A rare case of right coronary artery dissection during routine left heart catheterization.

Percutaneous coronary intervention (PCI) is an effective method for coronary revascularization, however, alongside its benefits, it can be accompanied by complications. Catheter induced coronary artery dissection (CICAD) is rare and the consequences can be devastating if left untreated. The incidence has been reported to be as low as 0.1%. Also, propagation of the dissection to the aortic root remains uncommon. The mechanism of dissection is related to mechanical injury to the arterial wall during manipulation with the catheter or wire. It may also occur due to injection of contrast, stenting or balloon dilation. Timely recognition is important in these cases to facilitate optimal patient outcomes which is usually accomplished with stenting. Herein, we report a rare case of a 68-year-old female with multivessel coronary artery disease who presented for routine left heart catheterization and developed catheter induced right coronary artery (RCA) dissection with propagation towards the aortic root which was treated with stenting and watchful waiting.

Exploring the content of epilepsy fellowship program websites: an analysis of information available to applicants.

BACKGROUND: Program websites are essential resources in the process of residency and fellowship application. We evaluated the information furnished on these resources by Epilepsy fellowship programs. The extent of information provided was compared across geographic zones, academic affiliation, and national ranking. METHODS: A list of Epilepsy fellowship programs was derived from the Fellowship and Residency Electronic Interactive Database (FREIDA). Links to program websites were obtained directly from FREIDA or using Google's search engine. Online data was categorized to reflect program information, education, recruitment, compensation, epilepsy center-specific information, and social media presence. Data points under each category were collected to develop a standardized scoring system. The frequency of criterion present was compared across geographic zones, academic affiliation, and national ranking using parametric and non-parametric statistical tests. Significance was determined at a p-value ≤ 0.05 for all cases. The study utilized IBM SPSS version 28 and Python 3.11.3. RESULTS: We analyzed 80 Epilepsy fellowship programs. The most reported feature was the program director's name and email (100.0%). The least reported features included board pass rates (1.3%), preparatory boot camp (8.8%), and post-fellowship placements (11.3%). Programs were found to be well-represented on X (88.8%), Facebook (81.3%), and Instagram (71.3%). Most (85.0%) of the programs were searchable through Google. The scores for program information, education, recruitment, compensation, epilepsy center-specific information, and social media visibility did not significantly vary based on location, academic affiliation, or rank status. CONCLUSIONS: Our results demonstrate that despite an online presence, there is much room for improvement in the content available to the applicant. To improve the Match process and attract a roster of well-informed fellows, Epilepsy fellowship programs should furnish program websites with up-to-date information relevant to program information, education, recruitment, compensation, and epilepsy center-specific information.

Healthcare workers' knowledge and risk perception regarding the first wave of COVID-19 in Khyber Pakhtunkhwa, Pakistan: an online cross-sectional survey.

Background: Increased COVID-19 transmission among the populace may be caused by healthcare workers (HCWs) who lack knowledge, awareness, and good preventive practices. Additionally, it may cause elevated stress levels, anxiety, poor medical judgement, and situational overestimation. Objectives: The present survey aimed to assess knowledge and risk perception regarding COVID-19 among HCWs in Khyber Pakhtunkhwa (KP), Pakistan. Methodology: A web-based online, pre-tested questionnaire comprising 26 items was circulated via social media in April 2020 amongst HCWs in major tertiary care facilities in KP. Results: The study's results, revealing both the commendable knowledge levels among HCWs about COVID-19 and their heightened risk perception, highlight the critical need for targeted interventions to address the potential impact on self-protective behaviour and mental health within this vital workforce. This insight is important for designing strategies that not only enhance HCWs' well-being but also ensure the continued effectiveness of healthcare delivery during pandemics. The percentage mean score (PMS) of COVID-19 knowledge was 85.14±10.82. Male HCWs and those with an age older than or equal to 32 years demonstrated a higher knowledge score (85.62±11.08; P=0.032 and 87.59±7.33, P=0.021, respectively). About 76% of HCWs feared contracting COVID-19. Nearly 82% of respondents were mentally preoccupied with the pandemic and also terrified of it. 'Of these, 81% were nurses, 87% had a job experience of 6-8 years and 54.45% were frontline workers. Feelings of panic and concern about the pandemic were found to be more in HCWs who were physicians above the age of 32, and who had 3-5 years of work experience. HCWs' overall risk perception was found to be significantly different between males (7.04±2.26) and females (8.01±1.97), job experience of 6-10 years (8.04±177) with 3-5 years and younger than or equal to 2 years job experience (7.18±2.43,6.93±2.22), respectively, and between frontline HCWs (7.50±2.10) and non-frontline HCWs (6.84±2.40). Conclusion: HCWs demonstrated good knowledge about COVID-19. As the risk perception of COVID-19 among HCWs is high, it can raise concerns about their self-protective behaviour, and mental health. These issues need to be addressed.

