Comparative phytochemical study of methanolic and ethanolic extracts of Thymus linearis and their antibacterial and antioxidant potential.

Thymus linearis (Thyme) is a medicinal plant widely distributed throughout Asia. Various parts of thyme are utilized for diverse medicinal purposes, including its use as a tonic and diuretic, for cough relief, as a flavoring agent, in treating dysentery, and for alleviating stomach disorders. Numerous studies have been conducted to explore the unexploited potential of thyme. Thyme was collected from the northern region of Pakistan, and sun-mediated extraction was conducted. Phytochemical analysis, utilizing GC-MS, revealed numerous bioactive phytochemical constituents with disease-preventing roles, including detoxifying agents, antioxidants, anticancer compounds, dietary fiber, neuropharmacological agents, and immunity-potentiating agents, in the methanolic and ethanolic (14 days) extracts of the flower, leaf, and stem. The 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay results indicated that the ethanolic and methanolic extracts of the stem exhibited the highest antioxidant activity, reaching up to 67.34% and 62.73%, respectively, while the values for the flower and leaf extracts (both methanol and ethanol) were around 60%. The IC50 (half maximal inhibitory concentration) values were also calculated for all the samples, ranging between 7 and 9 µg/mL. Positive antibacterial and antifungal effects against Bacillus subtilis and Escherichia coli, as well as Aspergillus niger (fungi), were observed only in the extracts of the flower (both methanol and ethanol). The sun-mediated technique was used for extraction for the first time in this study. Therefore, this study introduces a novel approach to the extraction of bioactive compounds from medicinal plants, ultimately contributing to the development of herbal drugs with more convenient and cost-effective methods.

Green synthesis of graphene-based metal nanocomposite for electro and photocatalytic activity; recent advancement and future prospective.

The presence of pollutants in waste water is a demanding problem for human health. Investigations have been allocated to study the adsorptive behavior of graphene-based materials to remove pollutants from wastewater. Graphene (GO) due to its hydrophilicity, high surface area, and oxygenated functional groups, is an effective adsorbent for the removal of dyes and heavy metals from water. The disclosure of green synthesis opened the gateway for the economic productive methods. This article reveals the fabrication of graphene-based composite from aloe vera extract using a green method. The proposed mechanism of GO reduction via plant extract has also been mentioned in this work. The mechanism associated with the removal of dyes and heavy metals by graphene-based adsorbents and absorptive capacities of heavy metals has been discussed in detail. The toxicity of heavy metals has also been mentioned here. The Polyaromatic resonating system of GO develops significant π-π interactions with dyes whose base form comprises principally oxygenated functional groups. This review article illustrates a literature survey by classifying graphene-based composite with a global market value from 2010 to 2025 and also depicts a comparative study between green and chemical reduction methods. It presents state of art for the fabrication of GO with novel adsorbents such as metal, polymer, metal oxide and elastomers-based nanocomposites for the removal of pollutants. The current progress in the applications of graphene-based composites in antimicrobial, anticancer, drug delivery, and removal of dyes with photocatalytic efficacy of 73% is explored in this work. It gives a coherent overview of the green synthesis of graphene-based composite, various prospective for the fabrication of graphene, and their biotoxicity.

The Role of Glucosamine and Chondroitin Sulfate in the Prevention of Colorectal Cancer: A Systematic Review.

Currently, colorectal cancer is the third most common cancer in the world. Recently, glucosamine and chondroitin have gained popularity for their beneficial effects on cancer. They have already been recognized for their therapeutic role in osteoarthritis. This systematic review aims to analyze the relationship between the combined consumption of glucosamine and chondroitin and the prevention of colorectal cancer. Three databases: PubMed, Google Scholar, and Science Direct, were searched to collect relevant articles. After screening full-text articles, seven studies were included in the systematic review. The review found a supportive association between glucosamine and chondroitin and the decreased incidence of colorectal cancer. Through an anti-inflammatory effect on the cell signaling pathway, the supplementation caused a reduction in colorectal cancer occurrence. The dose, frequency of usage of the supplement, and weight of individuals, along with the use of non-steroidal anti-inflammatory drugs, also affected the efficacy. To further assess this relationship, it is necessary to conduct double-blind, randomized controls trials for the supplements in cancer prevention and further explore their safety and efficacy with different ethnicities, drugs, doses, and weight individuals.

