Using HPLC-DAD and GC-MS Analysis Isolation and Identification of Anticandida Compounds from Gui Zhen Cao Herbs (Genus Bidens): An Important Chinese Medicinal Formulation.

Gui Zhen Cao is an herbal formulation that has been documented in Chinese traditional medicine as a remedy for diarrhea, dysentery, inflammation, and toxicity. The sources of this formulation (Bidens pilosa L., Bidens biternata (Lour.) Merr. & Sherff, Bidens bipinnata L.) are also listed in ethnomedicinal reports all over the world. In this study, all these plants are tested for in vitro anticandida activity. A quantitative evaluation of the phytochemicals in all these plants indicated that their vegetative parts are rich in tannins, saponins, oxalates, cyanogenic glycoside and lipids; moreover, the roots have high percentages of alkaloids, flavonoids, and phenols. The results indicated significant anticandida activity, especially for the hexane extract of B. bipinnata leaves which inhibited C. albicans (42.54%), C. glabrata (46.98%), C. tropicalis (50.89%), C. krusei (40.56%), and C. orthopsilosis (50.24%). The extract was subjected to silica gel chromatography and 220 fractions were obtained. Purification by High Performance Liquid Chromatography with Diode-Array Detection (HPLC-DAD) and Gas Chromatography tandem Mass Spectrometry (GC-MS/MS) analysis led to the identification of two anticandida compounds: dehydroabietic and linoleic acid having an inhibition of 85 and 92%, respectively.

Predictors of postpartum family planning uptake in Sindh and Punjab provinces of Pakistan.

OBJECTIVE: Combination of beneficiary and supply side factors for determining what influences Postpartum family planning use in Sindh and Punjab provinces of Pakistan. METHODS: A facility-based survey was conducted among 1690 married women of reproductive age (MWRA - i.e. married women between the ages of 15 and 49 years) visiting public facilities in six districts across Sindh and Punjab provinces of Pakistan. RESULTS: Half (53%) of the interviewed women used postpartum contraceptives. Participants who used PPFP were: 55% more likely to be from Punjab than Sindh, 39% more likely to be between 25 to 34 year of age than under 25 years. After adjusting for all variables in the model, women who delivered in the private sector remained to have lower odds of PPFP use compared to those who delivered in public facilities. Women who had four or more sons were nearly 20 time more likely to use PPFP compared to women with no sons, and the PPFP use increases with the number of sons. On the contrary, women who had four or more daughters were 16 times less likely to use PPFP compared with women with no daughters. CONCLUSIONS: Postpartum women are among those with the greatest unmet need as a result of a combination of beneficiary and supplier side factors. The health system's response to meet the contraceptive needs of postpartum women should work along the continuum of care from pregnancy to postpartum, with expanded method choice and alternative service delivery outlets.

Development and validation of a psychometric scale to assess attitude towards safe abortions in Pakistan.

Despite severe health and economic consequences that women face because of the negative attitude of healthcare providers towards safe abortion and post-abortion care (SA/PAC), no psychometric tool has yet been validated for assessing the attitude towards SA/PAC. Only a handful of studies have attempted to assess healthcare providers' attitude towards safe abortions in Pakistan. Therefore, this study aimed to develop and validate a psychometric scale to assess attitude towards safe abortions in Pakistan. The study collected data from 106 workers of an NGO that provides SA/PAC through an online and anonymous survey using the organisation's network. The study used factor analytic techniques and structural equation modelling to validate the factor structure and a final hierarchical model. A final scale of seven items relating to attitude towards elective abortions and moral attitude towards safe abortions was validated. The scales were highly reliable with both factors having reliability indicators greater than 0.7. The scale can be easily implemented to assess providers' attitude towards safe abortions. This will allow programmers to screen healthcare providers with a negative attitude, and evaluate the efficacy of their Value Clarification and Attitude Transformation (VCAT) programmes that are aimed at transforming providers' attitude towards safe abortions.

Effectiveness of community-based interpersonal communication for generating family planning demand in key groups.

