Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by a deficit in social communication, as well as restricted interests and repetitive behaviours. Various misconceptions about ASD management are rising, leading to parent's confusion and suffering and possible serious harm to ASD patients. This review aims to shed light on common misconceptions about ASD management, including the relationship between ASD and vaccines, the use of chelation therapy, hyperbaric oxygen therapy and gluten-free diet. In conclusion, there is no evidence of a link between vaccinations and the development of ASD, as well as no evidence to support using chelation therapy, hyperbaric oxygen therapy and a gluten-free diet, but rather there is evidence of harm. Educating parents to weigh the benefits and risks is a vital role for any health care provider.

Bushke-Lowenstein Tumor Giant or Condyloma Acuminata is a rare neoplasm induced by an oncogenic human papilloma virus (HPV 11 and 6). It is a sexually transmitted disease. Despite of its indolent character it can probably degenerate to an aggressif epidermoid carcinoma like in our observation. We report the case of a patient who developed this tumor with locoregional destruction .The Aim of this work is to describe this pathology via a literature review.

This was a prospective, multicenter, observational and non-interventional epidemiological study. Five hundred and fifty (550) male and female patients between 18 to 65 years with an established liver cirrhosis were enrolled. Patients recruited underwent screening of mental state by Mini Mental State Examination (MMSE). Patients with a score of MMSE > 24 were required to undergo Psychometric Hepatic Encephalopathy Score (PHES) examination to diagnose MHE. Subjects with an abnormal PHES score of -5 or less were diagnosed with MHE. Subjects with established MHE and those without MHE were assessed for quality of life (QoL). QoL was assessed for Health-Related Quality of Life (HRQoL) using the SF-36 questionnaire. The proportions for the physical component scores (PCS) and mental component scores (MCS) of the SF-36 were calculated and compared. Among the diagnostic scores the mean MMSE score was 27.5 ± 1.8. Of these subjects, 451 were found to have a MMSE score of 24 or higher and were administered the PHES examination. Two hundred and fifty-six (256) subjects (56.8%) had an abnormal score of ≤ -5 and were diagnosed as having minimal hepatic encephalopathy (MHE). Subjects were tested for quality of life through SF-36 questionnaire. Subjects with established MHE were found to have a significantly lower physical component score (PCS) compared to those without MHE. Frequency of Minimal Hepatic Encephalopathy was found to be 56.8% of patients with Chronic Liver Disease presenting to clinics. Impact of MHE on physical component of quality of life may be of clinical relevance.

This study highlights the characterization and biological activities (in vitro) of root extracts of Indigofera hirsuta (Ih-E) and Afrormosia laxiflora (Al-E). The results showed that total phenolic and flavonoid contents in dry Ih-E were 54.38 mg and 116.03 mg/gram, respectively, while in Al-E were 170.46 mg and 80.23 mg/gram. Both extracts exhibited antioxidant activities since they decreased lipid peroxidation, but increased antioxidant activities and anti-inflammatory activities as shown from inhibition of RBC haemolysis and inhibition of albumin denaturation. Also, they have cytotoxic effect against normal BHK-21 and HepG2 where IC50 for Ih-E were 309 µg/ml and 95µg/ml, respectively (selectivity index 1.58), while for Al-E 57.50µg/ml and 144.50 µg/ml, respectively (selectivity index 0.40). Ih-E has antimicrobial activities towards Pseudomonas aeruginosa, Staphylococcus aureus, Vibrio species and E-coli, while Al-E showed no antimicrobial activities. Conclusion: Both extracts possessed antioxidant, anti-inflammatory and anticancer activities, thus, can be used as pharmacological tools.

The purpose of review article is to find herbal drug for treatment of some diseases. Several side effects came from chemical drugs. Use of non-chemical, non-invasive natural remedies have no major adverse effect because contain naturally active biological components, therefore they have paying much attention within recent years. Possible usage of leaf extract of Papaya for treatment of dengue fever promising cure for dengue patients. Pomegranate contains high level of antioxidants which make it one of the best fruits for boosting blood count. Phenolic compound extraction from extra virgin olive oil has immune modulatory and anti-inflammatory effects in Systemic lupus erythematosus (SLE) patients. Wound healing properties are exerted from aloe Vera gel. Fenugreek seed best natural remedy for Poly ovarian cyst syndrome (POCS). Garlic and ginger are organosulfur compounds consisting upon its bio actives having an important role in cardiovascular diseases and cancer respectively.Nigella sativa recently demonstrates the role in diabetes mellitus. Allium cepa. L (Onion) contain phytochemicals that have antidiabetic, anticarcinogenic, anti-inflammatory, antibiotic, antioxidant, antimicrobial and antiplatelet effects on the human health.

