Malvidin attenuates behavioral and inhibits the TNF-α/Caspase-3/Nrf-2 expression in rotenone-induced Parkinson's disease in rats: insights from molecular docking.

OBJECTIVE: Malvidin is a natural, biologically active polyphenol found in several fruits. It exhibits several therapeutic benefits; however, limited studies are available on its effects on neurodegenerative clinical conditions, including Parkinson's disease. The study aimed to investigate the therapeutic properties of malvidin on rotenone-triggered Parkinson's disease in an animal model. MATERIALS AND METHODS: To determine the effects of malvidin, rotenone (1.5 mg/kg) was injected subcutaneously into Wistar rats for 21 days, followed by a dose of malvidin (200 and 100 mg/kg). Behavioral tests were performed on the experimental animals before sacrifice. On the 22nd day of the experiment, biochemical tests were performed, including superoxide dismutase (SOD), glutathione (GSH), malondialdehyde (MDA), and catalase (CAT). The activity of neurotransmitters and their metabolites, including acetylcholine (ACh), acetylcholinesterase (AChE), dopamine (DA), norepinephrine (NE), serotonin (5-HT), 3,4-dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA), and 5-hydroxyindoleacetic acid (5-HIAA) along with neuroinflammatory markers including interleukin-6 (IL-6), interleukin-1ß (IL-1ß), tumor necrosis factor- α (TNF-α), and nuclear factor erythroid 2-related factor 2 (Nrf-2) were estimated. Moreover, the level of the apoptotic marker, caspase-3, was also estimated. In addition, molecular docking was performed. RESULTS: The administration of rotenone resulted in oxidative stress, cholinergic imbalances, dopaminergic alternations, and increased expression of inflammatory compounds. The docking analysis revealed that malvidin displayed a favorable binding affinity for AChE, showcasing a binding energy of -9.329 Kcal/mol. CONCLUSIONS: The investigation concludes that malvidin exhibits neuroprotective effects due to its curative effects against inflammation and oxidative stress. These findings suggest that malvidin possesses therapeutic potential against rotenone-triggered behavioral, oxidative, and inflammatory abnormalities in rodents.

Tomographic ultrasound for three-dimensional visualization of temporal arteries.

OBJECTIVE: Conventional two-dimensional ultrasound has been assessed for the non-invasive diagnosis of giant cell arteritis (GCA), but the results are operator dependent, resulting in low sensitivity. Tomographic three-dimensional (3D) ultrasound is a novel technique that enables the objective documentation of vessel geometry. Here, for the first time, its utility is assessed for visualizing temporal arteries. METHOD: The temporal artery of 14 healthy subjects and three subjects with suspected GCA was examined using tomographic 3D ultrasound. RESULTS: This technique enabled 3D mapping of the architecture of the temporal artery. The inner and outer vessel diameters showed considerable interindividual variability. However, calculation of the vessel wall fraction revealed the combination of vessel wall thickening and lumen narrowing, which may be indicative of GCA. CONCLUSIONS: This proof-of-concept study indicates that tomographic 3D ultrasound can be used for objective mapping of the temporal artery. The technique must be evaluated regarding its diagnostic sensitivity in GCA before it can be introduced in clinical practice.

Protective effect of sterubin against neurochemical and behavioral impairments in rotenone-induced Parkinson's disease

This study was conducted to evaluate how sterubin affects rotenone-induced Parkinson's disease (PD) in rats. A total of 24 rats were distributed into 4 equal groups: normal saline control and rotenone control were administered saline or rotenone (ROT), respectively, orally; sterubin 10 received ROT + sterubin 10 mg/kg po; and sterubin alone was administered to the test group (10 mg/kg). Rats of the normal saline and sterubin alone groups received sunflower oil injection (sc) daily, 1 h after receiving the treatments cited above, while rats of the other groups received rotenone injection (0.5 mg/kg, sc). The treatment was continued over the course of 28 days daily. On the 29th day, catalepsy and akinesia were assessed. The rats were then euthanized, and the brain was extracted for estimation of endogenous antioxidants (MDA: malondialdehyde, GSH: reduced glutathione, CAT: catalase, SOD: superoxide dismutase), nitrative (nitrite) stress markers, neuroinflammatory cytokines, and neurotransmitter levels and their metabolites (3,4-dihydroxyphenylacetic acid (DOPAC), dopamine (DA), norepinephrine (NE), serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), and homovanillic acid (HVA)). Akinesia and catatonia caused by ROT reduced the levels of endogenous antioxidants (GSH, CAT, and SOD), elevated the MDA level, and altered the levels of nitrites, neurotransmitters, and their metabolites. Sterubin restored the neurobehavioral deficits, oxidative stress, and metabolites of altered neurotransmitters caused by ROT. Results demonstrated the anti-Parkinson's activities of sterubin in ROT-treated rats.