OBJECTIVE: The study aimed to document the impact of interpersonal communication (IPC) activities on increasing volume of family planning clients, new users, long term contraceptive uptake, post-partum, and post abortion family planning uptake at the associated health facilities of the Sabz Sitara Network. METHODOLOGY: A comparative secondary analysis of retrospective programme service delivery data from two groups of providers was performed. The exposure variable is defined as receipt of IPC. The six outcome variables are volume of: family planning (FP) clients, FP clients less < 25 years, intra-uterine device (IUD) insertions, post-partum FP clients (PPFP), users, and post-abortion FP (PAFP) clients. RESULTS: The increase in client volume in IPC supported providers is significant for all the FP outcomes when adjusted for provider qualification and location. The adjusted model shows a significant increase of 10 more FP clients, 2 more youth clients and IUD insertions each, 3 more new users, and 1 more client for post abortion services. CONCLUSIONS: The IPC intervention has a positive and significant impact on increasing client volume for all related FP outcomes at the associated provider facilities. Location and qualification of providers seem to moderate the impact. Considering qualification, and geo-social demographics of the area to tweak intervention intensity and design will help amplify the associated beneficial outcomes and minimize underperformance. To maximize return on investment, subsequent evaluations should help determine the ideal time frame required to achieve and sustain the positive results.

Engaging with community-based public and private mid-level providers for promoting the use of modern contraceptive methods in rural Pakistan: results from two innovative birth spacing interventions.

BACKGROUND: Family planning (FP) interventions aimed at reducing population growth have negligible during the last two decades in Pakistan. Innovative FP interventions that help reduce the growing population burden are the need of the hour. Marie Stopes Society--Pakistan implemented an operational research project--'Evidence for Innovating to Save Lives', to explore effective and viable intervention models that can promote healthy timing and spacing of pregnancy in rural and under-served communities of Sindh, Punjab and Khyber Pakhtunkhwa provinces of Pakistan. METHODS: We conducted a quasi-experimental (pre- and post-intervention with control arm) study to assess the effectiveness of each of the two intervention models, (1) Suraj model (meaning 'Sun' in English), which uses social franchises (SF) along with a demand-side financing (DSF) approach using free vouchers, and (2) Community Midwife (CMW) model, in promoting the use of modern contraceptive methods compared to respective controls. Baseline and endline cross-sectional household surveys were conducted, 24 months apart, by recruiting 5566 and 6316 married women of reproductive age (MWRA) respectively. We used Stata version 8 to report the net effect of interventions on outcome indicators using difference-in-differences analysis. Multivariate Cox proportional hazard regression analysis was used to assess the net effect of the intervention on current contraceptive use, keeping time constant and adjusting for other variables in the model. RESULTS: The Suraj model was effective in significantly increasing awareness about FP methods among MWRA by 14% percentage points, current contraceptive use by 5% percentage points and long term modern method--intrauterine device (IUD) use by 6% percentage points. The CMW model significantly increased contraceptive awareness by 28% percentage points, ever use of contraceptives by 7% percentage points and, IUD use by 3% percentage points. Additionally the Suraj intervention led to a 35% greater prevalence (prevalence ratio: 1.35, 95% CI: 1.22-1.50) of contraceptive use among MWRA. CONCLUSION: Suraj intervention highlights the importance of embedding subsidized FP services within the communities of the beneficiaries. The outcomes of the CMW intervention also improved the use of long-term contraceptives. These findings indicate the necessity of designing and implementing FP initiatives involving local mid-level providers to expand contraceptive coverage in under-served areas.

Comparing effectiveness of two client follow-up approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC) among the underserved in rural Punjab, Pakistan: a study protocol and participants' profile.

