A Cross-sectional Survey-based Study of Knowledge, Attitude, and Practice Towards Uses of Cosmetics and Cosmetovigilance in India

Background

In India, the cosmetics industry has expanded significantly because of changing lifestyles and increased awareness. In terms of earning the most money from the personal care and cosmetics industry in 2021, India is ranked fourth globally. Many cosmetics sold in India include ingredients that cannot be used on humans.

Objective

To assess knowledge, attitudes, and practice toward the uses of cosmetics and cosmetovigilance in India.

Methods

A cross-sectional study was conducted, from April to May 2022, among the general population living in the Delhi NCR region, India. Study questionnaires (printed and survey link) were distributed in public as well as at workplaces for the survey.

Results

Around 268 (54.78%) females and 223 (45.21%) males participated in the survey. Amongst the total respondents - 407 (83%) agreed that they are using cosmetic products on a daily basis, females 229 (85.44%), being the majority users compared to males 178 (80%), with a significant P value = 0.011. Most of the people reported side effects of shampoos - 7.13% (hair fall, hair thinning, dryness of the scalp, itching), followed by allergic reactions to moisturizers - 5.70%.

Conclusion

Because of the right safety and effectiveness mentorship of cosmetics, regulatory agencies and stakeholders should adopt this broadly. Cosmetovigilance needs to be put into practice.

Phytochemical profiling and anti-inflammatory, analgesic activity of Ficus religiosa L. and molecular docking study against iNOS, TNF-α enzyme

Ficus religiosa L., a member of the Moraceae family, is a medicinal plant having a number of pharmacological properties. The anti-inflammatory and analgesic actions of an ethanolic extract of F. religiosa bark FRE (at 100 and 200mg/kg dosages) and the biomarker component quercetin QC (at 5 and 10mg/kg doses) were investigated. The estimate of quercetin was carried by using an HPTLC analysis of FRE. Additionally, qualitative and quantitative screening for key important phytocomponents was done using dried, ground plant stem barks. By using molecular docking, the molecular interaction profile with several anti-inflammatory drug targets was examined. Both the FRE as well as QC showed a substantial decline in paw volume when compared with the relevant control groups (p<0.01 & p<0.001). Following the administration of acetic acid to mice, the FRE and QC both demonstrate a substantial lengthening of the paw licking or leaping towards Eddy's hot plate as well as a decrease in the number of writhes (p<0.01 & p<0.001). This study supports the use of these herbs in conventional medicine to treat pain and inflammation by through similar mechanism as compound quercetin (QC).

All-Microwave Leakage Reduction Units for Quantum Error Correction with Superconducting Transmon Qubits

Minimizing leakage from computational states is a challenge when using many-level systems like superconducting quantum circuits as qubits. We realize and extend the quantum-hardware-efficient, all-microwave leakage reduction unit (LRU) for transmons in a circuit QED architecture proposed by Battistel et al. This LRU effectively reduces leakage in the second- and third-excited transmon states with up to 99% efficacy in 220 ns, with minimum impact on the qubit subspace. As a first application in the context of quantum error correction, we show how multiple simultaneous LRUs can reduce the error detection rate and suppress leakage buildup within 1% in data and ancilla qubits over 50 cycles of a weight-2 stabilizer measurement.

Promising biomarkers and therapeutic targets for the management of Parkinson's disease: recent advancements and contemporary research

Parkinson's disease (PD) is one of the progressive neurological diseases which affect around 10 million population worldwide. The clinical manifestation of motor symptoms in PD patients appears later when most dopaminergic neurons have degenerated. Thus, for better management of PD, the development of accurate biomarkers for the early prognosis of PD is imperative. The present work will discuss the potential biomarkers from various attributes covering biochemical, microRNA, and neuroimaging aspects (α-synuclein, DJ-1, UCH-L1, β-glucocerebrosidase, BDNF, etc.) for diagnosis, recent development in PD management, and major limitations with current and conventional anti-Parkinson therapy. This manuscript summarizes potential biomarkers and therapeutic targets, based on available preclinical and clinical evidence, for better management of PD.

Novel therapeutic interventions for combating Parkinson's disease and prospects of Nose-to-Brain drug delivery

Parkinson disease (PD) is a progressive neurodegenerative disorder prevalent mainly in geriatric population. While, L-DOPA remains one of the major choices for the therapeutic management of PD, various motor and non-motor manifestations complicate the management of PD. In the last two decades, exhaustive research has been carried out to explore novel therapeutic approaches for mitigating motor and non-motor symptoms of PD. These approaches majorly include receptor-based, anti-inflammatory, stem-cell and nucleic acid based. The major limitations of existing therapeutic interventions (of commonly oral route) are low efficacy due to low brain bioavailability and associated side effects. Nanotechnology has been exploited and has gained wide attention in the recent years as an approach for enhancement of bioavailability of various small molecule drugs in the brain. To address the challenges associated with PD therapy, nose-to-brain delivery utilizing nanomedicine-based approaches has been found to be encouraging in published evidence. Therefore, the present work summarises the major challenges and limitations with antiparkinsonian drugs, novel therapeutic interventions, and scope of nanomedicine-based nose-to-brain delivery in addressing the current challenges of antiparkinsonian therapy. The manuscript tries to sensitize the researchers for designing brain-targeted nanomedicine loaded with natural/synthetic scaffolds, biosimilars, and nucleic acids that can bypass the first-pass effect for the effective management of PD.

