Case Presentation: An 18-year-old male with no previous medical history presented to the emergency department complaining of a rapidly enlarging painful neck mass in left anterior latero-cervical region progressively worsening over the last two weeks, accompanied by dysphagia and fever. Blood tests showed the presence of thyroiditis (suppressed TSH with increased free thyroxine, elevated inflammation markers and neutrophilic leucocytosis). Neck ultrasonography and CT showed a large abscess involving the left thyroid lobe and extending to the ipsilateral laterocervical region, suggesting the diagnosis of AST. Prompt antibiotic therapy was started and subsequent surgical drainage of the abscess was performed, resulting in a rapid clinical recovery and the restoration of normal thyroid function. The bacterial culture of the abscess showed exclusively the presence of Gemella morbillorum.

Conclusion: We present the first documented case of AST caused by Gemella morbillorum in an otherwise healthy young man. Although rare, AST in immunocompetent patients is possible; prompt diagnosis and treatment of this condition are fundamental to avoid severe complications.

Case Presentation: A 39-year-old man with a persistent fever was referred to our hospital. Echocardiography showed mitral valve infective endocarditis with severe aortic regurgitation due to a congenital bicuspid aortic valve. Before the surgery, a paroxysmal atrioventricular block appeared. Intraoperative inspection revealed an aortic-root abscess with ulcerated lesions below the commissure of the noncoronary-right coronary cusps and perforation of the anterior leaflet of the mitral valve. Considering the risk of atrioventricular block, the ulcerated lesions were only cleared with saline solution. After replacing the mitral valve with a mechanical mitral valve, the interventricular fibrous body and aortic annulus were reconstructed with a bovine pericardial patch. The mechanical aortic valve was sutured to the reconstructed aortic annulus. Two years after the surgery, severe atrioventricular block did not occur.

Conclusion: Our method may be effective when the risk of post-operative severe atrioventricular block is high and the patient’s prognosis worsens.

Objective: Explore the efficacy of contrast-enhanced ultrasound (CEUS) via vessels and surgical drain guidance percutaneous catheter drainage (PCD) in the treatment of pyogenic liver abscesses (PLA).

Materials and Methods: A total of 86 PLA patients who underwent PCD treatment in our hospital from May 2018 to February 2023 were retrospectively selected. Of them, 41 patients were treated under intravenous CEUS guidance (Control group), and 45 patients were treated under CEUS via vessels and surgical drain guidance (study group). Perioperative characteristics, treatment effectiveness, and incidence of complications were analyzed and compared between groups.

Results and Discussion: The duration of surgery, drainage, white blood cell recovery, body temperature recovery, and hospitalization in the study group were longer than those in the control group (P<0.05). The total effective rate of the study group (95.56%) was higher than that of the control group (80.49%) (P<0.05). The incidence of complications in the study group (4.44%) was lower than that in the control group (19.51%) (P<0.05).

Conclusion: Compared with intravenous CEUS alone, treatment under CEUS via vessels and surgical drains-guided PCD was associated with shorter surgical time, faster recovery, better treatment effect, lower risk of complications, and ensured treatment safety in PLA patients.

Methods: Seventy-one patients with rectal adenocarcinoma confirmed by pathology after surgical resection were collected retrospectively. According to pathology, they were divided into a poorly differentiated group (n=23) and a moderately differentiated group (n=48). The IVIM-DWI parameters and TA characteristics of the two groups were compared, and a prediction model was constructed by multivariate logistic regression analysis. ROC curves were plotted for each individual and combined parameter.

Results: There were statistically significant differences in D and D* values between the two groups (P < 0.05). The three texture parameters SmallAreaEmphasis, Median, and Maximum had statistically significant differences between groups (P = 0.01, 0.004, 0.009, respectively). The logistic regression prediction model showed that D*, the median, and the maximum value were significant independent predictors, and the AUC of the regression prediction model was 0.860, which was significantly higher than other single parameters.

Conclusion: 3.0T MRI IVIM-DWI parameters combined with TA can provide valuable information for predicting the histological grades of rectal adenocarcinoma one week before the operation.

Methods: Sixty-four patients with single pulmonary lesions (SPLs) received DCE-MRI at 3.0 T. Of them, 49 cases were diagnosed with lung cancer, and 15 with benign pulmonary nodules (8 inflammatory nodules, 5 tuberculosis, and 2 abscesses). SPLs were quantitatively analyzed to determine the pulmonary lesions-related perfusion parameters, including reflux constant (Kep), volume transfer constant (K_trans), the maximum slope of increase (MaxSlope), extravascular extracellular space volume fraction (Ve), apparent diffusion coefficient (ADC), the initial area in the signal intensitytime curve (IAUGC), and contrast-enhancement ratio (CER). In addition, a Student’s t-test was conducted to calculate statistical significance regarding the quantitatively analyzed perfusion parameters in benign SPLs compared to malignant SPLs. The area under (AUC) the receiver operating characteristic (ROC) curve was studied to investigate the performance of perfusion parameters in diagnosing lung cancer.

Results: Values of K_trans, Kep, Ve, MaxSlope, and IAUGC increased within malignant nodules relative to benign nodules (K_trans: 0.21 ±0.08 vs. 0.73 ±0.40, P = 0.0001; Kep: 1.21 ±0.66 vs. 1.83 ±0.90, P = 0.0163; Ve: 0.24 ±0.08 vs. 0.47 ±0.18, P < 0.0001; MaxSlope: 0.09 ±0.14 vs. 0.28 ±0.29, P = 0.0166; IAUGC: 0.18 ±0.09 vs. 0.55 ±0.34, P = 0.0001). Meanwhile, malignant nodules presented higher ADC than benign nodules (0.0016 ±0.0006 vs. 0.0012 ±0.0003, P = 0.0019). K_trans and IAUGC showed the best diagnostic performance with AUCs [1.0, 95%CI (0.99–1.0); 0.93, 95%CI(0.85–1.0), respectively].

Conclusion: Malignant pulmonary lesions had higher values of K_trans, Ve, Kep, MaxSlope, and IAUGC compared to benign pulmonary lesions. Overall, perfusion parameters of DCE-MRI facilitate discrimination between benign from malignant pulmonary nodules.

Methods: Dose length product total (tDLPs), volumetric CT dose index (CTDI_vol), size-specific dose estimate (SSDE), effective dose (E), and scan acquisition parameters for a total of 216 adult patients, who underwent an enhanced CT abdomen and pelvis exams over a one-year period, were obtained and retrospectively analyzed. Spearman coefficient and one-way ANOVA tests were used to check significant differences between dose metrics and the different CT protocols.

Results: The data exhibited 9 different CT protocols to acquire an enhanced CT abdomen and pelvis exam at our institute. Out of these, 4 were found more common, i.e., CT protocols were acquired for a minimum of 10 cases. Triphasic liver demonstrated the highest mean and median tDLPs across all 4 CT protocols. Triphasic liver protocol registered the highest E followed by gastric sleeve protocol with a mean of 28.7 and 24.7 mSv, respectively. Significant differences (p < 0.0001) were found between the tDLPs of anatomical location and the CT protocol.

Conclusion: Evidently, wide variability exists across CT dose indices and patient dose metrics relying on anatomical-based dose baseline, i.e., DRLs. Patient dose optimizations require establishing dose baselines based on CT protocols rather than the anatomical location.

Case Presentation: A 38-year-old woman presented to our hospital at a gestation age of 29 weeks due to an ultrasound that showed fetal ventriculomegaly. The fetus demonstrated ventriculomegaly, intrauterine growth restriction, and multiple cystic lesions close to the corticomedullary junction of the frontal, temporal and parietal lobes on both sides. The woman chose to terminate the pregnancy, and pathological examination confirmed the diagnosis of congenital toxoplasma encephalitis.

Conclusion: This is a rare report of MRI manifestations of fetal congenital toxoplasma encephalitis. Detailed knowledge of MRI findings in fetal congenital toxoplasma encephalitis is helpful for prenatal consultation and pregnancy management.]]> https://www.benthamscience.comarticle/137392 https://www.benthamscience.comarticle/133159Background: Group A ß-hemolytic Streptococcus (GABHS) is the leading bacterial cause of acute pharyngitis in children and adolescents worldwide.

