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Abstract Disparities in socio-economic status (SES) predict many immune system-related diseases, and previous research documents relationships between SES and the immune cell transcriptome. Drawing on a bioinformatically-informed network approach, we situate these findings in a broader molecular framework by examining the upstream regulators of SES-associated transcriptional alterations. Data come from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative sample of 4543 adults in the United States. Results reveal a network—of differentially expressed genes, transcription factors, and protein neighbors of transcription factors—that shows widespread SES-related dysregulation of the immune system. Mediational models suggest that body mass index (BMI) plays a key role in accounting for many of these associations. Overall, the results reveal the central role of upstream regulators in socioeconomic differences in the molecular basis of immunity, which propagate to increase risk of chronic health conditions in later-life.

Differentially Expressed Genes (DEGs) are treated as candidate biomarkers, and a small set of DEGs might be identified as biomarkers using either biological knowledge or data-driven approaches like machine learning and statistical analysis. In this study, we used a combination of the machine learning algorithm and statistical tests to identify the top 300 genes that are differentially expressed in ASD compared to Typically Developed (TD). Initially, we extracted microarray gene expression data of 15 ASD and 15 TD from NCBI GEO database and used a standard pipeline to preprocess the data. Further, Random Forest (RF) was used to discriminate genes between ASD and TD. We, then analyzed the upregulated and downregulated genes using the logFC value to gain insights into their potential roles in the development of ASD. We further used drug-gene interaction analysis from ConnectivityMap to identify drugs that can inhibit the expression of these genes. Our results show that the proposed RF model yields average 5-fold cross-validation accuracy, sensitivity, and specificity of 96.67%. Further, we obtained precision and F-measure scores of 97.5% and 96.57%, respectively. Our analysis identified several novel genes that are dysregulated in ASD, including genes (such as proliferation-inducing protein 38 and germinal centre expressed transcript 32) involved in synaptic transmission, neural development, and immune function. We also identified several drugs (such as ATPase_Inhibitor, kinase inhibitors, and histone deacetylase inhibitors) that can potentially be used to treat ASD. Our findings provide new insights into the molecular mechanisms of ASD and suggest potential targets for drug development. These findings may lead to new therapeutic approaches for the treatment of ASD.

Abstract Generating reference maps of interactome networks illuminates genetic studies by providing a protein-centric approach to finding new components of existing pathways, complexes, and processes. We apply state-of-the-art methods to identify binary protein-protein interactions (PPIs) for Drosophila melanogaster. Four all-by-all yeast two-hybrid (Y2H) screens of > 10,000 Drosophila proteins result in the ‘FlyBi’ dataset of 8723 PPIs among 2939 proteins. Testing subsets of data from FlyBi and previous PPI studies using an orthogonal assay allows for normalization of data quality; subsequent integration of FlyBi and previous data results in an expanded binary Drosophila reference interaction network, DroRI, comprising 17,232 interactions among 6511 proteins. We use FlyBi data to generate an autophagy network, then validate in vivo using autophagy-related assays. The deformed wings (dwg) gene encodes a protein that is both a regulator and a target of autophagy. Altogether, these resources provide a foundation for building new hypotheses regarding protein networks and function.

Background: Subclinical hypothyroidism (SCH) is defined as serum thyroid-stimulating hormone (TSH) concentration above the statistically defined upper limit of the reference range and serum-free thyroxine (fT4) concentration within its reference range. The correlation of higher levels of TSH and dyslipidaemia in children is controversial. This study was done among school children to document the prevalence of SCH and to investigate the association between the lipid profile and TSH in children with SCH. Methods: A cross-sectional study among 982 school-going children (6-12 years) was conducted and 91 children with SCH were included. Their weight, height, body mass index (BMI), fasting lipid profile (serum total cholesterol [TC], triglycerides [TG] and high-density lipoprotein [HDL]) were converted to z scores and compared with the reference population data. Results: The prevalence of SCH was 11%. Mean TC, TG and HDL levels (mg/dL) were 169 ± 8.8, 66.4 ± 7.7 and 40.5 ± 4.1, respectively. The mean HDL value in the study population was significantly lower, whereas the mean TC levels were significantly higher than the population mean. There was no correlation between TC z scores and TSH (ρ = 0.071) and HDL z scores and TSH (ρ = −0.01371). Multiple linear regression showed a statistically significant association between TSH and HDL z scores (P = 0.006) and TSH and TC z scores (P = 0.008) after adjusting for age and BMI z scores. Conclusions: Children with SCH have an abnormal lipid profile. There is association between TSH and dyslipidaemia (decreased HDL and increased TC) in SCH.

