Unlocking translational machinery for antitubercular drug development.

Targeting translational factor proteins (TFPs) presents significant promise for the development of innovative antitubercular drugs. Previous insights from antibiotic binding mechanisms and recently solved 3D crystal structures of Mycobacterium tuberculosis (Mtb) elongation factor thermo unstable-GDP (EF-Tu-GDP), elongation factor thermo stable-EF-Tu (EF-Ts-EF-Tu), and elongation factor G-GDP (EF-G-GDP) have opened up new avenues for the design and development of potent antituberculosis (anti-TB) therapies.

Sponge-shaped Au nanoparticles: A stand-alone metallic photocatalyst for driving the light-induced CO2 reduction reaction.

Coinage metal nanoparticles (NPs) enable plasmonic catalysis by generating hot carriers that drive chemical reactions. Making NPs porous enhances the adsorption of reactant molecules. We present a dewetting and dealloying strategy to fabricate porous gold nanoparticles (Au-Sponge) and compare their CO2 photoreduction activity with respect to the conventional gold nanoisland (Au-Island) morphology. Porous gold nanoparticles exhibit an unusually broad and red-shifted plasmon resonance which is in agreement with the results of finite difference time domain (FDTD) simulations. The key insight of this work is that the multi-step reduction of CO2 driven by short-lived hot carriers generated by the d → s interband transition proceeds extremely quickly as evidenced by the generation of methane. A 3.8-fold enhancement in the photocatalytic performance is observed for the Au-Sponge in comparison to the Au-Island. Electrochemical cyclic voltammetry measurements confirm the 2.5-fold increase in the surface area and roughness factor of the Au-Sponge sample due to its porous nature. Our results indicate that the product yield is limited by the amount of surface adsorbates i.e. reactant-limited. Isotope-labeled mass spectrometry using 13CO2 was used to confirm that the reaction product (13CH4) originated from CO2 photoreduction. We present the plasmon-mediated photocatalytic transformation of 4-aminothiophenol (PATP) into p,p'-dimercaptoazobenzene (DMAB) using Au-Sponge and Au-Island samples.

Adoption of the international classification of vestibular disorders criteria in cases of Benign positional paroxysmal vertigo: a single-center experience.

INTRODUCTION: Benign positional paroxysmal vertigo (BPPV) stands as the commonest cause for vertigo. It accounts for 20% of all cases of vertigo, even with its high prevalence rate it often goes underdiagnosed and undertreated. Development of the consensus document by the Bárány society's International Classification of Vestibular Disorders (ICVD)significantly facilitates the diagnosis of BPPV and its variants. This study assesses the utilisation of ICVD criteria for managing BPPV. METHODOLOGY: This is a cross-sectional descriptive study conducted at a tertiary care hospital in Northern India spanning from November 1, 2022, to November 30, 2023. A total of 110 participants diagnosed with BPPV were enrolled consecutively. All participants underwent Dix-Hallpike and supine log roll positional maneuvers. Diagnosis was made based on the history and type of nystagmus seen, and classified as per the ICVD criteria. RESULTS: Posterior semicircular canalolithiasis (pc-BPPV) accounted for 25.45% of cases and horizontal canal canalolithiasis (hc-BPPV) accounted for 20.91% of cases. Probable BPPV, spontaneously resolved (pBPPVsr) was diagnosed in 16.36% of participants and possible BPPV(pBPPV) was diagnosed in 18.18% of participants. Multiple canal BPPV (mc-BPPV) accounted for 17.27% of cases. One participant was diagnosed with horizontal canal cupulolithiasis and anterior canal canalolithiasis respectively. No participant was diagnosed with posterior canal cupulolithiasis. CONCLUSION: The most common type of BPPV was pc-BPPV followed by hc-BPPV. The affected canal in possible BPPV, can be identified, and appropriate repositioning maneuvers are effective in treating them as well as aids in confirming the diagnosis. The diagnostic clarity provided by ICVD, aids in effective management of BPPV. More studies with larger sample size are required to further validate its clinical utility.

Cell cycle dysregulation on prenatal and postnatal arsenic exposure in skin of Wistar rat neonates.

