Association of BDNF and SERT gene polymorphisms with depression among Pakistani population.

Brain-derived neurotrophic factor (BDNF) and serotonin transporter (SERT) is implicated in the adverse life events which lead to depression. The variation in genetic make-up of BDNF (Val66Met) and SERT (5'-HTTLPR) are potential biomarkers in the development of neuropsychiatric disorders including depression. The purpose of this study was to investigate the correlation of functional polymorphisms of BDNF and SERT genes with depression among Pakistani population. A total of 373 participants (204 cases with depressive episodes and 169 healthy controls) with age between 14 and 65yrs were recruited from Pakistani population. BDNF and SERT gene polymorphisms were genotyped using PCR-RFLP analysis. The result showed that lack of association of Val66Met (χ2: 3.596, p>0.05) and 5'-HTTLPR (χ2: 0.634, p>0.05) gene polymorphisms were found with depression. However, SERT 'SL' (OR: 1.150, 95%CI: 0.601-2.201) and BDNF 'AA' (OR: 1.651, 95%CI: 0.585-4.660) and 'GA' (OR: 2.279, 95%CI: 0.825-6.298) genotypes might be a risk genotypes for depression. Hence, it is concluded that the functional BDNF (Val66Met) and SERT (5'-HTTLPR) gene polymorphisms may not be associated with depression. Replication studies on these polymorphisms with large sample size are needed.

Therapeutic potential of medicinal plants for the management of scabies.

Sarcoptes scabiei (S. scabiei), a parasite mite which causes scabies disease resulting in serious public health concern. The long-term scabies disease can lead to complications such as septicemia, acute post-streptococcal glomerulonephritis, heart disease, and secondary infections. Timely treatment to the affected patients is required to control the disease and get rid of the causative agent. Delayed diagnosis and inappropriate treatment can lead to serious consequences. The most common treatment strategy is the use of allopathic medicines which can immediately relieve the patient but have the drawback of side effects. The safe and cost-effective alternative treatment strategy is the use of medicinal plants which have beneficial therapeutic potential against variety of diseases due to the presence of many bioactive phytoconstituents with no or minimal side effects. For the present review, the published articles describing scabies disease and its phytotherapeutic modalities were searched through different data bases including Google Scholar, PubMed, Medline, and ScienceDirect using the keywords like S. scabiei, prevalence of scabies disease, and phytotherapy of scabies. A large number of medicinal plants, such as Melaleuca alternifolia, Curcuma longa, Azadirachta indica, Rosmarinus officinalis, Capsicum annuum, Cinnamomum camphor, Solanum nigrum, and Eupatorium perfoliatum, have been reviewed for the promising future treatments of scabies. All the studied plants have many bioactive compounds with potential therapeutic effects against scabies and can be utilized for therapeutic purposes for this disease. This literature study has limitations because of the lack of sufficient data due to limited pre-clinical trials in this particular area. This review provides a baseline to explore the therapeutic potential of these medicinal plants against skin diseases. However, extensive studies are required to identify, authenticate, and characterize the bioactive compounds present in these plants which may lead to value addition in pharmaceutical industries providing the cost-effective way of treatment with minimal side effects.

Progress and prospects in the management of bacterial infections and developments in Phytotherapeutic modalities.

The advent of antibiotics revolutionized medical care resulting in significantly reduced mortality and morbidity caused by infectious diseases. However, excessive use of antibiotics has led to the development of antibiotic resistance and indeed, the incidence of multidrug-resistant pathogens is considered as a major disadvantage in medication strategy, which has led the scholar's attention towards innovative antibiotic sources in recent years. Medicinal plants contain a variety of secondary metabolites with a wide range of therapeutic potential against the resistant microbes. Therefore, the aim of this review is to explore the antibacterial potential of traditional herbal medicine against bacterial infections. More than 200 published research articles reporting the therapeutic potential of medicinal plants against drug-resistant microbial infections were searched using different databases such as Google Scholar, Science Direct, PubMed and the Directory of Open Access Journals (DOAJ), etc., with various keywords like medicinal plants having antibacterial activities, antimicrobial potentials, phytotherapy of bacterial infection, etc. Articles were selected related to the efficacious herbs easily available to local populations addressing common pathogens. Various plants such as Artocarpus communis, Rheum emodi, Gentiana lutea L., Cassia fistula L., Rosemarinus officinalis, Argemone maxicana L, Hydrastis canadensis, Citrus aurantifolia, Cymbopogon citrates, Carica papaya, Euphorbia hirta, etc, were found to have significant antibacterial activities. Although herbal preparations have promising potential in the treatment of multidrug-resistant bacterial infection, still more research is required to isolate phytoconstituents, their mechanism of action as well as to find their impacts on the human body.

