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Antibiotic resistance is increasing at an alarming rate and is now widely recognized as a global issue that requires urgent attention. Globally, the demand for new drugs has increased due to multidrug-resistant pathogens and emerging viruses. One promising avenue of research involves antibiotic resistance breakers (ARBs), which may or may not have direct antibacterial effects and can either be co-administered with or conjugated with failing antibiotics. This strategy may increase an antibiotic’s spectrum and its efficacy against bacteria that have acquired resistance against it and reduce the dosage necessary for an antibiotic. In this chapter, we have discussed antibiotic resistance breakers, their classification, and mechanisms of action in combating microbial resistance. Moreover, this chapter will also focus on the nanotechnological approach, a novel delivery platform using nano-carriers used to overcome the permeability barrier encountered in resistant bacteria. Nano-carriers are also used to selectively deliver high concentrations of antibiotics locally, thus avoiding systemic side effects. Several strategies have been studied to deliver antibiotics such as the use of antimicrobial polymers, nanoparticles, and liposomes. The current study will help to understand how the resistance ability of bacteria can be overcome or reversed through antibiotic resistance breakers and nano-antibiotics.

The gut microbiome has been connected with human health and sickness, including all those affecting the brain, according to new evidence. Abnormalities in this microbiota-gut-brain axis have emerged as a significant component in the pathophysiology of depression, prompting exploratory research into the neuro-active potential of gut microbial metabolic products. Over the last decade, research has revealed a plethora of complicated interactions between the microbiota and the immunological and metabolic systems, many of which have important consequences for human health. Therefore in review, we emphasise accumulating evidence suggesting the microbiome exerts effect on the brain via multiple routes linking the stomach to the central nervous system. While knowledge of the influence of gut bacteria on neurological function is still developing, understanding the gut-microbiome-brain links has the potential to transform neuroscience by discovering possibly new etiologies for mental and neurodegenerative diseases. Overall, our results show that patients with diverse brain disorders have changed bacterial metabolites, as well as the possible neuroactive effects of gut-derived SCFAs, p-cresol, serotonin derivatives, and bacterial amyloids on disease onset and progression. The results of this study might lead to more understanding of the gut–brain axis and, as a response, to possible diagnostic, therapeutic, or preventative measures for brain disorders. Keywords

The study of the TLR (Toll-like receptor) family has progressed our knowledge of the intrinsic insusceptible framework. The familiar resistant of microorganisms' constitutive and protected substances is the reason for intrinsic insusceptible response. Similarly, TLRs can be blocked by damaging substances. Favorable to provocative cytokines are created when TLRs are actuated by microbial or have determined mixtures that can be valuable or unsafe to the host. TLRs are found in an assortment of organs, including those of the cardiovascular framework, notwithstanding invulnerable cells. This review takes a gander at the job of TLRs in septic cardiomyopathy, viral myocarditis, there is a lack of knowledge not only about the role of clear to the TLRs in starting and coordinating homoeostatic processes inside the heart, but also about stressed actuated TLR enactment in cardiovascular framework tissues. As per mounting proof, TLRs might assume a part in the pathogenesis of atherosclerosis, viral myocarditis, widened cardiomyopathy, heart allograft dismissal, and sepsis-actuated left ventricular brokenness.

Medicinal plants are used as fundamental and low-cost source for remedy of numbers of infectious and metabolic diseases in developing and developed countries. Current research work was planned to evaluate the antibacterial, antifungal, and cytotoxic potential of hydroethanolic extract of E. grandiflorum. It was found that selected natural medicinal herb have significant (p

Rhinoplasty is one of the most commonly performed aesthetic surgical procedures in plastic surgery. Over the past 20 years, one of the most gratifying operations performed by facial plastic surgeons remains rhinoplasty. Both surgeries and patients may feel like they are running "home" when everything is running as scheduled, but mutual sadness may also occur when the outcome is different. Many of the typical complexities can be prevented with careful attention to particular operational maneuvers with intentional actions, extra grafts, or more conservative resections during the main rhino-plastic procedure. A view of these retrospective problems may reveal typical risks that are preemptive when the procedure is performed. Due to the subjective character of the esthetic outcome, the identification of problems in cosmetic rhinoplasty is challenging. One may expect rhino-plastic patients more critical of the outcomes, but our experience as well as those of others suggest that the surgeon is more likely than the patient to be satisfied. With a subsequent medial collapse, the ULCs might become destabilized. Moreover, the new dorsal septum produced by the excision of the hump is smaller than the original native dorsum. Even if the ULCs shrink solidly to the septum, a constricted middle vault region will be created.