Objective: This article aims to familiarize clinicians with the clinical manifestations, evaluation, diagnosis, and management of GABHS pharyngitis.

Methods: A search was conducted in December 2022 in PubMed Clinical Queries using the key term “group A β-hemolytic streptococcal pharyngitis”. This review covers mainly literature published in the previous ten years.

Results: Children with GABHS pharyngitis typically present with an abrupt onset of fever, intense pain in the throat, pain on swallowing, an inflamed pharynx, enlarged and erythematous tonsils, a red and swollen uvula, enlarged tender anterior cervical lymph nodes. As clinical manifestations may not be specific, even experienced clinicians may have difficulties diagnosing GABHS pharyngitis solely based on epidemiologic or clinical grounds alone. Patients suspected of having GABHS pharyngitis should be confirmed by microbiologic testing (e.g., culture, rapid antigen detection test, molecular point-of-care test) of a throat swab specimen prior to the initiation of antimicrobial therapy. Microbiologic testing is generally unnecessary in patients with pharyngitis whose clinical and epidemiologic findings do not suggest GABHS. Clinical score systems such as the Centor score and McIssac score have been developed to help clinicians decide which patients should undergo diagnostic testing and reduce the unnecessary use of antimicrobials. Antimicrobial therapy should be initiated without delay once the diagnosis is confirmed. Oral penicillin V and amoxicillin remain the drugs of choice. For patients who have a non-anaphylactic allergy to penicillin, oral cephalosporin is an acceptable alternative. For patients with a history of immediate, anaphylactic-type hypersensitivity to penicillin, oral clindamycin, clarithromycin, and azithromycin are acceptable alternatives.

Conclusion: Early diagnosis and antimicrobial treatment are recommended to prevent suppurative complications (e.g., cervical lymphadenitis, peritonsillar abscess) and non-suppurative complications (particularly rheumatic fever) as well as to reduce the severity of symptoms, to shorten the duration of the illness and to reduce disease transmission.

Objectives: The aim of this article is to provide an updated narrative review on the similarities and differences between SARS-CoV-2 and influenza encephalitis.

Methods: A PubMed search was performed with the function “Clinical Queries” using the key terms “SARS-CoV-2” OR “Influenza” AND “Encephalitis”. The search strategy included metaanalyses, clinical trials, randomized controlled trials, reviews and observational studies. The search was restricted to the English literature and pediatric population. This article compares similarities and contrasts between SARS-CoV-2 and influenza-associated encephalitis.

Results: Encephalitis is an uncommon manifestation of both influenza and SARS-CoV-2. Both viruses are associated with fever and respiratory symptoms. However, SARS-CoV-2 patients may only have mild symptoms or be asymptomatic as silent carriers, rendering the disease spread difficult to control. Influenza patients usually have more severe symptomatology and are often bed bound for several days limiting its spread. Influenza is associated with seasonal and annual outbreaks, whereas SARS-CoV-2 has become endemic. Complications of encephalitis are rare in both viral infections but, when present, may carry serious morbidity and mortality. Many long-term sequelae of COVID- 19 infections (long COVID-19) have been described but not with influenza infections. Mortality associated with encephalitis appears higher with influenza than with SARS-CoV-2. Prophylaxis by immunization is available for both influenza and SARS-CoV-2. Specific efficacious antivirals are also available with oseltamivir for influenza and nirmatrelvir/ritonavir for SARS-CoV-2. Steroids are indicated with more severe SARS-CoV-2 but their role is not distinct in influenza disease.

Conclusion: Encephalitis is a rare complication of influenza and SARS-CoV-2 infections. Both carry significant morbidity and mortality. Efficacious vaccines for prophylaxis and antivirals for treatment are available for both viruses.

Methods: A retrospective review of all PICU admissions from April 2019 to May 2021 was performed. The following data were retrieved: age, gender, diagnosis, comorbidity, clinical manifestation, type of fungus, duration of stay at PICU, absolute neutrophil count, use of immunosuppressive therapy, presence of central venous catheter and use of total parental nutrition. The primary outcomes were the incidence and mortality of IFIs among PICU patients. The secondary outcomes were risk factors for developing IFI in PICU and clinical course of IFIs. Numerical variables were compared between groups by Mann-Whitney U test and categorical variables by Fisher’s exact test.

Results: There were 692 PICU admissions over the study period from April 2019 to May 2021. The crude mortality was 3% (n=24 death cases) in the PICU. Fourteen patients (2%) fulfilling the criteria for IFIs were identified using hospital electronic record system and according to PICU documentation. Eight of these 14 patients (57%) had hematological malignancy, 2 (17%) had solid tumours and 4 had non-oncological conditions. Eight (57%) patients were neutropenic with absolute neutrophil count less than 1x 109 at diagnosis of IFI. Ten (71%) had received immunosuppressive therapy including steroid, cyclosporin A, Mycophenolate mofetil (MMF), Sirolimus or tacrolimus. 12 (86%) had had central venous catheter. Eight (57%) were on parenteral nutrition. IFIs due to Rhizopus or Aspergillus infection (5/14), or in post-haematopoietic stem cell transplant patients (5/14) were associated with non-survival (p = 0.031).

Conclusion: All patients with IFIs managed in the PICU had haemato-oncology diseases or were recipients of stem cell transplantation. IFIs with Rhizopus or Aspergillus as a group were associated with high mortality in the PICU. Awareness of this pathology with prompt diagnosis and treatment may improve the outcome of these infections and reduce the mortality.

Methods: In this study, we focused on the expression of recombinant PurA from SEZ ATCC 35246. We evaluated the immunoreactivity of this recombinant protein using convalescent minipig sera. Additionally, we conducted experiments in mice to assess its immunogenic properties.

Results: Our findings revealed that the recombinant PurA triggered a substantial antibody response in mice, resulting in an 80% protection rate against SEZ infection. Notably, mice immunized with PurA exhibited significantly reduced bacterial colonization in all organs compared to the PBS control group. Furthermore, the levels of IL-6, IL-8, IL-1β, and TNF-α in mouse serum were significantly elevated in the PurA-immunized group compared to the control group. Hyperimmune sera targeting PurA effectively eliminated SEZ in bactericidal tests. Remarkably, antibodies against PurA demonstrated a significant inhibitory effect on developing SEZ biofilm.

Conclusion: Immunization with PurA elicited robust humoral and cellular immune responses in mice. These promising results suggest the potential utility of PurA in developing SEZ vaccine immunogens, providing a valuable avenue for further research into SEZ infection prevention and control.

Methods: Together with the relevant literature, we retrospectively studied the clinical and imaging data of two patients (mother and child) with CSF rhinorrhea caused by patent meningoencephalocele of Sternberg’s canal of the sphenoid sinus, analyzed their diagnostic and treatment procedures, and proposed a potential, feasible treatment method.

Results: On the 2^nd day after surgery, the expansive sponge and iodoform gauze in the nasal cavity were removed in both patients, and the lumbar subarachnoid drainage was removed 3 days after the operation, as no nasal discharge was observed. One week after the operation, head magnetic resonance imaging (MRI) showed that the abnormal tissue in the sphenoid sinus had disappeared, and no accumulation of the CSF was observed. Both patients were discharged after 2 weeks. At the time of discharge, both patients were without nasal drip, fever, headache, and other discomforts, and they had grade 5 muscle strength in their extremities, with normal muscle tension.

Conclusion: CSF rhinorrhea is usually caused by secondary factors. Spontaneous CSF rhinorrhea caused by encephalocele of the skull base due to congenital dysplasia of the skull base is very rare and easily misdiagnosed. The presence of brain tissue or CSF signal in the sphenoid sinus on preoperative MR images is an important imaging feature of the disease. Conditional cisternography can be used to further detect CSF leaks. Endoscopic transnasal transsphenoidal repair of CSF leaks combined with short-term postoperative lumbar subarachnoid drainage is an effective treatment method. According to previous literature, the possible causes of meningoencephalocele with patent Sternberg’s canal of the sphenoid sinus include abnormal development of the sphenoid sinus or the craniopharyngeal canal and bone defects of the skull base. There are no related reports on patent meningoencephalocele caused by Sternberg’s canal in direct blood relatives, such as mother-son; therefore, the possibility of this disease having a genetic origin should be considered in future studies on its pathophysiological mechanisms.

