods: A narrative review was conducted using data from national surveys, regional studies, clinical trials and reviews. Literature searches were performed in PubMed, MEDLINE, and Embase using Brazil-specific terms related to micronutrients, cognitive health, and aging. Results: Deficiencies in vitamins B-complex, D, E, and minerals such as magnesium, zinc, and selenium are prevalent among older Brazilians, with some inadequacy rates exceeding 60–80%. These deficiencies are mechanistically linked to cognitive decline via oxidative stress, neuroinflammation, and elevated homocysteine levels. Evidence from clinical trials, notably COSMOS, and the 2025 Latin American Consensus Statement supports multivitamin and mineral supplementation (MVMs) as an effective strategy to improve memory and cognition. However, key barriers include lack of age-specific dietary reference values, national supplementation guidelines, and systematic integration of nutrition into geriatric care. Conclusions: Addressing micronutrient deficiencies through targeted supplementation and nutrition policy reforms represents a practical, evidence-based approach to promote cognitive resilience and healthy aging in Brazil.

Immunomodulatory effects of Lactobacillus acidophilus as a probiotic and aqueous Punica granatum peel extract on immune responses in BALB/c mice infected with experimentally induced Escherichia coli diarrhea

2026-05-01T23:21:57+00:00

Diarrheal disease caused by Escherichia coli is a major cause of disease worldwide. The mutations that bacteria undergo lead to antibiotic resistance, necessitating the development of evidence-based treatment alternatives. This research investigates the immunomodulatory effects of Lactobacillus acidophilus as a probiotic and pomegranate peel aqueous extract (PPE) from the pomegranate plant (Punica granatum L.), individually and in combination, on certain innate and adaptive immunity markers in experimentally infected BALB/c mice with E. coli-induced diarrhea. 40 male BALB/c mice (6–8 weeks old, weighing 20–25 g) were randomly assigned to five groups (8 mice per group): negative control (G1), positive control infected with E. coli only (G2), E. coli with Lactobacillus acidophilus (109 CFU/day) (G3), E. coli with pomegranate peel extract (200 mg/kg/day) (G4), and E.coli with the Mix therapy (G5). All treatments were administered orally for 21 days. The concentrations of cytokines (IL-6, TNF-α, IFN-γ, IL-10), immunoglobulins (IgG, IgM, IgA), splenic lymphocyte subsets (CD4+, CD8+, and natural killer cells), and the phagocytic index of phagocytes were measured at the end of the experiment. A significant decrease in the levels of the pro-inflammatory cytokines IL-6, TNF-α, and IFN-γ was observed in group G5 compared to group G2 (p ≤ 0.05), while IL-10 did not show a statistically significant difference between the two groups. Serum IgG and CD4+ T cell levels returned to normal significantly in group G5 (p ≤ 0.05), while IgM, IgA, CD8+ T cell levels, the CD4+/CD8+ ratio, and the frequency of natural killer cells remained largely unchanged. The phagocytosis index was also significantly higher in group G5 compared to group G2 (p ≤ 0.05). The synergistic action of L. acidophilus and the aqueous PPE extract demonstrated statistically significant immunomodulatory activity, suggesting its potential as an alternative treatment in the management of E. coli-induced diarrhea.

Outcomes of total hip arthroplasty for chronic hip diseases in Iraqi patients: a five-year prospective study of functional recovery and improving quality of life