Dermoscopy aids in lesion selection for microbiological and histopathological assessment of mycetoma.

Mycetoma, a chronic granulomatous infection of the skin and the subcutaneous tissue, is characterized by discharge of exudate containing grains. This report illustrates the importance of dermoscopy in selecting lesions for both microbiological and histopathological assessment, which are considered the gold standard of diagnosis in mycetoma.

Silicon nanoparticles: A promising approach for control of Pseudomonas aeruginosa biofilms.

Objectives: The current study aimed to investigate the control and treatment of biofilm-producing isolates of Pseudomonas aeruginosa using silicon nanoparticles (SiNPs). Materials and Methods: Biofilm-producing isolates of P. aeruginosa were recovered from various food samples and identified through fluorescent green colony formation on selective and differential media, as well as the amplification of oprI and oprL genes. Tube methods, Congo-red agar method, and scanning electron microscopy (SEM) were used to study biofilm phenotypes. The effect of SiNPs was evaluated by broth dilution assay. Results: The biofilm assay revealed that these isolates formed biofilms on glass surfaces within 72 hr of incubation. Scanning electron micrographs showed that the biofilm communities were composed of multicellular clusters of P. aeruginosa encased in matrix material. However, these isolates were unable to form biofilms on SiNPs-coated surfaces. The results showed that the planktonic isolates of P. aeruginosa were comparatively sensitive to the antibacterial properties of SiNPs, with minimum inhibitory concentration (MIC) ranging from 100 to 200 µg/ml. Contrarily, the biofilms were found to be 500 times more tolerant to the highest concentration of SiNPs (MIC of 500 µg/ml) and were more resistant. Under static conditions, the sedimentation of SiNPs resulted in their ineffectiveness. However, under shaking conditions, the biofilms were effectively dispersed and the cells were lysed. The results showed that SiNPs were effective against both the planktonic and the metabolically inactive forms of P. aeruginosa. Conclusion: This study suggests that SiNPs could be a useful tool for preventing the formation of biofilms and removing pre-existing biofilms.

Immunity-and-matrix-regulatory cells enhance cartilage regeneration for meniscus injuries: a phase I dose-escalation trial.

Immunity-and-matrix-regulatory cells (IMRCs) derived from human embryonic stem cells have unique abilities in modulating immunity and regulating the extracellular matrix, which could be mass-produced with stable biological properties. Despite resemblance to mesenchymal stem cells (MSCs) in terms of self-renew and tri-lineage differentiation, the ability of IMRCs to repair the meniscus and the underlying mechanism remains undetermined. Here, we showed that IMRCs demonstrated stronger immunomodulatory and pro-regenerative potential than umbilical cord MSCs when stimulated by synovial fluid from patients with meniscus injury. Following injection into the knees of rabbits with meniscal injury, IMRCs enhanced endogenous fibrocartilage regeneration. In the dose-escalating phase I clinical trial (NCT03839238) with eighteen patients recruited, we found that intra-articular IMRCs injection in patients was safe over 12 months post-grafting. Furthermore, the effective results of magnetic resonance imaging (MRI) of meniscus repair and knee functional scores suggested that 5 × 107 cells are optimal for meniscus injury treatment. In summary, we present the first report of a phase I clinical trial using IMRCs to treat meniscus injury. Our results demonstrated that intra-articular injection of IMRCs is a safe and effective therapy by providing a permissive niche for cartilage regeneration.