Protective effect of sterubin against neurochemical and behavioral impairments in rotenone-induced Parkinson's disease.

This study was conducted to evaluate how sterubin affects rotenone-induced Parkinson's disease (PD) in rats. A total of 24 rats were distributed into 4 equal groups: normal saline control and rotenone control were administered saline or rotenone (ROT), respectively, orally; sterubin 10 received ROT + sterubin 10 mg/kg po; and sterubin alone was administered to the test group (10 mg/kg). Rats of the normal saline and sterubin alone groups received sunflower oil injection (sc) daily, 1 h after receiving the treatments cited above, while rats of the other groups received rotenone injection (0.5 mg/kg, sc). The treatment was continued over the course of 28 days daily. On the 29th day, catalepsy and akinesia were assessed. The rats were then euthanized, and the brain was extracted for estimation of endogenous antioxidants (MDA: malondialdehyde, GSH: reduced glutathione, CAT: catalase, SOD: superoxide dismutase), nitrative (nitrite) stress markers, neuroinflammatory cytokines, and neurotransmitter levels and their metabolites (3,4-dihydroxyphenylacetic acid (DOPAC), dopamine (DA), norepinephrine (NE), serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), and homovanillic acid (HVA)). Akinesia and catatonia caused by ROT reduced the levels of endogenous antioxidants (GSH, CAT, and SOD), elevated the MDA level, and altered the levels of nitrites, neurotransmitters, and their metabolites. Sterubin restored the neurobehavioral deficits, oxidative stress, and metabolites of altered neurotransmitters caused by ROT. Results demonstrated the anti-Parkinson's activities of sterubin in ROT-treated rats.

Butin attenuates behavioral disorders via cholinergic/BDNF/Caspase-3 pathway in scopolamine-evoked memory deficits in rats.

OBJECTIVE: Recent research suggests that butin may also exert neuroprotective effects. However, its influence on cognitive performance and, specifically, its potential to mitigate scopolamine-induced memory impairment remains unexplored. The aim of the study is to investigate the effects of butin on the cognitive and behavioral performance of rats with scopolamine-induced memory impairment. MATERIALS AND METHODS: Scopolamine-injected memory-impediment model in rats was used to determine the efficacy of butin in higher and lower doses (10 and 20 mg/kg) for 14 days. Y-maze, along with Morris water, was used to assess the ability to recall spatial and working information. Biochemistry-related functions such as acetylcholinesterase, choline acetyltransferase, superoxide dismutase, glutathione transferase, malonaldehyde, catalase, nitric oxide, and neurotransmitters levels were estimated as indicators of free radical damage. Furthermore, we evaluated neuro-inflammatory responses by assessing tumor necrosis factor-alpha (TNF-α), interleukin 1 beta (IL-1ß), interleukin-6 (IL-6), brain-derived neurotrophic factor (BDNF) and caspase-3 immuno-reactive proteins. RESULTS: When assessed through behavioral paradigms, the butin-treated group enhanced the spatial and working memory of rodents. Scopolamine caused a substantial alteration in biochemical-related parameters, neuronal enzymatic, inflammation responses and apoptosis markers prominently restored by butin. CONCLUSIONS: This study concludes that butin protects scopolamine-injected rats from behavioral impairments and neuronal damage by reducing apoptosis and neuroinflammation.

Fustin alleviates lipopolysaccharide-induced anxiety-depression-like performances by modulation of oxidative stress/neuroinflammatory markers/ NF-κB/caspase-3/BDNF expression in rodents.

