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Children with severe inflammatory diseases are challenging to diagnose and treat, and the etiology of disease often remains unexplained. Here we present DIAPH1 deficiency as an unexpected genetic finding in a child with fatal inflammatory bowel disease who also displayed complex neurological and developmental phenotypes. Bi-allelic mutations of DIAPH1 were first described in patients with a severe neurological phenotype including microcephaly, intellectual disability, seizures, and blindness. Recent findings have expanded the clinical phenotype of DIAPH1 deficiency to include severe susceptibility to infections, placing this monogenic disease amongst the etiologies of inborn errors of immunity. Immune phenotypes in DIAPH1 deficiency are largely driven aberrant lymphocyte activation, particularly the failure to form an effective immune synapse in T cells. We present the case of a child with a novel homozygous deletion in DIAPH1, leading to a premature truncation in the Lasso domain of the protein. Unlike other cases of DIAPH1 deficiency, this patient did not have seizures or lung infections. Her major immune-related clinical symptoms were inflammation and enteropathy, diarrhea and failure to thrive. This patient did not show T or B cell lymphopenia but did have dramatically reduced naïve CD4+ and CD8+ T cells, expanded CD4-CD8- T cells, and elevated IgE. Similar to other cases of DIAPH1 deficiency, this patient had non-hematological phenotypes including microcephaly, developmental delay, and impaired vision. This patient's symptSoms of immune dysregulation were not successfully controlled and were ultimately fatal. This case expands the clinical spectrum of DIAPH1 deficiency and reveals that autoimmune or inflammatory enteropathy may be the most prominent immunological manifestation of disease.
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Formins , Mutation , Humans , Formins/genetics , Female , Alleles , Inflammatory Bowel Diseases/genetics , Inflammatory Bowel Diseases/immunology , Phenotype , Adaptor Proteins, Signal Transducing/geneticsABSTRACT
Kawasaki disease (KD), formerly called mucocutaneous lymph node syndrome, is one of the common vasculitides of childhood. KD most commonly occurs in children over six months up to five years of age, although it can occur in young infants, older children, and adults. Early diagnosis is critical to achieving optimal treatment. We present a case of a three-year-old female child who was admitted with a fever for five days and fulfilled the diagnostic clinical criteria for KD. She was given intravenous immunoglobulin (IVIG) and aspirin. However, the fever persisted, and a urine culture showed the growth of Klebsiella pneumoniae. We started an antibiotic based on her sensitivity. Since fever spikes were not subsiding, she was given a repeat dose of IVIG along with an oral corticosteroid for refractory KD, after which she showed clinical improvement. This case highlighted that refractory KD can coexist with infection.
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Peritoneal inflammation without a discernible intraperitoneal source is referred to as primary peritonitis. Only 2% of pediatric acute abdominal crises are diagnosed preoperatively. Association with other infections is uncommon and is often limited to hepatic and urinary pathogens. Here, we describe a case of primary peritonitis in a one-month-old child who had laparotomy and appendicectomy as per the recommended treatment plan. There were no accompanying hepatic and urinary diseases. In this instance, methicillin-resistant Staphylococcus aureus (MRSA) was the responsible bacteria. The use of linezolid, as per the culture sensitivity report of intraperitoneal pus, ensured a smooth recovery in this case.
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Growth and productivity of crop plants worldwide are often adversely affected by anthropogenic and natural stresses. Both biotic and abiotic stresses may impact future food security and sustainability; global climate change will only exacerbate the threat. Nearly all stresses induce ethylene production in plants, which is detrimental to their growth and survival when present at higher concentrations. Consequently, management of ethylene production in plants is becoming an attractive option for countering the stress hormone and its effect on crop yield and productivity. In plants, ACC (1-aminocyclopropane-1-carboxylate) serves as a precursor for ethylene production. Soil microorganisms and root-associated plant growth promoting rhizobacteria (PGPR) that possess ACC deaminase activity regulate growth and development of plants under harsh environmental conditions by limiting ethylene levels in plants; this enzyme is, therefore, often designated as a "stress modulator." TheACC deaminase enzyme, encoded by the AcdS gene, is tightly controlled and regulated depending upon environmental conditions. Gene regulatory components of AcdS are made up of the LRP protein-coding regulatory gene and other regulatory components that are activated via distinct mechanisms under aerobic and anaerobic conditions. ACC deaminase-positive PGPR strains can intensively promote growth and development of crops being cultivated under abiotic stresses including salt stress, water deficit, waterlogging, temperature extremes, and presence of heavy metals, pesticides and other organic contaminants. Strategies for combating environmental stresses in plants, and improving growth by introducing the acdS gene into crop plants via bacteria, have been investigated. In the recent past, some rapid methods and cutting-edge technologies based on molecular biotechnology and omics approaches involving proteomics, transcriptomics, metagenomics, and next generation sequencing (NGS) have been proposed to reveal the variety and potential of ACC deaminase-producing PGPR that thrive under external stresses. Multiple stress-tolerant ACC deaminase-producing PGPR strains have demonstrated great promise in providing plant resistance/tolerance to various stressors and, therefore, it could be advantageous over other soil/plant microbiome that can flourish under stressed environments.