Introduction: Pregnancy Induced Hypertension (PIH) can lead to intrauterine growth restriction resulting in Low Birth Weight (LBW) neonates. LBW remains a significant cause of under-five mortality in India and Asia. Aim: To calculate the prevalence of PIH and to study the correlation between Birth Weight (BW) of neonates and severity of maternal hypertension; and compare the incidence of neonatal morbidities across varying severity of maternal hypertension. Materials and Methods: A longitudinal study was conducted among 153 pregnant mothers, diagnosed with PIH. They were classified into mild {Systolic Blood Pressure (SBP) ≥140- 149 mmHg or Diastolic Blood Pressure (DBP) ≥90-99 mmHg}, moderate (SBP ≥150-159 mmHg or DBP ≥100-109 mmHg) and severe (SBP ≥160 mmHg or DBP ≥110 mmHg) hypertension. A total of 142 neonates, born to PIH mothers, were included. The neonates were followed-up for seven days to check for early neonatal outcomes and deaths. Correlation between maternal blood pressure (systolic and diastolic) and BW of the neonates was assessed using Pearson’s correlation coefficient (r). Binary Logistic Regression (BLR) was performed to analyse the impact of confounders on BW. Results: The prevalence of PIH was 7.76% (153/1972). The mean BW of neonates born to mothers with moderate (2.435 kg) and severe hypertension (2.342 kg) was significantly lower than that of neonates born to mothers with mild hypertension (2.828 kg) (p

Traditional medicine claims that various components of the Phoenix dactylifera (date plant) can be used to treat memory loss, fever, inflammation, loss of consciousness, and nerve disorders. The present study aims to evaluate the effectiveness of Phoenix dactylifera fruit extracts (PDF) against rat sickness behaviour caused by lipopolysaccharide (LPS) by assessing behavioural and biochemical parameters. PDF was prepared by extracting dry fruits of P. dactylifera with a methanol:water (4:1, v/v) mixture. The PDF was evaluated for phenolic and flavonoid content and HPLC analysis of quercetin estimation. Adult Wistar rats were treated with LPS, PDF + LPS and dexamethasone + LPS. Water and food intake, behavioural tests such as locomotor activity, tail suspension and forced swim tests were conducted. Furthermore, alanine transaminase (ALT) and aspartate transaminase (AST) were estimated in plasma and malondialdehyde (MDA), reduced glutathione (GSH), nitrite, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), were estimated in the brain. PDF ameliorated LPS-induced sickness behaviour by reducing MDA, nitrite, IL-6, and TNF-α levels and improving GSH, behavioural alteration, water and food intake in the treated rats. In the plasma of the treated rats, PDF also decreased the levels of ALT and AST. The outcomes demonstrated the efficacy of PDF in reducing the sickness behaviour caused by LPS in rats. The authors believe that this study will provide the groundwork for future research to better understand the underlying mechanisms of action and therapeutic efficacy.

Growing evidence suggests that neuronal dysfunction in the endo-lysosomal and autophagic processes contributes to the onset and progression of neurodegenerative diseases such as Alzheimer's disease (AD). Since they are the primary cellular systems involved in the production and clearance of aggregated amyloid plaques, endo-lysosomal or autophagic equilibrium must be maintained throughout life. As a result, variations in the autophagic and endo-lysosomal torrent, as a measure of degenerative function in these sections or pathways, may have a direct impact on disease-related processes, such as Aß clearance from the brain and interneuronal deposition of Aß and tau aggregates, thus disrupting synaptic plasticity. The discovery of several chromosomal factors for Alzheimer's disease that are clinically linked to regulation of the endocytic pathway, including protein aggregation and removal, supports the theory that the endo-lysosomal/autophagic torrent is more susceptible to impairment, especially as people age, thus catalysing the onset of disease. Although the role of endo-lysosomal/autophagic dysfunction in neurodegeneration has progressed in recent years, the field remains underdeveloped. Because of its possible therapeutic implications in Alzheimer's disease, further study is needed to explain the possibilities for effective autophagy regulation.