Chronic Hepatitis C infection is a common worldwide disorder, caused by Hepatitis C Virus (HCV). Right around 180 million individuals are affected by Hepatitis C Virus infection globally and more than 50 million in South Asia. Ribavirin and interferon are used for many years for the treatment of HCV, direct acting agents, and combination therapy as well. The main problem with these therapies is that a lot of side effects are observed. A novel procedure is utilized for the treatment of HCV which is called nanotechnology. The major advantages of those technology are that there is no wastage of drugs and avoid the hydrolysis of drugs. Different kinds of the bearer are utilized as a part of the treatment of HCV like nanoparticles, bio-conjugation, micelle development and dendrites. Diverse sorts of Nano transporters are utilized that convey the medication stacked particles to target points and diminish symptoms. According to this description, the part of nanocomposite like a transporter for anti-hepatitis C virus vaccine, anti-hepatitis C virus deoxyribozymes, anti-HCV aptamers, anti-HCV phenolic compounds and their focused-on conveyance are talked about. Additionally, nanoparticles give a different strategy to antigen conveyance, which not just actuates distinctive components of the same framework yet, in addition, has great biocompatibility., {"references":["1.\tSchaefer EA, Chung RT. Anti− Hepatitis C Virus Drugs in Development. Gastroenterology. 2012 May 1;142(6):1340-50.","2.\tShepard CW, Finelli L, Alter MJ. Global epidemiology of hepatitis C virus infection. The Lancet infectious diseases. 2005 Sep 1;5(9):558-67.","3.\tBlach S, Zeuzem S, Manns M, Altraif I, Duberg AS, Muljono DH, Waked I, Alavian SM, Lee MH, Negro F, Abaalkhail F. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. 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Health problems in the whole world are started to increase due to new viruses, with the beginning of 20th century. Wuhan coronavirus (which is also known as nCoV-2019) is one of current examples of such type of viruses. The people infected with this disease are likely to get genuinely unwell and need care on an ICU. A number of cultural and civic norms were monitored throughout this examination. Most standards follow a common logic that unquestionably follows the previously demonstrated method to system design. Indians are advised to look at the extremely comprehensive, tastefully prepared Guidelines of the Indian Society for Anesthesia. In this study our focus on the preventing to COVID-19 in OTT and ICU with its basic and necessary conditions which are required to secure the patients as well as the medicals staff. And also determine the products for health information.

Obesity have negative effects on the fertility of males and females. In females the obesity can induce hormonal imbalances for example adipokines (leptin, adiponectin, resistin, visfatin, omentin, chemerin) on reproductive axis, irregularities in menstrual cycle, reduce conception rate and complications in pregnancy. The adverse effect is insulin resistance and insulin excess that is associated with PCOS (polycystic ovary syndrome)-irregular periods. In males the obesity affects HPG gland that in turn disturb the endocrine regulation of reproductive function with high level of estrogen and low level of testosterone, progesterone, and SHBG (sex-hormone binding globulin). DNA damage of sperm, high scrotal temperature because of highly fatted scrotum area, low production of sperms and decreased motility of sperm are all the effects of obesity in males that cause infertility. The aim of the review article is to thoroughly cover the effect of obesity on reproductive functions, hormonal concentrations & fertility potential in females & males.

