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In search of selective cytotoxic compounds from Ferula species as potential leads for the treatment of various cancer diseases, a bioactivity-guided isolation study was performed on the roots of Ferula caspica M. Bieb. COLO 205 (colon), K-562 (leukemia), and MCF-7 (breast) cancer cell lines were used to monitor the cytotoxic activity of column fractions and determine the IC50 value of the active compounds. In addition to the seven known (5–11) compounds, four previously unknown compounds: kayserin A (1), kayserin B (2), 8′-epi-kayserin B angelate (3), and 3-epi-ferulin D (4) were isolated from the dichloromethane extract of the roots of F. caspica. Structure elucidation of the isolated compounds was carried out by extensive spectroscopic analyses such as 1D- and 2D-NMR spectroscopy, High-Resolution Mass Spectroscopy (HRMS), IR spectroscopy, and UV spectroscopy. Although all of the isolated compounds showed various degrees of cytotoxic activity on COLO 205, K-562, and MCF-7 cancer cell lines, the most potent compounds were identified in the following order: 1-Hydroxy-1-(1′-farnesyl)-4,6-dihydroxyacetophenone (HFDHAP, 11), 3-epi-ferulin D (3EFD, 4), and 7-desmethylferulin D (7DMFD, 6). The cytotoxic activities of all three compounds were more potent than that of the reference compound cisplatin (Cis) against all tested cancer cell lines. Still, only HFDHAP (11) was more potent than the reference compound doxorubicin (Dox) against the MCF-7 cancer cell line. The mechanism of action of these three compounds was investigated on the COLO 205 cell line. The results indicated that compounds 4, 6, and 11 trigger caspase-3/8/9 activation and suppress the anti-apoptotic protein, Bcl-xL. Molecular docking studies confirmed the interactions of the three cytotoxic molecules with the active site of the Bcl-xL protein.

Objective: Neurological manifestations associated with coronavirus disease-2019 (COVID-19) are broad and heterogeneous. Although the predominant clinical presentation is respiratory dysfunction, concerns have been raised about the neurological hallmarks. Many reports suggest some findings on electroencephalography (EEG) can be relevant to COVID-19. Materials and Methods: Patients with COVID-19 admitted to hospital and referred for EEG from March 1, 2020 to February 15, 2021, were retrospectively enrolled. When research databases were queried with the terms “COVID-19 (ICD code: 10: U07.3) and “EEG”, total number of patients obtained was 32. Number of patients excluded due to unconfirmed diagnose with COVID-19 was 12. Twenty adult patients with certain diagnose of COVID-19 who underwent 21-electrode routine EEG during the outbreak with neurological deterioration were identified. Results: Background abnormalities was evident in one of fourth patients (n=5, 25%). Mild diffuse slowing (n=3, 15%) and focal slowing (n=3, 15%) with left frontotemporal tendency (n=2, 10%) were observed. Epileptiform abnormalities and seizures were detected showing focal (n=4, 20%) or generalized onset (n=1, 5%). Conclusion: Here we performed a retrospective single-centre study to evaluate the electroencephalographic findings in patients diagnosed with COVID-19 since it remains unknown. it needs to be more clarified with increasing number of recordings

Epilepsia partialis continua is characterized by continuous clonic contractions of a certain area of the body. One of the most common causes of Epilepsia partialis continua in adults is cerebrovascular events. Other causes include meningoencephalitis, Rasmussen encephalitis, diabetic nonketotic hyperosmolar coma, central nervous system malignancies, tuberculosis, cerebral venous thrombosis, or idiopathic. A 70-year-old male patient was admitted to the emergency department with abdominal muscle contractions for about an hour. Neurodiagnostic imaging revealed an encephalomalasia area secondary to the area of the previous infarction in the left frontoparietal region. Focal motor findings were controlled within 5 min after the VPA (valproic acid) treatment at a dose of 15 mg/kg admission, and then the treatment was continued with 1500 mg/day Valproic acid. Here, we aimed to emphasize that myoclonic jerks confined to the abdominal region is a rare motor phenomenon and may be a feature of Epilepsia partialis continua, the history of stroke should be questioned in the etiology, and seizures can be controlled with IV Valproic acid treatment.

