Journal of Medicinal and Chemical Sciences
Volume:7 Issue: 1, Jan 2024

The most prevalent hemoglobinopathy is sickle cell disease, which is followed by β-thalassemia and thalassemia syndrome. The Mediterranean region, Middle East, Indian subcontinent, South east Asia, and the northern coast of Africa have been found to have the highest prevalence of both diseases. The majority of affected youngsters in many of these regions pass away before turning five without ever receiving a diagnosis. Our understanding of hemoglobinopathies' clinical and therapeutic features as well as their laboratory diagnosis has increased as a result of several study articles. Erythrocyte index, hemoglobin analysis by HPLC and capillary electrophoresis, and recently employed next-generation sequencing (NGS) to screen for thalassemia are the main biochemical and molecular procedures used in clinical laboratories. Preventive treatment and genetic counselling can be performed when SCD is detected and diagnosed early, which helps to lower mortality and minimize sequelae. Current diagnosis procedures are laboratory-based and call for expensive diagnostic tools and qualified employees. India has a vast population, making it impossible for them to pay for traditional diagnostics. The primary benefit of POCT is its low cost, and its effect on hemoglobinopathies may ultimately contribute to the improvement of India's health situation and other relevant fields.

This study aimed to evaluate the expression of hypoxia inducible factor-1 alpha (HIF-1α) and CD44 markers to detect their potential role in the progression of oral epithelial dysplasia (OED) to oral squamous cell carcinoma (OSCC). The study involved 50 patients with different grades of OED and OSCC taken from different anatomical sites by the head and neck surgeons. The pathologists used ordinary stained slides for histological evaluation and immunostaining of HIF-1α and CD44 antibodies using conventional and remote examination tools. The results showed that the mean area percentage of HIF-1α and CD44 immunostaining was significantly higher in severe dysplasia, followed by moderate dysplasia and mild dysplasia. Similar results were observed in OSCC, with poorly differentiated OSCC showing the highest mean expression and the mean area percentages in all cases were higher in OSCC (44.24%) and (47.09%) than in OED (14.50%) and (20.29%). The study concluded that HIF-1α and CD44 markers could be helpful in accurate classification of oral epithelial lesions with potential and therapeutic value, however further clinical studies are recommended.

Cognitive impairment represents a major but under-determined comorbidity in children with temporal lobe epilepsy. Exposure to oxidation stress may induce cellular damage and functional disruption in the developing brain.  This comparative study included 42 children with newly diagnosed temporal lobe epilepsy and 42 healthy children as a control group. Cognition was assessed using Wechsler Intelligence Scale. Malondialdehyde and Advanced Oxidation Protein Products were measured as markers for oxidants while plasma catalase and total antioxidant capacity was measured as markers for antioxidants. Biomarkers of oxidation stress were correlated to clinical data and cognition scores of included children. Children with temporal lobe epilepsy have significant higher circulating malondialdehyde, Advanced Oxidation Protein Products and lower catalase, total anti-oxidant capacity, and cognition ability scores than healthy controls. Cognition ability scores have significant negative correlation with malondialdehyde and Advanced Oxidation Protein Products levels and significant positive correlation with the age of onset of seizures, plasma catalase and total anti-oxidant capacity levels. Oxidation stress may be associated with decreased cognitive abilities in children with newly diagnosed temporal lobe epilepsy. Treatment strategy for children with newly diagnosed temporal lobe epilepsy should be adjusted to decrease oxidation stress to avoid worsening of cognitive function.