Hereditary haemochromatosis, haemophagocytic lymphohistiocytosis and COVID-19.

BACKGROUND: Syndromes of iron overload have been shown to increase the risk of severe clinical disease in viral infections. Immune dysfunction is similarly described in hereditary haemochromatosis (HH). We present here the case of a 51-year-old man who developed severe coronavirus disease 2019 (COVID-19) complicated by suspected haemophagocytic lymphohistiocytosis (HLH). He was found to have HH post-mortem and we propose a link between his iron overload and the development of severe COVID-19. CASE REPORT: The initial clinical presentation consisted of cough, shortness of breath and fever. Pancytopenia, markedly elevated ferritin and d-dimer were present. Computed tomography (CT) showed bilateral ground glass changes consistent with COVID-19, widespread lymphadenopathy and splenomegaly. A subsequent combined nose and throat swab was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). HLH was suspected based upon the H-score and Anakinra, an IL-1 receptor antagonist, was commenced. Liver function acutely worsened and magnetic resonance cholangiopancreatography (MRCP) revealed hepatic haemosiderosis. Intense splenic and cervical lymph node uptake were seen on a positron emission tomography (PET) scan and high doses of intravenous steroids were administered due to concerns over haematological malignancy. RESULTS: Day fourteen of admission heralded the start of progressive clinical deterioration with rapid increase in oxygen demands. Continuous positive airway pressure (CPAP) was trialled without success and the patient unfortunately died seventeen days into admission. Results returned after his death showed homozygous C282Y mutation of the HFE gene consistent with a diagnosis of HH. Post-mortem examination revealed widespread haemosiderin deposition in the liver along with lung pathology in keeping with severe COVID-19 and widespread splenic infarctions. CONCLUSION: An association between HH and COVID-19 is not currently described in the literature. What does exist, however, is an evidence base for the detrimental impacts iron overload has on viral infections in general and the negative effects of HH on the immune system. We therefore postulate that the underlying metabolic and immune disturbances seen in HH should be considered a potential risk factor for the development of severe COVID-19. This case also adds to the evidence that hyperinflammation appears to be a unique and interesting characteristic of this novel viral disease.

A Rare Case of Juvenile Idiopathic Arthritis following a Ruptured Baker's Cyst in a Toddler.

A Baker's cyst is usually an incidental finding in adults being investigated for a joint arthropathy, and its rupture preceding the diagnosis of juvenile idiopathic arthritis (JIA) is rare in children. Here, we describe a case of a 4-year-old girl who presented to the Emergency Department with right calf pain, swelling, and no preceding history of trauma. MRI confirmed a ruptured Baker's cyst with inflammatory arthropathy alongside an extensive synovial proliferation throughout the knee joint with large joint effusions and associated soft tissue oedema tracking superiorly and inferiorly along the medial head of gastrocnemius and anteriorly along the tibia. Further investigations revealed bilateral uveitis consistent with a diagnosis of juvenile idiopathic arthritis.

Changes in thyroid function status of suicidal patients

Abstract Background This study was carried out at Punjab Institute of Mental Health and Centre for Nuclear Medicine Mayo Hospital, Lahore. It is aimed at the possible association of thyroid malfunctioning with suicide attempts of patients. Objective Determination of thyroid function status of suicidal psychiatric patients and their comparison with psychiatric patients without suicide attempt or ideation. Methods Total 54 patients with either past history of suicide attempt or current suicidal ideation were selected for analysis of their thyroid function status (age 15-55 years). Age matched 50 non-suicide psychiatric patients were included for comparison. Results Two patients with suicide attempt had overt thyroid dysfunction. Remaining patients had serum FT4, FT3 and TSH level within normal range. Suicide attempter patients had lower FT4 but increased FT3 and TSH levels compared to suicidal ideation patients. Serum FT4 and TSH levels in suicidal patients were not different from psychiatric patients. Serum FT3 in suicidal patients was lower than psychiatric patients (3.7 ± 0.8 vs. 4.3 ± 0.5; p < 0.05). Female suicidal patients had lower FT3 levels compared to male patients (3.4 ± 0.6 vs. 3.9 ± 0.8 pmol/L; p < 0.05). Discussion Local suicidal patients have higher incidence of overt thyroid disorder and lower FT3 levels compared to non-suicidal psychiatric patients.

