Starch is the most abundant naturally occurring carbohydrate reserve in plants and is found in cereals, roots, tubers, legumes and some immature fruits like bananas or mangos. Starch is usually employed as a food additive, such as a thickening, stabilizer, or texture enhancer to improve some of the products quality characteristics, pharmaceutical and among other. The application of native starch is often restricted owing to its constricted solubility, weak functional attributes and limited tolerance to a wide array of processing conditions. Its low resistance to shear, high retrogradation, and poor freeze-thaw stability, limit the use of starch in industrial applications. These natural shortcomings can be overcome by different methods of modification. In recent decades, enzymatic modifications have been adopted, partly replacing the chemical and physical methods for the preparation of modified starch, as enzymes are safer and healthier than chemical method for both the environment and food consumers. Several enzymes viz., alfa-amylase, beta-amylase, glucose isomerase, pullulanase, xylanase, among others are use in modification of starch. The enzymatic modification of starch molecules directly affected properties of the modified starch especially in freeze-thaw stability of gels and retardation of retrogradation during storage. Combined enzymatic modification resulted in a marked increase in resistant starch and enzyme modified starch can be well utilized as a fat replacer. It is environment-friendly method and can provide desired functional characteristics.

Background: Severe acute pancreatitis (SAP) is associated with high morbidity and mortality due to the development of pancreatic and an infection that follows extra-pancreatic necrosis, and multisystem organ failure (MOF). Objective: To determine the value of jejunal tube in the treatment of severe acute pancreatitis. Methods: A cross-sectional study was conducted at Saidu group of teaching hospitals, Saidu Sharif Swat, Pakistan, which was performed between July 2020 and March 2022, The total number of patients in our study were 112. The number of Male patients were 33 and female were 79. In 112 consecutive patients who underwent for blood tests and Procedures. We did CT scan for all patients to determine the grade of pancreatitis. Data was tabulated and analyzed by SPSS. Results: In a current study total of 112 patients were enrolled with mean±SD age of 52.61±5.54 years. The maximum age were 61 and minimum ages were 41. The mean±SD of serum lipase were 639.56±209.9. The maximum serium lipase were 1107 and minimum serium lipase were 299. The mean±SD of time of patients recovery were 5.96±1.09. The maximum time of patients recovery were 10 and minimum time of patients recovery were 5. The mean±SD of recovery days were 5.63±0.78. The maximum recovery days of patients were 9 and minimum recovery time were 5. Bar graph showing gender distribution in which females patients were 79 and males patients were 33. In this graph females patients were more as compared to males patients. The number of patients with abdominal pain were 109. The number of patients came to hospital with nausea were 86. The number of patients present with vomiting were 26. The patients who have gall stone were 51. The effectivenss of J-Tube in patients were 33. The complication were noted in 4 patients and the jejunal Tube were pass to 36 patients. Mild pancreatitis patients were 22%, moderate pancreatitis patients were 48% and severe pancreatitis patients were 30%. Conclusion: The recovery time of patients from severe acute pancreatitis was 5 to 10 days. Jejunal tube is more effective in the patients who has more vomiting in severe acute pancreatitis. Jejunal tube is pass to the patient as soon as possible when patient is diagnose with sever acute pancreatitis. In severe acute pancreatitis patients have more vomiting and abdominal pain. We can diagnose patient of sever acute pancreatitis on Serium lipase blood test. In our study females were more as compare to males.

A plethora of research has implicated hundreds of putative biomarkers for depression but has not yet fully elucidated their roles in depressive illness or established what is abnormal in which patients and how biologic information can be used to enhance diagnosis, treatment, and prognosis. This lack of progress is partially due to the nature and heterogeneity of depression, in conjunction with methodological heterogeneity within the research literature and the large array of biomarkers with potential, the expression of which often varies according to many factors. We review the available literature, which indicates that markers involved in inflammatory, neurotrophic, and metabolic processes, as well as neurotransmitter and neuroendocrine system components, represent highly promising candidates. These may be measured through genetic and epigenetic, transcriptomic and proteomic, metabolomic, and neuroimaging assessments. The use of novel approaches and systematic research programs is now required to determine whether, and which, biomarkers can be used to predict response to treatment, stratify patients to specific treatments, and develop targets for new interventions. We conclude that there is much promise for reducing the burden of depression through further developing and expanding these research avenues.

