Rationale: Salmonella (S.) typhi is a rare cause of osteomyelitis in immunocompetent adults. Extensive drug resistance (XDR) may lead to more complicated cases of S. typhi osteomyelitis. Patient concern: A 55-year-old female presented with a persistent low-grade fever and a swelling on her lower left chest with a sinus discharging purulent fluid for the past 8 months. Her symptoms had been unresponsive to previous anti-microbial therapy. Diagnosis: Rib osteomyelitis caused by XDR S. typhi. Interventions: Surgical wound debridement, left 7th-9th rib resection and intravenous IV meropenem were done. Outcome: Fever resolved and left-sided swelling resected without recurrence. Lessons: The prevalence of XDR S. typhi is growing in South Asia and should be considered as the differential diagnosis of chronic osteomyelitis.

Spinal cord injuries are debilitating and life threatening. Paraplegia due to direct traumatic gunshot injury to the spinal cord is common. The most common cause of spinal cord injury is road traffic accidents. This is followed by spinal cord injury due to a fall from a height. Most of the spinal cord injuries due to gunshot wounds occur as a result of direct traumatic effects. We present a rare case of a 49-year-old male with trauma. He developed paraplegia after a gunshot wound injury to the neck and contusion to the spinal cord, with no direct trauma. Paraplegia due to direct gunshot injury can have many different outcomes. In our case, the patient was managed conservatively, and the outcome was favorable.
Accidents, Traffic ; Contusions ; Humans ; Male ; Middle Aged ; Neck ; Paraplegia* ; Spinal Cord Injuries* ; Spinal Cord* ; Wounds, Gunshot

Our recent studies have shown that co-activation of Gq and Gi proteins by 5-hydroxytryptamine (5-HT) and adrenaline show synergism in human platelet aggregation. This study was conducted to examine the mechanism(s) of synergistic interaction of 5-HT and platelet activating factor (PAF) in human platelets. We show that PAF, but not 5-HT, increased platelet aggregation in a concentration-dependent manner. However, low concentrations of 5-HT (2 microM) potentiated platelet aggregation induced by subthreshold concentration of PAF (40 nM) indicating a synergistic interaction between the two agonists and this synergism was blocked by receptor antagonists to either 5-HT or PAF. 5-HT also potentiated the effect of PAF on thromboxane A2 (TXA2) formation and phosphorylation of extracellularly regulated mitogen-activated protein kinases (ERK1/2). The synergism of 5-HT and PAF in platelet aggregation was inhibited by calcium (Ca2+) channel blockers, verapamil and diltiazem, phospholipase C (PLC) inhibitor, U73122, cyclooxygenase (COX) inhibitor, indomethacin, and MEK inhibitor, PD98059. These data suggest that synergistic effect of 5-HT and PAF on human platelet aggregation involves activation of PLC/Ca2+, COX and MAP kinase pathways.
Diltiazem/pharmacology ; Dose-Response Relationship, Drug ; Drug Synergism ; Estrenes/pharmacology ; Flavones/pharmacology ; Human ; In Vitro ; Indomethacin/pharmacology ; Kinetics ; Mitogen-Activated Protein Kinases/metabolism ; Phosphorylation/drug effects ; Platelet Activating Factor/*pharmacology ; Platelet Activation/drug effects ; Platelet Aggregation/*drug effects/physiology ; Pyrrolidinones/pharmacology ; Serotonin/*pharmacology ; Thromboxane A2/biosynthesis ; Verapamil/pharmacology

