Diphtheria in an Adult: How Well Prepared Are We in Tackling the Disease? A Case Report

Diphtheria is a forgotten communicable disease and presumed to be under sufficient control so much so that life savings drugs required for its treatment has disappeared from most hospitals. Contrary to this belief, classical diphtheria continues to exist in many parts of India despite extensive immunizations campaigns raising the suspicion of resurgence. The absence of essential drugs in treatment of this condition has further worsened the situation. The expenditure involved in procuring these drugs is yet another constraint. We here by present one such case of adult diphtheria and discuss the problems associated with its diagnosis and treatment.     

Indigenous knowledge of medicinal plants from Gujranwala district,Pakistan

Aim of study

This study was focused with the aim to investigate and document the indigenous medicinal knowledge and commonly used medicinal plants from Gujranwala district, Pakistan and to establish a baseline data in continuing studies aimed at more comprehensive investigations on bio-active compounds of indigenous medicinal plants.

Material and methods

Rapid appraisal approach (RAA) was used along with the interviews, group meetings with people having knowledge about indigenous uses of medicinal plants and individual meetings with herbalists were conducted, to collect the ethnomedicinal data.

Results and discussions

About 71 species of medicinal plants belonging to 38 families have been documented through 203 informants. Most favored plant part used for indigenous medicine was leaves (38%) followed by the seed (13%), whole plant (11%), flower (9%), fruit (8%), root and bark (6%) and the main source of these medicines was wild herbs (54%) followed by the wild shrubs, wild trees (13%), cultivated herbs (10%), cultivated trees (5%), cultivated shrubs (3%) and wild grasses (2%). The herbal preparations were mainly administrated orally and topically.

Conclusion

Gujranwala district has great diversity of medicinal plants and people are aware about their medicinal values. Few plants are playing vital role in the basic health care needs of study areas; such plants should be screened for detailed pharmacological studied to explore new biological compounds.     

Therapeutic cloning by xenotransplanted oocytes, supplemented with species specific reprogramming factors

For therapeutic medication, a lot of work has been done regarding human embryonic stem (ES) cell lines derivation, but immunorejection is a major dilemma of this cell based therapy. Since long time, derivation of patient matched stem cells have been hoped to overcome this problem. Oocytes after nuclear transfer are the most reliable source for patient matched ES cells derivation, for therapeutic use. In humans, utilization of oocytes for stem cell research raises sensitive logistical and ethical questions; primarily surrounding participation of women as oocyte donors. It has been claimed that therapeutic cloning would lead to commercial exploitation of poor women. On the other hand, the therapeutic promise of embryonic stem cell is so huge that there is a strong incentive to find some alternate sources of human oocytes. Here we propose to utilize the cross species oocytes supplemented with human ES cellular extracts to establish patient specific ES cell lines.     

Excited states of ribosome translocation revealed through integrative molecular modeling

The dynamic nature of biomolecules leads to significant challenges when characterizing the structural properties associated with function. While X-ray crystallography and imaging techniques (such as cryo-electron microscopy) can reveal the structural details of stable molecular complexes, strategies must be developed to characterize configurations that exhibit only marginal stability (such as intermediates) or configurations that do not correspond to minima on the energy landscape (such as transition-state ensembles). Here, we present a methodology (MDfit) that utilizes molecular dynamics simulations to generate configurations of excited states that are consistent with available biophysical and biochemical measurements. To demonstrate the approach, we present a sequence of configurations that are suggested to be associated with transfer RNA (tRNA) movement through the ribosome (translocation). The models were constructed by combining information from X-ray crystallography, cryo-electron microscopy, and biochemical data. These models provide a structural framework for translocation that may be further investigated experimentally and theoretically to determine the precise energetic character of each configuration and the transition dynamics between them.     

Aspirin significantly decreases the nonopsonic phagocytosis and immunogenicity of macrophages in mice

Objective and design  

The effect of acetylsalicyclic acid (ASA) on the phagocytosis and immunogenicity of macrophages remains to be determined.     