Biosynthesized Silver Nanoparticles Using Alnus nitida Leaf Extract as a Potential Antioxidant and Anticancer Agent.

Biogenic synthesis of silver nanoparticles (AgNPs) using plant extracts is gaining attention as a substitute to the conventional physical and chemical synthesis methods. This study reports a facile, cost-effective, and ecofriendly synthesis of AgNPs using leaf extract of Alnus nitida (A. nitida) and their antioxidant and antiproliferative activities. The biosynthesized AgNPs were characterized using various analytical techniques including UV-visible spectroscopy, energy-dispersive spectrometry, scanning electron microscopy (SEM), Fourier transform infrared (FTIR), X-ray diffraction (XRD), and dynamic light scattering. The antioxidant and cytotoxic potential of the extract and AgNPs was evaluated using different in vitro models. The UV-vis analysis revealed a surface plasmon resonance peak of 400 nm corresponding to the synthesis of AgNPs. SEM analysis confirmed the formation of heterogeneously dispersed particles of nano size, while the XRD and FTIR spectra confirmed the crystallinity and existence of different functional groups that helped in capping and stability of AgNPs. The antioxidant activity of AgNPs and extract, studied by 1,1-diphenyl 2-picryl hydrazyl (DPPH), fluorescence recovery after photobleaching (FRAP), 2, 2'-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS), and H2O2 scavenging assays, showed a dose-dependent effect. The AgNPs at 1000 µg/mL significantly scavenged DPPH, FRAP, ABTS, and H2O2 by 66.45, 74.65, 78.81, and 72.56% with an average IC50 value of 33.31, 18.50, 16.46, and 15.65 µg/mL, respectively. The cytotoxic potential investigated by MTT assay revealed promising antiproliferative effects against different cancer cell lines. The IC50 values of AgNPs on MDA-MB-231, A549, and Hep-G2 cells were 14.88, 3.6, and 5.38 µg/mL, respectively. The results showed that AgNPs were more effective against lung and hepatocellular carcinoma. The selectivity index showed that AgNPs remained highly selective in retarding the growth of A549 and Hep-G2 cells as compared to normal cell lines HPAEpiC and HRPTEpiC. Overall, this study showed that biosynthesized AgNPs were associated with considerable antioxidant and cytotoxic effects. Our work suggests that A. nitida-mediated AgNPs should be evaluated further in order to develop safe and effective formulations for the treatment of different degenerative diseases.

Efficacy and safety of ultra-short wave diathermy on COVID-19 pneumonia: a pioneering study.