This study explores the effects of prenatal and postnatal (until weaning period) arsenic exposure given via pregnant females on Wistar rat neonates. Pregnant female rats were divided in four groups - control, low dose, moderate dose and high dose groups of sodium arsenite exposure during gestation and weaning period. Half of the neonates were sacrificed at day 1 of birth and other half at day 21 of birth. Cell cycle analysis in epidermal keratinocytes using flowcytometer revealed that there was a consistent increase in number of cells in G2/M phase from 0.04% in control group to 0.88%, 1.59% and 2.77% in low, moderate and high dose groups respectively for neonates sacrificed at day-1. Whereas, the increase in number of cells with increasing doses in G2/M phase of neonates sacrificed at day-21 was from 3.44% to 5.1%, 6.82%, and 9.17%. At postnatal day 21, mRNA expression of Cyclin A and B1, p53, Caspases 3, 7 and 9, and Bax were found to be up-regulated. Whereas that of Cyclin E, CDK 1 and 2 and Bcl2 were down regulated consistently in skin tissues of arsenic exposed groups.

Carbamate as a potential anti-Alzheimer's pharmacophore: A review.

Alzheimer's disease (AD) is a progressive age-related neurodegenerative brain disorder, which leads to loss of memory and other cognitive dysfunction. The underlying mechanisms of AD pathogenesis are very complex and still not fully explored. Cholinergic neuronal loss, accumulation of amyloid plaque, metal ions dyshomeostasis, tau hyperphosphorylation, oxidative stress, neuroinflammation, and mitochondrial dysfunction are major hallmarks of AD. The current treatment options for AD are acetylcholinesterase inhibitors (donepezil, rivastigmine, and galantamine) and NMDA receptor antagonists (memantine). These FDA-approved drugs mainly provide symptomatic relief without addressing the pathological aspects of disease progression. So, there is an urgent need for novel drug development that not only addresses the basic mechanisms of the disease but also shows the neuroprotective property. Various research groups across the globe are working on the development of multifunctional agents for AD amelioration using different core scaffolds for their design, and carbamate is among them. Rivastigmine was the first carbamate drug investigated for AD management. The carbamate fragment, a core scaffold of rivastigmine, act as a potential inhibitor of acetylcholinesterase. In this review, we summarize the last 10 years of research conducted on the modification of carbamate with different substituents which primarily target ChE inhibition, reduce oxidative stress, and modulate Aß aggregation.

Extreme climate index estimation and projection in association with enviro-meteorological parameters using random forest-ARIMA hybrid model over the Vidarbha region, India.

This study aims to estimate and analyse extreme climate indices such as standardised precipitation index (SPI) coupled with enviro-met (air pollutants and meteorological) parameters over the Vidarbha region from 1980 to 2019. Seasonal SPI, also known as the draught index, is derived from rainfall data using the R language. An attempt is made to determine the best combination of enviro-met on SPI using the random forest (RF) models. The study region is divided into four zones to assess the microclimatic impact on the forecast model. Three sets of data combinations, viz., meteorological and air pollution parameters, are applied for SPI prediction using RF. The autoregressive integrated moving average (ARIMA) model is also used for a future scenario projection. It is observed from the projection results that the drought severity is enhancing with time. The drought severity scale from 1980 to 1989 is found to be between - 1 and 1, but the scale increases from 1990 to 2019 (- 3). From 1990 to 2019, SPI's negative (-) scale has become more prominent in all Vidarbha regions. These trends are indicative of drought severity and will have a significant impact on both life and property.

Interaction of aerosol with meteorological parameters and its effect on the cash crop in the Vidarbha region of Maharashtra, India.

Regional weather variability depends on various meteorological variables such as temperature and rainfall. The current research focuses on the variability and trends in annual aerosol optical depth (AOD), temperature (T), and rainfall (RF) in 11 Vidarbha districts. The annual trend analysis of AOD, T, and R is determined using the non-parametric Sen slope and Mann-Kendall (MK) test at a 5% significant level from 1980 to 2019. Annual T and AOD indicate a substantial increase in this study, whereas rainfall shows a non-significant trend (MK, test) over the study period. According to Sen's slope trends, the relatively high rainfall area (Chandrapur = 1.273 and Garchiroli = 4.06) got positive trends, but Gondia and Bhandara districts have negative (Sen's slope = - 2.79 and - 2.56) trends. The moderate rainfall areas are showing a less negative Sen slope (Wardha = - 0.21, Washim = - 1.13 and Yavatmal = - 2.75), whereas Nagpur districts' Sen's slope shows a positive value (Sens's slope = 0.72). The assured rainfall area districts show Sen's slope trends are positive (Akola = 0.45, Amravati = 1.17 and Buldana = 0.42). Sen's slope trend indicates rising rainfall, whereas negative trends indicate decreasing rainfall in the time series. This study has also looked at the effect of RF, AOD, and T on the last two decades' cash crop production (2000-2019) for Vidarbha districts. The relationship between rainfall departure (DRF) and cash crop yield has also been highlighted. Five cash crops, such as cotton (Ct), total cereals (TCrl), total oilseeds (TOsd), total pulses (TPS), and sugarcane (Sc), are selected for the present study.