BACKGROUND: Pakistan observes a very high i.e. 37 percent modern contraceptive method related discontinuation rates within 12 months of their initiation. And almost 10 percent of these episodes of discontinuation happened due to the side effects or health concerns experienced by the women. Most importantly, it was noted that more than 12,000 first-level care facilities are located in the rural areas, including rural health centers, basic health units, and family welfare centers, but more than 30% of these facilities are nonfunctional. This paper presents a study protocol and participants' profiling of a prospective cohort follow-up to compare the effectiveness of household based and telephonic approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC) whilst to facilitate lowering method related discontinuation and increasing switching amongst the contraceptive users. METHODS: A 12-month multi-centre, non-inferiority prospective user follow-up is employed using three different study categories: a) household based follow-up; b) telephonic follow-up; and c) passive or need-based follow-up along with the hypothetical assumption that the telephonic client follow-up is not inferior to the household based follow-up by continuation rate of LARC and the telephonic follow-up is less-costly than the household based client follow-up. This follow-up will be conducted in 22 health facilities - (16 rural and 6 urban based facilities) in district Chakwal. The first two study categories will receive scheduled but different follow-up from the field workers at 1, 3, 6, 9, and 12 month while the third one i.e. the 'passive or need-based follow-up' will serve as a control group. Using sampling software PASS 11, it was estimated to have 414 clients in each study category and around 1366 clients will be recruited to account for 10% attrition rate. DISCUSSION: The study will help us to examine a more convenient method of effective follow-up for managing side effects, decreasing method discontinuation and increasing switching amongst users. The study information will also facilitate to develop a robust, effective and efficient mechanism for client follow-up to promote the continuation rates of LARC methods. The follow-up results and lessons learnt will be widely shared with stakeholders for their implementation and streamlining in health system.

Assessing predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan: results of a cross-sectional baseline survey.

BACKGROUND: Although Pakistan was one of the first countries in Asia to launch national family planning programs, current modern contraceptive use stands at only 26% with a method mix skewed toward short-acting and permanent methods. As part of a multiyear operational research study, a baseline survey was conducted to understand the predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan. This paper presents the baseline survey results; the outcomes of the intervention will be presented in a separate paper after the study has been completed. METHOD: A cross-sectional baseline household survey was conducted with randomly selected 3,998 married women of reproductive age (MWRA) in the Chakwal, Mianwali, and Bhakkar districts of Punjab. The data were analyzed on SPSS 17.0 using simple descriptive and logistic regression. RESULTS: Most of the women had low socio-economic status and were younger than 30 years of age. Four-fifths of the women consulted private sector health facilities for reproductive health services; proximity, availability of services, and good reputation of the provider were the main predicators for choosing the facilities. Husbands were reported as the key decision maker regarding health-seeking and family planning uptake. Overall, the current contraceptive use ranged from 17% to 21% across the districts: condoms and female sterilization were widely used methods. Woman's age, husband's education, wealth quintiles, spousal communication, location of last delivery, and favorable attitude toward contraception have an association with current contraceptive use. Unmet need for contraception was 40.6%, 36.6%, and 31.9% in Chakwal, Mianwali, and Bhakkar, respectively. Notably, more than one fifth of the women across the districts expressed willingness to use quality, affordable long-term family planning services in the future. CONCLUSION: The baseline results highlight the need for quality, affordable long-term family planning services close to women's homes. Furthermore, targeted community mobilization and behavior change efforts can lead to increased awareness, acceptability, and use of family planning and birth spacing services.

Continuation rates and reasons for discontinuation of intra-uterine device in three provinces of Pakistan: results of a 24-month prospective client follow-up.

