Efficacy of Steroid Therapy in Management of Sydenham’s Chorea in Children: A Comparative Prospective Study

Objective: To determine the efficacy of steroid therapy in Sydenham’s chorea in children. Study Design: Comparative prospective study. Place and Duration of Study: Inpatient and Outpatient Department of Pediatric Neurology, Children Hospital and Institute of Child Health, Lahore Pakistan, from Dec 2019 to May 2020. Methodology: Sixty-eight children of Sydenham’s chorea were divided in Group A and B. Each Group was treated with Diazepam (0.3mg-1mg/kg/day) and an injection of Benzathine Penicillin. Group-B was given additional oral prednisolone (2mg/kg/day) for four weeks, with tapering in the next two weeks. Epidemiological data, clinical features and laboratory parameters were collected. The Universiade Federal de Minas Gerais Sydenham’s chorea Rating Scale (USCRS) was applied to both groups at the presentation after two weeks and four weeks. Results: Out of 68 patients, the mean Universidade Federal de Minas Gerais (UFMG) Sydenham's Chorea Rating Scale (USCRS) got progressively better in Group-B (mean score improvement was 25.73±5.56 at two weeks and 41.06±6.89 at four weeks) than in Group-A (mean score improvement was 9.12±3.75 at two weeks and 17.97±3.89 at four weeks) with p-value of <0.05. Conclusion: Steroid therapy significantly improved patients with Sydenham’s chorea compared to those who did not receive any steroid therapy. Keywords: Efficacy, Steroid therapy, Sydenham chorea

Sulforaphane inhibits growth of human breast cancer cells and augments the therapeutic index of the chemotherapeutic drug, gemcitabine

Phytochemicals are among the natural chemopreventive agents with most potential for delaying, blocking or reversing the initiation and promotional events of carcinogenesis. They therefore offer cancer treatment strategies to reduce cancer related death. One such promising chemopreventive agent which has attracted considerable attention is sulforaphane (SFN), which exhibits anti-cancer, anti-diabetic, and anti-microbial properties. The present study was undertaken to assess effect of SFN alone and in combination with a chemotherapeutic agent, gemcitabine, on the proliferative potential of MCF-7 cells by cell viability assay and authenticated the results by nuclear morphological examination. Further we analyzed the modulation of expression of Bcl-2 and COX-2 on treatment of these cells with SFN by RT-PCR. SFN showed cytotoxic effects on MCF-7 cells in a dose- and time-dependent manner via an apoptotic mode of cell death. In addition, a combinational treatment of SFN and gemcitabine on MCF-7 cells resulted in growth inhibition in a synergistic manner with a combination index (CI)\u3c1. Notably, SFN was found to significantly downregulate the expression of Bcl-2, an anti-apoptotic gene, and COX-2, a gene involved in inflammation, in a time-dependent manner. These results indicate that SFN induces apoptosis and anti-inflammatory effects on MCF-7 cells via downregulation of Bcl-2 and COX-2 respectively. The combination of SFN and gemcitabine may potentiate the efficacy of gemcitabine and minimize the toxicity to normal cells. Taken together, SFN may be a potent anti-cancer agent for breast cancer treatment

Inhibitory effect of genistein on the invasive potential of human cervical cancer cells via modulation of matrix metalloproteinase-9 and tissue inhibitiors of matrix metalloproteinase-1 expression

Background: One of the most challenging stumbling blocks for the treatment of cancer is the ability of cancer cells to break the natural barriers and spread from its site of origin to non-adjacent regional and distant sites, accounting for high cancer mortality rates. Gamut experimental and epidemiological data advocate the use of pharmacological or nutritional interventions to inhibit or delay various stage(s) of cancer such as invasion and metastasis. Genistein, a promising chemopreventive agent, has gained considerable attention for its powerful anti-carcinogenic, anti-angiogenic and chemosensitizing activities. Methods: In this study, the cytotoxic potential of genistein on HeLa cells by cell viability assay and the mode of cell death induced by genistein were determined by nuclear morphological examination, DNA laddering assay and cell cycle analysis. Moreover, to establish its inhibitory effect on migration of HeLa cells, scratch wound assay was performed and these results were correlated with the expression of genes involved in invasion and migration (MMP-9 and TIMP-1) by RT-PCR. Results: The exposure of HeLa cells to genistein resulted in significant dose- and time-dependent growth inhibition, which was found to be mediated by apoptosis and cell cycle arrest at G2/M phase. In addition, it induced migration-inhibition in a time-dependent manner by modulating the expression of MMP-9 and TIMP-1. Conclusion: Our results signify that genistein may be an effective anti-neoplastic agent to prevent cancer cell growth and invasion and metastasis. Therefore therapeutic strategies utilizing genistein could be developed to substantially reduce cancer morbidity and mortality. © 2012 Elsevier Ltd

Monitoring Microbial Diversity of a Full-Scale Municipal Wastewater Treatment Plant in Dubai