To find the accuracy of prolactin levels and identify the severity and complications.Materials & This was a cross-sectional study performed in the Department of Medicine at Sri R.L. Jalappa Hospital and Research Centre.Participants: The study involves participants who are diagnosed with liver cirrhosis of age above 18 years. Participants with other health complications were excluded from the study.Interventions: Child pugh scores were compared with serum prolactin levels and the predictive value of serum prolactin was assessed. In the 69 subjects studied mean age was 50.93±8.84 the study population, with the majority of them being males (85.51%) and females 14.49%. The difference in serum prolactin between Child-Pugh scores was statistically significant (P value - < 0.001). The present study found a significant (P <0.001) higher median prolactin levels in grade 4 hepatic encephalopathy compared to grade 3, 2, and grade 1 (grade 4- 66.00(61.5 to 71.5), grade 3- 47.00(42.0 to 54.0), grade 2-43.00(39.25 to 50.5) and grade 1-40.50(31.25 to 48.25), whereas in cirrhosis cases without hepatic encephalopathy, we found significantly lesser prolactin levels (median- 27.00(range 25.0 to 33.0) compared to cases present with hepatic encephalopathy. The serum prolactin had a sensitivity of 82.61% specificity was 73.91% and diagnostic accuracy was 76.81% in predicting severe child pugh score. There was a higher frequency of cirrhosis complications in patients who had higher blood prolactin levels at admission. Hence, serum prolactin can be considered as a low-cost, biomarker for liver cirrhosis.

Clear cell renal cell carcinoma (ccRCC) is the most common type of kidney cancer and the incidence is steadily increasing. T Stage is one of the most important information to assess the disease magnitude. Both CXCL12 and PLK1 play important role in several pathways that lead to proliferation of tumor cells. The disruption of this pathway is seen in many cancers including clear cell renal cell carcinoma. This research aimed to describe the expression and the correlation between CXCL12 and PLK1 in various T stage of ccRCC. This was an analytic observational study with cross-sectional approach. The study included 50 samples throughout January 2014 until June 2022. The samples were divided into T1, T2, T3, and T4 based on histopathology examination. Immunohistochemistry examination was performed using CXCL12 and PLK1 antibodies. The correlation was analyzed using statistical tests. There was positive correlation between CXCL12 and PLK1 expression in various T stage of ccRCC (p=0.005), but when correlated separately, there was no significant result in both CXCL12 and PLK1 (p=0.443 and p=0.292, respectively). CXCL12 and PLK1 expression varied throughout different T stages in this study, but in tandem, the work of CXCL12 positively affect PLK1, resulting greater tumor size.

Dengue hemorrhagic fever (DHF) is still a major problem in the world. It diagnosis is based on clinical and supporting examinations including leukocytes and platelets examinations, as well as antigen and antibody tests for dengue virus. Prompt and early diagnosis will reduce the risk of disease severity. Examination of lymphocytes and atypical lymphocytes are done to strengthen the diagnosis of dengue hemorrhagic fever patients. Lymphocytes in dengue hemorrhagic fever have their own characteristics and roles in relation to the body's immune system. Lymphoctes and atypical lymphocyes are increased in DHF patients. In this review, the characteristics and role of lymphocytes and atypical lymphocytes are described in dengue hemorrhagic fever.

Acute coronary syndrome (ACS) has a significant morbidity and fatality rate. An early diagnosis and accurate prognosis are necessary. Therefore, biomarkers that are associated with coronary artery stenosis and hazard for coronary artery disease (CAD) development are far required. The objective of the current study is to identify the role of plasma miR-122 and miR 151-3p as diagnostic and prognostic indicators in patients with ACS.

A total of 100 Egyptian subjects were enrolled that included 25 unstable angina (UA) patients, 25 NSTEMI patients, 25 STEMI patients, and 25 healthy volunteers. Quantitative real-time PCR (RT-PCR) for both plasma miR-122 and 151-3p expression were performed and Cardiac Catheterization had been performed for displaying the severity of stenosis.

There was steadily significant elevation in miRNA-122 and miR151-3p levels from control group to STEMI group (p<0.001). In studied cases, there were substantial positive correlation between both miR-122 and miR 151-3p with cardiac Troponin (p<0.001) and coronary stenosis (p<0.001).

Both miR-122 and miR-151 -3p were diagnostic biomarkers for ACS and were capable of evaluation of the grade of coronary artery stenosis to expect the necessity for percutaneous coronary intervention (PCI) in medical practice. Moreover, they have prognostic value for adverse cardiac events (ACE).