Introduction: Ursodeoxycholic acid (AUDC) is the standard treatment for primary biliary cholangitis (PBC). Prescribing it at an early stage slows the progression of the disease and improves survival. Thus, the biological response to AUDC is considered as the main predictor of survival without liver transplantation. New scores, the Globe-score, and UK-score have recently been validated as the main prognostic factor during PBC. The purpose was to study the association between the Globe-score, UK-Score and the AUDC response during PBC. Patients and Methods: This is a retrospective study of all PBC cases treated by AUDC at a dose of 13-15mg/kg over a 22-year period (January 1998-May 2019). Treatment response was defined by the Paris II criteria at 1 year (a serum alkaline phosphatase (PAL) level 1.5 times the upper limit of normal (LSN), an aspartate aminotransferase (ASAT) level 1.5 times the LSN, normal bilirubinemia). The Globe-score and UK-PBC score have been calculated for all our patients. The statistical analysis of the data was done using the SPSS software. The comparison between good treatment responders and non-responders was made using the Chi2 test for qualitative variables and the Mann-Whitney test for quantitative variables. A combination of variables was considered statistically significant if p < 0.05. Results: During the study period, 90 cases of PBC were collected. There were 85 women and 5 men. The average age was 49 12.3. 52.3% patients (n=34) had a complete therapeutic response while 31 patients (47.7%) retained non-response after one year of AUDC treatment. The average Globe score for good responders was -0.62[-0.72; -0.36] and for non-responders was 1.53[1.32; 1.75] with a statistically significant difference (p0.001). The average UK-score value at 5 years; 10 years; 15 years for the correct answers was 1.8% [1.6-2.5]; 5.9%[5.2-8.2]; 10.7%[9.5-14.8] and for non-responders was 9.1%[6.7-9.9]; 27.4%[20.4-29.5]; 44.9%[34.6-47.8] respectively with a st

Medication therapy to Chronic Kidney Disease patients is complex because of the co morbidities and the major risk associated with these patients. A prospective, cross sectional study was conducted for a period of 6 months in a tertiary care hospital. A total of 130 patients, aged 18 years or older, diagnosed with all stages of Chronic Kidney Disease were included in the study. Patient data were collected from the patient medical records, the prescriptions were analyzed and the drug related problems were identified and classified according to Hepler and Strand. Descriptive analysis was done for age, gender, stages, drugs and Drug Related Problems. A total of 1454 drugs were prescribed for the patients with an average of 13.3±3.53 drugs per prescription. An average of 1.25±1.23 Drug Related Problems per prescription were observed among the study population. The most common Drug Related Problems identified was Adverse Drug Reactions (11.53%) and Drug combinations to use with caution and need close monitoring (11.53%), followed by over dose 9.23%. Other Drug Related Problems identified were untreated indication 7.69%, Drug without indication 3.08%, improper drug selection 1.53%, Treatment duplicity 0.76%, and potential Drug interactions 80.00%.Continual identification and resolution of Drug Related Problems in Chronic Kidney Disease could play a vital role in achieving better clinical outcomes.

Background: Diabetes is a highly prevalent chronic disease and Bahrain is ranked amongst the top ten. Diabetes has many complications. Retinopathy caused by diabetes if considered number one leading cause of blindness world wild. This study explore the factors influencing the uptake of the Digital Retinopathy Screening Programs (DRGP). Methods: Five of the Primary Care centers in the country providing the (DRSP) have been visited on daily basis for two weeks in row and patients attending for the test have been questioned, defaulters were called and questioned through the phone for the causes. Results: A total of 367 type II DM patients were enrolled in the study with a (42.5%) are within the age range of 50-59. 75.2 % of the sample attended for the screening and were questioned and the remaining non attendees were questioned through the phone. A Comparison between the characteristics and reasons behind attendance and non attendance amongst the two groups was conducted statistically by SPSS using Chi Sequare test and Fisher’s exact test. Results using P-Value showed that the major reasons for non attending the appointments are forgetting the appointment, ignorance, neglect, some special circumstances like sickness or travel and miscommunication between patients and staff or physicians. While on the other hand, reminders and physician recommendations have show to be of a positive influence over patients’ attendance.