Abstract A study was conducted to evaluate the groundwater quality and health risk assessment for drinking purposes around inactive mining areas in the rural regions of Vemula-Vempalli region using the water quality index (WQI) method. For this study, forty groundwater samples were collected from bore wells and analyzed for physical parameters and major cations and anions followed by standard methods of APHA. From the analytical results, most of the groundwater samples are in alkaline nature; EC, TDS, and TH values are below the permissible limit and major cations (Ca2+, Mg2+, K+, Na+) & anions (Cl−, HCO3, SO4 2−, F−, NO3 −) also within the permissible limit except fluoride and nitrate. Fluoride and nitrate in the groundwater range between 0.24–3 and 0.14–269 mg/L, respectively. Magmatic intrusions and water–rock interactions are main responsible for elevated fluoride in groundwater, and agricultural practices and usage of fertilizer are major responsible for higher nitrates in the groundwater. Piper diagram reveals that most of the samples belong to hydrochemical facies Ca2+–Mg2+–HCO3 − category in this region. A higher concentration of fluoride and nitrate in the groundwater may cause a serious impact on human health. Non-carcinogenic effects of F− and NO3 − were computed using total hazard index by adopting USEPA guidelines; THI values in drinking water range from 0.41 to 7.28 (adults), 0.41 to 7.38 (children) and 0.31 to 5.62 (infants); it reveals that children are more prone to the health impact than adults and infants. Overall assessment of WQI values (83.7–186.1 mg/L) shows that 7.5% (excellent), 80% (good), and 12.5% groundwater samples are very poor for drinking purpose in this region.

The main purpose of this study is to evaluate the groundwater quality for human consumption by developing a water quality index for the southwest (SW) part of the Cuddapah Basin. In order to study this various physico-chemical parameters were analyzed, distribution maps were prepared using Geographical Information System (GIS). Except for fluoride and nitrate, most of the chemical parameters are within the allowable range, which is due to geogenic and anthropogenic sources, respectively. Most of the heavy metals were below the permissible limit except cadmium, which might be due to anthropogenic activities. The piper diagram shows that most samples belong to the Ca2+-Mg2+-HCO3− category. Rock dominance is the predominant hydrogeochemical factor controlling groundwater chemistry. According to WQI classification, 12% of samples are not potable due to anthropogenic activities. This study proved that the combined application of GIS and WQI is very effective in accessing groundwater quality.

The host’s response to acute infections or tissue injury is a sophisticated and coordinated adaptive modification called sickness behaviour. Many herbs have been studied for their ability to protect animals against experimentally induced sickness behaviour. However, there is a lack of knowledge and experimental evidence on the use of herbal bioactive compounds (HBACs) in the management of sick behaviour. The goal of this review is to provide a concise summary of the protective benefits and putative mechanisms of action of phytochemicals on the reduction of lipopolysaccharide (LPS)-induced sickness behaviour. Relevant studies were gathered from the search engines Scopus, ScienceDirect, PubMed, Google Scholar, and other scientific databases (between 2000 and to date). The keywords used for the search included “Lipopolysaccharide” OR “LPS” OR “Sickness behaviour” OR “Sickness” AND “Bioactive compounds” OR “Herbal medicine” OR “Herbal drug” OR “Natural products” OR “Isolated compounds”. A total of 41 published articles that represented data on the effect of HBACs in LPS-induced sickness behaviour were reviewed and summarised systemically. There were 33 studies that were conducted in mice and 8 studies in rats. A total of 34 HBACs have had their effects against LPS-induced changes in behaviour and biochemistry investigated. In this review, we examined 34 herbal bioactive components that have been tested in animal models to see if they can fight LPS-induced sickness behaviour. Future research should concentrate on the efficacy, safety, and dosage needed to protect against illness behaviour in humans, because there is a critical shortage of data in this area.