Awareness and current knowledge of epilepsy.

Epilepsy is a severe neural disorder that affects approximately fifty million individuals globally. Despite the fact that for most of the people with epilepsy, convulsions are better controlled by current accessible antiepileptic medicines, yet there are more than 30% of individuals affected with medically intractable epilepsy and around 30-40% of all patients with epilepsy affected by many adverse reactions and convulsion resistance to the present antiepileptic drugs. Consequently, various scientists attempt to develop new strategies to treat epilepsy, for instance, to find out novel antiepileptic ingredients from traditional medicines. This work aims to present a complete summary of natural medicines prescribed as antiepileptic agents all over the world by ethnic groups and different tribes. We undertook an extensive bibliographic analysis by searching peer reviewed papers and classical textbooks and further consulting well accepted worldwide scientific databases. We carried out PubMed, EMbase and CENTRAL searches by means of terms such as "antiepileptic" and "anti-convulsant" activity of plants. Medicinal plants have been prescribed to treat epilepsy and have been recognized as antiepileptic medicines. In this review, a variety of herbs have been reviewed for thorough studies such as Cuminum cyminum, Butea monosperma, Solanum americanum, Anacyclus pyrethrum, Leonotis leonurus, Elaeocarpus ganitrus and Angelica archangelica. This paper shows that it was high time experimental studies are increased to obtain novel potential active principles from medicinal plants. Plant extracts and their chemical constituents should be further evaluated to clarify their mechanisms of action. This paper provides a solid base upon which to further investigate the clinical efficacy of medicinal plants that are both currently prescribed by physicians as traditional antiepileptic agents, but also could be effective as an antiepileptic drug with further research and study.

Autism Cognizance: A dilemma among medical and Allied Medical practitioners.

OBJECTIVES: To determine the awareness about autism among Medical and Allied-Medical Practitioners. METHODS: This cross-sectional survey recruited a sample of n=300 participants including n=150 Medical and n=150 Allied-Medical practitioners using convenience sampling from Benazir Bhutto Hospital and Autism Resource Centre, Rawalpindi, Pakistan between 20th May 2018 to 20th October 2018. Sample included both genders, aged 21 to 50 years. Basic demographic sheet and Knowledge about Childhood Autism among Health Workers (KCAHW) Questionnaire was used to collect data. Statistical analysis was done using SPSS 21. RESULTS: Study revealed the total mean KCAHW score of 15.20 ± 5.17 and 8.84 ± 6.31 for Allied-Medical and Medical practitioners respectively. While the Domain-I mean KCAHW scores was 6.28±2.10 and 3.68±2.41; Domain-II score 0.86 ± 0.35 and 0.45 ± 0.50; Domain-III score 3.28 ± 1.00 and 1.91 ± 1.65; and Domain-IV score of 4.83 ±1.72 and 2.80 ± 1.75 for Allied-Medical and Medical practitioners respectively. CONCLUSION: The present study shows that there is significant awareness regarding autism among Allied-Medical compared to Medical practitioners.

Hypophagic and weight reducing effect of Momardica charinta fruit by Enhancing 5-HT neurotransmitter in rats brain.

