Traditional ecological knowledge sustains due to poverty and lack of choices rather than thinking about the environment.

In this debate article, we have tried to discuss Traditional Ecological Knowledge (TEK) and its close link to the available resources and lack of options in the indigenous communities. We came across the article of Hartel et al. where they initiated a discussion on this important but debatable topic of TEK and its merits and demirits for the environment. We believe that this discourse could continue to clarify both sides of the picture. Our research group is working on species facing extinction threats due to extensive utilization, leading to overexploitation of the taxa, which the TEK seldom cares for. We are of the opinion that the marginalized tribal communities living around the globe extensively use some of the species and natural resources for their food, fodder, fiber, shelter, energy, health and other benefits, irrespective of their conservation needs, and many other ecosystem services. They have to sustain their basic live's needs from the resources available for their livelihood. They collect economically important medicinal and other species in large quantities to gain higher earnings, rather than thinking of the issues faced by them. Hence, we believe that the continuity and utilization of TEK are driven by poverty and lack of choices rather than positive environmental values, historically. Nevertheless, those communities sometimes have their local system of protection which sometimes works very well or otherwise with the passage of time and the formation of government-driven regulations in the recent past, TEK itself has lost its real sense especially, related to conservation and management. Therefore, TEK could be linked with existing research-based policies and regulations for long-lasting benefits to the environment and its sustainable future. Such bridging can benifit all the stake hoders-the TEK holders, regulatory bodies, government agencies and many more. This debate can lead to a positive and critical discourse towards the clarification of the conundrum under consideration as well as creation of more questions hyptheses related to TEK.

Prescription drug dependence with and without concurrent illicit drug use: a multicenter cross-sectional survey among an addiction treatment seeking population.

Background: Dependence on prescription drugs and illicit drugs imposes a global health and social burden. Despite accumulating evidence of prescription drugs and illicit drugs dependence, none of the systematized studies has explored the magnitude of this problem in Pakistan. The aim is to investigate the extent and associated factors of prescription drug dependence (PDD), as opposed to concomitant prescription drug dependence and illicit drug use (PIDU), within a sample of individuals seeking addiction treatment. Methods: The cross sectional study was conducted on the sample recruited from three drug treatment centers in Pakistan. Face-to-face interviews were conducted with participants who met ICD-10 criteria for prescription drug dependence. Several aspects like substance use histories, negative health outcomes, patient attitude, pharmacy and physician practices also collected to predict the determinants of (PDD). Binomial logistic regression models examined the factors associated with PDD and PIDU. Results: Of the 537 treatment seeking individuals interviewed at baseline, close to one third (178, 33.3%) met criteria for dependence on prescription drugs. The majority of the participants were male (93.3%), average age of 31 years, having urban residence (67.4%). Among participants who met criteria for dependence on prescription drugs (71.9%), reported benzodiazepines as the most frequently used drug, followed by narcotic analgesics (56.8%), cannabis/marijuana (45.5%), and heroin (41.5%). The patients reported alprazolam, buprenorphine, nalbuphine, and pentazocin use as alternatives to illicit drugs. PDD was significantly negatively associated with injectable route (OR = 0.281, 95% CI, 0.079-0.993) and psychotic symptoms (OR = 0.315, 95% CI, 0.100, 0.986). This implies that PDD is less likely to be associated with an injectable route and psychotic symptoms in contrast to PIDU. Pain, depression and sleep disorder were primary reasons for PDD. PDD was associated with the attitude that prescription drugs are safer than illicit drugs (OR = 4.057, 95%CI, 1.254-13.122) and PDD was associated with being on professional terms (i.e., having an established relationship) with pharmaceutical drugs retailers for acquisition of prescription drugs. Discussion and conclusion: The study found benzodiazepine and opioid dependence in sub sample of addiction treatment seekers. The results have implications for drug policy and intervention strategies for preventing and treating drug use disorders.

Antiviral COVID-19 protein and molecular docking: In silico characterization of various antiviral compounds extracted from Arisaema jacquemontii Blume.