Malaria poses a substantial threat to healthcare systems across the globe. The escalating resistance of malaria parasites to the absence of affordable and accessible antimalarial medications has exacerbated the challenges associated with malaria treatment. This research aims to evaluate the antimalarial and antioxidant properties of Stichopus hermanni in combination with artemisinin, employing murine malaria models. This study employed the 4-day suppression test procedure and conducted an experimental investigation with a post-test-only control group design. The study involved 35 male BALB/c mice, aged 7-10 weeks, each infected with Plasmodium berghei ANKA/PbA. The sample was divided into five groups: C1 (negative control), C2 (positive control), T1 (administered 15 mg/Kg BW/day of Stichopus hermanni ethanol extract and 0.04 mg/g BW/day of artemisinin), T2 (administered 17 mg/Kg BW/day of Stichopus hermanni ethanol extract and 0.04 mg/g BW/day of artemisinin), and T3 (administered 20 mg/Kg BW/day of Stichopus hermanni ethanol extract and 0.04 mg/g BW/day of artemisinin). The parameters measured included % parasitemia level, % growth inhibition, and malondialdehyde (MDA) levels. The T3 group exhibited the lowest parasitemia level and the highest degree of growth inhibition compared to the other groups (p-value < 0.05). However, statistically, it did not differ significantly from C2 and T1. Meanwhile, the T3 group demonstrated the lowest MDA levels and the most significant antioxidant capacity compared to the other groups (p-value < 0.05). Based on both descriptive and statistical analyses, the combination of Stichopus hermanni ethanol extract and artemisinin exhibits antimalarial and antioxidant activities.

Healthcare personnel involved in COVID-19 care have been negatively affected by the associated excess stress. This study aimed to investigate the relationship between moral distress and moral courage among operating room nurses due the hidden conditions of the effects of COVID during the outbreak of the coronavirus disease (COVID-19) crisis. This descriptive-correlation study was conducted on all operating room nurses working in educational and medical centers in Shiraz, Iran, 2022. The samples (n=141) were selected using a convenience sampling method. The required data were collected by questionnaires of demographic form, the Professional Sekerka Moral Courage and the Moral Distress Scale. The gathered data were analyzed in SPSS software through descriptive and analytical statistics. The mean scores of moral courage and moral distress only nurses who as Circuler Nurse were obtained at 61.67±7.79 was 47.4±18.9, respectively. It was revealed that there was a statistically significant relationship between the dimensions of moral courage and the dimensions of errors and inappropriate competencies and responsibilities of moral distress (P>0.05). The moral courage and moral distress of the nurses showed significant differences in terms of the type of employment, length of working experience, specialized field of surgery, and working ward, age, specialized field of surgery during the COVID-19 crisis. Moral agency and multiple values showed a statistically significant and direct relationship with total moral distress (R=0.20, P=0.01). Concerning the results of study, there can be stated that nurses were inclined to perform moral behaviors and an increase in their sense of responsibility during the COVID-19 crisis would lead to courageous behaviors and ultimately, a reduction in moral distress. Therefore, it is necessary that managers pay serious attention to the employment of training programs and improving the psychological knowledge of involved nurses and sharing nurses’ experiences of moral distress.

The seven human coronavirus, sever acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had started a worldwide health pandemic that raised concern regarding its severe outcomes in the healthcare system and specifically for patients who are diagnosed with chronic diseases such as obesity and diabetes. The purpose of the study was to assess the severity of COVID-19 in obese and diabetic hospitalized patients in National Guard Health Affairs (NGHA). A descriptive cross-sectional study was done at King Abdulaziz Medical City, NGHA in Riyadh, Saudi Arabia. Data was collected from The BestCare system using a non-probability purposive which was done by including all patients applicable to our inclusion criteria. SPSS version 24 was used for data analysis. The study included 5,257 patients that were with positive test results for COVID-19. Of all the patients, 2,499 (47.5%) males and 2,758 (52.5%) females were diagnosed. The majority (97.9%) of the patients were diabetic and more than half of the subjects (53.1%) in the sample were hypertensive. There was a strong association between ICU admission and chronic diseases and between death due to COVID-19 complications and: heart failure, renal disease, and obesity. There was a strong association between ICU admission and diabetes, heart failure, renal disease, and obesity. Moreover, there were a strong association between death due to COVID-19 complications and heart failure, renal disease, and obesity.

