31 research outputs found

    Thyroid Nodule: Approach and Management

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    A thyroid nodule is a discrete radiologically distinct lesion in the gland parenchyma. These are a common finding in the general population, majority being diagnosed incidentally during neck imaging. The major clinical relevance lies in the fact that 4–6.5% of nodules can be malignant. A thorough clinical evaluation and examination should be followed by serum TSH assessment and ultrasonography for assessment of size, number, imaging characteristics suggestive of malignancy, cervical lymphadenopathy. FNA should be done based on clinical and sonographic characteristics. Further choice of management modality and extent of surgery should be based on cytopathological findings supplemented by molecular testing if available

    Effect of plasma glucose at admission on COVID-19 mortality: experience from a tertiary hospital

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    Objective: Plasma glucose has been correlated with in-hospital mortality among many diseases including infections. We aimed to study the plasma glucose at the admission of hospitalized patients with COVID-19 at a tertiary care referral hospital at Jodhpur, India and its relation with mortality. Design: A hospital-based clinical study of plasma glucose of COVID-19 patients conducted from May 15 to June 30, 2020 after ethical approval. Measurements: Random blood samples at admission were collected for plasma glucose, interleukin-6 (IL6) and high sensitivity C-reactive protein (hsCRP) after written informed consent was obtained. Plasma glucose was analyzed by the automated analyzer, IL6 by chemiluminescent immunoassay and hsCRP by immune-turbidimetric assay. Results: A total of 386 patients were studied (female 39.6%); 11.1% had severe disease and 4.1% expired. There were 67 (17.4%) patients with known diabetes mellitus (DM). Patients with a history of DM had three times higher mortality (6/67, 9%) than those without DM (10/309, 3.1%). Patients with moderate and severe disease according to ICMR and WHO grading had higher plasma glucose than those with asymptomatic or mild disease (P 100–200, >200–300 and >300 mg/dL, respectively, compared to those with random plasma glucose of <100 mg/dL at admission. Plasma glucose was strongly correlated with hsCRP (P < 0.001) and IL6 (P < 0.0001). Conclusions: Plasma glucose at admission in hospitalized COVID-19 patients is a strong predictor of mortality

    Antimicrobial Activity of Secondary Metabolites in Medicinal Plants: An Update

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    Plants have filled in as a significant wellspring of elements for conventional drugs for centuries. Verifiable records and present day ethno botanical field examines feature their significance in the conventional treatment of irresistible malady. Be that as it may, plants form just a minor level of present collection of FDA-endorsed antimicrobial medications. The present article gives an outline of active components of plants as hint for other wellspring of antimicrobial agents to be used in the battle against microscopic organisms. It additionally surveys the ethno botanical way to deal with sedate disclosure and talks about various inventive focuses for future medication revelation endeavours in this field. Without an uncertainty, antimicrobials are miracle tranquilizers. They have represented a very long time against different irresistible infections and spared a huge number of lives. The ongoing disappointment of antimicrobials because of the sensational rise of multidrug-safe microbes and fast spread of new diseases, be that as it may, prompts wellbeing associations and the pharmaceutical business worldwide to change their methodology and to expand improvement of antimicrobials against quickly rising anti-infection safe microorganisms. In spite of the fact that there is thinking about elective wellsprings of characteristic antimicrobial molecules from plants having different methods of activity, some of which have been utilized in regular medication for a considerable length of time and have appeared to have serious impacts contrasted with other antimicrobials. This examination portrays plant intensity as an elective hotspot for antimicrobial agents

    Green chemistry and catalysis: An emerging sustainable approach in synthetic chemistry

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    This tutorial review summarizes the basic new concepts of green chemistry in relation to education and pharmaceutical industries. The origin and history of Green analytical chemistry is described in detail. Basic twelve principles are well summarized with suitable examples of each principle such as oxidation of alcohol, enzymatic reactions, and non-covalent derivatization. This article also covers the concept of E-factor for waste minimization, detailed various solvent selection guidelines and tools for betterment of synthetic pathways at laboratory and industrial level. The efficiency of green chemistry in organic synthesis for greenness of traditional organic synthesis methods are discussed. Nowadays, there is a constant need to add catalysts for chemical synthesis to minimize or downsize the risks correspondent with chemical manufacture. Catalyst helps to enhance air quality by reducing harmful gas emissions such as NOx. It cuts down on the use of VOCs (volatile organic compounds). It developed an alternative catalytic method which substitutes the usage of chlorine-based intermediates in chemical synthesis and processes. Biocatalysts is a term used to describe compounds that aid in the stimulation of biological reactions. In the fine chemical industry, cleaner biocatalytic alternatives are replacing traditional chemical operations