In this study, fluorescence in situhybridization (FISH) technique was employedfor monitoring the microbial community in the activated sludge system of a full-scale municipal wastewater treatment plant in Dubai over a period of one year. A total of 96 activated sludge mixed liquor samples were characterized using ribosomal RNA (16S and 23S rRNA) targeted oligonucleotide probes for defined phylogenetic groups of bacteria. Several filamentous and non-filamentous bacteriawere predominantly found throughout the study period in all activated sludge mixed liquor samples. The bacterial species belonging to High G+C group were detected in both branched and single cell morphotypes. The previously published genus and species specific probes detected several of members belonging to archaea, sulphate reducing bacteria, ammonia-oxidizing bacteria, nitrobacter, nitrospira including halophilic and halotolerantnitrosomonasspp.In conclusion, the overall microbial community populations detected by the sub-group and species specific 16S and 23S rRNA targeted oligonucleotide probes found to be quite diverse and varied seasonally

Application in medicine: Has artificial intelligence stood the test of time

Artificial intelligence (AI) has proven time and time again to be a game-changer innovation in every walk of life, including medicine. Introduced by Dr. Gunn in 1976 to accurately diagnose acute abdominal pain and list potential differentials, AI has since come a long way. In particular, AI has been aiding in radiological diagnoses with good sensitivity and specificity by using machine learning algorithms. With the coronavirus disease 2019 pandemic, AI has proven to be more than just a tool to facilitate healthcare workers in decision making and limiting physician-patient contact during the pandemic. It has guided governments and key policymakers in formulating and implementing laws, such as lockdowns and travel restrictions, to curb the spread of this viral disease. This has been made possible by the use of social media to map severe acute respiratory syndrome coronavirus 2 hotspots, laying the basis of the smart lockdown strategy that has been adopted globally. However, these benefits might be accompanied with concerns regarding privacy and unconsented surveillance, necessitating authorities to develop sincere and ethical government-public relations

Root resorption in ameloblastoma: a radiographic analysis of 35 cases

Background and Objective: Odontogenic tumors are heterogenous lesions with diverse clinical manifestations and histopathological features. Ameloblastoma is a slow growing, sizeable benign tumor with an increased recurrence potential. Radiographically, ameloblastoma mimics other odontogenic tumors occurring in the same region but can be differentiated based on certain features. The objective of the study was to evaluate the radiographic features and presence of root resorption in ameloblastoma as a diagnostic feature in the local population. Methods: This retrospective hospital-based study was conducted at the Oral and Maxillofacial Surgery Department of Multan Medical and Dental College Multan, Pakistan from 1st Oct 2019 to 31st March 2020. Radiographs of 35 histopathologically confirmed cases of ameloblastoma were included in the study. These radiographs were assessed for site, locularity, and root resorption. Data were processed and analyzed by using SPSS version 23.0 Results: Mean age of the patients was 35.35&plusmn;18.2 years with male predominance (66% vs. 34%). A total of 55% cases presented below 35 years age group showing increased prevalence in young adults. Multilocular appearance was seen in 24 (68.5%) cases while uni-locular pattern was seen in 12 (31.5%) cases. Root resorption was detected in 19 (54.3%) cases. Statistically, root resorption was not significantly associated with the gender or age of the patients (p &gt; 0.05). Conclusion: Multi-locular appearance and root resorption are the key radiographical features of ameloblastoma presenting in our population.</p

Clinical and epidemiological features of pediatric population hospitalized with COVID-19: A multicenter longitudinal study (March 2020-December 2021) from Pakistan

Background: We aimed to explore the epidemiological, clinical, and phenotypic parameters of pediatric patients hospitalized with COVID-19 in Pakistan.Methods: This longitudinal cohort study was conducted in five tertiary care hospitals in Pakistan from March 2020 to December 2021. Data on various epidemiological and clinical variables were collected using Case Report Forms (CRFs) adapted from the WHO COVID-19 clinical data platform at baseline and at monthly follow-ups for 3 months.Findings: A total of 1090 children were included. The median age was 5 years (Interquartile range 1-10), and the majority presented due to new signs/symptoms associated with COVID-19 (57.8%; n = 631), the most common being general and respiratory symptoms. Comorbidities were present in 417 (38.3%) children. Acute COVID-19 alone was found in 932 (85.5%) children, 81 (7.4%) had multisystem inflammatory syndrome (MIS-C), 77 (7.0%) had overlapping features of acute COVID-19 and MIS-C, and severe disease was found in 775/1086 (71.4%). Steroids were given to 351 (32.2%) patients while 77 (7.1%) children received intravenous immunoglobulins. Intensive care unit (ICU) care was required in 334 (31.6%) patients, and 203 (18.3%) deaths were reported during the study period. The largest spike in cases and mortality was from July to September 2021 when the Delta variant first emerged. During the first and second follow-ups, 37 and 10 children expired respectively, and medical care after discharge was required in 204 (25.4%), 94 (16.6%), and 70 (13.7%) children respectively during each monthly follow-up.Interpretation: Our study highlights that acute COVID-19 was the major phenotype associated with high severity and mortality in children in Pakistan in contrast to what has been observed globally.Funding: The study was supported by the World Health Organization (WHO), which was involved in the study design but played no role in its analysis, writeup, or publication