A tropical disease of zoonotic origin, Leptospirosis is a public health concern, particularly in developing countries. This present investigation sought to determine the seroprevalence of Leptospira in healthy people referred to Shahid Motahari Laboratory, Zanjan, Iran. 181 healthy people referred to Shahid Motahari laboratory in Zanjan, Iran, were included in the present study. Serum samples were collected from each participant, whose demographic information was gathered using a questionnaire. After being stored -20 °C, the samples were analyzed for Anti-Leptospira IgG antibodies using NovaLisa Leptospira IgG ELISA" kit, the results of which were reported as positive, negative, or equivocal. Out of 181 serum samples, 43 (23.7%) samples were positive, 36 (19.9%) were equivocal, and 102 (56.4%) were negative for anti-Leptospira IgG. The average age of the participants was 40.6 years old. No significant difference was shown between age and gender with anti-Leptospira IgG. IgG levels were not found to be correlated significantly with the rural residence of the participants, as well as the other demographic characteristics of participants. The results of this investigation contribute to the understanding of the epidemiological aspects of Leptospirosis in the region and underscore the importance of continued surveillance and awareness efforts.

Pangasius hypophthalmus fish, as a dietary source, contains vitamins and minerals that serve as antioxidants, effectively preventing oxidative stress. Diabetes mellitus is rooted in oxidative stress-related pathophysiology. The experimental subjects were categorized into three groups: K1, the control group without treatment; K2, intraperitoneally (i.p) induced with alloxan at a dose of 150 mg/kgBW on the seventh day, with a three-day interval; and K3, the treatment group, which, similar to K2, received alloxan induction while also being administered Pangasius hypophthalmus fish oil extract at a dose of 73 mg/kgBW through intragastric sonde for 14 days. Alloxan induction results in pancreatic cell damage and decreased insulin production, leading to dysregulation of blood glucose levels and consequent hyperglycemia. A significant reduction in blood glucose levels (p = 0.009) was observed in the alloxan-induced group and the alloxan-induced treatment group, which received Pangasius hypophthalmus fish oil extract. The presence of Omega-3 in Pangasius hypophthalmus oil stimulates zinc transportation to the cell membrane, promoting insulin stabilization, reducing degradation, and enhancing insulin sensitivity. Comparatively, uric acid levels demonstrated a decline in the alloxan-induced animal group when compared to the untreated group (p = 0.008). However, the observed mean increases in uric acid levels within the experimental animal group-induced by alloxan and subsequently administered Pangasius hypophthalmus fish extract-did not attain statistical significance (p = 0.059). The Pearson correlation test revealed a robust inverse association of -0.51 between blood glucose levels and uric acid concentrations. Pangasius hypophthalmus fish extract contributes to the reduction of blood glucose levels in experimental animals induced by alloxan. However, no distinct variance in uric acid levels was observed.

Cholangiocarcinoma remains a problem in several tropical and subtropical parts of the world, especially in Southeast Asia. The study determined plasma protein binding and blood-to-plasma ratio (B:P) of atractylodin (AT) and β-eudesmol (BE), the two active constituents of Atractylodes lancea (Thunb.) D.C., which is currently under development as an alternative treatment for cholangiocarcinoma. Plasma protein binding studies were performed using the ultracentrifugation method. Plasma samples (n=10) were spiked with AT or BE (2.5, 5, and 10 µg/mL) and incubated at 37 °C for 1 h. Blood to plasma (B:P) ratios of both compounds (0.5 mg/ml) were determined in human plasma produced from the spiked whole blood and the spiked plasma (n=10 each) and incubated at 37 °C for 10 min and 1 hour, respectively. Concentrations of AT and BE were determined using HPLC-UV. Plasma protein binding (%PPB) of AT and BE were relatively high (>90%), with low unbound fractions (fu < 0.05). The AT and BE concentrations in plasma and red blood cells (RBCs) were comparable, with the KRBC/Plasma (B:P) ratio of about 1. The high partitioning in blood circulation and high plasma protein binding of AT and BE may limit the extent of their distribution and delivery to the target tissues (bile ducts). Either plasma or whole blood can be used as the matrix of choice for pharmacokinetic studies. The information obtained would provide essential input parameters in the pharmacokinetic models to predict optimal dose regimens of AL in clinical studies.