2026-04-29T02:18:52+00:00

Introduction: Chronic hip diseases — hip osteoarthritis, avascular necrosis of the femoral head and the sequelae of osteoporotic femoral-neck fractures — are leading causes of pain and functional disability. Total hip arthroplasty (THA) is established as the principal intervention for these chronic diseases, with improving quality of life as its goal. Iraqi data are limited. Objective: To assess the functional and pain outcomes of primary THA performed for chronic hip diseases in an Iraqi cohort and identify baseline factors associated with improving quality of life. Methods: Prospective observational study (2019–2023) in four hospitals in Al-Najaf, Iraq. Sixty-four consecutive adults aged ≥40 years (ASA I–II) undergoing primary THA were enrolled. The Harris Hip Score (HHS) was recorded preoperatively and at 3 weeks, 3, 6 and 12 months. Predictors of the 12-month HHS were modelled by multivariable linear regression. Sample-size adequacy was confirmed by post-hoc power analysis (G*Power 3.1.9.7; α = 0.05, two-tailed; achieved power ≥ 0.80 for the primary association). STROCSS 2021 reporting was followed. Results: Mean age was 60.9 ± 13.1 years (70.3% ≥60 years); 53.1% women; 82.8% overweight or obese. Indications were avascular necrosis (40.6%), femoral-neck fracture (31.3%), hip osteoarthritis (25.0%) and intertrochanteric fracture (3.1%). The HHS rose from 43.2 ± 8.3 preoperatively to 92.1 ± 6.3 at 12 months (P < 0.001), with 92.2% of patients achieving good or excellent outcome — substantial improving quality of life. Body mass index was the only baseline variable independently associated with the outcome (standardised β = −0.327, P = 0.002). Complications were limited (leg-length discrepancy 7.8%, heterotopic ossification 4.7%, dislocation 4.7%, one superficial infection); no revision or mortality occurred. Conclusions: Primary THA is highly effective for chronic hip diseases in Iraqi patients, producing durable, clinically important improving quality of life. Body mass index emerges as a modifiable nutrological target whose optimisation may further enhance outcomes.

Reframing rectus diastasis (diastasis recti abdominis) as a chronic disease of the abdominal wall: multidimensional burden and multimodal strategies for improving quality of life: a narrative review with a nutrological perspective

2026-04-29T01:29:10+00:00

Introduction: Diastasis recti abdominis (DRA), defined as the widening of the linea alba with separation of the rectus muscles, is commonly managed as a benign cosmetic consequence of pregnancy. However, increasing evidence suggests that DRA should be reconceptualised as a chronic disease of the abdominal wall, given its association with significant impairment in quality of life. Objective: This review synthesises current evidence to reframe DRA as a chronic disease of the abdominal wall, characterises its multidimensional impact on quality of life, and evaluates conservative, surgical, and nutraceutical strategies for improving quality of life. Methods: PubMed/MEDLINE, Embase, Scopus, and Web of Science were searched from 1 January 2000 to 31 January 2026 for systematic reviews, randomised controlled trials, and longitudinal cohort studies addressing DRA epidemiology, pathophysiology, validated patient-reported outcomes (PROs), and management. Reporting adhered to the SANRA scale and relevant items from the PRISMA 2020 statement for narrative reviews. The search identified 487 records; after duplicate removal and staged screening, 52 sources were included for thematic synthesis (Section 2.4 and Figure S1). Methodological quality was assessed qualitatively using the Cochrane Risk of Bias 2 tool and the AMSTAR 2 tool. Results: DRA persisted in 32–46% of women at 12 months postpartum and in 22–36% between 5 and 30 years postpartum, meeting epidemiological criteria for a chronic condition. Validated PROs (SF-36, HerQLes, PFDI-20, Disability Rating Index, body-image scales) consistently demonstrated impairment in physical function, body image, urinary symptoms, and mental health. Surgical plication and minimally invasive techniques resulted in statistically significant and sustained improvements in quality of life. Conservative exercise modestly reduced the inter-recti distance and contributed to improved quality of life as part of a multimodal care strategy. Conclusions: DRA should be recognised as a chronic disease of the abdominal wall. Nutrition-informed multimodal care, including nutritional optimisation, structured rehabilitation, and individualised surgical repair, is essential for improving quality of life in this prevalent population.

Serum hBD-2, IL-36γ, CCL20/MIP-3α, and soluble FGL-2 as innate-immune biomarkers in Iraqi patients with plaque psoriasis: a case-control study with diagnostic-performance evaluation

