Transient binocular vision loss and pain insensitivity in Klippel-Feil syndrome: a case report.

BACKGROUND: Klippel-Feil syndrome is a rare congenital bone disorder characterized by an abnormal fusion of two or more cervical spine vertebrae. Individuals with Klippel-Feil syndrome exhibit diverse clinical manifestations, including skeletal irregularities, visual and hearing impairments, orofacial anomalies, and anomalies in various internal organs, such as the heart, kidneys, genitourinary system, and nervous system. CASE PRESENTATION: This case report describes a 12-year-old Pashtun female patient who presented with acute bilateral visual loss. The patient had Klippel-Feil syndrome, with the typical clinical triad symptoms of Klippel-Feil syndrome, along with Sprengel's deformity. She also exhibited generalized hypoalgesia, which had previously resulted in widespread burn-related injuries. Upon examination, bilateral optic disc swelling was observed, but intracranial pressure was found to be normal. Extensive investigations yielded normal results, except for hypocalcemia and low vitamin D levels, while parathyroid function remained within the normal range. Visual acuity improved following 2 months of calcium and vitamin D supplementation, suggesting that the visual loss and optic nerve swelling were attributed to hypocalcemia. Given the normal parathyroid function, it is possible that hypocalcemia resulted from low vitamin D levels, which can occur after severe burn scarring. Furthermore, the patient received a provisional diagnosis of congenital insensitivity to pain on the basis of the detailed medical history and the findings of severe and widespread loss of the ability to perceive painful stimuli, as well as impaired temperature sensation. However, due to limitations in genetic testing, confirmation of the congenital insensitivity to pain diagnosis could not be obtained. CONCLUSION: This case highlights a rare presentation of transient binocular vision loss and pain insensitivity in a patient with Klippel-Feil syndrome, emphasizing the importance of considering unusual associations in symptom interpretation.

Predictors of Ophthalmology Resident Performance From Medical Student Application Materials.

OBJECTIVE: To determine whether elements in ophthalmology residency applications are predictors of future resident performance. DESIGN: This multi-institutional, cross-sectional, observational study retrospectively reviewed the residency application materials of ophthalmology residents who graduated from residency from 2006 through 2018. Resident performance was scored by 2 faculty reviewers in 4 domains (clinical, surgical, academic, and global performance). Correlation between specific elements of the residency application and resident performance was assessed by Spearman correlation coefficients (univariate) and linear regression (multivariate) for continuous variables and logistic regression (multivariate) for categorical variables. SETTING: Seven ophthalmology residency programs in the US. PARTICIPANTS: Ophthalmology residents who graduated from their residency program. RESULTS: High-performing residents were a diverse group, in terms of sex, ethnicity, visa status, and educational background. Residents with United States Medical Licensing Examination Step 1 scores higher than the national average for that year had significantly higher scores in all 4 performance domains than those who scored at or below the mean (all domains P < 0.05). Residents who had honors in at least 4 core clerkships and who were members of Alpha Omega Alpha Medical Honor Society also had higher scores in all 4 performance domains (all domains P ≤ 0.04). Step 1 score (ρ=0.26, P < 0.001) and the difference between Step 1 score and the national average for that year (ρ=0.19, P = 0.009) positively correlated with total resident performance scores. Residents who passed the American Board of Ophthalmology Written Qualifying Examination or Oral Examination on their first attempt had significantly higher Step 1/2 scores (P ≤ 0.005), Ophthalmology Knowledge Assessment Program scores (P = 0.001), and resident performance scores (P ≤ 0.004). CONCLUSIONS: In this new landscape of increasing numbers of applicants to residency programs and changing of the Step 1 score to pass/fail, our findings may help guide selection committees as they holistically review applicants to select exceptional future residents in ophthalmology.

Antioxidant, LC-MS Analysis, and Cholinesterase Inhibitory Potentials of Phoenix dactylifera Cultivar Khudari: An In Vitro Enzyme Kinetics and In Silico Study.