BACKGROUND: Long-acting reversible contraceptives, such as the intrauterine device (IUD), remain underutilised in Pakistan with high discontinuation rates. Based on a 24-month prospective client follow-up (nested within a larger quasi-experimental study), this paper presents the comparison of two intervention models, one using private mid-level providers branded as "Suraj" and the other using community midwives (CMWs) of Maternal Newborn and Child Health Programme, for method continuation among IUD users. Moreover, determinants of IUD continuation and the reasons for discontinuation, and switching behaviour were studied within each arm. METHODS: A total of 1,163 IUD users, 824 from Suraj and 339 from the CMW model, were enrolled in this 24-month prospective client follow-up. Participants were followed-up by female community mobilisers physically every second month to ascertain continued IUD usage and to collect information on associated factors, switching behaviour, reasons for discontinuation, and pregnancy occurrence. The probabilities of IUD continuation and the risk factors for discontinuation were estimated by life table analysis and Cox proportional-hazard techniques, respectively. RESULTS: The cumulative probabilities of IUD continuation at 24 months in Suraj and CMW models were 82% and 80%, respectively. The difference between the two intervention areas was not significant. The probability distributions of IUD continuation were also similar in both interventions (Log rank test: χ(2) = 0.06, df = 1, P = 0.81; Breslow test: χ(2) = 0.6, df = 1, P = 0.44). Health concerns (Suraj = 57.1%, CMW = 38.7%) and pregnancy desire (Suraj = 29.3%, CMW = 40.3%) were reported as the most prominent reasons for IUD discontinuation in both intervention arms. IUD discontinuation was significantly associated with place of residence in Suraj and with age (15-25 years) in the CMW model. CONCLUSION: CMWs and private providers are equally capable of providing quality IUD services and ensuring higher method continuation. Pakistan's National Maternal Newborn and Child Health programme should consider training CMWs and providing IUDs through them. Moreover, private sector mid-level providers could be engaged in promoting the use of IUDs.

A study protocol: using demand-side financing to meet the birth spacing needs of the underserved in Punjab Province in Pakistan.

BACKGROUND: High fertility rates, unwanted pregnancies, low modern contraceptive prevalence and a huge unmet need for contraception adversely affect women's health in Pakistan and this problem is compounded by limited access to reliable information and quality services regarding birth spacing especially in rural and underserved areas. This paper presents a study protocol that describes an evaluation of a demand-side financing (DSF) voucher approach which aims to increase the uptake of modern contraception among women of the lowest two wealth quintiles in Punjab Province, Pakistan. METHODS/DESIGN: This study will use quasi-experimental design with control arm and be implemented in: six government clinics from the Population Welfare Department; 24 social franchise facilities branded as 'Suraj' (Sun), led by Marie Stopes Society (a local non-governmental organization); and 12 private sector clinics in Chakwal, Mianwali and Bhakkar districts. The study respondents will be interviewed at baseline and endline subject to voluntary acceptance and medical eligibility. In addition, health service data will record each client visit during the study period. DISCUSSION: The study will examine the impact of vouchers in terms of increasing the uptake of modern contraception by engaging private and public sector service providers (mid-level and medical doctors). If found effective, this approach can be a viable solution to satisfying the current demand and meeting the unmet need for contraception, particularly among the poorest socio-economic group.

Beyond the norm: a rare presentation of dengue fever resulting in combined rhabdomyolysis and TMA-induced AKI-a case report.

Dengue is the most prevalent arthropod-transmitted infection worldwide. Its clinical presentation ranges from subclinical illness to multi-organ failure. Acute kidney injury (AKI) is one of its complications, having a number of different pathogeneses. The patient herein described presented with thrombotic microangiopathy (TMA) and rhabdomyolysis, a combination never previously reported in the literature. He was diagnosed with dengue at a primary care hospital, after which he was referred to us with fever and oliguria. His blood workup and kidney biopsy revealed a picture of combined TMA and rhabdomyolysis-induced AKI. He developed sepsis after his first session of plasmapheresis, that had to be discontinued and he was further managed with dialysis and supportive care. The patient showed remarkable recovery, regaining kidney function after one month.

Temperature-dependent heterojunction ternary nanocomposite: Assessing photocatalytic and antibacterial applications.

