Identification of potential drug candidates to treat gastritis and associated oxidative stress based on some novel 2-aryl-1H-naphtho[2,3-d]imidazole: synthesis, in vitro and in silico analysis

To identify potential scaffolds to treat gastritis and oxidative stress, 2-aryl-1H-naphtho[2,3-d]imidazole derivatives (1-15) were synthesized. The synthesis was conveniently carried out by condensing 2,3-diaminonaphthalene with variously substituted aldehydes to yield 15 new 2-aryl-1H-naphtho[2,3-d]imidazole derivatives. Structures of all synthesized compounds were elucidated using MS and NMR spectroscopic techniques. Compounds containing an imidazole moiety have continued to spark interest in the field of medicinal chemistry due to their unique properties. In continuation of this statement, to further explore the biological potential of these types of compounds, newly synthesized imidazole derivatives were evaluated for their inhibitory potential against urease and antioxidant activities. Compounds 4 and 11 were identified as the most potent urease inhibitors in the series, with IC50 values of 34.2 ± 0.72 and 42.43 ± 0.65 μM, respectively. Compounds 1, 3, 6, 11, and 15, with EC50 values in the range of 37-75 μg ml-1, showed significant antioxidant activity. Molecular docking studies of the selected synthesized compounds 3, 4, 9, and 11 were also performed to determine their binding interaction with the jack bean urease. Through docking studies, it was revealed that all the compounds that showed good inhibitory potential against urease fit well within the protein's binding pocket. Furthermore, ADME analysis was carried out to explore the drug-likeness properties of the compounds. The findings of the present work revealed that compounds 4 and 11 could be better options to treat gastritis and associated oxidative stress.

A common presentation of uncommon disease - Biliary Fasciola Hepatica

Hepatobiliary fascioliasis is one of the rare but important parasitic infection in endemic areas such as Pakistan. Clinical manifestations overlap with common clinical conditions such as hepatitis and biliary stones causing common bile duct obstruction. Fascioliasis is a zoonotic infection caused by a leaf-shaped organism known as Fasciola Hepatica. Humans are accidentally infected by consuming contaminated water or food, especially undercooked cattle and sheep liver or raw green vegetables. We report three cases with similar clinical manifestations presenting in two different cities in Pakistan. After detailed clinical evaluation and laboratory investigations, the diagnosis was established by abdominal ultrasound and diagnostic and therapeutic cholangiography. Patients were followed till complete resolution of their symptoms and normalisation of liver function tests.

Portal vein thrombosis in patients with hepatocellular carcinoma and early cirrhosis-prevalence and risk factors

Introduction

Hepatocellular carcinoma (HCC) is frequently associated with portal vein thrombosis (PVT) with prevalence ranging from 25% to 50%. PVT is associated with poor prognosis, limiting the available therapeutic options for these patients. Our objective was to determine the prevalence and risk factors for PVT in patients with HCC.

Method

A retrospective analysis was performed on the prospectively collected data from January 2018 to March 2020. All patients with HCC discussed in our weekly multidisciplinary liver clinic were reviewed. Multivariate analysis was done to identify the independent risk factors for PVT in HCC patients. A p-value of <0.05 was considered significant.

Result

Of 316 patients, the prevalence of PVT was 31% (n = 98). Larger tumour size (p < 0.001), raised Alpha Fetoprotein (AFP) level (p = 0.036) and higher Child-Pugh class (p = 0.008) were significantly associated with PVT. In 216 patients with preserved liver function (Child-Pugh class A), PVT was seen in 53 (24.5%) patients. Large tumour size (p < 0.001) and higher AFP levels (p = 0.021) were independent risk factors.

Conclusion

Overall prevalence of PVT in HCC was 31% whereas 24.5% in patients with early cirrhosis (Child-Pugh class A). We identified various risk factors associated with PVT in our local population, highlighting the importance of early and regular screening of cirrhotic patients including Child-Pugh class A.

Silent Secretory Otitis Media in Cases with Adenoid Hypertrophy

Objective: to determine the cases brought to the Otolaryngology Department with adenoidal hyperplasia. Study Design: Cross-sectional study. Place and Duration of Study: ENT Department, Combined Military Hospital, Multan Pakistan from Jan to May 2022. Methodology: The study was conducted on children of age more than 2.5 years having adenoid hypertrophy that was confirmed by an X-Ray lateral view of the nasopharynx for adenoids. Their tympanogram was obtained. Results: The study showed that 2(2%) cases had a Type-B curve in a single ear, and 14(14.3%) had a Type-B curve in both ears.PTA was normal in 32(32.7%) cases. Up to 25 decibels (dB) of hearing loss was seen in 6(6.1%) cases. In 8(8.2%) cases, hearing loss, was more than 25Db. Conclusion: The tympanometry test is an objective test which is very easy to carry out and can very easily detect patients having glued ears which can be managed, and possible complications of the disease can be avoided.