Piper betle L. is an evergreen perennial dioecious creeper and it is native to Malaysia. It is commonly used in our day to day life. In present investigation an attempt has been made for the pharmacognostic standardization and phytochemical evaluation of Piper betle L. leaves. The pharmacognostic evaluation comprises of detailed morphology, powdered microscopy, quantitative microscopy and physical constants such as extractive and ash values. The leaves extract were subjected to preliminary phytochemical screening. The data obtained in present study will serve as valuable tool for identification, authentication and detection of adulterants standardization and quality control of the drug. In this research work the anthelmintic property of leaves extract of Piper betle L. belonging to family Piperaceae was studied for anthelmintic activity against Pheretima Posthuma (Indian earthworm). The leaves powder of Piper betle L. was subjected to successive extraction by maceration using solvents like Aqueous, Acetone + Aqueous and Pet. Ether. Four concentrations (25, 50, 75 and 100 mg / ml) of different extract of leaves were studied in a bioassay, which involved the determination of time of paralysis and time of death of the worms. 100 mg/ml conc. of Aqueous + Acetone extract of leaves of Piper betle L. reveal considerable anthelmintic activity as compared to other two concentrations and piperazine citrate (10 mg/ml). Piperazine citrate and saline water were included in the assay as standard reference drug and control, respectively.

Introduction: As we aim to cater high-quality health-care system to the masses with limited available resources, increased usage of generic medicines can improve affordability of the health care without compromising the quality. The attitude of healthcare providers is a significant challenge towards dealing with the rising healthcare cost. It is during internship that attitudes of future physicians towards prescribing are developed. Data regarding knowledge, attitude and practice of intern doctors for the use of generic medicines are lacking. Objectives: The study was conducted to assess knowledge, attitude and practice of intern doctors regarding use of generic medicines at a tertiary care teaching hospital. Materials and Methods: A questionnaire based cross sectional study was conducted after the approval of institutional ethics committee among the intern doctors at tertiary care teaching hospital, who were willing to respond to the study questionnaire were enrolled. The pre-validated questionnaire with 11 questions regarding knowledge, attitude and practice were sent to the participants via email. Responses were submitted online and data was analyzed in frequency and percentage.

Rosuvastatin is regularly recommended for the treatment of hypercholesterolemia and applies its impact through focused collection in the liver. Current dosing rules show no inclination for sustained or fasted rosuvastatin organization. In this investigation, lower plasma level was noted in mice with nourishment 2 hours after an oral rosuvastatin portion, while liver fixation was unaffected. We presume that taking an oral portion with nourishment rather than on an unfilled stomach, don’t fundamentally influence the cholesterol-bringing down limit of rosuvastatin. Since a typical unfavorable occasion noted with statin treatment is muscle torment/harm related with high coursing statin levels, our discoveries can possibly fill in as a novel and basic system for relieving statin myopathy hazard.

A new simple, accurate, precise and reproducible RP-HPLC method has been developed for the simultaneous estimation of ibuprofen and famotidine in naturally sweet dispersible pediatric tablets using C 18 column in isocratic mode. Methanol: buffer (90:10), pH 5, 25 mM; flow rate 0.9 ml/min; column length: 25cm is optimized. The flow rate was 1.0 ml/min and detection wavelength was carried out at 284 nm. The retention times of ibuprofen and famotidine were 5.293 min and 2.543 minutes respectively. The method was linear over the concentration range for ibuprofen 50-450µg/mL and 2-18µg/mL for ibuprofen and famotidine respectively. The recoveries of ibuprofen and famotidine were found to be in the range of 99.037-100.766% and 99.703-100.433% respectively. The validation of method was carried out utilizing ICH-guidelines. The described HPLC method was successfully employed for the analysis of pharmaceutical formulations containing combined dosage form.

A chemical injury of the eye presents a genuine, acute emergency and requires immediate evaluation and management. Ocular chemical injury management remains one of the most difficult ocular emergencies. The prognosis for an eye injury depends not only on the severity of the injury but also on the rapidity and mode of initial treatment. Reconstruction of ocular surface following chemical burn by amniotic membrane (AM) for grafting is a very effective technique. AM graft promotes epithelial regeneration and facilitates migration of epithelial cells. Eight years old boy presented with ocular chemical injury by chemical mixed water holi balloon in his left eye. Patient presented with severe pain, excessive watering, with swollen lids and conjunctiva. More than 90% of the cornea surface, whole of the bulbar as well as palpaberal conjunctiva was eroded and whole eye was stained with green colour (chemical). Amniotic Membrane Transplantation (AMT) done under general anesthesia with corneal continuous girdle suture, conjunctival forniceal lid sutures and finally Bandage Contact Lens was applied. Patient had three months follow regular follow up and was clinically asymptomatic.