2026-04-26T19:51:35+00:00

Introduction: Plaque psoriasis is driven by an IL-23/IL-17–centred axis in which keratinocyte-derived innate mediators amplify and sustain cutaneous inflammation. Circulating biomarkers that capture this axis in Iraqi patients are poorly characterised. Objective: To compare serum human β-defensin-2 (hBD-2), interleukin-36γ (IL-36γ), CCL20/MIP-3α, and soluble fibrinogen-like protein 2 (sFGL-2) between adults with plaque psoriasis and matched healthy controls, and to evaluate their diagnostic performance. Methods: This case–control study enrolled 45 patients with clinically diagnosed plaque psoriasis and 45 age- and sex-matched healthy controls at Marjan Teaching Hospital, Babylon Governorate, Iraq (October 2025 – March 2026). Serum biomarkers were quantified by sandwich ELISA. Group comparisons, Pearson correlation, ROC analysis, and logistic regression were performed. Results: hBD-2, IL-36γ, and CCL20 were significantly higher in patients than controls (all p < 0.05); sFGL-2 showed a non-significant trend. Strong positive correlations were observed between hBD-2 and the other three mediators. IL-36γ had the best diagnostic performance (AUC = 0.714, p = 0.001). All four biomarkers were associated with psoriasis in univariate logistic regression, with attenuation in multivariable models consistent with shared pathway regulation. Conclusion: A coordinated innate-immune serum signature is present in Iraqi plaque-psoriasis patients; IL-36γ showed the most promising diagnostic utility, although these findings are hypothesis-generating and require validation before clinical use.

Graphical Abstract

Functional Molecular Biomarkers in the Identification of Probiotic Strains

2026-04-23T08:00:06+00:00

Identification of novel probiotic strain candidates based on sequence information of currently available probiotic strains and their key biomarkers requires comprehensive functional evaluation to establish their contributions to human health. Potential functional molecular biomarkers play a vital role in facilitating the discovery of new probiotic strains through sequence similarity analyses, remarkably within metagenomic datasets and unexplored microbial “dark matter”. It is critical to evaluate probiotic properties beyond taxonomical identifications by including the most important functional, metabolic, antibacterial and immunological features, as well as by using them as a marker for selection of probiotics. This review highlighted some key molecular biomarkers of probiotics, but also considered challenges like lack of standardization and in vitro and in vivo data, and discussed potential for further use. Probiotic screening by molecular markers in combination with bioinformatic search technology, which might represent future development direction toward the generation of next-generation probiotic strains.

Psychological resiliency and associated factors among adults with obesity: a cross-sectional study

2026-04-22T18:49:49+00:00

Introduction: Obesity is a complex health problem affecting physical, psychological, and social aspects. Those affected face stressors such as social stigma and low self-esteem, making resilience crucial for improving their health. Psychological resilience is an individual's ability to adapt positively to stress. which positively impacts their health and quality of life. Objective: The study aimed to assess the psychological resiliency and its relationship with socio-demographical and clinical data among adults with obesity. Methods: Descriptive cross sectional study design adapted to obtain objectives related to study phenomena from the period 10 September 2025 to 8 May 2026. Non probability convenience sample method was selected to participate in the study to achieve the objectives, (180) person selected to carrying out this study. Data were analyzed using SPSS version 26, employing descriptive and inferential statistics. Results: More than half of the participants (54.4%) have a moderate level of psychological resiliency. Statistically significant differences were found between psychological resiliency and six factors (age, sex, employment status, economic status, smoking, and daily living activities) at p. value (< 0.05). The highest values were associated with age (≥50 years). Clinically, statistically significant difference was found between associated comorbidities and body mass index (BMI), with significant correlations with medications and family history at p. value (< 0.05). Conclusion: The study finding indicate that psychological resilience plays a significant role among adults with obesity. The psychological resiliency was less than acceptable and affected by several factors among adults suffered from obesity. Recommendation: The findings also underscore the importance of fostering these aspects through integrated health care and educational programs, given their positive impact on improving overall health and quality of life.

Potential of nutraceutical fucoidan against periodontal pathogens: a novel molecular docking study