Fibromuscular Dysplasia with Spontaneous Coronary Artery Disease Presenting as Acute Myocardial Infarction.

A 40-year-old female presented to a rural hospital with crushing substernal chest pain. An initial electrocardiogram showed ST elevation in lead II and aVF with elevated troponin I. She was immediately transferred to a tertiary care hospital. An emergent coronary angiogram did not show any significant coronary artery disease. On the second day, the patient experienced recurrence of severe chest pain with ST elevations in leads I, aVL, V5-V6, ST depressions in V1-V3, T-wave inversion over V2-V5. The troponin I level increased to > 40 ng/ml (normal 0.0 to 0.04 ng/ml). An emergent angiogram was performed revealing local dissection of the mid to distal left main coronary artery and a totally occluded diagonal artery. It was deemed unsafe to perform percutaneous coronary intervention because it was a non-flow limiting left main coronary artery dissection and was difficult to cannulate with the guide catheter. Subsequently, an elective angiogram was performed after a 48-hour interval to evaluate the progression of dissection and to make a definitive decision for revascularization versus medical management. On the third angiogram, stenosis seen in the diagonal branch on the previous angiogram progressed to dissection, and local dissection of the left main coronary artery seen on the previous angiogram spontaneously resolved. The patient was symptom-free and hemodynamically stable. It was decided to manage the patient conservatively due to the spontaneous resolution of occlusion in the diagonal artery and dissection of the left main coronary artery. The patient was started on conservative medical treatment. A magnetic resonance angiography of the right internal carotid artery revealed a "string of beads" appearance, which confirmed the diagnosis of fibromuscular dysplasia. She was followed closely in the clinic and has remained asymptomatic for the past one year.

Duvoglustat HCl Increases Systemic and Tissue Exposure of Active Acid α-Glucosidase in Pompe Patients Co-administered with Alglucosidase α.

Duvoglustat HCl (AT2220, 1-deoxynojirimycin) is an investigational pharmacological chaperone for the treatment of acid α-glucosidase (GAA) deficiency, which leads to the lysosomal storage disorder Pompe disease, which is characterized by progressive accumulation of lysosomal glycogen primarily in heart and skeletal muscles. The current standard of care is enzyme replacement therapy with recombinant human GAA (alglucosidase alfa [AA], Genzyme). Based on preclinical data, oral co-administration of duvoglustat HCl with AA increases exposure of active levels in plasma and skeletal muscles, leading to greater substrate reduction in muscle. This phase 2a study consisted of an open-label, fixed-treatment sequence that evaluated the effect of single oral doses of 50 mg, 100 mg, 250 mg, or 600 mg duvoglustat HCl on the pharmacokinetics and tissue levels of intravenously infused AA (20 mg/kg) in Pompe patients. AA alone resulted in increases in total GAA activity and protein in plasma compared to baseline. Following co-administration with duvoglustat HCl, total GAA activity and protein in plasma were further increased 1.2- to 2.8-fold compared to AA alone in all 25 Pompe patients; importantly, muscle GAA activity was increased for all co-administration treatments from day 3 biopsy specimens. No duvoglustat-related adverse events or drug-related tolerability issues were identified.

Non-occupational risk factors of urinary bladder cancer in Faisalabad and Lahore, Pakistan.

OBJECTIVE: To investigate the non-occupational risk factors of the urinary bladder cancer in Faisalabad, Pakistan. METHOD: Several risk factors related to urinary bladder cancer--smoking, gender, residential area, fluid consumption, family history of cancer, use of tea and coffee--were examined. For the retrospective study, 149 subjects, 20 women and 129 men, were interviewed. Descriptive and inferential statistics were used to explain the risk factors of the disease. Odds ratios (OR) and 95% Confidence Intervals (CIs) of odds ratios were computed using the logistic regression model. RESULTS: The significant odds ratios for moderate lifestyle, education, smoking and fluid consumption were: (OR: 0.103, 95% CI: 0.037-0.290), (OR: 0.193, 95% CI: 0.058-0.638), (OR: 13.129, 95% CI: 4.215-40.9) and (OR: 0.116, 95% CI: 0.040-0.333), respectively. CONCLUSIONS: The study suggests that smoking increases the chances of an individual getting the disease. Protective agents include a moderate lifestyle, awareness and the use of 10 or more glasses of water per day.