We evaluated the therapeutic potentials of Khudari fruit pulp, a functional food and cultivar of Phoenix dactylifera, against neurological disorders. Our results demonstrate a good amount of phytochemicals (total phenolic content: 17.77 ± 8.21 µg GA/mg extract) with a high antioxidant potential of aqueous extract (DPPH assay IC50 = 235.84 ± 11.65 µg/mL) and FRAP value: 331.81 ± 4.56 µmol. Furthermore, the aqueous extract showed the marked inhibition of cell-free acetylcholinesterase (electric eel) with an IC50 value of 48.25 ± 2.04 µg/mL, and an enzyme inhibition kinetics study revealed that it exhibits mixed inhibition. Thereafter, we listed the 18 best-matched phytochemical compounds present in aqueous extract through LC/MS analysis. The computational study revealed that five out of eighteen predicted compounds can cross the BBB and exert considerable aqueous solubility. where 2-{5-[(1E)-3-methylbuta-1,3-dien-1-yl]-1H-indol-3-yl}ethanol (MDIE) indicates an acceptable LD50. value. A molecular docking study exhibited that the compounds occupied the key residues of acetylcholinesterase with ΔG range between -6.91 and -9.49 kcal/mol, where MDIE has ∆G: -8.67 kcal/mol, which was better than that of tacrine, ∆G: -8.25 kcal/mol. Molecular dynamics analyses of 100 ns supported the stability of the protein-ligand complexes analyzed through RMSD, RMSF, Rg, and SASA parameters. TRP_84 and GLY_442 are the most critical hydrophobic contacts for the complex, although GLU_199 is important for H-bonds. Prime/MM-GBSA showed that the protein-ligand complex formed a stable confirmation. These findings suggest that the aqueous extract of Khudari fruit pulp has significant antioxidant and acetylcholinesterase inhibition potentials, and its compound, MDIE, forms stably with confirmation with the target protein, though this fruit of Khudari dates can be a better functional food for the treatment of Alzheimer's disease. Further investigations are needed to fully understand the therapeutic role of this plant-based compound via in vivo study.

Myths and Misconceptions of Breast Cancer in the Pakistani Population.

Background Breast cancer is one of the most prevalent types of cancer in the female population. The cultural diversity, religious beliefs, myths, and misinformation regarding the disease contribute to diagnostic delays and enhanced burden on the healthcare system. This study aimed to ascertain the extent of knowledge and prevalence of erroneous beliefs and misconceptions regarding breast cancer among Pakistani women belonging to diverse socioeconomic and educational backgrounds. Methodology This cross-sectional study was performed in a tertiary care hospital in Karachi, Pakistan. A total of 350 women were enrolled in the study as a representative female population, and 300 participants were included who met the inclusion criteria. Participants were conveniently interviewed using a pre-piloted questionnaire designed to assess the prevalent myths and misconceptions about breast cancer. The data were analyzed by SPSS version 23 (IBM Corp., Armonk, NY, USA) using descriptive statistics. Results The study findings point to a significant prevalence of erroneous beliefs and a lack of accurate information on breast cancer. The mean age of the participants was 20.8 ± 10.4 years. The majority of the participants belonged to a middle socioeconomic status (70%) and were undergraduates (61.4%). The participants' friends and family members were the most frequent sources of information regarding breast cancer. The most common myth was "breast-feeding offers immunity to breast cancer completely" (76.6%), followed by "breast cancer spreads after biopsy" (63.8%). Participants also believed that breast tissue biopsy can lead to the spread of cancer (63.4%) and that faith healers and alternative medicine can cure breast cancer (47.5%). One-third (33.3%) of the participants considered all lumps to be breast cancer; however, approximately half (41.6%) of the participants thought that only painful lumps were associated with breast cancer. A significant number of participants believed breast cancer to be a result of God's curse (31.4%) or evil eye (38.7%). Conclusions The findings suggest a critical need for community-based breast health education initiatives that take into account Pakistani women's distinctive cultural and societal attitudes and work to dispel common misconceptions about the condition.

Effect of reduced versus usual lipid emulsion dosing on bilirubin neurotoxicity and neurodevelopmental impairment in extremely preterm infants: study protocol for a randomized controlled trial.

