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Introduction: Acute pancreatitis (AP) following drug-induced hypertriglyceridemia is a rare clinical phenomenon. Immune checkpoint inhibitors have revolutionized treatment for a variety of solid organ and hematological malignancies. Pembrolizumab is a programmed cell death receptor-1 (PD-1) inhibitor that has shown promising responses in many advanced cancers. However, a constellation of immune-related adverse events has also been described. There are reports of pembrolizumab-induced hypertriglyceridemia, but AP as a result of this side effect remains an exceedingly rare clinical sequela. Case report: We delineate a case of a patient with stage IVB non-small-cell lung cancer who developed progressive abdominal pain and nausea following administration of pembrolizumab for four months. Laboratory studies revealed increased serum lipase and triglyceride levels at 12,562 IU/L and 16,901 mg/dL, respectively. The diagnosis of AP was made based on the revised Atlanta classification criteria. After ruling out alternative causes, pembrolizumab-induced hypertriglyceridemia was considered the likely etiology of AP. Management and outcome: The patient was transferred to the medical intensive care unit for close monitoring. Treatment was initiated with intravenous fluids, pain medications, and an insulin infusion. However, her hypertriglyceridemia levels remained persistently elevated, necessitating therapeutic apheresis. She recovered well with no complications after triglyceride apheresis. Discussion: AP following pembrolizumab-associated hypertriglyceridemia remains a rare clinicopathologic entity. Given the widespread clinical use of immune checkpoint inhibitors, knowledge of such rare adverse events is crucial. Evaluation of serum triglyceride levels before and after initiating pembrolizumab therapy may be mandated, especially in patients with metabolic comorbidities. [ABSTRACT FROM AUTHOR]

Gout arthritis is a joint pain disorder characterized by swelling around joints and elevated uric acid levels. These elevated uric acid levels result in joint stiffness and pain. The elevated uric acid level is due to over activity of xanthine oxidase. Lemon peel can inhibit the activity of xanthine oxidase. In this study, twenty male albino Wistar rats with induced arthritis were enrolled and were divided into four groups; control group (Go) and treatment group G1, G2, and G3. Treatment groups were given three different levels of lemon peel 150mg, 300mg and 450 mg per kg of body weight. Serum uric acid levels were measured before and after the trial. Chemical characterization and phytochemical analysis were also performed. The presence of 9.07±1.16% moisture in lemon peel. A total of 1.71±0.13% ash was present in lemon peel while 62.45±8.09% of carbohydrates were present in lemon peel. 4.04±0.08% crude protein, 9.87±1.63% crude fat, and 12.86±0.09% crude fiber wass present in lemon peel. Lemon peel held a significant amount of TPC and TFC depicted in fig. 1. Total phenolic content (TPC) was 1204±23.02 mg GAE/100g and total flavonoid content (TFC) was 471.98±11.74 mg QE/100g. The investigation had shown a significant (p<0.05) reduction in uric levels in response to lemon peel powder in all treatment groups. ANOVA test showed a significant reduction in uric acid levels when lemon peel was given to subjects. [ABSTRACT FROM AUTHOR]

This study aims to synthesize the literature on the top management team (TMT) characteristics influence on environmental disclosures of public organizations and identify recent trends, key themes, influential journals, and authors. Our study recruited 88 research articles on the relationship of TMT characteristics and environmental disclosures from 54 academic journals published from 2010 to 2021 for bibliometric analysis. Our study has identified three influential streams: (1) Role of Politically connections of TMT, good governance in environmental disclosures; (2) Significance of environmental disclosures and performance; and (3) institutional investors and environmental disclosures. Thematic map classifies the TMT characteristics and environmental disclosures relationship themes into four categories: Niche theme (e.g., financial expertise, CFO characteristics, CEO tenure, and board backgrounds); motor themes (e.g., environmental sustainability and climate change); emerging/declining themes (e.g., Environmental disclosure, managerial ownership, and CEO tenure); and basic/transversal themes (e.g., CEO characteristics, upper echelon theory, corporate governance). This study assists academicians, policymakers, managers, and consultants in the corporate sector to understand the role of different dimensions of TMT characteristics regarding environmental disclosures. Our study concludes with important practical implications and future research directions. [ABSTRACT FROM AUTHOR]