Recent Advances in Theranostic Applications of Nanomaterials in Cancer

Early detection and accurate monitoring are two critical factors affecting the outcome of anticancer therapy. However, both these factors are affected by the limitations of conventional approaches of diagnosis and treatment. Nanomedicine has progressively offered a scientific solution in improved delivery and better diagnosis of various cancers, thus providing a targeted treatment approach. With the advances in the field, simultaneous delivery and diagnosis are becoming a reality. The present manuscript discusses various drug delivery challenges, provides the scope for theranostic nanomaterials in the diagnosis and treatment of cancer. The clinical and translational potential of theranostic nanomedicine and the future directions for further research are also presented in the manuscript.

Efficacy and safety of Barg-e-Sahajna (Moringa oleifera Lam.) in primary hypothyroidism

OBJECTIVES

Hypothyroidism is the most common disorder arising from hormone deficiency. It frequently affects women than men. The prevalence of overall hypothyroidism has been reported to be 4.8-11%. Levothyroxine is the treatment of choice for all types of hypothyroidism. The purpose of this pilot study was to evaluate the efficacy and safety of Barg-e-Sahajna (Leaves of Moringa oleifera Lam.) among diagnosed patients of primary hypothyroidism.

METHODS

This study was an open observational study. A total of 22 patients were screened, out of which 10 were excluded (did not meet inclusion criteria) and 2 refused to consent to be part of the study, rest 10 participants were enrolled after obtaining written informed consent finally 8 subjects completed the study and 2 are dropout in last follow up. The drug was given in the form of decoction at the dose of 5 g fresh leaves twice a day after meal for 45 days.

RESULTS

The study effects on objective parameter thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) were found extremely significant when compared before (16.62 ± 11.49, 132 ± 19.32, 9.28 ± 1.46) and after (4.75 ± 3.12, 150.37 ± 20.68, 11.84 ± 3.81) treatment with a significant decrease in serum TSH level (p<0.0246) and an increase in serum T3 (p<0.0005) and T4 (p<0.0438) levels. The results were analyzed using paired "t" test.

CONCLUSIONS

The improvements in thyroid profiles (TSH, T3 and T4) after consuming 'Barg-e-Sahajna' show that the test drug is effective in primary hypothyroidism and the relief was considerable. No significant effect on safety parameters (serum-glutamic-oxaloacetic-transaminase [SGOT], serum glutamic-pyruvic transaminase [SGPT], blood urea, and serum creatinine) was observed. Therefore, it may be concluded that the Barg-e-Sahajna is preliminarily safe and effective in the management of primary hypothyroidism.

Efficacy and safety of Barg-e-Sahajna (Moringa olifera Lam.) in primary hypothyroidism

OBJECTIVES

Hypothyroidism is the most common disorder arising from hormone deficiency. It frequently affects women than men. The prevalence of overall hypothyroidism has been reported to be 4.8-11%. Levothyroxine is the treatment of choice for all types of hypothyroidism. The purpose of this pilot study was to evaluate the efficacy and safety of Barg-e-Sahajna (Leaves of Moringa olifera Lam.) among diagnosed patients of primary hypothyroidism.

METHODS

This study was an open observational study. A total of 22 patients were screened, out of which 10 were excluded (did not meet inclusion criteria) and 2 refused to consent to be part of the study, rest 10 participants were enrolled after obtaining written informed consent finally 8 subjects completed the study and 2 are dropout in last follow up. The drug was given in the form of decoction at the dose of 5 g fresh leaves twice a day after meal for 45 days.

RESULTS

The study effects on objective parameter thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) were found extremely significant when compared before (16.62 ± 11.49, 132 ± 19.32, 9.28 ± 1.46) and after (4.75 ± 3.12, 150.37 ± 20.68, 11.84 ± 3.81) treatment with a significant decrease in serum TSH level (p<0.0246) and an increase in serum T3 (p<0.0005) and T4 (p<0.0438) levels. The results were analyzed using paired "t" test.

CONCLUSIONS

The improvements in thyroid profiles (TSH, T3 and T4) after consuming 'Barg-e-Sahajna' show that the test drug is effective in primary hypothyroidism and the relief was considerable. No significant effect on safety parameters (serum-glutamic-oxaloacetic-transaminase [SGOT], serum glutamic-pyruvic transaminase [SGPT], blood urea, and serum creatinine) was observed. Therefore, it may be concluded that the Barg-e-Sahajna is preliminarily safe and effective in the management of primary hypothyroidism.