Case Presentation: In this case report we describe a case of intracranial infection of T. marneffei in a 42-year-old AIDS patient. Contrast enhanced MRI showed the left occipital lobe mass with ring enhancement, MRS showed elevated AAs and Lip waves in the mass. Surgical resection of the occipital lobe confirmed the lesion to be T. marneffei infection and possibly with tuberculosis after a pathological examination. Patients with intracranial ring enhancing space-occupying lesions on MRI should be considered for intracranial T. marneffei infection. Intracranial T. marneffei infection is relatively rarely reported and recently studied.

Conclusion: The MRI, in this case, suggests that ring enhancement mass and elevated AAs and Lip waves are helpful in the diagnosis of T. marneffei infection.

Case Presentation: A 26-year male driver presented with pain, watering, redness, whitish discoloration, and blurring of vision in the left eye for the last 3-4 days. Upon examination, he had a dry-looking corneal ulcer with infiltration and satellite lesions. Corneal scrapings were positive for septate fungal hyphae by Gram staining and KOH mount. After five days, the growth observed was presumptively identified as genus Acrophialophora and finally identified as Acrophialophora fusispora by genetic sequencing. The patient failed to respond medically and was planned for therapeutic keratoplasty.

Discussion: To date, four cases of ocular involvement due to Acrophialophora have been described. Amongst which one case was associated with an immunocompromised state. Three of the cases were resolved medically, while one required therapeutic keratoplasty, indicating possible strong pathogenicity to the eye.

Conclusion: As Acrophialophora seems to have a predilection for eye infections, an early diagnosis with timely appropriate treatment is the best way to restore the normal vision of a patient.

Although several common therapies, such as surgery and anti-tumor necrosis factor-alpha (TNF-α) drugs as well as a combination of these methods is used to improve this disease, however, due to the low effectiveness of these treatments, the use of new strategies with higher efficiency is still recommended. Cell therapy is among the new emerging therapeutic strategies that have attracted great attention from clinicians due to its unique capabilities. One of the most widely used cell sources administrated in cell therapy is mesenchymal stem cell (MSC).

This review article will discuss preclinical and clinical studies about MSCs as a potent and promising therapeutic option in the treatment of CD and anal fistula.

Radiopharmaceuticals have also started to benefit from rapid developments in computational methods. Here, we review the types of computational molecular design techniques that have been used for radiopharmaceuticals design. We also provide a thorough examination of success stories in the design of radiopharmaceuticals, and the strengths and weaknesses of the computational methods.

We begin by providing a brief overview of therapeutic and diagnostic radiopharmaceuticals and the steps involved in radiopharmaceuticals design and development. We then review the computational design methods used in radiopharmaceutical studies, including molecular mechanics, quantum mechanics, molecular dynamics, molecular docking, pharmacophore modelling, and datadriven ML. Finally, the difficulties and opportunities presented by radiopharmaceutical modelling are highlighted. The review emphasizes the potential of computational design methods to accelerate the production of these very useful clinical radiopharmaceutical agents and aims to raise awareness among radiopharmaceutical researchers about computational modelling and simulation methods that can be of benefit to this field.

Objective: Boerhavia, a polymorphic genus, has been treated as a single genus encompassing species belonging to a morphologically related genus, Commicarpus. Owing to this taxonomic quandary with regard to the merger or separation of the two genera by different workers, there are different reports on the number of species belonging to this genus. This has further resulted in flawed reporting of ethnomedicinal as well as ethnopharmacological studies. The present review focuses on resolving any confusion regarding taxonomic treatment and highlighting the ethnomedicinal uses supported by ethnopharmacological data and the phytochemistry of Boerhavia and Commicarpus species found in India.

Conclusion: In India, four species of Boerhavia and two species belonging to Commicarpus are found. The literature survey revealed that except for B. diffusa, no other species of Boerhavia has been explored in detail. This presents an opportunity to conduct research on Boerhavia species and find new phytochemicals with promising therapeutic effects.

Objectives: This review aims to provide an overview of the role of cannabinoids in various diseases like metabolic disorders, infectious diseases, and psychological disorders.

Methods: Various e-resources like Pubmed, Science Direct, and Google Scholar were thoroughly searched and read to make an informative, comprehensive manuscript. Here we tried to summarize the therapeutic aspect of Cannabis sativa and its bioactive compound cannabinoids with respect to various diseases.

Results: This review highlights the various constituents which are present in Cannabis sativa, the endocannabinoid system, and the role of cannabinoids in various diseases.

Conclusion: Recent research on Cannabis has suggested its role in neurodegenerative diseases, inflammation, sleep disorders, pediatric diseases, and their analgesic nature. Therefore, the authors majorly focus on the therapeutic aspect of Cannabis sativa in various diseases. The focus is also on the endocannabinoid system (ECS) and its role in fighting or preventing bacterial, parasitic, fungal, and viral infections.

Objective: The main objective of this review is to abridge different ADFs and various laboratory- based in vitro manipulation and extraction studies, demonstrating that these approved ADFs have the capabilities to deter abuse.

Methods: The method includes the collection of data from different search engines like PubMed, FDA guidance documents, ScienceDirect, Google Patents to get coverage of literature in order to get appropriate information regarding ADFs.

Results: Various in vitro studies demonstrate that ADFs are effective in minimizing opioid drug abuse, including opioid overdose. However, real impact of these ADFs on reducing the drug abuse can be concluded only after receiving the post marketing data.

Conclusion: ADFs are embracing fundamentally different paradigms in the management of severe pain. We believe that the development of abuse deterrent technologies would shift the architype, deterring multipill abuse and can prove as a breakthrough strategy in controlling this opioid epidemic menace.

Objective: The aim of the study was to review the literature on the effects of garlic compounds and preparations on immunomodulation and viral infection management, with emphasis on SARS-CoV- -2.

Methods: Exhaustive literature search has been carried out on electronic databases.

Conclusion: Garlic is a fundamental part of a well-balanced diet which helps maintain general good health. The reported information regarding garlic’s ability to beneficially modulate inflammation and the immune system is encouraging. Nonetheless, more efforts must be made to understand the actual medicinal properties and mechanisms of action of the compounds found in this plant to inhibit or diminish viral infections, particularly SARS-CoV-2. Based on our findings, we propose a series of innovative strategies to achieve such a challenge in the near future.

Conclusions: E. meningoseptica, a high alert organism associated with meningitis among premature underweight neonates. High degree of resistant to most of the broad-spectrum antibiotics makes its management a challenging task. A good communication between the clinician and the microbiologist becomes very important for the proper management of the patients.]]> https://www.benthamscience.comarticle/116941 Objective: The aim of the study is to investigate the patterns of bioaccumulation and toxic effects of CuO NPs after multiple oral exposures.

Methods: The particle size was determined by scanning electron microscopy and dynamic laser light scattering. The specific surface area was measured by the method of Brunauer, Emmett, Teller. Total pore volume - by the method of Barrett, Joyner, Khalenda. Twenty-four hours after the final exposure, blood samples were taken for biochemical and hematological analysis, and internal organs were taken to determine their mass, copper concentration and histological analysis. The study was carried out in comparison with copper (II) oxide microparticles (CuO MPs).