Mathematical modelling and characterization of drying of pre-treated sweet corn (Zea mays L.) kernels.

The pre-treated sweet corn samples were dried at temperatures of 55, 60, 65 and 70 °C and thin layer drying characteristics of sweet corn were assessed. Mathematical models were fitted and evaluated using R2, χ2, RMSE values. The effective diffusivities for the drying process were 4.32 × 10-10 to 1.08 × 10-9 m2/s and activation energies were 34.51 to 38.99 kJ/mol. Total sugar and ascorbic acid of dehydrated sweet corn kernels varied from 5.50 to 13.00 g/100 g and 3.30 to 10.50 mg/100 g respectively. The sample pre-treated with microwave blanching and dried at 70 °C obtained higher sensory score after rehydration, indicating suitability of the dehydrated sweet corn.

Further SAR studies on natural template based neuroprotective molecules for the treatment of Alzheimer's disease.

In our earlier paper, we described ferulic acid (FA) template based novel series of multifunctional cholinesterase (ChE) inhibitors for the management of AD. This report has further extended the structure-activity relationship (SAR) studies of this series of molecules in a calibrated manner to improve upon the ChEs inhibition and antioxidant property to identify the novel potent multifunctional molecules. To investigate the effect of replacement of phenylpiperazine ring with benzylpiperazine, increase in the linker length between FA and substituted phenyl ring, and replacement of indole moiety with tryptamine on this molecular template, three series of novel molecules were developed. All synthesized compounds were tested for their acetyl and butyryl cholinestrases (AChE and BChE) inhibitory properties. Enzyme inhibition and PAS binding studies identified compound 13b as a lead molecule with potent inhibitor property towards AChE/BChE (AChE IC50 = 0.96 ± 0.14 µM, BChE IC50 = 1.23 ± 0.23 µM) compared to earlier identified lead molecule EJMC-G (AChE IC50 = 5.74 ± 0.13 µM, BChE IC50 = 14.05 ± 0.10 µM, respectively). Molecular docking and dynamics studies revealed that 13b fits well into the active sites of AChE and BChE, forming stable and strong interactions with key residues Trp86, Ser125, Glu202, Trp 286, Phe295, Tyr 337 in AChE, and with Trp 82, Gly115, Tyr128, and Ser287 in BChE. The compound, 13b was found to be three times more potent antioxidant in a DPPH assay (IC50 = 20.25 ± 0.26 µM) over the earlier identified EJMC-B (IC50 = 61.98 ± 0.30 µM) and it also was able to chelate iron. Co-treatment of 13b with H2O2, significantly attenuated and reversed H2O2-induced toxicity in the SH-SY5Y cells. The parallel artificial membrane permeability assay-blood brain barrier (PAMPA-BBB) revealed that 13b could cross BBB efficiently. Finally, the in-vivo efficacy of 13b at dose of 10 mg/kg in scopolamine AD model has been demonstrated. The present study strongly suggests that the naturally inspired multifunctional molecule 13b may behave as a potential novel therapeutic agent for AD management.

Intraperitoneal exposure of iron oxide nanoparticles causes dose-dependent toxicity in Wistar rats.

