Objective: The present study is an attempt to explore the anti-inflammatory activity of n-Hexane extract (HS), Ethyl acetate extract (EAS) and Residual ethanolic extract (RES) of fruits of Sida tiagii Bhandari by using carrageenan and egg-albumin induced paw edema, xylene induced ear edema and cotton wool granuloma animal models. Methods: The biochemical markers like or lysosomal enzymes viz. serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT) and alkaline phosphatase (ALP) were also found out in blood serum. Results:There was decrease in edema volume in EAS and RES administered animals in carrageenan and egg-albumin induced edema models. The percentage inhibition of inflammation in EAS (34.15%) and RES (39.66%) was found comparable with that of the standard drug, diclophenac sodium (46.69%). The two extracts EAS and RES was found to have good anti-inflammatory activity as compared to standard drug. Conclusions: Thus the plant can be used as a potential anti-inflammatory candidate in animals.

Background: Tenofovir (TDF) has been associated with renal function deterioration, but local data regarding the incidence and risk factors for this adverse event were lacking. Objectives: To determine the incidence of nephrotoxicity in HIV-infected patients on tenofovir-based regimens and to evaluate risk factors involved in tenofovir-associated renal function decline. Methods: This is a single-centre retrospective cohort study of 440 HIV-infected adults who were started on tenofovirbased antiretroviral regimens. Data were extracted from electronic medical and pharmacy records. Results: A decline in eGFR of 25% or more was seen in 67 patients (15.2%) with an estimated incidence rate of 12 per 100 person-years. Among all 440 subjects, 22 discontinued TDF-based therapy due to renal complication. From multivariate analysis, the odds of developing >25% decrease in eGFR with tenofovir-containing regimen was three times higher for patients with baseline moderate renal impairment (HR 3.19; 95% CI, 1.43-7.12; p=0.005) and 14 times higher for patients with baseline severe renal impairment (HR 14.2; 95% CI, 11.20-170.7; p=0.036) as compared to those without pre-existing renal insufficiency. Age above 50 years and CD4 cell count of less than 50 were significantly associated with >25% decrement in eGFR. Conclusion: The incidence rate of tenofovir-related renal dysfunction was found to be 12 per 100 person-years. Preexisting renal impairment, age 50 and above, and CD4 cell count below 50 as were predictors for renal function decline. Given that the use of tenofovir is escalating in Malaysia, increased awareness about this adverse event is essential.

Cockayne's syndrome (CS) is a rare, autosomal recessive disease resembling progeria. The features of CS do not appear until 4 to 5 years of age. Most patient presents with cachectic dwarfism, cutaneous photosensitivity, loss of adipose tissue, mental retardation, skeletal and neurological abnormalities, similar to the current case. The additional feature observed in the present case was actinic chelitis. We report a case of Cockayne‟s syndrome with pronounced oral manifestations and an unusual feature of actinic chelitis.

To investigate the hepatoprotective efficacy of 6-gingerol against acetaminophen-induced hepatotoxicity in mice.

Pantoprazole sodium, a substituted benzimidazole derivative, is an irreversible proton pump inhibitor which is primarily used for the treatment of duodenal ulcers, gastric ulcers, and gastroesophageal reflux disease (GERD). The monographs of European Pharmacopoeia (Ph. Eur.) and United States Pharmaco-poeia (USP) specify six impurities, viz.; impurities A, B, C, D, E and F, respectively for its active phar-maceutical ingredient (API). The identification and synthesis of all impurities except impurity E are well described in the literature; however, there is no report related to impurity E. The prospects to the for-mation and controlling of impurity E up to ≤0.03％ in the synthesis of pantoprazole sodium sesquihydrate (PAN) were discussed in detail for the first time. The present work described the journey towards the successful development of an optimal preparation procedure of dimer impurity E. The most plausible mechanism involved in the formation of impurity E has been proposed.