2026-04-20T17:09:01+00:00

Introduction: Fucoidan from seaweed has gained significant attention due to its diverse therapeutic properties. Its antibacterial potential in periodontitis needs exploration. Objective: This paper aims to explore the suitability of fucoidan to treat periodontitis by molecular docking methods. Methods: Molecular docking of fucoidan was done with targets from Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans. Binding energy, inhibition constant, number of hydrogen bonds, aminoacid residues involved in H-Bond were identified. Control docking was done with chlorhexidine and compared. Results: Docking of Porphyromonas gingivalis enzyme, gingipain K (Kgp) with fucoidan had an inhibition constant of -6.83, ODP from T. denticola with fucoidan had binding energy of -4.52, anti-CRISPR protein AcrIF9 with fucoidan had a binding energy of 4.81 and Tannerella forsythia potempin E with Fucoidan had a binding energy of -3.09 all expresssed as kcal/mol. Respective inhibition constants were 67.3 µM, 485.11µM, 295.72 µM and 5.47 mM. All binding energies ranged from -3 to -6 range suitable for inhibition of their targets. Conclusion: Inhibition constant for targets from T. denticola and A. actinomycetemcomitans had highest values indicating that fucoidan inhibits T. denticola and A. actinomycetemcomitans more significantly than P. gingivalis and T. forsythia.

Thyme extracts as a natural and environmentally friendly alternative for the biological control of house fly (Musca domestica Lin.) in meat processing facilities

2026-04-12T15:03:37+00:00

Introduction: Houseflies (Musca domestica) are one of the most significant sources of microbial contamination in meat processing facilities, as they act as direct mechanical vectors for numerous pathogens that can adversely affect food safety and human health. Given the risks posed by conventional chemical pesticides, this study highlights the need to seek safe and environmentally friendly alternatives, such as plant extracts (thyme extracts), which can help reduce the prevalence of this insect and mitigate its harmful effects.Objective: The study aims to evaluate the biological efficacy of alcoholic and aqueous extracts of thyme in controlling the various larval stages of the housefly, with a focus on comparing their respective effectiveness in inducing mortality rates and their impact on prolonging the larval growth period, as well as to study the effect of these treatments on pupal development and the resulting pupal weights. Methods: Alcoholic and aqueous thyme extracts were used at various concentrations (15, 20, 25, and 30 mg/mL), and the three larval stages (first, second, and third) of the housefly were exposed to these extract concentrations under strictly controlled laboratory conditions. Mortality rates were recorded for each stage, larval development duration was monitored, and the survival rate and weights of the pupae were assessed, in comparison with a control group that received no treatment. Results: The results showed that the alcoholic extract was more effective than the aqueous extract, with mortality rates of 100%, 90.3%, and 74.3% in the first, second, and third larval stages, respectively, while the mortality rates for the aqueous extract were 82.2%, 60.2%, and 50% for the same stages, compared to a very low rate of 3% in the control group. An increase in larval growth duration was also observed, particularly in the first instar, which lasted 4-4.5 days compared to 2 days in the control group; in addition, the highest mortality rate (100%) was recorded among pupa that emerged from larvae treated during the first and second instar. The results also showed a significant decrease in pupae weights, with the alcoholic extract recording the lowest weight of 11 mg, while weights ranged from 17–18 mg in the aqueous extract compared to 26 mg in the control group. Conclusions: The outcomes of the study indicate that thyme extract, particularly the alcoholic extract, is highly effective as a natural insecticide against houseflies, as it caused increased mortality rates in the larval stages, slowed growth, and negatively affected the development and weight of pupae, making it a promising and environmentally friendly option that can be adopted within integrated pest management programs to limit the spread of this insect.

Interactive effects of quail strain and dietary arginine on the chemical composition of the breast and thigh meat

2026-04-05T22:10:13+00:00

This study was conducted to evaluate the interactive effects of quail strain and dietary L-arginine levels on the chemical composition of breast and thigh meat. A total of 270 one-day-old Japanese quail chicks from three strains (white, brown, and grey) were randomly assigned to a 3×3 factorial experimental design. The birds were fed diets supplemented with three levels of L-arginine (0%, 5%, and 10%) for a period of 35 days. The results indicated that dietary L-arginine significantly influenced the chemical composition of the meat. In breast meat, the 10% arginine group showed a significantly higher fat content (1.977%) compared to the 0% and 5% groups. Ash and carbohydrate contents in the breast were also significantly affected by arginine levels (p≤0.05). In thigh meat, the 5% arginine level resulted in the highest protein content (25.542%), while the 10% level was associated with the highest fat (19.401%) and ash (0.43%) contents. In contrast, the quail strain did not significantly affect the chemical features of either breast or thigh meat, including moisture, fat, ash, protein, and carbohydrate levels. These findings suggest that nutritional intervention through arginine supplementation is a more dominant factor in determining meat quality than genetic strain under uniform environmental conditions. The study concludes that optimizing arginine levels, specifically at moderate concentrations, is essential for enhancing the nutritional value and production efficiency of Japanese quail.