High-Fidelity Controlled-Z Gate with Maximal Intermediate Leakage Operating at the Speed Limit in a Superconducting Quantum Processor

Simple tuneup of fast two-qubit gates is essential for the scaling of quantum processors. We introduce the sudden variant (SNZ) of the net zero scheme realizing controlled-Z (CZ) gates by flux control of transmon frequency. SNZ CZ gates realized in a multitransmon processor operate at the speed limit of transverse coupling between computational and noncomputational states by maximizing intermediate leakage. Beyond speed, the key advantage of SNZ is tuneup simplicity, owing to the regular structure of conditional phase and leakage as a function of two control parameters. SNZ is compatible with scalable schemes for quantum error correction and adaptable to generalized conditional-phase gates useful in intermediate-scale applications.

Herbal approach for the management of C0VID-19: an overview

COVID-19 is the most recently discovered coronavirus infectious disease and leads to pandemic all over the world. The clinical continuum of COVID-19 varies from mild illness with non-specific signs and symptoms of acute respiratory disease to extreme respiratory pneumonia and septic shock. It can transmit from animal to human in the form of touch, through the air, water, utensils, fomite and feco-oral route blood. The pathogenesis and clinical features of COVID-19 be the same as the clinical manifestation associated epidemic Fever. In Unani medicine, various herbal drugs are described under the caption of epidemic disease. Great Unani scholar also Avicenna (980-1037 AD) recommended that during epidemic condition movement should be restricted, self-isolation, fumigation around the habitant with perfumed herbs (Ood, Kafoor, Sumbuluttib, Saad Kofi, Loban, etc.), and use of appropriate antidotes (Tiryaqe Wabai) and vinegar (Sirka) as prophylaxis. Herbal approach is based on single (Unnab-Ziziphus jujuba, Sapistan-Cordia myxa, Bahidana-Cydonia oblonga, Khatmi-Althea officinalis, Khubazi-Malva sylvestris, Zafran-Crocus sativus, Sibr-Aloe barbedensis, Murmuki-Commiphora myrrha, Darchini-Cinnamomum zeylanicum, Qaranfal-Syzygium aromaticum, Rihan-Oscimum sanctum, Habtus Sauda-Nigella sativa, Aslus Sus-Glycyrrhiza glabra, Maghze Amaltas-Cassia fistula and Adusa-Adhatoda vasica) and compound drugs (Habbe Bukhar, Sharbat Khaksi, Sharbat Zanjabeel, Naqu Nazla, Majoon Chobchini, Jawrish Jalinus and Khamira Marvareed) most of them are claimed for anti-viral, anti-pyretic, blood purifier, cardioprotective and expectorant activities. Traditionally most of the herbal practitioners are using it.

Navigating the Diagnostics of COVID-19

Introduction/Objective

The recent outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in Hubei province, China in December 2019 and has spread worldwide at an alarming rate. With millions of individuals infected and over two hundred thousand deaths, the necessity to develop fast and efficient diagnostic methods is of high importance. Diagnostic modalities rely on a combination of epidemiology, clinical presentation, laboratory examination, and appropriate imaging to diagnose and distinguish SARS-CoV-2 from other pulmonary infections. The purpose of this paper is to report on currently available diagnostic screening methods for patients infected with SARS-CoV-2 to guide frontline healthcare workers involved with COVID-19 patient care.

Methods

An electronic literature search was performed for peer-reviewed articles published from January 1, 2020, until April 26, 2020. Articles were then reviewed and included based on the applicability to the topic.

Results

The preferred diagnostic approach is reverse transcription of the virus’ RNA followed by PCR amplification (RT-PCR). This method recognizes the gene-specific primers to target various viral protein genes, such as the envelope protein gene or the nucleocapsid protein gene, which enables this test to be both sensitive and specific toward SARS-CoV-2. However, this method has been proven to be time-consuming taking hours-to-days for the results. In order to improve the speed and efficiency of diagnostics, newer rapid diagnostic serological tests are being developed for testing SARS-CoV-2, each with its own unique advantages and disadvantages. They could potentially be used as triage tests to rapidly identify patients who are very likely to have COVID-19 in combination with other accurate diagnostic methods.

Conclusion

Therefore, a combination of diagnostic testing used in a timely manner may be beneficial for the rapid and accurate detection of SARS-CoV-2. This was evident in cases where despite initial negative RT-PCR tests for various patients, who later demonstrate chest CT scans with various degrees of consolidation and ground-glass opacity. Thus establishing the need for radiology diagnosis to be complementary to RT-PCR for COVID-19 patients. Hopefully, the continuous development and use of rapid diagnostic tests and the implementation of public health measures will help control the spread of the disease.

Nanomedicines in Diagnosis and Treatment of Cancer: An Update

:

Nanomedicine has revolutionized the field of cancer detection and treatment by enabling the delivery of imaging agents and therapeutics into cancer cells. Cancer diagnostic and therapeutic agents can be either encapsulated or conjugated to nanosystems and accessed to the tumor environment through the passive targeting approach (EPR effect) of the designed nanomedicine. It may also actively target the tumor exploiting conjugation of targeting moiety (like antibody, peptides, vitamins, and hormones) to the surface of the nanoparticulate system. Different diagnostic agents (like contrast agents, radionuclide probes and fluorescent dyes) are conjugated with the multifunctional nanoparticulate system to achieve simultaneous cancer detection along with targeted therapy. Nowadays targeted drug delivery, as well as the early cancer diagnosis is a key research area where nanomedicine is playing a crucial role. This review encompasses the significant recent advancements in drug delivery as well as molecular imaging and diagnosis of cancer exploiting polymer-based, lipid-based and inorganic nanoparticulate systems.

