PYODERMA GANGRENOSUM AND ITS HEALING WITH HERBO-MEDICINAL OINTMENT MARHAM-E-RAAL – A CASE STUDY

Pyoderma gangrenosum (PG) is one which is supposed to be a quickly growing and harshly devastating skin disease. Ulcers are frequently deep and painful, distinguished by aggressive (purple-colored) margins. The etiology of this disease is almost uncertain. The disease may be idiopathic or associated with some other chronic illness like inflammatory bowel disease; including Crohn's disease, or hematological or rheumatic ailments. Basically it is supposed to be an auto-immune disease. If the disease is left untreated, the ulcers may last several months or few years. Treatment in modern medicine includes high doses of steroids and intravenous immunoglobulin. In our case series the patient of pyoderma gangrenosum who had taken the steroids in a high dose is treated with topical ointment i.e. Marham-e-raal and Unani immunomodulator drugs. A male patient of PG was taken into study and was given oral Unani formulations and a herbo-medicinal ointment; Marham-e-raal for local application for 1 month. PG of lower limbs presents with burning and non healing chronic ulcers which are often resilient to healing either by steroids or antibiotics. The optimal treatment of PG is oral use of Unani immune-modulators and topical application of Marham-e-raal. The patient was managed with the same treatment and within the follow up of 2 months; there was no sign of PG

Redox biology of Mycobacterium tuberculosis H37Rv: protein-protein interaction between GlgB and WhiB1 involves exchange of thiol-disulfide

<p>Abstract</p> <p>Background</p> <p><it>Mycobacterium tuberculosis</it>, an intracellular pathogen encounters redox stress throughout its life inside the host. In order to protect itself from the redox onslaughts of host immune system, <it>M. tuberculosis </it>appears to have developed accessory thioredoxin-like proteins which are represented by ORFs encoding WhiB-like proteins. We have earlier reported that WhiB1/Rv3219 is a thioredoxin like protein of <it>M. tuberculosis </it>and functions as a protein disulfide reductase. Generally thioredoxins have many substrate proteins. The current study aims to identify the substrate protein(s) of <it>M. tuberculosis </it>WhiB1.</p> <p>Results</p> <p>Using yeast two-hybrid screen, we identified alpha (1,4)-glucan branching enzyme (GlgB) of <it>M. tuberculosis </it>as a interaction partner of WhiB1. <it>In vitro </it>GST pull down assay confirmed the direct physical interaction between GlgB and WhiB1. Both mass spectrometry data of tryptic digests and <it>in vitro </it>labeling of cysteine residues with 4-acetamido-4' maleimidyl-stilbene-2, 2'-disulfonic acid showed that in GlgB, C⁹⁵and C⁶⁵⁸are free but C¹⁹³and C⁶¹⁷form an intra-molecular disulfide bond. WhiB1 has a C³⁷XXC⁴⁰motif thus a C⁴⁰S mutation renders C³⁷to exist as a free thiol to form a hetero-disulfide bond with the cysteine residue of substrate protein. A disulfide mediated binary complex formation between GlgB and WhiB1C⁴⁰S was shown by both in-solution protein-protein interaction and thioredoxin affinity chromatography. Finally, transfer of reducing equivalent from WhiB1 to GlgB disulfide was confirmed by 4-acetamido-4' maleimidyl-stilbene-2, 2'-disulfonic acid trapping by the reduced disulfide of GlgB. Two different thioredoxins, TrxB/Rv1471 and TrxC/Rv3914 of <it>M. tuberculosis </it>could not perform this reaction suggesting that the reduction of GlgB by WhiB1 is specific.</p> <p>Conclusion</p> <p>We conclude that <it>M. tuberculosis </it>GlgB has one intra-molecular disulfide bond which is formed between C¹⁹³and C⁶¹⁷. WhiB1, a thioredoxin like protein interacts with GlgB and transfers its electrons to the disulfide thus reduces the intra-molecular disulfide bond of GlgB. For the first time, we report that GlgB is one of the <it>in vivo </it>substrate of <it>M. tuberculosis </it>WhiB1.</p