Ancient physicians frequently used the resin of Ferula species to treat cancer. Today, some folkloric recipes used for cancer treatment also contain the resin of Ferula species. The dichloromethane extract of the roots of Ferula huber-morathii exhibited cytotoxic activities against COLO 205 (colon), K-562 (lymphoblast), and MCF-7 (breast) cancer cell lines (IC50 = 52 µg/mL, 72 µg/mL, and 20 µg/mL, respectively). Fifteen sesquiterpene coumarin ethers with cytotoxic activity were isolated from the dichloromethane extract of the roots of F. huber-morathii using bioactivity-directed isolation studies. Extensive spectroscopic analyses and chemical transformations have elucidated the structures of these sesquiterpene coumarin ethers as conferone (1), conferol (2), feselol (3), badrakemone (4), mogoltadone (5), farnesiferol A (6), farnesiferol A acetate (7), gummosin (8), ferukrin (9), ferukrin acetate (10), deacetylkellerin (11), kellerin (12), samarcandone (13), samarcandin (14), and samarcandin acetate (15). The absolute configuration of samarcandin (14) was unequivocally determined by the X-ray crystallographic analysis of the semi-synthetic (R)-MTPA ester of samarcandin (24). Conferol (2) and mogoltadone (5) were found to be the most potent cytotoxic compounds against all three cancer cell lines; furthermore, these compounds exhibit low cytotoxic activity against the non-cancerous human umbilical vein epithelial cells (HUVEC) cell line. Investigation of the biological activity mechanisms of mogoltadone (5) revealed that while suppressing the levels of Bcl-XL and procaspase-3 in the COLO 205 cancer cell line, it did not have a significant effect on the Bcl-XL, caspase-3, and β-catenin protein levels of the HUVEC cell line, which may explain the cytotoxic selectivity of mogoltadone (5) on cancer cell lines.

Summary Gelastic seizures are typically associated with hypothalamic hamartoma. Given the rarity of gelastic seizures, pathways for the motor and emotional aspects of laughter have been hypothesized but remain unclear. Only few case reports of patients with tuberous sclerosis complex who developed gelastic epilepsy have been reported. In this case study, we report a case of TS that presented itself mainly with dermatologic manifestations and without any neurological findings other than gelastic seizures. Ictal EEG revealed an active epileptic activity on the right fronto-temporal region. Clinical and laboratory findings were consistent with gelastic epilepsy that originated from temporal and extra-temporal lobes. Seizures were controlled using carbamazepine and levetiracetam polytherapy. In our case, there is no evidence of cortical and subcortical tubers, subependymal glial nodules, giant cell astrocytomas or aneurysm.

Abstract The international CIHLMU Occupational Safety and Health Symposium 2019 was held on 16th March, 2019 at the Ludwig-Maximilians-Universität Munich, Germany. About 60 participants from around the world representing occupational health and safety professionals, students, instructors from several institutions in Germany and abroad, attended the symposium. The main objective of the symposium was to create awareness on global challenges and opportunities in work-related respiratory diseases. One keynote lecture and six presentations were made. While the keynote lecture addressed issues on occupational diseases in the twenty-first century, the six presentations were centered on: Prevention and control of work-related respiratory diseases, considerations; Occupational health and safety in Mining: Respiratory diseases; The prevention of TB among health workers is our collective responsibility; Compensation and prevention of occupational diseases and discussion on how artificial intelligence can support them: Overview of international approaches; Work-related Asthma: Evidence from high-income countries; and The role of imaging in the diagnosis of work- related respiratory diseases. A panel discussion was conducted following the presentations on the importance and challenges of data acquisition which is needed to have a realistic picture of the occupational safety and health status of workers at different levels. The current summary is an attempt to share the proceedings of the symposium.