Momardica charint seed as vegetable and folk medicine in Pakistan, India, China, Bangladesh and other Asian countries Momardica charinta also known as Kerala, bittergourd ,balsam pear. It possesses many biological active constituents including glycosides, saponins, phenolic and flavonoids compound, protein, triterpenes, steroid, saponins, alkaloid. It also contain thiamine ,beta carotene, folate, riboflavin, calcium, iron, potassium, zinc and fiber. Several studies have been done to show medicinal importance of its fruit which has different biological functions such as anti-diabetes antihypertension, antiviral, antibacterial and antifungal infection, anti-tumorous as well as anti-carcinogenic effects. The present research is big contribution of Momardicacharinta activity as weight reducing plant through serotonergic neurotransmitter Decrease in body weight and food intake might be due to increased concentration of serotonin in their respective receptors in brain, which produce hypophagic effect in rats treated with water extract of Momardicacharinttia. More animal and human trials needed to confirm, the safety and antiobesity effect of MC and the role of neurotransmitter involve in reduction of body weight.

Evaluation of wound healing effects of Syzygium cumini and laser treatment in diabetic rats.

This study was aimed to investigate the antioxidant effects of Syzygium cumini (S. cumini) seeds extract along with wound healing score in correlation to glutathione and blood glucose levels in diabetic rats. Sprague-Dawley rats were divided into 8 groups (n=6) and diabetes was induced by a single intraperitoneal injection of streptozotocin (40 mg kg-1 body weight). An alcoholic extract of S. cumini was administered to punch plier induced wounded rats and changes in serum glutathione levels, wound healing score and blood glucose levels were examined. Laser treatment of 500 mW for 5 minutes was given once a day for 12 days at 810 and 630 nm respectively. Statistical analysis was performed using one way ANOVA. A p-value <0.05 was considered significant and p-value <0.001 was considered highly significant. There was significant increase in glutathione levels and wound healing score when S. cumini extract was administered oral and topical along with topical laser therapy. There was significant reduction in the blood glucose levels upon administration of S. cumini extract in diabetic rats. This study concludes that there was a positive relation between the glutathione levels and wound healing score, since there was increase in wound healing score with the increase in the glutathione levels.

An alternative approach to treat obesity with leptogenic polyherbal formulation obesecure: A randomized clinical trial study.

Obesity is a common disease of developing countries, including Pakistan. Obesity is a risk factor for many diseases which can be life threatening or making the person unable to perform daily routine work. In the current study, clinical trials were designed to evaluate the effects of medical intervention by comparing the effects of placebo control drug "Plasicure" with the herbal medicinal formulation "Obesecure". The test drug formulation was designed on the basis of the screening study for Leptogenic drugs. To evaluate the safety of the test drug, the toxicity index and the safety profile of test formulation was assessed on animal models. The drug was found safe for further clinical study. Randomized Controlled Clinical Trials were conducted. The statistical analysis was carried out by the application of Two-Way Repeated Analysis of Variance test. The clinical findings of randomized controlled trial revealed that the test drug was Leptogenic and effective in weight reduction as compared to control drug Plasicure therapy as the p-value deduced was 0.001 in leptin level and 0.000 in case of BMI after the conduction of Two-Way Repeated Analysis of Variance test. Hence it is concluded that obscure therapy is more significant than control drug Plasicure therapy in the management and treatment of obesity.

Synthesis, characterization, antibacterial, hemolytic and thrombolytic activity evaluation of 5-(3-chlorophenyl)-2-((N-(substituted)-2-acetamoyl)sulfanyl)-1,3,4-oxadiazole derivatives.

A novel series of 5-(3-Chlorophenyl)-2-((N-(substituted)-2-acetamoyl)sulfanyl)-1,3,4-oxadiazole derivatives was efficiently synthesized and screened for antibacterial, hemolytic and thrombolytic activities. The molecule 7c remained the best inhibitor of all selected bacterial strains and furthermore possessed very low toxicity, 8.52±0.31. Compound 7a 7b and 7f showed very good thrombolytic activity relative to Streptokinase employed as reference drug. In addition to low toxicity and moderately good thrombolytic activity, the synthesized compounds possessed excellent to moderate antibacterial activity, relative to ciprofloxacin. All compounds especially 7b and 7f can be consider for further clinical studies and might be helpful in synthesis of new drugs for treatment of cardiovascular diseases.