Results: In terms of size, surface area, and pore volume, the studied copper (II) oxide sample is a nanomaterial. The median lethal dose of CuO NPs was 13187.5 mg/kg of body weight. Bioaccumulation occurs in the stomach, blood, intestines, liver, lungs, kidneys and brain. Pathomorphological changes in the liver are manifested in the form of necrosis, degeneration, hepatitis; kidney - proliferation of mesangial cells, dystrophy; stomach - gastritis; small intestine - hyperplasia, enteritis; large intestine - colitis; lungs - hyperplasia, abscess, pneumonia, bronchitis, vasculitis. Clumps of brown pigment were detected in the kidneys, stomach and lungs. The mass of the stomach and intestines increased, the mass of the liver, kidneys and lungs decreased. Pathomorphological changes in organs are likely to cause an increase in the levels of activity of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, lactate dehydrogenase, amylase, malondialdehyde concentration and a decrease in plasma antioxidant activity. The proportion of segmented neutrophils and the number of leukocytes are raised, the proportion of lymphocytes is reduced.

Conclusion: The degree of bioaccumulation and toxicity of CuO NPs are more expressed in relation to CuO MPs.]]> https://www.benthamscience.comarticle/114082 https://www.benthamscience.comarticle/116784Background: Proper identification of the causative organism in pediatric sepsis is crucial for early diagnosis and prevention of septic shock and organ failure.

Objectives: The aim of the present study was to evaluate the multiplex polymerase chain reaction (PCR) for detection of Acinetobacter baumannii, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia from positive blood cultures for these pathogens isolated from children with hospital- acquired sepsis compared to the conventional biochemical reactions for identification of these organisms.

Methods: This study was a cross-sectional study performed on 100 isolates from pediatric blood cultures, including Acinetobacter baumannii, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia. The study also included 100 isolates of Escherichia coli as a negative control. All isolates were identified by API 20NE and the multiplex PCR with primers specific to the 3 tested bacteria.

Results: Multiplex PCR was positive in 96% of isolates and 4 isolates had negative results. Falsepositive results were reported with three E. coli strains. Multiplex PCR identified all the isolates of Acinetobacter baumannii, 29 isolates of Pseudomonas aeruginosa and 27 isolates of Stenotrophomonas maltophilia. The diagnostic value of the multiplex PCR compared to the biochemical identification revealed sensitivity 96.04%, specificity 96.9%, positive predictive value 97.00%, negative predictive value 96.00% and accuracy 96.50%.

Conclusion: The present study highlights the diagnostic value of multiplex PCR to identify Acinetobacter baumannii, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia from positive blood cultures. Multiplex PCR was sensitive, specific and accurate. The accuracy differs according to the organisms with 100% accuracy for Acinetobacter baumannii.

Objective: The present study is aimed at exploring chemical composition, pharmacological and biological activities of Ajuga species as worked out by researchers and scientific community. Due to the excessive use of Ajuga species it needs to be conserved and requires important measures for its conservation.

Methods: The analysis of essential oils and plant extract has been reported through solvent extraction, steam distillation method, GC-MS analysis and HPLC.

Results: Literature survey revealed reports of Ajuga L. to be used against various ailments such as stomach-ache, dermatitis, malaria, snake-bite, ear-ache, arthritis, bleeding, wounds, asthma, pneumonia, respiratory problems, fever, dysentery, and joint pain.

Conclusion: The detailed description would be helpful in future studies. Recent biotechnological approaches have been reported useful to conserve A. bracteosa due to over exploitation for research purpose whereas A. brachystemon and A. macrosperma have been reported rarely in the wild.

Case Report: In this case report, the patient experienced severe headache with nausea, vomiting, and blurred vision for 12 days, and had a history of hypertension. Physical examination revealed a clear state of mind, normal speech, normal limb muscle strength, 2 transverse fingers of neck stiffness, and negative bilateral Babinski signs. Brain CT, MRI, MRA, and MRV showed no obvious abnormalities. SWI suggested the possibility of capillary dilation. The cerebrospinal fluid was pale yellow in appearance after lumbar puncture.

Diagnosis: The patient was diagnosed with subarachnoid hemorrhage (SAH) and capillary dilatation.

Interventions: Therapeutic management of blood pressure and brain edema was started.

Conclusion: Lumbar puncture should be performed when subarachnoid hemorrhage is clinically suspected and CT is negative. While searching for the cause of subarachnoid hemorrhage, the presence of telangiectasia should be ascertained.

Objective: The aim of this work is to investigate anti-amyloidogenic activity of antibiotics as repurposing agents via inhibiting Aβ aggregation and fibril formation employing in silico and in vitro approaches.

Methods: In silico screening was designed with receptor and ligand preparation, grid formation, docking simulation and its analysis. Thioflavin T-amyloid binding and protease-digestion studies were intended as in vitro assays. These methods assessed the pharmacological potential of antibiotics as anti-amyloidogenic agents.

Results: Paromomycin and Neomycin were identified with a higher order of estimated free energy of binding in in silico experiments. In in vitro screening, paromomycin significantly (p<0.01) reduced the fluorescence intensity and resistance to tryptic degradation of Aβ(1-42) peptides while neomycin had no or little effect (p<0.01) when compared to control. Results from docking and wet lab studies were found in correlation.

Conclusion: Paromomycin exhibited higher anti-Aβ aggregating and defibrillogenic activity than neomycin and left an indication for further in vivo testing and could be a future promising antiamyloidal candidate for the treatment of several amyloidoses.

The multidrug resistance (MDR) and antibiotics losing efficacy, esp. in methicillin resistance Staphylococcus aureus (MRSA) urge for novel antimicrobial agents. The MRSA strains are resistant to the entire class of β-lactam antibiotics and limit effective treatment, leading to still spread of staphylococcal infections. MRSA also exhibits resistance to cephalosporins, macrolides, fluoroquinolones, aminoglycosides, and glycopeptides (teicoplanine and vancomycin), leading to resistant strains-glycopeptide resistant strain (GRSA) and glycopeptide intermediate (GISA) S. aureus. In this review, chemical constituents responsible for the anti-MRSA activity of tea are explored.

Methods: A total of 90 K. pneumoniae isolates were collected from different clinical samples at hospitals in Tehran during the year 2016 and 2018. Antimicrobial susceptibility testing was performed on bacterial isolates using the Kirby-Bauer disc diffusion method on Mueller Hinton agar plates. PCR experiments were carried out to detect the presence of the bla_OXA genes, including bla_{OXA- 1}, bla_OXA-2, bla_OXA-4, bla_OXA10, and bla_OXA-48-like, using specific primers.

Results: The antibiotics susceptibility results showed that 41% of the K. pneumoniae isolates were resistant to imipenem and meropenem. Resistance rates for cephalosporin agents, including cefpodoxime, ceftazidime, cefuroxime, cefotaxime, and cefepime, were measured as 72.3%, 67.8%, 67.7%, 65.5%, and 60%, respectively. In the present study, 51.1% of isolates were classified as multidrug-resistant K. pneumoniae strains. The molecular assays showed that 56.6% of isolates harbored bla_OXA-2. In addition, bla_OXA-4, bla_OXA-1, bla_OXA-10, and bla_OXA-48-like genes were also found in 16.7%, 5.6%, 1.1%, and 1.1% of isolates, respectively.

Conclusion: The spread of bla_OXAs, especially bla_OXA-48-like, among K. pneumoniae isolates indicated the inadequate dissemination control of multidrug-resistant bacteria in the Iranian hospital environment. There is a reason to assume that OXA producing K. pneumoniae will limit clinical therapeutic options in the future and pose threats to national public health among the Iranian population.

Curcumin, a redox-active natural product, for centuries, has been used in Asian traditional medicine for the treatment of various diseases. It is known for possessing multiple biological and pharmacological activities. Curcumin has been investigated extensively over the years for its anti-inflammatory, anticancer, antiparasitic, antiviral and antibacterial activities, and no toxicity is associated with the compound. Despite its potency and good safety profile, curcumin is still in clinical trials for the treatment of diseases, such as tuberculosis, acquired immunodeficiency syndrome (AIDS), Crohn’s disease, colorectal cancer, and multiple myeloma, among many others, as it is yet to be qualified as a therapeutic agent. This review summarizes events over the last decade, especially regarding the discovery of curcumin, an update of its synthesis, its pathogen specific mechanisms of action, and the pharmacological effects of its derivatives, combinations and formulations as potential antibacterial, antifungal, antiparasitic and antiviral agents for the treatment of various infectious diseases.