Background: The ultra-short wave diathermy (USWD) is widely used to ameliorate inflammation of bacterial pneumonia, however, for COVID-19 pneumonia, USWD still needs to be verified. This study aimed to investigate the efficacy and safety of USWD in COVID-19 pneumonia patients. Methods: This was a single-center, evaluator-blinded, randomized controlled trial. Moderate and severe COVID-19 patients were recruited between 18 February and 20 April 2020. Participants were randomly allocated to receive USWD + standard medical treatment (USWD group) or standard medical treatment alone (control group). The negative conversion rate of SARS-CoV-2 and Systemic Inflammatory Response Scale (SIRS) on days 7, 14, 21, and 28 were assessed as primary outcomes. Secondary outcomes included time to clinical recovery, the 7-point ordinal scale, and adverse events. Results: Fifty patients were randomized (USWD, 25; control, 25), which included 22 males (44.0%) and 28 females (56.0%) with a mean (SD) age of 53 ± 10.69. The rates of SARS-CoV-2 negative conversion on day 7 (p = 0.066), day 14 (p = 0.239), day 21 (p = 0.269), and day 28 (p = 0.490) were insignificant. However, systemic inflammation by SIRS was ameliorated with significance on day 7 (p = 0.030), day 14 (p = 0.002), day 21 (p = 0.003), and day 28 (p = 0.011). Time to clinical recovery (USWD 36.84 ± 9.93 vs. control 43.56 ± 12.15, p = 0.037) was significantly shortened with a between-group difference of 6.72 ± 3.14 days. 7-point ordinal scale on days 21 and 28 showed significance (p = 0.002, 0.003), whereas the difference on days 7 and 14 was insignificant (p = 0.524, 0.108). In addition, artificial intelligence-assisted CT analysis showed a greater decrease in the infection volume in the USWD group, without significant between-group differences. No treatment-associated adverse events or worsening of pulmonary fibrosis were observed in either group. Conclusion: Among patients with moderate and severe COVID-19 pneumonia, USWD added to standard medical treatment could ameliorate systemic inflammation and shorten the duration of hospitalization without causing any adverse effects.Clinical Trial Registration: chictr.org.cn, identifier ChiCTR2000029972.

Optimization of heterologous production of Bacillus ligniniphilus L1 laccase in Escherichia coli through statistical design of experiments.

Laccases are powerful multi-copper oxidoreductases that have wide applicability as "green" biocatalysts in biotechnological, bioremediation, and industrial applications. Sustainable production of large amounts of functional laccases from original sources is limited by low yields, difficulties in purification, slow growth of the organisms, and high cost of production. Harnessing the full potential of these versatile biocatalysts will require the development of efficient heterologous systems that allow high-yield, scalable, and cost-effective production. We previously cloned a temperature- and pH-stable laccase from Bacillus ligniniphilus L1 (L1-lacc) that demonstrated remarkable activity in the oxidation of lignin and delignification for bioethanol production. However, L1-lacc is limited by low enzyme yields in both the source organism and heterologous systems. Here, to improve production yields and lower the cost of production, we optimized the recombinant E. coli BL21 strain for high-level production of L1-lacc. Several culture medium components and fermentation parameters were optimized using one-factor-at-a-time (OFAT) and Plackett-Burman design (PBD) to screen for important factors that were then optimized using response surface methodology (RSM) and an orthogonal design. The optimized medium composition had compound nitrogen (15.6 g/L), glucose (21.5 g/L), K2HPO4 (0.15 g/L), MgSO4 (1 g/L), and NaCl (7.5 g/L), which allowed a 3.3-fold yield improvement while subsequent optimization of eight fermentation parameters achieved further improvements to a final volumetric activity titer of 5.94 U/mL in 24 h. This represents a 7-fold yield increase compared to the initial medium and fermentation conditions. This work presents statistically guided optimization strategies for improving heterologous production of a bacterial laccase that resulted in a high-yielding, cost-efficient production system for an enzyme with promising applications in lignin valorization, biomass processing, and generation of novel composite thermoplastics.

Efficacy of orthotic support in mitigating low back pain and disability in low back pain sufferers.

BACKGROUND: Low back pain (LBP) is a prevalent disabling ailment that affects people all over the world. A wide variety of orthotic designs, ranging from lumbosacral corsets to rigid thermoplastic thoraco-lumbosacral orthosis are used for managing LBP. OBJECTIVE: Explore and summarize quality literature on the efficacy of orthotic devices in the management of LBP. METHODS: A systematic review and meta-analysis of the literature on the efficacy of orthosis in low back pain management conducted using electronic databases. Studies utilizing orthotic management alone or combined with other therapies for 2 weeks or above were included. A meta-analysis was performed on primary and secondary variables using Mean difference (MD), Inverse variance (IV), and fixed effect model with 95% CI, Physiotherapy Evidence Database (PEDro) scale, Cochrane Risk of Bias 2 (RoB2) tool were used to assess the quality of evidence and the risk bias. RESULTS: Out of 14671 studies, only 13 Randomized Controlled Trials (RCT) were deemed eligible for inclusion in this study, all level 1 evidence. We found that orthotics could significantly mitigate LBP (P-value < 0.00001). Similarly, a significant reeducation in LBP-associated disability was observed after orthotic intervention (P-value 0.004). CONCLUSION: Lumber orthosis plays a significant role in LBP and associated disability mitigations in sufferers of LBP.