Thrombotic Thrombocytopenic Purpura is a potentially fatal disease that can be life-threatening. The association with Sjogren’s syndrome is rare entity that deserves special attention. To this end, we report the case of a Thrombotic thrombocytopenic purpura complicating secondary Sjögren's syndrome. This is a 49-year-old patient with a history of pure nephrotic syndrome with minimal glomerular lesions (LGM), who developed Sjögren's syndrome two years later. The diagnosis of Sjögren's syndrome was retained with an etiological investigation suggesting SS secondary to SLE systemic lupus erythematosus. Six months after the diagnosis of secondary SS, the patient was admitted with headache, ecchymotic and petechial lesions on the upper limbs. The laboratory analysis revealed severe thrombocytopenia, haemolytic anemia with a schizocyte count at 6% supporting the diagnosis of thrombotic microangiopathy. The ADAMTS 13 activity assay was less than 5% and the anti-ADAMTS 13 antibody test was positive, attesting thus, the diagnosis of acquired TTP complicating SS secondary to SLE. The patient received an emergency blood transfusion of fresh frozen plasma combined with corticosteroid therapy and mycophenolate mofetil. The clinico-biological outcome, at 6 month and 1 year, was favorable with complete remission. To the best of our knowledge, this is the first case report of TTP complicating Sjögren’s syndrome in Africa. It highlights the rarity of association between autoimmune disease particulary Sjögren’s syndrome and TTP.

The escalating trend of microbial resistance has become a pressing global concern, challenging the effectiveness of antimicrobial agents in treating infections. This study was aimed at evaluating the antimicrobial activity of the n-hexane, ethyl acetate, and methanol extracts of Securidaca longipedunculata against selected human pathogens. The antimicrobial screening against bacterial pathogens- (e.g., Methicillin-resistant staphylococcus aureus, Vancomycin-resistant Enterococci, Staphylococcus aureus, Staphylococcus feacalis, Escherichia coli, Salmonella typhimurium, Pseudomans fluorescens and Klebsiella pneumonieae) and fungal pathogens (which includes Candida albicans, Candida krusei, Aspergillus niger, Aspergillus fumigates, and Microsporum canis) was performed using agar well diffusion and broth dilution methods. The results demonstrated significant antimicrobial activity, with higher efficacy against S. aureus. Susceptibility test results showed that the extract inhibited the growth of all the test organisms (bacteria and fungi) with a mean zone of inhibition range of 18-29 mm, with the exception of VRE, S. typhimurium, P. fluorescens, C. krusei and M. canis in all the three extracts, while Hexane extract showed no inhibition against E. coli and A. niger. The standard drugs sparfloxacin and ciprofloxacin (500 µg/cm3) had zone of inhibition ranging from 28 - 40 mm. While the antifungal drugs fluconazole and fulcin exhibited zone of inhibition ranging from 27 mm to 34 mm. The Minimum inhibitory concentration (MIC) for the extracts ranges from 62.5 - 250µg/cm3, while the Minimum Bactericidal/Fungicidal Concentrations (MBC/MFC) range from 250 - 500 µg/cm3, respectively. The ethyl acetate extracts possessed higher antimicrobial activity among the three extracts tested against S. Aureus. The findings suggest that S. longipedunculata leaves hold promise as a natural source of antimicrobial agents, warranting further exploration for potential therapeutic applications.

