Neurological care and training in the times of covid-19: a tertiary care center experience

Resilience in these challenging times of COVID-19 at a professional and personal level is cardinal. Trainees and faculty have had to adapt to this adversity with striking limitations on formal neurological, neurovascular and neurophysiological residencies and fellowships. The revision of schedules and reallocation of assignments to cope with the practical aspects in a teaching tertiary care hospital have been overbearing. Novel structural innovation, testing, communications and supervision to assure a modified yet impactful training educational programme is mandatory and the need of the hour. Healthcare service providers remain at the highest risk of acquiring COVID-19 worldwide. Urgent measures to educate them about personal protective equipment (PPE), disease course, infectivity and complications were initialized at the first impact of COVID-19. Foreseeing the pandemic in months to come, here we describe the elemental changes made at the Aga Khan University Hospital (AKUH) Karachi, Pakistan a leading academic institute in health sciences and one of the largest tertiary care hospitals in the country and all the modifications contrived in the section of neurology to deal with the brunt of the pandemic. The neurology section devised a strategy balancing clinical work, research and academic activities.Tele health clinics were encouraged and set up across all specialties to minimize in hospital encounters whilst answering concerns of patients and their caregivers. Collaborative efforts, nationally and globally are the requirement as we continue to learn through clinical experience, trials and research on all the potential complications of COVID-19 in these dismal times

Validation of a food frequency questionnaire for assessing Macronutrient and calcium intake in adult Pakistani population

Objective: To develop and validate a food frequency table (FFQ) for use in urban Pakistani population. Study Design: A validation study. Place and Duration of Study: The Aga Khan University, Karachi, from June to November 2008. Methodology: Healthy adult females, aged ≥ 18 years who consented to be included in the study were inducted, while males, unhealthy females, aged below 18 years or who did not consent were excluded. The FFQ was administered once while 4, 24 hours recalls spread over a period of one year were administered as the reference method. Daily intakes for energy, protein, fat, and calcium intake were estimated for both the tools. Crude and energy adjusted correlations for nutrient intakes were computed for the FFQ and mean of 4, 24 hours recalls and serum N-telopeptide of type-I collagen (NTx). Results: The correlation coefficients for the FFQ with mean of 4, 24 hours recall ranged from 0.21 for protein to 0.36 for calcium, while the correlation for nutrient estimates from the FFQ with NTx ranged from -0.07 for calcium to 0.01 for energy. Conclusion: Highly significant correlations were found for nutrient intakes estimated from the FFQ vs. those estimated from the mean of 4, 24 hours recalls but no correlations was found between nutrient estimates from the FFQ and serum NTx levels. FFQ was concluded to be a valid tool for assessing dietary intake of adult females in Pakistan

Anticonvulsant evaluation of 2-pyrazolines carrying naphthyl moiety: An insight into synthesis and molecular docking study

A series of N-substituted-3-(napthalen-2-yl)-5-substituted phenyl-4,5-dihydropyrazole-1-carbothioamide derivatives (4a-n) were synthesized with the view of structural requirements of pharmacophore for potential anticonvulsant agents. The synthesized compounds were assayed intraperitoneally (i.p.) and subcutaneously (s.c.) in mice against seizures induced by MES and scPTZ methods, respectively. Neurologic deficit was evaluated by rotarod method. Among the tested compounds, 4g, 4i, 4j and 4n emerged as the most active molecule in the MES model at a dose of 30 mg/kg at 0.5h comparable to standardscarbamazepine and phenytoin. In the scPTZ test,4e and 4l were found to be most active compounds at the lowest dose of 30 mg/kg at 0.5h, in the management of the convulsive disorder. Molecular docking studies of the titled compounds were also donewith 3D crystal structure of human cytosolic branched chain amino transferase (hBCATc) enzyme and compound 4e was found to have five hydrogen bond interactions with the most important active site residues.In neurotoxicity studies, except compounds 4b, 4c, 4h and 4k, rest of the compounds showed no sign of toxicity

Antimicrobial activity of Dracaena cinnabari resin from Soqotra Island on multi drug resistant human pathogens

Background: Few studies showed that Dracaena cinnabari resin, collected from Soqotra Island,  Yemen,  has antimicrobial activity. This study is the first to investigate antimicrobial activity of the resin on both antibiotic multi-resistant human pathogens and on poly-microbial culture.Material and Methods: Antimicrobial activity of ethanolic extract of Dracaena cinnabari resin from  Soqotra Island on multidrug resistant Gram-positive and Gram-negative human ATCC standard pathogens  and Ascosphaera apis, the causal organism of chalkbrood disease of honeybee was studied using the agar disc diffusion method. The minimal inhibitory concentration of extracts was carried out by  the broth micro dilution method.Results: Ethanolic extract of Dracaena cinnabari resin showed a considerable antimicrobial activity  against all the pathogens tested. The zone of inhibition were between 4.9-11.5 mm. The most sensitive  microbe was Staphylococcus aureus and least sensitive was Aspergillus nidulans. The minimal inhibitory concentration of the extract against Escherichia. coli ATCC 10402, Klebsiella pneumonia ATCC 10031, and Staphylococcus aureus ATCC 29212 was 1.25 μg/mL (w/v) and for the other pathogens (Candida albicans ATCC 10231, Salmonella typhimurum ATCC 3311 and Pseudomonos aeruginosa ATCC 2785) was 2.5 μg/mL (w/v).Conclusion: Ethanolic extract of Dracaena cinnabari resin has a considerable antimicrobial activity  against Gram-positive and Gram-negative human pathogens and fungi. This extract might possess a role in the management of microbial infections in human and honeybee disease.Key words: Antimicrobial Activity, Dracaena cinnabari, Human pathogens, Minimum Inhibitory Concentratio