Our recent studies have shown that co-activation of Gq and Gi proteins by 5-hydroxytryptamine (5-HT) and adrenaline show synergism in human platelet aggregation. This study was conducted to examine the mechanism(s) of synergistic interaction of 5-HT and platelet activating factor (PAF) in human platelets. We show that PAF, but not 5-HT, increased platelet aggregation in a concentration-dependent manner. However, low concentrations of 5-HT (2 microM) potentiated platelet aggregation induced by subthreshold concentration of PAF (40 nM) indicating a synergistic interaction between the two agonists and this synergism was blocked by receptor antagonists to either 5-HT or PAF. 5-HT also potentiated the effect of PAF on thromboxane A2 (TXA2) formation and phosphorylation of extracellularly regulated mitogen-activated protein kinases (ERK1/2). The synergism of 5-HT and PAF in platelet aggregation was inhibited by calcium (Ca2+) channel blockers, verapamil and diltiazem, phospholipase C (PLC) inhibitor, U73122, cyclooxygenase (COX) inhibitor, indomethacin, and MEK inhibitor, PD98059. These data suggest that synergistic effect of 5-HT and PAF on human platelet aggregation involves activation of PLC/Ca2+, COX and MAP kinase pathways.
Diltiazem/pharmacology ; Dose-Response Relationship, Drug ; Drug Synergism ; Estrenes/pharmacology ; Flavones/pharmacology ; Human ; In Vitro ; Indomethacin/pharmacology ; Kinetics ; Mitogen-Activated Protein Kinases/metabolism ; Phosphorylation/drug effects ; Platelet Activating Factor/*pharmacology ; Platelet Activation/drug effects ; Platelet Aggregation/*drug effects/physiology ; Pyrrolidinones/pharmacology ; Serotonin/*pharmacology ; Thromboxane A2/biosynthesis ; Verapamil/pharmacology

PURPOSE: This study aimed to evaluate the effect of incorporating zirconium oxide nanoparticles (nano-ZrO 2 ) in polymethylmethacrylate (PMMA) denture base resin on flexural properties at different material thicknesses. MATERIALS AND METHODS: Heat polymerized acrylic resin specimens (N = 120) were fabricated and divided into 4 groups according to denture base thickness (2.5 mm, 2.0 mm, 1.5 mm, 1.0 mm). Each group was subdivided into 3 subgroups (n = 10) according to nano-ZrO2 concentration (0%, 2.5%, and 5%). Flexural strength and elastic modulus were evaluated using a three-point bending test. One-way ANOVA, Tukey’s post hoc, and two-way ANOVA were used for data analysis (α = .05). Scanning electron microscopy (SEM) was used for fracture surface analysis and nanoparticles distributions. RESULTS: Groups with 0% nano-ZrO2 showed no significant difference in the flexural strength as thickness decreased (P = .153). The addition of nano-zirconia significantly increased the flexural strength (P < .001). The highest value was with 5% nano-ZrO2 and 2 mm-thickness (125.4± 18.3 MPa), followed by 5% nano-ZrO2 and 1.5 mm-thickness (110.3 ± 8.5 MPa). Moreover, the effect of various concentration levels on elastic modulus was statistically significant for 2 mm thickness (P = .001), but the combined effect of thickness and concentration on elastic modulus was insignificant (P = .10). CONCLUSION Reinforcement of denture base material with nano-ZrO2 significantly increased flexural strength and modulus of elasticity. Reducing material thickness did not decrease flexural strength when nano-ZrO2 was incorporated. In clinical practice, when low thickness of denture base material is indicated, PMMAano-ZrO2 could be used with minimum acceptable thickness of 1.5 mm.