BACKGROUND: Bilirubin neurotoxicity (BN) occurs in premature infants at lower total serum bilirubin levels than term infants and causes neurodevelopmental impairment. Usual dose lipid infusions in preterm infants may increase free fatty acids sufficiently to cause bilirubin displacement from albumin, increasing passage of unbound bilirubin (UB) into the brain leading to BN and neurodevelopmental impairment not reliably identifiable in infancy. These risks may be influenced by whether cycled or continuous phototherapy is used to control bilirubin levels. OBJECTIVE: To assess differences in wave V latency measured by brainstem auditory evoked responses (BAER) at 34-36 weeks gestational age in infants born ≤ 750 g or < 27 weeks' gestational age randomized to receive usual or reduced dose lipid emulsion (half of the usual dose) irrespective of whether cycled or continuous phototherapy is administered. METHODS: Pilot factorial randomized controlled trial (RCT) of lipid dosing (usual and reduced) with treatment groups balanced between cycled or continuous phototherapy assignment. Eligible infants are born at ≤ 750 g or < 27 weeks' gestational age enrolled in the NICHD Neonatal Research Network RCT of cycled or continuous phototherapy. Infants will randomize 1:1 to reduced or usual dose lipid assignment during the first 2 weeks after birth and stratified by phototherapy assignment. Free fatty acids and UB will be measured daily using a novel probe. BAER testing will be performed at 34-36 weeks postmenstrual age or prior to discharge. Blinded neurodevelopmental assessments will be performed at 22-26 months. Intention-to-treat analyses will be performed with generalized linear mixed models with lipid dose and phototherapy assignments as random effects covariates, and assessment for interactions. Bayesian analyses will be performed as a secondary analysis. DISCUSSION: Pragmatic trials are needed to evaluate whether lipid emulsion dosing modifies the effect of phototherapy on BN. This factorial design presents a unique opportunity to evaluate both therapies and their interaction. This study aims to address basic controversial questions about the relationships between lipid administration, free fatty acids, UB, and BN. Findings suggesting a reduced lipid dose can diminish the risk of BN would support the need for a large multicenter RCT of reduced versus usual lipid dosing. TRIAL REGISTRATION: Clinical Trials.gov, NCT04584983, Registered 14 October 2020, https://clinicaltrials.gov/ct2/show/NCT04584983 Protocol version: Version 3.2 (10/5/2022).

Traditional foraging for ecological transition? Wild food ethnobotany among three ethnic groups in the highlands of the eastern Hindukush, North Pakistan.

BACKGROUND: The Patrak Valley is home to communities, which have been inextricably linked with nature for generations, and local plant knowledge (LPK) represents an important part of their local cultural diversity. In general, globalization has come at the expense of local plant knowledge among several mountain societies, and therefore the current investigation has been undertaken to record the (possibly) last remaining wild food plant/mushroom foraging practices among Pathans, Kohistanis, and Gujjars living in the highlands of the Hindukush, North Pakistan. METHODS: Data on the uses of wild food plants and mushrooms (WFPs) were collected through 120 semi-structured interviews. The data were cross-culturally compared among the three linguistic groups. Venn diagrams were used to visualize the comparative analysis. To determine the patterns of similarities in plant use among the different ethnic groups, we used the Jaccard similarity index (JI). The recorded data were also compared with the existing Pakistani food ethnobotanical literature. RESULTS: A total of 68 WFPs were recorded, the majority of which were used as raw snacks and as cooked vegetables. Fruit was the most frequently reported plant part among the three researched groups. Cross-cultural comparison revealed that 37% of the used plants were commonly shared by the three studied groups. Pathans have retained rich knowledge on WFPs, and they show a comparatively closer affinity with Kohistanis is the use of WFPs compared to Gujjars. While we observed some idiosyncrasies for each of the researched groups, the distinctive plant uses among Gujjars provide insight into their food ecology, their particular human-ecological system centered on mobile pastoralism and their limited exchanges of local food/ecological knowledge due to endogamic patterns. A literature survey revealed some novel or little-known ingredients within Pakistani food ethnobotany/ethnomycology, such as Aesculus indica, Agaricus campestris, Apteranthes tuberculata, Duchesnea indica, Equisetum arvense, Eremurus himalaicus, Isodon rugosus, Morella esculenta, Sophora mollis, and Drimia indica. CONCLUSION: The researched communities have retained important plant knowledge which could be implemented through future development programs considering that most of these traditional foraging practices fulfill environmental and social sustainability standards. Further field studies are required to thoroughly investigate the patterns of foraging among highland pastoral societies in other parts of the Hindukush region and especially their potential for the ongoing ecological transition.

Effect of Reduced Versus Usual Lipid Emulsion Dosing on Bilirubin Neurotoxicity and Neurodevelopmental Impairment in Extremely Preterm Infants: Study Protocol for a Randomized Controlled Trial.