Risk factors for urinary bladder cancer in Baluchistan.

BACKGROUND: Urinary Bladder cancer is a life threatening and aggressive disease. This retrospective study was conducted in Baluchistan for assessing the risk factors for urinary bladder cancer. METHOD: A questionnaire was developed in order to collect the requisite information about the characteristics like age, drinking habits, smoking history, family history of cancer and others factors. Interview method was used to obtain the information from 50 cases and 100 controls from two hospitals of the province. Binary logistic regression model was run to study the odds ratios and 95% confidence intervals. RESULTS: The odds ratios and 95% confidence intervals for cigarette smoking, fluid consumption and higher use of fruits were [26.064; 7.645-88.856], [0.161; 0.059-0.441], and [0.206; 0.059-0.725] respectively. CONCLUSIONS: The higher risk of urinary bladder cancer was observed in smokers as compared to non-smokers. Higher consumption of fluid and fruits are protective factors against the disease.

MCT oil-based diet reverses hypertrophic cardiomyopathy in a patient with very long chain acyl-coA dehydrogenase deficiency.

Very long chain acyl-CoA dehydrogenase (VLCAD) deficiency is one of the genetic defects of mitochondrial fatty acid beta-oxidation presenting in early infancy or childhood. If undiagnosed and untreated, VLCAD deficiency may be fatal, secondary to cardiac involvement. We assessed the effect of replacing part of the fat in the diet of a 2 ½-month-old male infant, who was diagnosed with VLCAD deficiency,with medium-chain triglyceride (MCT) oil and essential fats. The patient presented with vomiting, dehydration, and was found to have persistent elevation of liver function tests, hepatomegaly, pericardial and pleural effusion, right bundle branch block, and biventricular hypertrophy. Because of the cardiomyopathy, hepatomegaly, and an abnormal acylcarnitine profile and urine organic acids, he was suspected of having VLCAD deficiency. This was confirmed on acyl-coA dehydrogenase, very long chain (ACADVL) gene analysis. He was begun on an MCT oil-based formula with added essential fatty acids, uncooked cornstarch (around 1 year of age), and frequent feeds. By 7 months of age, cardiomyopathy had reversed and by 18 months of age, all cardiac medications were discontinued and hypotonia had improved such that physical therapy was no longer required. At 5 years of age, he is at the 50(th) percentile for height and weight along with normal development. Pediatricians need to be aware about the basic pathophysiology of the disease and the rationale behind its treatment as more patients are being diagnosed because of expansion of newborn screen. The use of MCT oil as a medical intervention for treatment of VLCAD deficiency remains controversial mostly because of lack of clear phenotype-genotype correlations, secondary to the genetic heterogeneity of the mutations. Our case demonstrated the medical necessity of MCT oil-based nutritional intervention and the need for the further research for the development of specific guidelines to improve the care of these patients.

Allelic dropout can cause false-positive results for Prader-Willi and Angelman syndrome testing.

The diagnosis of many genetic disorders relies on a combination of clinical suspicion and confirmatory genetic testing. Our laboratory uses a standard methylation-sensitive PCR (MSP) to target the differentially methylated SNRPN gene to test for Prader-Willi syndrome (PWS) and Angelman syndrome. One patient, a 27-month-old female, who lacked the classical clinical features of PWS, but had a molecular diagnosis of PWS by MSP by another laboratory, had repeat testing in our laboratory. Testing by MSP in our laboratory also identified an apparent loss of the unmethylated paternal allele, consistent with a diagnosis of PWS. Confirmatory testing using Southern blot analysis with a methylation-sensitive restriction enzyme showed a normal pattern of methylation, detecting both the methylated maternal and unmethylated paternal alleles. To investigate these discrepant results, we amplified and sequenced the SNRPN locus in this patient and identified a single nucleotide change within the binding site for the unmethylated DNA-specific primer. These results indicate this nucleotide change led to allelic dropout in the MSP analysis, yielding the false-positive result. Subsequently, MSP analysis using an alternate primer set that was developed by our laboratory detected both methylated and unmethylated alleles. These findings illustrate that allelic dropout due to the presence of rare polymorphisms can cause false-positive results in commonly used MSP assays and lead to molecular misdiagnosis.