The relationship between 5G technology affordances, consumption values, trust and intentions: An exploration using the TCV and S-O-R paradigm.

5G mobile communication technology is anticipated to merge with many other sectors, spurring innovation and creating substantial ripple effects. Despite the significance of this advancement, current research provides limited knowledge of users' behavioral reactions to the affordances, values, and trust generated from 5G technology. To investigate this relationship, this study used the Stimulus-response theory and the consumption values theory. The empirical data was gathered from 373 consumers in China using a survey method. To validate the model's suggested relationships, the author utilized the partial least squares-structural equation modelling (PLS-SEM) technique. The finding designates that the affordances and purchase intention relationship was mediated by consumption values and trust. Given the significance of 5G technology and its potential, this study investigates what drives and deters consumers from obtaining 5G technology. Original findings insights on the role of affordances in developing marketing strategies and increasing consumer intentions to purchase 5G technology products.

A Primary Epithelioid Angiosarcoma Arising in a Bilharzial Urinary Bladder: A Reappraisal and Case Report.

BACKGROUND: Angiosarcoma (AS) of the urinary bladder is a very rare and aggressive malignancy with a dismal outcome. CASE REPORT: Here, we report a primary epithelioid angiosarcoma (EAS) of the urinary bladder in a forty-nine-year-old male patient who presented with severe hematuria. Cystoscopic examination revealed hemorrhagic ulcerated bladder mucosa but no definite mass lesions. Intractable hematuria raised the initial clinical impression of idiopathic hemorrhagic cystitis. Analysis of the cystoscopic biopsy revealed features of old bilharzial cystitis, markedly atypical epithelioid endothelial cells arranged as primitive anastomosing vascular structures and expressing vascular markers. The diagnosis of EAS was established. The patient developed intractable severe hematuria, and a radical cystoprostatectomy was performed. The patient was started on chemotherapy but suddenly developed widespread distant metastasis (liver, lung, suprarenal glands, and lymph nodes) and succumbed to death two months after the surgery. CONCLUSION: To the best of these authors' knowledge, we presented the first report of primary EAS arising in a bilharzial bladder. The relevant studies were discussed.

An Overview on Rumex dentatus L.: Its Functions as a Source of Nutrient and Health-Promoting Plant.

Rumex dentatus L. (Polygonaceae), also known as toothed dock or Aegean dock, is a medicinal plant with a high culinary value in addition to being used as an ethnomedicinal plant. This review focuses on the botanical, nutritional, phytochemical, and pharmacological activities of R. dentatus, as well as the future prospects for systematic investigations into these areas. R. dentatus has been subjected to scientific evaluation, which has confirmed its traditional uses and demonstrated a wide range of biological and pharmacological potentials, including antioxidant, anticancer, antifungal, antibacterial, anti-inflammatory, and other biological properties. Phytochemical analyses showed the presence of anthraquinones, chromones, flavonoids, and essential oils. As a result of this current review, the medicinal significance of R. dentatus has been confirmed, and future research on its unexplored aspects, such as the identification of pharmacologically active chemical constituents and related mechanisms and safety, may be stimulated, with the goal of developing it into a drug.

Where Adults with Congenital Heart Disease Die: Insights from the CDC-WONDER Database.