OBJECTIVE: Anxiety and depression are common psychiatric disorders that affect millions of people worldwide. Lipopolysaccharide (LPS) is a bacterial endotoxin that has been demonstrated to cause depression and anxiety-like behaviors in animal models. Fustin is a flavonoid found in various plant species that have been reported to have neuroprotective effects. The study proposed the evaluation of fustin's impact on anxiety and depression in LPS-injected rats. MATERIALS AND METHODS: The efficacy of fustin in higher and lower doses was studied by administering a single dose of LPS-injected anxiety/depression in rodents. Behavioral models like the elevated plus maze test, open field test, marble burying test, force swimming test, tail suspension test, and hyperemotionality behavior were performed to evaluate anxiety/depression in rodents. The neuroinflammatory markers such as interleukin-6 (IL-6), interleukin-1ß (IL-1ß), nuclear factor-κB (NF-κB), tumor necrosis factor-α (TNF-α), apoptosis marker caspase-3, and brain-derived neurotrophic factor (BDNF) were also measured as a part of the study. Additionally, biochemical markers of oxidative stress, such as malonaldehyde (MDA) and antioxidants, including superoxide dismutase (SOD), glutathione (GSH), catalase (CAT), and nitric oxide (NO), were also evaluated. RESULTS: LPS administration resulted in significant (p<0.001) changes in behavior tests and biochemical markers including IL-1ß, IL-6, NF-κB, TNF-α, NO, caspase-3, BDNF, MDA, CAT, SOD, and GSH. In contrast, treating the rats with fustin significantly improved the behavior tests and restored the changes in biochemical markers. CONCLUSIONS: The current work established the efficacy of fustin with its therapeutic impact on depression and anxiety-like behaviors in rodent experimental models through its modulation of apoptosis markers, oxidative stress, and neuroinflammation.

Deciphering gynaecological pathologies in women with acne and alopecia: an imaging experience.

Polycystic ovarian syndrome manifests acne and alopecia in teenagers and young adult females. To evaluate ovarian morphology and the prevalence of polycystic ovarian morphology (PCOM) in females between the ages of 21 and 45 who are in the reproductive stage and have isolated acne and/or androgenic alopecia. And their association. The present study was done with patients in the age group of 21 to 45 years with acne and/or androgenic alopecia. Modified Ferriman-Gallwey score was used to assess the degree of hirsutism (with score of more or equal to 8 as significant). Grading of acne vulgaris and androgenic alopecia was done by a single observer. Subjects were then evaluated for biochemical investigations of Hormonal assays on day 2 to 7. Transabdominal ultrasonography was performed in the follicular phase to demonstrate the ovarian morphology. In our study isolated androgenic alopecia was present in 28 patients (24.34%). In our study 54 (46.95%) patients out of 115 had combined acne and androgenic alopecia. In our study out of 33 patients with isolated acne 17 (51.5%) had PCO Morphology with grade I, grade II, grade III having prevalence of 46.2%, 53.8% and 57.1% respectively. In our study of the 28 patients with isolated androgenic alopecia 16 (57.1%) had PCOM with grade I, II and III respectively having prevalence of 56.3%, 55.6%, 66.7% with P value of 0.939. Patients with normal ovarian morphology were 12 in number (42.9%). Of the 54 patients with combined acne and androgenic alopecia 32 (59.3%) had PCOM and 22 patients had normal ovarian morphology. Higher overall prevalence was found in patients with combined acne and alopecia (59.3%) than in isolated groups; acne (51.5%), alopecia (57.1%). In our study it was to found that women with dermatological manifestations like acne and androgenic alopecia with regular menstruation. In our study it was found that these women with have high prevalence of PCOS.

Ultrasound centre frequency shifts as a novel approach for diagnosing giant cell arteritis.