Arisaema jacquemontii Blume is a highly medicinal and poisonous plant belong to the family Araceae. It is used to treat several deadly diseases, including viral infections. It has antioxidant, anti-cancerous, antimalarial, anti-vermicidal, and antiviral activities. Therefore, five parts of the Arisaema jacquemontii Blume plant, such as leaf, seed, stem, pulp, and rhizome extract, were evaluated for metabolic and in silico characterization of probable compounds using gas chromatography-mass spectrometry (GC-MS) analysis. A total of 22 compounds were isolated from the methanolic extracts of A. jacquemontii Blume. A selected antiviral COVID-19 protein i.e., protease (6LU7) was docked against the obtained compounds. Different affinities were obtained through various compounds. The best results were shown by three different compounds identified in the rhizome. The maximum binding affinity of these compounds is 8.1 kJ/mol. Molecular docking (MD) indicate that these molecules have the highest binding energies and hydrogen bonding interactions. The binding mode of interaction was discovered to be reasonably effective for counteracting the SARS virus COVID-19. The findings of this study could be extremely useful in the development of more phytochemical-based COVID-19 therapeutics.

Traditional cauterization among children in Bint Al-Huda Hospital in Al-Nasiriya City, Iraq.

Cutaneous cautery is a form of traditional medicine practiced in many countries. It was mentioned in the books of many ancient, pre-, and post-Islamic scholars. Patients may resort to traditional medicine (cauterization in particular) for many reasons. This study aims is to acquire more knowledge about the cautery practices and the reasons for practicing cautery in children together with other implications from adverse events of the cautery. This is a cross-sectional study in which 133 children were enrolled (77 males and 56 females with age ranged from 0.5 to 108 months) who had been admitted to Bint Al-Huda Maternity and Childhood Teaching Hospital in Nasiriya city, Thi-Qar Governorate, Southern Iraq, from December 1, 2019 to end of July 2020). The study found that >80% of cauterized children were below 1 year, (53.4%) of rural residency. Parents of the cauterized children were mainly of illiterate and primary education constituting the highest percentage (91.6%) of cauterized children were of low per capita monthly income. The grandmothers were advisors in more than half of the cauterized children, a vast majority of the advisors were either illiterate or had primary education, The person performing the cautery was a traditional healer (95.5%). Cauterization was done mostly in the head and abdomen, and a vast majority of it was done by a lighted cotton-tipped application (97%). The number of cauterization points ranged from 2 to 25 with a mean of 8.8 cautery marks. Approximately 59% of patients did not improve or worsened, whereas 30% showed partial improvement, and 11% improved. Complications were seen in 9% of the cases. There is a necessity to spread awareness regarding the dangers and complications of traditional cauterization in health care centers by health care providers. Improving the delivery of medical services to areas far from the city centers as well as spreading health awareness by use of multimedia together with eradicating illiteracy is needed.

Preparation and Characterization of Silymarin-Conjugated Gold Nanoparticles with Enhanced Anti-Fibrotic Therapeutic Effects against Hepatic Fibrosis in Rats: Role of MicroRNAs as Molecular Targets.

BACKGROUND: The main obstacles of silymarin (SIL) application in liver diseases are its low bioavailability, elevated metabolism, rapid excretion in bile and urine, and inefficient intestinal resorption. The study aimed to synthesize and characterize silymarin-conjugated gold nanoparticles (SGNPs) formulation to improve SIL bioavailability and release for potentiating its antifibrotic action. METHODS: Both SGNPs and gold nanoparticles (GNPs) were prepared and characterized using standard characterization techniques. The improved formulation was assessed for in vitro drug release study and in vivo study on rats using CCl4 induced hepatic fibrosis model. SIL, SGNPs, and GNPs were administered by oral gavage daily for 30 days. At the end of the study, rats underwent anesthesia and were sacrificed, serum samples were collected for biochemical analysis. Liver tissues were collected to measure the genes and microRNAs (miRNAs) expressions. Also, histopathological and immunohistochemistry (IHC) examinations of hepatic tissues supported these results. RESULTS: The successful formation and conjugation of SGNPs were confirmed by measurements methods. The synthesized nanohybrid SGNPs showed significant antifibrotic therapeutic action against CCl4-induced hepatic damage in rats, and preserved normal body weight, liver weight, liver index values, retained normal hepatic functions, lowered inflammatory markers, declined lipid peroxidation, and activated the antioxidant pathway nuclear factor erythroid-2-related factor 2 (NRF2). The antifibrotic activities of SGNPs mediated through enhancing the hepatic expression of the protective miRNAs; miR-22, miR-29c, and miR-219a which results in suppressed expression of the main fibrosis mediators; TGFßR1, COL3A1, and TGFßR2, respectively. The histopathology and IHC analysis confirmed the anti-fibrotic effects of SGNPs. CONCLUSIONS: The successful synthesis of SGNPs with sizes ranging from 16 up to 20 nm and entrapment efficiency and loading capacity 96% and 38.69%, respectively. In vivo studies revealed that the obtained nano-formulation of SIL boosted its anti-fibrotic effects.