In modern years, there has been a large dealing of work toward the area of free radical chemistry. Free radicals reactive oxygen species and reactive nitrogen species are create by our body by various endogenic systems, influence to different physio chemical conditions or unhealthy states. A balance between free radicals and antioxidants is necessary for proper physiological function. If free radicals overwhelm the body's ability to modulate them, a condition known as oxidative stress ensues. Free radicals thus unfavorable alter lipids, proteins, and DNA and activate a number of human diseases. Hence application of external source of antioxidants can assist in coping this oxidative stress. Synthetic antioxidants such as butylated hydroxytoluene and butylated hydroxyanisole have recently been reported to be dangerous for human health. The present review provides a brief overview on oxidative stress mediate cellular damages and role of dietary antioxidants as functional foods in the organization of human diseases. We need to take balance diet which provide much more antioxidants to lower risks of health and run to life longer.The purpose of this review is that we want awareness related to sources of antioxidants from plants and highlight the studies of antioxidants and free radicals which provide prove for maintaining healthy aging. Key words: antioxidant, free radicals, aging, oxidative stress. Graphically Abstract

Fasting is a part of many world religions and in Islam fasting is obligatory for every adult Muslim during the month of Ramadan. Islam has exempted sick people from fasting; however, many people still partake in this activity. We investigated how Islamic fasting affects patients with heart failure with preserved ejection fraction (HFpEF). We enrolled 938 patients (fasting n = 456; non-fasting = 482) in this prospective observational study. The fasting group showed a decrease in NYHA functional class III (23.36% vs. 17.77%; p-value0.05) and IV (3.76% vs. 2.19%; p-value0.05), and an increase in class I(35.57% vs. 43.64%; p-value0.05). symptoms. This is an important area for physicians to advise patients with HFpEF to fast in the month of Ramadan as it can have a favorable effect on their symptoms and quality of life.

Cystic fibrosis is a recessive autosomal disease. A nosographic entity that considered lethal in childhood. In organs such as the hypothalamus, kidney, and bone, the protein is directly affected, where its malfunction is likely to imply linear delays in growth, delayed pubertal onset, modulation of bone density, and susceptibility to renal calculus, which may be present in CF and have been in use for years, Nevertheless, the most researched and recognized cause of renal wound is iatrogenic in CF patients due to the consumption by pulmonary exacerbation of large doses of aminoglycosides (3-5 mg/kg/dose). The rise in the incidence of CF nephrocalcinosis does not seem to be connected to an inherent renal issue. Among fact, chronic kidney disease (CKD) prevalence in CF patients looks to be at least twice as high with a double rise every 10 years impacting over 20% of individuals older than 55 years. There has been no substantial change in proteome content in the treatment of CFTR modulators. These data indicate that a re-regulating proteasome activities adapts CF cells to the CFTR deficiency and impairs autophagy and endosomal aiming.

Pharmaceutical drug is a chemical substance which is used to maintain growth, cure, treat, prevent and diagnose a disease. Up to the middle of the nineteenth century, man had access to a wide range of natural remedies to ease his suffering. As part of pharmacodynamics, we consider both drug activity and drug effect, which refers to the first effects of therapeutic receptor contact and the effects that follow. Infections are a leading cause of mortality in the underdeveloped nations. This is primarily owing to the advent of emerging infectious agents, more particularly the emergence of antibiotic resistance. Drug resistance or Antimicrobial resistance (AMR), progresses when microbes, including parasites i.e viruses, bacteria and fungi no longer effective against a drug that formerly treated them effectually. Clinicians will benefit from a better grasp of the processes of antibiotic resistance when it comes to prescribing antibiotic. As a result of this review, researchers are encouraged to apply gene manipulation, increased usage of stem cells (adult and embryonic), and improve bioavailability of nutrients utilizing nanotechnology in order to overcome the negative effects of pharmaceutical medications.

The structural, electronic, optical, and mechanical characteristics of cubic inorganic perovskites XZrO3 (X = Rb and K) were studied using the Cambridge serial total energy package-based DFT.