Objective: To determine the diagnostic accuracy of MRS in differentiating neoplasm and non-neoplastic brain lesion.

Methodology: This is a cross-sectional descriptive study conducted at Khartoum State from the period of 2015 to 2017. Thirty cases with brain lesions were included in the study investigated with MRS (Single-voxel spectroscopy) and conventional MRI. A comparison of MRS findings and histopathologic analysis was performed. The ratios of Cho/Cr and Cho/NAA were analyzed and compared between neoplastic and non-neoplastic brain masses. Data were analyzed using SPSS version 23.

Results: Out of the 30 patients affected with brain lesions, there were 16 females and 14 males with a mean age of 44 +- 18 years. The ratios of Cho/Cr and Cho/NAA were higher in gliomas, astrocytoma, and meningioma than non-neoplastic lesions. Kappa statistical value (K) showed a good agreement between MRS and histopathological analysis (K= 0.60). The diagnostic accuracy of MRS was 100%, with 82.60% sensitivity, 85.71% specificity, 95% PPV, and 60% NPV.

Conclusion: MRS has high diagnostic accuracy in differentiating neoplasm from non-neoplastic brain tumors. The elevation ratios of Choline-to- N-acetyl aspartate and choline-to- creatine can help neurosurgeons and clinicians differentiate benign from malignant masses.

Methods: The candidate compounds of H. cordata Thunb and the potential targets were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), PubMed, CNKI, PubChem Database, and Swiss Target Prediction database. Then the potential targets and pathways of H. cordata Thunb against RSV were screened by GeneCards, GenCLiP 3, and NCBI Database. We developed a Protein-Protein Interactions (PPI) Network and Compound-Target-Pathway Network through the Cytoscape software. Furthermore, core targets were preliminary verified by Gene Expression Omnibus (GEO) database by bioinformatics methods. At last, the first six pathways were screened out to draw a map of the main target signal pathways.

Results: A total of 12 potentially active compounds and 47 potential interaction targets were screened. PPI Network and data from GEO showed that IL-6, STAT3, TNF, AKT1, PTGS2, SRC, and MAPK3 may play a core role in the antivirus process. KEGG enrichment pathway analysis predicted that H. cordata Thunb exerted its anti-RSV effect by regulating TNF, Rap1, HIF-1, PI3KAkt, MAPK, and VEGF signaling pathways.

Conclusion: This study preliminarily predicted the main active compounds, targets and related pathways of H. cordata Thunb in the treatment of RSV-induced diseases, which laid a good foundation for further revealing its mechanism.

The current review is a critical study for the evaluation of state-of-the-art concerning phytochemistry, pharmacology and traditional uses of bamboo species of different genera, which put forward systemic research stratagems and to streamline the therapeutic exploration for the management of human ailments.

The present review documents systemic overview of the scientific reports relating to the different bamboo species from older text, ancient literature available in the last five to six decades, e-books and various online databases (PubMed, MEDLINE, Scopus, Google Scholar, Springer, Francis &Taylor, SciFinder, etc.). Additional information was acquired from conference proceedings, botanical books, and dissertations for this work.

Bamboo species belonging to six different genera were explored for its medicinal and ethnomedicinal uses for treatment of inflammatory disorders, ulcers, diabetes, solid tumour, blood purifier, menstrual disorders, and infertility to name a few. The therapeutic potentials, along with their mechanism of action, are concisely deliberated and recapitulated in this review. Bamboo is rich in its nutritive value and has been explored as food and fodder. Studies related to the biological activity of bamboo species revealed that they possess twenty-one promising activities such as anticancer, antidiabetic, cardioprotective, anti-inflammatory, antioxidant, hepatoprotective, neuroprotective, and antibacterial. Eighty-two phytochemical studies have been summarized in this review which is majorly due to the presence of secondary active metabolites such as phenolics, flavonoids, terpenoids, steroid glycosides and coumarins along with minor constituents like polysaccharides, ketones, tannins, lignans, vitamins, amino acids, minerals, and essential oils. A critical assessment of the compiled scientific literature indicates serious efforts for systemic evaluation of the traditional claims and to identify, isolate and evaluate the phytoconstituents for nutritional and therapeutic potentials. Although the plant has immense potential in the health care system, still there is abundant need and avenues for commercialisation and awareness to society for the use of new health care products of bamboo.

The present review affirms that bamboo owing to its rich phytochemical spectrum is the epitome plant with a vast potential for the pharmaceutical, cosmeceutical, nutraceutical, and food industry.

Case Series: In this article, we recorded 5 cases of extramedullary-intradural lumbar spinal cysticercosis, in which one case displayed cystic lesions in both brain and spine, one case showed an independent cystic lesion in the spine, and three remaining cases showed diffuse lesions in the spinal canal.

Conclusion: Thus, in any case of single or numerous cystic lesions or dispersed lesions entering the spinal canal, spinal cysticercosis should be considered.

Methods: We assembled a systematic review, following the PRISMA guidelines and using Pubmed as our database. Our aim was to show some peculiarities among patients that present neurological manifestations in acute porphyria attack. We obtained the patients’ age, sex, clinical presentation, eurological manifestations and porphyria type of 16 patients. We also evaluated the time between symptoms onset and neurological manifestations. The average age was 28,4 ± 11,1; 50% of patients were male.

Results: AIP was the most prevalent porphyria type. The average time between symptoms onset and neurological manifestations was of 9,53 ± 11,6 days. Abdominal pain; nausea and vomiting and psychiatric manifestations were the most common symptoms preceding neurological attacks. Seizures and consciousness disturbance were the most prevalent findings within an attack. We also presenting a case to illustrate how difficult this diagnosis can be.

Results: Of 287 children with fever-related seizure, 127 (45.7%) were male and 151 (54.3%) were female. History of seizure, history of obstructed labor, abnormal MRI, complete delay, use of antiepileptic drug and history of trauma were 22(9.9%), 1 (0.4%), 11(4%), 5(1.8%), 259(93.2%) and 12 (4.3%), respectively. Of 11 patients with abnormal MRI, 4 had MTS lesions, 2 had tumor lesions, 2 had scarring trauma, 1 had an epidural abscess and 1 had meningitis. The frequency of organic lesions had no significant differences based on gender, use of antiepileptic drug and traumatic history, but it had a significant relation with obstructed labor andthehistory of seizure.

Conclusion: The results showed that organic brain lesions in children with fever-unrelated seizure had a significant relationship with the history of seizure and obstructed maternal labor.]]> https://www.benthamscience.comarticle/110628Background: The fibroblast growth factor (FGF) family is comprised of 23 highly regulated monomeric proteins that regulate a plethora of developmental and pathophysiological processes, including tissue repair, wound healing, angiogenesis, and embryonic development. Binding of FGF to fibroblast growth factor receptor (FGFR), a tyrosine kinase receptor, is facilitated by a glycosaminoglycan, heparin. Activated FGFRs phosphorylate the tyrosine kinase residues that mediate induction of downstream signaling pathways, such as RAS-MAPK, PI3K-AKT, PLCγ, and STAT. Dysregulation of the FGF/FGFR signaling occurs frequently in cancer due to gene amplification, FGF activating mutations, chromosomal rearrangements, integration, and oncogenic fusions. Aberrant FGFR signaling also affects organogenesis, embryonic development, tissue homeostasis, and has been associated with cell proliferation, angiogenesis, cancer, and other pathophysiological changes.

Objective: This comprehensive review will discuss the biology, chemistry, and functions of FGFs, and its current applications toward wound healing, diabetes, repair and regeneration of tissues, and fatty liver diseases. In addition, specific aberrations in FGFR signaling and drugs that target FGFR and aid in mitigating various disorders, such as cancer, are also discussed in detail.

Conclusion: Inhibitors of FGFR signaling are promising drugs in the treatment of several types of cancers. The clinical benefits of FGF/FGFR targeting therapies are impeded due to the activation of other RTK signaling mechanisms or due to the mutations that abolish the drug inhibitory activity on FGFR. Thus, the development of drugs with a different mechanism of action for FGF/FGFR targeting therapies is the recent focus of several preclinical and clinical studies.