Fast, High-Fidelity Conditional-Phase Gate Exploiting Leakage Interference in Weakly Anharmonic Superconducting Qubits

Conditional-phase (cz) gates in transmons can be realized by flux pulsing computational states towards resonance with noncomputational ones. We present a 40 ns cz gate based on a bipolar flux pulse suppressing leakage (0.1%) by interference and approaching the speed limit set by exchange coupling. This pulse harnesses a built-in echo to enhance fidelity (99.1%) and is robust to long-timescale distortion in the flux-control line, ensuring repeatability. Numerical simulations matching experiment show that fidelity is limited by high-frequency dephasing and leakage by short-timescale distortion.

3D Printing in Personalized Drug Delivery

Background:

Personalized medicines are becoming more popular as they enable the use of patient’s genomics and hence help in better drug design with fewer side effects. In fact, several doses can be combined into one dosage form which suits the patient’s demography. 3 Dimensional (3D) printing technology for personalized medicine is a modern day treatment method based on genomics of patient.

Methods:

3D printing technology uses digitally controlled devices for formulating API and excipients in a layer by layer pattern for developing a suitable personalized drug delivery system as per the need of patient. It includes various techniques like inkjet printing, fused deposition modelling which can further be classified into continuous inkjet system and drop on demand. In order to formulate such dosage forms, scientists have used various polymers to enhance their acceptance as well as therapeutic efficacy. Polymers like polyvinyl alcohol, poly (lactic acid) (PLA), poly (caprolactone) (PCL) etc can be used during manufacturing.

Results:

Varying number of dosage forms can be produced using 3D printing technology including immediate release tablets, pulsatile release tablets, and transdermal dosage forms etc. The 3D printing technology can be explored successfully to develop personalized medicines which could play a vital role in the treatment of lifethreatening diseases. Particularly, for patients taking multiple medicines, 3D printing method could be explored to design a single dosage in which various drugs can be incorporated. Further 3D printing based personalized drug delivery system could also be investigated in chemotherapy of cancer patients with the added advantage of the reduction in adverse effects.

Conclusion:

In this article, we have reviewed 3D printing technology and its uses in personalized medicine. Further, we also discussed the different techniques and materials used in drug delivery based on 3D printing along with various applications of the technology.

Design and development of Unani anti-inflammatory cream

Inflammation is the symptom of many diseases like rheumatoid arthritis and osteoarthritis. Many side effects are associated with the Non-Steroidal Anti-inflammatory Drugs (NSAIDs) used as conventional treatment for these conditions. In Unani, there are large number of single and compound drugs for inflammatory conditions. One dosage form of Unani system of medicine is named as Zimad in which paste is formed by mixing powder in oil, water, herbal extract. Zimadat is prepared just before application and used in many disease conditions as resolving, styptic, astringent, and antiseptic. As the pre-application procedure is difficult and also complicated for patients, hence, the present study attempted to modify the form of Zimad into cream. Various batches of cream of Zimad Mohallil were prepared by using extracts of the formulation and by adding additives. Various physicochemical parameters of prepared cream were carried and compared with market cream. The optimized cream of Zimad Mohallil (F₄) was selected after preliminary tests and evaluated further. The optimized cream showed good results in physicochemical parameters equivalent to market sample. Zimad Mohallil was converted into convenient cream form by adding minimum additives and benefits could be achieved without any hassle and cumbersome work, which is encountered in crude or paste form. The optimized cream was equivalent to standard market cream.

Serological evidence of hepatitis E virus infection in pigs and jaundice among pig handlers in Bangladesh

Hepatitis E virus (HEV) is the most common cause of viral hepatitis in humans. Pigs may act as a reservoir of HEV, and pig handlers were frequently identified with a higher prevalence of antibodies to HEV. The objectives of this study were to identify evidence of HEV infection in pigs and compare the history of jaundice between pig handlers and people not exposed to pigs and pork. Blood and faecal samples were collected from 100 pigs derived from three slaughterhouses in the Gazipur district of Bangladesh from January to June, 2011. We also interviewed 200 pig handlers and 250 non-exposed people who did not eat pork or handled pigs in the past 2 years. We tested the pig sera for HEV-specific antibodies using a competitive ELISA and pig faecal samples for HEV RNA using real-time RT-PCR. Of 100 pig sera, 82% (n = 82) had detectable antibody against HEV. Of the 200 pig handlers, 28% (56/200) demonstrated jaundice within the past 2 years, whereas only 17% (43/250) of controls had a history of jaundice (p < .05). Compared to non-exposed people, those who slaughtered pigs (31% versus 15%, p < .001), reared pigs (37% versus 20%, p < .001), butchered pigs (35% versus 19%, p < .001) or involved in pork transportation (28% versus 13%, p < .001) were more likely to be affected with jaundice in the preceding 2 years. In multivariate logistic regression analysis, exposure to pigs (odds ratio [OR]: 2.2, 95% CI: 1.2-3.9) and age (OR: 0.97, 95% CI: 0.95-0.99) was significantly associated with jaundice in the past 2 years. Pigs in Bangladesh demonstrated evidence of HEV infection, and a history of jaundice was significantly more frequent in pig handlers. Identifying and genotyping HEV in pigs and pig handlers may provide further evidence of the pig's role in zoonotic HEV transmission in Bangladesh.