Heterojunction nanocomposites (ZnO:NiO:CuO) were synthesized via a hydrothermal method and annealed at three different temperatures (400 °C, 600 °C, and 800 °C). The structural, optical, and electrical properties were examined by employing XRD, SEM, UV-Vis, FTIR, and LCR meter techniques to investigate the effects of annealing. Increasing the annealing temperature resulted in the nanocomposites (NCPs) exhibiting enhanced crystallinity, purity, optical properties, and improved electrical and dielectric behavior. The calculated crystalline sizes (Debye-Scherrer method) of the NCPs were determined to be 21, 26 and 34 nm for annealing temperature 400 °C, 600 °C, and 800 °C, respectively. The calculated bandgaps of synthesized samples were found in the range of 2.92-2.55 eV. This temperature-dependent annealing process notably influenced particle size, morphology, band-gap characteristics, and photocatalytic efficiency. EDX analysis affirmed the sample purity, with elemental peaks of Zn, Cu, Ni, and O. These NCPs demonstrated exceptional photocatalytic activity against various dyes solutions (Methyl orange (MO), Methylene Blue (MB), and mixed solution of dyes) under sunlight and also showed good antibacterial properties assessed by the disc diffusion method. Notably, the nanocomposite annealed at 400 °C exhibited a particularly high degradation efficiency by degrading 96% MB and 91% MO in just 90 min under sunlight.

Impact of educational intervention on hypertension management by primary care physician: A randomized control trial.

Objective: The current study aimed to observe hypertension educational intervention's effect on general physicians (GPs) to improve blood pressure control and patient outcomes indirectly. Methods: This randomized control trial includes 42 GPs divided into 2 groups. GPs in group 1 receive face-to-face education with structured educational material on hypertension management strategies by a senior cardiologist. GPs in group 2 receive the print version of education material. The data was collected from six major cities in Pakistan. GPs with at least three years of experience in the broad primary care disciplines, with ages above 18 years, were included in the study. Results: A total of 42 physicians (21 from each group) completed questionnaires, while out of 420 hypertension patients, 105 newly diagnosed and already diagnosed patients enrolled under physicians of both groups. The educational material did just as well at informing clinicians as the face-to-face group intervention did and both the interventions had a significant effect on knowledge and BP control. Conclusion: After the 3-month follow-up, both interventions, including face-to-face and educational approaches, demonstrated significant effectiveness in improving knowledge and blood pressure control. Innovation: The study shows that hypertension educational intervention's effect on general physicians indirectly improves blood pressure control and patient outcomes. And emphasize for developing a hypertension educational program targeted at general physicians.

Fabrication of ternary metal oxide (ZnO:NiO:CuO) nanocomposite heterojunctions for enhanced photocatalytic and antibacterial applications.

In this article, ZnO:NiO:CuO nanocomposites (NCPs) were synthesized using a hydrothermal method, with different Zn : Ni : Cu molar ratios (1 : 1 : 1, 2 : 1 : 1, 1 : 2 : 1, and 1 : 1 : 1). The PXRD confirmed the formation of a NCP consisting of ZnO (hexagonal), NiO (cubic), and CuO (monoclinic) structures. The crystallite sizes of NCPs were calculated using Debye Scherrer and Williamson-Hall methods. The calculated crystalline sizes (Scherrer method) of the NCPs were determined to be 21, 27, 23, and 20 nm for the molar ratios 1 : 1 : 1, 2 : 1 : 1, 1 : 2 : 1, and 1 : 1 : 2, respectively. FTIR spectra confirmed the successful formation of heterojunction NCPs via the presence of metal-oxygen bonds. The UV-vis spectroscopy was used to calculate the bandgap of synthesized samples and was found in the range of 2.99-2.17 eV. SEM images showed the mixed morphology of NCPs i.e., irregular spherical and rod-like structures. The dielectric properties, including AC conductivity, dielectric constant, impedance, and dielectric loss parameters were measured using an LCR meter. The DC electrical measurements revealed that NCPs have a high electrical conductivity. All the NCPs were evaluated for the photocatalytic degradation of Methylene blue (MB), methyl orange (MO), and a mixture of both of these dyes. The NCPs with a molar ratio 1 : 1 : 2 (Zn : Ni : Cu) displayed outstanding photocatalytic activity under sunlight, achieving the degradation efficiency of 98% for methylene blue (MB), 92% for methyl orange (MO) and more than 87% in the case of a mixture of dyes within just 90 minutes of illumination. The antibacterial activity results showed the more noxious nature of NCPs against Gram-negative bacteria with a maximum zone of inhibition revealed by the NCPs of molar ratio 1 : 2 : 1 (Zn : Ni : Cu). On the basis of these observations, it can be anticipated that the NCPs can be successfully employed for the purification of contaminated water by the degradation of hazardous organic compounds and in antibacterial ointments.