Genome-scale metabolic models (GEMs) provide a powerful framework for simulating the entire set of biochemical reactions in a cell using a constraint-based modeling strategy called flux balance analysis (FBA). FBA relies on an assumed metabolic objective for generating metabolic fluxes using GEMs. But, the most appropriate metabolic objective is not always obvious for a given condition and is likely context-specific, which often complicate the estimation of metabolic flux alterations between conditions. Here, we propose a new method, called ΔFBA (deltaFBA), that integrates differential gene expression data to evaluate directly metabolic flux differences between two conditions. Notably, ΔFBA does not require specifying the cellular objective. Rather, ΔFBA seeks to maximize the consistency and minimize inconsistency between the predicted flux differences and differential gene expression. We showcased the performance of ΔFBA through several case studies involving the prediction of metabolic alterations caused by genetic and environmental perturbations in Escherichia coli and caused by Type-2 diabetes in human muscle. Importantly, in comparison to existing methods, ΔFBA gives a more accurate prediction of flux differences.

Introduction: National Family Health Survey-4 reports that 44.8% of boys and 41.9% of girls aged 15-19 are underweight. Globally, there is a lacuna of data on early adolescent children (10-14 years). Aim: To estimate the prevalence of malnutrition among school going adolescent children in Medchal, Telangana and also to assess the correlation between nutritional status of adolescent children and their parents’ literacy level and socio-economic class. Materials and Methods: A cross-sectional study was carried out in 1000 adolescent children aged between 10-16 years. Pilot study was conducted on 110 students to test the questionnaire comprising basic data and socio-demographic characteristics before starting the study. Weight and height were measured. Body Mass Index (BMI) was calculated and based on BMI, children were classified into undernutrition, normal, overweight and obese. Parental literacy was ascertained. Parents were divided into five categories of socio-economic class according to BG Prasad Classification. Primary endpoint measured was prevalence of malnutrition among adolescent children and secondary endpoint measured was correlation of mother’s and father’s literacy status with nutritional status which was ascertained using spearman’s rank correlation test. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 21.0. Results: Prevalence of undernutrition and overnutrition (overweight and obesity) was 48.5% and 4.6% respectively. There was statistically significant (p=0.046) difference between boys and girls with respect to prevalence of undernutrition and overnutrition. Majority of undernourished boys (49.1%) and girls (46.8%) were 13-14 years old. Spearman’s rank coefficient (rho-ρ) showed strong positive correlation between nutrition and socio-economic class (ρ:0.706) with moderate and weak correlation seen for mothers’ education (ρ:0.425) and fathers’ educational status (ρ:0.333), respectively. Conclusion: Undernutrition remains to be a common problem among early adolescents. Socio-economic class and literacy level of parents play significant role in nutrition of adolescents. At school level, adolescent children and their teachers need to be empowered to understand better about the necessity and impact of maintaining a normal nutritional status on their future health.

Comprehensive mapping of binary protein-protein interactions requires to combine several complementary assays. Here, the authors show that complete coverage could be reached with a minimal number of assays as long as they explore various experimental conditions.

Steganalysis is the process of analyzing and predicting the presence of hidden information in images. Steganalysis would be most useful to predict whether the received images contain useful information. However, it is more difficult to predict the hidden information in images which is computationally difficult. In the existing research method, this is resolved by introducing the deep learning approach which attempts to perform steganalysis tasks in effectively. However, this research method does not concentrate the noises present in the images. It might increase the computational overhead where the error cost adjustment would require more iteration. This is resolved in the proposed research technique by introducing the novel research method called Non-Gaussian Noise Aware Auto Encoder Convolutional Neural Network (NGN-AEDNN). Classification technique provides a more flexible way for steganalysis where the multiple features present in the environment would lead to an inaccurate prediction rate. Here, learning accuracy is improved by introducing noise removal techniques before performing a learning task. Non-Gaussian Noise Removal technique is utilized to remove the noises before learning. Also, Gaussian noise removal is applied at every iteration of the neural network to adjust the error rate without the involvement of noisy features. This proposed work can ensure efficient steganalysis by accurate learning task. Matlab has been employed to implement the method by performing simulations from which it is proved that the proposed research technique NGN-AEDNN can ensure the efficient steganalysis outcome with the reduced computational overhead when compared with the existing methods.