Comparison of MACE between High and Low TIMI Risk

Introduction: Patients with ST-segment elevation myocardial infarction (STEMI) have increased risk for death and adverse cardiac events. Of great concern is the risk of cardiac arrest that accounts for the majority of early deaths and other major adverse cardiac events. Significant hospital resources are dedicated to these high risk patients. Objective: To see the correlation of MACE between High and Low TIMI Risk. Methodology: This cross-sectional prospective study was conducted in the Department of Cardiology, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from July 2017 to June 2018. Fifty patients with definite diagnosis of acute STEMI, received streptokinase, aged above 18 years and both sex were included. Prior myocardial infarction, coronary revascularization procedures either CABG or angioplasty or coronary stenting; co-morbidities such as renal failure, heart failure, cardiomyopathy, valvular heart disease and congenital heart disease were excluded. On admission TIMI was recorded. In hospital MACE were also recorded. Results: The mean age of patients was 52.64 (SD 11.88) years and majority of the patients were male (84%) with male to female ratio was 5.25:1. The mean TIMI risk score for STEMI 4.50 (SD 2.38). In hospital major adverse cardiac events (MACE) occurred in 19 (38.0%) cases. TIMI risk score for STEMI was significantly higher in patients with MACE compared to without MACE (16.95, SD 1.78 versus 3.00, SD 1.10; p&lt;0.001) respectively. Conclusion: In hospital major adverse cardiac events (MACE) occurred in 19 (38.0%) cases. TIMI risk score for STEMI was significantly higher in patients with MACE compared to patients without MACE (16.95, SD 1.78 versus 3.00, SD 1.10; p&lt;0.001) respectively.&nbsp; From the study we conclude that TIMI risk score (5 or above) is a reliable tool in predicting in- hospital major adverse cardiac events in ST-segment elevation myocardial infarction

In Hospital Outcome of Acute Anterior Myocardial Infarction in Diabetic and Non-Diabetic Patients

Background: Patients with acute anterior myocardial infarction and diabetes have a poor prognosis. Objectives: To&nbsp;see the in-hospital outcome of acute anterior myocardial infarction in diabetic and non-diabetic patients. Methodology: This cross-sectional observational study was conducted in the Department of Cardiology, Sylhet MAG Osmani Medical College Hospital, Sylhet over a period of two years from July 2015 to June 2017. A total of 100 acute anterior MI patients (50 diabetic and 50 non diabetic) were included in this study. Acute anterior MI patients admitted after 6 hours of symptom onset or who did not receive streptokinase were excluded. Results: Male predominance was obvious in both groups [40 (80%) versus 42 (84%); p&gt;0.05] in diabetic and non-diabetic group respectively. Mean age was 53.34 ± 11.32 and 54.84 ± 14.12 years in diabetic and non-diabetic groups respectively. Dyslipidemia [6 (12%) versus 6 (12%); p &gt;0.05], Smoking [32 (64%) versus 34 (68%); p &gt;0.05] and Family history of cardiovascular disease [6 (12%) versus 4 (8%); p &gt;0.05] were similar among diabetic and non-diabetic respectively. Hypertension was found more among non-diabetic [27 (54%) versus 19 (38%); p&gt;0.05] but difference was not statistically significant. Diabetic group had more Apical Anterior MI [22 (44%) versus 19 (38%); p&lt;0.05] and Extensive Anterior MI [20 (40%) versus 11 (22%); p&lt;0.05] while non-diabetic group had more Septal MI [10 (20%) versus 3 (6%); p&lt;0.05] and Mid Anterior MI [10 (20%) versus 4 (8%); p&lt;0.05]. LV ejection fraction was found significantly low in diabetic patients [43.96 ± 5.95 versus 53.68 ± 6.36; p&lt;0.01]. Killip Class III was more in diabetic [24 (48%) versus 9 (18%); p&lt;0.01] and Killip Class I was more in non-diabetic group [18 (36%) versus 3 (6%); p&lt;0.01] according to Killip classification of HF which was statistically significant between the two groups. Atrial Fibrillation was more in diabetics [6 (12%) versus 1 (2%); p&lt;0.05] while sinus tachycardia was more among non-diabetics [20 (40%) versus 5 (10%); p&lt;0.05] which are statistically significant. Diabetic group had more acute MR [2 (4%) versus 0 (0%); p&gt;0.05] but was not significant. Death was more in diabetic group than that of non-diabetic group [7 (14%) versus 3 (6%); p&gt;0.05] but it was statistically not significant. Conclusion: It is concluded from the present study that in hospital outcomes of acute anterior myocardial infarction are worse in diabetic patients than in non-diabetic patients

