Cytotoxic and microbial studies of mixed metal complexes

Breast cancer and its treatment have become a prominent and challenging problem today. The increasing multidrug resistance to microbial pathogens is the root cause of breast cancer. Women suffering from cancer showed high levels of E. coli and S. aureus. In the last few decades, there has been a considerable need in the medical field for the discovery of new compounds endowed with antimicrobial activity, despite the fact that several antibiotics and chemotherapy drugs are currently accessible. Substantial research was conducted, particularly on transition complexes as metal-based drugs in pharmacological applications to provide therapeutic options. The synthesis, characterization, antibacterial activity, and cytotoxic activity of copper complexes with specific ligands of amino acids such as tyrosine and arginine are discussed in this work.

A Primer on Interoception and its Importance in Psychiatry

Interoception is the perception of signals from inside the body. It plays a significant role in the nervous, cardiovascular, respiratory, gastrointestinal, genitourinary, and endocrine systems. It is also closely related to the autonomic nervous system and inflammatory pathways and plays a significant role in our optimal functioning. Recently, interoception has gained more attention in neuropsychiatric research. Anatomical and physiological aspects of interoception like relevant brain areas, the role of the vagus nerve, and the autonomic nervous system are gradually being understood. Different facets of interoception like interoceptive attention, detection, magnitude, discrimination, accuracy, awareness, and appraisal have been proposed and their assessments and importance are being evaluated. Further, interoception is often dysregulated or abnormal in psychiatric disorders. It has been implicated in the psychopathology, etiopathogenesis, clinical features and treatment of mood, anxiety, psychotic, personality and addiction-related disorders. This narrative review attempts to provide a nuanced understanding of the pathway(s), components, functions, assessments, and problems of interoception and will help us to detect its disturbances and evaluate its impact on psychiatric disorders, leading to a better perspective and management. This will also advance interoception-related research.

Prevalence of Food Addiction among People with Diabetes in an Urban Health Center (Ketagihan Makanan di Kalangan Pesakit Diabetes di Klinik Kesihatan Kawasan Bandar) / Jurnal Sains Kesihatan Malaysia

@#Food Addiction (FA) is a concept of dependence on substance related to the consumption of palatable foods high in fat, sugar, and salt. This dependence may influence dietary modification advice as dietary modification is an essential component in managing people with diabetes. The objective of this study is to determine the prevalence of FA among people with diabetes. A cross-sectional study was conducted between June and August 2021 at Klinik Primer, Pusat Perubatan Universiti Kebangsaan Malaysia (Cheras, Kuala Lumpur) involving 142 people with diabetes. FA was assessed using the validated Bahasa Melayu version of Yale Food Addiction Scale 2.0. The median age of participants was 58 years (IQR=10), and the majority (88%, n=125) of them were above the age of 45 years. A large majority) had central obesity (90.1%, n=128) and were overweight and obese (91%, n=129). The median duration of diabetes was 10 years (IQR=11) with more than two-thirds (63.4%, n=90) of them having diabetes for more than 5 years. Majority (73.9%, n=105) also had poor glucose control with median HbA1c level of 7.5% (IQR =2). Our study found that the prevalence of FA among people with T2DM was low (2.8%, n=4). This could be because the participants were mostly from the older age group with long standing disease. These two features may have influenced their eating behaviour, becoming more compliant and adapted to diabetic diet advice received over the long duration of the condition. A similar study among young diabetics and those with new onset disease may better reflect FA among this group of people.

Derivative 6 as an additional chromosomal abnormality along with t(15;17): A case report

Acute promyelocytic leukemia (APL) is a type of acute myeloid leukemia (AML) characterized by the presence of t(15;17)(q22;q21) translocation leading to fusion between PML and RARa gene. Treatment combining all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) has dramatically improved the prognosis of APL. We report a rare finding of primary clone of t(15;17) followed by a sequential clonal evolution of additional derivative chromosome 6 formation by a two hit mechanism. Our case showed a good clinical response with a four years and nine months event free survival after ATRA and ATO combination therapy in spite of existence of three chromosomal abnormalities stating that targeted therapy overcomes the adverse effects of additional genetic markers. However, close monitoring with assessment for long term prognostic behavior is required.

