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For millennia, people have successfully treated a wide range of illnesses, including bacterial infections, with different plant parts or extracts. “MDR strain” typically refers to a “multi-drug resistant strain” of a bacteria. In the context of infectious diseases, a multi-drug resistant strain refers to a strain of the pathogen that has acquired resistance to multiple drugs that are commonly used to treat infections caused by that specific pathogen. MDR strains can present significant challenges in healthcare settings as they limit the effectiveness of standard treatments and may require more aggressive or specialized approaches to manage the infection. The discdiffusion method was used in this investigation to test the antimicrobial properties of Petroleum ether, acetone, ethanol, methanol, and aqueous extracts of Ficus auriculata leaves against four bacterial strains namely Salmonella enteric serovar typhi, Salmonella enteric ser Paratyphi (MDR strain) Pseudomonas aeruginosa and Escherichia coli. The findings showed that all of the investigated organisms (zone of inhibition of 0.5 ± 0.15 & 18 ± 1.7 mm) were significantly inhibited by the petroleum ether, ethanol, and methanol extracts, with the exception of Salmonella typhi (an 18 mm inhibitory zone). The restricted area (≤5) indicated moderate activity in the aqueous extracts. It’s crucial to remember that antimicrobial activity analysis of plant extracts is just one step in the process of identifying potential natural antimicrobial agents. Further studies, including the identification and isolation of specific bioactive compounds, toxicology assessments, and clinical trials, are required before any plant extract can be considered for use as a drug development.

Malignant melanoma of the rectum is an exceedingly rare type of cancer with an aggressive presentation, comprising up to 4% of all anorectal cancers. Presentation of this cancer tends to occur in individuals in their late 80s, with nonspecific symptoms such as anal pain or rectal bleeding. Diagnosing rectal melanoma, especially in early stages, is difficult due to its amelanotic presentation and lack of pigmentation, which results in poor remission rates and prognosis. Furthermore, surgical treatment is difficult as these types of malignant melanomas tend to spread along submucosal planes; thus, complete resections are impractical, especially if caught later. In this case report, we present the radiological and pathological features as seen in a 76-year-old man diagnosed with rectal melanoma. Based on his presentation of a heterogeneous bulky anorectal mass with extensive local invasion, initial impressions were colorectal carcinoma. However, surgical pathology found the mass to be a c-KIT+ melanoma, with positive SOX10, Melan-A, HMB-45, and CD117 biomarkers. While the patient was treated with imatinib, the melanoma was too widespread and aggressive, leading to progression and ultimately death.

Multiple myeloma (MM) is associated with the secretion of a unique monoclonal protein (M-protein) due to overproduction of immunoglobulin (Ig) by a clone of abnormally proliferating plasma cells. However, in 4% of the cases more than one M-protein can be found. This category of gammopathies is called “double monoclonal gammopathies.” Here, we present a rare case of MM with double monoclonal gammopathy, where the presence of both M-proteins was observed in the single sharp peak on capillary zone electrophoresis (CZE). Further the interference of Hook effect is also discussed. Double monoclonal gammopathies need to be identified to increase diagnostic accuracy and reliability, and to get a better understanding of the disease pathogenesis and progression.

Integrated teaching is a well-known concept in medical education and has been reintroduced in the competency-based curriculum. The physiology department started the exercise in the topic of hematology in 2019 in the offline mode and again in 2021 in the online mode (due to the pandemic). This article is an attempt to describe what went through in its conceptualization and implementation. The background of integration, types of integration, how the exercise was planned, and the feedback of the faculty are included. This could benefit the phases 2 and 3 faculty members who must be planning similar exercises now. In addition, it would act as a screenshot to others, phase 1 faculty included, to help them do a similar or other exercises in the coming years. Integration in competency-based curriculum is here to stay. We can gradually improve upon it and innovate it.

The present clinical study was conducted in ten Labrador retriever obese dogs with lameness associated with hip osteoarthritis to evaluate the effect of weight loss on its management. The weight loss protocol involved feeding of high protein and low-fat diet (for 90 days) along with conservative therapy (for 30 days) to assess the effect of these interventions on lameness, quality of life, haemato-biochemical parameters and subcutaneous fat thickness in obese dogs. After 90 days of feeding weight loss diet, dogs achieved on an average 6.5 % body weight loss at the rate of 0.5% weight loss per week. Body condition score, lameness scores (Numeric Rating Scale, NRS and Visual Analogue Scale, VAS) and quality of life showed significant improvement at the end of the study. Subcutaneous fat thickness significantly reduced from mid abdomen and chest on day 30, day 60 and day 90. The mean haemoglobin and packed cell volume increased significantly, whereas mean relative neutrophil counts decreased significantly on day 30, day 60, day 90 as compared to day 0. The mean serum cholesterol, calcium and C-reactive protein concentrations also decreased significantly.