Physical properties of multifunctional TM-doped ZnO nanorods and their photocatalytic and anti-bacterial activities.

Dilute magnetic semiconductor Zn1-xCuxO (x = 0, 1.5, 3.0, and 4.5%) nanorods were prepared by hydrothermal method. The impact of dopant concentration on the physical properties was investigated along with the anti-bacterial and photocatalytic activities. Synthesis of ZnO nanorods was confirmed by the characteristic band at 380 nm in UV-Visible spectra of the synthesized samples. A red shift in absorbance spectra was observed from 380 to 465 nm with an increase in dopant concentration. The hexagonal wurtzite geometry and rod-like morphology of Cu-doped ZnO nanorods having an average size of 29 nm were confirmed by X-ray diffraction analysis (XRD) and scanning electron microscopy (SEM), respectively. An increase in the crystallinity of the material was observed with an increase in the dopant (Cu) ratio without any alteration in geometry. EDX analysis was used to confirm the purity of samples. FTIR spectra were recorded to explore the functional group present in samples. The hysteresis loop drawn by a vibrating-sample magnetometer (VSM) was utilized to analyze the ferromagnetic behavior. As-synthesized pure and Cu-ZnO nanorods were evaluated for their photocatalytic behavior for the photodegradation of methyl orange (MO) dye. Zn1 - xCuxO with x = 4.5%, pH 3, and catalyst dosage of 0.5 g has shown the maximum efficiency. Results elucidated > 81% degradation of MO dye with a rate constant (k) value of - 1.930 × 10-2 min-1 in just 90 min of exposure to a visible light source. ZnO nanorods have also exhibited anti-bacterial potential against gram-positive and gram-negative strains of bacteria. However, smaller size nanorods were found more effective to suppress the growth of gram-negative bacteria. A slight decrease (11%) in catalytic potential was observed in the 5th cycle during recycling and reuse experiments.

Rates of IUCD discontinuation and its associated factors among the clients of a social franchising network in Pakistan.

BACKGROUND: Modern Intrauterine contraceptive device (IUCD) is very safe, highly effective reversible and inexpensive family planning method which offers 5-10 years of protection against pregnancy. The contraceptive use in Pakistan has been merely 30% for over a decade with IUCD being the least used method. Higher discontinuation rates are documented in developing countries; however no such data is available for Pakistan. Marie Stopes Society (MSS) established a social franchise outlets network branded as 'SURAJ' (Sun) in Pakistan to provide quality family planning services. This study attempts to determine IUCD discontinuation rates and its associated risk factors. Using a semi-structured questionnaire, a cross-sectional study was conducted with 3000 clients who availed IUCD services from Suraj provider 6, 12 and 24 month back,. Data were analyzed in SPSS 17.0; adjusted prevalence ratios were calculated to see associations between discontinuation and its risk factors. CASE PRESENTATION: We found that 22.7% of the IUCD acceptors experienced some health problem; while the overall discontinuation rate was 18.9% with average time of usage of 7.4 (SD ± 5.8) months before discontinuation. Half of them showed health concerns (49.8%); of which a majority (70.2%) returned to Suraj provider for IUCD removal. Women living in Punjab, residing at a travelling time of 30-60 minutes and no previous use of contraceptive are more likely to discontinue IUCD. However, among total women 81.7% still expressed willingness to avail IUCD services from Suraj provider in future, if needed. CONCLUSION: The findings suggest a need for training the providers and field workers to prevent early discontinuation of IUCD among the Suraj clients and by addressing the health concerns through proper counseling, continued follow-up and immediate medical aid/referral in case of complications.

Xanthone C-glycosides isomers purified from Dryopteris ramosa (Hope) C. Chr. with bactericidal and cytotoxic prospects.