OBJECTIVE: Giant cell arteritis (GCA) is a treatable, but potentially sight- and life-threatening form of systemic vasculitis. Prompt and correct diagnosis is therefore important. Temporal artery biopsy (TAB) is the gold standard for diagnosing GCA, but is associated with risks. There is no reliable non-invasive technique for the diagnosis of GCA. Ultrasound centre frequency shift (CFS) is a novel technique that uses high-frequency ultrasound and the analysis of the centre frequency of the ultrasound pulse, which is dependent on the size of the microstructures in the tissue. This provides an objective measure of the scattering microstructures in the tissue, and thus has the potential to discriminate changes due to disease. The aim of this study was to assess ultrasound CFS as a means of discriminating arteries affected by GCA from healthy arteries. METHOD: TAB specimens from 68 subjects, 53 female and 15 male, with a mean age of 73 (range 52-87) years, with suspected GCA were examined using ultrasound ex vivo and the CFS was analysed. The temporal arteries were then examined histopathologically. RESULTS: Histopathological examination revealed that 25 of the 68 biopsies of the temporal artery showed inflammatory changes in the vessel wall compatible with GCA. The ultrasound CFS decreased less in TAB-positive than in TAB-negative temporal arteries (p < 0.05). CONCLUSIONS: This proof-of-principle study indicates that ultrasound CFS has the potential to detect GCA in temporal arteries. Further technical development will be needed before in vivo examination can be performed and the clinical applicability can be assessed.

Protective effect of barbigerone against ethanol-induced ulcers via the interleukins/ICAM-1/Bcl-2 pathway.

OBJECTIVE: The objective of the study was to assess the protective effects of barbigerone in ethanol-induced gastric ulcers in rats. MATERIALS AND METHODS: Male Wistar rats (180±20 g) were used in the study (n=06). The rats were randomly divided into different groups, i.e., the normal group, ethanol control, and barbigerone 10 and 20 mg/kg group. Various biochemical parameters were assessed - total acidity and pH values, oxidative stress biomarkers such as superoxide dismutase (SOD), glutathione (GSH), malondialdehyde (MDA), and catalase (CAT) along with markers, i.e., tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-1ß, intercellular adhesion molecule-1 (ICAM-1) and expression of B-Cell Leukemia/Lymphoma 2 (Bcl-2). Also, histopathology was performed. RESULTS: Treatment with barbigerone in the ethanol-induced-ulcer rats restored the levels of biochemical parameters such as SOD, GSH, MDA, CAT, and markers expression, including TNF-α, IL-6, IL-1ß, ICAM-1, and Bcl-2 with protected against cellular necrosis. CONCLUSIONS: Barbigerone protective effects can be attributed to its ability to reduce oxidative stress and inflammation, as well as promote gastroprotection against ethanol-induced ulcers in rats.

The direct and indirect impact of trauma types and cumulative stressors and traumas on executive functions.

The goal was to measure the effects of trauma types, cumulative trauma, posttraumatic stress disorder (PTSD), existential annihilation anxiety (EAA), and posttraumatic growth (PTG) on executive functions. The study sample consists of 1155 from Egypt and Kuwait. Measures included adults working memory deficits (WMD) and inhibition deficits (ID), and cumulative stressors and traumas (CST) and trauma types, PTSD, EAA, and PTG. We used Stepwise regression and PROCESS macro to analyze the data. Results indicated that survival and cumulative traumas have direct effects on a lower WMD and ID, attachment traumas and gender discrimination by parents have direct impacts on higher WMD and ID, while personal identity, status identity, secondary trauma, gender discrimination by society, community violence do not have any direct effects on WMD or ID. All traumas have indirect effects on higher WMD or/and ID via PTSD. Gender discrimination by society, community violence, and CST has an additional indirect higher impact on WMD and ID via EAA. There were indirect trajectories from survival trauma, personal identity, status identity trauma, secondary trauma, gender discrimination by society, and CST on lower WMD or/and ID via PTG. Attachment trauma, gender discrimination by parents, perpetration traumas, and community violence were not associated with PTG and its trajectories of lower WMD or/and ID. We discussed the research and clinical implication for these results.

Diffusion-Weighted Imaging: An Exciting and Problem-Solving Tool in Patients with Hepatic Metastases.

