Pathophysiology, Diagnosis, and Management of Takayasu Arteritis: A Review of Current Advances.

Takayasu arteritis (TA) is a rare, chronic, inflammatory vasculitis that primarily affects large arteries, causing significant morbidity and mortality. This review provides an overview of the pathophysiology, diagnosis, and management of TA based on current advances in the field. TA is characterized by autoimmune-mediated inflammation, vascular remodeling, and endothelial dysfunction. The disease progresses through three stages (active, chronic, and healing phase) each presenting distinct clinical features. Diagnosis of TA can be challenging due to non-specific clinical manifestations and the lack of specific diagnostic tests. Various imaging modalities, such as angiography, ultrasound, and Doppler techniques, play a crucial role in the diagnosis of TA by visualizing arterial involvement and assessing disease extent. Management of TA involves a multidisciplinary approach, with disease-modifying anti-rheumatic drugs (DMARDs) as the cornerstone of medical therapy. Synthetic and biologic DMARDs are used to induce remission, control inflammation, and prevent complications. Non-pharmacologic interventions, such as resistance exercises and curcumin supplementation, show potential benefits. Invasive interventions, including endovascular therapy and open surgery, are used for managing vascular lesions. However, challenges remain in disease understanding and management, including the heterogeneity of disease presentation and the lack of standardized treatment guidelines. The future of TA management lies in precision medicine, utilizing biomarkers and molecular profiling to personalize treatment approaches and improve patient outcomes. Further research is needed to unravel the underlying mechanisms of TA and develop targeted therapies.

FLT3-ITD Mutation and Allogeneic Stem Cell Transplantation in Acute Myeloid Leukemia: A Case Study.

Acute myeloid leukemia (AML) is a hematologic cancer that is characterized by unchecked myeloid precursor cell growth in the bone marrow and peripheral circulation, which results in an overabundance of immature myeloid cells. The 22-year-old man featured in this case report had a fever, tiredness, and easy bruising. Pancytopenia was discovered through laboratory testing, and an AML diagnosis was confirmed by a bone marrow biopsy, with myeloid blasts making up 85% of the nucleated cells. FLT3-ITD and NPM1 mutations were found by genetic testing. After receiving induction chemotherapy using the drugs daunorubicin and cytarabine, the patient experienced complete remission after just one cycle of treatment. He then had an allogeneic stem cell transplant and was still in remission during follow-up. This example highlights the significance of early AML diagnosis and detection, as well as the function of molecular profiling and risk stratification in directing treatment choices. It emphasizes the requirement for continued study to produce novel treatments and enhance results for AML patients. In general, this case study advances knowledge of AML and its management techniques. For AML patients to experience the best results, early diagnosis, risk assessment, and individualized therapy plans based on molecular profiling are essential. AML patients' prognosis and quality of life can be improved by the development of targeted medicines, which require ongoing study to better understand the disease.

Advances in Understanding and Managing Autoimmune Hepatitis: A Narrative Review.

Autoimmune hepatitis (AIH) is a chronic liver disease characterized by immune-mediated destruction of hepatocytes, leading to inflammation and fibrosis. In recent years, significant advances have been made in understanding the pathogenesis, epidemiology, diagnosis, and treatment of AIH. This comprehensive narrative review aims to provide an up-to-date overview of these advances. The review begins by outlining the historical background of AIH, dating back to its initial recognition in the 1940s, and highlights the evolution of diagnostic criteria and classification based on autoantibody profiles. The epidemiology of AIH is explored, discussing its varying prevalence across different regions and the role of genetic predisposition, viral infections, and drug exposure as risk factors. Furthermore, the review delves into the pathogenesis of AIH, focusing on the dysregulated immune response, involvement of T cells, and potential contribution of the gut microbiome. Clinical presentation, diagnostic criteria, and liver biopsy as crucial tools for diagnosis are also discussed. Regarding management, the review provides an in-depth analysis of the standard first-line treatments involving glucocorticoids and azathioprine, as well as alternative therapies for non-responsive cases. Additionally, emerging second and third-line treatment options are examined. In conclusion, this narrative review highlights the complexity of AIH and underscores the importance of early diagnosis and individualized treatment approaches to improve patient outcomes. Further research and clinical trials are needed to optimize AIH management and ensure a better long-term prognosis for affected individuals.