Objective: The objective of this study was to formulate SLN of Itraconazole (ITZ) for intranasal administration.

Methods: ITZ-loaded SLN were prepared by high pressure homogenization technique using the Central Composite Design (CCD). The concentration of surfactant (X1) and drug to lipid ratio (X2) was considered as independent variables, whereas particle size (Y1) and percentage entrapment efficiency (Y2) were considered as a response. The compatibility of ingredients with the drug was tested using differential scanning calorimetry. SLN were characterized for their particle size, entrapment efficiency, transmission electron microscopy, in vitro drug release, and ex vivo study.

Results: The solid lipid nanoparticles were successfully prepared using high pressure homogenization technique and glyceryl monostearate was used as solid lipid. The lipid ratio significantly increases the particle size as well as entrapment efficiency. The particle size and (%) entrapment efficiency of optimized formulation were found to be 29 nm and 78.9%, respectively. The differential scanning calorimetry confirmed that the drug existed in amorphous form. Nasal histopathology study on sheep mucosa revealed that the developed SLN was non-toxic and safe to use for intranasal administration. The results of ex vivo study showed that the Higuchi pattern of drug release was followed. The in vitro release studies showed the significant difference in drug release from ITZ-loaded SLN compared to plain ITZ-solution.

Conclusion: ITZ-loaded SLN were successfully prepared and validated. The best batch was selected based on the desired particle size, and EE which is an important characteristic for SLN formulations. The developed formulations were nontoxic as determined by histo-pathological studies.

Discussion: This review focuses on different imaging techniques such as X-rays, PET, CT- Scan, and MRI. This survey identifies a different approach with better accuracy for tumor detection. This further includes the image processing method. In most applications, machine learning shows better performance than manual segmentation of the brain tumors from MRI images as it is a difficult and time-consuming task. For fast and better computational results, radiology used a different approach with MRI, CT-scan, X-ray, and PET. Furthermore, summarizing the literature, this paper also provides a critical evaluation of the surveyed literature which reveals new facets of research.

Conclusion: The problem faced by the researchers during brain tumor detection techniques and machine learning applications for clinical settings have also been discussed.

Case Report: A fifty-year-old Surinamese woman without any medical history was admitted for diabetic ketoacidosis. No specific anti-pancreatic autoimmunity was observed, and the C-peptide level was low, indicating atypical type-1 diabetes mellitus. DKA was associated with thyrotoxicosis in the context of thyroiditis and complicated by nonbacterial pericarditis and a Staphylococcus aureus subcutaneous abscess. The patient was infected with HTLV-1.

Conclusion: To our knowledge, this uncommon association is described for the first time. Few studies have analyzed the implications of HTLV-1 infection in thyroiditis and diabetes mellitus. We did not find any reports describing the association of pericarditis with HTLV-1 infection. Additional studies are necessary to understand the role of HTLV-1 in endocrine and cardiac disorders.

Objective: The aim of this work was to sequence the genome of a pvl-positive USA1100 Vancomycin- Intermediate-Resistant S. aureus (VISA) isolate from Rio de Janeiro, Brazil.

Methods: The 13420 genome was sequenced using the HiSeq 2500 platform. The draft genome, plasmids annotation, and genome analysis were performed using RAST. Comparison of the relative pvl gene expression of six S. aureus isolates was performed by qRT-PCR.

Results: The isolate presented the ϕPVL phage codifying for the H2b PVL protein isoform, and another prophage carrying a PVL variant named lukF and lukS-PV.2. The 13420 genome presented a high number of virulence determinants, such as genes codifying for serine-protease proteins, enterotoxins (egc), the immune evasion cluster (IEC), adhesion proteins, spermine/spermidine acetyltransferase gene (blt), superantigen-like proteins, as well as the ica operon. Point mutations at vraS, tcaA, and tcaB genes were detected. Moreover, the PVL mRNA relative expression of the 13420 isolate was five times higher than mRNA PVL levels of the USA300/ST8 reference strain.

Conclusion: We described for the first time the genome sequence of a VISA isolate harboring two pvl-associated genes and other virulence factors that may improve the USA1100/ST30 lineage fitness and impact its pathogenicity and spreading at Brazilian hospitals.

Methodology: In this paper we investigate the antioxidant and antibacterial potential of sulfonamides derived from carvacrol, a small molecule with drug-like properties. Most sulfonamides had antioxidant and antibacterial potential, especially compound S-6, derived from beta-naphthylamine.

Results: To understand the possible mechanisms of action involved in biological activity, the experimental results were compared with molecular docking data.

Conclusion: This research allows appropriate discussion on the identified structure activity relationships.

Methods: We undertook structured searches of bibliographic databases of peer-reviewed research literature which pertained to natural products, medicinal chemistry of natural products and drug discovery from fungi. With the strategic improvement in screening and identification methods, fungi are still a potential resource for novel chemistries. Thus the searches also comprised of bioactive agents from fungi isolated or derived from special ecological groups and lineages. To find different molecules derived or isolated from fungi under clinical studies, clinical trial data from the NIH as well as from pharmaceutical companies were also explored. This comprised of data wherein the pharmaceutical industries have acquired or licensed a fungal bioactive compound for clinical study or a trial.

Results: Natural product chemistry and medicinal chemistry continue to play an important role in converting a bioactive compound into therapeutic moieties or pharmacophores for new drug development.

Conclusion: Thus one can say fungal bioactive compounds are alive and well for development into new drugs as novel ecological groups of fungi as well as novel chemistries are being uncovered. This review further emphasizes the collaboration of fungal biologists with chemists, pharmacologists and biochemists towards the development of newer drugs for taking them into the drug development pipeline.]]> https://www.benthamscience.comarticle/92468

Methods: a 57 years-old male with intraparenchymal hemorrhage at CT imaging initially in reduction ad serial imaging and suspected right fronto-temporo-parietal lesion at MRI underwent dynamic and static (60' after tracer injection) FCH PET/CT of the brain.

Results: FCH PET/CT showed rapid tracer uptake after few second from injection at dynamic acquisition and consequent incremental mild uptake at static imaging after 60 minutes at the level of oval formation in the right cerebral hemisphere characterized by annular and peripheral high metabolic activity. The central region of the lesion was characterized by the absence 18F-FCH uptake most likely due to blood component. The patient underwent surgery for tumor removal; the histopathological examination confirmed the suspect of GBM. Chemo-radiotherapic adjuvant protocol according to Stupp protocol was therefore administrated; to date the patient is alive without any progression disease at 5 months from treatment.

Conclusion: In this case report FCH PET/CT represented the final diagnostic technique to confirm the suspicious of a cystic GBM. Our case demonstrated the potential role of 18F-FCH PET/CT for discrimination of higher proliferation area over intraparenchymal hemorrhage, supporting the potential use of this imaging biomarker in surgical or radiosurgical approach. Obviously, further prospective studies are needed to confirm this role and to exactly define possible routinely applications.]]> https://www.benthamscience.comarticle/91030

Objective: Pseudomonas aeruginosa is an emerging pathogen that has been associated with IE. However, it is not known whether P. aeruginosa can bind and interact with HAECs. The aim of this study was to determine whether P. aeruginosa can bind and colonize HAECs.

Methods: The invasion of HAECs by P. aeruginosa was assessed by gentamicin protection assay. Cytokine levels were determined by enzyme-linked Immunosorbent Assay (ELISA) kits. Cell damage was determined by Lactate Dehydrogenase (LDH) assay.

Results: P. aeruginosa can bind and invade HAECs. Infection of HAECs with P. aeruginosa induces TNF-α IL-1β, IL-6 and IL-8 cytokine production leading to the generation of inflammatory milieu that can cause tissue damage as observed in human clinical cases of IE. We also observed that P. aeruginosa induces cell damage in HAECs.

Conclusion: In this study, we demonstrate for first time that P. aeruginosa can invade and survive inside HAECs. This cell culture model can be of immense importance to determine the efficacy of drug targets against IE.]]> https://www.benthamscience.comarticle/91201

Objective: In this review we focused on the challenges of epidemiological and clinical feature of tuberculosis presented by the HIV coinfection.