Papillary thyroid cancer in a patient with MUTYH-associated polyposis (MAP).

We describe a patient with MUTYH-associated polyposis diagnosed with colon cancer at 33 years of age, as well as gastric polyps at a later age. She was also diagnosed with papillary thyroid cancer at age 35. MUTYH-associated polyposis is an autosomal recessively inherited disease which has clinical overlap with Familial adenomatous polyposis and its attenuated form, in that it is associated with risk of colon cancer at a young age. Extra-intestinal cancers have also been reported in patients with MUTYH-associated polyposis; however the tumor spectrum is still evolving. National Comprehensive Cancer Network guidelines recommend screening for colon, duodenal and gastric polyps in individuals with MUTYH-associated polyposis. Screening for extra-intestinal cancers i.e. thyroid cancer is presently not part of these recommendations. These will likely continue to evolve as the MUTYH-associated polyposis tumor spectrum is better understood as a result of future case reports and research.

Assessment of hepatitis B vaccination status in doctors of services hospital, Lahore.

BACKGROUND: Hepatitis B is the most common serious infection of the liver and can lead to premature death from liver cancer or liver failure. Of the two billion people who have been infected with Hepatitis B virus, more than 350 million have chronic infection. The objectives of this study were to assess the Hepatitis B vaccination status, reasons for non-compliance and the risk of exposure to doctors at a tertiary care hospital. METHODS: Three hundred and twenty-two doctors were selected from the various departments of the hospital by simple random sampling. They were given a self-administered questionnaire after taking verbal consent. Some doctors refused to fill-in the questionnaire while some others were on leave during the time of study and the remaining 215 doctors responded to the questionnaire. RESULTS: A total of 215 doctors, (age range 22-59 years) responded to the questionnaire. Amongst them 11.6% had not received even a single dose of Hepatitis B vaccine while 14.4% had not completed the required course of vaccination. Most common reason cited by doctors for non-immunisation was that they had not thought about it. Consultants were more likely of the other doctors to have received completed vaccination (83.9% versus 69.9%) (p<0.05). They were also significantly more likely to know their antibody titre after completing vaccination. Needle stick injuries were common. One hundred and forty-five doctors in the study admitted having received at least one needle prick/sharp injury. Of them, 51.6% had received a needle prick/sharp injury more than once. CONCLUSION: Despite the availability of an effective vaccine in the market doctors continue to remain non-vaccinated. It is the lack of awareness and carelessness on part of doctors coupled with the negligence of the risk that has led them being incompletely vaccinated. There is a need to ensure that every doctor is completely vaccinated against Hepatitis B before he/she enters professional practice.

Risk factors of urinary bladder cancer in Peshawar region of Khyber Pukhtoonkhawa.

BACKGROUND: Urinary Bladder cancer is a fatal disease. No work about its risk factors has been conducted in northern Pakistan. This case control study was conducted in order to investigate the risk factors of the urinary bladder cancer in that area. METHOD: For this study 150 subjects including 50 cases and 100 controls were interviewed from the 2 tertiary care hospitals of Peshawar and the information was collected about the characteristics like gender, age, smoking habits, family history of cancer, etc. Descriptive and inferential statistics were used to explain the risk factors of the disease. Odds ratios and 95% Confidence Intervals were computed by using logistic regression model. RESULTS: The odds ratio and 95% confidence interval for chemical exposure are 4.637 and (1.022-21.053), for cigarette smoking 19.526 and (4.688-81.329), for lifestyle 0.171 and (0.031-0.943), for fluid consumption 0.025 and (0.005-0.115), for fried items 5.934 and (1.429-24.648), and for fruits are 0.173 (0.045-0.660), respectively. CONCLUSIONS: Chemical exposure, cigarette smoking, and high use of fried items increase the risk of urinary bladder cancer. Moderate lifestyle, high fluid consumption and use of fruits are protective against the disease.