Background : Bilirubin neurotoxicity ( BN ) occurs in premature infants at lower total serum bilirubin levels than term infants and causes neurodevelopmental impairment. Usual dose lipid infusions in preterm infants may increase free fatty acids sufficiently to cause bilirubin displacement from albumin, increasing passage of unbound bilirubin ( UB ) into the brain leading to BN and neurodevelopmental impairment not reliably identifiable in infancy. These risks may be influenced by whether cycled or continuous phototherapy is used to control bilirubin levels. Objective : To assess differences in wave V latency measured by brainstem auditory evoked responses ( BAER ) at 34-36 weeks gestational age in infants born ≤750 g or <27 weeks' gestational age randomized to receive usual or reduced dose lipid emulsion (half of the usual dose) irrespective of whether cycled or continuous phototherapy is administered. Methods : Pilot factorial randomized controlled trial ( RCT ) of lipid dosing (usual and reduced) with treatment groups balanced between cycled or continuous phototherapy assignment. Eligible infants are born at ≤750 g or <27 weeks' gestational age enrolled in the NICHD Neonatal Research Network RCT of cycled or continuous phototherapy. Infants will randomize 1:1 to reduced or usual dose lipid assignment during the first 2 weeks after birth and stratified by phototherapy assignment. Free fatty acids and UB will be measured daily using a novel probe. BAER testing will be performed at 34-36 weeks postmenstrual age or prior to discharge. Blinded neurodevelopmental assessments will be performed at 22-26 months. Intention-to-treat analyses will be performed with generalized linear mixed models with lipid dose and phototherapy assignments as random effects covariates, and assessment for interactions. Bayesian analyses will be performed as a secondary analysis. Discussion : Pragmatic trials are needed to evaluate whether lipid emulsion dosing modifies the effect of phototherapy on BN. This factorial design presents a unique opportunity to evaluate both therapies and their interaction. This study aims to address basic controversial questions about the relationships between lipid administration, free fatty acids, UB, and BN. Findings suggesting a reduced lipid dose can diminish the risk of BN would support the need for a large multicenter RCT of reduced versus usual lipid dosing. Trial Registration : Clinical Trials.gov, NCT04584983, Registered 14 October 2020, https://clinicaltrials.gov/ct2/show/NCT04584983 Protocol Version : Version 3.2 (10/5/2022).

Effect of Daily Vitamin D Supplementation on Serum Vitamin D Levels in Children with Epilepsy Receiving Sodium Valproate Monotherapy: A Randomized, Controlled Trial.

OBJECTIVES: To compare the change in serum vitamin D levels and to compare the changes in serum levels of calcium, phosphate, alkaline phosphatase and parathyroid hormone in vitamin D supplemented and unsupplemented groups after 3 mo. METHODS: In this randomized, parallel group, nonblinded, controlled trial, 40 children, 2-12 y of age with newly diagnosed epilepsy, and vitamin D sufficient status, and started on valproate monotherapy, were randomized into the intervention group (n = 20), which was given daily oral 600 IU vitamin D supplementation, and the control group (n = 20), which was not given any supplementation. Changes in the biochemical parameters was measured in the two groups after 3 mo. RESULTS: There was a significant reduction in the median (IQR) vitamin D levels in the control group as compared to an increase seen in the intervention group [-6.64 (-8.4, -2.65) vs. 5.66 (1.81, 7.12); p < 0.001]. In the control group, 37.5% children developed vitamin D insufficiency and 12.5% developed deficiency whereas only 5% of the intervention group developed vitamin D insufficiency (p = 0.005). There was a significant decrease in ionized calcium (p = 0.02), increase in serum phosphate (p = 0.02), and alkaline phosphatase level (p = 0.003) in the unsupplemented group as compared to the supplemented group. CONCLUSION: Vitamin D supplementation can reduce the valproate-associated decline in vitamin D levels and the negative impact on other markers of bone mineral metabolism. TRIAL REGISTRATION: TCTR20200621002, 19.06.2020, retrospectively registered.

Celiac disease: Pathogenesis, disease management and new insights into the herbal-based treatments.

Celiac disease (CD) is a gluten intolerance autoimmune disorder which its symptoms involve the gastrointestinal tract and sometimes the other organs. It is one of the most prevalent health problems rising in many populations as statistics show that in every 100 people about one person is suffering from CD. It has been observed that the persons who genetically contain the human leukocyte antigen (HLA) DQ2 and HLA DQ8 genes involved in the immune system haplotypes are more prone to develop an allergy to gluten. The only treatment currently available for CD is a strict gluten-free diet. However, recent research has shown promising new insights into the herbal-based treatments of CD. New insight on CD is now offering various prospects to manage its treatment, diagnosis, and serving in the development of advanced therapies. Several herbs and botanical extracts have demonstrated anti-inflammatory, immunomodulatory, and gut-healing properties that make them potential candidates for the management of CD. Here, we provide an updated review on pathogeneses and managements of CD. In particular, we summarize the current understandings of herbal-based treatments for CD and highlights their potential benefits.

Prolific contribution of Pseudomonas protegens in Zn biofortification of wheat by modulating multifaceted physiological response under saline and non-saline conditions.