ACR Appropriateness Criteria® screening for pulmonary metastases

Screening for pulmonary metastatic disease is an important step for staging a patient with a known or recently discovered malignancy. Here we present our recommendations for screening for metastatic disease based on recommendations from the literature and experiences of pulmonary radiologists. In short, chest computed tomographic (CT) screening is the most appropriate tool for evaluation of pulmonary metastasis in the majority of cases. Chest computed tomographic screening is also recommended for follow-up and to determine response to therapy. Other modalities such as chest radiography, magnetic resonance imaging, and scintigraphy will also be discussed. Please note that this study is a summary of the complete version of this topic, which is available on the ACR website at www.acr.org. Practitioners are encouraged to refer to the complete version.     

Nail mine in stomach

Ingestion of foreign bodies is a common clinical scenario in any emergency department. Presence of thousands ingested foreign bodies inside stomach is a rare scene. However, only a few such cases have been reported. Here we present a case of young adult man with known psychiatric disorder, having 2562 nails in his stomach leading to gastric outlet obstruction. Gastrotomy was employed to relieve the stomach of this mine of nails. Later psychiatric care was also provided.     

对合缝合与内翻缝合消化道吻合口微循环及愈合过程的对比观察

目的 比较对合缝合与内翻缝合消化道吻合口微循环及组织愈合过程.方法 将成年家兔随机分为A、B两组,距Trietz韧带以远20 cm和40 cm处分别完全切断小肠,行端端吻合,A组在20 cm处吻合口采取对合缝合法,40 cm处吻合口行内翻缝合法 B组则在20 cm处吻合口行内翻缝合法,40 cm处行对合缝合法.于术后3、7、14及28 d进行活体肉眼观察并检测吻合口微区血流和增生毛细血管数量,评估炎性反应、胶原增生、黏膜上皮及平滑肌修复情况.结果 活体肉眼观察两组吻合口均无出血、裂开、渗漏以及肠梗阻和腹腔脓肿.对合缝合吻合口各层组织对合严密、整齐,炎性反应轻,创面符合I期愈合 内翻吻合口组织错位,对合不良,炎性反应较重,创面接近Ⅱ期愈合.两种缝合方法术后3 d吻合口处即可测得吻合口局部微区血流,并见微血管增生 7 d开始微区流速加快,微血管增生明显 至28 d,对合缝合吻合口微区血流和微血管分布达到正常水平,但内翻缝合吻合口仍低于正常水平.术后各个检测时间点,对口缝合吻合口微区血流、毛细血管计数、炎性反应积分、黏膜上皮细胞再生积分及平滑肌厚度均高于内翻缝合吻合口,胶原组织密度低于内翻缝合吻合口（P＜0.05）.结论 采用对合缝合法,吻合口局部微循环重建和各期组织修复均优于内翻缝合法.     

Aspirin may do wonders by the induction of immunological self-tolerance against autoimmune atherosclerosis

Induction of immune tolerance is one of the recent novel immunomodulatory strategies to directly intervene the autoimmune-driven atherosclerosis. Aspirin is a prototypic non-steroidal anti-inflammatory drug, which is now being regarded as a life-saver in variety of atherosclerotic cardiovascular complications. Considerable amount of data emerged during last few years clearly suggests that aspirin can cause immunomodulation by several mechanisms, particularly, its ability to induce tolerogenic dendritic cells (DCs) and to upregulate T regulatory (Treg) cells is especially appealing with respect to induction of immunological self-tolerance. Based on this fact, we hypothesize that aspirin, in addition to its anti-inflammatory effect, may also specifically inhibit autoimmune response in atherosclerosis by actively increasing CD4 + CD25 + FOXP3 + Treg cells as well as by inducing tolerogenic DCs which induce hyporesponsiveness in responder naïve T cells. If proved to be correct, this hypothesis will provide an opportunity to medical community with an already available aspirin-based immunotherapeutic approach for inducing immune tolerance against atherosclerosis.