Genus Berberis: A comprehensive and updated review on ethnobotanical uses, phytochemistry and pharmacological activities.

Genus Berberis is an excellent choice for research due to its history in traditional medicine, diverse pharmacological properties, and it has potential for drug discovery. This review presents information on the ethnobotany, pharmacological activities, and many phytochemicals identified from Berberis species. It examines the existing literature on the genus Berberis, drawn from online databases, including PubMed, Web of Science, Science Direct, Elsevier, and Google Scholar, etc encompassing the data from 1960 to 2023. This review focuses on the structural details of reported phytochemicals of Berberis species and pharmacological actions. Different extraction techniques were evaluated for extracts preparation. According to literature review, phytochemical analysis exhibited the presence of alkaloids, flavonoids, and phenolic compounds. A major bioactive alkaloid, berberine exhibits its main role in treatment of many gastric, infectious, and chronic disorders. This literature indicates that Berberis genus exhibits a variety of biological activities, i.e anti-inflammatory, cytotoxic, hepatoprotective, antimicrobial, antidiabetic and antioxidant activities and utilization of these effects in the treatment and management of various diseases, like diabetes, microbial infections, inflammation, liver disorders, and cancer. However, conventional medicines, validation of traditional uses, and in-depth phytochemical analysis are areas of research in genus Berberis.

Ocular manifestations in a patient with Dandy-Walker malformation: A case report.

We present a unique case of a ten-month-old boy with a protruding left globe and vitreous haemorrhaging, and later being diagnosed as a case of a dandy-walker syndrome (DWS) with buphthalmos and vitreous haemorrhage. Treatment is depending on the symptoms reported, thus close monitoring and a multidisciplinary approach are essential. We would like to recommend that even if there are no cardinal symptoms of DWS, paediatric patients with ocular signs should have Dandy walker Malformation (DWM) considered as a differential diagnosis.

Role of awake prone positioning in patients with moderate-to-severe COVID-19: an experience from a developing country.

There is limited evidence on the efficacy of awake prone positioning (PP) in non-ventilated patients with COVID-19 who have hypoxemia. We, therefore, aim to describe our experience with the use of early proning in awake, non-intubated patients with confirmed COVID-19. In our retrospective observational study, 23 patients with confirmed positive PCR test results for Severe Acute respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and hypoxemia that required oxygen therapy with or without non-invasive ventilation were treated with PP. Patients were classified into mild, moderate and severe COVID-19 disease. There were no targeted number of hours for proning per day and patients were kept in prone position according to their tolerance. The primary outcome measure was the avoidance of intubation and secondary outcomes were in-hospital mortality, length of hospital stays and complications related to PP. The mean (standard deviation) age of our cohort was 54.5 (11.7) years, and the majority were males (21/23, 91.3%). Sixty-one per cent (14/23) of the patients were suffering from severe disease and 82.6% (19/23) had bilateral lung involvement with interstitial infiltrates. Majority of the patients were prone positioned for a median of 6 days (IQR 4 - 8). Only one patient required transfer to ICU for mechanical ventilation and subsequently died due to severe ARDS. All 22 patients showed progressive improvement in oxygen requirement and PF ratio, mostly after 3-5 days of proning. The mean length of hospital stay was 12 days. All patients, except one, were discharged in stable conditions, on room air or on a minimal oxygen requirement of 1-2 liters. No major complication of PP was recorded. Awake prone positioning is a valuable and safe therapeutic adjunct that can be applied in patients with moderate-to-severe COVID-19. It can also be included in the home-based management protocols of COVID-19 to improve patient outcomes and mitigate the burden on health care facilities.

Gemella morbillorum endocarditis in a patient with a bicuspid aortic valve.

Infective endocarditis caused by Gemella morbillorum is a very rare occurrence and only a few cases have been reported in the literature so far. We describe a case of G. morbillorum endocarditis in a 31-year-old Pakistani woman who had a congenitally bicuspid aortic valve. She had also undergone repair of a large aortic aneurysm 1 year before this presentation. She presented to our institution with a 1.5-month history of fever, exertional dyspnea and generalized edema. A transthoracic echocardiogram showed two large, echogenic and mobile vegetations (7 x 15 mm and 8 x 10 mm) attached to the right coronary cusp and non-coronary cusp. Blood cultures of the patient grew pan-sensitive G. morbillorum. The patient fulfilled the Duke's criteria for infective endocarditis. She was successfully treated with ceftriaxone and gentamycin therapy. At two years' follow up she has remained well. This case represents a rare cause of infectious endocarditis that was successfully managed with medical treatment alone in a patient with the predisposing risk factor of a bicuspid aortic valve.