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In the recent decades, energy drinks consumption has increased dramatically. Many researches found their adverse effects on the structure and function of organs and systems, with nervous and cardiovascular systems most studied. Liver is one of the priority target organs in case of beverages consumption. The purpose of this paper is to explore the effects of energy drink consumption on morphofunctional conditions of liver.

A search in PubMed, Web of Science, Scopus and eLIBRARY.ru databases was performed using relevant keywords.

Both clinical and experimental data concerning effects of energy drink use on structure and function of liver are summarized and systematized in this review. Most of them documented hepatotoxicity after prolonged over-consumption of energy drinks. Probable mechanisms of action of their basic ingredients (sugars, caffeine, taurine, D-glucuronolactone, vitamin B3) on morphology and functioning of liver as well as combined use of energy drinks with alcohol are described.

This review paper represents evidential information about the negative impact of energy drink consumption on morphofunctional conditions of liver.

The results of human studies evaluating the efficacy of plant Phytosterols on liver function were inconsistent. Therefore, the purpose of this paper is to eliminate these controversies about the Phytosterols consumption on liver serum biochemistry in adult subjects.

The literatures systematically searched throughout PubMed and Scopus databases up to June 2018; it was conducted by using related keywords. Estimates of effect sizes were expressed based on weighted mean difference (WMD) and 95% CI from the random-effects model (erSimonian and Laird method). Heterogeneity across studies was assessed by using I2 index. Eighteen studies reported the effects of Phytosterols (PS) supplementation on liver serum biochemistry.

The current meta-analysis did not show a significant effect on ALT (MD: 0.165 U/L, 95% CI: −1.25, 1.58, p = 0.820), AST (MD: −0.375 IU/Liter, 95% CI: −1.362, 0.612, p = 0.457), ALP (MD: 0.804 cm, 95% CI: −1.757, 3.366, p = 0.538), GGT (MD: 0.431 U/L, 95% CI: −1.803, 2.665, p = 0.706) and LDH (MD: 0.619 U/L, 95% CI: −4.040, 5.277, p = 0.795) following PS consumption.

The authors found that no protective or toxic effects occur after the consumption of Phytosterols on liver enzymes including ALT, AST, ALP, LDH and GGT.

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease which has become a public health concern, whose growing prevalence has been reported as around 33.9% in Iran. As oxidative stress plays a crucial role in the pathogenesis of NAFLD, antioxidant compounds such as quercetin could ameliorate the side effect of oxidative stress. The aim of the current study was to assess the effect of quercetin on lipid profile, liver enzymes and inflammatory indices in NAFLD patients.

In a randomized, double-blind, placebo-controlled trial conducted as a pilot study, 90 patients with NAFLD were supplemented with either a quercetin or a placebo capsule twice daily (500 mg) for 12 weeks. Both groups were advised to follow an energy-balanced diet with physical activity recommendations. Blood sample was obtained for laboratory parameters at baseline and the end of week 12.

At the end of the follow-up, quercetin group had significantly greater reduction in anthropometric parameters, cholesterol (−15 ± (−41, 0.00) in Q group versus −1± (−8, 2) in control group, p = 0.004), TG (−56.7 ± 22.7) in Q group versus −13.4 ± 27.7 in control group, p = 0.04), and tumor necrosis factor-α (TNF-α) (−49.5 ± (−99, 21) in Q group versus −5 ± (−21, 0.30) in the control group, p < 0.0001) compared to the control group. However, changes in fatty liver grade, liver enzymes, as well as high density lipoprotein-cholesterol and high-sensitivity C-reactive protein were not significantly different between the two groups.

To the best of the authors’ knowledge, this was the first study which assessed the effect of quercetin supplementation on liver enzymes, lipid profile and inflammatory indices of NAFLD patients as a double-blind placebo-controlled pilot study.

Several audits of clinical practice have confirmed that there is insignificant yield from screening of prolonged jaundice babies with a wide range of tests including thyroid function test (TFT) and full blood count (FBC). This paper aims to audit local practice based on a newly adopted rationalised protocol of selective screening with split bilirubin supplemented with other investigations based on clinical risk assessment.

The paper uses a retrospective audit of 50 babies referred for prolonged jaundice to a large district hospital in South West England. The authors also designed an easy‐to‐use, user‐friendly software application as a quick aid for implementation of the prolonged jaundice protocol.

The overall annual incidence of prolonged jaundice was 2.2 per cent of all live births. 32 patients (64 per cent) had only split biliburin test according to the protocol. In total 16 patients (32 per cent) had 18 tests requested unnecessarily including seven liver function test (LFT), eight FBC, one each of glucose, TFT and serum electrolytes. No patient with any serious liver disease was missed.

Appropriate recommendations for optimising the implementation of the current protocol based on the available scientific evidence were introduced.

After two years of implementation of the protocol, it has been found to be cost‐effective and safe. The electronic software provides a useful prompt in guiding the investigation of prolonged jaundice.

The purpose of this paper is to assess the nutritional status and quality of life in patients according to the clinical severity of liver cirrhosis.

A total of 151 cirrhotics were selected for study. Nutritional assessment was done by anthropometry, subjective global assessment, malnutrition universal screening tool, biochemical estimations and 72‐hour dietary recall. Quality of life was assessed by chronic liver disease questionnaire.