Nanoparticles of iron oxide, with diameters beteween 1 to 100 nm, have notable implications for human health and well being. In the current study, we have investigated the effects of iron oxide nanoparticles (IONP) exposure on general physiology and health of adult Wistar rats. IONP used in the study had spherical shape and average size in the range of 15-20 nm. A total of eight groups of rats were repeatedly injected with 0 (control), 20, 40, and 80 mg IONP per kg body weight intraperitoneally under two different exposure schemes (sub-acute and sub-chronic). IONP exposure caused significant changes in lungs, liver, and kidney indices in both exposure schemes. Sub-acute exposure did not affect body weight gain in treated rats, but longer duration exposure was responsible for significant reduction in body weight. Mesenteries, visceral fatty tissues, and visceral peritoneal membranes demonstrated apparent accumulations of IONP in a dose and time-dependent manner. Hematological analysis showed that total RBC count, hemoglobin content, hematocrit, mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and mean platelet volume (MPV) were not affected by IONP exposure. Total lymphocyte count, however, was elevated in low- and mid-dose treated rats, but not in high-dose group. Serum lactate dehydrogenase (LDH) increased significantly in rats treated with mid and high doses as compared to control. Serum creatinine and blood urea nitrogen levels were also significantly altered in treated rats. Histological study found significant hepatic damage and mild spleen toxicity. Our report suggests that IONP exhibit significant toxicity in rats.

Impacts of partial to complete COVID-19 lockdown on NO2 and PM2.5 levels in major urban cities of Europe and USA.

SARS CoV-2 (COVID-19) coronavirus has been causing enormous suffering, death, and economic losses worldwide. There are rigorous containment measures on industries, non-essential business, transportation, and citizen mobility to check the spread. The lockdowns may have an advantageous impact on reducing the atmospheric pollutants. This study has analyzed the change in atmospheric pollutants, based on the Sentinel-5Ps and ground-station observed data during partial to complete lockdown period in 2020. Results revealed that the mean tropospheric NO2 concentration substantially dropped in 2020 due to lockdown against the same period in 2019 by 18-40% over the major urban areas located in Europe (i.e. Madrid, Milan, Paris) and the USA (i.e. New York, Boston, and Springfield). Conversely, urban areas with partial to no lockdown measures (i.e. Warsaw, Pierre, Bismarck, and Lincoln) exhibited a relatively lower dropdown in mean NO2 concentration (3 to 7.5%). The role of meteorological variability was found to be negligible. Nevertheless, the reduced levels of atmospheric pollutants were primarily attributed to the shutdown of vehicles, power plants, and industrial emissions. Improvement in air quality during COVID-19 may be temporary, but regulatory bodies should learn to reduce air pollution on a long-term basis concerning the trade-offs between the environment, society, and economic growth. The intersection of urban design, health, and environment should be addressed by policy-makers to protect public health and sustainable urban policies could be adopted to build urban resilience against any future emergencies.

Development of ready to reconstitute dehydrated traditional sweet corn halwa.

The halwa is a traditional thick sweet generally consumed by millions in the Middle East with more concentrated population in the South and Central Asia. Sweet corn halwa is one such traditional type prepared in the tribal region of middle Gujarat, India. It is one of the dairy delicacies of traditional Indian desserts, which needs to be optimized and dehydrated to assure the availability of the product during off-season and to provide good value in terms of money and enhancement of shelf life. The milk and sugar were added in 50 to 250 g/100 g and 12 to 14 g/100 g respectively for cooking of ingredients for 10 to 20 min to provide value to this traditional product for getting higher return to the entrepreneurs. The optimized sweet corn halwa was dehydrated in thin layers at 60 °C and drying data was fitted thin layer drying models. The physico-chemical properties and sensory evaluation of sweet corn halwa were evaluated during this experiment. The rehydrated product maintained similar overall acceptability, indicating comparable sensory characteristics with fresh sweet corn halwa.

Structure-Based Virtual Screening to Discover Potential Lead Molecules for the SARS-CoV-2 Main Protease.