Potpourri of retinopathies in rare eye disease – A case series

This case series describes the ocular and retinal manifestations of rare eye diseases in systemic syndromes. This observational case series consists of five patients with varied ophthalmic manifestations and documentation of imaging in rare pediatric and adult retinopathies. Two patients had Kearns Sayre syndrome (KSS) based on the classical triad of external ophthalmoplegia, pigmentary retinopathy, and onset before 20 years of age. In one patient of KSS, the mitochondrial retinopathy was seen in an asymmetric pattern, and the second patient presented with KSS after being mis-diagnosed as myasthenia gravis elsewhere. A case of Senior Loken syndrome in pediatric age is described in this series with varied ophthalmic manifestations ranging from retinitis pigmentosa to orbital abscess. This series also enlightens features of Hallervorden Spatz syndrome presenting with bull’s eye maculopathy and a case of spino-cerebellar ataxia type 7 presenting with pigmentary retinopathy.

Cutaneous Xanthoma- A Clue to Familial Hypercholesterolemia

A thirty-year-old female presented with multiple non-tender symmetrical slow growing swellings over dorsal aspect of bilateral foot, bilateral elbows and over interphalangeal joints for 5 years. The patient had similar swellings over the natal cleft, left knee, and dorsum of the hand which was surgically excised fifteen years ago. Her elder brother and sister also had similar complaints of multiple painless swellings.

Pancreatic Neuroendocrine Tumour- An Interesting Case Report.

Neuroendocrine neoplasms of the pancreas are moderately uncommon, representing roughly 1–2% of every pancreatic neoplasm, and are composed of epithelial neoplastic cells with neuroendocrine differentiation. Neuroendocrine neoplasms are potentially malignant including well-differentiated types and poorly differentiated types. We present a case report of a 40-year-old female patient with complaints of pain abdomen after consumption of food and loss of weight and appetite over a period of three months with a diagnosis of pancreatic neuroendocrine tumour made based on histopathology.

Clinicopathologic Study of Tongue Lesions at a Tertiary Care Hospital

Tongue lesions constitute a considerable proportion of oral mucosal lesions. Varying pathologic conditions may affect the tongue of which chronic lesions often necessitate biopsy and histological diagnosis.Most of the studies are based on clinical presentation of tongue lesions or histopathological study of oral cavity lesions as a whole. There are limited studies on clinico-pathologic review of histologically diagnosed tongue lesions which are mostly case specific. Lesions of tongue encompass a diverse spectrum of non-neoplastic and neoplastic entities. Varying pathologic conditions may affect the tongue of which chronic lesions often necessitate biopsy. Clinico-pathological correlation with microscopic examination helps in accurate diagnosis and management of patients.METHODSThis retrospective study included 192 tongue biopsies, and was conducted over a period of one year from January 2018 to December 2018 at a tertiary ENT hospital. Data on age, gender, tobacco usage, site distribution, type of lesion and histological diagnosis was analysed. RESULTSTongue lesions were seen in 133 males and 59 females. The predominant age group affected was the 5th decade of life accounting for 40 cases (20.8%). Biopsies of ulceroproliferative type of lesions were most commonly submitted. Neoplastic lesions constituted 137 cases (71.3 %) of total cases of which well differentiated squamous cell carcinoma was the most common malignant lesion accounting for 85 cases (44.2%). Using the WHO ICD-O code for topography of lesions, the tongue lateral border (ICD-O-2.1) was the most commonly affected site in the present study.CONCLUSIONSTongue lesions are relatively common in our environment with male predilection, above 40 years age group, strong association with tobacco usage, a predominance of neoplastic lesions, predilection for the lateral border of the tongue and squamous cell carcinoma as the most common histological diagnosis. The high frequency of tongue involvement emphasizes the importance of early adequate biopsy of elementary lesion. Histological characterization can help the clinician in planning early successful management of cases.