Amyloid Light chain (AL) amyloidosis is characterised by deposition of intact free light chains or their fragments in extracellular space. Here, authors describe the journey of a diagnostically challenging patient who presented with features of nephrotic syndrome and was finally diagnosed with AL amyloidosis. A 45-year-old female presented to the Outpatient Department (OPD) with gradually progressive generalised body swelling. On examination, hepatomegaly, cardiomegaly and macroglossia were observed. Renal biopsy, capillary serum protein electrophoresis, immunotyping and serum free light chain assay were performed along with routine blood and urine investigations to detect the presence of monoclonal protein. Bone marrow biopsy was conducted for confirmation of diagnosis. Proteinuria with hypoalbuminaemia 1.8 g/dL was detected during routine investigations. Renal biopsy showed presence of amyloid deposits in glomerular mesangium and walls of medium sized blood vessels which tested positive for Immunoglobulin (Ig) G, IgA, kappa and lambda chains on immune florescence. Serum protein capillary electrophoresis findings demonstrated increase in beta 2 fraction and distortion in gamma region. Immuno typing showed presence of monoclonal IgA heavy chains and lambda light chains. Bone marrow biopsy confirmed presence of plasma cell dyscrasia. Based on these findings authors concluded that capillary gel electrophoresis is more sensitive method than agarose gel electrophoresis in detecting beta migrating monoclonal proteins.

Introduction: Information Technology (IT) has influenced all fields including healthcare and Medical Education (ME). The present generation of students have grown up in an IT enriched atmosphere and are comfortable with most IT tools and gadgets. Aim: To understand the perception of first year MBBS students regarding role of IT in ME. Materials and Methods: A cross-sectional, questionnaire based study was carried out on 250 first year MBBS students from August 1st, 2019 to August 31st, 2019 over a period of one month. A questionnaire containing three sections was administered to the students before the starting of IT module in foundation year. The responses to the items of the questionnaire were assessed on the basis of the student responses on the likert scale. Results: The study revealed that students acknowledged the utility of IT for academic purposes and were primed for its inclusion as an essential component of the medical curriculum. The students conceded to browsing internet on their computers and smartphones for social media handles. However, when it came to teaching methods, students were not comfortable with the idea of replacing traditional teaching methods with e-learning. Also, students were more comfortable in reading hard copies instead of e-books. Conclusion: It was concluded that there is a need to amalgamate the traditional teaching methods with the innovative e-learning platforms in such a way that they become mutually inclusive and facilitate the learning process. Also, ME practices need to be continuously re-evaluated to make the educational process more effective for learners, teachers and for the society in general.

Treatment of skeletal Class III patients at younger age is highly unpredictable. The patient may respond well to the treatment or may show excessive mandibular growth during growth spurt which may require orthognathic surgery later on. If not treated at earlier stages of life, the condition may worsen with time. This case report will present the comprehensive orthodontic management of a 9-year-old prepubertal girl in late mixed dentition with prognathic mandible. Chin cup therapy was started and continued for 3 years. After chin cup therapy, maxillary and mandibular dentition were bonded with standard edgewise appliance. After leveling and alignment, Class III elastics were started. Fixed orthodontic treatment was completed in 3 years. At the end, good Class I molar and canine relationship with normal overjet and overbite were achieved. The total treatment time of orthopedic and orthodontic correction was 6 years, 2 months. The patient revealed the same Class I molar and canine relationship after 6 years of treatment. Redirection of mandibular growth pattern from hyperdivergent to normodivergent advocates the use of chin cup as a viable treatment regimen for the management of prognathic mandible in prepubertal patients.

A tonic pupil is usually caused due to parasympathetic denervation of the iris sphincter muscles. It's usually seen in females and in 80 % cases it's unilateral, and 4% of these cases progress to bilateral involvement. Adie's tonic pupil has been reported in literature to have multiple syndromic associations. Simultaneous bilateral occurrence of Adie's tonic pupil in an asymptomatic healthy adult male is sparsely reported in literature. The diagnostic dilemma in the setting of a busy clinical practice is henceforth discussed.