This study aimed to determine the risk factors that affect anxiety and depression in patients diagnosed with malignancy in Makassar. A cross-sectional study was conducted involving 55 patients with malignancy who met the research criteria. Assessment of anxiety and depression was conducted using the GAD-7 and PHQ-9 instruments. The statistical test employed the Chi-Square test. The results were considered significant if the p-value <0.05. The study found that 49.1% of the patients had anxiety, 61.8% had depression, and 45.5% had a combination of anxiety and depression. The analysis showed a significant relationship between performance status and anxiety (p<0.01), performance status and depression (p<0.05), as well as performance status with mixed anxiety and depression (p<0.001). The findings of this study suggest that performancee status ECOG ≥3 is a risk factor for anxiety, depression, and both anxiety and depression in patients diagnosed with malignancy.

Titanium dioxide nanoparticles (TiO2-NPs) are widely utilized as a whitish pigment with potential applications in various sectors, including cosmetics, pharmaceuticals, food production, textiles, and water treatment. They are commonly employed as a sanitizing agent for microorganism control. Due to their small size and expansive surface area, these nanoparticles can inflict severe toxic effects on various human organs and cause serious damage to the surrounding environment. This study investigated the gonadal toxicity induced by TiO2-NPs in male Sprague Dawley rats. Accordingly, TiO2-NPs were employed with an average particle size of 55 nm. Twenty-five adult male Sprague Dawley rats weighing 107 ± 120 g underwent a 7-day acclimatization period and were subsequently randomly divided into five groups: The Control group (C), which received no treatment; the saline-treated group (S), treated with normal saline; and three treatment groups (G1, G2, and G3), each consisting of five rats. The rats were exposed to different concentrations of TiO2-NPs for 28 days on alternate days, determined after establishing the LC50 value. TiO2 was administered intraperitoneally with injection at doses of 50, 90, and 130 mg/kg body weight. The blood samples were collected at the beginning and end of the experiment. The 28-day exposure results revealed severe histological damage in testicular tissues at high and medium doses compared to the control and saline-treated groups. These damages included widened lumen, basement membrane damage, necrosis, and vacuolation in the tissues, which were highly significant in both the G1 and G2 groups. This study demonstrates the toxic effects of titanium dioxide nanoparticles on the gonads of Sprague Dawley rats. It is concluded that the selected concentrations of TiO2 negatively impact the health of living organisms.

Cardiovascular complications are the primary reason for death in diabetic patients. Speckle tracking echocardiography is the method that can detect heart systolic dysfunction in the preclinical stage, even when the ejection fraction is normal range. This study aims to evaluate left ventricular myocardial strain parameters using the speckle tracking echocardiography method and to investigate the relationship between these parameters and cardiovascular risk factors in populations with type 2 diabetes mellitus. A controlled cross-sectional descriptive study was carried out on 75 people who have suffered type 2 diabetes mellitus and 75 controls. Participants in the study must satisfy the inclusion and exclusion criteria to be invited. They will be interviewed to take history, do clinical examinations, and do laboratory tests, and echocardiography. All data recorded on the data collection form was coded. The group of T2DM had a global longitudinal strain (-17.02±3.06%) and global circumferential strain (-29.04±6.39%) that were lower significantly than the controls. The global longitudinal strain had a positively significant correlation with values of blood pressure (r=0.3 for systolic and r=0.2 for diastolic), HbA1c (r=0.2), fasting plasma glucose (r=0.5), and total cholesterol (r=-0.25). The study also recorded there was a statistically significant correlation between global circumferential strain and values of blood pressure values (r=0.3 for systolic and r=0.2 for diastolic), and HDL (r=-0.3). Both the global circumferential and global longitudinal strain have been reduced in individuals with type 2 diabetes mellitus. The reduction of global longitudinal strain and global circumferential strain has been correlated with cardiovascular risk factors (i.e. hypertension, poor glycemic control, increased BMI, and dyslipidemia).