The concept of trapped vortex combustion is emerging as a viable method of burning fuel effectively in aero-gas turbine engines. In a two-dimensional trapped vortex combustor (TVC), fuel-air mixing is characterized by using the parameter intensity of segregation (Is). When fuel and oxidizer are present (with some macro-mixing already having taken place), the parameter quantifies the extent of local micro-mixing within the domain. The regions of maximum fuel-oxidizer mixedness are identified to be the vortex edge and dump shear layer of the cavity. These two regions are observed to be zones of very good fuel-air mixing with higher levels of turbulence. Increasing aspect ratio (L/D) and the mainstream velocity (Vms) increases mainstream air entrainment into cavity, resulting in improved fuel-air distribution and mixing. However, an optimal L/D=1.2 and Vms=40 m/s results in stable vortex being trapped with better fuel distribution throughout the cavity. While non-optimal L/D and Vms may result in improved mainstream air entrainment, it is found to disrupt the trapped vortex, which is not conducive for combustion. Hence, for a given L/D, there is an optimal momentum ratio between the cavity injections and mainstream flow, which results in a single large vortex being trapped that can roll up the fuel-air injected and distribute them across the cavity, required for stable combustion in a TVC. [ABSTRACT FROM AUTHOR]

Context: The rise in the incidence of clinical resistance to antifungal therapy and failure to respond in recent years underscores the need for a time-honored approach to treat the disease using natural drugs instead of synthetic drugs, which have lesser adverse effects and good patient response. Punica granatum (pomegranate) is a fruit that has admirable medicinal value. Aims: The study aimed to evaluate the in vitro antifungal efficacy of P. granatum peel extract against oral Candida compared with clotrimazole. Settings and Design: The study design involves an in-vitro study. Subjects and Methods: Saliva from candidiasis patients was inoculated and cultured on 60 separate Sabouraud dextrose agar plates and incubated at 37°C for 48 h from which Candida species were collected. Agar well-diffusion method was followed. Different concentrations of P. granatum peel extracts, ethanol solvent (control) and standard clotrimazole were added into the wells and allowed to diffuse at room temperature for 2 h. The plates were incubated at 37°C for 48 h. The antifungal potential of test compounds was determined based on the mean diameter of the zone of inhibition around the well in millimeters. Statistical Analysis Used: Statistical analysis was performed using IBM software SPSS version 20 at one-way ANOVA. Results: Antifungal efficacies of P. granatum peel extract and clotrimazole were statistically significant, and there was an increase in inhibitory efficacy with an increase in concentration. Minimum inhibitory concentration of P. granatum peel extract approximated with that of clotrimazole. Conclusions: The results of this study indicate that P. granatum peel extract can be used as an effective natural substitute for synthetic antifungal agents. [ABSTRACT FROM AUTHOR]

Alzheimer’s disease (AD) is the most common neurodegenerative disease affecting the elderly worldwide. Mitochondrial dysfunction has been proposed as a key event in the etiology of AD. We have previously modeled amyloid-beta (Aβ)-induced mitochondrial dysfunction in a transgenic Caenorhabditis elegans strain by expressing human Aβ peptide specifically in neurons (GRU102). Here, we focus on the deeper metabolic changes associated with this Aβ-induced mitochondrial dysfunction. Integrating metabolomics, transcriptomics and computational modeling, we identify alterations in Tricarboxylic Acid (TCA) cycle metabolism following even low-level Aβ expression. In particular, GRU102 showed reduced activity of a rate-limiting TCA cycle enzyme, alpha-ketoglutarate dehydrogenase. These defects were associated with elevation of protein carbonyl content specifically in mitochondria. Importantly, metabolic failure occurred before any significant increase in global protein aggregate was detectable. Treatment with an anti-diabetes drug, Metformin, reversed Aβ-induced metabolic defects, reduced protein aggregation and normalized lifespan of GRU102. Our results point to metabolic dysfunction as an early and causative event in Aβ-induced pathology and a promising target for intervention.

This paper investigates the effects of the renewable energy consumption and the tourism investments along with the per capita gross domestic product (GDP), the real effective exchange rate, and trade openness on both tourism revenues (total tourism contribution to GDP) and international tourist arrivals in the sample of the G20 members. The annual data from 1995 to 2015 and the panel econometric techniques are utilized to achieve the objectives of the current paper. The results for the long-run elasticities from the panel fully modified ordinary least squares (FMOLS) estimations suggest that the renewable energy uses and tourism investments have a considerable positive impact on both the tourism revenues and the tourist arrivals. Given these results, it is argued that promoting both renewable energy and tourism investments should be considered as the major driving forces of tourism development in the G20 countries. Given these arguments, policymakers should initiate more of sustainable tourism development policies, which may assist those countries to expand the tourism industry further.