Extent of Farm Mechanization in North Bank Plains Zone of Assam, India

The study was conducted from April, 2022 to March, 2023 in the North Bank Plains Zone (NBPZ) of Assam, India to assess the extent of mechanization and its impact on crop production. Among the six (6) districts of North Bank Plains Zone of Assam, three districts viz., Lakhimpur, Sonitpur and Darrang were selected randomly. Mechanization Index (MI) values were calculated for three key crops: sali rice, toria, and potato. Among these, potato had the highest MI (84.87%), followed by sali rice (74.65%) and toria (51.29%). Most farmers (72%) were classified under the medium mechanization category, indicating a moderate adoption of agricultural machinery. Mechanization significantly improved cropping intensity, which rose from 131.42% to 140.93%, an 8.45% increase, highlighting more effective land utilization and higher productivity. Additionally, mechanization reduced labor intensity, increased operational efficiency, and enhanced yields across crops. However, the adoption of mechanized technologies was not without challenges. Farmers faced high fuel costs, inadequate access to machinery during peak agricultural seasons, and a shortage of skilled personnel for machine operation and maintenance. Furthermore, frequent machinery breakdowns, often attributed to poor quality, disrupted farming activities and escalated costs. To address these challenges, the establishment of additional custom hiring centers (CHCs) was recommended. These centers would enable farmers to access high-quality machinery at affordable rates, minimizing delays and operational costs. Furthermore, training programs for operators and regular maintenance support at CHCs could alleviate technical difficulties. By addressing these constraints, mechanization can be effectively scaled, ensuring increased productivity and fostering sustainable agricultural development in the NBPZ

Check list of Anthocerophyta and Marchantiophyta of Pakistan and Kashmir

In the present study, a review of previously published literature regarding Anthocerophyta and Marchantiophyta of Pakistan and Kashmir has been done in order to know the diversity of these groups. Previous contributions collectively reveal 122 taxa distributed in 36 genera and 24 families. Of these 118 taxa (97.52%) are belonging to the Marchantiophyta, while the rest of 4 species (3.30%) members to Anthocerophyta. Aytoniaceae is the largest family with 16 species. Genera-wise, Riccia is the largest genus with 12 species. An average number of species/genera is c. 3.36. A major portion of Pakistan is still un-explored especially Sindh and Balochistan province of Pakistan, and on the basis of this study it can be said that many more taxa will be added to the list

Association between Cardiac Enzymes Level in Type 2 Diabetes Mellitus from Jazan Region, Saudi Arabia

Diabetes mellitus is characterized by deficiencies in insulin secretion and action, often leading to complications such as cardiac dysfunction associated with insulin-resistance syndrome. This study aimed to investigate the associations between serum cardiac enzyme levels (lactate dehydrogenase [LDH] and creatine kinase-MB [CK-MB]) and the incidence of type 2 diabetes mellitus in the Jazan population. Conducted at the MLT-Biochemistry laboratory of the College of Applied Medical Sciences, Jazan University, Saudi Arabia, the study involved the collection of 5 ml blood samples from 55 patients with type 2 diabetes and 35 control subjects. The mean (±S.D.) levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the control group were found to be 12.13±0.70 and 17.47±0.70 U/L, respectively, while in diabetic patients, the levels were significantly elevated at 20.55±1.90 and 24.15±2.10 U/L. Statistical analysis revealed significant differences in the means of ALT and AST levels between the two groups. The findings indicate that individuals with type 2 diabetes exhibit markedly higher serum liver enzyme levels compared to non-diabetic individuals, highlighting a greater incidence of liver function test (LFT) abnormalities in diabetic subjects. This study underscores the need for monitoring liver enzyme levels in patients with type 2 diabetes to better understand the associated risks and complications