Method: The article consists of a summary of the most important effects presented by the HIV coinfection on epidemiological and clinical feature of tuberculosis. The article analyzes and summary the causes for these challenges.

Results: The major challenges to strategy of TB control and clinical feature of TB-HIV coinfection are presented in this paper.

Conclusion: HIV/TB co-infection is synergic, interactive and reciprocal with significant impact. The infection of HIV and Mtb affect each other and the breakdown the immune function in TB/HIV coinfected individual. HIV infection has changed the strategy of TB control, however HIV increases global burden of TB, the reduction in the TB incidence rate is far from sufficient. Atypically clinical manifestations in TB/HIV co-infected patients and increased MDR-TB and XDR-TB contribute to the challenges in the diagnosis and treatment. Increased complexity of managing patients requires expertise in the clinical m knowledge. The focused efforts to control HIV-related TB are of great urgency. These findings will provide insight into the prevention, detection and treatment of tuberculosis and will guide advances towards tuberculosis control.]]> https://www.benthamscience.comarticle/89391

Method: Google scholar and Pubmed search engines were used to construct historic timeline after discovery of MTZ with a journey of ~3 decades of research. Similar search was conducted for its in vivo carcinogenic activities, further extended to elaborate its role in carcinogenicity in humans.

Results: In addition to preclinical in vitro validation of DNA damage, MTZ has been reported to induce cancer in a variety of animal models including lung cancer, malignant lymphomas, breast cancer, hepatocellular carcinoma, pituitary tumors, testicular neoplasms and uterine cancer. Several retrospective cohort studies have reported MTZ as a potential risk factor for lung cancer (n = 771), cervical cancer (n = 2500), breast cancer (n = 2), cholangiocarcinoma (n = 1), and neuroblastoma (n = 28). So far, all the reported data have confirmed MTZ carcinogenicity in animals; however it is still controversial in humans. Based on previous observations, the oxidative metabolites from MTZ are shown to have more carcinogenic effects than the parent drug itself.

Conclusion: Due to potent carcinogenic behaviour, use of MTZ for animals’ treatment and its uses in animal food products is prohibited in USA and European countries; however its clinical use in human population is still increasing. Therefore, regular research studies are required to explicate its mechanism/s involved in carcinogenesis.]]> https://www.benthamscience.comarticle/88516

Case Presentation: A 53-year-old never-smoker woman was diagnosed with ALK-rearranged stage IV lung adenocarcinoma. After a brilliant response to crizotinib and several lines of systemic therapy, NGT positioning intended for ceritinib administration was required, given the development of a pleuro-esophageal fistula. Enteral drug administration allowed a significant reduction of hepatic and cerebral disease localizations.

Literature review and discussion: The majority of kinase inhibitors administration through NGT or PEG accounts for EGFR-mutated (seven) or ALK-positive (seven, including our report) NSCLC patients. Five additional cases concerning different malignancies were described. Enteral drug administration was mostly required by disease-related respiratory impairment, requiring mechanical ventilation in the emergency setting. In our case, the cerebral and extra-cranial response obtained with enteral ceritinib intake suggests the proposition of novel inhibitors in these circumstances may take place after first-generation compounds failure or even upfront. Indeed, their grater potency and activity against brain metastases point out the role of their enteral administration in the first-line setting too, when a rapid systemic and intra-cerebral disease response is required.]]> https://www.benthamscience.comarticle/91204

Objective: To provide an update on the evaluation, diagnosis, and treatment of community-acquired pneumonia in children.

Methods: A PubMed search was completed in Clinical Queries using the key term “communityacquired pneumonia”. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. Patents were searched using the key term “community-acquired pneumonia” from www.google.com/patents, http://espacenet.com, and www. freepatentsonline.com.

Results: Generally, viruses, notably respiratory syncytial virus, are the most common cause of community- acquired pneumonia in children younger than 5 years. Streptococcus pneumoniae is the most common bacterial cause across all age groups. Other important bacterial causes in children younger than 5 years include Haemophilus influenzae, Streptococcus pyogenes, Staphylococcus aureus, and Moraxella catarrhalis. In children 5 years or older, in addition to S. pneumoniae, other important bacterial causes include Mycoplasma pneumoniae and Chlamydophila pneumonia. In the majority of cases, bacterial and viral pneumonia cannot be reliably distinguished from each other on clinical grounds. In practice, most children with pneumonia are treated empirically with antibiotics; the choice of which depends on the patient’s age and most likely pathogen. Recent patents related to the management of community-acquired pneumonia are discussed.

Conclusion: In previously healthy children under the age of 5 years, high dose amoxicillin is the treatment of choice. For those with type 1 hypersensitivity to penicillin, clindamycin, azithromycin, clarithromycin, and levofloxacin are reasonable alternatives. For children with a non-type 1 hypersensitivity to penicillin, cephalosporins such as cefixime, cefprozil, cefdinir, cefpodoxime, and cefuroxime should be considered. In previously healthy children over the age of 5 years, macrolides such as azithromycin and clarithromycin are the drugs of choice.]]> https://www.benthamscience.comarticle/90811

Results: The medical complications of ED are extremely variable and can occur with only modest biological and physical damage up to extremely serious and life-threatening conditions; the mortality rate of young subjects with AN is 4 - 11% with a risk of death about 12 times higher than that of subjects of the same age of the general population. The management of the medical-internship aspects of AN and BN is rightly placed within complex and articulated programs of interdisciplinary treatment with different levels of intensity of care (outpatient, semi-residential/residential, hospital in cases of emergency/medical and/or psychiatric emergency).

Conclusion: the results of the investigations carried out, describe the functions of the various organs and apparatuses and the alterations detected, the possible complications and physiological adaptations to malnutrition.]]> https://www.benthamscience.comarticle/84044

Methods: Initial damage force results in Primary brain injury, causing tissue destruction and distortion in the early post-injury period. These secondary injuries from TBI cause changes in cell performance and dissemination of trauma via activities like free-radical generation, depolarization, and formation of edema, excitotoxicity, and disruption of blood brain barrier, calcium homeostasis, and intracranial hematoma. The expectation for developing effect in TBI sufferers is the best knowledge of these activities and enhancement of remedies that restrict secondary brain damage.

Results: The focal point of this study is on knowing the complex outburst of secondary impairments and studying the pathophysiology of TBI which provides alternative treatment benefits.

Conclusion: While injured persons demonstrate dissimilar levels of harm and every case is novel with specific recovery profiles, this article strengthens the recent pathophysiological sight of TBI mainly attention on oxidative stress, excitotoxicity, cerebral oxygenation and cerebral blood flow (CBF), development of edema, and inflammatory activities. For initial research acknowledgment of these recurring factors could permit clarification of possible beneficial targets.]]> https://www.benthamscience.comarticle/88834 https://www.benthamscience.comarticle/85050

Material & Method: This paper represents a comprehensive search through TPM texts and manuscripts with the intention to seek possible clues on MS from potentially valuable age-old resources. We predominantly focused our search on the works of five eminent physicians of Medieval Persia: Avicenna (980-1037 AD), Haly Abbas (949-982 AD), Rhazes (865-925 AD), Averroes (1126-1198 AD) and Jorjani (1042-1137 AD).

Results: In this paper, the authors attempt a theory and conclude with high probability that a conjunction of a series of signs, symptoms found in TPM texts under the terms khadar, isterkha and falej form the symptoms and the disease pattern of modern day MS. This theory draws upon existent similarities in terms of disease pathology, disease patterns and predisposing factors seen between MS and the related morbidities within Persian Medicine.

Conclusion: We recommend further examinations of such potentially valuable long-standing resources, examining the diagnoses and treatments as set forth by Persian Medicine through international collaboration within the global scientific community.]]> https://www.benthamscience.comarticle/86616

Methods: We undertook a comprehensive, critical and systematic literature survey on ethnomedicinal, phytochemical and pharmacological aspects of P. cineraria. Efforts were made to establish/corroborate the scientific reasons of ethnomedicinal use with the help of published modern studies.