The role of early postoperative parathyroid hormone level after total thyroidectomy in prediction of hypocalcemia.

BACKGROUND: Estimation of parathyroid hormone (PTH) after thyroid surgery helps to predict the development of hypocalcemia and allows early intervention and management with oral calcium and/or vitamin D supplementation in the postoperative period. PATIENTS AND METHODS: This retrospective study included 57 patients who underwent total or completion thyroidectomy within 4 years. Measurement of serum PTH level was done 3 h after surgery for its change and prediction of hypocalcemia. RESULTS: The mean age was 42.11 years, females constituted 46 patients (80.7%), the main surgical procedure was total thyroidectomy in 51 patients (89.5%), and the main cause for surgery was multinodular goiter in 33 patients (57.8%). Three hours after surgery 47 patients (82.5%) had serum PTH levels of >10 pg/ml (mean 28.06) and 44 patients (77.2%) had normal serum calcium (mean 8.66). Most of these 47 patients (82.46%) didn't require postoperative supplementation, while from other 10 patients (17.5%) with serum PTH level of <10 pg/ml, 7 patients (12.28%) required both oral calcium and vitamin D, and 3 patients (5.26%) required only oral vitamin D.There was a significant correlation between the 3-h postoperative PTH level and hypocalcemia (P-value 0.000). The type of pathology had no significant association with lowserum PTH level after surgery (P-value 0.166). CONCLUSION: PTH measurements at 3 h after total thyroidectomy is an accurate predictor for the development of hypocalcemia and allows starting early calcium and/or vitamin D supplements for the asymptotic patients with PTH level of less than 10 pg/ml, which is considered a high-risk group. Also it facilitates a safe and early (2nd t day post operative) discharge of those patients with serum PTH levels greater than 10 pg/ml without any supplements.Further studies are needed to compare the result of early serum PTH level with the day one serum PTH level after total thyroidectomy to predict hypocalcemia.

Dysregulated fatty acid metabolism in coronary ectasia: An extended lipidomic analysis.

BACKGROUND: Coronary artery ectasia (CAE) is not an uncommon clinical condition, which could be associated with adverse outcome. The exact pathophysiology of the disease is poorly understood and is commonly interpreted as a variant of atherosclerosis. In this study, we sought to undertake lipidomic profiling of a group of CAE patients in an attempt to achieve better understanding of its disturbed metabolism. METHODS: Untargeted lipid profiling and complementary modelling strategies were employed to compare serum samples from 16 patients with CAE (mean age 63.5±10.1years, 6 female) and 26 controls with normal smooth coronary arteries (mean age 59.2±6.6years and 7 female). Sample preparation, LC-MS analysis and metabolite identification were performed at the Swedish Metabolomics Centre, Umeå, Sweden. RESULTS: Phosphatidylcholine levels were significantly distorted in the CAE patients (p=0.001-0.04). Specifically, 16-carbon fatty acyl chain phosphatidylcholines (PC) were detected in lower levels. Similarly, 11 meioties of Sphyngomyelin (SM) species were detected at lower concentrations (p=0.000001-0.01) in the same group. However, only three metabolites were significantly higher in the pure CAE subgroup (6 patients) when compared with the 10 mixed CAE patients (two meioties of SM species and one of PC). Atherosclerosis risk factors were not different between groups. CONCLUSION: This is the first lipid profiling study reported in coronary artery ectasia. While the lower concentration and dysregulation of sphyngomyelin suggests an evidence for premature apoptosis, that of phosphatidylcholines suggests perturbed fatty acid elongation/desaturation, thus may be indicative of non-atherogenic process in CAE.