An effort to find new α-amylase inhibitors as potent antidiabetics compounds based on indole-based-thiadiazole analogs

Inhibition of α-amylase enzyme is of key significance for the therapy of diabetes mellitus (DM). Numerous indole-based compounds have earlier been described for broad range of bioactivities. From our previous study, we knew that indole and thiadiazole are potent inhibitors of diabetics II. We design the hybrid molecules of them and synthesized 18 derivatives of indole-based-thiadiazole (1-18). All synthesized compounds were characterized using different spectroscopic methods and evaluated for their α-amylase inhibitory activities. All synthetic compounds, except 4, 13, 15 and 16, were found to be strongly active (IC₅₀ values in the range of 0.80 ± 0.05 - 9.30 ± 0.20 µM) than the standard drug, acarbose (IC₅₀ = 11.70 ± 0.10 µM). Nevertheless, compound 18 was found to be inactive. The modes of binding interactions of five most active compounds 2, 3, 5, 10 and 17 were also studies through molecular docking study. In brief, current study identifies a novel class of α-amylase inhibitors which can be further studied for the treatment of hyperglycemia and obesity.Communicated by Ramaswamy H. Sarma.

EAR RECONSTRUCTION SURGERY: OUTCOME ANALYSIS OF 108 PATIENTS

Objective: To find out the outcome of the ear Reconstruction and its association with improvement in psychological wellbeing along with physical benefits. Study Design: A cross-sectional study. Place and Duration of Study: Department of Plastic Surgery and ENT, Combined Military Hospital Quetta and Multan in liaison with the department of Psychiatry, from Jan 2017 to Jan 2021. Methodology: A sample size of 108 was estimated while keeping level of significance 5%, confidence level 90%, estimated true proportion 63% based on the observation made in the study by Steffen, and 5% of absolute precision. Specific performas were filled by the patient pre and post operatively and data analysis was performed using SPSS-20. Results: The mean age was 20 ± 8.75 years with a range of 12-29 years. Thirteen (11.11%) were male and ninety-five (87.8%) were females, 14 (12.9%) were married, 94 (86%) were un-married and all (100%) had social support. Fifty-two (48.1%) had primary education. Ninety-four (94%) were un-employed. Fifty-five (50.9%) of participants had congenital ear defect. Ninetyeight (90.7%) of the participants showed confidence in surgical procedure and would go for the same procedure if required, 5 (4.6%) said no to the same procedure while 8 (7.4%) did not know whether to opt for same procedure. Conclusion: Ear Reconstruction is a very rewarding procedure for surgeon and patients. Apart from aesthetic and functional improvement it also enhances the self-esteem of the patients.

AESTHETIC SURGERY: IMPACT ON QUALITY OF LIFE

Objective: To determine the impact of aesthetic surgery on quality of life. Study Design: Cross-sectional study. Place and Duration of Study: The departments of Psychiatry, Plastic Surgery and ENT, Combined Military Hospital Multan, from Jan to Nov 2020. Methodology: Seventy-four patients were enrolled for this study. They underwent aesthetic surgery. A standard questioner was designed for these patients and response was obtained before undertaking the procedure and then after six months postoperatively. The questions were designed keeping in mind the specific type of surgery. Questions on Life Satisfaction, and the Patient Health Questionnaire (PHQ-4) were asked. The data were collected and analyzed by using SSPS-25. Results: There is high satisfaction postoperatively after aesthetic surgery. There are improvements in quality of life (p=0.03), physical well-being (Health) (p=0.03), body image (p=0.02), emotional stability (p<0.01) and emotional distress (Depression) (p=0.04 and anxiety (p=0.01) were noted to be reduced. Conclusion: Aesthetic surgery leads to higher satisfaction in physical appearance, health, emotional stability and reduction of anxiety.

