Anti-N-methyl-D-aspartate receptor encephalitis presenting as atypical psychosis in multiple sclerosis: a case report.

BACKGROUND: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disorder which often presents with neuropsychiatric symptoms. A large proportion of cases are associated with an identifiable tumor, most commonly ovarian teratoma. However, recent literature has also described an overlap of anti-NMDAR encephalitis and demyelinating syndromes. Cases have been reported of anti-NMDAR encephalitis in patients with ADEM, optic neuritis, myelitis and multiple sclerosis. This link is considered rare, however has important clinical implications as treatments and prognosis may differ. CASE PRESENTATION: A 33-year-old female with a history of multiple sclerosis presented with new-onset neuropsychiatric symptoms. After substance-induced psychosis was ruled out, she was admitted to the medical ward for work up of psychosis secondary to multiple sclerosis. However, the consultation-liaison psychiatry service noted atypical symptoms which were concerning for autoimmune encephalitis. Admission to a psychiatric inpatient ward was deferred. Anti-NMDAR encephalitis was diagnosed with CSF analysis demonstrating lymphocytic pleocytosis and anti-NMDAR antibodies. In addition to first-line treatment of encephalitis with steroids, second-line immunotherapies were also implemented given the patient's underlining demyelinating syndrome. The patient's neurologic and psychiatric symptoms began to improve. CONCLUSIONS: There is literature to demonstrate a possible connection between anti-NMDAR encephalitis and demyelinating syndromes. As such, autoimmune encephalitis should be considered in patients with multiple sclerosis presenting with atypical symptoms. Determining the correct diagnosis is crucial to inform the appropriate treatment protocol, and to improve prognosis.

Antifungal potential and structure activity relationship of carrot seed constituents.

The aim of this study was to evaluate in vitro antifungal potential of carrot seed extracts, its essential oil, different fractions, isolated compounds, and their derivatives against three phytopathogenic rice fungi (Fusarium moniliforme, Bipolaris oryzae, and Rhizoctonia solani) using poisoned food technique. Carrot seed essential oil was extracted using hydrodistillation method and extracts were prepared using different solvents viz. dichloromethane, hexane, and methanol. The pure compounds daucene, carotol, and daucol were isolated using column chromatography and derivatized using different reagents. The study demonstrated that antifungal potential of all tested compounds varied in a dose dependent manner. Structure activity relationship of isolated and derivatized compounds showed that polar moieties possessed more antifungal potential as compared to non-polar moieties. The results suggested that carrot seed methanol extract and carotol possessed strong antifungal potential as compared to other components tested. PRACTICAL APPLICATIONS: Phytopathogenic fungi are the major problems causing harmful damage to the rice crop. Only available control of these diseases is synthetic fungicides but their repeated use led to serious environmental issues, residual toxicity, and development of resistance. Therefore, it's better to find some natural alternatives. The current study was conducted to evaluate in vitro antifungal potential of carrot seed essential oil, its constituents and extracts against phytopathogenic fungi of rice. The methanol extract and carotol possessed highest antifungal potential which might be due to their polar nature. This information may add a new dimensions to biological activity of these natural molecules mainly in the field of agriculture as fungal diseases are found to be associated with major losses in agriculture. Hence these compounds can act as natural antifungal agents against rice fungi.

A systematic review of proactive psychiatric consultation on hospital length of stay.

OBJECTIVE: Roughly half of general hospital patients may have a psychiatric issue that impacts care, yet most of these are not recognized during hospital admission. Proactive mental health screening offers an opportunity for timely identification and clinical attention to improve outcomes. METHOD: We conducted a PRISMA systematic review of Pubmed, Embase, PsycINFO, and Cochrane Library for proactive models of psychiatric consultation to reduce hospital length of stay (LOS) in adult inpatients. For each study, we evaluated the level of evidence and defined the study sample, means of group allocation, screening process, interventions, and outcomes. RESULTS: Of the 12 included studies, the 8 whose screening was informed by clinicians with mental health care expertise or whose providers were integrated with primary services reported a reduction in LOS. Two of these also reported favorable cost-benefit analyses. All positive studies represent versions of either psychiatrists embedded within medical or surgical settings or a multidisciplinary team-based model. CONCLUSIONS: Proactive CL psychiatry with clinically-informed screening and integrated care delivery appear to reduce LOS. Further studies are needed to explore a broader range of outcomes, hospital populations beyond hospital medicine, and additional benefits of proactive integrated mental health care in the general hospital.

Antioxidant activity of Anethum graveolens L. essential oil constituents and their chemical analogues.

In the present study, Dill (Anethum graveolens) seed essential oil, its nonpolar and polar fractions, compounds isolated and derivatized were evaluated for their antioxidant potential using different in vitro assays. The major compounds carvone, limonene, and camphor were isolated from dill seed essential oil using column chromatography and characterized using spectroscopic techniques. Among all the tested components for antioxidant activity, carveol and perillyl alcohol were most effective (IC50 values < 0.16 mg/ml), whereas camphor was least effective (IC50 values > 10 mg/ml). All the tested compounds exhibited lower antioxidant potential than the standard. PRACTICAL APPLICATIONS: Oxidation of food products was delayed by compounds known as antioxidants. The use of synthetic antioxidant is restricted because of carcinogenicity in human servings and plant-based natural antioxidant are preferred due to safety and less toxicity. The aim of this in vitro study was to assess the antioxidant activity of the different constituents of dill seed essential oil. The present study revealed that carvone and its derivatives are potent scavengers of free radicals which might be due to the presence of unsaturated hydroxyl group. Thus, natural antioxidants are the important source of alternative medicines and natural therapy in the pharmaceutical industry.

Cichorium intybus from India: GC-MS Profiling, Phenolic Content and in vitro Antioxidant Capacity of Sequential Soxhlet Extracted Roasted Roots

Abstract Research on the bio-activities and chemical composition of roasted C. intybus roots from India is very little. In present studies GC-MS analysis of volatile components of roasted C. intybus roots, phenolics and flavonoid content estimation and antioxidant potential of roasted C. intybus roots was carried out. Antioxidant potential was also evaluated using FRAP, DPPH, hydroxyl radical, nitric oxide and superoxide free radical scavenging method. Extracts were prepared by sequential Soxhlet extraction. GC-MS analysis of volatile components of roasted C. intybus root extracts revealed that 5-hydroxymethyl furfural was major volatile component in dichloromethane and methanol extract whereas lupeol and its derivative compounds were major constituents of hexane extract. Quantitative estimation for total phenols and flavonoids showed that the methanol extract of C. intybus roots contained highest phenolic and flavonoid content as compared to other extracts and also showed strong radical scavenging activities which were comparable with ascorbic acid used as standard. All extracts showed IC50 values less than 0.6 mg/mL furthermore, extracts of roasted C. intybus showed the high total antioxidant potential for the reduction of Fe3+ to Fe2+. The C. intybus roots possess good antioxidant capacity even after roasting and all the extracts showed good activities.