Role of medicinal plants in HIV/AIDS therapy.

Human immunodeficiency virus (HIV) causes the potentially life-threatening and chronic disease called acquired immune deficiency syndrome (AIDS). The main target of this viral disease is to suppress the immune system and make the body unresponsive to external stimuli. According to global health observatory data since epidemic, more than 78 million people were affected by HIV and 39 million people died globally. Until 2017, 36.5 million people were living with HIV. An estimated 0.8% (0.6%-0.9%) of adults aged 15-49 years worldwide is living with HIV. The World Health Organization (WHO) reported that the African region remains most severely affected, with nearly one in every 25 adults (4.1%) living with HIV and accounting for nearly two-thirds of the people living with HIV worldwide. WHO reported that globally only 21.7 million (19.1 million-22.6 million) people have had access to antiretroviral therapy up to 2017. Currently, antiretroviral therapy (ART) is available for the control of HIV but has serious associated side effects such as lipodystrophy. Because of the limitations, associated with ART, researchers throughout the world are trying to explore and develop more reliable and safe drugs from natural resources to manage HIV infection. A wide range of medicinal plants have been studied and have reported significant potential against HIV. Plants like Rheum palmatum L., Rheum officinale, Trigonostem axyphophylloides, Vatica astrotricha, Vernonia amygdalina, Hypoxias pelargonium, Sidoides hemerocallidea and Sutherlandia frutescens etc. have high efficacy to cure HIV. The exact mechanism of action is still not known but various phytoconstituents isolated from medicinal plants such as alkaloids, flavonoids, polyphenols, terpenoids, tannins, proteins and coumarins have the potential to interrupt the life cycle of HIV as well as act as immunomodulators to enhance the immune system of infected patients with no well reported side effects. It could be concluded that medicinal plants have potential for the management of HIV/AIDS but more studies are needed to reveal rigorous efficacy and safety concerns by conducting clinical trials at vast level to explore therapeutic impact of medicinal plants.

A new approach to design 3(3-sulfamoylbenzamido) benzoic acid containing transition metal complexes: Characterization and Biological activities.

Zn, Cu, Co and Ni are biocompatible metals as they are active center of many enzymes in the human body. Incorporation of these biocompatible metals into 3-(o-Sulfamoylphenyl) carbamoylbenzoic acid (I) makes them able to prove an excellent antimicrobial agent. In the present study Ni (II), Co (II), Cu(II) and Zn (II) complexes (III-VI) were synthesized from ligand (I) derive from 3-(o-Sulfamoylphenyl) carbamoylbenzoic acid and zinc, nickel, cobalt acetate tetrahydrate/copper acetate monohydrate. Synthesized complexes (III-VI) were characterized by FT-IR, 1H NMR and 13CNMR. III-VI have 81-93% yield while melting points recorded were in the range of 209-239oC. Purity of ligands and their respective complexes was confirmed by TLC. Results of antibacterial properties suggested that III, IV, V and VI were highly active against gram +ve (S. epidermidis, B. subtilis. S. aureus, S. mutans) and gram -ve bacteria (E. coli and P. aruginosa). Comparison was also performed to check whether metal complexes or ligand with its derivative exhibit best result against all tested strains. The anthelmintic activity of the complexes III-VI against tape worm, liver fluke, thread worm, and hook worm using three different concentrations (15, 30, 45mg/mL), significantly (p<0.01) paralyzed the worms followed by death, which was comparable with that of the standard. Overall results indicated that S. epidermidis, S. mutans, E. coli and B. subtilis are very sensitive to complex III & IV and can be used for treatment of bacterial infections whereas Complex-V, could a potent target for anti-parasite therapy.

Prevalence and co-infection of Malaria and Typhoid in the local population of Faisalabad, Pakistan.

