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Microorganisms are ubiquitous and have far-reaching effects on human life. Since their discovery in the 19th century, microorganisms have fascinated biologists. Microbes play a crucial role in the material and elemental cycles of the natural world. Growing own microbes for research purposes requires a significant time and financial investment. On the other hand, high-throughput sequencing technology cannot advance at the same clip as the culture method. The area of microbiology has made substantial use of machine learning (ML) methods to tackle this problem.

Tuberculosis is known to be a great mimicker, and it can present in a myriad of ways, which often result in an incorrect diagnosis. In a country that is endemic to tuberculosis, the presentation can take many forms ranging from tumour to trauma. We present a case of Baker’s cyst that was provisionally diagnosed as pigmented villonodular synovitis (PVNS) of the knee and eventually turned out to be tuberculous arthritis. A 46-year-old male presented with an insidious swelling on the posterior aspect of his knee for one year. Magnetic resonance imaging was suggestive of PVNS as the likely diagnosis. The patient presented 21 days later with a foot drop. On following-up with further investigations, he was found to have a lesion at the level of the L4-L5 spine. Chest radiograph changes were suggestive of tuberculosis. A synovial biopsy of the knee was done, and the tuberculosis culture report was positive. The patient was started on anti-tubercular treatment and then operated on, with arthroscopic synovectomy and posterior open cyst excision. The histology report was positive for tuberculous synovitis. The patient completed the course of anti- tubercular drugs and had physiotherapy. He demonstrated a clinically and radiologically healed disease at the final follow-up with a good functional outcome. Clinicians must have a high index of suspicion for tuberculosis, especially in endemic areas. Getting a chest radiograph is recommended in every case. Early diagnosis with the appropriate treatment will give a good functional outcome for the patient.

Bushra Abdul Hadi,1 Saleh M Sbeitan,2 Ashok K Shakya11Faculty of Pharmacy and Medical Sciences, Al-Ahliyya Amman University, Amman 19328, Jordan; 2Intensive Care Unit, Specialty Hospital, Amman 19328, JordanAim: Lumbar foraminotomy surgery requires a potent opioid with short duration and rapid onset of action. In the present study we intended to compare the efficacy of fentanyl alone vs the combination of dexmedetomidine and fentanyl during lumbar foraminotomy surgery.Methods: The duration and requirements for first postoperative analgesics, hemodynamic stability, and respective side effects were studied. A prospective, randomized, double blind study of 40 patients (fentanyl group [Fen group] and fentanyl-dexmedetomidine group [Fen-Dex group], n=20 each) scheduled for lumbar foraminotomy surgery under pharmaceutical care intervention was carried out. Patients were classified as class I or II, according to the American Society of Anesthesiologists physical status classification. Patients received intraoperative propofol, sevoflurane, atracurium, and either fentanyl loading dose of 1.0 μg/kg and maintenance infusion dose of 0.2 μg/kg/h in both groups. The patients of the Fen group received normal saline (0.9%) placebo, while the patients of the Fen-Dex group received dexmedetomidine infusion (0.5 μg/kg/h) along with the fentanyl infusion. Postoperative morphine doses were given. Hemodynamic stability, pain, postoperative analgesia requirement, side effects of drugs, and other effects were monitored.Results: In the Fen-Dex group, the pain score was significantly less than in the Fen group (p

A series of N-(2-(benzoyl/4-chlorobenzoyl)-benzofuran- 3-yl)-2-(substituted)-acetamide derivatives (4a-l, 5a-l) was synthesized in good yield. All synthesized compounds were in agreement with elemental and spectral data. The anticonvulsant activity of all synthesized compounds was assessed against the maximal electroshock induced seizures (MES) model in mice. Neurotoxicity was evaluated using the rotarod method. The majority of compounds exhibited anticonvulsant activity at a dose of 30 mg kg-1 body mass during 0.5-4 h, indicating their ability to prevent seizure spread at low doses. Relative to phenytoin, [N-(2-(4-chlorobenzoyl)benzofuran-3-yl)-2-(cyclohexyl( methyl) amino)-acetamide] (5i) and [N-(2-(4-chlorobenzoyl)benzofuran-3-yl)-2-(4-methylpiperidin-1- yl)-acetamide] (5c) demonstrated comparable relative anticonvulsant potency of 0.74 and 0.72, respectively, whereas [(N-(2-(4-chlorobenzoyl)benzofuran-3-yl)-2-(4-(furan-2-carbonyl)-piperazin-1-yl)-acetamide] (5f) exhibited the lowest relative potency of 0.16. The ALD50 of tested compounds ranged from 1.604 to 1.675 mmol kg-1 body mass. The ED50 of synthesized compounds ranged from 0.055 to 0.259 mmol kg-1 (~23.4 to 127.6 mg kg-1) body mass. The pharmacophore mapping of the examined compounds on standard drugs (phenobarbital, phenytoin, ralitolin and carbamazepine) strongly suggests that these compounds may exert their anticonvulsant activity via the same established mechanism as that of known drugs.

We estimate how much the average grade of students enrolled in introductory macroeconomics changes when the professor sends a reminder email. We utilize observational data to implement a difference-in-differences strategy and identify the plausibly causal effect of email nudges on the student's grade. The professor's reminder email boosts low-performing student grades by 22-28 points per 50 points.

Ajaya Kumar Dhakal, Arati Shakya, Devendra Shrestha, Subhash Chandra Shah, Henish Shakya Department of Pediatrics, KIST Medical College Teaching Hospital, Imadol, Lalitpur, Nepal Abstract: Hepatitis A virus infection is a common public health problem in developing countries primarily due to poor hygiene and sanitation. The clinical features of hepatitis A virus are mostly related to the derangement of liver function with occasional extrahepatic complications. Herein, a 2.5-year-old girl presented with abdominal pain and decreased appetite for 4 days, high-colored urine for 3 days, and yellowish discoloration of the eyes for 2 days. On presentation, there was icterus along with hepatomegaly and diminished breath sounds on the right side were noted 1 day after admission. Chest X-ray revealed right sided pleural effusion; however, ultrasonography of chest and abdomen displayed bilateral pleural effusion (right more than left) and minimal ascites with thickened gall bladder wall. Immunoglobulin M anti-hepatitis-A virus serology was positive. The pleural effusion in this child resolved spontaneously in 10 days. We report this case to highlight that hepatitis A infection should be considered in the differential diagnosis of pleural effusion in a patient with features of acute hepatitis. However, other common causes of pleural effusion such as tuberculosis and parapneumonic effusions that may coexist with hepatitis, especially in developing world, need to be excluded. Keywords: hepatitis A, pleural effusion, viral hepatitis