Introduction: Tuberculosis is one of the major causes of mortality and morbidity in childhood. It is challenging to diagnose in childhood population due to difficulty in collection of sample and paucibacillary nature. Despite of considering mycobacterium culture as gold-standard test, it is time consuming (4-8 weeks) while traditional ZN stain is poorly sensitive or specific. In 2013, WHO endorsed Cartridge Based Nucleic Acid Amplification Test (CBNAAT) for diagnosis of TB. Still, there is lack of adequate research on TB detection efficacy of CBNAAT over ZN stain or culture. Aims & Objective: Comparison of CBNAAT over ZN stain & mycobacterium culture, in terms of Sensitivity, Specificity, Positive Predictive Value, Negative predictive value. Materials & Methods: Total of 565 patients admitted to Paediatric Medicine department over 2 years from July 2017 to July 2019 with clinical signs (radiological) and symptoms of local & disseminated tuberculosis and history of close contact were selected and grouped under pulmonary and extra-pulmonary categories. Each sample was analyzed by CBNAAT, ZN smear and culture.

The nose is the central element of the face and has well defined racial, sexual and environmental characteristics and differences. Anthropometric analysis in the context of each patient’s ethnic heritage forms the basis of an excellent result in rhinoplasty. Caucasian parameters have served as endpoints for nasal aesthetic and reconstructive surgery for centuries. As more non-Caucasians seek these surgeries, it has become evident that using a set of parameters cannot account for the great variability noted in people especially Africans. The objective of this study was to develop a reference for Ibibio nasal parameters which will guide reconstructive and aesthetic surgery and compare this with other ethnic groups in Nigeria and with other races. This was a prospective cross sectional community based study involving 200 males and 200 females aged 18-60 years, of Ibibio ethnic group in Akwa Ibom State, with no facial anomalies or history of facial surgery. Measurements were made with digital calipers and goniometers. Data were analyzed with SPSS version 20, independent t-test used to assess sexual dimorphism with significance level of p<0.05. The nasal parameters assessed for males and females were: Nasal length(46.4±1.7mm and 46.1±1.6mm), Nasal width (44.1±1.6mm and 41.2±1.3mm), Nasal index (95.2±3.2 and 89.6±3.4), Ear length/Nasal length ( 0.8±0.5 and 0.8±0.1); Nasal width/intercanthal distance (1.2±0.0 and 1.2±0.0); Nasal width/Mouth width (0.8 and 0.8±0.1); Neoclassical cannons assessed as follows: Nasoaural Canon IV fits 6% males and 4.5% females, Naso-occular canon V was the least frequently validated, and fits 2.5% males and 3% females, Naso-oral Canon VII was most frequently validated and fits 13.5% males and 8% females. Ibibio nose is predominantly platyrrhine.

Controlled animal experiment was done at Department of Pharmacology, R. G. Kar Medical College and Hospital after getting permission from institutional animal ethics committee to find out a drug with good analgesic & safety profile for long term use in high risk population like hepatic, cardiac, hypertensive, diabetic patients. Flupirtine maleate, Tramadol hydrochloride and Paracetamol these three compounds have known analgesic property of their own and they are relatively safe than NSAIDS and opioids. Conventional Hot plate and Tail flick methods were used to access the analgesic effects of drugs. Total number of 36 screened Swiss albino mice were taken in the experiment. Mices were divided into six groups from Ato F with six mices in each group, where A is the control, B,C,D,E,F are the flupirtine(B), tramadol(C), paracetamol(D), combined half(E) and comboned full doses(F) of these three drugs. Result were noted at 20, 60 and 90 minutes intervals. Analgesic effects between these groups were compaired and p value were extracted. All the drugs individually as well as in combinations with their half and full doses showed an increase reaction time in comparison with control. Combinations in half and full doses also showed more nalgesic property than individual drugs. So, we may conclude that combination of flupirtine, tramadol and paracetamol have supra additive analgesic effects.