Downmodulation of lysophosphatidic acid by Berberine loaded folate-conjugated glycol chitosan nanoparticles (BFGCN) to mitigate Rheumatoid arthritis (RA) & Cardio-vascular disease(CVD): Current knowledge and future perspectives

The perils of cardiovascular diseases (CVD) are enhanced by systemic chronic inflammation in autoimmune disorders like Rheumatoid arthritis (RA), in which the patients generally exhibit a high inflammatory burden, dyslipidemia causing 50-60% of RA patients susceptible to CVD dependent mortality. Lysophosphatidic acid (LPA) is a polar, pleiotropic lipid molecule that is water soluble and present in the synovial fluid that can be exploited as an effective biomarker for lipid-signalling. Current research on alternative medicine has recognized various new molecular targets of Berberine (BBR) and established novel signals in support of the efficacy and therapeutic potential of BBR to fight CVD. Therefore, BBR, an alkaloid with poor aqueous solubility could be foreseen as a therapeutic strategy for the reduction of inflammation induced lipidemia by targeting the macrophages and modulating their functions. Hence, a novel BBR loaded folate-conjugated glycol chitosan nanoparticles (BFGCN) could be hypothesized as a three-pronged approach to target activated macrophages, fibroblasts of synovial fluid for downmodulation of LPA. The greatest challenge is the heterogeneity, complexity and interdependence of RA and CVD. Investigation of prognostic and predictive biomarkers is urgently required. Therefore, an improved understanding of the pathogenesis of RA would facilitate identifying an improved targeted treatment and management of RA patients.

Cerebral Hydatid Cyst: A Case Report.

Objective: Cerebral Hydatid disease (CHD) is very rare manifestation of echinococcosis, representing only 2% of all celebral space occupying lesion even in the countries where the disease in is endemic. The aim of this paper is to describe the characteristic features of cerebral hydatid disease in computed tomography, magnetic resonance Imaging (MRI) and to report a multiloculated cyst (more than 100 loculi) along with its management. Case Presentation: In this paper we have reported a young boy of 20yrs with primary CHD without associated extracranial lesions with focal neurological deficits and intracranial hypertension. The extracranial investigations were found to be negative. CT and MRI of the patient suggested it to be a multiloculated Hydatid cyst. The patient was managed surgically and more than 100 daughter cysts were recovered, antihelminthic medications were given to the patient was discharged successfully. Conclusion: Multilocular Hydatid cyst is a rare SOL of Brain. When present the patient remains asymptomatic for long followed mostly by symptoms of headache and vomiting. Patients may also present with focal deficit or seizures‑Surgery remains the mainstay of treatment with careful evacuation of the cysts alongwith the medications for the causative agent (Echinococcus granulosus or multilocularies). Prevention of the disease should be given utmost emphasis.