Rathke’s cleft cyst abscess from Klebsiella

Pituitary abscesses are uncommon lesions accounting for <1% of all pituitary diseases. We report a case of a female microbiology technician with a rare congenital heart disease who developed an Rathke’s Cleft Cyst abscess from Klebsiella. A 26-year-old female biotechnician with a history of congenital heart disease and subclinical immunosuppression presented with a 10-month history of weight loss, amenorrhea, and visual deterioration. There was a history of previous unsuccessful transsphenoidal surgery. Radiology revealed a cystic lesion in the sellar region. The patient underwent an endoscopic endonasal intervention and the cystic cavity was washed with gentamicin, and the patient received meropenem postoperatively. The patient was followed up and had gradual improvement in her overall health, complete normality of her menstrual cycle, her visual field recovering to near normal and improving, no recurrence, and a stable cyst on magnetic resonance imaging

A Novel Single-Fed Dual-Band Dual-Circularly Polarized Dielectric Resonator Antenna for 5G Sub-6GHz Applications

In this research article, a single-fed dual-band circular polarized (CP) dielectric resonator antenna (DRA) for dual-function communication, such as GPS and WLAN, was made. Initially, the proposed design process was initiated by designing a linearly polarized singly fed-DRA. To attain CP fields, the cross-shape conformal metal strip was optimized to excite the fundamental and the high-order mode in the two frequency bands. The metallic strip (parasitic) was utilized on top of the rectangular DRA to improve and widen the impedance and axial ratio (AR) bandwidth. This step led to a 2.73% improvement on the lower band and an impact of 6.5% on the upper band while on the other side a significant improvement was witnessed in the AR bandwidth in both frequency bands. A prototype was designed and fabricated in order to validate its operations. The measurement outcomes of the proposed antennas authenticated wideband impedance bandwidths of 6.4% and 25.26%, and 3-dB axial ratios (AR) of 21.26% and 27.82% respectively. The prototype is a decent candidate for a global positioning system (GPS) and wireless local area network (WLAN).This project has received funding from the Universidad Carlos III de Madrid and the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska- Curie Grant 801538

Development and optimization of fluoxetine orally disintegrating tablets using Box-Behnken design

Purpose: To develop and optimise some variables that influence fluoxetine orally disintegrating tablets (ODTs) formulation.Methods: Fluoxetine ODTs tablets were prepared using direct compression method. Three-factor, 3- level Box-Behnken design was used to optimize and develop fluoxetine ODT formulation. The design suggested 15 formulations of different lubricant concentration (X1), lubricant mixing time (X2), and compression force (X3) and then their effect was monitored on tablet weight (Y1), thickness (Y2), hardness (Y3), % friability (Y4), and disintegration time (Y5).Results: All powder blends showed acceptable flow properties, ranging from good to excellent. The disintegration time (Y5) was affected directly by lubricant concentration (X1). Lubricant mixing time (X2) had a direct effect on tablet thickness (Y2) and hardness (Y3), while compression force (X3) had a direct impact on tablet hardness (Y3), % friability (Y4) and disintegration time (Y5). Accordingly, Box-Behnken design suggested an optimized formula of 0.86 mg (X1), 15.3 min (X2), and 10.6 KN (X3). Finally, the prediction error percentage responses of Y1, Y2, Y3, Y4, and Y5 were 0.31, 0.52, 2.13, 3.92 and 3.75 %, respectively. Formula 4 and 8 achieved 90 % of drug release within the first 5 min of dissolution test.Conclusion: Fluoxetine ODT formulation has been developed and optimized successfully using Box- Behnken design and has also been manufactured efficiently using direct compression technique.Keywords: Box-Behnken experimental design, Orally disintegrating tablets, Direct compression, Antidepressant, Magnesium stearate, Mixing tim

A Short History of Evolution of Indigenous Plants and Medicine System

The importance of plants is well known to us. Life and its growth cannot be imagined without plants. Food for our survival is produced by plants and they also create a healthy and eco-friendly environment to live (Sazada et al., 2009).The use of various parts of different medicinal plants to cure specific ailments has been common from ancient times in India. The indigenous system of medicine namely Ayurvedic, Siddha and Unani have been in existence for many centuries. Apart from India, these systems are also prominent in Korea, China, Singapore, West Asia and many other countries. The knowledge of medicinal plants has been inherited traditionally therefore; the utilization of this knowledge has become important for human existence. In the old times, plants were used as remedies for the diseases. The oldest religious book of the World “Rigveda” provides information about the medicinal use of plant “Soma” as a medicinal agent by the Indo-Aryans, which was written between 4000 and 1600 B.C. (Bhattacharjee, 2004).The plant “Soma” is considered to have intoxicating characteristics. This plant is used for sacrificial objectives by Aryans and they also identified its juice as a stimulating beverage (Steiner, 1986). The Aryans also played a vital role in the presentation of therapeutical properties of other medicinal herbs and plants. The knowledge of Aryans about a large number of medicinal plants is demonstrated by the work of Charaka and Sushruta (Kirtikar, 1958).The ancient Indian literature is helpful in driving the current knowledge of using cinchona in malaria, digitalis, strophanthus and physostigma in heart diseases and of quassia as a bitter tonic. The indigenous system of medicine in the Indian sub-continent known as Ayurveda goes back to 700 B.C. and its systematization is attributed mostly to Charaka and Sushruta who have cited about 700 medicinal plants. The book “Sushruta Samhita” compiled in 1000 B.C. includes a comprehensive chapter on herbal therapeutics and contains remarkable information about the use of medicinal plants (Singh and Abrar, 1990)