Sickness Certification Behavior amongst Primary Care Physicians: A Descriptive Analysis of Indirect Measures Using the Theory of Planned Behavior / 가정의학회지

Background@#The provision of sick leave to patients in general practice often entails a complex decision-making process. Commonly, general practitioners believe that the act of providing sick leave can become confrontational. We assessed the intention, attitude, subjective norm, and perceived behavioral control of general practitioners in relation to sick leave provision at public health clinics in Malaysia. @*Methods@#A cross-sectional study design was implemented using data from 86 primary health care clinics in two states in Malaysia from February 2014 to March 2015. A questionnaire that comprised indirect measures were developed on the basis of the Theory of Planned Behavior. The questionnaire assessed several dimensions related to sickness certification provision viz., intention, attitude, subjective norm, and perceived behavioral control. @*Results@#The mean scores in this study revealed that physicians acknowledged that patient factors such as clinical symptoms (6.59±0.04), debilitating signs and symptoms of diseases (6.45±0.06), importance of illness recovery (6.07±0.07), and approval of employers (5.35±0.09) played an important role in their decision to provide sick leave. @*Conclusion@#The act of providing sickness certification to patients is a complex decision-making process. The findings of this study can be used to devise a targeted intervention to reduce the conflict that physicians face in issuing sick leaves.

Periodontal vaccines: a systematic review / Vacinas periodontais: uma revisão sistemática

Background: vaccination is the best known application of immunology to human health. Effective vaccines have successfully eradicated the prevalence of several infectious diseases that were common less than a generation ago. The success of Periodontal vaccines is still elusive due to the complexity of periodontal pathogens that have multiple serotypes. No periodontal vaccine trials have satisfied all the requirements such as preventing colonization of pathogens, protection against tissue destruction and alveolar bone loss, elicit immunoglobulins for phagocytosis, stimulation of T-helper cells. This review aims to discuss the various immunization strategies attempted so far. Objective: this review aims to discuss the various in-vitro and in vivo studies that present supporting evidence for the feasibility of formulating a prophylactic periodontal vaccine that could emerge as an adjunct to mechanical therapy in the future. Material and Methods: an extensive literature Search was performed in electronic databases, such as PUBMED, Cochrane central register of controlled trials, Google scholar and science direct using various search terms such as " periodontal vaccines", " porphyromonas gingivalis", "chronic periodontitis", " genomic vaccine ", " recombinant vaccine", "immune response", " vaccination against periodontal bacteria". No limits and language restriction were applied during the electronic search to include all the possible animal studies, clinical trials in the potential relevant article search phase of the systematic review. Conclusion: Studies evaluating Porphyromonas gingivalis are the most common and the structures showing the most potential as a vaccine candidate are Outer membrane proteins, fimbriae and gingipains, the structure having the least potential is Lipopolysaccharide. (AU)

Fundamentação: a vacinação é a aplicação mais conhecida da imunologia à saúde humana. As vacinas eficazes erradicaram com sucesso a prevalência de várias doenças infecciosas que eram comuns há menos de uma geração atrás. O sucesso das vacinas periodontais ainda é ilusório devido à complexidade de patógenos periodontais que possuem múltiplos sorotipos. Nenhum estudo de vacina periodontal atendeu a todos os requisitos, como prevenção da colonização de patógenos, proteção contra destruição de tecidos e perda óssea alveolar, estimulação de imunoglobulinas para fagocitose, estimulação de células T auxiliares. Esta revisão tem como objetivo discutir as várias estratégias de imunização tentadas até o momento. Objetivo: esta revisão tem como objetivo discutir os vários estudos in vitro e in vivo que apresentam evidências de apoio à viabilidade de formular uma vacina periodontal profilática que possa emergir como um complemento da terapia mecânica no futuro. Material e Métodos: Foi realizada uma extensa pesquisa bibliográfica em bancos de dados eletrônicos, como PUBMED, registro central de ensaios controlados Cochrane, Google Acadêmico e science direct, usando vários termos de pesquisa como "vacinas periodontais", "porphyromonas gingivalis", "periodontite crônica" , "Vacina genômica", "vacina recombinante", "resposta imune", "vacinação contra bactérias periodontais". Nenhum limite e restrição de idioma foi aplicado durante a busca eletrônica para incluir todos os possíveis estudos em animais e ensaios clínicos na fase de busca de artigos potencialmente relevantes da revisão sistemática. Conclusão: Estudos avaliando Porphyromonas gingivalis são os mais comuns e as estruturas que mostram maior potencial como candidato a vacina são proteínas de membrana externa, fímbrias e gengivinas, a estrutura com o menor potencial é lipopolissacarídeo.(AU)