Background: Counseling regarding conceiving and contraception in post renal transplant female recipients is neglected and important aspect of post-transplant care. Aim: To conduct to report use of contraceptive measures, pregnancy and its outcomes during post-transplant period. This study highlights the importance of contraceptive counseling after renal transplant. Results: Out of total 14 patients of our study only 5 (36%) were using contraception while 9 (64%) were not using any contraceptive method. Out of 9 non users 7 patients were never counseled regarding contraception. Moreover they had no awareness regarding drug modification or renal and feto-maternal outcomes of pregnancy after renal transplant. Conclusion: Reproductive age female patients undergoing renal transplant should be given special attention regarding counselling on contraception, pregnancy and it outcomes. Key words: Contraception, renal transplant, pregnancy

Technology affects almost every aspect of life and is constantly changing. Digital communication technology has made it easier and faster to connect people all over the world. Digital technology is used in varies fields, including business, industries, companies, and educational institutions. There are various benefits of technology; it is also associated with a number of risks and dangerous threats known as cybercrimes. Cybercrime is a criminal activity that targets digital technology, like a computer, a computer network, or a mobile device. Cybersecurity is the way we reduce the risk of becoming a victim of cybercrime. Cybersecurity is the process of defending against cyberattacks. By using these concepts, we investigated the interval-valued complex T-spherical fuzzy relations (IVCT-spherical-FRs) introduced in this paper. We studied the relationships between different types of cybersecurity and the sources of cyberattacks. Furthermore, the Hasse diagram for the interval-valued complex T-spherical partial order set and relation is developed. The concepts of Hasse diagram are being used to examine various cybersecurity techniques and practices. The most effective method is identified using the features of Hasse diagrams. Finally, comparison tests are used to demonstrate the benefits of the proposed methods.

Hepatitis C virus (HCV) is a primary cause of chronic liver disease along with various complications like liver cirrhosis and malignancy which leads to death. It has infected more than 185 million people worldwide. There is no congruence established for the treatment of various genotypes of HCV infection owing to diversity in prevalence globally. Assessment of affected individuals with HCV by polymerase chain reaction (PCR), viral load of HCV and liver enzyme levels (i.e., ALT and AST) are the foundation to evaluate the safety and efficacy of HCV therapies. The antiviral efficacy has been greatly improved and sustained viral response (SVR) rates increased from 6% with interferon monotherapy to 50-80% with PEG-interferon/ribavirin combination therapy to95% after the approval of all interferon free oral direct acting antiviral agents. The main objective of this review article is to compile data from reference sources regarding the old and current therapeutic strategies used to manage HCV infection. It is accepted that chronic HCV infection increases patient's thrombocytopenia and neutropenia risk and complications increased in co-morbid disorders like in tuberculosis, HIV, diabetes etc. In past treatment associated side effects were the major consequences and many patients have to stop the treatment. But after the approval of direct acting antiviral drugs create a revolution in the treatment of HCV infection. So, it could be concluded that current combination therapies are a promising hope to eradicate and to control HCV but some safety concerns required more considerations Therefore, this review focus on the available latest combination therapies and their effectiveness to eradicate HCV infection.

Management of endogenous Cushing syndrome is based on its aetiology. Increased Adrenocorticotropic Hormone (ACTH) levels are the most common cause of this disorder and, therefore, it is critical to determine the source of ACTH before further management. Dynamic post contrast MRI is currently the most common investigation implied to diagnose pituitary adenoma; however, it comes with the drawback of low specificity and high false positive results. Inferior petrosal sinus sampling (IPSS) is an established invasive procedure performed to differentiate central versus peripheral source of ACTH which, in turn, results in hypercortesolaemia. This is a series of 14 patients who underwent IPSS at the Department of Radiology, Aga Khan University Hospital, Karachi, from January 2006 to December 2018. The case series emphasises the role of IPSS in the management of ACTH-dependent Cushing syndrome and combined efficacy of Dynamic post-contrast MRI and the procedure under focus. Continuous....