Background The diffusion-weighted imaging (DWI) is based on the random Brownian motion of water molecules that influences image contrast depending on different pathological conditions. Objective The purpose of this study was to evaluate the efficacy of various magnetic resonance imaging (MRI) sequences including diffusion-weighted and gadobenate-enhanced MRI in the detection and characterization of liver lesions in a patient of known primary malignancy and to compare MRI with contrast-enhanced computed tomography (CECT) and ultrasonography (USG) in the detection of liver metastases. Methods All patients underwent a multiphase MRI. The final diagnosis was established by histopathological examination. Results A total of 43 patients of known primary malignancy were enrolled. MRI gave a provisional diagnosis of liver metastases in 21 patients and benign disease in 22 patients with histopathological correlation revealing two false-negative and one false-positive result. In the detection of lesions, DWI outscored other sequences (92.9 vs. 83.5% in hepatobiliary phase vs. 55.0% in T 2 -weighted sequences) with a statistically significant difference noted only in comparison with T 2 -weighted sequences ( p < 0.001). In 16 patients, MRI added new lesions that were not detected by CECT/USG. The sensitivity and specificity of MRI for detecting metastases were 90.9%/95.2% and 97.9%/96.8% for per-patient and per-lesion basis, respectively. Conclusion Multiphase MRI improved both the detection and characterization of liver metastases. Adding DWI to the routine MR sequences helped in detecting small liver metastases (<10 mm) not detected by other sequences.

Drug repurposing: Iron in the fire for older drugs.

Repositioning or "repurposing" of existing therapies for indications of alternative disease is an attractive approach that can generate lower costs and require a shorter approval time than developing a de novo drug. The development of experimental drugs is time-consuming, expensive, and limited to a fairly small number of targets. The incorporation of separate and complementary data should be used, as each type of data set exposes a specific feature of organism knowledge Drug repurposing opportunities are often focused on sporadic findings or on time-consuming pre-clinical drug tests which are often not guided by hypothesis. In comparison, repurposing in-silico drugs is a new, hypothesis-driven method that takes advantage of big-data use. Nonetheless, the widespread use of omics technology, enhanced data storage, data sense, machine learning algorithms, and computational modeling all give unparalleled knowledge of the methods of action of biological processes and drugs, providing wide availability, for both disease-related data and drug-related data. This review has taken an in-depth look at the current state, possibilities, and limitations of further progress in the field of drug repositioning.

Utilization of N-bromosuccinimide for the sensitive spectrophotometric determination of pipazethate HCl as antitussive drug in pure and dosage forms.

OBJECTIVES: Three simple, sensitive, precise, reproducible and validated spectrophotometric methods have been developed for the quantification of pipazethate HCl as antitussive drug in pure and dosage forms. METHODS: The methods are based on utilization of N-bromosuccinimide as an oxidant and three dyes, amaranth, methylene blue, and indigo carmine, as auxiliary reagents. The proposed methods are based on oxidation reaction of pipazethate HCl with a known excess of N-bromosuccinimide in acid medium, followed by determination of unreacted N-bromosuccinimide by the reaction with a fixed amount of dyes, amaranth, methylene blue, and indigo carmine followed by the measurement of the absorbance at 520, 663 and 610nm, respectively. The optimization of the reaction conditions was investigated. RESULTS: Under the optimum conditions, linear relationships with good correlation coefficients (0.9998-0.9999) were found over the concentration ranges of 0.3-9.0, 0.5-12 and 0.5-10µgmL-1 with a limit of detection (LOD) of 0.1, 0.15 and 0.15µgmL-1 using amaranth, methylene blue, and indigo carmine methods, respectively. Intra-day and inter-day accuracy and precision of the methods have been evaluated. No interference was observed from the common tablet excipients. CONCLUSION: The developed methods were validated in accordance with ICH guidelines and successfully applied to the analysis of pipazethate HCl in dosage forms with good accuracy and precision. The reliability of the methods was further ascertained by performing recovery studies via the standard addition method. Statistical comparison of the results obtained by applying the proposed methods with those of the reported method by applying Student's t-test and variance ratio F-test at the 95% confidence level revealed good agreement and indicates no significant difference in accuracy and precision.

Development and validation of spectrophotometric methods for estimation of antimigraine drug eletriptan hydrobromide in pure form and pharmaceutical formulations.