ENT SURGEONS AS MASTER TRAINERS OF CRICOTHYROIDOTOMY WILL SAVE PRECIOUS LIVES IN EMERGENCIES

Objective: To train young doctors and paramedical staff on needle cricothyroidotomy and surgical cricothyroidotomy and provision of kits in trauma centers, main operation theatres and medical reception centers of the hospitals. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital Peshawar and Pakistan Naval Ship Shifa, Karachi Pakistan, from Nov 2017 to Oct 2020. Methodology: Doctors and paramedical staff were selected on volunteer basis. Small groups were trained in 2-3hours. The participants were shown two videos of two procedures in Urdu language first and then were trained on mannequin. Results: A total of 345 participants including 205 males and 140 females were trained with mean age was 28.2667 ± 6.24 (SD) years. Out of 61 residents, 54 medical officers, 143 house officers, 35 nurses and 52 paramedical staff were participants. Conclusion: ENT surgeons must arrange mannequins and conduct training sessions of small groups after every 1 to 2 months.

Rise in temperature causes decreased fitness and higher extinction risks in endemic frogs at high altitude forested wetlands in northern Pakistan

The larvae of some amphibian species grow and develop more slowly at lower temperature and attain larger body size at the end of metamorphosis, but this is not true for all amphibians. We have for the first time provided empirical data by using a combination of field and lab-based studies with a robust sample size (360 adults, 1000 tadpoles) for Hazara Torrent Frog (Allopaa hazarensis) and Murree Hills Frog (Nanorana vicina). In this study, we examined how tadpoles responded to different temperatures through metamorphosis, body size, developmental complications or deformities, fitness and survival. We found that the tadpoles of A. hazarensis and N. vicina showed the same response to elevated temperatures under laboratory conditions including faster metamorphosis, reduction in the body size, more frequent developmental complications or deformities such as edema and tail kinks, lower fitness and higher mortality at elevated temperatures (>26 °C). The comparison of thermal sensitivity between the two species showed that N. vicina was more sensitive to higher temperatures. Pakistan has been experiencing changes in climatic patterns, and the ecosystems in northern Pakistan are losing biodiversity due to increasing temperature, frequency of drought and intensity of floods. It is feared that these frogs may experience local extinction in future. Our findings contribute to filling the information gap regarding impacts of temperature increase on biodiversity of high altitude forested montane ecosystems and is an important contribution to future studies associating biodiversity and climate change.

Synthesis, acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities, and molecular docking studies of a novel compound based on combination of flurbiprofen and isoniazide

A novel compound (1) shows ∼2.5 and ∼1.7 times enhanced AChE inhibition activity and BuChE inhibition activity respectively compared to flurbiprofen and standard drug (i.e. physostigmine). It has also been confirmed by comparative AutoDock studies.

Rosai-Dorfman's disease, an uncommon cause of common clinical presentation

Sinus histiocytosis with massive lymphadenopathy also known as Rosai-Dorfman disease is a rare benign disease that typically manifests as lymphadenopathy with or without systemic manifestations whose etiology remains poorly understood. Most common clinical presentation is painless bilateral cervical lymphadenopathy. However, it also can present in various extranodal sites and can easily be missed because of its rarity if not considered in the differential diagnosis. It commonly occurs in children and young adults with a slightly male predominance. Clinically patients may be mistaken for lymphoma and other infectious disorders like tuberculosis especially in developing countries like in Pakistan where tuberculosis is more prevalent. Here we report a case of a 38-years-old gentleman with bilateral cervical lymphadenopathy and worsening ascites. His symptoms initially mimicking tuberculosis and lymphoma, was finally diagnosed as having Rosai-Dorfman's Disease on intra abdominal lymph node biopsy.

Loasins A and B, new flavonoids from Eremostachys loasifolia

Loasins A (1) and B (2), new flavonoids, have been isolated from the ethyl acetate soluble sub-fraction of the ethanolic extract of Eremostachys loasifolia along with apuleisin (3) and apuleidin (4), isolated for the first time from this species. Their structures were assigned on the basis of their spectral data including 1D and 2D NMR.

Isolation, cloning and characterization of argF gene DNA from Escherichia coli K-12

A 1650 base pair (BP) fragment carrying the entire argF structural gene with its associated control regions was isolated from an EcoRI/BamHI digest of phi80argFilambda cI857 DNA. This segment was cloned using the EcoRI and BamHI cleavage sites in the plasmid pBR322. A preliminary restriction map of the argF region was prepared. RNA polymerase binding studies indicated that the argF promoter is located approx. 30 base pairs from the EcoRI terminus of the cloned DNA segment.