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A novel CO2 tolerant microalga Tetradesmus obliquus CT02, was previously evaluated to be a suitable bio refinery platform for synthesis of bioactive molecules, biodiesel, and biofertilizer. In the present study, a process engineering strategy was developed targeting improved growth performance of the strain at large scale under fluctuating outdoor environmental conditions. The strategy relies on maintaining pH of the culture at its optimal value via cascade control with CO2 feeding. The strategy was developed at laboratory scale bubble column photobioreactor under diurnal variation of simulated sunlight intensity and was further validated through growth performance of the strain under outdoor conditions in a 100 L airlift bioreactor. Under laboratory condition, 53.3% and 85.16% improvement in biomass concentration (1.87 g L-1) and productivity (114.8 mg L-1 day-1) was achieved as compared to the uncontrolled pH, respectively. The strategy demonstrated a significant improvement in biomass concentration and productivity by 225.7% and 121.6% respectively, compared to the pH uncontrolled batch, even under outdoor fluctuating environmental condition.
Subject(s)
Carbon Dioxide , Microalgae , Biofuels , Biomass , Hydrogen-Ion Concentration , PhotobioreactorsABSTRACT
INTRODUCTION: Coenzyme Q10 (CoQ10) has a potential role in reducing the risk of myocardial infarction by slowing the progression of atherosclerosis and improving ischemia. In this study, we will assess the role of coenzyme Q10 in prophylaxis for reducing myocardial infarction and mortality related to myocardial infarction. METHODS: This open-label two open placebo-controlled randomized clinical trial was conducted in a tertiary care hospital in Sukkur, Pakistan from April 2016 to September 2019. Eight hundred nighty-two (892) patients with clinically diagnosed and documented evidence of hypertension were enrolled in the study from the outpatient department. Participants were randomized into two groups by 1:1 ratio using an online randomizer software, Research Randomizer (https://www.randomizer.org/). Group A received 100 mg coenzyme Q10 daily (coenzyme Q10 group) in addition to standard therapy and group B received standard therapy only (placebo group). RESULTS: Participants who received coenzyme Q10 had fewer incidence of non-fatal myocardial infarction over 12 months (5.4% vs 8.4%) with relative risk reduction of 2.92 (confidence interval 95%, 0.55-2.76). The number needed to treat to prevent one non-fatal myocardial infarction was 34. Participants who received coenzyme Q10 had fewer incidence of fatal myocardial infarction over 12 months (1.5% vs 3.1%) with relative risk reduction of 1.65 (confidence interval 95%, 0.39-3.69). Number needed to treat to prevent one fatal myocardial infarction was 60. CONCLUSION: According to this study, coenzyme Q10 reduced the incidence of fatal and non-fatal myocardial infarctions. Clinicians should consider adding coenzyme Q10 to the treatment regimen of high-risk patients of myocardial infarction. We suggest coenzyme Q10 may be an effective prophylactic agent in patients at risk of myocardial infarction and it may help in reducing burden on the health care system.