The current study aimed to characterize the contribution of bacterium CP17 in zinc (Zn) biofortification in wheat under saline and non-saline conditions. This bacterial strain effectively solubilized Zn and tolerated up to 20% NaCl concentration. The Zn-solubilization potential was also quantified using AAS in a liquid broth supplemented with zinc oxide and zinc carbonate at various NaCl concentrations. Lowering the pH of liquid broth and analyzing a wide range of organic acids (thioacetic acid, glutamic acid, carboxylic acid, propionic acid, and so on) using UPLC-MS provided mechanistic insight for zinc solubilization. This strain was also shown to possess plant probiotic characteristics like phosphate solubilization, production of siderophore, indole acetic acid (IAA), exopolysaccharide (EPS), ACC deaminase, and ammonia. CP17 was identified as a Pseudomonas protegens based on the 16S rRNA gene analysis. In addition, the amplified product of the ACC deaminase producing gene (acdS) provided a molecular indication of the strain's endurance towards stress. The towel paper assay confirmed that the inoculation of Pseudomonas protegens CP17 significantly increased wheat seedlings' germination, growth, and biomass under different NaCl concentrations (0 mM, 100 mM, and 150 mM). Afterward, In situ pot experiment study was designed with the inoculation of Pseudomonas protegens in wheat under saline and non-saline conditions. The harvested wheat plants showed an elevated pattern of zinc content in the grain (i.e. 24.33 and 29.33mg/kg), straw (i.e. 45.73 and 50.23mg/kg) and soil (i.e. 0.978 and 1.32mg/kg) under saline and non-saline conditions, respectively and shown significant improvement over control. The results of the pot study revealed the amelioration in plant health, yield and uptake of available zinc from rhizospheric soil to straw and grain, along with enhanced dehydrogenase and phosphatase activities of rhizospheric soil under saline and non-saline conditions. This study supports the integrative role of Pseudomonas protegens CP17 as a bioinoculant for the efficacious strategy of zinc biofortification and growth promotion in wheat and ensures sustainable nutrient quality production under salinity stress.

Microscopic (LM and SEM) visualization of pollen ultrastructure among honeybee flora from lower Margalla Hills and allied areas.

Microscopic visualization of micro-morphological characters were analyzed using a scanning electron microscopic (SEM) tool, which has proven to be very successful to analyze the pollen surface peculiarities. The significant goal of this research was to perform microscopic examination of pollen of some of the most frequently visited honeybee floral species around apiaries. Micro-morphological characterization of frequented honeybees foraged plants were discussed. A total of 15 species, belonging to 11 different families were identified for the foraging activities of honeybees, namely, Lantana camara, Jatropha integerrima, Helianthus annuus, Tecoma stans, Lagerstroemia indica, Duranta erecta, Cosmos sulphureus, Hymenocollis littoralis, Moringa oleifera, Cestrum nocturnum, Parthenium hysterophorus, Volkameria inermis, Catharanthus roseus, Malvastrum coromandelianum, and Citharexylum spinosum. The microscopic slides were prepared using the acetolysis method, and the qualitative and quantitative features were measured and described using microscopic tools. The pollen type sculpture varies from psilate scabrate to echinate and colpi from tricolpate to tetracolpate. Quantitative parameters such as polar diameter, mesocolpium distance, equatorial dimensions, aperture size, spine diameter, and exine thickness were calculated using IBM SPSS Statistics 20. The exine thickness was measured at its maximum in C. roseus (3.85 µm), whereas it was at its minimum of 0.90 µm in L. indica and D. erecta. Pollen fertility was estimated to be highest in H. annus (88%). The current research validates scanning microscopic features of pollen of the honeybee floral species, which is helpful for the accurate identification and commercializing of honey production to generate revenue for beekeepers through the exploration of bee floral diversity. RESEARCH HIGHLIGHTS: Pollen spectrum examination using microscopic imaging techniques. Variations examined through scanning microscopy in pollen ultrastructure. Micro-morphology has taxonomic value for accurate identification of honeybee flora. Authentication of Honeybee floral species for sustainable beekeeping.

Antimicrobial activities of different solvent extracts from stem and seeds of Peganum Harmala L.