Recurrent Retroperitoneal Spindle Cell Sarcoma: A Challenging Case Report and Management Considerations.

Soft-tissue sarcomas (STS) comprise a heterogeneous category of malignant tumors originating from mesenchymal tissue. Spindle cell sarcoma, characterized by its infrequent occurrence, poses diagnostic and therapeutic complexities owing to its rarity. We present a case of an 80-year-old male with a diagnosis of spindle cell sarcoma in the retroperitoneal space. The patient underwent midline exploratory laparotomy for tumor excision and was planned for postoperative chemotherapy. Unfortunately, the tumor recurred aggressively, leading to a fatal outcome. This case highlights the uncommon occurrence of retroperitoneal spindle cell sarcoma (RPSCS) and the importance of accurate diagnosis, appropriate surgical management, and adjuvant therapy.

Phytochemistry and polypharmacology of cleome species: A comprehensive Ethnopharmacological review of the medicinal plants.

ETHNOPHARMACOLOGICAL RELEVANCE: Cleome species in particular (C. gynandra Linn, C. viscosa Linn, C. rutidosperma DC, C. felina Linn.), commonly known as spider flowers, belong to the genus of flowering plants in Cleomaceae family. Found primarily in the African countries (Kenya, Tanzania, Egypt, South Africa, and Nigeria), Asian countries (India and Afghanistan), European countries (Italy), and also in other countries like Brazil and Austria. These plants are commonly cultivated as a vegetable crop for their nutritional benefits, and the leaves are widely consumed for their health-promoting effects. The different parts of the plants, such as leaves, seeds, flowers, and roots, are used to treat acute and chronic inflammatory disorders, hepatotoxicity, malaria, fungal diseases, and cancer. AIM OF THE STUDY: Detailed investigations in underlining the molecular mechanisms and their wide variety of effects in treating various diseases remain ambiguous. The review focuses on an in-depth discussion of studies targeting phytochemistry and polypharmacology. Thus, the review aims to recapitulate the therapeutic potential of the components of Cleome involved in the treatment of a wide variety of ailments from ancient times were collected and presented along with strategies aiming for future studies. MATERIALS AND METHODS: The information provided is collected from several scientific databases (PubMed, Elsevier, ScienceDirect) and traditional medicine books, and other professional websites. RESULTS AND CONCLUSION: Investigations and current evidence revealed that the different chemical constituents present in cleome species possess various health-promoting effects along with the aerial parts showing promising traditional uses in traditional healing and culinary. An explorative survey in the current review highlights the traditional healing effects along with a broad scope of studies that can be performed in the future.

Elaeocarpus floribundus Bl. seeds as a new source of bioactive compounds with promising antioxidant and antimicrobial properties.

The fruits of Elaeocarpus floribundus Bl. (Elaeocarpaceae) are edible and are normally prescribed for treatment of diseases. The medicinal uses of the fruit create considerable quantities of seeds as wastes. In an attempt to valorise this biomass, we studied the antimicrobial and antioxidant activities of the ethanolic seed extract. The extract inhibited the growth of the tested pathogens and was also a very strong scavenger of DPPH free radicals. Consequently, the extract was phytochemically investigated and this study reports the initial isolation of five phenolic compounds from this source. The structures of the isolated compounds were elucidated by spectra analyses including HR-ESI-MS, 1D and 2D NMR experiments. The isolated compounds exhibited a wide range of antimicrobial activities against the tested pathogens. Gallic acid (4) showed the most activity against Bacillus subtilis with a minimum inhibitory concentration (MIC) value of 30 µg/mL, while the MIC values of the antimicrobial standards range between 10 and 35 µg/mL. Compound 4, crude ethanolic extract, and the ethyl acetate fraction were more a potent free radical scavenger of DPPH compared to ascorbic acid. Hence, the seeds of E. floribundus could be considered as a new source of bioactive compounds for pharmaceutical and food-related industries.