According to reports, fungus-related keratitis accounts for roughly 50% of all bacterial keratitis instances involving therapeutic penetration keratoplasty, making it a significant contributor to ocular morbidity. Fungal keratitis is a difficult condition to identify and manage.Patients and

A prospective investigation was carried out. A total of 40 eyes from 40 participants with fungal keratitis (26 men and 14 women) were enrolled in this study. Grouping 20 eyes first go through Voriconazole intrastromal Grouping 20 eyes are examined again with Amphotericin B injection.

Following intrastromal voriconazole administration, the satellite lesions in 9 participants and the hypopyons in 3 individuals in the first cohort vanished without subsequent infection or ocular rupture. After injections, the infiltration's size considerably shrank to 5.41± 2.21 mm (P <0.001), but the ulcer's size remained the same (4.25 ±1.83 mm, P = 0.071). Seven of the 17 effectively hospitalized groups in the first patient received just one injection, while six received two injections, and four received three.

The treatment of fungal keratitis is still difficult. The causes for the poor prognosis in fungal keratitis are compounded by newly emerging fungal infections and resistance to already available antifungal medications. For persistent deeply fungal corneal ulcers, intrastromal voriconazoles and intracameral amphotericin B seem to be a successful therapy option. Thus, we draw the conclusion that in some individuals, intrastromal voriconazole may be administered as a replacement for fungal ulcers that do not heal.

Partial or an incomplete penetration of bonding agent into the demineralized dentin can leave the denuded collagen fibres susceptible to degradation by photolytic enzymes. It is well known that the demineralized dentin and its collagen network is susceptible to degradation with time which can significantly affect the bond strength between root canal and sealer materials. The current study attempts assess the protective effect of proanthocyanidin (PA) loaded PLGA nanoparticles in minimizing the deterioration of demineralized dentin over a period. This is realized by determining/evaluating the push out bond strength between a glass fibre post cemented to root canal using resin luting cement. Ninety human mandibular premolars with single root canals were randomly divided into nine groups (n=10) after endodontic treatment and post space preparation. The root canal dentin of the control group was left unconditioned and the experimental groups i.e. proanthocyanidin and PA loaded PLGA nanoparticles (PA-NP) were conditioned respectively with the test solutions. The glass fibre posts (GFP) were cemented into the root canal with dual cure resin cement (RC). The push out bond strength (POBS) was measured at 30, 60, and 90 days. The mode of failure was evaluated with the help of stereomicroscope. The POBS were statistically analysed and evaluated with the help of paired t-test, ANOVA test and post hoc Bonferroni test at a confidence interval of 95% (α = 0.05). Unloaded NP's average particle size was found to be 237 16 nm, and its zeta potential was -54±4 mV. There was a statistically significant difference between the mean POBS at all time intervals among the groups tested. PA-NP showed a statistically significant higher bond strength compared to control at all time intervals, while it showed significantly better POBS compared to PA at 180 days. All the experimental groups showed higher POBS at all intervals of time compared to control group. Application of natural cross-linkers such as PA improves POBS of GFP bonded to root canal dentin. PA loaded PLGA nanoparticles (PA-NP) as a conditioning liquid prior to root canal cementation not only improved POBS significantly, but also reduced the time dependent reduction in the bond strength.