Wild medicinal herbs have been used as folk and traditional medicines all across the world since well before recorded history. This present study was designed to test the antimicrobial activities of five different solvent extracted samples (n-hexane, n-butanol, ethyl acetate, methanol, and water) of Peganum harmala using stems and seeds. Two different strains of Gram-negative bacteria (Escherichia coli and Klebsiella pneumonia), two Gram-positive bacteria (Bacillus subtilus and Staphylococcus aureus), and one fungal strain (Candida albicans) were used. The antimicrobial activities were measured using a disc diffusion assay. Two concentrations of the extracts (1 and 2mgDisc-1) were used. Ethyl acetate fraction was found more affective among the tested solvents and showed maximum activity (zone of inhibition) against S. aureus (65.53 and 81.10%), E. coli (46.22 and 61.29%) while n-butanol and water fractions gave maximum activity against S. aureus (78.86 and 70.00%) and K. pneumonia (57.00 and 61.39%) respectively. Water fraction showed maximum activity against C. albicans (60.00 and 81.88%). In the case of the stem, Ethyl acetate again showed more activity against B. subtilus (38.57 and 42.10%) and S. aureus (36.66 and 46.66%) while n-butanol showed maximum activity against K. pneumonia (24.55 and 32.44%) and E. coli (27.93 and 37.61%). Methanol was found more effective against C. albicans (25.71 and 43.80%). Seed extracted samples were found more effective compared to the stem. Ethyl acetate, butanol, and aqueous extracted samples showed good activity against the tested microbes, so these fractions are recommended for study their mechanism of actions and isolation of bioactive metabolites responsible for antimicrobial activities. The P. harmala should be evaluated for their bioactive compounds to be used in future studies. Our objective is to provide the framework for future study on the roles of P. harmala as traditional medicines.

Micro-morphological diversity of pollen among Asteraceous taxa from Potohar Plateau-Pakistan.

Microscopic pollen characters from 19 species of family Asteraceae collected from different areas of the Potohar Plateau of Pakistan have been investigated using light and scanning electron microscopy. This study uses microscopic techniques to provide detailed information on pollen and its exine structure based on qualitative and quantitative characters. The present study has observed three types of pollen grains based on their apertures, that is, trizonocolporate, tetrazonocolporate, and tricolporate. Exine sculpturing is echinate in all studied taxa. Some species also exhibit Lacunae which differ in their shape and sizes. The size of the spines and the number of spines between the colpi play a vital role in differentiating the species of the same genus. Pollen fertility ranges from 94.3 to 74.19, showing that these species are well established in the study area. For the correct identification of species, a light and scanning electron microscopy was used that provides sufficient information for a taxonomist to distinguish species taxonomically. RESEARCH HIGHLIGHTS: Light and Scanning electron microscope is comparatively used to investigate the pollen characters of some species of the family Asteraceae. A scanning electron microscopy is used to study the micro-morphological characters of pollen grains. Qualitative and quantitative characters of pollen were studied.

Implication of scanning electron microscopy and light microscopy for oil content determination and seed morphology of Verbenaceae.

Due to increase in energy catastrophe and accompanying environmental issues, the search for renewable and alternative energy resources is a fiercely disputed problem in the scientific world. Biodiesel has proven to be the finest sustainable alternative to gasoline. Because of their environment-friendly character and cost-effectiveness, nonedible oil-bearing seeds could be the possible resource for biodiesel production. Therefore, the present study uses scanning electron microscopy (SEM) to investigate and identify micromorphological features of six novel, nonedible oil-bearing seeds of Verbenaceae as potential biodiesel feed stocks. Selected seeds of Verbenaceae range in size from 1 to 5 mm in width and 1.8 to 6.4 mm in length, according to light microscopic studies. The oil content of seeds ranges from14 to 19%. Seed texture, color, shape, size, periclinal and anticlinal wall patterns, and cell outline are all more variable in SEM-mediated seed ultrastructure analyses. The findings of this work imply that SEM could be a useful method for revealing hidden micromorphological features in a variety of nonedible oil-producing seeds, which could aid to future investigation, proper identification, seed categorization, and authenticity. These seeds were hard to be identified by the native people due to their resemblance in seed color and shape, so there is a need to give a detailed description of seed characters for proper identification of these plants. This work will determine the new features of the seeds, which will be helpful in near future.

Implication of scanning electron microscopy as a tool for identification of novel, nonedible oil seeds for biodiesel production.

Biodiesel is a promising, bio-based, renewable, nontoxic, environment friendly, and alternative fuel for petroleum derived fuels which helps to reduce dependency on conventional fossil fuels. In this study, six novel, nonedible seed oil producing feedstock were explored for their potential for sustainable production of biodiesel. It is very important to correctly identify oil yielding plant species. Scanning electron microscopy (SEM) was used as reliable tool for authentic identification of oil yielding seeds. Macromorphological characters of seeds were studied with light microscopy (LM). Outcomes of LM of seeds exposed distinctive variation in seed size from 16.3 to 3.2 mm in length and 12.4 to 0.9 mm in width, shape varied from oval to triangular, and color from black to light brown. Oil content of nonedible seed ranged from 25 to 30% (w/w). Free fatty acid content of seed oil varied from 0.32 to 2.5 mg KOH/g. Moreover, ultra structural study of seeds via SEM showed variation in surface sculpturing, cell arrangement, cell shape, periclinal wall shape, margins, protuberances, and anticlinal wall shape. Surface sculpturing varied from rugged, reticulate, varrucose, papillate, and striate. Periclinal wall arrangements confirmed variation from rough, wavy, raised, depressed, smooth, and elevated whereas, anticlinal walls pattern showed variation from profuse undulating, smooth, raised, grooved, deep, curved, and depressed. It was concluded that SEM could be a latent and advanced technique in unveiling hidden micromorphological characters of nonedible oil yielding seeds which delivers valuable information to researchers and indigenous people for precise and authentic identification and recognition.