Graphical Abstract

A prospective clinical study on metabolomic profiling for early detection of response to nutritional interventions in pediatric obesity

2026-04-03T10:39:58+00:00

Introduction: Obesity in children is a significant health issue, exposing children to the risk of metabolic and insulin resistance and long-term cardiometabolic complications. It is essential to detect and identify the responses to nutritional interventions at the earliest possible time to provide effective and personalized treatments. The overall evaluation of small-molecule metabolites in biological samples, termed metabolomics profiling, could be applicable in the characterization of real-time biological biochemical responses related to pediatric obesity and nutritional intervention. Objective: This research aimed to determine how metabolomics could serve to detect early biological metabolic changes to scientific dietary interventions in children by exploiting lipid, carbohydrate, and amino acid metabolism biomarkers. Methods: As its look at the use of metabolomic markers in methods that define clinical response measures (e.g., clinical, anthropometric), it also shows that the distinctive molecular responses that are discovered by the metabolomics can forecast individual reactions to dietary interventions, which allow the reaction to occur within effective and precise time frames. Results: It was observed that it is possible to engage in metabolomic-guided nutritional planning at the pediatric level, a transition between evidence-based nutrition and personalized nutrition. It also evaluated the possibility of applying metabolomics in clinical practice to assist the establishment of treatment efficacy, metabolic health optimization, and prevention of the development of obesity-related problems. Conclusion: In general, metabolomic profiling is a new method of pediatric nutrition with practical implications to stimulate early diagnosis, personalized therapy, and better treatment outcomes in childhood obesity.

A randomized controlled trial on the efficacy of intermittent fasting and mediterranean diet on visceral adiposity and gut microbiota in overweight adults

2026-04-03T03:00:38+00:00

Introduction: Obesity, particularly visceral adiposity, is a considerable risk factor for metabolic diseases, including insulin resistance, dyslipidemia, and chronic inflammation. A growing body of evidence suggests that the gut microbiota is influenced by food and plays a role in energy homeostasis and systemic metabolism, with dysbiosis typically observed in individuals with excess weight. Nutritional strategies of intermittent fasting (IF) and the Mediterranean diet (MD) have each been independently shown to help reduce adiposity and alter gut microbiota composition. However, there remains a dearth of research on the effects of IF and the MD when combined. Objective: The purpose of this study was to assess the effectiveness of a combination of IF and MD intervention for visceral fat loss, and for the dietary intervention to modify gut microbiota. Methods: A total of 60 participants were recruited into a 12-week human intervention study, along with longitudinal assessment of dietary intake and compliance. Visceral adiposity was measured using imaging-based techniques, and gut microbiota profiles were analysed using 16S rRNA sequencing. Results: As a result of the intervention, there were considerable reductions in visceral fat, increased microbial diversity, and enrichment of some beneficial bacterial taxa that are linked to better metabolic health. Conclusion: The data demonstrate that the time-restricted feeding in combination with the Mediterranean diet is an experimental dietary approach resulting in a decrease of visceral fat mass and restoration of the microbiota toward a healthy one. It also provides a required evidence-based structure for therapeutic nutrition in the treatment of metabolic complications induced by obesity.

Major relevances of nutrological therapy and gut microbiota in neurodegenerative diseases: a systematic review

2026-04-02T14:12:42+00:00

Introduction: Critical patients, both due to brain injury and neurodegenerative diseases, have an increased risk of developing nutritional malnutrition due to complex problems and deleterious effects of diseases on protein and energy metabolism, resulting in metabolic dysregulation, hypercatabolic state and depletion of energy reserves energy. Objective: It was to carry out a systematic review to externalize and discuss the main findings on the effects of enteral nutritional therapy, as well as on the action of the gut microbiota in patients with brain injuries or neurodegenerative diseases. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from March to May 2025 in the Web of Science, Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 108 articles were found, and 20 articles were evaluated in full, and 08 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 30 studies with a high risk of bias and 24 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X²=88.9%>50%. Enteral nutrition supplemented with probiotics effectively decreases the risk of mortality, gastrointestinal complications, and infection, and shortens the length of stay in the intensive care unit, therefore, it should be widely adopted for the management of these patients. Nasal inspiratory pressure during a sniff at baseline is an early indicator of disease progression and therefore the need for enteral nutrition in amyotrophic lateral sclerosis. Furthermore, problems with tolerance, diarrhea, and abdominal distension decreased between the 3 and 6-month visits in patients who received home enteral nutrition.