Background and Objectives: Crohn's disease (CD) is a chronic inflammatory disease of the intestine. It can evaluate by the occurrence of intestinal complications in particular fistulas whose management can be medical or surgical. The objective of our work is to specify the evolutionary modalities, as well as the predictive factors of bad prognosis. Patients and Methods: this is a monocentric, descriptive and analytical retrospective study conducted in a hepato gastroenterology department including patients with fistulizing Crohn's disease, outside ano perineal fistulas from 1990 to 2023. Statistical analysis was performed using SPSS22.0 software. Results: Of a total of 960 patients, 38 had fistulizing CD. 65% of our patients were classified as A3 according to the Montreal classification, and 34% as A2. They were 24 women with a sex ratio of 1.71 F/H. The type of fistula was Greco-Greatic in 4 patients (10.5%), Greco-Colic in 5 patients (13%), Entero-Cutaneous in 12 patients (31.5%), Gastro-Colic in 3 patients (7.9%), Interdigestive and Entero-Cutaneous in 10 patients (26%), Interdigestive and Greco-Vesical in 2 patients. All our patients had benefited from a bi-antibiotic therapy, 33 had benefited from surgical resection. Postoperative treatments were based on therapeutic abstention in 5 patients (13.1%), immunosuppressive treatment in 18 patients (47%), anti TNF treatment in 7 patients (18%). The endoscopic recurrence rate 6 months after treatment was 32.5%. In univariate analysis, the factors influencing the evolution of fistulizing crohn's disease were the number of fistulas and age with p values lower than 0.05 (respectively 0.022 and 0.009). Conclusion: Digestive fistulas represent a complication during CD, which pose a problem of medical-surgical management and have an impact on the quality of life of the patients. Our study showed that age (p=0.022) and the number of fistulas (p=0.009) represent the factors influencing the natural history of fistulizing CD.

Background: Atorvastatin is BCS class II drug; it is lipid-lowering medication. Okra gum (OKG), from the pods of Abelmoschus esculentus, is natural product contain polymers having advantages over synthetic ones as it is safe, chemically inert, nonirritant, biodegradable, and does not require toxicological studies. Aim: This study aimed to assess the effect of okra gum solid dispersion in atorvastatin solubility. Method: The gum was extracted by hot water extraction and the dry extract was evaluated for percentage practical yield, flow properties, pH values and FTIR spectroscopy. Then solid dispersions with different drug to polymer ratios were prepared from OKG, and hydroxy propyl methyl cellulose (HPMC) by solvent evaporation method. Saturation solubility was tested for the solid dispersions prepared, the physical mixtures and atorvastatin. Tablets were prepared from solid dispersions with the highest saturation solubility, then tablets were tested and evaluated. Finally, in vivo test was done using Swiss albino mice and data were analyzed using one way Anova test followed by T test. Results: The content percent of atorvastatin in the solid dispersion prepared were 99,9- 100.1%, the tablets showed satisfactory physicochemical properties as 1.29% RSD in tablet weight variation, 24 min disintegration time, 5.24±0.457 Hardness and OKGSD tablets showed sustained release manner and 87% of drug released in 6 hrs. Lipid profile results showed significant decrease in total cholesterol level with marked decrease in LDL when using OKGSD tablets. Conclusion: It was concluded that OKG is promising excipient that can be used in dosage forms formulation to enhance solubility of low soluble drugs.