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INTRODUCTION: Post severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, an immune response is generated among healthy, immunocompetent individuals with immunoglobulins (IgG and IgM) antibodies. IgM rises earlier than IgG, indicating a recent infection. However, a detailed analysis is required to assess long-term immune reactions induced by antibodies. METHOD AND MATERIALS: The study was conducted at a tertiary care hospital in Pakistan from June 2020 to October 2020 where serum samples were collected from patients. The samples were obtained by phlebotomy for antibody testing. All the reactive patients were followed up after 60 days of initial testing. RESULTS: A total of 728 patients participated in the study, of which 79â (10.8%) were seropositive at baseline. Seventy-two (91.1%) participants came back for follow-up after 60 days (two months) and were included in the final analysis. Among the 72 participants, 35 (48.6%) exhibited symptoms of coronavirus disease 2019 (COVID-19) infection and 37 (51.4%) were asymptomatic. After 60 days, 37 (including 20 symptomatic and 17 asymptomatic) participants were still seropositive for SARS-CoV-2 enzyme-linked immunosorbent assay (ELISA) test. Mean change in percentage from seropositive to seronegative was more in asymptomatic compared to symptomatic patients (54.0% vs. 42.8%). CONCLUSION: In this study, humoral immunity against SARS-CoV-2 is not long-lasting among individuals with mild signs and symptoms. Care should be taken while implicating that antibodies can provide long term protection against SARS-CoV-2. Further large-scale studies are needed.
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Introduction Correlation between decreased levels of vitamin D in the blood of elderly patients and incidence of falls and fractures has been assessed in various studies; however, there is still ambiguity in data. In this study, we aim to establish the role of vitamin D supplements in minimizing the burden of falls and non-vertebral fractures in the elderly population in a local setting. Methods This single-blind, placebo-controlled randomized interventional study was conducted in the Internal Medicine Department of a tertiary care hospital in Pakistan from March 2018 to July 2020. Patients between the ages of 50 to 75 years were enrolled in the study and were randomly assigned to receive either placebo or 100,000 IU vitamin D oral tablets and were followed over 24 months, with regular follow-ups every three months. Results There was no significant difference in the probability of one or more falls for those assigned to the vitamin D group compared to those who received placebo (24.70% vs. 24.85%; hazard ratio [HR]: 0.99; 95% CI: 0.68-1.43). Similarly, the probability of non-vertebral fracture was also non-significant between both groups (4.7% vs. 5.7%; HR: 0.81; 95% CI: 0.32-2.01). Conclusion As per the results of this study, vitamin D supplementation had no beneficial effect on the reduction of falls and non-vertebral fractures in elderly patients. Further multi-center studies of longer duration are required to prove the favorable effects of vitamin D supplements.
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INTRODUCTION: Asthma can lead to fatigue, frequent hospital visits, psychological problems, and learning problems in children. One of the complications of asthma is its life-threatening acute exacerbation. It is important to identify precipitating factors responsible for frequent acute exacerbations of asthma. METHODS: This case-control study was conducted in the pulmonology ward of Liaquat University of Medical and Health Sciences, Jamshoro, from May 2019 to February 2020. Sampling was done by convenient probability technique. The case group was identified as patients with two or more episodes of acute exacerbation of asthma and the control group was identified as asthmatic patients without acute exacerbation in the last year. RESULTS: Factors leading to acute exacerbation of asthma include number of asthma attacks in the past seven days (4.9 ± 3.4 vs. 2.2 ± 2.0; p < 0.0001) and number of nights with troublesome cough in the past 28 days (12.2 ± 8.1 vs. 4.3 ± 3.1; p < 0.0001). Participants with recent upper respiratory tract infection (38.4% vs. 10%; odds ratio [OR] 5.62), smoking history (30.7% vs. 12%; OR 3.25), gastroesophageal reflux disease (26.9% vs. 8.0%; OR 4.2) and non-adherence to medication (26.9% vs. 8.0%; OR 4.2) were more likely to experience from exacerbation of asthma. CONCLUSION: It is important to identify risk factors that may cause acute exacerbation of asthma in the patients. Patients should be educated of the risk factors and complications of the exacerbation episode of asthma.
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Introduction Rheumatoid arthritis is a chronic, inflammatory, and multisystem disease, which, along with the joints, can involve the cardiovascular system. The treatment of rheumatoid arthritis or rheumatoid arthritis itself can lead to atherosclerosis, which is considered one of the major causes by which it can affect the cardiovascular system. In this study, we will assess the risk of cardiovascular events in patients with rheumatoid arthritis as compared to the general population. Method This case-control study was conducted from January 2018 to November 2018. Two-hundred twenty-two (222) patients with diagnosed rheumatoid arthritis were included as cases in the study. Two-hundred eleven (211) patients were included in the study as the control group (patients without rheumatoid arthritis). All the data were recorded in a self-structured questionnaire. Result Participants with rheumatoid arthritis also showed an increased risk of myocardial infarction (MI) by an odds ratio of 2.50 (95% CI; 0.77-8.14). There was also an increased risk of cardiovascular death in participants with rheumatoid arthritis by an odds ratio of 1.99 (0.58-6.71). Conclusion The study suggests that rheumatoid arthritis along with joint inflammation can also affect the cardiovascular system. Hence, a multidisciplinary team of rheumatologists and cardiologists should manage patients suffering from rheumatoid arthritis, which will improve morbidity and mortality in such patients.