Metabolic actions of the gut microbiota in obesity: a systematic review

2026-04-01T16:00:52+00:00

Introduction: Obesity is a multifactorial disease that is difficult to manage and causes several comorbidities, such as physiological and mental disorders, diabetes, stroke, and depression. Worldwide, more than 2.3 billion people are overweight or obese. The gut microbiota interacts with several organs, including the brain, and can regulate metabolism, adiposity, homeostasis, energy balance, and central signaling of appetite and food reward. Objective: To explore and describe the metabolic actions of the gut microbiota and probiotics in the management of patients with obesity. Methods: The systematic review guidelines of the PRISMA Platform were followed. The search was conducted from August to November 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. Study quality was based on the GRADE instrument, and risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 125 articles were found. A total of 32 articles were fully evaluated, and 21 were included and developed in this systematic review. Using the Cochrane risk of bias tool, the overall assessment resulted in 23 studies with a high risk of bias and 25 studies that did not meet the GRADE and AMSTAR-2 criteria. Most studies presented homogeneous results, with X²=74.8%>50%. It was concluded that bidirectional signaling occurs within the gut-brain axis in the pathophysiology of obesity, mediated by metabolic, endocrine, neural, and immune system mechanisms. Fecal microbiota transplantation and supplementation with probiotics and prebiotics may be potential treatments for obesity. Diet is a determining factor for healthy colonization of the gut microbiota. Studies in obese humans also found a lower proportion of Bacteroidetes compared to those in normal-weight individuals. After weight loss, the proportion of Firmicutes is reduced and becomes more similar to that of lean individuals. Inulin supplementation can significantly promote intestinal bacterial diversity and improve gut microbiota dysbiosis in obese patients. Low-carb diets and time-restricted feeding are effective in weight management and produce profound changes in the gut microbiome and metabolome, in addition to caloric restriction.

Randomized controlled clinical study on proteomic analysis of skeletal muscle adaptations to high-protein nutrition in post-bariatric surgery patients with obesity

2026-03-31T14:58:36+00:00

Introduction: Bariatric surgery can cause complicated metabolic and physiological changes in some patients, leading to a significant amount of loss of lean mass. The preservation of skeletal muscle mass is important for metabolic health, functional performance, and long-term weight maintenance. Proteomics provides detailed information on muscle tissue molecular responses, but can be best utilized when coupled with intentional nutritional interventions such as high-protein diets. Objective: The intent of the present study was to examine skeletal muscle proteomic responses to bariatric surgery in obese males and females using a high-protein nutrition intervention. Methods: Patients with obesity after bariatric surgery followed a standardized high-protein nutritional intervention (≥ 1.5g protein per kg per day). Muscle biopsies were taken at baseline (pre-treatment) and 12 weeks post-surgery. Muscle biopsies were taken, proteins extracted, digested, and analyzed by LC-MS-MS (label-free quantification). It used bioinformatic applications to perform differential quantitative analysis of protein expression, pathway enrichment, and functional annotation of differentially expressed proteins. Results and Conclusion: High protein nutrition resulted in upregulation of proteins associated with mitochondrial function, oxidative phosphorylation, and translation, while demonstrating downregulation of proteins representing catabolic and inflammatory pathways. Also, many of the proteomic adaptations identified were supportive of improved muscle remodelling (i.e., improved structural contractile proteins and regulators of protein synthesis). High protein nutritional support after bariatric intervention promotes advantageous skeletal muscle proteomic remodelling, which promotes retention of lean mass and recovery of metabolic status. The data also demonstrated that high-protein nutrition, after bariatric surgery, was associated with positive molecular adaptations.