Results: Based on in-depth analysis of more than 200 studies, we were able to corroborate a large number of facts pertaining to uses of different parts of this plant for treating various maladies. Further, it yielded several new insights on phyto-pharmacological aspects of P. cineraria.

Conclusion: Results of this study are useful for commercialization of the products derived from phytochemicals of P. cineraria.]]> https://www.benthamscience.comarticle/87299

Methods: A Pubmed search was performed, and 207 studies concerning the relationship between use of PPIs and cardiovascular diseases, kidney impairment, nutritional disorders, fractures, infections, functional decline, and mortality were selected and reviewed.

Results: PPIs may cause potentially harmful effects by several mechanisms, including endothelial dysfunction, hypomagnesemia, drug interactions, reduced absorption of selected nutrients, increased gastric microbiota and small intestine bacterial overgrowth, reduced immune response, tubular-interstitial inflammation, increased bone turnover, accumulation of amyloid in the brain. Clinical and epidemiologic evidence is not consistent in regard to some negative outcomes during PPI treatment. Data from randomized clinical trials seem to deny most of them, but they are usually designed to investigate efficacy of drugs in ideal conditions and are not powered enough to detect adverse events. Besides being at special risk of experiencing negative outcomes during long-term treatment with PPIs, older and complex patients treated with polypharmacy regimens are persistently excluded from randomized clinical trials. Thus, large observational studies involving real-world patients should be considered as an important informative source about potential risks related to PPIs.

Conclusions: Current evidence suggests that use of PPIs may be associated with negative outcomes by eliciting several different pathophysiologic mechanisms. While short-term PPIs could be considered effective and safe in adult patients with acid-related disorders, their long-term and often inappropriate use in patients carrying vulnerability to adverse events and/or high risk of drug-interactions should be avoided.]]> https://www.benthamscience.comarticle/84454

Objective: The main objective of this review article is to emphasize on the recent efforts of researchers to study and understand the pharmacological aspects of various pyrazolines and their analogues derived from chalcone derivatives.

Methods: A well known synthetic method for the preparation of pyrazolines is the ring closure reaction of α, β unsaturated ketones with nitrogen based nucleophiles like hydrazine and its derivatives. The synthetic manipulations of pyrazoline derivatives offer a high degree of varied medicinal properties with improved potency and good pharmacological actions.

Results: The present review compiles the different synthetic methods to arrive at diversely substituted pyrazoline derivatives. It presents the biological evaluations such as, antimicrobial, antioxidant, antidepressant, antimalarial, analgesic, anti-inflammatory, antiviral, antidiabetic, antitubercular, anticancer and anticonvulsant properties and also documents the utility of these compounds based on their potency.

Conclusion: This review presents that the synthetic pyrazolines are excellent scaffolds which possess multiple biological and medicinal properties.]]> https://www.benthamscience.comarticle/83272

Conclusion: We present a review of the neuroradiological manifestations of neonatal and paediatric encephalopathies which will aide paediatricians and radiologists in their assessment of children with this condition.]]> https://www.benthamscience.comarticle/85952

Conclusion: This review includes the detailed view of phytochemistry and medicinal properties of Shatavari extracts and their application in some widely consumed food products like milk and milk products, bread, biscuits etc., which could be a good choice for the delivery of functionality of Shatavari extract to the consumers.]]> https://www.benthamscience.comarticle/87064

Methods: Retrospective single-centre study of HIV patients treated with HAART.

Results: A total of 417 patients were included. We identified 45 cases of IRIS in 37 patients; an incidence of 13.3 cases over 1000 person-years. In univariate analysis, IRIS development was significantly associated with CDC stage, the presence of an opportunistic infection (OI) at diagnosis, CD4 cell count and viral load at diagnosis and HAART initiation and the use of integrase strand inhibitors (INSTIs). In multivariate analysis, INSTIs use (OR 2.89; 95%CI 1.26-6.64; p=0.012), CD4≤200/mm3 (OR 5.56; 95%CI 2.2-13.98; p<0.001), and the presence of an OI (OR 4.74; 95%CI 2.13-10.23; p=0.012) were independent risk factors. Among INSTI regimens, dolutegravir (OR 4.99 vs. NNRTI; 95%CI 1.11-22.55; p=0.037) and elvitegravir (OR 4.82 vs. NNRTI; 95%CI 1.43-16.19; p=0.011) seem to carry increased risk. Mortality was 18.9% (7/37) for IRIS patients compared to 9.7% (37/380) in the non-IRIS group. Mortality at any given time during follow-up was significantly higher in the IRIS group (HR 3.2; 95%CI 1.39-7.36; p=0.006).

Conclusion: The use of INSTIs and especially DTG and EVG is associated with a higher probability for the development of IRIS in the background of late presentation and the presence of OIs. These data highlight the need for further research.]]> https://www.benthamscience.comarticle/85301

Methods: We have reviewed the recent literature using the following search terms: “metastatic prostate cancer”, “castration-resistant”, “bone metastases”, “bone scan”, “abiraterone”, “enzalutamide”.

Results: Bone scintigraphy has evolved recently with new and more sensitive tracers that can accurately diagnose even low volume disease progression. MRI has an established role in the diagnosis of spinal cord compression.

Conclusion: Metastatic, castration-resistant prostate cancer is a discrete and different phase of prostate cancer with newer agents that have shown great promise in controlling the disease and offering a survival benefit for patients. Recommendations regarding the choice of imaging, trigger points for repeating imaging and intervals between imaging are still under development for this phase of the disease especially for patients treated with new androgen targeted agents.]]> https://www.benthamscience.comarticle/85773

Objective: In order to optimize and standardize, MSC based therapy for IBD, a better understanding of cellular and molecular mechanisms of the therapeutic activities of MSCs, is extremely mandatory. There has been a plethora of publications in the last decade which elucidates the biologic rationale that makes MSC a promising therapeutic tool for IBD. Recent studies have witnessed a replacement of hypotheses regarding the mechanism of MSCs in curing IBD. The present review summarizes all these discussions, the results of the trials carried out to date and the future prospects in this field.

Conclusion: Based on the current development of MSC-based clinical trials and the ever-increasing rate of in-vitro studies, with a purpose to unveil the mechanism of curative approach of these cells, MSC based therapy for IBD can be expected to achieve clinical relevance in the near future.]]> https://www.benthamscience.comarticle/84151

Objective: The aim of this study is to estimate the Incidence Rates (IR) of infections and malignancies in patients treated with anti-TNFs across different IMIDs, as well as potential risk factors. Methods: IR/100 patient-years were evaluated in adult patients treated for any IMID with an anti-TNF between January 2000 and December 2014. Predictors were tested with bivariate and multivariate statistical analysis.

Results: The IR/100 patient-years of serious infections was 4.02 (95% CI 3.20-5.04) with significant differences across IMIDs and anti-TNF agents. The most frequent site of serious infection was the gastrointestinal system. Five cases [IR of 0.28 (95% CI 0.12-0.66) /100 patient-years] of tuberculosis were diagnosed, exclusively in patients treated with monoclonal antibodies. Three (60%) of those were extrapulmonary. The IR/100 patient-years of malignancy was 1.75 (95% CI 1.24-2-47).

Conclusion: There is significant variability in the IR of infections across indications and agents. Thus, physicians should be thoughtful when generalizing data from literature regarding the use of an anti-TNF agent in a specific IMID. Further studies are necessary to clear aspects regarding the safety of individual anti-TNF biologics and to clarify their impact in the different IMIDs.]]> https://www.benthamscience.comarticle/81357

Methods: Considering that antimicrobial resistance can vary according to geographical location, we investigated the status of antibiotic resistance in Ilam province from 2008 to 2013.

Results: The results of our study showed that antibiotic resistance rates to aztreonam, cefotaxime, ceftazidime and ceftriaxone were 38%, 39%, 43% and 48% respectively.

Conclusion: Antibiotic resistance had increased (except for aztreonam) during the period from 2008 to 2013.]]> https://www.benthamscience.comarticle/83763