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Introduction Leptin, a hormone released by the body to regulate energy balance by inhibiting hunger, decreases fat storage in adipocytes. Leptin is thought to play some role in obesity and insulin resistance. In this study, our aim is to see the association of leptin with obesity and insulin resistance. Methods This case-control study was conducted in a tertiary care hospital in Pakistan from January 2020 to April 2020. Ninety-two participants with BMI greater than 25 kg/m2, with no known comorbidities were enrolled in the study after informed consent. Ninety-two participants, who came to the outpatient department without a history of chronic disease, with BMI less than 25 kg/m2 were enrolled as a control group. Data were collected via self-structured questionnaires. Their blood was drawn and sent to the laboratory for cholesterol levels, insulin resistance and leptin levels. Results Serum leptin levels (51.24 ± 18.12 vs. 9.10 ± 2.99: p-value, < 0.0001), serum cholesterol levels (198.2 ± 32.1 vs. 151.2 ± 21.2, p-value < 0.0001) and insulin resistance (7.9 ± 2.1 vs. 6.3 ± 1.9, p-value < 0.0001) were higher in obese patients. Conclusion As per the results of this study, obesity was associated with increase serum leptin levels and insulin resistance. Further multi-centric studies are required to prove the possible relationship, which might help devise plans to manage obesity.
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Introduction Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are two common treatment options used in patients suffering from coronary artery disease. Selection and favorability of one over the other depend on individual clinical scenarios. The purpose of this study is to compare outcomes after treatment with PCI and CABG. Methods This longitudinal observational study was conducted from April 2018 to July 2019 in a cardiovascular unit of a tertiary care hospital. Participants who were eligible for revascularization were randomized either to receive stent (PCI) or surgery (CABG). Patients were then followed up for 12 months for the development of all-cause mortality and major adverse cardiovascular events (MACEs). Results At 12 months, patients randomized to the PCI group had an increased risk of repeat revascularization (21.3% vs. 7.4%; p = 0.007), whereas a similar number of patients in both groups died (3.8% vs. 3.7%), suffered myocardial infarction (7.6% vs. 5.6%), or had a cerebrovascular accident (3.8% vs. 2.8%). Conclusions This study showed that PCI had an increased risk of repeat revascularization compared to CABG. However, both had comparable significance in the development of MACEs. Nevertheless, there is a need for further study to better assess the outcomes of either, especially in the long run.
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A low-cost and scalable harvesting process was demonstrated for Chlorella sp. FC2 IITG, which offered an improved process economy for the production of a microalgal biomass feedstock via (i) the utilization of a cheaper commercial grade chemical flocculant; (ii) the recycling of post-harvested nutrient-rich spent water for the successive growth of the FC2 cells and (iii) the modulation of the flocculant dose, resulting in the non-requirement of a pH adjustment of the spent water and separate inoculum development step. Ferrous sulphate and ferric chloride were screened from a pool of four commercial grade flocculants, resulting in high harvesting efficiencies of 99.83% and 99.93% at the lower flocculant doses (g of flocculant g of dry biomass-1) of 2.5 and 3, respectively. The effect of the recycled nutrient-rich spent water and treated non-flocculated microalgal cells after harvesting was evaluated for the growth performance of the FC2 cells in six successive batches. It was found that ferrous sulphate was superior over ferric chloride in terms of the recyclability of the spent water for more number of batches, offering similar growth kinetics and nutrient recovery efficiency as compared with that of the control sample. The scale-up feasibility of the harvesting process was evaluated with a 5 L photobioreactor under indoor conditions and a 350 L open raceway pond under outdoor conditions with a modulated flocculant dose of 1.5 g ferrous sulphate. g dry biomass-1. The harvesting cost of 1 kg biomass using commercial grade ferrous sulphate was estimated to be in the range of 0.17-0.3 USD and was significantly lower as compared to that of analytical grade ferrous sulphate.