Malaria and typhoid fever are among the major infectious diseases which impose significant health and socioeconomic burden on affected populations. Further, co-infection and resembling symptomatology in both infections, mostly leads to misdiagnosis and mistreatment. So co-infection of malaria and typhoid fever is becoming a major issue in tropical and subtropical countries. The current study was planned to explore the rate of co-infection of malaria and typhoid fever to show the diagnostic challenges and people health implications in the local population of Faisalabad-Pakistan. For this purpose, 144 samples (n=144) were collected from suspected subjects both male (n=74) and female (n=70) (comprises of three age group ranges viz >01-10, 11-20 and above 20 years old) of typhoid fever and malaria from October to December 2017 at Children Hospital, Faisalabad-Pakistan. Thick smear as a gold standard technique for malaria diagnosis and Widal agglutination technique for typhoid diagnosis were used. Results revealed that the prevalence of co-infection in selected subjects was 6.3% (n=9) with higher prevalence in female subjects (7.1%) as compared to males (5.4%). Further, it was also reported that age groups >01-10 years old, 11-20 years old and 21-above years old have6.6 % (n=75), 5.7 % (n=35) and 5.8% (n=34), coinfection prevalence respectively. In the present study, it could be concluded that although the prevalence of co-infection of malaria and typhoid fever in the studied population was possible but sensitivity of diagnostic tools was limited, so more reliable, specific and sensitive diagnostic tools are required to report confidently more precise correlation of these infectious diseases.

Correlation of metformin with intravenous iodinated contrast media and precautions.

To discuss metformin and iv-contrast induced acute renal failure with its reported cases worldwide, associated risk factors and precautions that can be taken to reduce this tragedy & to address this sensitive issue to my technologist family working in clinical situations. As these studies were observational studies and just report contrast induced nephrotoxicity in different countries by analyzing patients data. By Personal experience or by analyzing data available on PACS (Picture archiving and communication system) most commonly available in Hospitals now a days, that is why these studies did not use any scientific procedure. In our study, we collected opinions of Senior Doctors about use of Metformin before and after contrast study. All Doctors were agreed upon investigation of serum creatinine before contrast study. Doctors were not agreed on single opinion but surely they agreed on stop of Metformin before and after procedure. They said its responsibility of imaging technologist or Radiologist to guide patient about this problem. Diabetic patients using Metformin are at high risk of acute renal acidosis if they are undergoing for iodinated contrast study.

Anti-diabetic activity of aqueous extract of Ipomoea batatas L. in alloxan induced diabetic Wistar rats and its effects on biochemical parameters in diabetic rats.

Diabetes is a condition where the fasting blood glucose level elevated above the normal range (80-120mg/dL). This increase in blood glucose level may be due to the insulin deficiency i.e. insulin dependent diabetes mellitus (IDDM or type I) or due to insulin resistance i.e. non-insulin dependent diabetes mellitus (NIDDM or type II). Diabetes leads to severe complications in the body even life treating complications e.g. nephropathy, retinopathy, neuropathy increased vascular permeability and delayed wound healing if left untreated. Different drugs are used for the treatment of diabetes mellitus, but synthetic drugs are costly and possess severe side effects. So, more emphasis is being placed on the use of traditional medicines because these sources have fewer side effects than the synthetics drugs and are economical. So the white skinned sweet potato (Ipomoea batatas L.) peel-off was selected for its anti-diabetic effect as well as to see its effects on biochemical parameters. Both young (3-4 months) and old (up to 1 year) Wistar rats were selected for current study. It was found that the aqueous extract of WSSP peel-off had shown beneficial effects. In addition to the decrease in blood glucose level it also decreased protein glycation level total cholesterol, triglycerides, and LDL-cholesterol. Increase in HDL-cholesterol was also observed after treating the rats with aqueous extract of Ipomoea batatas. Additionally, WSSP peel-off had also shown positive results on total protein concentration, albumin, globulin, and plasma enzymes (SGOT and SGPT). Further research would be needed in order to purify the anti-diabetic components and it should be available in compact dose form for all diabetic patients.