Zika virus is an icosahedral, enveloped, single-stranded RNA virus, a member of the family Flaviviridae, transmitted to humans by Aedes species mosquitoes. Unique features of Zika virus infection are sexual and transplacental transmission and associated neurological morbidities. The main objective of our review is to summarize the most of current information including epidemiology and pathophysiology of routes of transmission, prevalence, mode of infection, symptoms, diagnosis, treatment and vaccine strategies of Zika viral infection. This article is helpful to improve the treatment of Zika viral infection which will be beneficial for society. There are two different methods to diagnose the viral infection through RT-PCR and RNA NAT analysis. Vaccines have been developed against Zika virus, DNA vaccine effects actively than mRNA and live attenuated vaccines, due to its unique mode of infection. Treatment of Zika fever is supportive and primarily involves acetaminophen for fever, headache, or myalgia. ZIKV illness is generally mild in nature, requiring no specific treatment. As with treatment for dengue, nonsteroidal anti-inflammatory agents should be avoided if thrombocytopenia is present. The most successful trials are given by the DNA and mRNA vaccine which act by targeting the genome of the Zika virus or by inhibiting its protein synthesis mechanism.

Background: Phytomedicine is becoming more acceptable as an alternative medicinal approach in the modern era.Objectives: The current study examined the antioxidant capacity and in vitro response of phytochemical constituents of Withania somnifera (Ashwagandha) on standard parameters of healthy volunteer semen.Methods: The phytochemicals and their pharmacological response in a hydroethanolic (30:70 v/v) extract of W. somnifera roots were determined using standard protocols.Results: The constituents included flavonoids, phenolic acids, alkaloids, and terpenoids were reported. High-performance liquid chromatography and Fourier-transform infrared spectroscopy determined a diverse array of biologically active chemical constituents in the extract. The extract of W. somnifera exhibits substantial antioxidant properties, including total antioxidant capacity, 2,2-diphenyl-1-picrylhydrazyl inhibition, H2O2 scavenging, and Fe3+ reducing potential ( P < .05). The analysis of essential natural minerals explored adequate levels determined using atomic absorption spectrophotometer. Cytotoxic studies revealed significant thrombolytic, RBC membrane stabilization, and DNA damage protection activity ( P < .05) while remaining non-mutagenic against Salmonella typhi TA98 and TA100. The best protective response of W. somnifera extract on human semen parameters (n = 30), such as total motility, progressive motility, and viability, demonstrated a significant ( P < .05) improvement, particularly at the dose of 25 μg/mL and 50 μg/mL.Conclusion: The study concludes that W. somnifera possesses favorable in vitro characteristics that could aid in the preservation of sperm during intrauterine insemination and in vitro fertilization.

Hantaviruses are enveloped negative (-) single-stranded RNA viruses belongs to Hantaviridae family, hosted by small rodents and entering into the human body through inhalation, causing haemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS) also known as hantavirus cardiopulmonary syndrome (HCPS). Hantaviruses infect approximately more than 200 000 people annually all around the world and its mortality rate is about 35%-40%. Hantaviruses play significant role in affecting the target cells as these inhibit the apoptotic factor in these cells. These viruses impair the integrity of endothelial barrier due to an excessive innate immune response that is proposed to be central in the pathogenesis and is a hallmark of hantavirus disease. A wide range of different diagnostic tools including polymerase chain reaction (PCR), focus reduction neutralization test (FRNT), enzyme-linked immunosorbent assay (ELISA), immunoblot assay (IBA), immunofluorescence assay (IFA), and other molecular techniques are used as detection tools for hantavirus in the human body. Now the availability of therapeutic modalities is the major challenge to control this deadly virus because still no FDA approved drug or vaccine is available. Antiviral agents, DNA-based vaccines, polyclonal and monoclonal antibodies neutralized the viruses so these techniques are considered as the hope for the treatment of hantavirus disease. This review has been compiled to provide a comprehensive overview of hantaviruses disease, its pathophysiology, diagnostic tools and the treatment approaches to control the hantavirus infection.

Gastrointestinal and neurological symptoms can precede or be isolated manifestations of COVID-19 infection, therefore health care professionals must be aware of presentations, which can help in identification and appropriate isolation of such cases.

Treatment of Cushing syndrome depends on diagnosis of etiology responsible for hypercortisolism in the body, which sometimes presents with a challenge. Inferior petrosal sinus sampling for ACTH levels, followed by peripheral venous sampling is a proven tool to be a gold standard for differentiating between peripheral and central cause of ACTH dependent Cushing syndrome. This case report is of an elderly female who presented as an outpatient in the endocrinology clinic of Aga Khan university hospital on 22/6/2017 with clinical features of hypercortisolism. After workup she was found to have cushing syndrome secondary to ACTH secreting bronchial carcinoid tumour.