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Introduction There is ample data available to determine the impact of deranged lipid values of acute myocardial infarction (AMI); however, there is a paucity of data from low-income countries like Pakistan. In this study, we aim to determine the correlation of lipid values with AMI. Materials and methods This case-control study was conducted from 1 February 2019 to 30 October 2019 in a tertiary care hospital in Sukkur, Pakistan. There were a total of 421 participants divided into two groups; Case Group (patients with AMI, n=212) and Control Group (patients without AMI, n=209). Results Total cholesterol and low-density lipoprotein (LDL) were significantly higher in patients with AMI and HDL was lower. There was no significant difference between triglycerides in both groups. Conclusion Dyslipidemia is an important risk factor for AMI. There is a need for more large scale multi-center studies to further understand the role of lipid profile in AMI and the various factors that influence it.
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Introduction Beta-blockers again are now considered as first-line therapy for various cardiovascular diseases. In this study, we compare the cardiovascular event between two beta-blocker, i.e. Nebivolol and Bisoprolol. Materials and Methods It is a two-arm open-label randomized prospective study that was conducted from 1st Jan 2016 to 30th July 2019 in tertiary care hospital, Nawabshah. One thousand and fifty-six (n=1056) hypertensive patients were enrolled after informed consent, which were randomized into two equal groups. Patients were followed up for one year. Results Comparison between Nebivolol and Bisoprolol showed that all-cause mortality (9.8% vs 11.48%), cardiovascular mortality (5.4% vs 7.0%), all-cause hospitalization (14.4% vs 16.3%), and cardiovascular hospitalization (9.8% vs 12.09%) was numerically lower in nebivolol but the difference was not statistically significant. Conclusion Further large scale multicentric trials with a longer follow up period are needed to compare various beta-blockers for cardiovascular event.
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The living system on earth is largely using oxygen for burning metabolic fuel for energy. The toxicity of oxygen is largely due to the formation of free radicals in living systems. Stress is also responsible for the generation of free radicals. The evidence for the involvement of free radicals and oxidative injury in producing metabolic disturbance, maladjustment and many diseases has been accumulating since long. It is largely believed that the root cause of many chronic diseases is stress induced free radicals and resultant oxidative injury.
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Rhodiola imbricata is a high-altitude plant, possesses adaptogenic, immunomodulatory, anti-oxidant and cytoprotective activity, and is widely used in traditional medicine. The present study was designed to ascertain the safety of aqueous extract of R. imbricata root when administered by gavage to rats for 90 days. Four groups of animals, each consisting of 15 males and 15 females, were administered 0, 100, 250 or 500 mg kg(-1) extract, in a single dose per day. The experimental rats when administered 100 mg kg(-1) of extract did not show any significant change in their body weight gain, organ/body weight ratio, or histological, hematological and biochemical variables studied. However, at higher doses of 250 and 500 mg kg(-1) extract, an increase in the body weight of rats of both the sexes was apparent without any change in their organ/body weight ratio. Furthermore, a noteworthy increase in plasma glucose and protein levels was recorded at both the higher doses, which were restored to normal after a 2-week withdrawal of treatment. Based on the findings of this study, the no observed effect level was 100 mg kg(-1) body weight per day of aqueous root extract of R. imbricata in rats administered subchronically.
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Plant Extracts/pharmacology , Rhodiola/chemistry , Administration, Oral , Animals , Blood Glucose/analysis , Body Weight/drug effects , Dose-Response Relationship, Drug , Female , Male , No-Observed-Adverse-Effect Level , Organ Size , Plant Roots/chemistry , Rats , Rats, Sprague-DawleyABSTRACT
The present investigation was undertaken to evaluate the healing efficacy of lyophilized aqueous leaf extract of Sea buckthorn (Hippophae rhamnoides L., family Elaeagnaceae) (SBT) and to explore its possible mechanism of action on experimental burn wounds in rats. The SBT extract, at various concentrations, was applied topically, twice daily for 7 days. Treatment with silver sulfadiazine (SSD) ointment was used as reference control. The most effective concentration of the extract was found to be 5.0% (w/w) for burn wound healing and this was further used for detailed study. The SBT-treated group showed faster reduction in wound area in comparison with control and SSD-treated groups. The topical application of SBT increased collagen synthesis and stabilization at the wound site, as evidenced by increase in hydroxyproline, hexosamine levels and up-regulated expression of collagen type-III. The histological examinations and matrix metalloproteinases (MMP-2 and -9) expression also confirmed the healing efficacy of SBT leaf extract. Furthermore, there was significant increase in levels of endogenous enzymatic and non-enzymatic antioxidants and decrease in lipid peroxide levels in SBT-treated burn wound granulation tissue. The SBT also promoted angiogenesis as evidenced by an in vitro chick chorioallantoic membrane model and in vivo up-regulated vascular endothelial growth factor (VEGF) expression. The SBT leaf extract had no cytotoxic effect on BHK-21 cell line. In conclusion, SBT aqueous leaf extract possesses significant healing potential in burn wounds and has a positive influence on the different phases of wound repair.