Xanthones C-glycosides are plants secondary metabolites with diverse biological activities. Among the C-glycoside xanthones, the mangiferin (MF) is of widespread occurrence in plants while isomangiferin (IsoMF) is not very common. For the present study mangiferin (MF) and isomangiferin (IsoMF) were isolated from Dryopteris ramosa. The antibacterial potential of MF and IsoMF was evaluated by using agar well diffusion method while cytotoxic properties of MF and IsoMF were assessed by brine shrimp lethality test (BSLT). The antibacterial potential of MF and IsoMF increases in dose dependent manner. The minimum inhibitory concentration (MIC) indicated strong antibacterial potential of MF against Salmonella setubal (125 µg/mL) and Bacillus subtilis (125 µg/mL) while MF showed weak antibacterial potential against Escherichia coli (500 µg/mL). On the other hand the IsoMF showed better antibacterial potential against all the tested strain including Escherichia coli (MIC = 250 µg/mL). The MF and IsoMF showed poor cytotoxicity towards Brine shrimp nauplii as indicated by their LD50 (969.77 ± 0.67 and 768.92 ± 0.81 µg/mL respectively). The present study has highlighted the antibacterial potential of MF and IsoMF. Further evaluation of these two isomeric compounds may prove to be the future remedies for various bacterial infections and other human ailments.

Correction: Ishaque et al. Iriflophenone-3-C-ß-d Glucopyranoside from Dryopteris ramosa (Hope) C. Chr. with Promising Future as Natural Antibiotic for Gastrointestinal Tract Infections. Antibiotics 2021, 10, 1128.

At the request of Dr. Markus Bacher, Dr. Johann Schinnerl, and Dr. Karin Valant-Vetschera, they have been removed as authors of the paper [...].

Outcome of Post-intubation Tracheal Stenosis (PITS) with Primary Resection and Anastomosis.

OBJECTIVE: To ascertain the outcome of primary resection anastomosis in patients of post-intubation tracheal stenosis (PITS) and the associated morbidity. STUDY DESIGN: A case series. PLACE AND DURATION OF STUDY: Department of Thoracic Surgery, Combined Military Hospital, (CMH) Rawalpindi, Lahore and Multan from January 2010 to August 2018. METHODOLOGY: Patients with tracheal stenosis due to prolonged intubation with functional were included. Exclusion criteria were patients having stenosis due to malignant cause, trauma and glottic stenosis involving vocal cords. Clinical examination, computerised tomography (CT) of neck plus chest and fiberoptic bronchoscopy were done in all the patients, while virtual bronchoscopy were done in 35 cases. Sharp dissection, aided by loupes, was the preferred technique. Thyroid tissue and strap muscle were used as flap for high cricoid lesion. Guardian stitch was applied to all cases. Postoperative elective bronchoscopy was performed after a fortnight. RESULTS: Among 43 patients, [26 (60.5%) men and 17 (39.5) women] 18 patients were intubated for days >10 ,18 for <10 and 7 for <3 days. Thirty-four (79.1%) patients were under 40 years of age, while 23 patients had tracheostomy incorporated in surgery. Bronchoscopy evaluation of distance from vocal cords showed involvement of the first ring in six patients, 1st ring normal in 1, 2 rings normal in 17, while 3 or more rings spared in 19 patients. Length of stenotic segment was <2 cm in 17, between 2-3 cm in 21, and between 3-5 cm in five patients. All patients were successfully extubated. Two patients had twin lesions. Seven patients required hyoid bone excision and release. There was one recurrent stenosis managed successfully with dilatation and granulation removal. CONCLUSION: Post-intubation tracheal stenosis (PITS) is curable disease. Primary resection and anastomosis remain the gold standard with acceptable morbidity and mortality. Key Words: Tracheal stenosis, Intubation, Resection, Primary anastomosis.

Pharmacological properties and preliminary phytochemical analysis of Pseudocaryopteris foetida (D.Don) P.D. Cantino leaves.