Estimation of oxidative stress, antioxidants and trace elements for COVID-19 patients: a cross-sectional study

2026-03-30T18:17:27+00:00

Introduction: The World Health Organization announced coronavirus-disease 2019 (COVID-19) to be a global pandemic. Recently oxidative stress has implicated in the pathogenesis of COVID-19. The buildup of free radicals together with the inability of the antioxidant system to counterbalance the free radicals produces oxidative stress which ultimately exacerbate respiratory diseases including COVID-19. Objective: This was a study to explore the impact of corona virus 2019 (COVID-19) on blood oxidants and antioxidants. Methods: A total of blood samples were taken from (60) patients infected with COVID-19 and 40 volunteers as a control group. Results: The Copper levels that show a significant increase of Copper levels in the COVID-19 patients compared to the healthy subjects, and Selenium levels show a significant decrease of Selenium levels for the COVID-19 patients compared to the healthy subjects, and total oxidant levels show a very high significant increase of COVID-19 patients compared to the healthy subjects, and Vitamin C levels show a significant decrease of Vitamin C levels for the COVID-19 patients compared to the healthy subjects. Conclusion, in COVID-19 positive patients, the levels of the antioxidant substances are decreased as they are progressively consumed to balance the injurious effect of the free radicals.

Graphical Abstract

Immunohistochemical evaluation of Bcl-2 protein expression in thyroid follicular pathology: a retrospective observational study

2026-03-27T15:17:56+00:00

The use of chemotherapy in treating malignant thyroid neoplasms with aggressive biological behavior, such as doxorubicin, has been associated with an overall poor outcome. Therefore, it has been suggested that thyroid malignant cells are resistant to apoptosis induced by chemotherapy agents. The objective of this study was to compare the immunohistochemical expression of Bcl-2 in thyroid tissues obtained from follicular hyperplasia, follicular adenoma, and follicular carcinoma of thyroid glands. This retrospective observational study was conducted at the Department of Pathology, College of Medicine, Al-Nahrain University, Baghdad, Iraq, covering the period from January 2013 to December 2023. The study focused on cases of thyroid follicular hyperplasia (20 cases), thyroid follicular adenoma (20 cases), and thyroid follicular carcinoma (12 cases) found in thyroidectomy specimens. Immunohistochemical analysis was performed on 4µm thick sections obtained from a paraffin block of tumor tissue to detect Bcl-2. Comparison of mean bcl-2 immunohistochemical score among study groups revealed that the median score was 2 in both follicular hyperplasia and follicular adenoma groups, whereas the median score was 3 in the group of follicular carcinomas, thus it was significantly higher in this later group in comparison with adenoma and hyperplasia (p <0.001). There was no significant association between Bcl-2 immunohistochemical expression and invasiveness. Bcl-2 immunohistochemical expression can be detected in follicular thyroid neoplasms with the highest intensity in carcinoma cases, suggesting a role for Bcl-2 in marinating the growth of these neoplasms, but it does not correlate with the degree of tumor invasiveness.

Major clinical approaches to palliative care and nutrology in dentistry: a systematic review

2026-03-26T22:14:09+00:00

Introduction: Poor oral health is a common and neglected concern in palliative care (PC), negatively impacting patients' quality of life. There is a significant gap in the knowledge and practices of primary care physicians regarding oral health due to various barriers, with few documented support strategies in this area, as well as an information gap on the nutritional aspects that complement palliative practices in oral care. Objective: It was to carry out a concise systematic review in order to present the main clinical approaches to palliative care in dentistry, as well as showing the associated nutritional importance. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from December 2025 to January 2026 across the Web of Science, Scopus, Embase, PubMed, ScienceDirect, SciELO, and Google Scholar databases. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneity in their results, with X²=77.8%>50%. A total of 136 articles were found and submitted for eligibility analysis, with 12 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 33 studies with a high risk of bias and 26 studies that did not meet GRADE and AMSTAR-2 standards. It was concluded that early palliative care intervention can be effective in reducing psychological suffering and improving the quality of life of critically ill dental patients. Dentists can play a key role in linking tertiary and community care to promote patient well-being. Weight loss and impaired oral intake were associated with psychosocial distress affecting patients and caregivers. Future research is needed to explore the experiences of patients, caregivers, and healthcare professionals regarding nutrition and to evaluate the effectiveness of alternative nutritional strategies.