Cataracts are characterized by the clouding of the eye lens, resulting from changes in lens metabolism that can lead to lens hydration (fluid accumulation), denaturation of lens proteins, or both. Autophagy is a subcellular process involving the recycling of damaged proteins or organelles by lysosomes. Inhibition of autophagy in lens cells can hinder cell differentiation, contributing to cataract formation. Understanding the functional role of autophagy in lens tissue is essential for considering it as a potential therapeutic strategy for cataract treatment. This study involved several statistical analysis tests, including descriptive statistics to calculate the mean and standard deviation (SD), data normality tests to assess data distribution, data homogeneity tests to examine data diversity, and the Homogeneity of Variance test. A t-test was conducted to assess significant differences between the two independent test groups. Statistical analysis was performed using SPSS version 20.0. This study explored the role of the autophagy pathway in cataracts induced by oxidative stress, focusing on the expression of ROS, SOD, mTOR, LC3-II, p-62, IL-1β, Caspase-3, and lens tissue histology. Cataract formation was clinically examined in the eye lens of experimental animals. Immunohistochemical methods were used to analyze ROS, SOD, LC3-II, p-62, IL-1β, and Caspase-3. ROS, SOD, LC3-II, and p62 were collected from the anterior lens capsule, while IL-1β and Caspase-3 were collected from the eye lens. mTOR expression was collected from the lens capsule and determined by Western blot. The expression levels of mTOR, ROS, SOD, LC3-II, and caspase-3 in Wistar rats induced by the sodium selenite cataract model were lower than those in the control group. On the other hand, ROS expression and IL-1β expression in the sodium selenite-induced cataract model of Wistar rats were higher than those in the controls. The mechanism underlying cataract formation in Wistar rats induced by sodium selenite involves autophagy, as evidenced by the expression of ROS, LC3-II, IL-1β, and caspase-3.

This review discusses the antimicrobial potential of Curcuma longa, a plant traditionally recognized for its medicinal properties. The emerging concern over antimicrobial resistance, coupled with the adverse effects of synthetic drugs, necessitates an exploration of plant-based natural antimicrobials. Curcuma longa, commonly known as turmeric, provides a compelling case with its broad spectrum of antimicrobial activity. The review first delves into the phytochemical composition of Curcuma longa, focusing on its primary bioactive compounds, the curcuminoids, with curcumin being the most prominent. These compounds, along with essential oils and polysaccharides, contribute significantly to the antimicrobial properties of the plant.

Breast cancer is ranked as the fifth major contributor to global cancer-related fatalities. Cyclin D1 is frequently overexpressed in cases of invasive ductal breast cancer and plays a specific role during the advanced stages of tumor evolution. However, the utilization of cyclin D1 overexpression as a predictive tool remains a subject of debate. This study aims to determine the relationship between cyclin D1 expression and the histopathological grading of invasive ductal carcinoma in breast cancer. The results can serve as scientific evidence that cyclin D1 can aid in predicting the prognosis of patients, making it a valuable tool in health facilities. In this cross-sectional study, employing flow cytometric techniques, cyclin D1 expression was assessed in 30 patients categorized as having grade 1, grade 2, or grade 3 invasive ductal breast cancer based on histopathological diagnoses. The analysis indicated a negligible difference in cyclin D1 expression levels between patients with invasive ductal breast cancer grades 1 and 2 (P = 0.283). In contrast, a statistically significant disparity in cyclin D1 expression was observed between patients diagnosed with grades 1 and 3 of invasive ductal breast cancer (P = 0.026), as well as between grades 2 and 3 (P = 0.026). Our findings underscore a moderate yet significant correlation between cyclin D1 expression and breast cancer grading (R: 0.508; P < 0.05). A moderate correlation between cyclin D1 expression and the histopathological grade of breast cancer was substantiated. These observations lend credence to the utilization of cyclin D1 as a marker indicative of an unfavorable prognosis.

Quick and smooth recovery after bariatric surgery for morbidly obese patients may pose a challenge to anesthesiologists, especially if there is any cardiac comorbidity. The addition of spinal anesthesia besides general anesthesia is a strategy that can be considered in this procedure.