Alpinia nigra fruits mediated synthesis of silver nanoparticles and their antimicrobial and photocatalytic activities.

In the present systematic study, silver nanoparticles have been synthesized using the fruits of Alpinia nigra. Apart from the presence of saponins, glycosides, alkaloids, steroids, the extract of A. nigra fruits are rich in polyphenols. The Total Flavonoid and Phenol Content of A. nigra fruits extract is 718 mgRE/g extract and 74.9 mgGAE/g extract respectively. The formation of the nanoparticles was validated through characterization techniques like UV-Vis spectroscopy, X- ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and Energy dispersive X-ray spectroscopy (EDX). The spherical shape of silver nanoparticles is observed in Transmission Electron Microscopy (TEM) images. The average particle size of the silver nanoparticles is 6 nm. The biomolecules of the fruit extract played the dual role of reducing and capping agents which is evident from Fourier Transform Infrared (FTIR) spectrometer and Scanning Electron Microscopy (SEM) image analysis. The A. nigra capped silver nanoparticles exhibited promising antimicrobial activity against gram negative bacteria Klebsiella pneumoniae, gram positive bacteria Staphylococcus aureus and the pathogenic fungus, Candida albicans. Amongst the three pathogens, Klebsiella pneumoniae is the most susceptible to silver nanoparticles. Furthermore, the nanoparticles efficiently catalysed the degradation of the anthropogenic dyes Methyl orange, Rhodamine B and Orange G in the presence of sunlight. The photocatalytic degradation process follows the pseudo-first order kinetics. These results confirm that the silver nanoparticles can be efficiently synthesized via a green route using A. nigra fruits with applications as antimicrobial and catalytic agents.

Biogenic synthesis of gold nanoparticles and their application in photocatalytic degradation of toxic dyes.

Plants and their extracts play an important role in the green synthesis of nanoparticles mainly because of their environmental benignity. Based on plant extracts number of metal nanoparticles have been synthesized. In our study, we report a green technique for the synthesis of gold nanoparticles using the aqueous extracts of Alpinia nigra leaves and their photocatalytic activities. The antioxidant, antibacterial and antifungal potential of the synthesized nanoparticles were also evaluated. The aqueous extract of the plant is rich in flavonoids with Total Flavonoid Content of 491mgRE/g extract. The presence of flavonoids was further confirmed through analytical High Performance Liquid Chromatography (HPLC) analysis. The A. nigra mediated syntheses of gold nanoparticles (ANL-AuNPs) were characterized by UV-Vis spectrophotometer, Fourier Transform Infrared (FTIR) Spectroscopy, X-ray Diffraction (XRD) and Transmission Electron Microscopy (TEM). The crystalline nature of the ANL-AuNPs was confirmed by the powder XRD analysis. The TEM micrographs showed that the ANL-AuNPs was predominantly spherical in shape and the average particle size was 21.52 nm. The polyphenolics and other functional groups present in the aqueous extract that acted as reducing and capping agent in the synthesis of the Au-NPs were identified via FTIR spectral analysis. These green synthesized nanoparticles exhibited antioxidant activity with IC50 value of 52.16 µg/ml and showed inhibition in the growth of both gram-positive and gram-negative bacteria. The pathogenic fungus, Candida albicans was also susceptible to these nanoparticles. The ANL-AuNPs in the presence of sunlight catalyzed the degradation of the anthropogenic pollutant dyes, Methyl Orange and Rhodamine B with percent degradation of 83.25% and 87.64% respectively. The photodegradation process followed pseudo first order kinetic model. These results confirm that Alpinia nigra is a potential bioresource for the synthesis of Au-NPs with versatile applications.