Application and implication of scanning electron microscopy for evaluation of palyno-morphological features of Vitaceae from Pakistan.

The present study aimed to investigate the palyno-morphological features of species of family Vitaceae from Pakistan. A total of nine species, belonging to four genera were collected, pressed, identified, and then analyzed microscopically. Both quantitative and qualitative characters of the pollen grains were recorded including polar and equatorial diameter, P/E ratio, number of colpi and pores, exine thickness and shapes of the pollen in both polar and equatorial view, and exine sculpturing using Leica microscope fitted with camera Meiji Infinity 1 and then analyzed statistically using software IBM SPSS Statistics 20. The results of the present study demonstrated the variations in polar and equatorial diameter, exine thickness, P/E ratio, pollen shape, and exine sculpturing of the studied species and highlighted the significance of pollen morphology as an identification tool. The present study may contribute to better understand the classification at genus level, which will support the future phylogenetic characterization of the family.

Ethnoveterinary plants of Pakistan: a review.

BACKGROUND: Ethnoveterinary medicine is crucial in many rural areas of the world since people living in remote and marginal areas rely significantly on traditional herbal therapies to treat their domestic animals. In Pakistan, communities residing in remote areas, and especially those still attached to pastoralist traditions, have considerable ethnoveterinary herbal knowledge and they sometimes use this knowledge for treating their animals. The main aim of the study was to review the literature about ethnoveterinary herbals being used in Pakistan in order to articulate potential applications in modern veterinary medicine. Moreover, the review aimed to analyze possible cross-cultural and cross regional differences. METHODS: We considered the ethnobotanical data of Pakistan published in different scientific journals from 2004 to 2018. A total of 35 studies were found on ethnoveterinary herbal medicines in the country. Due to the low number of field studies, we considered all peer-reviewed articles on ethnoveterinary herbal practices in the current review. All the ethnobotanical information included in these studies derived from interviews which were conducted with shepherds/animals breeders as well as healers. RESULTS: Data from the reviewed studies showed that 474 plant species corresponding to 2386 remedies have been used for treating domestic animals in Pakistan. The majority of these plants belong to Poaceae (41 species) followed by the Asteraceae (32 species) and Fabaceae (29 species) botanical families, thus indicating a possible prevalence of horticultural-driven gathering patterns. Digestive problems were the most commonly treated diseases (25%; 606 remedies used), revealing the preference that locals have for treating mainly minor animal ailments with herbs. The least known veterinary plants recorded in Pakistan were Abutilon theophrasti, Agrostis gigantea, Allardia tomentosa, Aristida adscensionis, Bothriochloa bladhii, Buddleja asiatica, Cocculus hirsutus, Cochlospermum religiosum, Cynanchum viminale, Dactylis glomerata, Debregeasia saeneb, Dichanthium annulatum, Dracocephalum nuristanicum, Flueggea leucopyrus, Launaea nudicaulis, Litsea monopetala, Sibbaldianthe bifurca, Spiraea altaica, and Thalictrum foetidum. More importantly, cross-cultural comparative analysis of Pathan and non-Pathan ethnic communities showed that 28% of the veterinary plants were mentioned by both communities. Cross-regional comparison demonstrated that only 10% of the plant species were used in both mountain and plain areas. Reviewed data confirm therefore that both ecological and cultural factors play a crucial role in shaping traditional plant uses. CONCLUSION: The herbal ethnoveterinary heritage of Pakistan is remarkable, possibly because of the pastoral origins of most of its peoples. The integration of the analyzed complex bio-cultural heritage into daily veterinary practices should be urgently fostered by governmental and non-governmental institutions dealing with rural development policies in order to promote the use of local biodiversity for improving animal well-being and possibly the quality of animal food products as well.

Cycled Phototherapy Dose-Finding Study for Extremely Low-Birth-Weight Infants: A Randomized Clinical Trial.