Enhanced production of Lovastatin by filamentous fungi through solid state fermentation.

Lovastatin is a natural competitive inhibitor of 3-hydroxy-3-methyl glutaryl coenzyme-A (HMG-CoA) reductase and inhibits specifically rate limiting step in cholesterol biosynthesis. Further, lovastatin in comparison with synthetic drugs has no well-reported side effects. Four pure isolated filamentous fungal strains including Aspergillus niger IBL, Aspergillus terreus FFCBP-1053, Aspergillus flavus PML and Aspergillus nidulans FFCBP-014 have been cultured by solid state fermentation (SSF) using rice straw as substrate for the synthesis of lovastatin. After selecting Aspergillus terreus FFCBP-1053 as the best producer of lovastatin, various selected physical parameters including pH, temperature, inoculums size and moisture content were optimized through response surface methodology (RSM) under center composite design (CCD) for lovastatin hyper production. Maximum lovastatin production of 2070±91.5 was predicted by the quadratic model in the medium having moisture content 70% and pH 4.5 at 35°C which was verified experimentally to be 2140±93.25µg/g DW of FM (microgram/gram dry weight of fermentation medium), significantly (P<0.05) high as compared to un-optimized conditions while it was noted that lovastatin production is independent on inoculum size (P>0.05) measured by spectrophotometer at 245 nm against standard. It was determined that optimized conditions for the hyper-production of lovastatin from fungal sources have a significant effect.

Effects of methanolic and aqueous extracts of Ipomoea batatas L on mineral contents level (calcium and magnesium) in alloxan-induced diabetic rats.

In diabetic patients, electrolyte disorders frequently occur with the characteristic changes in minerals like calcium and magnesium etc. Several medicines are used to manage diabetes mellitus but they exert adverse effects. Plants are a valuable alternative to synthetic medicines because they are easily available, economical and have fewer side effects. Ipomoea batatas L is a well-known antidiabetic plant (sweet potato) but its effects on calcium and magnesium concentration have not studied. The prime focus of this study is to estimate the potential of Ipomoea batatas L peel-off on magnesium and calcium level in Alloxan-induced diabetic rats. Alloxan monohydrate was mixed in 0.9% NaCl solution and administrated [150 mg/kg (S/C)] to male Wistar rats to induce diabetes. After three days blood samples were collected and blood glucose level was recorded. Wistar rats having a blood glucose level of 200 mg/dl and above were selected for the study. Methanol and water extract of Ipomoea batatas L peel-off was given orally with a dose rate of 4g/day. Calcium and magnesium estimation was done using an atomic absorption spectrophotometer. Our results revealed an increase in both the calcium and magnesium level in heart, brain, liver, hind limb, and forelimb after Ipomoea batatas extract treatment. In kidneys decreased calcium level was noted as they excrete calcium. Mineral (Calcium, magnesium) level was increased in all organs except kidney after both extracts treatment. Ipomoea batatas being anti-diabetic in nature also maintain the homeostasis of calcium and magnesium in diabetes. Therefore, we propose the long-term use of such agents might help in the prevention of diabetes-associated complications. However, the validation of these results to human population needs further extensive study.

The evaluation ofefficacy and safety of Cough (EMA) granules used for upper respiratory disorders.

Ivy leaf is used for the treatment of respiratory diseases with the intensive mucus formation, respiratory infections, and irritating cough coming from the common cold. Conferring to clinical trials, the efficacy, and tolerability of ivy leaf is good. The main compounds accountable for biological activity are triterpene and saponins. Ivy leaves show convulsive/antispasmodic, anti-inflammatory, antimicrobial, analgesic, anthelmintic and anti-thrombin activity. Not only ivy but also marshmallow and mustard seeds are used for these indications. This study was conducted to evaluate the efficacy and safety of Cough (EMA; European Medicines Agency) granules used for upper respiratory disorders. This clinical trial was conducted on 150 patients, out of which 75received the Cough (EMA) granules and 75received the placebo. The age range of patients was 3 years to above 15 years. The sample paired t-test was applied to evaluate the significant level. Cough (EMA) granules were found effective in the treatment of cough, cold, and flu symptoms. The new treatment Cough (EMA) granules were safe and well tolerated in patient at given specific age group. The study recommends that Cough (EMA) granules can be used effectively in the treatment of upper respiratory tract infection.