OBJECTIVES: The present study aims to develop and validate four simple, sensitive, reproducible, and low-cost spectrophotometric methods for the determination of antimigraine drug (eletriptan hydrobromide) in pure form and pharmaceutical formulations. METHODS: The methods are based on the formation of yellow colored ion-pair complex between eletriptan hydrobromide and four acid dyes, namely, bromocresol purple (BCP), bromocresol green (BCG), bromophenol blue (BPB), and bromothymol blue (BTB) with absorption maxima at 410, 420, 414 and 416nm, respectively. Several parameters such as pH, buffer type and volume, reagent volume, sequence of addition and effect of extracting solvent were optimized. RESULTS: Under the optimum experimental conditions, beer's law is obeyed over the concentration ranges of 1.0-20 and 1.0-16µgmL-1 for (BCP or BCG) and (BPB or BTB), respectively with good correlation coefficients (0.9995-0.9999). The apparent molar absorptivity and Sandell's sensitivity values are reported for all methods. The limit of detection (LOD) and the limit of quantification (LOQ) values are found to be 0.27, 0.28, 0.25, and 0.30µgmL-1 and 0.90, 0.93, 0.83, and 1.0µgmL-1 for BCP, BCG, BPB and BTB, respectively. The stoichiometric ratio of the formed ion-pair complexes was found to be 1:1 (drug: reagent) for all methods. CONCLUSION: The developed methods were successfully applied for the determination of eletriptan hydrobromide in pharmaceutical formulations with good accuracy and precision. Statistical comparison of the results was performed using Student's t-test and variance ratio F-test at the 95% confidence level and there was no significant difference between the reported and proposed methods regarding accuracy and precision. Further, the validity of the proposed methods was confirmed by recovery studies via standard addition method.

Highly Selective Optical Sensor Eu (TTA)3 Phen Embedded in Poly Methylmethacrylate for Assessment of Total Prostate Specific Antigen Tumor Marker in Male Serum Suffering Prostate Diseases.

A low-cost, simple, and highly selective method was used for the assessment of total prostate specific antigen (tPSA) in the serum of prostate cancer patients. This method is based on quenching the intensity of luminescence displayed by the optical sensor Eu (TTA)3 phen/poly methylmethacrylate (PMMA) thin membrane or film upon adding different concentrations of tPSA. The luminescent optical sensor was synthesized and characterized through absorption, emission, scanning electron microscopy (SEM), and x-ray diffraction (XRD), and is tailored to present red luminescence at 614 nm upon excitation at 395 nm in water. The fabricated sensor fluorescence intensity is quenched in the presence of tPSA in aqueous media. The fluorescence resonance energy transfer (FRET) is the main mechanism by which the sensor performs. The sensor was successfully utilized to estimate tPSA in the serum of patients suffering prostate cancer in a time and cost effective way. The statistical results of the method were satisfactory with 0.0469 ng mL-1 as a detection limit and 0.99 as a correlation coefficient.

Metformin is associated with increase in lactate level in elderly patients with type 2 diabetes and CKD stage 3: A case-control study.

The FDA has recently endorsed metformin use in patients with T2D and stage 3 CKD (CKD3). However, metformin safety in elderly individuals is unknown. The aim of this study was to identify frequency and risk factors of lactic acid (LA) elevation in ambulatory elderly male US veterans with stable diabetic CKD3 treated with metformin. We studied 92 patients with non-diabetic CKD3 (Group1), diabetic CKD3 not on metformin (Group2) and diabetic CKD3 on metformin (Group 3). Mean LA levels were similar at 1.3 ±â€¯0.3 and 1.3 ±â€¯0.4 mmol/L in Groups 1 and 2, respectively; while, LA was significantly higher in Group 3 (2.1 ±â€¯1.0 mmol/L, P < .001). Only 1 patient in each Groups 1 (4%) and 2 (4%) had hyperlactatemia (LA > 2.0 mmol/L), as compared with 17 (42.5%) patients in Group 3 (P < .05). No differences in age, BMI, eGFR, metformin dosage, and HbA1c were seen in Group 3 patients with and without hyperlactatemia. In the multivariate logistic regression analyses, metformin use was the only factor significantly associated with hyperlactatemia (adjusted OR 25.48, P < .005). In conclusion, metformin therapy is associated with increased risk of hyperlactatemia in elderly men with diabetic CKD3.