Medicinal plants have significant contribution in pharmaceutical industries being producers of compounds utilized as precursors for drug development. A plant of Lamiaceae family; Pseudocaryopteris foetida had not been investigated for its biomedical potential. Current research was aimed to investigate phytochemical analysis, cytotoxic potential and antioxidant activity of crude methanolic extract and fractions of Pseudocaryopteris foetida (leaves). The preliminary phytochemical analysis of crude methanolic extracts and fractions of Pseudocaryopteris foetida revealed that plant is rich in phenolic and flavonoid classes of secondary metabolites while presence of tannin was observed only in crude methanolic extract. The cytotoxicity was determined using brine shrimp lethality test. Different concentrations (25, 50, 100, 150, 200 and 250 µg/mL) of crude methanolic extract and fractions exhibited dose dependent cytotoxicity. However, The LD50 for all the extracts was more than 200 µg/mL indicating weak cytotoxic potential of Pseudocaryopteris foetida. The antioxidant capabilities of crude methanolic extract and fraction of Pseudocaryopteris foetida were analyzed by in vitro bio assays including DPPH, ABTS, Reducing power and phosphomolybdate antioxidant assays using ascorbic acid as standard. The crude methanolic extract showed IC50 (256.38 ± 0.6 and 314.95 ± 1.1 µg/mL) for DPPH and ABTS respectively, while total antioxidant capacity was calculated as 55.79 ± 0.5 µg/mL for crude methanolic extract of Pseudocaryopteris foetida while ascorbic acid indicated total antioxidant capacity of 71.89 ± 2.3 µg/mL. Study concluded that leaves of Pseudocaryopteris foetida were the rich source of antioxidant phytochemicals. Based on preliminary investigations further research should be focused to isolate bioactive phytochemicals as leading source of clinical medicines in future.

Iriflophenone-3-C-ß-d Glucopyranoside from Dryopteris ramosa (Hope) C. Chr. with Promising Future as Natural Antibiotic for Gastrointestinal Tract Infections.

Ethnopharmacological approaches provide clues for the search of bioactive compounds. Dryopteris ramosa (Hope) C. Chr. (plant family: Dryopteridaceae) is an ethnomedicinal plant of the Galliyat region of Pakistan. The aqueous fraction (AqF) of D. ramosa is being used by inhabitants of the Galliyat region of Pakistan to treat their gastrointestinal tract ailments, especially those caused by bacteria. The aims of the present study were as follows: (i) to justify the ethnomedicinal uses of the AqF of D. ramosa; (ii) to isolate a bioactive compound from the AqF of D. ramosa; and (iii) to evaluate the antibacterial and cytotoxic potential of the isolated compound. Column chromatography (CC) techniques were used for the isolation studies. Spectroscopic techniques (UV-Vis, MS, 1&2D NMR) were used for structural elucidation. The agar-well diffusion method was used to evaluate the antibacterial potential of "i3CßDGP" against five bacterial strains, and compare it with the known antibiotic "Cefixime". The brine shrimp lethality test (BSLT) was used for cytotoxic studies. The AqF of D. ramosa afforded "iriflophenone-3-C-ß-D glucopyranoside (i3CßDGP)" when subjected to LH20 Sephadex, followed by MPLC silica gel60, and purified by preparative TLC. The "i3CßDGP" showed a strong potential (MIC = 31.1 ± 7.2, 62.5 ± 7.2, and 62.5 ± 7.2 µg/mL) against Klebsiella pneumoniae, Staphylococcus aureus, and Escherichia coli, respectively. On the other hand, the least antibacterial potential was shown by "i3CßDGP" (MIC = 125 ± 7.2 µg/mL), against Bacillus subtilis, in comparison to Cefixime (MIC = 62.5 ± 7.2 µg/mL). The cytotoxicity of "i3CßDGP" was significantly low (LD50 = 10.037 ± 2.8 µg/mL) against Artemia salina nauplii. This study not only justified the ethnomedicinal use of D. ramosa, but also highlighted the importance of ethnomedicinal knowledge. Further studies on AqF and other fractions of D. ramosa are in progress.