Biosecurity Conditions in Small Commercial Chicken Farms, Bangladesh 2011-2012

In Bangladesh, highly pathogenic avian influenza H5N1 is endemic in poultry. This study aimed to understand the biosecurity conditions and farmers' perception of avian influenza biosecurity in Bangladeshi small commercial chicken farms. During 2011-2012, we conducted observations, in-depth interviews and group discussions with poultry farmers in 16 farms and in-depth interviews with seven local feed vendors from two districts. None of the farms were completely segregated from people, backyard poultry, other animals, households, other poultry farms or large trees. Wild birds and rodents accessed the farms for poultry feed. Farmers usually did not allow the buyers to bring egg trays inside their sheds. Spraying disinfectant in the shed and removing feces were the only regular cleaning and disinfection activities observed. All farmers sold or used untreated feces as fish feed or fertilizer. Farmers were more concerned about Newcastle disease and infectious bursal disease than about avian influenza. Farmers' understanding about biosecurity and avian influenza was influenced by local vendors. While we seldom observed flock segregation, some farmers used measures that involved additional cost or effort to protect their flocks. These farmers could be motivated by interventions to protect their investment from diseases they consider harmful. Future interventions could explore the feasibility and effectiveness of low-cost alternative biosecurity measures.

Nck2, an unexpected regulator of adipogenesis

The regulation of adipose tissue expansion by adipocyte hypertrophy and/or hyperplasia is the topic of extensive investigations given the potential differential contribution of the 2 processes to the development of numerous chronic diseases associated with obesity. We recently discovered that the loss-of-function of the Src homology domain-containing protein Nck2 in mice promotes adiposity accompanied with adipocyte hypertrophy and impaired function, and enhanced adipocyte differentiation in vitro. Moreover, in severely-obese human's adipose tissue, we found that Nck2 expression is markedly downregulated. In this commentary, our goal is to expand upon additional findings providing further evidence for a unique Nck2-dependent mechanism regulating adipogenesis. We propose that Nck2 should be further investigated as a regulator of the reliance of white adipose tissue on hyperplasia versus hypertrophy during adipose tissue expansion, and hence, as a potential novel molecular target in obesity.

Medication reconciliation errors in a tertiary care hospital in Saudi Arabia: admission discrepancies and risk factors

Background:

Medication reconciliation is a major component of safe patient care. One of the main problems in the implementation of a medication reconciliation process is the lack of human resources. With limited resources, it is better to target medication reconciliation resources to patients who will derive the most benefit from it.

Objective:

The primary objective of this study was to determine the frequency and types of medication reconciliation errors identified by pharmacists performing medication reconciliation at admission. Each medication error was rated for its potential to cause patient harm during hospitalization. A secondary objective was to determine risk factors associated with medication reconciliation errors.

Methods:

This was a prospective, single-center pilot study conducted in the internal medicine and surgical wards of a tertiary care teaching hospital in the Eastern province of Saudi Arabia. A clinical pharmacist took the best possible medication history of patients admitted to medical and surgical services and compared with the medication orders at hospital admission; any identified discrepancies were noted and analyzed for reconciliation errors. Multivariate logistic regression was performed to determine the risk factors related to reconciliation errors.

Results:

A total of 328 patients (138 in surgical and 198 in medical) were included in the study. For the 1419 medications recorded, 1091 discrepancies were discovered out of which 491 (41.6%) were reconciliation errors. The errors affected 177 patients (54%). The incidence of reconciliation errors in the medical patient group was 25.1% and 32.0% in the surgical group (p<0.001). In both groups, the most frequent reconciliation error was the omission (43.5% and 51.2%). Lipid-lowering (12.4%) and antihypertensive agents were most commonly involved. If undetected, 43.6% of order errors were rated as potentially requiring increased monitoring or intervention to preclude harm; 17.7% were rated as potentially harmful. A multivariate logistic regression model showed that patients aged ≥65 years, polypharmacy, and prescriptions for hypoglycemic drugs and warfarin were more likely associated with reconciliation errors.

Conclusion:

There is a high failure rate in medication reconciliation process in patients admitted to the medical and surgical department. The reconciliation process proves to be a useful tool since nearly half of avoided reconciliation errors were unintentional and had the potential for harm. This strategy, based on our results and the difficulty of applying the process to all patients should be directed primarily to the patients at increased risk of error.

Moxifloxacin-induced acute psychosis: A case report with literature review

Third generation quinolones are extensively used to treat a variety of common bacterial infections. Due to their extensive use in clinical practice, an increase in neuropsychiatric events has been reported. We report the case of psychotic symptoms occurs after three doses of moxifloxacin in a healthy adult male with no underlying risk factors. After the discontinuation of moxifloxacin treatment, there was a complete resolution of patient's symptoms. The case draws attention to a rare side effect of a commonly use drug and alert the clinicians to be cautious in those patients that have a baseline risk factors which makes the patient more susceptible to such adverse drug effect.