Case description: 

The 27 y.o. woman with a BMI of 53,8 kg/m2, atrial septal defect, and arrhythmogenic right ventricular dysplasia planned for bariatric surgery. The patient received preoxygenation for 24 hours before the day of surgery. After standard bedside monitoring for surgery had been applied, spinal anesthesia was administered at lumbal level L1–L2. General anesthesia was conducted after confirmation of a successful neuraxial block. Modifications of the surgical technique include low-flow CO2 insufflation. An episode of hypotension occurred once during the procedure and has been treated successfully with a 10 mg ephedrine bolus. Ventricle extrasystole appeared several times, but resolved with increasing oxygen fraction. Before extubation, infiltration of bupivacaine was done on a surgical wound. Paracetamol was intravenously administered for analgesia post-surgery. The patient was content with the anesthesia management and returned home without any complications.

A combination of anesthetic modalities may provide good abdominal relaxation, reduce the intraabdominal pressure during pneumoperitoneum, and reduce the use of muscle relaxants and opioids, which is important to gain optimal results in morbidly obese patients.

General anesthesia is widely used for laparoscopic bariatric surgery. The addition of spinal anesthesia in morbidly obese simple left-to-right atrial septal defect patients is still safe and may be a good alternative technique in selected cases.

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has been associated with severe respiratory disease incidence and increased morbidity and mortality of patients all over the world. The aim of this study is evaluation of Atorvastatin effect on patients with COVID-19. This is a prospective randomized controlled trial with 100 adults diagnosed with COVID-19. Participants randomly received Atorvastatin or just routine protocol of treatment for 10 days. Primary outcomes are duration of fever and cough, atrial oxygen saturation (SPO2), length of hospitalization and ICU stay, duration of oxygen therapy or intubation, and mortality rate. Secondary outcomes contain white blood cell count, lymphocyte percentage, lactate dehydrogenase, and creatine phosphokinase level. There was no significant difference in age and sex between two groups. Atrial oxygen saturation (SPO2) with/without non-invasive oxygen therapy was significantly higher in statin group (P=0.001, P=0.002, respectively). However, other primary and secondary outcomes was similar in both groups. Statin use was associated with higher percentage of SP02, but there were no significant differences in other outcomes.

Pseudomonas aeruginosa is the most prevalent cause of keratitis, which can cause progressive corneal injury, scarring, thinning and corneal perforation. Antibiotic treatment alone is inadequate in some cases because the inflammatory process continues even after the bacteria have been eliminated. Anti-inflammatory adjuvant therapy is needed to prevent further complications. Epigallocatechin gallate (EGCG) is the main polyphenol in Camellia sinensis. EGCG has anti-inflammatory and antioxidant properties that are widely recognized. It is known that EGCG acts by inhibiting NF-κB, so it is speculated that the necroptosis process will be reduced due to the TNF-α downregulation and that the wound healing process will begin promptly due to the polarization of M2 macrophages, as indicated by the upregulation of IL-10, therefore, preventing corneal thinning and perforation.

High use of antibiotics in sepsis patients can lead to irrational use of antibiotics. Irrational antibiotic therapy in septic patients in the ICU increases the mortality rate in the hospital. Efforts to maximize the rational use of antibiotics are one of the pharmacist's responsibilities. This study aims to evaluate the quality and quantity of antibiotic use in sepsis patients in the Intensive Care Unit (ICU) ward using the Gyssens and ATC/DDD methods and to evaluate the effect of pharmacist intervention in improving the quality of antibiotic use and therapeutic outcomes. The research was carried out prospectively during the period of August-November 2018 using a one-group pretest-posttest pre-experimental study design. Recommendations are given to prescribers regarding the problem of inappropriate use of antibiotics. Qualitative evaluation using the Gyssens method found that rational use of antibiotics in sepsis patients was 85.1% and 14.9% were irrational. The interventions increased the accuracy of the use of antibiotics (0% to 64.7%), reduced the problem of choosing antibiotics (88.2% to 32.4%), the problem of the duration of antibiotic administration (5.9% to 0%) and the problem of the route of administration of antibiotics (5.9% to 0%). The results of the quantitative evaluation obtained the value of the use of antibiotics, namely 63.8 DDD/100 days of treatment, with the greatest value for meropenem antibiotics, namely 32.9 DDD/100 days of treatment. There are differences in the therapeutic results between the quality of rational use of antibiotics and the quality of irrational use of antibiotics in the ICU ward of Fatmawati Hospital.