BACKGROUND: Fentanyl-induced cough (FIC) has a reported incidence of 13–65% on induction of anesthesia. Incentive spirometry (IS) creates forceful inspiration, while stretching pulmonary receptors. We postulated that spirometry just before the fentanyl (F) bolus would decrease the incidence and severity of FIC. METHODS: This study enrolled 200 patients aged 18–60 years and with American Society of Anesthesiologists status I or II. The patients were allocated to two groups of 100 patients each depending on whether they received preoperative incentive spirometry before fentanyl administration. Patients in the F+IS group performed incentive spirometry 10 times just before an intravenous bolus of 3 µg/kg fentanyl in the operating room. The onset time and number of coughs after fentanyl injection were recorded as primary outcomes. Any significant changes in blood pressure, heart rate, or adverse effects of the drug were recorded as secondary outcomes. RESULTS: Patients in the F+IS group had a significantly lower incidence of FIC than in the F group (6% vs. 26%) (P < 0.05). The severity of cough in the F+IS group was also significantly lower than that in group F (mild, 5 vs. 17; moderate 1 vs. 7; severe, 0 vs. 2) (P < 0.05). The median onset time was comparable in both groups (9 s [range: 6–12 s] in both groups). CONCLUSIONS: Preoperative incentive spirometry significantly reduces the incidence and severity of FIC when performed just before fentanyl administration.
Anesthesia ; Blood Pressure ; Cough* ; Fentanyl ; Heart Rate ; Humans ; Incidence ; Motivation* ; Operating Rooms ; Prospective Studies* ; Spirometry*

Paraspinal abscess and spondylodiscitis due to Citrobacter koseri is a very rare condition. We report a remarkable case of Citrobacter koseri bacteraemia complicated by paraspinal abscess and spondylodiscitis in a patient who has successfully been treated in our hospital. Our patient demonstrates one of the common challenges in the practice of infectious disease medicine, wherein an innocuous presentation may and often underlie a serious infection. This case report elucidates to us that the diagnosis of a paraspinal abscess and spondylodiscitis requires a high index of suspicion in at risk patient presenting with compatible signs and symptoms.

Alzheimer disease (AD) is a chronic, progressive brain disorder that slowly destroys affected individuals’ memory and reasoning faculties, and consequently, their ability to perform the simplest tasks. This study investigated the hub genes of AD. Proteins interact with other proteins and non-protein molecules, and these interactions play an important role in understanding protein function. Computational methods are useful for understanding biological problems, in particular, network analyses of protein-protein interactions. Through a protein network analysis, we identified the following top 10 hub genes associated with AD: PTGER3, C3AR1, NPY, ADCY2, CXCL12, CCR5, MTNR1A, CNR2, GRM2, and CXCL8. Through gene enrichment, it was identified that most gene functions could be classified as integral to the plasma membrane, G-protein coupled receptor activity, and cell communication under gene ontology, as well as involvement in signal transduction pathways. Based on the convergent functional genomics ranking, the prioritized genes were NPY, CXCL12, CCR5, and CNR2.

Alzheimer disease (AD) is a chronic, progressive brain disorder that slowly destroys affected individuals’ memory and reasoning faculties, and consequently, their ability to perform the simplest tasks. This study investigated the hub genes of AD. Proteins interact with other proteins and non-protein molecules, and these interactions play an important role in understanding protein function. Computational methods are useful for understanding biological problems, in particular, network analyses of protein-protein interactions. Through a protein network analysis, we identified the following top 10 hub genes associated with AD: PTGER3, C3AR1, NPY, ADCY2, CXCL12, CCR5, MTNR1A, CNR2, GRM2, and CXCL8. Through gene enrichment, it was identified that most gene functions could be classified as integral to the plasma membrane, G-protein coupled receptor activity, and cell communication under gene ontology, as well as involvement in signal transduction pathways. Based on the convergent functional genomics ranking, the prioritized genes were NPY, CXCL12, CCR5, and CNR2.

Klebsiella pneumoniae is a gram-negative bacterium that is known for causing infection innosocomial settings. As reported by the World Health Organization, carbapenem-resistantEnterobacteriaceae, a category that includes K. pneumoniae, are classified as an urgentthreat, and the greatest concern is that these bacterial pathogens may acquire genetictraits that make them resistant towards antibiotics. The last class of antibiotics, carbapenems, are not able to combat these bacterial pathogens, allowing them to clonally expandantibiotic-resistant strains. Most antibiotics target essential pathways of bacterial cells;however, these targets are no longer susceptible to antibiotics. Hence, in our study, we focused on a hypothetical protein in K. pneumoniae that contains a DNA methylation proteindomain, suggesting a new potential site as a drug target. DNA methylation regulates theattenuation of bacterial virulence. We integrated computational-aided drug design by using a bioinformatics approach to perform subtractive genomics, virtual screening, and fingerprint similarity search. We identified a new potential drug, koenimbine, which could bea novel antibiotic.