    Common variants in CLDN2 and MORC4 genes confer disease susceptibility in patients with chronic pancreatitis

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    A recent Genome-wide Association Study (GWAS) identified association with variants in X-linked CLDN2 and MORC4 and PRSS1-PRSS2 loci with Chronic Pancreatitis (CP) in North American patients of European ancestry. We selected 9 variants from the reported GWAS and replicated the association with CP in Indian patients by genotyping 1807 unrelated Indians of Indo-European ethnicity, including 519 patients with CP and 1288 controls. The etiology of CP was idiopathic in 83.62% and alcoholic in 16.38% of 519 patients. Our study confirmed a significant association of 2 variants in CLDN2 gene (rs4409525—OR 1.71, P = 1.38 x 10-09; rs12008279—OR 1.56, P = 1.53 x 10-04) and 2 variants in MORC4 gene (rs12688220—OR 1.72, P = 9.20 x 10-09; rs6622126—OR 1.75, P = 4.04x10-05) in Indian patients with CP. We also found significant association at PRSS1-PRSS2 locus (OR 0.60; P = 9.92 x 10-06) and SAMD12-TNFRSF11B (OR 0.49, 95% CI [0.31–0.78], P = 0.0027). A variant in the gene MORC4 (rs12688220) showed significant interaction with alcohol (OR for homozygous and heterozygous risk allele -14.62 and 1.51 respectively, P = 0.0068) suggesting gene-environment interaction. A combined analysis of the genes CLDN2 and MORC4 based on an effective risk allele score revealed a higher percentage of individuals homozygous for the risk allele in CP cases with 5.09 fold enhanced risk in individuals with 7 or more effective risk alleles compared with individuals with 3 or less risk alleles (P = 1.88 x 10-14). Genetic variants in CLDN2 and MORC4 genes were associated with CP in Indian patients

    Lines of healing

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    Lyotropic Liquid Crystal System for Drug Delivery of Astaxanthin: Physical Characterization and Enhanced Antioxidant Potential

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    Astaxanthin is a xanthophyll carotenoid, well known for its potent anti-inflammatory and antioxidant properties, owing to its unsaturated molecular structure. Aquatic plants and animals contain the hydrophobic carotenoid astaxanthin, which is thought to possess a number of advantageous biological traits. However, due to its weak bioavailability and low water solubility, its use as a nutraceutical in food is currently restricted. Cubosomal encapsulation has been considered an effective alternative for improving the bioavailability and solubility of hydrophobic bioactives. The current paper aimed to conquer these issues by encapsulating astaxanthin in lyotropic liquid crystal nano-formulations prepared via the fabrication method. The physicochemical properties of astaxanthin-loaded cubosomes (AST-LC) have also been analyzed, in order to know the morphology of the prepared formulations and their bioavailability in the biological system. The formulation has been tested for particle size, thermal behavior, zeta potential, crystallinity, encapsulation efficiency, and drug-polymer interactions. The observed experimental results showed the particle size and zeta potential of astaxanthin-loaded cubosomes (AST-LC) as 199 ± 0.23 nm −27.4 ± 4.67 mV, with a small polydispersity index (0.283 ± 1.01). The cubic structure and nano-range size of the ideal formulation were verified by a field emission scanning electron microscope (FESEM) and (HRTEM) high-resolution transmission electron microscopic examination. The formulation exhibits a higher encapsulation efficiency with good yield. Results from X-ray diffraction and diffraction scanning calorimetry demonstrated an amorphous state of astaxanthin incorporated into the formulation. Fourier transform infrared spectroscopy (FTIR) analysis of AST-LC showed the absence of astaxanthin main peaks, indicating its complete encapsulation inside the formulation. The drug–excipient interaction was carried out with diffraction scanning calorimetry DSC and FTIR, resulting in no interaction between them. These results offered important details about increasing astaxanthin bioavailability by incorporating it into cubosomes. Furthermore, the astaxanthin loaded into cubosomes has been evaluated for antioxidant potency, compared with astaxanthin extract using 2,2-diphenylpicrylhydrazylassay (DPPH assay)
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