Synthesis and Characterization of ZnO Nanoparticles Derived from Biomass (Sisymbrium Irio) and Assessment of Potential Anticancer Activity.

Cancer treatment development is hampered by chemotherapy side effects, drug resistance, and tumor metastasis, giving cancer patients a gloomy prognosis. Nanoparticles (NPs) have developed as a promising medicinal delivery technique in the last 10 years. The zinc oxide (ZnO) NPs can precisely and captivatingly promote the apoptosis of cancer cells in cancer treatment. There is also an urgent need to discover novel anti-cancer therapies, and current research suggests that ZnO NPs hold significant promise. ZnO NPs have been tested for phytochemical screening and in vitro chemical efficiency. The green synthesis method was employed for the preparation of ZnO NPs from Sisymbrium irio (L.) (Khakshi). An alcoholic and aqueous extract of S. irio was prepared using the Soxhlet method. Various chemical compounds were revealed in the methanolic extract through qualitative analysis. The results of quantitative analysis showed that the total phenolic content has the highest amount (42.7861 mgGAE/g), while the resultant amounts of (5.72175 mgAAE/g) and (15.20725 mgAAE/g) were obtained in total flavonoid content and antioxidant property, respectively. ZnO NPs were prepared using a 1:1 ratio. The synthesized ZnO NPs were identified to have a hexagonal wurtzite crystal arrangement. The nanomaterial was characterized by scanning electron microscopy, transmission electron microscopy, and UV-visible spectroscopy. The ZnO-NPs' morphology exhibited an absorbance at 350-380 nm. Furthermore, different fractions were prepared and assessed for anticancer activity. As a result of this anticancer activity, all fractions exhibited cytotoxic activity against both BHK and HepG2 human cancer cell lines. The methanol fraction showed the highest activity of 90% (IC50 = 0.4769 mg/mL), followed by the hexane fraction that showed 86.72%, ethyl acetate showed 85%, and chloroform fraction showed 84% against BHK and HepG2 cell lines. These findings suggested that synthesized ZnO-NPs have anticancer potential.

A New MBH Adduct as an Efficient Ligand in the Synthesis of Metallodrugs: Characterization, Geometrical Optimization, XRD, Biological Activities, and Molecular Docking Studies.

This article reports the synthesis, characterization, geometrical optimization, and biological studies of new MBH-based organometallic compounds of medicinal significance. The ligand (MNHA) was prepared via the Morita-Baylis-Hillman (MBH) synthetic route, from aromatic aldehyde containing multiple functional groups. Metal complexes were prepared in an alkaline medium and under other suitable reaction conditions. Spectral and elemental analyses were used to identify the structural and molecular formulas of each compound. Optimized geometry was determined through density functional theory (DFT) B3LYP and 6-311++ G (d,p) basis set for the MBH adduct, whereas structures of novel complexes were optimized with the semi-empirical PM6 method. Powder XRD analysis furnished the crystal class of complexes, with Co3+, Cr3+, and Mn2+ being cubic, while Ni2+ was hexagonal, and Cu2+ was orthorhombic. Moreover, the ligand, along with Ni2+ and Co3+ complexes, showed profound antibacterial action against S. aureus, E. coli, B. pumilis, and S. typhi. Additionally, all of the complexes were shown to persist in the positive antioxidant potential of the ligand. Contrarily, not a single metal complex conserved the antifungal potentials of the ligand.

Synthesis, Characterization, Biological Activities and Ab-initio Study of Transition Metal Complexes of [Methyl 2-((4-chlorophenyl)(hydroxy)methyle) Acrylate].

Taking cognizance of the medicinal significance and diverse functions of synthetic Morita-Baylis-Hillman adducts (MBHA), the title ligand was synthesized and purified through column chromatography. Cr+3, Mn+2, Co+3, Ni+2, Cu+2 complexes of the ligand were synthesized under basic conditions, subjected to characterization through spectral analyses and verified with the IR spectrum that was generated computationally by the DFT B3LYP method, with 6-311++ G (d,p) basis set and Hartree Fock (HF) B3LYP method in conjunction with 3-21G(d,p) basis set. Powder XRD helped to testify crystals of the complexes. Moreover, the antibacterial, and antioxidant characteristics of MBHA and its complexes were also established. All of them were found to be active antioxidants. The antibacterial activities, examined against S. aureus, E. coli, B. pumilis and S. typhi have revealed that its Cobalt complex has an excellent potential to act against all of them. Hence, these compounds maybe having potentialities for the discovery of new, cheaper and efficient drugs against various infectious diseases. The study also uncovers the first example of utilization of MBHA towards metal complex formation.