Langerhans Cell Histiocytosis - A Rare Case Diagnosed Cytologically

LCH is a rare idiopathic disorder characterized by pathogenic clonal proliferation of bone marrow derived langerhans cells which are immature dendritic cells characterized by presence of Birbeck granules. The annual incidence of LCH is nearly 5.4cases per one million people with male predominance. LCH is primarily a pediatric disease with peak age ranging between 1-4 yrs commonly involving bone. It manifests as single system unifocal, multifocal or multisystem disease. The purpose of this case report is to describe a case of 10 month old male baby with unifocal bone involvement and discuss the clinical, radiological and characteristic cytological features that lead to the diagnosis of LCH.

Epidemiological and clinical profile of various plant poisons in a tertiary care center in South Tamilnadu, India

Background: Plant poisoning is a common scenario in a toxicology unit . Some of the plants contain active components used as medicines. However, some of the plant constituents are poisonous with wide variety of clinical manifestations. Authors aimed to study the pattern of various types of plant poisons and clinical presentations and complications of various plant poisons admitted in our toxicological unit.Methods: A total of 87 patients admitted with history of plant poison ingestion, in toxicological unit of Tirunelveli medical college were studied . It was a retrospective observational study and was done over a period of one year.Results:  Out of 87 cases studied, 92%were due to consumption with suicidal intention. Plant poisoning ranks second only to pesticide poisoning . among the plant poisons encountered 66.6% were due to Oleander poison, followed by Datura (8%) and Glory lily(5.7%). Common parts of plant consumed by patients include seeds and plant oils . Vomiting and abdominal pain were the commonest presentations. Encephalopathy, dyselectrolytemia and arrhythmias were the notable complications in our study.Conclusions: Early admission and prompt first aid and monitoring at tertiary care center are key to the reduced mortality. The study throws light on various manifestations, toxic parts and complications of plant poisons.

Comparative Evaluation of GENE-XPERT MTB/RIF with AFB Smear Microscopy Methods for the Diagnosis of Tuberculosis in Sputum Specimens of Suspected Pulmonary Tuberculosis Patients

Tuberculosis is a major public health problem worldwide and remains one of the most significant causes of death from an infectious agent. India contributes to 25.5% of the global new TB case detection. In recent times, emphasis has shifted from older phenotypically and biochemical methods of diagnosis to molecular methods such as GeneXpert MTB/RIF, a real time PCR that can detect MTB and rifampicin resistence simultaneously. Methods: This study aims at assessing the performance of acid fast bacilli (AFB) smear microscopy in comparison with GeneXpert MTB RIF, in the diagnosis of pulmonary tuberculosis. Study was a cross-sectional study carried out at the Department of Pulmonary Medicine, Muzaffarnagar Medical College, from January 2018 to April 2019. Result: The detection of MTB and rifampicin resistance using the Xpert MTB/RIF assay was assessed in 67 specimens from patients suspected of having pulmonary tuberculosis and compared with conventional smear microscopy. Out of these 67 sputum specimens, 38 samples were MTB positive by smear microscopy while 56 samples were MTB detected by Gene Xpert assay. Gene Xpert detected 18 additional tubercular cases and identify two cases of Rifampicin resistant MTB. Conclusion: Study show that there was no statistically significance in diagnostic value between GeneXpert and AFB smear microscopy in sputum samples however Gene Xpert MTB/RIF is useful method for rapid detection of MTB and Rifampicin resistance simultaneously.