Rhabdomyosarcoma (RMS) is a malignant form of neoplasm that originates from skeletal muscle. RMSs can exist anywhere in the human body but are more commonly detected in the neck region and extremities. The alveolar type is one of the subtypes of RMS that has a poor prognosis. Because the clinical manifestation of a tumour can be a painless mass, symptoms might be non-contributary to the diagnosis. Herein, a four-month-old girl was admitted to the emergency department with complaints of respiratory distress without a runny nose, cough, and fever. Recurrent effusions subsided with subsequent tube thoracostomy. Video-assisted thoracoscopic surgery (VATS) was performed to determine the aetiology of the recurrent effusion. The Tru-Cut biopsy obtained during VATS resulted in the diagnosis of alveolar rhabdomyosarcoma. Pleural effusion decreased, and the tube drainage was stopped rapidly after first vincristine, actinomycin-D, and cyclophosphamide chemotherapy cycle. Persistent and recurrent pleural effusions should alert physicians to rule out unusual diagnoses like that of our case.

There is an increasing number of cancer patients undertaking treatment-focused genetic testing despite not having a strong family history or high a priori risk of being carriers because of the decreasing cost of genetic testing and development of new therapies. There are limited studies on the psychosocial outcome of a positive result among breast cancer patients who are at low a priori risk, particularly in women of Asian descent. Breast cancer patients enrolled under the Malaysian Breast Cancer Genetic Study between October 2002 and February 2018 were tested for BRCA1, BRCA2 and PALB2 genes. All 104 carriers identified were invited by a research genetic counsellor for result disclosure. Of the 104 carriers, 64% (N = 66) had low a priori risk as determined by PENN II scores. Psychosocial, risk perception and health behaviour measures survey were conducted at baseline (pre-result disclosure), and at two to six weeks after result disclosure. At baseline, younger carriers with high a priori risk had higher Cancer Worry Scale scores than those with low a priori risk but all scores were within acceptable range. Around 75% and 55% of high a priori risk carriers as well as 80% and 67% of low a priori risk carriers had problems in the “living with cancer” and “children” psychosocial domains respectively. All carriers regardless of their a priori risk demonstrated an improved risk perception that also positively influenced their intent to undergo risk management procedures. This study has shown that with sufficient counselling and support, low a priori risk carriers are able to cope psychologically, have improved perceived risk and increased intent for positive health behaviour despite having less anticipation from a family history prior to knowing their germline carrier status.

Introduction: The COVID-19 Movement Control Order (MCO) has caused a concern on the food consumption among university students. This study aimed to assess food diversity and its relationship with accommodation among university students in Sarawak. Methods: This cross-sectional study was conducted among students of the University Malaysia Sarawak in Kota Samarahan during the MCO. Data on socio-demographic characteristics and food diversity were collected using an online questionnaire. Results: A total of 478 respondents participated in this study. The majority of the respondents were women (77.4%), and almost half were Malays (49.6%). Half of the respondents stayed at home with their family, while 36.4% stayed in their college dormitories. Except for legumes, nuts and seeds and milk and milk products, all other food groups were common in the respondents’ diet, with the highest consumption observed from cereal and cereal products, followed by meat and meat products and water. One-way ANOVA showed that there were significant differences in the intake of fish and seafood; legumes, nuts and seeds; milk and milk products; and fruits between those who stayed in college dormitories, at home with their families and in rented houses (P

Many electrocardiogram changes associated with subarachnoid hemorrhage have been described. A 55-year-old female patient was admitted to the emergency service due to complaints of dizziness and fainting after headache persisting for several days. Left bundle branch block was detected on electrocardiogram, and a subarachnoid hemorrhage was detected on brain tomography. Our case illustrates that left bundle branch block may occur in patients with subarachnoid hemorrhage, having no symptoms of a heart problem, previously.

Adult coeliac disease commonly presents without classical symptoms as chronic diarrhea and weight loss. We describe the case of a 31-year-old woman with persistent life-threatening hypokalemia, acute renal failure, and acute quadriplegia due to diarrhea that had continued for one month. Although there are cases of coeliac disease diagnosed with hypokalemic rhabdomyolysis in the literature, none of the cases developed acute renal failure. This is the first case in the literature diagnosed with acute renal failure due to hypokalemic rhabdomyolysis as a presentation of coeliac disease. In acute renal failure cases that present with hypokalemic rhabdomyolysis due to severe diarrhea, coeliac disease should be considered as a differential diagnosis despite the negative antigliadin IgA antibody.