Alternative treatment in Hepatitis B by using polyherbal formulation.

The hepatitis B is most prevalent diseases (along with morbidities) in Asian countries. This research study has been conducted to provide an alternative treatment which is safe, effective and cost-effective to comprehend relations of disease, symptoms, patients response and the clinical response via better management of hepatitis B. The goal of this research is to evaluate efficacy and safety of herbal medicine as compared to allopathic medicine in patients suffering from hepatitis B. This was a single blind, randomized controlled clinical trial conducted at Shifa-ul-Mulk Memorial Hospital Hamdard University, Karachi and Dar ul Shifa Unani Dawakhana Karachi, Pakistan. The patients of both genders ranging from 25 to 50 years with symptoms and diagnosed for hepatitis B that fulfilled the criteria for membership, and consented for participation were registered. Ethical committee clearance and permission was obtained from the concerned committee at Faculty of Eastern Medicine, Hamdard University, Karachi, Pakistan. No significant difference was identified after treatment and it was found that the efficacy of Alpha (Control drug) is same as Safoof akseer e jigar (Test drug). The data offered support to the null hypothesis and therefore research hypothesis was rejected. According to the statistical analysis by chi square, hepatitis B was recorded as negative in 26 patients (57.77%) out of 45 patients by the use of Interferon Alpha (control therapy) and in 27 patients (64.28%) out of 42 patients by the use of Safoof akseer e jigar (test drug). Comparison of the data recorded of the patients was determined as both drugs showed significant improvement and p value>0.05. The efficacy response is equal in both drugs while test drug showed more safety response. It is concluded that Safoof akseer e jigar possesses as effective a therapeutic value in treating hepatitis B as allopathic medicine.

Neoadjuvant Chemotherapy with Laser Interstitial Thermal Therapy in Central Nervous System Neuroblastoma: Illustrative Case and Literature Review.

Primitive neuroectodermal tumors of the central nervous system, or CNS neuroblastoma, are rare neoplasms in children. Recently, methylation profiling enabled the discovery of four distinct entities of these tumors. The current treatment paradigm involves surgical resection followed by chemotherapy and radiation. However, upfront surgical resection carries high surgical morbidity in this patient population due to their young age, tumor vascularity, and often deep location in the brain. We report a case of CNS neuroblastoma that can be successfully treated with neoadjuvant chemotherapy followed by minimally invasive laser interstitial thermal therapy and radiation. The patient has complete treatment with no evidence of recurrence at one year follow-up. This case illustrates a potential paradigm shift in the treatment of these rare tumors can be treated using minimally invasive surgical approach to achieve a favorable outcome.

Bilateral ptosis/blepharitis due to lepromatous leprosy.

PURPOSE: To underscore the importance of histopathological evaluation in cases presenting with a constellation of unusual ocular inflammation and physical findings. OBSERVATION: A 51-year-old male, presented with a chief complaint of worsening visual field loss due to droopy eyelids two months post excision of a right upper eyelid squamous cell carcinoma. His past medical history included chronic edematous facial features, chronic sinusitis, unexplained peripheral neuropathy, and worsening fatigue. Pre-blepharoplasty work-up revealed mechanical ptosis from lid edema, madarosis, a concave nasal bridge, pancytopenia, and numerous burn marks due to inadvertent injuries. Bilateral blepharoplasty was performed, and the excised tissue submitted for histopathological evaluation that revealed non-caseating granulomatous perineural inflammation with numerous acid-fast bacilli in dermal layers and nerves. These findings prompted a diagnosis of lepromatous leprosy with suspected bone marrow involvement. The source of the infection was unknown. The blepharoplasty restored his visual fields and multi-drug therapy (MDT) improved his general health and wellbeing with concomitant reductions of pancytopenia, fatigue, and facial edema. CONCLUSIONS AND IMPORTANCE: Biopsy histopathology, in patients with longstanding ocular adnexal inflammation, can facilitate diagnosis and treatment. To the authors' knowledge, this is an unusual ocular leprosy presentation and represents the first leprosy case diagnosed via blepharoplasty.

Use of Autologous Platelets for Lamellar Macular Hole Repair.

The consensus of lamellar macular hole repair generally entails vitrectomy with internal limiting membrane with/without epiretinal membrane peeling with gas tamponade, although the risk of a full thickness macular hole remains. In this case report, we investigate the role of the regenerative properties of autologous platelets in the repair of a lamellar macular hole with pars plana vitrectomy, an autologous platelet plug, and 12% C3F8 without prone posturing. All three patients in this case report experienced visual improvement along with anatomic closure of the lamellar macular hole. Further randomized studies with larger sample sizes will contribute to the existing data regarding this procedure and its outcomes.

Pre-natal diagnosis of caudal regression syndrome.

Caudal regression syndrome is a rare syndrome characterized by absence of the lower spine to a varying degree. It has particularly high incidence in patients with Insulin Dependent Diabetes Mellitus (IDDM). We report a case of caudal regression syndrome in a newly diagnosed case of IDDM at 30 weeks of gestation.

A Point-of-Care Immunosensor for Human Chorionic Gonadotropin in Clinical Urine Samples Using a Cuneated Polysilicon Nanogap Lab-on-Chip.

Human chorionic gonadotropin (hCG), a glycoprotein hormone secreted from the placenta, is a key molecule that indicates pregnancy. Here, we have designed a cost-effective, label-free, in situ point-of-care (POC) immunosensor to estimate hCG using a cuneated 25 nm polysilicon nanogap electrode. A tiny chip with the dimensions of 20.5 × 12.5 mm was fabricated using conventional lithography and size expansion techniques. Furthermore, the sensing surface was functionalized by (3-aminopropyl)triethoxysilane and quantitatively measured the variations in hCG levels from clinically obtained human urine samples. The dielectric properties of the present sensor are shown with a capacitance above 40 nF for samples from pregnant women; it was lower with samples from non-pregnant women. Furthermore, it has been proven that our sensor has a wide linear range of detection, as a sensitivity of 835.88 µA mIU(-1) ml(-2) cm(-2) was attained, and the detection limit was 0.28 mIU/ml (27.78 pg/ml). The dissociation constant Kd of the specific antigen binding to the anti-hCG was calculated as 2.23 ± 0.66 mIU, and the maximum number of binding sites per antigen was Bmax = 22.54 ± 1.46 mIU. The sensing system shown here, with a narrow nanogap, is suitable for high-throughput POC diagnosis, and a single injection can obtain triplicate data or parallel analyses of different targets.

Antithrombotics and thrombolytics in stroke.

Although angioplasty, stenting and thrombolysis of the cerebral circulation are being attempted with increasing frequency, antithrombotic and antiplatelet regimens have not yet been standardized in the treatment of stroke. Safety and efficacy of antithrombotic therapies during cerebrovascular interventions may depend onclinical presentation and carotid lesion characteristics. Platelet glycoprotein (GP) IIb/IIIa receptor antagonists might have potential value as a monotherapy or as an adjunctive therapy with thrombolytics or interventional procedures. However, the risk of cerebral hemorrhage may be higher in patients with acute stroke than in subjects with transient ischemic attack (TIA) or partial occlusion. For high-risk cerebrovascular lesions such as basilar artery, atherothrombosis or acute carotid artery occlusion, initial experience suggests that platelet GPIIb/IIIa receptor antagonists may have implications in reducing acute re-occlusion rates during the various interventional procedures. The aim of this paper is to review the use of antithrombotics as prophylaxis treatment in stroke, in addition, to comparing the benefits/risks of using thrombolytics as acute intervention.