The population of adults with congenital heart disease (ACHD) is rapidly increasing. There is limited understanding of location of death and associated disparities in these patients. From 2005-2018, a trend-level analysis was performed using death certificate data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Database, with individual-level mortality data obtained from National Center for Health Statistics. Places of death were classified as hospital, home, hospice facility, nursing home/long-term care and other. A total of 15,507 total deaths were identified in ACHD from 2005-2018 (54% Male, 84% White). ACHD patients were more likely to die in the hospital (64%) compared to general population (41%). Younger decedents (20-34) with ACHD were more likely to die in the hospital, while older decedents (≥65) were more likely to die at Hospice/Nursing facilities. Black and Hispanic patients with ACHD were more likely to die in the hospital compared to White and non-Hispanic patients. A significantly large proportion of ACHD deaths are observed in younger patients and occur in inpatient facilities. End-of-life planning among socially vulnerable populations should be prioritized.

Evaluation of Phytochemistry and Pharmacological Properties of Alnus nitida.

In the current study, the anti-inflammatory and analgesic potential of Alnus nitida (leaves and fruits) was evaluated in the Sprague-Dawley rat. Traditionally, A. nitida was used for the treatment of inflammatory ailments. However, A. nitida leaves and fruits have not been yet reported regarding any potential medicinal effects. Leaves/fruits of A. nitida were extracted with methanol and fractionated to attain n-hexane, chloroform, ethyl acetate and aqueous fractions. These extracts were then evaluated for in vivo analgesic and anti-inflammatory potential. For in vivo anti-inflammatory activity, carrageenan-induced paw edema assay, Freunds' complete adjuvant-induced edema, xylene-induced ear edema and histamine-induced paw edema models were used in rats, which showed significant (p < 0.01) reduction (70−80%) in edema in comparison of inflammatory controls. On other hand, for the analgesic assessment, hot plate assay and acetic acid-induced writhing tests were used, which showed a significant (p < 0.01) rise in latency time (40−60%) as compared with pain-induced controls. These results were comparable with standard drugs in a concentration-dependent manner and no mortality or toxicity was observed during all experiments. Then, for the identification of chemical constituents gas chromatography−mass spectrometry (GC-MS) analysis was performed, which indicated the presence of neophytadiene, 3,7,11,15-Tetramethyl-2-hexadecen-1-ol, phytol and vitamin E, justifying the use of A. nitida to treat inflammatory disorders.

Utilization of Implantable Cardioverter-Defibrillators in Patients With Heart Transplant (from National Inpatient Sample Database).

Heart transplant (HT) recipients represent a unique and vulnerable population in whom medium and long-term outcomes are significantly affected by the risk of arrhythmias and sudden cardiac death. The use of implantable cardioverter-defibrillators (ICDs) in this population remains debated. A retrospective analysis of the National Inpatient Sample data between 2009 and 2018 was conducted. Hospitalization data on patients who underwent HT, or who had a preexisting HT, and who received a new ICD were included (excluding the preexisting ICD). Outcomes assessed included inpatient mortality, length of stay, and inflation-adjusted costs. We explored temporal trends in ICD placement and mean length of stay, and predictors of ICD placement. Between 2009 and 2018, 22,673 hospitalizations were recorded for HT, during which patients either received a concurrent new ICD placement (n = 70 [0.31%]) or no new ICD placement (n = 22,603 [99.7%]). During the same period, 146,555 admissions were recorded in patients with a history of HT. ICD placement in patients with a preexisting HT was associated with significantly higher inflation-adjusted costs ($55,680.7 vs $17,219.2; p <0.001). Predictors of ICD placement in preexisting patients with HT included cardiac arrest during hospitalization (odds ratio [OR]:14.3 [3.5 to 58.6]), drug abuse (OR:6.0 [1.3 to 27.1]), and previous PCI (OR:6.0 [2.1 to 17.3]). In conclusion, ICD placement in patients with HT history was associated with significantly higher inflation-adjusted costs. In patients with HT history, factors predicting ICD placement included cardiac arrest at hospitalization, previous PCI, and drug abuse.