Background: The study highlights the historical significance of bilateral orchidectomy as the traditional 'gold standard' for surgical androgen deprivation in treating advanced prostate cancer. The study presented aims to compare total orchidectomy and subcapsular orchidectomy, considering factors such as androgen ablation, disease progression control, and patient satisfaction. Objective: This study aims to compare the effectiveness and patient satisfaction of bilateral subcapsular orchidectomy and bilateral total orchidectomy treatment in managing hormone-sensitive metastatic prostate cancer. Methods and materials: In this prospective study of 18 months at North East Medical College Hospital, 40 participants with Metastatic Carcinoma of Prostate underwent bilateral orchidectomy, among them 20 subcapsular and 20 total orchidectomy. The research focused on evaluating the impact of these treatments on serum testosterone levels, serum PSA levels, employing as outpatient procedures and a 3-month follow-up, utilizing a satisfaction scoring scale. Data, including age, Gleason Grade Group, PSA, and testosterone levels at diagnosis & at 3-month follow-up were recorded and analyzed using IBM SPSS-21 software. Result: The study compared Bilateral Subcapsular Orchidectomy and Bilateral Simple Orchidectomy for Hormone-Sensitive Metastatic Carcinoma of Prostate in 40 patients. The highest frequency was in the 71-75 age group (30%), with a mean age of 66.67 ± 2.21 years. Gleason grade group 3 dominated (40%), followed by 2 (25%). Pre-operative PSA levels were 31.14±1.27 ng/ml for Subcapsular and 35.21±1.70 ng/ml for Total Orchidectomy, decreasing post-operatively to 8.25±0.41 ng/ml and 7.32±0.80 ng/ml, respectively. Pre-operative testosterone levels were 513.21±3.01 ng/dl for Subcapsular and 498.40±2.10 ng/dl for Total Orchidectomy, decreasing post-operatively to 21.14±2.84 ng/dl and 16.90±1.08 ng/dl, respectively, with non-significant p-values. Surgery related Satisfaction scores in the Follow-Up phase were significantly higher for Subcapsular Orchidectomy, 2.91±0.31 comparing with Total Orchidectomy, 2.05±0.45. The results emphasize better patient satisfaction after subcapsular orchidectomy, while maintaining similar cancer control in the form of PSA and testosterone level changes. Conclusion: In conclusion, our study advocates for the reconsideration of bilateral subcapsular orchidectomy as a preferred method for surgical androgen ablation in metastatic prostatic carcinoma, offering comparable efficacy to traditional total orchidectomy approach while prioritizing patient satisfaction and psychological well-being. This suggests a potential paradigm shift in the landscape of cost-effective androgen deprivation therapy within the urological field.

Acute lung injury is a disorder of acute inflammation that causes disruption of the lung endothelial and epithelial barriers. Acute Respiratory Distress Syndrome or ARDS is a diffuse inflammatory lung process that frequently manifests in critically ill patients, with an estimated incidence of 3 million people a year. Clinically, ARDS is manifested by bilateral or diffuse radiographic infiltrates, hypoxemia, decreased lung compliance, and increased ventilatory dead space. The histological manifestation of ARDS is diffuse alveolar damage as defined by epithelial injury, hyaline membrane formation and alveolar flooding with proteinaceous fluid, increase alveolar surface area and frequently neutrophilic inflammation. The animal model correlate to ARDS as an acute lung injury (ALI). Models were employed to test potential new therapeutic interventions and to investigate under-lying mechanistic pathways that lead to diffuse lung injury. In this study cage cigarette smoke model was used for an acute lung injury. For that purpose, thirty (30) young albino healthy rats were used, and their duration of trial was 21 days. Each group was given an oral drug administration containing MgO-150mg/kg, MgO-300mg/kg BW for treatment and diet schedule in young albino rats of male sex for the experimental procedure of 0 to 21 days. Mean body weight, BALF, lipid profile, liver profile and lung histology were assessed. Results revealed that MgO nanoparticles exhibited antioxidant capacity at dosages of 300mg/kg, and 150mg/kg. This formulation of selected nanoparticles at high dose exhibited an acute lung injury and antioxidant effects as compared to low dose extract. Additionally, transcriptional factors revealed up-regulation at high dose in contrast to the low dose extract in lung injury treated groups.

Introduction: The aim of this study was to describe the epidemiological and clinical aspects of low-lying ARF in children aged 1 month to 14 years seen in the emergency department of the Nianankoro Fomba Ségou Hospital. Methodology: We included for this prospective descriptive study all children aged 1 month to 14 years of both sexes, seen in consultation at the pediatric emergency department, presenting with low-onset ARF, from January to December 2020. Results: The frequency of low ARF was 6.5%. More than half the patients were aged between 3 months and 2 years. Males predominated. The most frequent reason for consultation was fever. The most common diagnosis was bronchitis (63.23%). 78.6% of patients had moderate anemia and hyperleukocytosis. An opacity was found in 66.67 of the radiographs taken. Amoxicillin was the antibiotic of choice. Hospital mortality was 3.59%. Conclusion: ARIs are frequent in emergency consultations.