Introduction: Several studies have been conducted over the years for a simple, reliable, cost effective investigation to know the intensity of systemic inflammation in patients suffering from shock, major surgery, sepsis, cancers, thromboembolic disorders (stroke, cardiovascular diseases, peripheral vascular diseases). Significance of granulocytes especially the critical role played by neutrophils in pathophysiology of various infections, inflammatory diseases and cancers has recently begun to emerge. Increased number of neutrophils in the peripheral blood and tumour microenvironment is seen in different type of cancers. Neutrophilia with lymphocytopenia is the feature of various infections. Neutrophil Lymphocyte Ratio (NLR) has been proposed as a simple, reliable and cost effective test. The NLR can be calculated easily from data that are routinely available. NLR could be an important predictor of outcome of critically ill patients. Aim: To explore the average values of NLR in adult, both outpatient and inpatient undergoing diagnostic investigation in a tertiary care, teaching hospital, Bengaluru, India. Materials and Methods: Prospective study was conducted for a period of 3 months from February to April 2015. Subjects

The aim of this study was to investigate the potential of duckweed (Lemna gibba) in heavy metal (Pb and Cd) from water under different pH and metal loads. A total of three (2, 5 and 10 mg/L) strengths of Pb and Cd were used with varying pH (5, 7 and 9) and changes in metal concentration and metal uptake yield of system were recorded. The Pb and Cd removal ranged between 60.1% (2 mg/L at 9 pH) and 98.1% (10 mg/L at 7 pH) and 41.6% (10 mg/L at pH 9) and 84.8% (2 mg/L at pH 7), respectively. The duckweed set-up with pH 7 showed the optimum metal removal. The metal removal rate showed an inverse relationship with pH (r2 > 0.60, for all). Bioconcentration factor (BCF) and metal uptake yield per unit of dry biomass (qm) were recorded: 403–738 and 445–616, respectively for BCFPb and BCFCd. The qm suggest the dose (mg/L) 5 and 10 at pH 5 as the best combinations for the optimum removal. Results, thus suggest that L. gibba can be a suitable candidate for removal of heavy metals from pollutant water bodies.

Breast cancers which overexpress the human epidermal growth factor receptor 2 (HER2) proteins generally have poor prognosis. Trastuzumab is a monoclonal antibody which inhibits HER-2 activation and has been shown to be an effective therapy for women with breast cancers that overexpress HER2 proteins. The most important side effect of trastuzumab is cardiotoxicity. We report a patient with left ventricular dysfunction and pericardial effusion after treatment with pertuzumab and trastuzumab.

This paper presents lower bounds on the number of parity-check digits required for a linear code that is capable of detecting errors which are ‘m-repeated burst errors’. Further, codes capable of detecting and simultaneously correcting such errors have also been studied.

The mitochondrial control region has been the first choice for examining the population structure but hypervariability and homoplasy have reduced its suitability. We analysed eight populations using control region for examining the population structure of Hilsa. Although the control region analysis revealed broad structuring between the Arabian Sea and Bay of Bengal (FST 0.0441, p

Hepatic epithelioid hemangioendothelioma (HEH) is extremely rare, occurring in 1 to 2 per 100,000, with chemotherapy options not well defined. Our case involved a 49-year-old female who had hepatic masses and metastasis to the lungs with a liver biopsy revealing HEH. After developing a rash from sorafenib, thalidomide was started with the progression of disease stabilized. Resection is only an option in 10% of the cases; therefore, chemotherapy is the only line of treatment. Newer chemotherapy alternatives are targeting angiogenesis via the vascular endothelial growth factor. Thalidomide was first used as an antiemetic, but, sadly, soon linked to phocomelia birth defects. Given the mechanism of action against angiogenesis, thalidomide has a valid role in vascular tumors. In conclusion, the use of thalidomide as chemotherapy is novel and promising, especially in the setting of a rare vascular liver tumor such as HEH.

Dexras1 and RHES, monomeric G proteins, are members of small GTPase family that are involved in modulation of pathophysiological processes. Dexras1 and RHES levels are modulated by hormones and Dexras1 expression undergoes circadian fluctuations. Both these GTPases are capable of modulating calcium ion channels which in turn can potentially modulate neurosecretion/hormonal release. These two GTPases have been reported to prevent the aberrant cell growth and induce apoptosis in cell lines. Present review focuses on role of these two monomeric GTPases and summarizes their role in pathophysiological processes.

Malignant transformation of endometriosis is rare and is usually seen in ovarian endometriosis. The colon and rectum are the most common sites for extragonadal endometriosis, and although serosal involvement is commonly seen, mucosal involvement is rare. Malignant transformation of endometriosis is a rare but a well-known complication of endometriosis. We report an unusual presentation of endometrioid adenocarcinoma with lymph node metastasis, arising from endometriosis in the caecal wall and causing ileocaecal intussusception. The patient presented with sudden onset of abdominal pain with features suggestive of acute appendicitis. Diagnostic laparoscopy revealed an ileocaecal intussusception. Conversion to open surgery confirmed a caecal mass causing ileocaecal intussusception, and a radical right hemicolectomy was performed. Histology revealed endometrioid adenocarcinoma arising in a focus of endometriosis in the muscularis propria and involving the mucosa, with one regional metastatic lymph node.