The COVID-19 disease is caused by a new strain of the coronavirus family (SARS-CoV-2), and it has affected at present millions of people all over the world. The indispensable role of the main protease (Mpro) in viral replication and gene expression makes this enzyme an attractive drug target. Therefore, inhibition of SARS-CoV-2 Mpro as a proposition to halt virus ingression is being pursued by scientists globally. Here we carried out a study with two objectives: the first being to perform comparative protein sequence and 3D structural analysis to understand the effect of 12 point mutations on the active site. Among these, two mutations, viz., Ser46 and Phe134, were found to cause a significant change at the active sites of SARS-CoV-2. The Ser46 mutation present at the entrance of the S5 subpocket of SARS-CoV-2 increases the contribution of other two hydrophilic residues, while the Phe134 mutation, present in the catalytic cysteine loop, can cause an increase in catalytic efficiency of Mpro by facilitating fast proton transfer from the Cys145 to His41 residue. It was observed that active site remained conserved among Mpro of both SARS-CoVs, except at the entrance of the S5 subpocket, suggesting sustenance of substrate specificity. The second objective was to screen the inhibitory effects of three different data sets (natural products, coronaviruses main protease inhibitors, and FDA-approved drugs) using a structure-based virtual screening approach. A total of 73 hits had a combo score >2.0. Eight different structural scaffold classes were identified, such as one/two tetrahydropyran ring(s), dipeptide/tripeptide/oligopeptide, large (approximately 20 atoms) cyclic peptide, and miscellaneous. The screened hits showed key interactions with subpockets of the active site. Further, molecular dynamics studies of selected screened compounds confirmed their perfect fitting into the subpockets of the active site. This study suggests promising structures that can fit into the SARS-CoV-2 Mpro active site and also offers direction for further lead optimization and rational drug design.

Enhancing photocatalytic degradation of quinoline by ZnO:TiO2 mixed oxide: Optimization of operating parameters and mechanistic study.

This study focuses on the photocatalytic degradation of quinoline, a recalcitrant heterocyclic nitrogenous aromatic organic compound, using the mixed oxide ZnO-TiO2 photo-catalyst. Photo-catalysts were synthesized by the solid-state reaction method at different calcination temperatures of 400 °C, 600 °C, and 800 °C. Different analytical methods, including Field emission scanning electron microscope, Brunauer-Emmett-Teller surface area, X-ray diffraction, UV-vis diffuse reflectance spectroscopy, Fourier-transform infrared spectroscopy, Raman spectroscopy, and X-ray photoelectron spectroscopy analysis were used for the catalyst characterization. The highest pore surface area of 57.9 m2g-1 was obtained for the photo-catalyst calcined at 400 °C. The effects of calcination temperature, solution pH, initial concentration, catalyst dose as well as irradiation time were studied. At the optimum condition, i.e., calcination temperature of 400 °C, pH ≈8 and catalyst dose of 2.5 gL-1, maximum quinoline degradation and total organic carbon (TOC) removal efficiency of ≈92% and ≈78% were obtained after 240 min for initial quinoline amount of 50 mgL-1. The 1st, 2nd, and nth-order kinetic models were applied to analyze the quinoline degradation rate. The photocatalytic mechanism was studied by drawing energy level diagram with the help of the band-gap structures of the ZnO and TiO2, potential of the free radicals like OH and O2 and HOMO-LUMO energy gap of the quinoline molecule. The proposed pathways of quinoline mineralization were suggested on the basis of the identified intermediates by the gas chromatograph-mass spectrometer analysis and scavenger study.

Foaming properties of custard apple pulp and mathematical modelling of foam mat drying.

Foaming of custard apple pulp was carried out using foaming agent and stabilizer for drying of pulp in thin layers. The effect of parameters was studied and optimization was performed using response surface methodology. The concentration of egg albumen (0-20%, w/w) as foaming agent with methyl cellulose (0.0-0.50%, w/w) as stabilizer were added for whipping time (5-25 min). The foam properties were influenced by concentration of foaming agent and whipping time. The desirable foaming properties (high foam expansion, lower foam density and high foam stability) was observed at 15% of egg albumen, 0.37% of methyl cellulose for a whipping time of 17.32 min. Dehydration of optimized foamed pulp was completed within 100-140 min for 60-75 °C temperatures at 2 mm thickness of pulp. Average effective diffusivities remained 2.01-9.67 × 10-08 m2/s and activation energy was 29.99 kJ/mol.

Mechanistic evaluation of heterocyclic aromatic compounds mineralization by a Cu doped ZnO photo-catalyst.