Pharmacokinetic behavior of montelukast in indigenous healthy male volunteers.

Aim of present study was to investigate the pharmacokinetic behavior of Montelukast in the healthy male volunteers under indigenous conditions. One tablet of montelukast 10 mg was administered in each subject and blood at different time intervals. Concentration of montelukast in plasma samples was analyzed by high performance liquid chromatography method to calculate pharmacokinetic parameters. The plasma concentration of montelukast was in the range of 1.31-1.76µg/mL at 0.5-12 hours with Cmax value of 1.59±0.16µg/mL at 3.71±0.64 hours. These values of plasma drug concentrations were above the minimum effective concentration of montelukast during the entire study hours. Absorption and elimination half-lives of the montelukast were evaluated as 2.52±0.54 hours and 2.63±0.35 hours, respectively. The volume of distribution and total body clearance of montelukast were investigated as 0.34±0.01 L/kg and 0.01±0.00 L/hr/kg, respectively. The pharmacokinetic parameters i.e. Cmax, AUC, t1/2, Vd and ClB of montelukast calculated in present study were found different as compared to that of the previous literature values which was due to genetic and environmental variation.

Review-Medicinal plants and management of Diabetes Mellitus: A review.

Diabetes is a metabolic disorder characterized by chronic hyperglycemia and associated with dysfunction and failure of various body organs. Alarming increase in prevalence rate has made this disorder a major health problem globally. The available treatment modalities are not sufficient to combat diabetes and associated complications. A number of medicinal plants have a significant antidiabetic potential against diabetes mellitus. We have listed the use of important medicinal herbs for the treatment and management of diabetes in this review.

Consanguineous marriages increase the incidence of recurrent tuberculosis: Evidence from whole exome sequencing.

BACKGROUND: In this study, we have identified multiple mutations in the IL-12R1 gene among Pakistani patients who have inherited them through consanguineous marriages. These patients have experienced severe Bacille-Calmette-Guérin (BCG) infection as well as recurrent tuberculosis. We will demonstrate the pivotal role of interleukin (IL)-12/interferon (IFN)-γ axis in the regulation of mycobacterial diseases. METHODOLOGY: First, we checked the patients' medical records, and then afterward, we assessed interferon-gamma (IFN-γ) production through ELISA. Following that, DNA was extracted to investigate IL-12/IFN- abnormalities. Whole exome sequencing was conducted through Sanger sequencing. Secretory cytokine levels were compared from healthy control of the same age groups and they were found to be considerably less in the disease cohort. To evaluate the probable functional impact of these alterations, an in silico study was performed. RESULTS: The study found that the patients' PBMCs produced considerably less IFN-γ than expected. Analysis using flow cytometry showed that activated T cells lacked surface expression of IL-12Rß1. Exon 7 of the IL-12Rß1 gene, which encodes a portion of the cytokine binding region (CBR), and exon 10, which encodes the fibronectin-type III (FNIII) domain, were found to have the mutations c.641 A > G; p.Q214R and c.1094 T > C; p.M365T, respectively. In silico analysis showed that these mutations likely to have a deleterious effect on protein function. CONCLUSION: Our findings indicate the significant contribution of the IL-12/IFN-γ is in combating infections due to mycobacterium. Among Pakistani patients born to consanguineous marriages, the identified mutations in the IL-12Rß-1 gene provide insights into the genetic basis of severe BCG infections and recurrent tuberculosis. The study highlights the potential utility of newborn screening in regions with mandatory BCG vaccination, enabling early detection and intervention for primary immunodeficiencies associated with mycobacterial infections. Moreover, the study suggests at the potential role of other related genes such as IL-23Rß1, TYK2, or JAK2 in IFN-γ production, warranting further investigation.