Community pharmacist and primary care physician collaboration: The missing connection in pharmaceutical care

Pharmaceutical care (PC) involves the active participation of the pharmacist in the improvement of the quality of life of the patient through the dispensation, counselling, and monitoring of drug therapy. Community pharmacists often encounter patients first, and, for some patients, the pharmacist is their only contact with a healthcare professional. It is easier and quicker for patients to contact a community pharmacist. However, there is a very limited or a total absence of PC services in community pharmacies of the KSA. To describe the inter-professional collaboration between primary care physicians and community pharmacists concerning PC services, a qualitative study was designed using a thorough, in-depth interview carried out in the cities of Dhahran and Dammam of the Eastern province of the Kingdom.

Some Unique Considerations in Treatment of Multiple Sclerosis

Multiple sclerosis is one of several diseases described as demyelinating because it causes damage to the myelin sheath. The presence of additional medical condition like pregnancy, osteoporosis and infections is common with multiple sclerosis that adversely affects the health outcomes. The treatment of MS becomes more complex when compounded by these existing additional medical condition. This review highlight important pharmacotherapeutic considerations in treatment of MS in these special patient population.

Raising Backyard Poultry in Rural Bangladesh: Financial and Nutritional Benefits, but Persistent Risky Practices

Poultry is commonly raised by households in rural Bangladesh. In 2007, the Government of Bangladesh began a mass media campaign to disseminate 10 recommended precautions to prevent transmission of H5N1 from poultry to humans. This longitudinal study explored the contribution of backyard poultry on household economy and nutrition and compared poultry-raising practices to government recommendations. From 2009 to 2012, we enrolled a nationally representative sample of 2489 primary backyard poultry raisers from 115 rural villages selected by probability proportional to population size. Researchers interviewed the raisers to collect data on poultry-raising practices. They followed the raisers for 2-12 months to collect data on household income and nutrition from poultry. Income from backyard poultry flocks accounted for 2.8% of monthly household income. Return on annual investment (ROI) per flock was 480%. Yearly, median family consumption of eggs was one-fifth of the total produced eggs and three poultry from their own flock. Respondents' reported practices conflicted with government recommendations. Sixty per cent of raisers had never heard of avian influenza or 'bird flu'. Among the respondents, 85% handled sick poultry or poultry that died due to illness, and 49% slaughtered or defeathered sick poultry. In 37% of households, children touched poultry. Fifty-eight per cent never washed their hands with soap after handling poultry, while <1% covered their nose and mouth with a cloth when handling poultry. Only 3% reported poultry illness and deaths to local authorities. These reported practices did not improve during the study period. Raising backyard poultry in rural Bangladesh provides important income and nutrition with an excellent ROI. Government recommendations to reduce the risk of avian influenza transmission did not impact the behaviour of poultry producers. Further research should prioritize developing interventions that simultaneously reduce the risk of avian influenza transmission and increase productivity of backyard poultry.

Efficiency of the Clinical Veterinary Diagnostic Practices and Drug Choices for Infectious Diseases in Livestock in Bangladesh

As in most low-income countries, adequate laboratory facilities are not available in Bangladesh to assist veterinarians in diagnosing animal diseases. We aimed to determine the efficiency of veterinary diagnoses for two common ruminant diseases in Bangladesh: Peste des petits ruminants (PPR) and foot-and-mouth disease (FMD). We conducted the study from May 2009 to August 2010 in three government veterinary hospitals where veterinarians collected samples from sick livestock and recorded the presumptive diagnosis on the basis of clinical presentations. Samples were tested for PPR and FMD using real-time RT-PCR. We estimated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the presumptive diagnoses when compared to laboratory tests. We tested 539 goats for PPR and 340 cattle and goats for FMD. Our results indicate that the veterinarians' presumptive diagnoses were different from laboratory findings for both PPR (P < 0.05) and FMD (P < 0.05). The overall sensitivity of the presumptive clinical diagnoses was 54% (95% CI: 47-61%) while specificity was 81% (95% CI: 78-84%) compared to real-time RT-PCR tests. The kappa value obtained in our validation process for PPR (kappa: 0.25) and FMD (kappa 0.36) indicated a poor performance of the presumptive diagnoses. Most of the animals (93%) were treated with antibiotics. Our findings indicate that veterinarians can detect animals not infected with FMD or PPR but miss the true cases. The clinical competency of these veterinarians needs to be improved and access to laboratory diagnostic facilities could help veterinarians to improve the diagnostics and outcomes. The rational use of antibiotics by veterinarians in animals must be ensured.