This research article is based on the biodiesel synthesis from the marine green macroalga Ulva fasciata , collected from the coast of Karachi, Pakistan using new and the most potential waste catalysts from Pakistan Steel Industry. The oil was extracted with n -hexane then it was analyzed by GC, TLC and by the examination of fuel properties. The metal analysis of catalysts was carried out by chemical tests and flame atomic absorption spectroscopy (FAAS). The thermal treatment of catalysts at 1500–1700 °C during various processes in steel manufacturing industry converted the metals to metal oxides. The presence of CaO, MgO and ZnO in these catalysts made them highly reactive for biodiesel synthesis. The basicity of waste industrial catalysts was calculated to know their basic strength. The transesterification of U. fasciata oil was performed by fast stirring using 9:1 molar ratio of methanol/oil in the presence of seven different waste industrial catalysts for 6 h at 80–100 °C. The solid catalysts were easily separated from product for re-use. In addition, the rate of reaction in the presence of these catalysts was found to be quite feasible. The waste brown dust from the steel converter gave the highest yield (88%) of biodiesel. The production of biodiesel was confirmed by TLC examination and fuel properties in comparison with the ASTM standards.

This research article presents production of bioelectricity, bioethanol, and fertilizer from different industrial wastewaters supplemented with waste fruit and vegetables. Bioelectricity was generated from wastewater through the development of different microbial fuel cells (MFCs). It was observed that the voltage was increased in series combination, whereas current was increased in parallel combinations. The series combination of four units of single-chamber and eight units of double-chamber MFCs produced the power output of 5.43 mW and 4.08 mW, respectively, which is sufficient to light up the light emitting diode (LED). Power output was increased by the addition of waste fruit and vegetables. The leftover filtrates of MFCs were used for the production of bioethanol using Saccharomyces cerevisiae, while residues were used as fertilizer to check the growth of okra plant. The result showed that minor amount of bioethanol is produced from different samples, which was confirmed by the preparation of ethylbenzoate derivative.

Comparative effects of 4-Cl-IAA and kinetin on photosynthesis, nitrogen metabolism and yield of black cumin (Nigella sativaL.)The leaves of 40-day old plants of black cumin (Nigella sativaL.) were sprayed with 10-7, 10-6, 10-5M 4-Cl-IAA, and 10-6, 10-5and 10-4M kinetin. Both the hormones improved vegetative growth, photosynthetic efficiency and seed yield of the test plants as compared to deionized water (control). However, 10-6M4-Cl-IAA was most prominent in its effect, generating 42, 30, 40, 41 and 51% higher values for carbonic anhydrase, nitrate reductase, net photosynthetic rate, leaf protein content and dry mass respectively, as compared to the control in 70-day old plants. Similarly, capsule number and seed yield per plant were elevated by 41 and 43% over the untreated control at harvest (130 days after sowing) following the same treatment. Overall, the auxin showed a higher efficiency than kinetin in all treatment concentrations.

Field experiments during two successive winter seasons (2000–2001 and 2001–2002) at the Agricultural Farm of Aligarh Muslim University, Aligarh, India, studied the effect of soil nitrogen (0, 40, 60, 80 or 100 kg Nha−1) alone or in combination with a foliar spray of kinetin (10−5 M) at the vegetative stage on growth, physiology, and yield of black cumin (Nigella sativa L. cv. KJ-125). Nitrogen fertilization, especially at a dosage of 80 kg Nha−1, significantly enhanced chlorophyll content, net photosynthetic rate, stomatal conductance, leaf nitrogen content, leaf area, and total dry mass production (measured 30 days after the kinetin spray) and the number of seed capsules plant−1, 1,000-seed weight, seed yield ha−1, biological yield ha−1, and harvest index (measured at 130 days after spraying) of the experimental plants. All positive effects of nitrogen application were accentuated by application of a kinetin spray at 40 days after seeding, although the effects were minor at 0, 40, or 60 kg Nha−1...