The effectiveness of conducting home visits by medical students among Malaysians with type 2 diabetes: A retrospective analysis / Journal of the ASEAN Federation of Endocrine Societies

@#<p><strong>BACKGROUND: </strong>Medical students at the International Medical University (IMU), Seremban, Malaysia were required to assess patients at home over a period of two years as a part of their curriculum. The students conducted six visits to educate their patients and help them utilize available resources to manage their disease.</p><p>This study aims to examine whether patients with diabetes visited improve their control of their disease, specifically in terms of their HbA1c measurement.</p><p> METHODOLOGY:</b> We used a retrospective, matched before and after study design to prevent biased levels of effort by students conducting the home visits over two years. Information was obtained through reports written by IMU students. Convenient sampling was used to select outpatients undergoing treatment 'as usual' from a health clinic and were subsequently matched as controls.</p><p><strong>RESULTS:</strong> There was a significant decrease in the mean HbA1c among 57 patients with diabetes who were CFCS subjects [from 8.4% (68 mmol/mol) to 7.3% (57mmol/mol) p<0.001], while the mean HbA1c levels among 107 matched control subjects rose significantly from 7.9% (63 mmol/mol) to 8.3% (67 mmol/mol) (p=0.019) over a similar period. The two groups were controlled for most biological and socioeconomic variables except for comorbidities, diabetic complications and medication dose changes between groups.</p><p><strong>CONCLUSION:</strong> Behavioural intervention in the form of home visits conducted by medical students is an effective tool with a dual purpose, first as a student educational initiative, and second as a strategy to improve outcomes for patients with diabetes</p>

Adult Langerhans cell histiocytosis: An unusual cause of referred knee pain

@#Langerhans cell histiocytosis (LCH) in adults is rare and regarded as an ‘orphan disease.’ The systemic symptoms of LCH can mimic many other undifferentiated diseases seen at the primary care level. Failure to diagnose and delays in referral are common pitfalls in the management of this disease. We present a case of a 34-year-old woman with referred knee pain who was eventually diagnosed with multi-system LCH 4 years after the initial presentation. The mean age of presentation of LCH symptoms in adults is 33. Bone lesions are the frequent presentation of LCH in this age group. Endocrine involvement in LCH is seen in the form of diabetes insipidus (DI), which remains the most common extraskeletal presentation of LCH in adults. In the case discussed here, a definitive diagnosis of LCH was established through tissue biopsy. The spectrum of undifferentiated symptoms underscores the difficulty and delay in making a diagnosis associated with the condition. Most GPs not only face the predicament of initial recognition but also fail to merge presenting symptoms to form a purposeful referral of this elusive disease to a tertiary care unit.

Metallopharmaceuticals: Synthesis, characterization and bio-active studies

Riboflavin can be described as a biological chelating ligand due to the existence of nitrogen and oxygen atoms on its structure that can act as coordinating sites for metal ion on chelation. Co (II) with Riboflavin have been synthesized and characterized by IR, LC-MS, UV, TG-DTA confirms the coordination of ligand. Complex is screened for Anti-microbial activity and Cytotoxicity.

Bioaccumulation of heavy metals in different tissues of Nile tilapia (Oreochromis niloticus) in Bangladesh

@# Introduction: The culture of Nile tilapia (Oreochromis niloticus) has become wide spread because of its high productivity over a short period of time. Its production partially fulfills the demand for food in rural people in Bangladesh. However, the accumulation of toxic heavy metals in the human body through consumption of fish contaminated by it causes various diseases. The aim of this study was to evaluate the bioaccumulation of five heavy metals, namely, cadmium (Cd), chromium (Cr), lead (Pb), nickel (Ni) and copper (Cu) in cultured Nile tilapia in the Noakhali region of Bangladesh. Methods: Fish were collected from three different fish farms in the Noakhali region and samples of gill, muscles and liver of tilapia were assayed for Cd, Cr, Pb, Ni and Cu using atomic absorption spectroscopy. Proximate composition of the tilapia was also determined. Results: Metal accumulation in different tissues was as follows: liver > gill > muscle. The accumulation of metals in the muscle, gill and liver was Ni > Pb > Cr > Cu > Cd, Pb > Ni > Cu > Cr > Cd and Pb > Cu > Ni > Cr > Cd, respectively. The bioaccumulation of lead was significantly increased in liver and gill while muscle showed the lowest value. Conclusion: It can be concluded that bioaccumulation of Pb, Cr and Ni in Nile tilapia in this study exceeds the permissible limits set for heavy metals by Food and Agriculture Organization (FAO) and International Atomic Energy Agency (IAEA)-407. This is potentially risky for consumers.