Child's status was A/B/C in 29/68/59, respectively. Muscle and fat depletion was significantly higher in grade C patients as compared to grade A and B patients. Incidence of malnutrition was lowest in grade A patients (72.4 percent) and highest in grade C patients (90.74 percent) (p = 0.00). Calorie and protein intake was significantly lower in grade C patients compared to grade A and B patients (p = 0.00). Child Pugh score was found to be an independent risk factor for various nutritional and clinical parameters.

The data presented reflect the assessment of a very small cohort of these patients and should be done on a larger scale.

Looking into the high prevalence of malnutrition and the negative impact of disease severity, nutritional assessment of these patients should be done on a regular basis and nutritional therapy planned accordingly.

Data on malnutrition from India are scarce. This study is a small attempt to throw light on the nutritional status and its variation according to clinical severity of liver cirrhosis.

The purpose of this study is trying to document and examine the impacts of pesticide use on farmers' health. Different from previous studies, the paper is not only going to focus on the visible effect, but also the invisible effect. At the same time, the paper is going to divided the pesticides into highly toxic and low toxic pesticides and estimate their different impacts on farmers' health, respectively.

This paper uses regression techniques based on a farm household survey gathered by the authors in Zhejiang provinces. In addition to a sit‐down interview with 100 households, the authors gave a comprehensive physical examination and a blood examination to farmers who applied pesticides most frequently in each household.

This paper indicates that farmers who spray more pesticides are more likely to have headache, nausea and skin problems. Beside these visible effects, this paper also finds that exposure to pesticides has significant invisible impact on farmers' neurological, liver and kidney systems.

This, it is believed, is one of the first comprehensive studies to give comprehensive physical examination and blood examination to farmers who applied pesticides most frequently in each household.

A model is constructed describing the interaction of systems of carbohydrate and fatty‐lipoid metabolism. The model equations can be presented in the form of a system of linear differential equations which combines 36 velocities of different metabolic and hormonal variances in different tissues into a system of combined feedback loops. A simplified variant is given of the model of a system of regulating sugar in blood. The mathematical model being available, it is possible to choose proper dosage. Mathematical models are used for practical medical applications.

In this study, a hybrid rough and grey set-based rule model is designed for diagnosis of one type of blood cancer called multiple myeloma (MM). The grey clustering method is used to combine the same condition attributes and to improve the validity of the final model.

Some tools of the rough set theory (RST) and grey incidence analysis (GIA) are used in this research to analyze the serum protein electrophoresis (SPE) test results. An RST-based rule model is extracted based on the laboratory SPE test results of patients. Also, one decision attribute and 15 condition attributes are used to extract the rules. About four rule models are constructed due to the different algorithms of data complement, discretization, reduction and rule generation. In the following phases, the condition attributes are clustered into seven clusters by using a grey clustering method, the value set of the decision attribute is decreased by using manual discretizing and the number of observations is increased in order to improve the accuracy of the model. Cross-validation is used for evaluation of the model results and finally, the best model is chosen with 5,216 rules and 98% accuracy.

In this paper, a new rule model with high accuracy is extracted based on the combination of the grey clustering method and RST modeling for diagnosis of the MM disease. Also, four primary rule models and four improved rule models have been extracted from different decision tables in order to define the result of SPE test of patients. The maximum average accuracy of improved models is equal to 95% and related to the gamma globulins percentage attribute/object-related reducts (GA/ORR) model.

The total number of observations for rule extraction is 115 and the results can be improved by further samples. To make the designed expert system handy in the laboratory, new computer software is under construction to import data automatically from the electrophoresis machine into the resultant rule model system.

The main originality of this paper is to use the RST and GST together to design and create a hybrid rule model to diagnose MM. Although many studies have been carried out on designing expert systems in medicine and cancer diagnosis, no studies have been found in designing systems to diagnose MM. On the other hand, using the grey clustering method for combining the condition attributes is a novel solution for improving the accuracy of the rule model.

New hepatitis C medicines such as sofosbuvir underline the need to balance considerations of innovation, clinical evidence, budget impact and equity in health priority-setting. The purpose of this paper is to examine the role of public participation in addressing these considerations.

The paper employs a comparative case study approach. It explores the experience of four countries – Brazil, England, South Korea and the USA – in making coverage decisions about the antiviral sofosbuvir and involving the public and patients in these decision-making processes.

Issues emerging from public participation ac tivities include the role of the universal right to health in Brazil, the balance between innovation and budget impact in England, the effect of unethical medical practices on public perception in South Korea and the legitimacy of priority-setting processes in the USA. Providing policymakers are receptive to these issues, public participation activities may be re-conceptualized as processes that illuminate policy problems relevant to a particular context, thereby promoting an agenda-setting role for the public.

The paper offers an empirical analysis of public involvement in the case of sofosbuvir, where the relevant considerations that bear on priority-setting decisions have been particularly stark. The perspectives that emerge suggest that public participation contributes to raising attention to issues that need to be addressed by policymakers. Public participation activities can thus contribute to setting policy agendas, even if that is not their explicit purpose. However, the actualization of this contribution is contingent on the receptiveness of policymakers.

A new model of multidisciplinary team working with health and social care is being developed in Exeter. This article describes how inclusion of a domiciliary pharmacist in the team has improved medicines management for patients with long‐term conditions and for adult patients identified as needing support with their medicines. Initial results are discussed, case studies are described and future developments for the service are outlined.