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Anti-oxidative potential of Rhodiola imbricata root aqueous extract was examined in rats, administered orally at a dose of 100 mg/kg both in single and multiple doses, 30 min prior to cold (5 degrees C)-hypoxia (428 mmHg)-restraint (C-H-R) exposure. Lipid per-oxidation, anti-oxidant parameters and lactate dehydrogenase (LDH), were studied in blood, liver and muscle of rats on attaining T(rec)23 degrees C during C-H-R exposure and after recovery (T(rec)37 degrees C) from C-H-R induced hypothermia. The results of untreated control rats on attaining T(rec)23 degrees C showed a significant increase in blood, liver and muscle malondialdehyde (MDA) and LDH levels. Hepatic catalase (CAT) and muscle glutathione S-transferase (GST) also increased significantly. Administration of single dose of Rhodiola imbricata root aqueous extract significantly restricted rise in blood MDA, increased blood reduced glutathione (GSH) and superoxide dismutase (SOD) activity with restricted rise in blood, liver and muscle LDH; improved liver and muscle SOD on attaining T(rec)23 degrees C and T(rec)37 degrees C; liver CAT on attaining T(rec)23 degrees C and liver GST during recovery. Multiple doses treatment of the extract further increased blood, liver and muscle GSH and GST levels; restricted increase in LDH on attaining T(rec)23 degrees C and recovery; increased CAT during recovery. Results suggested the anti-oxidant potential of Rhodiola root extract during C-H-R exposure and post-stress recovery and it also maintained cell membrane permeability.
Subject(s)
Antioxidants/pharmacology , Hypothermia/drug therapy , Hypoxia/drug therapy , Plant Extracts/pharmacology , Rhodiola/chemistry , Stress, Psychological/drug therapy , Administration, Oral , Animals , Chromatography, High Pressure Liquid , Hypothermia/complications , Hypothermia/physiopathology , Hypoxia/complications , Hypoxia/physiopathology , L-Lactate Dehydrogenase/metabolism , Lipid Peroxidation/drug effects , Liver/drug effects , Liver/metabolism , Male , Malondialdehyde/metabolism , Muscle, Skeletal/drug effects , Muscle, Skeletal/metabolism , Oxidative Stress/drug effects , Oxidoreductases/drug effects , Oxidoreductases/metabolism , Plant Roots/chemistry , Rats , Recovery of Function , Restraint, Physical , Stress, Psychological/etiology , Water/chemistryABSTRACT
Mechanism of rhodiola root extract adaptogenic activity was studied in rats. The extract was orally administered in rats (100mg/kg body weight), 30 min prior to cold (5 degrees C)-hypoxia (428 mmHg)-restraint (C-H-R) exposure up to fall of T(rec)23 degrees C and recovery (T(rec)37 degrees C) from hypothermia. In untreated control rats serum lactate and non-esterified fatty acids (NEFA) increased on attaining T(rec)23 degrees C with decreased blood enzyme activities hexokinase (HK), phosphofructokinase (PFK), citrate synthase (CS) and glucose-6-phosphate dehydrogenase (G-6-PD), on attaining T(rec)23 degrees C and T(rec)37 degrees C. Decreases were also observed in liver and muscle tissues HK and G-6-PD enzyme activities and liver glycogen and CS on attaining T(rec)23 degrees C and recovery; muscle PFK during recovery; muscle CS on attaining T(rec)23 degrees C. Single and five doses of extract administration restricted increase in serum lactate values of rats on attaining T(rec)23 degrees C and maintained blood NEFA in single dose extract treated animals, indicating improved utilization of NEFA as energy fuel. The single and five doses extract treatment decreased or better maintained tissue glycogen and enzyme activities, viz. HK, PFK, CS and G-6-PD, in blood, liver and muscle, on attaining T(rec)23 degrees C and recovery. The results suggest that rhodiola extract treatment in rats shifted anaerobic metabolism to aerobic, during C-H-R exposure and post stress recovery.