Mediastinal Lymphadenopathy As A Predictor Of Worse Outcome In Severe Covid-19 Cases.

BACKGROUND: This cross-sectional study is aimed at evaluating the association of mediastinal lymphadenopathy with COVID-19 prognosis in severe cases. Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital, Pakistan, from June to July 2020. METHODS: One hundred and fifty (150) laboratory-confirmed SARS CoV-2 infected, severe cases in Intensive Care Unit/ High Dependency Unit were included. These cases were divided into two categories, i.e., with and without mediastinal lymphadenopathy on High Resolution Computed Tomography chest. The two categories were compared on the basis of data obtained including age, gender, comorbid, White Blood Cell count, lymphocyte count, median days of hospitalization, need for invasive ventilation, Intensive Care Unit admission, clinical outcome and High-Resolution Computed Tomography chest findings. The data was compiled on a questionnaire and analysed on SPSS 24. RESULTS: Total 155 severe COVID-19 patients were reviewed, out of which 36 (23.2%) had mediastinal lymphadenopathy (category 1) and 119 (76.8%) had no mediastinal lymphadenopathy (category 2). Laboratory findings including median of white blood cells and lymphocyte percentage had no significant change in both categories. Intensive care unit admissions were 12 (33.3%) and 56 (47.1%) in category 1 and 2 respectively. Median days of hospitalization (8 days) and mortality rate (16%) were almost the same in both categories. CONCLUSIONS: Our study concludes that presence of mediastinal lymphadenopathy in severe COVID-19 cases is not associated with worse outcome. However, overall prevalence of mediastinal lymphadenopathy in severe cases is high (23.2%).

Clearing the Fog: Is Hydroxychloroquine Effective in Reducing Coronavirus Disease-2019 Progression? A Randomized Controlled Trial.

Background Hydroxychloroquine (HCQ) has been considered for the treatment of coronavirus disease 2019 (COVID-19), but data on its efficacy are conflicting. We analyzed the efficacy of HCQ along with standard of care (SOC) treatment, compared with SOC alone, in reducing disease progression in mild COVID-19. Methods A single-center open-label randomized controlled trial was conducted from April 10 to May 31, 2020 at Pak Emirates Military Hospital, Rawalpindi. Five hundred patients of both genders between the ages of 18 and 80 years with mild COVID-19 were enrolled in the study. A total of 349 patients were assigned to the intervention group (standard dose of HCQ plus SOC) and 151 patients were assigned to SOC only. The primary outcome was progression of disease while secondary outcome was polymerase chain reaction (PCR) negativity on days 7 and 14. The results were analyzed on Statistical Package for Social Sciences (SPSS; IBM Corp., Armonk, NY) version 23. A p-value <0.05 was considered significant.  Results The median age of the intervention group was 34 ± 11.778 years and control group was 34 ± 9.813 years. Disease progressed in 16 patients, 11 (3.15%) of which were in the intervention group and 5 (3.3%) in the control group (p-value = 0.940). PCR negative cases in intervention and control groups on day 7 were 182 (52.1%) and 54 (35.8%), respectively (p-value = 0.001); and on day 14 were 244 (69.9%) and 110 (72.9%), respectively (p-value = 0.508). Consecutive PCR negativity on days 7 and 14 was observed in 240 (68.8%) patients in the intervention group compared to 106 (70.2%) in the control group (p-value = 0.321). Conclusion The addition of HCQ to SOC in hospitalized mild COVID-19 patients neither stops disease progression nor helps in early and sustained viral clearance.

Therapeutic plasma exchange for coronavirus disease-2019 triggered cytokine release syndrome; a retrospective propensity matched control study.