The Prevalence of Pharmacogenomics Variants and Their Clinical Relevance Among the Pakistani Population.

Background: Pharmacogenomics (PGx), forming the basis of precision medicine, has revolutionized traditional medical practice. Currently, drug responses such as drug efficacy, drug dosage, and drug adverse reactions can be anticipated based on the genetic makeup of the patients. The pharmacogenomic data of Pakistani populations are limited. This study investigates the frequencies of pharmacogenetic variants and their clinical relevance among ethnic groups in Pakistan. Methods: The Pharmacogenomics Knowledge Base (PharmGKB) database was used to extract pharmacogenetic variants that are involved in medical conditions with high (1A + 1B) to moderate (2A + 2B) clinical evidence. Subsequently, the allele frequencies of these variants were searched among multiethnic groups of Pakistan (Balochi, Brahui, Burusho, Hazara, Kalash, Pashtun, Punjabi, and Sindhi) using the 1000 Genomes Project (1KGP) and ALlele FREquency Database (ALFRED). Furthermore, the published Pharmacogenomics literature on the Pakistani population was reviewed in PubMed and Google Scholar. Results: Our search retrieved (n = 29) pharmacogenetic genes and their (n = 44) variants with high to moderate evidence of clinical association. These pharmacogenetic variants correspond to drug-metabolizing enzymes (n = 22), drug-metabolizing transporters (n = 8), and PGx gene regulators, etc. (n = 14). We found 5 pharmacogenetic variants present at >50% among 8 ethnic groups of Pakistan. These pharmacogenetic variants include CYP2B6 (rs2279345, C; 70%-86%), CYP3A5 (rs776746, C; 64%-88%), FLT3 (rs1933437, T; 54%-74%), CETP (rs1532624, A; 50%-70%), and DPP6 (rs6977820, C; 61%-86%) genes that are involved in drug response for acquired immune deficiency syndrome, transplantation, cancer, heart disease, and mental health therapy, respectively. Conclusions: This study highlights the frequency of important clinical pharmacogenetic variants (1A, 1B, 2A, and 2B) among multi-ethnic Pakistani populations. The high prevalence (>50%) of single nucleotide pharmacogenetic variants may contribute to the drug response/diseases outcome. These PGx data could be used as pharmacogenetic markers in the selection of appropriate therapeutic regimens for specific ethnic groups of Pakistan.

Anatomical Characterization, HPLC Analysis, and Biological Activities of Ilex dipyrena.

Ilex dipyrena Wall (Aquifoliaceae), is a traditional medicinal plant abundantly found in India and Pakistan. In the current research work, initially, the anatomical characteristics were recorded through microscopic examination of selected plant parts, such as leaf, petiole, and midrib. Then, the quantitative phytochemical screening was performed using standard tests reported in literature. The whole-plant powdered sample was then soaked in methanol to obtain crude extract, which was then fractionated into solvents of different polarities to obtain ethyl acetate, chloroform, butanol, hexane, and aqueous extracts. The phytochemical composition of the crude ethyl acetate and chloroform extracts (being the most active fractions) was then confirmed through HPLC analyses, where the possible phytochemical present were predicted through comparison of retention time of a given compound peak with the available standards. The extracts were also evaluated for their in vitro antioxidant and ani-lipoxygenase potentials using standard methods. The microscopic examination revealed the presence of anomocytic type stomata on the abaxial side of the leaf as well as unicellular trichrome and calcium oxalate druses crystals in the midrib and petiole, with a single, centered U-shaped collateral arterial bundle, which was directed toward the adaxial and the phloem toward the abaxial sides of the selected plant parts, respectively. Almost all tested representative groups of phytochemicals and essential minerals were detected in the selected plant, whereas five possible phytochemicals were confirmed in crude and chloroform extract and seven in ethyl acetate fraction. As antioxidant, chloroform fraction was more potent, which exhibited an IC50 value of 64.99, 69.15, and 268.52 µg/mL, determined through DPPH, ABTS, and FRAP assays. Ethyl acetate extract was also equally potent against the tested free radicals. Chloroform and ethyl acetate extracts were also potent against lipoxygenase, with IC50 value of 75.99 and 106.11 µg/mL, respectively. Based on the results of biological studies, Ilex dipyrena was found to good inhibitor of free radicals and lipoxygenase that could be further investigated to isolate compounds of medicinal importance.