Human Nasal Rhinosporidiosis - A Case Report

Rhinosporidiosis is primarily an infection of the nose caused by Rhinosporidium seeberi. Other sites that can be involved are conjunctiva, urethra, palate, tongue, epiglottis, larynx, trachea, bronchi, skin, vulva, and vagina. It is endemic in certain parts of India and Sri Lanka. The pathogen is difficult to grow in culture and Hematoxylin and Eosin staining helps in confirmation of the etiological agent. Surgery remains the mainstay of treatment. Here is a report aimed at documenting a 26-year-old female patient with nasal rhinosporidiosis.

Transbronchial Lung Cryobiopsy for Diagnosis of Pediatric Interstitial Lung Disease

Background: Tissue diagnosis of Childhood interstitial lung diseases is of paramountimportance to outline management. Case characteristics: A 10-year-old boy withprolonged cough, and computed tomography of thorax with features suggestive ofprimary Langerhans’s cell histiocytosis. Intervention: Transbronchial cryobiopsy of lungusing flexible cryoprobe, revealed a final diagnosis of Surfactant protein C/ABCA3deficiency. Message: Transbronchial cryobiopsy of the lung can provide adequate lungtissue for a categorical diagnosis of interstitial lung diseases in children.

A study on outcome of malaria and acute gastroenteritis induced acute kidney injury requiring hemodialysis

Background: Acute kidney injury previously known as acute renal failure, is characterized by the sudden impairment of kidney function resulting in the retention of nitrogenous and other waste products normally cleared by the kidneys. Acute Kidney Injury is usually manifested as multiorgan failure syndrome and extracorporeal support may also target fluid overload and heart failure, extracorporeal CO2 removal for combined kidney and lung support, albumin dialysis for liver support. Haemodialysis is more effective than peritoneal dialysis for management of Acute Kidney injury as Peritoneal dialysis is associated with clearance limitation and difficulties with fluid removal and is thus rarely used in adults in developed countries.Methods: The study was conducted in the Department of Medicine, Pt. J.N.M. Medical College and Dr. B.R.A.M. Hospital, Raipur (CG), India, from 2010 to 2012. All patients of both the sexes who were diagnosed as a case of Acute Kidney Injury due to Acute Gastroenteritis and Malaria and who were advised for Hemodialysis were included in the study. In our study, 32 patients of Acute Kidney Injury were included. The criteria used for AKI in the study was RIFLE criteria. Hemodialysis was done in all the cases. Quantitative variables are reported as means±SD and qualitative variables as percentage. Factor(s) determining outcome of AKI were tested by univariate analysis using “fisher’s exact test”. All variables with a P value <0.05 in the univariate analysis were defined statistically significant.Results: Out of 32 patients of Acute Kidney Injury in our study, 50% (n=16) were of Malaria associated AKI cases and other 50% (n=16) patients were of Acute Gastroenteritis associated AKI in which 87.5% males,12.5% Females were of Malaria and 75% male,25% Female were in AGE associated AKI. Maximum number of patients presented with features of AKI within first 3days of disease onset i.e. 56.25% (n=9) of malaria patients and 68.75% (n=11) of AGE patients. Mortality due to MOD was more common in Malaria patients as compared to AGE patients. AGE associated AKI patients had different level of deranged SOFA score.Conclusions: Acute kidney injury due to acute gastroenteritis differs from other causes of AKI by frequent occurrence of hypokalemia. Early diagnosis and prompt management can restore the kidney function.