A case report of an uncommon Extra-Pulmonary Tuberculosis presenting as an Isolated Tuberculous Liver Abscess in a 63-year-old immunocompetent male

BACKGROUND@#Hepatic or liver tuberculosis is an uncommon form of extra-pulmonary tuberculosis which accounts for less than 1% of all tuberculous infections. Furthermore, tuberculous liver abscess (TLA), a subset of hepatic tuberculosis is extremely rare with a prevalence of 0.34% and is usually associated with foci of infection either in the lung, gastrointestinal tract, or an immunocompromised state.@*CASE PRESENTATION@#A case of a 63-year-old immunocompetent male, with no history of prior pulmonary tuberculosis, was initially diagnosed with pyogenic liver abscess and treated with empiric two-week therapy of Metronidazole 500mg/tab 1 tablet TID and Ciprofloxacin 500mg/tab 1 tablet BID. However, there was the persistence of right upper quadrant pain and jaundice despite compliance to therapy, hence admission. Initial antibiotics were re-initiated and subsequently underwent ultrasound-guided liver aspiration draining a thick, light brown abscess. Microbiologic cultures of the abscess turned out negative but AFB smear revealed 1+ on the AFB national TB program scale signifying 10-99 AFB seen/ 100 visual fields in at least 50 fields. Currently, there are no local treatment recommendations specific for isolated tuberculous liver abscess, thus was empirically started on 2HRZE/4HR for six months. On follow-up, the patient had no recurrence of liver abscess via a repeat ultrasound of the whole abdomen. @*CONCLUSION@#This is an uncommon presentation of extra-pulmonary tuberculosis, an isolated tuberculous liver abscess in an immunocompetent male presenting with persistent right upper abdominal quadrant pain and jaundice. Despite the endemicity of tuberculosis in the Philippines, an isolated tuberculous liver abscess is uncommon or often overlooked. The excellent clinical prognosis of these patients with appropriate therapy necessitates timely diagnosis of this infrequent clinical entity and will prevent further unnecessary surgical interventions.

Risk factors for acute respiratory infection in children younger than five years in Bangladesh.

OBJECTIVES: Acute respiratory infections (ARIs) are one of the major causes of child morbidity and mortality in the developing world. There is a lack of information regarding ARIs in children in Bangladesh. The study aims to determine the potential risk factors that are associated with ARIs among children younger than 5 years in Bangladesh. STUDY DESIGN: A cross-sectional study design was used. METHODS: Data were retrieved from the 2014 Bangladesh Demographic and Health Survey, which provides data for monitoring indicators in population, health and nutrition. In total, 7032 children (weighted) younger than 5 years were eligible for our analysis. Children with a cough and chest-related short, rapid breathing in the 2 weeks before the survey were considered having an ARI. A binary logistic regression model was used to determine the significant risk factors. RESULTS: The prevalence of ARI was 5.3% (95% confidence interval [CI]: 4.7-6.0) in the sample population. Infants aged 0-11 months (odds ratio [OR] = 2.87, 95% CI: 1.92-4.28), toddlers aged 12-23 months (OR = 2.03, 95% CI: 1.21-3.38) and children aged 24-35 months (OR = 1.67, 95% CI: 1.11-2.50) had a greater risk of ARI than older children. Children of lower economic (OR = 2.03, 95% CI: 1.27-3.27) and middle economic (OR = 1.67, 95% CI: 1.06-2.64) families were also at a higher risk of ARI. Girls (OR = 0.75, 95% CI: 0.56-0.99) had a lower risk of ARI compared with boys. In addition, stunting or slow growth rate in children (OR = 1.42, 95% CI: 1.02-1.97) was significantly associated with ARI. CONCLUSION: Young children, boys and stunted children are at greater risk of ARI. Educating mothers on the nutritional needs of children and subsequently reducing stunting due to malnutrition would help in the effort to reduce child morbidity and mortality caused by ARI.