Feature-Based Fusion Using CNN for Lung and Heart Sound Classification.

Lung or heart sound classification is challenging due to the complex nature of audio data, its dynamic properties of time, and frequency domains. It is also very difficult to detect lung or heart conditions with small amounts of data or unbalanced and high noise in data. Furthermore, the quality of data is a considerable pitfall for improving the performance of deep learning. In this paper, we propose a novel feature-based fusion network called FDC-FS for classifying heart and lung sounds. The FDC-FS framework aims to effectively transfer learning from three different deep neural network models built from audio datasets. The innovation of the proposed transfer learning relies on the transformation from audio data to image vectors and from three specific models to one fused model that would be more suitable for deep learning. We used two publicly available datasets for this study, i.e., lung sound data from ICHBI 2017 challenge and heart challenge data. We applied data augmentation techniques, such as noise distortion, pitch shift, and time stretching, dealing with some data issues in these datasets. Importantly, we extracted three unique features from the audio samples, i.e., Spectrogram, MFCC, and Chromagram. Finally, we built a fusion of three optimal convolutional neural network models by feeding the image feature vectors transformed from audio features. We confirmed the superiority of the proposed fusion model compared to the state-of-the-art works. The highest accuracy we achieved with FDC-FS is 99.1% with Spectrogram-based lung sound classification while 97% for Spectrogram and Chromagram based heart sound classification.

Chemical characterization and evaluation of the nephroprotective potential of Parrotiopsis jacquemontiana (Decne) Rehder and Periploca hydaspidis Falc crude extract in CCl4-induced Male Sprague-Dawley Rats.

Biochemical, antioxidant, serum, and urine profiles together with physical examination can deliver important information regarding animal health status, and are vital in the diagnosis and treatment of patients. CCl4, a potent nephrotoxin, was used for causing toxicity in rat kidneys. The present study aimed at exploring the nephroprotective potential of P. jacquemontiana leaves methanol extract (PJM) and P. hydaspidis whole-plant methanol extract (PHM) on kidney cells of male rats after oxidative stress and DNA damage was instigated by CCl4. Various parameters including enzymatic levels, serum profiles, urine profiles, genotoxicity, and histological studies were conducted. In renal samples of rats treated with CCl4, the antioxidant enzymes (POD, SOD, CAT), PH level, protein level, and glutathione contents were significantly (p < 0.05) declined whereas renal biochemicals (H2O2, TBARS, and nitrite), specific gravity, level of urea, urobilinogen, serum BUN and creatinine were markedly (p < 0.05) increased relative to control group. Co-administration of PJM and PHM with CCl4 displayed protective ability against CCl4 intoxication by restoring activities of antioxidant enzymes, urine profile, biochemical parameters, and serum profile in rats. CCl4 also induced prominent DNA damages and glomerular atrophy with abnormal appearance of glomerulus and Bowman's capsule. These damages results in impaired corticular sections, edema in Bowman's capsule, accumulation of necrotic cells, dilation of convoluted tubules, and narrowing of space between Bowman's capsule, which were successfully ameliorated after co-administration of PJM and PHM fractions in a dose-dependent manner (200 and 400 mg/kg b.w.). The results obtained suggest the therapeutic role of PJM and PHM in oxidative-stress related disorders of kidney and may be helpful in kidney trauma.