Fluorescence microscopy image noise reduction using a stochastically-connected random field model

Fluorescence microscopy is an essential part of a biologist’s toolkit, allowing assaying of many parameters like subcellular localization of proteins, changes in cytoskeletal dynamics, protein-protein interactions, and the concentration of specific cellular ions. A fundamental challenge with using fluorescence microscopy is the presence of noise. This study introduces a novel approach to reducing noise in fluorescence microscopy images. The noise reduction problem is posed as a Maximum A Posteriori estimation problem, and solved using a novel random field model called stochastically-connected random field (SRF), which combines random graph and field theory. Experimental results using synthetic and real fluorescence microscopy data show the proposed approach achieving strong noise reduction performance when compared to several other noise reduction algorithms, using quantitative metrics. The proposed SRF approach was able to achieve strong performance in terms of signal-to-noise ratio in the synthetic results, high signal to noise ratio and contrast to noise ratio in the real fluorescence microscopy data results, and was able to maintain cell structure and subtle details while reducing background and intra-cellular noise.

Proprotein convertase subtilisin/kexin type 9 enzyme inhibitors: An emerging new therapeutic option for the treatment of dyslipidemia

The treatment of hypercholesterolemia entered in a new phase of development with the introduction of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in the market. The Food and Drug Administration and European Medicines Agency recently approved the alirocumab and evolocumab, subcutaneously injectable monoclonal antibody every 2 or 4 weeks against PCSK9, for the treatment of hypercholesterolemia in patients with intolerance or inadequate response to statins, especially for the secondary prevention or in the case of familial hypercholesterolemia. This decision is based on several clinical trials demonstrating that inhibitors of PCSK9 lower the low-density lipoprotein cholesterol compared to placebo while studies are underway to assess their role in secondary prevention of major cardiovascular events.

Unusually High Mortality in Waterfowl Caused by Highly Pathogenic Avian Influenza A(H5N1) in Bangladesh

Mortality in ducks and geese caused by highly pathogenic avian influenza A(H5N1) infection had not been previously identified in Bangladesh. In June-July 2011, we investigated mortality in ducks, geese and chickens with suspected H5N1 infection in a north-eastern district of the country to identify the aetiologic agent and extent of the outbreak and identify possible associated human infections. We surveyed households and farms with affected poultry flocks in six villages in Netrokona district and collected cloacal and oropharyngeal swabs from sick birds and tissue samples from dead poultry. We conducted a survey in three of these villages to identify suspected human influenza-like illness cases and collected nasopharyngeal and throat swabs. We tested all swabs by real-time RT-PCR, sequenced cultured viruses, and examined tissue samples by histopathology and immunohistochemistry to detect and characterize influenza virus infection. In the six villages, among the 240 surveyed households and 11 small-scale farms, 61% (1789/2930) of chickens, 47% (4816/10 184) of ducks and 73% (358/493) of geese died within 14 days preceding the investigation. Of 70 sick poultry swabbed, 80% (56/70) had detectable RNA for influenza A/H5, including 89% (49/55) of ducks, 40% (2/5) of geese and 50% (5/10) of chickens. We isolated virus from six of 25 samples; sequence analysis of the hemagglutinin and neuraminidase gene of these six isolates indicated clade 2.3.2.1a of H5N1 virus. Histopathological changes and immunohistochemistry staining of avian influenza viral antigens were recognized in the brain, pancreas and intestines of ducks and chickens. We identified ten human cases showing signs compatible with influenza-like illness; four were positive for influenza A/H3; however, none were positive for influenza A/H5. The recently introduced H5N1 clade 2.3.2.1a virus caused unusually high mortality in ducks and geese. Heightened surveillance in poultry is warranted to guide appropriate diagnostic testing and detect novel influenza strains.

The origin of the B-genome of bread wheat (Triticum aestivum L.)

Understanding the origin of cultivated wheats would further their genetic improvement. The hexaploid bread wheat (Triticum aestivum L., AABBDD) is believed to have originated through one or more rare hybridization events between Aegilops tauschii (DD) and the tetraploid T. turgidum (AABB). Progenitor of the A-genome of the tetraploid and hexaploid wheats has generally been accepted to be T. urartu. In spite of the large number of attempts and published reports about the origin of the B-genome in cultivated wheats, the donor of the B-genome is still relatively unknown and controversial and, hence, remains open. This genome has been found to be closely related to the S-genome of the Sitopsis section (Ae. speltoides, Ae. longissima, Ae. sharonensis, Ae. searsii, and Ae. bicornis) of the genus Aegilops L. Among Sitopsis species, the most positive evidence has been accumulated for Ae. speltoides as the progenitor of the B-genome. Therefore, one or more of the Sitopsis species were proposed frequently as the B-genome donor. Although several reviews have been written on the origin of the genomes of wheat over the years, this paper will attempt for the first time to review the immense literature on the subject, with a particular emphasis on the B-genome which has attracted a huge attention over some 100 years. The ambiguity and conflicting results in most of the methods employed in deducing the precise B-genome donor/s to bread wheat are also discussed.

Acquired phimosis after plastibell circumcision: a preventable consequence

INTRODUCTION

The plastibell device is used successfully for religious and cultural circumcisions in the community. The aim of this article is to highlight the recognition and management of iatrogenic phimosis.

METHODS

A retrospective study was performed of outcomes of plastibell circumcision in a community-based circumcision service provided by trained paediatric surgeons. The objective was to assess the complication of slipped plastibell rings and to ascertain the effectiveness of its management.