PURPOSE: This study aimed to evaluate the effect of incorporating zirconium oxide nanoparticles (nano-ZrO 2 ) in polymethylmethacrylate (PMMA) denture base resin on flexural properties at different material thicknesses. MATERIALS AND METHODS: Heat polymerized acrylic resin specimens (N = 120) were fabricated and divided into 4 groups according to denture base thickness (2.5 mm, 2.0 mm, 1.5 mm, 1.0 mm). Each group was subdivided into 3 subgroups (n = 10) according to nano-ZrO2 concentration (0%, 2.5%, and 5%). Flexural strength and elastic modulus were evaluated using a three-point bending test. One-way ANOVA, Tukey’s post hoc, and two-way ANOVA were used for data analysis (α = .05). Scanning electron microscopy (SEM) was used for fracture surface analysis and nanoparticles distributions. RESULTS: Groups with 0% nano-ZrO2 showed no significant difference in the flexural strength as thickness decreased (P = .153). The addition of nano-zirconia significantly increased the flexural strength (P < .001). The highest value was with 5% nano-ZrO2 and 2 mm-thickness (125.4± 18.3 MPa), followed by 5% nano-ZrO2 and 1.5 mm-thickness (110.3 ± 8.5 MPa). Moreover, the effect of various concentration levels on elastic modulus was statistically significant for 2 mm thickness (P = .001), but the combined effect of thickness and concentration on elastic modulus was insignificant (P = .10). CONCLUSION Reinforcement of denture base material with nano-ZrO2 significantly increased flexural strength and modulus of elasticity. Reducing material thickness did not decrease flexural strength when nano-ZrO2 was incorporated. In clinical practice, when low thickness of denture base material is indicated, PMMAano-ZrO2 could be used with minimum acceptable thickness of 1.5 mm.

A multi-centred study was designed to collect dengue epidemiologic data from government and registered private hospitals/clinics and maintained archive of frozen specimens in bio-bank to be used for future dengue epidemic control program, and assess the epidemiology of dengue fever (DF) by evaluating biochemical and oxidative status of patients. ELISA IgM antibodies test was done to confirm DF. From August 2010 to December 2011, 101 confirmed blood samples of DF patients referred to pathology lab of Jinnah Hospital Lahore were subjected to the epidemiologic assessment by evaluating the biochemical and physiological indices and alterations of circulating antioxidants. Clinical features of DF patients and effect of fever on blood components and serum proteins of liver were recorded. The hospital stay in DF, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) showed significant difference. Significant increases in serum alanine amino transferase (ALT) (P=0.000), aspartate amino transferase (AST) (P=0.000), alkaline phosphatase (ALP) (P=0.000), malondialdehyde (MDA) along with significant decreases in total protein (TP) (P=0.000), reduced glutathione (GSH) (P=0.000), superoxide dismutase (SOD), catalase (CAT) (P=0.000), and sialic acid contents (P=0.016) were observed. A positive correlation existed between bound sialic acid levels, liver enzymes and circulating antioxidants (r=0.656, P=0.016). In the present study, alterations of circulating antioxidants in DF suggest that DF might be a metabolic response to an acute, self-limiting tropical viral infection, and a consequence of the viral inflammatory process.
Adult ; Antioxidants ; metabolism ; Biomarkers ; blood ; China ; Dengue ; classification ; diagnosis ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Immunoglobulin M ; metabolism ; Male ; Middle Aged ; Young Adult

Three new alkyl substituted anthraquinone derivatives, trivially named as symploquinones A-C (Compounds 1-3) were isolated from Symplocos racemosa. The structures of these compounds were determined on the basis of extensive spectroscopic analyses (UV, IR, Mass, H- and C-NMR, and two-dimensional (2D) NMR techniques). The resulting data were also compared with the reported literature. These compounds were then subjected to antibacterial or antibiofilm testing. Compounds 1 and 3 exhibited good antibacterial activity in the concentration range of 160-83 μg·mL against Streptococcus mutans, methicillin resistant Staphylococcus aureus and Proteus mirabilis. Both compounds were further screened for anti-biofilm activity, which revealed promising activities at sub-MIC concentrations. None of the compounds were found to be active against Klebsiella pneumoniae.
Anthraquinones ; chemistry ; isolation & purification ; pharmacology ; Anti-Bacterial Agents ; chemistry ; isolation & purification ; pharmacology ; Biofilms ; drug effects ; growth & development ; Ericales ; chemistry ; Magnetic Resonance Spectroscopy ; Mass Spectrometry ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; physiology ; Microbial Sensitivity Tests ; Proteus mirabilis ; drug effects ; physiology ; Spectrophotometry, Infrared ; Streptococcus mutans ; drug effects ; physiology