In this study, Cu doped ZnO photo-catalysts were used for the degradation of the heterocyclic compounds, pyridine and quinoline. Three ZnO based photo-catalysts with different amounts of Cu doping (1%, 5% and 10%) were synthesized by precipitation method. The characterization of the catalyst was done using field emission scanning electron microscopy (FE-SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD), Brunauer Emmett Teller (BET), diffuse reflectance spectroscopy (DRS) and photo-luminescence (PL) techniques. The band gaps of the pure ZnO, and 1%, 5% and 10% Cu doped ZnO photo-catalysts were found to be 3.27 eV, 3.21 eV, 3.17 eV and 2.91 eV, respectively. The effects of pH, photo-catalyst dose and irradiation time were studied. Under optimum conditions (5% Cu doped ZnO, dose of 1.2 g L-1 for pyridine and 1.6 g L-1 for quinoline, pH = 11 and time = 5 h), the maximum pyridine and quinoline mineralization efficiencies were found to be 92.4% and 74.3%, respectively. The mineralization process followed first-order kinetics. The in situ formation of singlet oxygen, hydroxyl radicals and superoxide radicals was confirmed by reactive oxygen species (ROS) scavenger studies. Catalyst reusability studies showed excellent mineralization up to four consecutive cycles. The enhanced photo-catalytic mechanism was studied by comparing the band structure with respect to the potential of highly reactive species (˙OH and O2˙-). A possible mineralization pathway was proposed on the basis of the intermediates detected by gas chromatography coupled with mass spectrometry (GC-MS) analysis.

Ventricular bigeminy in enteric fever.

Salmonella infection causes a wide range of intestinal and extraintestinal manifestations as well as a lifetime carrier state. Untreated patients may develop complications, which can be life-threatening. Electrocardiogram (ECG) changes are a common occurrence in enteric fever and may be helpful in predicting myocarditis. Common ECG changes are decreased amplitude of QRS complexes, QTc prolongation and right bundle branch block. Ventricular bigeminy in enteric fever is a rare phenomenon. We report its occurrence in a patient.

Assessment of genetic diversity and population structure in gladiolus (Gladiolus hybridus Hort.) by ISSR markers.

ISSR (Inter simple sequence repeat) markers were used to assess the genetic diversity and population structure in 53 indigenous and exotic genotypes of gladiolus (Gladiolus hybridus Hort.). Molecular markers analysis showed PIC ranges from 0.42 (ISSR 861) to 0.99 (ISSR 855, ISSR 856 and ISSR 889) with an average 0.812, marker index ranged from 0.99 (ISSR 889) to 9.26 (ISSR 851) with an average 4.66 and resolving power of the primers ranged from 0.03 (ISSR 889) to 11.58 (ISSR 861) with an average value 3.80. The dendrogram based UPGMA clustering showed that all the 53 genotypes grouped into three main clusters. Nei's gene diversity (Na) varied from 0.929 to 1.717, effective number of alleles (Ne) varied from 1.262 to 1.369, Shannon's information index (I) ranged from 0.251 to 0.359 and gene diversity (He) was in the range from 0.167 to 0.229. Population structure analysis revealed three groups in which 32 genotypes were admixture types.

Process kinetics on physico-chemical and peroxidase activity for different blanching methods of sweet corn.

Blanching was performed to inactivate the enzyme using microwave, steam and hot water blanching methods and effect on the enzymatic activity, chemical properties and physical properties of the sweet corn were studied. The effectiveness of each blanching process was evaluated by measuring the loss of peroxidase activity, which was lost after 60, 90 and 120 s with k-values 0.016, 0.024 and 0.028 s-1 following first order kinetics for microwave, steam and hot water blanching respectively. The total sugar, ascorbic acid, moisture content, kernel mass and geometric diameter changed from 8.40 to 6.30, 7.20 and 7.50 g/100 g; 7.15 to 5.70, 6.10 and 6.60 mg/100 g; 76 to 79.20, 78.20 and 75.30%; 0.47 to 0.53, 0.50 and 0.42 g; 8.00 to 8.50, 8.30 and 7.20 mm at optimum level of blanching during microwave, steam and hot water blanching respectively, indicating higher retention of total sugar and ascorbic acid in microwave blanching. The change in colour, especially increase in brownness was observed during blanching processes. The average R2 for zero-order model was 0.945, suggesting use of model for prediction of physico-chemical parameters during blanching process of sweet corn.

Terbinafine-induced liver injury.

Terbinafine is a common antifungal agent with few reports of liver injury. We present a 64-year-old man who developed terbinafine-induced liver injury. Drug-induced liver injury is an important cause of morbidity and an early diagnosis may prevent progression to severe and chronic forms of liver injury including fulminant hepatic failure.