Importance: Cycled (intermittent) phototherapy (PT) might adequately control peak total serum bilirubin (TSB) level and avoid mortality associated with usual care (continuous PT) among extremely low-birth-weight (ELBW) infants (401-1000 g). Objective: To identify a cycled PT regimen that substantially reduces PT exposure, with an increase in mean peak TSB level lower than 1.5 mg/dL in ELBW infants. Design, Setting, and Participants: This dose-finding randomized clinical trial of cycled PT vs continuous PT among 305 ELBW infants in 6 US newborn intensive care units was conducted from March 12, 2014, to November 14, 2018. Interventions: Two cycled PT regimens (≥15 min/h and ≥30 min/h) were provided using a simple, commercially available timer to titrate PT minutes per hour against TSB level. The comparator arm was usual care (continuous PT). Main Outcomes and Measures: Mean peak TSB level and total PT hours through day 14 in all 6 centers and predischarge brainstem auditory-evoked response wave V latency in 1 center. Mortality and major morbidities were secondary outcomes despite limited power. Results: Consent was requested for 452 eligible infants and obtained for 305 (all enrolled) (mean [SD] birth weight, 749 [152] g; gestational age, 25.7 [1.9] weeks; 81 infants [27%] were multiple births; 137 infants [45%] were male; 112 [37%] were black infants; and 107 [35%] were Hispanic infants). Clinical and demographic characteristics of the groups were similar at baseline. After a preplanned interim analysis of 100 infants, the regimen of 30 min/h or more was discontinued, and the study proceeded with 2 arms. Comparing 128 infants receiving PT of 15 min/h or more with 128 infants receiving continuous PT among those surviving to 14 days, mean peak TSB levels were 7.1 vs 6.4 mg/dL (adjusted difference, 0.7; 95% CI, 0.4-1.1 mg/dL) and mean total PT hours were 34 vs 72 (adjusted difference, -39; 95% CI, -45 to -32). Wave V latency adjusted for postmenstrual age was similar in 37 infants receiving 15 min/h or more of PT and 33 infants receiving continuous PT: 7.42 vs 7.32 milliseconds (difference, 0.10; 95% CI, -0.11 to 0.30 millisecond). The relative risk for death was 0.79 (95% CI, 0.40-1.54), with a risk difference of -4.5% (95% CI, -10.9 to 2.0). Morbidities did not differ between groups. Conclusions and Relevance: Cycled PT can substantially reduce total PT with little increase in peak TSB level. A large, randomized trial is needed to assess whether cycled PT would increase survival and survival without impairment in small, preterm infants. Trial Registration: ClinicalTrials.gov Identifier: NCT01944696.

Viscosine as a Potent and Safe Antipyretic Agent Evaluated by Yeast-Induced Pyrexia Model and Molecular Docking Studies.

The antipyretic potential of viscosine, a natural product isolated from the medicinal plant Dodonaea viscosa, was investigated using yeast-induced pyrexia rat model, and its structure-activity relationship was investigated through molecular docking analyses with the target enzymes cyclooxygenase-1 (COX-1), cyclooxygenase-2 (COX-2), and microsomal prostaglandin E synthase-1 (mPGES-1). The in vivo antipyretic experiments showed a progressive dose-dependent reduction in body temperatures of the hyperthermic test animals when injected with viscosine. Comparison of docking analyses with target enzymes showed strongest bonding interactions (binding energy -17.34 kcal/mol) of viscosine with the active-site pocket of mPGES-1. These findings suggest that viscosine shows antipyretic properties by reducing the concentration of prostaglandin E2 in brain through its mPGES-1 inhibitory action and make it a potential lead compound for developing effective and safer antipyretic drugs for treating fever and related pathological conditions.

Micro-morphological, environmental and phytochemical investigation of herbal medicines by using LM and SEM: A quality control tool.

The use of quality control tool for authentication of Jadwar (Delphinium denudatum Wall. ex Hook.f. & Thomson), a folk herbal drug used for the treatment of different ailments, was studied. People face problems of adulteration for this drug at global, regional, national and local levels. Two different plant species are commercially marketed in the Indo-Pak Subcontinent under the same trade name of Jadwar. One is D. denudatum Wall. ex Hook.f. & Thomson and the other is Aconitum heterophyllum Wall. ex Royle. To focus on this problem, a marketable available drug sample of Jadwar was authenticated by using basic microscopy tools (LM) and advanced chemo-taxonomic markers. Authentication, quality and standardization of this drug was achieved using morphology, organoleptography, UV and IR analyses, scanning electron microscopy of pollen and anatomical investigations. The techniques used for authentication marked the clear difference between the studied plants. Microscopic studies, chemotaxonomic investigation and other techniques used in this project provided the basis for the authentication of this species.