BACKGROUND: Cytokine release syndrome (CRS) plays a pivotal role in the pathophysiology and progression of Coronavirus disease-2019 (COVID-19). Therapeutic plasma exchange (TPE) by removing the pathogenic cytokines is hypothesized to dampen CRS. OBJECTIVE: To evaluate the outcomes of the patients with COVID-19 having CRS being treated with TPE compared to controls on the standard of care. METHODOLOGY: Retrospective propensity score-matched analysis in a single centre from 1st April to 31st July 2020. We retrospectively analyzed data of 280 hospitalized patients developing CRS initially. PSM was used to minimize bias from non-randomized treatment assignment. Using PSM 1:1, 90 patients were selected and assigned to 2 equal groups. Forced matching was done for disease severity, routine standard care and advanced supportive care. Many other Co-variates were matched. Primary outcome was 28 days overall survival. Secondary outcomes were duration of hospitalization, CRS resolution time and timing of viral clearance on Polymerase chain reaction testing. RESULTS: After PS-matching, the selected cohort had a median age of 60 years (range 32-73 in TPE, 37-75 in controls), p = 0.325 and all were males. Median symptoms duration was 7 days (range 3-22 days' TPE and 3-20 days controls), p = 0.266. Disease severity in both groups was 6 (6.6%) moderate, 40 (44.4%) severe and 44 (49%) critical. Overall, 28-day survival was significantly superior in the TPE group (91.1%), 95% CI 78.33-97.76; as compared to PS-matched controls (61.5%), 95% CI 51.29-78.76 (log rank 0.002), p<0.001. Median duration of hospitalization was significantly reduced in the TPE treated group (10 days vs 15 days) (p< 0.01). CRS resolution time was also significantly reduced in the TPE group (6 days vs. 12 days) (p< 0.001). In 71 patients who underwent TPE, the mortality was 0 (n = 43) if TPE was done within the first 12 days of illness while it was 17.9% (deaths 5, n = 28 who received it after 12th day (p = 0.0045). CONCLUSION: An earlier use of TPE was associated with improved overall survival, early CRS resolution and time to discharge compared to SOC for COVID-19 triggered CRS in this selected cohort of PS-matched male patients from one major hospital in Pakistan.

A YOUNG GIRL WITH FITS.

A young girl presented with fits vomiting and epigastric pain. Investigations including CT-Scan brain, MRI brain, MRV brain and cerebrospinal fluid (CSF) examination were normal. Her urine was screened for porphobilinogen which was positive. She responded to intravenous dextrose and hypercaloric diet

Spectrofluorometric study of iron removal from bovine lactoferrin by ethylenediamminetetraacetic acid.

The kinetics of iron removal from the two metal binding sites of the bovine lactoferrin by ethylenediaminetetraacetic acid (EDTA) was investigated at pH 7.5 and 33°C. Solutions were buffered at pH 7.5 by 0.15 M Tris-HCl. Pseudo first-order rate constants as a function of ligand concentration were measured for iron removal from diferric lactoferrin and from N- and C-terminal monoferric lactoferrin. Diferric lactoferrin showed simple saturation behavior while both the monoferric forms showed a two-term dependence of kobs on ligand concentration that signifies two pathways for iron removal under the conditions applied. Moreover, the results show that the N-terminal site is more labile towards iron removal by EDTA than the C-terminal site.

Microalbuminuria: association with ischaemic heart disease in non-diabetics.

BACKGROUND: In view of the high morbidity and mortality associated with ischemic heart disease (IHD), the estimation of individual cardiovascular risk over and above the assessment of classic risk factors, such as age, hypercholesterolemia and hypertension, is an important prerequisite for focusing preventive measures and therapeutic measures. Microalbuminuria (MA) as a marker of IHD in nondiabetics is currently under international debate. The present descriptive study undertaken at Combined Military Hospital, Lahore was aimed to determine the frequency of MA in nondiabetic IHD patients. METHODS: One hundred consecutive non diabetic patients with IHD (73 males, 27 females). Patients showing clinical albumiuria and with other causes of proteinuria were excluded. Urinary albumin in first morning sample was estimated by immunoturbidimetry method. Albumin to creatinine ratio (ACR) was calculated as mg/g. RESULTS: The frequency of MA (ACR >30 mg/g) was 37% in patients. Frequency was highest in older age bracket for both genders. The mean ACR was 131.8 +/- 66.2 mg/g. Significant difference was observed in mean MA level among different age groups. CONCLUSION: MA is common in nondiabetics patients with IHD. The mean level of MA was higher in older patients.