RESULTS

A total of 5 patients with a slipped plastibell ring were indentified out of 560 plastibell circumcisions. Three patients presented with acquired phimosis. In two patients early diagnosis and management prevented any further complications and a second operation was avoided.

CONCLUSIONS

Plastibell circumcision in the community is safe and effective. Detection of minor bleeding due to a slipped ring is important. Early management can avoid the risk of acquired phimosis due to cicatrix formation and can save parents of undue anxiety.

Molecular characterization of Syrian date palm cultivars using plasmid-like DNA markers

Date palm (Phoenix dactylifera L.) is one of the most important domesticated fruit trees in the Near East and North African countries. This tree has been, for several decades, in serious threat of being completely destroyed by the "Bayoud" disease caused by Fusarium oxysporum f. sp. albedinis. In this study, 18 Syrian date palm cultivars and four male trees were analyzed according to the identity of mitochondrial plasmid-like DNAs. A PCR strategy that employs plasmid-like DNAs-specific primer pair was used. These primers amplify a product of either 373-bp or 265-bp that corresponds to the S-(Bayoud-susceptible) or the R-plasmid (Bayoud-resistant), respectively. Generated data revealed that only six cultivars ('Medjool', 'Ashrasi', 'Gish Rabi', 'Khineze', and yellow- and red-'Kabkab') have the S-plasmid, suggesting their susceptibility to the fusariosis, while the remaining 12 cultivars and the four male trees contain the R-plasmid, suggesting their resistance to the fusariosis. The PCR process applied here has been proved efficient for the rapid screening for the presence of the S and R DNAs in Syrian date palm. PCR markers developed in this study could be useful for the screening of date palm lines growing in the field. The availability of such diagnostic tool for plasmid characterization in date palm would also be of great importance in establishing propagation and breeding programs of date palm in Syria.

A critical evaluation of HIPE data

Resource allocation and planning of future services is dependent on current volumes, making it imperative that procedural data is accurately recorded. We sought to evaluate the effectiveness of the information gathered by the Hospital Inpatient Enquiry (HIPE) system in recording such activity. Five index vascular procedures (open/endovascular abdominal aneurysm repair, carotid endarterectomy, lower limb angioplasty/bypass) were chosen to reflect activity. The Economic and Social Research Institute (ESRI), and HIPE databases were interrogated to obtain the regional and hospital specific figures for the years 2005, 2006 and 2009, and then compared with the prospective vascular database in St James's hospital. Data for 2006 (the most recent year available) shows significant discrepancies between the HIPE and vascular database figures for St James's hospital. The HIPE and database figures respectively for; open aneurysm 13/30 (-50%), endovascular aneurysm 39/31 (+25%), carotid 62/48 (+29%), angioplasty 242/111 (+100%) and bypass 24/10 (+100%) These inaccuracies are likely to be magnified on a regional and national level when pooling data.

A set of plastid DNA-specific universal primers for flowering plants

MatKand rbcL are recommended as the official barcode loci for higher plants but there remains a need for additional universal markers. We generated a series of 84 new universal primers targeting 42 plastid loci that all yielded single amplicons when applied to DNA templates from 19 diverse higher plant families. Marker utility ultimately depends on sequence variability, with rapidly evolving loci being useful for barcoding or biogeographic applications and more conserved loci being better suited to deep phylogeny reconstruction. Whereas excessive size variation is undesirable for many applications, modest size variability caused by indels and the sequence variation frequently associated with indels are highly desirable. We therefore performed a quick screen of the markers for size and sequence variation using pooled DNA templates from 96 taxonomically diverse species. All markers produced little or no size variation (consistent with the presence of minor indels). The seven regions exhibiting most size variation in pooled (rpl23&rpl2.1, 16S, 23S, 4.5S&5S, petB&D, and rpl2, rpoCl and trnK introns) were then amplified for all species individually, confirming the pooled template results. When the most variable loci (introns of trnK and rpoC1) were sequenced for all 96 species, a high level of sequence variation (nucleotide substitutions and indels) was observed among congeneric species groups for both loci. Both markers therefore have potential as supplementary barcode markers.

Hematology and serum chemistry reference values of stray dogs in Bangladesh

Hematology and serum chemistry values were obtained from 28 male and 22 female stray dogs in Chittagong Metropolitan area, Bangladesh. The goal of the study was to establish reference value for hematology and serum chemistry for these semi wild animals in relation to age, sex, reproductive stage and body condition. No significant differences were found for mean values of hemoglobin, packed cell volume, mean corpuscular hemoglobin concentration, white blood cell, differential leukocyte count, total protein, albumin, glucose, cholesterol, phosphorus and potassium among or between sexes, ages, reproductive states or body conditions. Significant differences were noted for erythrocyte sedimentation rate (p<0.02) between sexes. Among different age groups significant differences were found for total red blood cell count (p<0.001). Different body conditions have significant differences in red blood cell count, mean corpuscular volume and mean corpuscular hemoglobin (p<0.001). Pregnant and non-pregnant females differed significantly in their red blood cell count, mean corpuscular volume and mean corpuscular hemoglobin (p<0.001).