Aim : The acrylic resin material is an indispensable material in removable prosthodontics. There has been continuous search to reduce processing time and enhance physical properties such as strength deformation. Fracture of acrylic resin is an unresolved problem in removable prosthodontics. Numerous attempts have been made to determine its causes. The present study was done to compare the fracture resistance of acrylic resin denture base reinforced with steel strengtheners. Materials and Methods : To measure the fracture resistance of heat cure acrylic resin, a total of ,, specimens were prepared and divided into , categories: Group,: No strengtheners, Group ,: Thin gauge strengtheners and Group ,: Thick gauge (,., mm X , mm). All the samples prepared were of specific dimensions i.e. ,, mm in length, ,, mm in width and , mm in thickness as a means for standardization. The flexural strength of the samples was recorded using a universal testing machine and the data obtained was statistically analysed. The statistical analysis was done by calculating the average and standard deviation for each parameter used in the study. To find out the significant difference between different concentrations and different time intervals unpaired ′t′ test was performed. Here ′p′ and′t′ value is used to evaluate the fracture resistance. Results: Acrylic samples with steel strengtheners fared better when compared to those without steel strengtheners. Thick gauge strengtheners were found to be more resistant to fracture. The difference was statistically significant. Conclusion: The incorporation of thick steel strengtheners few millimetres apart and perpendicular to anticipated line of fracture will produce significant resistance to flexure and reduce the likelihood of fracture of the acrylic resin denture base.

Stenotrophomonas maltophila (S.maltophila) is an aerobic Gram-negative bacillus that is a frequent colonizer of fluids used in the hospital setting. The organism is known to cause life threatening infections in immuno-compromised patients especially in those who are neutropenic, on chemotherapy or on broad spectrum antibiotics. We report a case of ventilator associated pneumonia caused by Stenotrophomonas maltophila in a two-month old infant who later developed multi organ dysfunction syndrome. In seriously ill paediatric patients, S.maltophila should also be considered as a possible pathogen for Ventilator-Associated Pneumonia (VAP), hence empiric antibiotic choice should include antimicrobials that are active against S. maltophila. An early identification and treatment of VAP with Multi-Drug Resistant (MDR) strains with appropriate antibiotics has a significant impact on morbidity and mortality.

M Srinivasa Rao,1 B Syed Asad,1 MA Fazil,1 RD Sudharshan,1 SA Rasheed,1 HA Pradeep,1 S Aboobacker,2 AH Thayyil,1 AK Riyaz,1 M Mansoor,1 MA Aleem,1 K Zeeyauddin,3 M Lakshmi Narasu,4 A Anjum,1,5 M Ibrahim1,51Nizam Institute of Pharmacy, Andhra Pradesh; 2Department of Pharmacology, Jamiya Salafiya College of Pharmacy, Kerala; 3Department of Pharmacology, Deccan School of Pharmacy, Andhra Pradesh; 4Centre for Biotechnology, Jawaharlal Nehru Technological University, Andhra Pradesh; 5Asian Institute of Advanced Scientific and Pharmaceutical Research, Hyderabad, Andhra Pradesh, IndiaAim: This investigation aimed to assess the hepatoprotective effect of saponin fraction isolated from the fruit pericarp of Sapindus mukorossi on carbon tetrachloride (CCl4)-induced hepatotoxicity.Methods: Fruit of S. mukorossi was collected and authenticated, and dried pericarp powder subjected to extraction with cold ethanol (70%) by maceration followed by isolation of total saponin fraction. Hepatoprotective activity was demonstrated in the CCl4-damaged primary monolayer culture. In in vivo studies, pretreatment with total saponin fraction (50,100 and 150 mg/kg per os once a day for 4 days before CCl4 introduction and continued afterward for 3 days) attenuated the CCl4-induced acute increase in serum glutamic pyruvic transaminase, serum glutamic oxaloacetic transaminase, and alkaline phosphatase activities and considerably reduced histopathological alterations. Further, saponin fraction reduced thiopentone-induced (4 mg/kg, intraperitoneal) sleeping time in rats.Results: Saponin fraction pretreatment improves bromsulphalein clearance and also increases cellular viability. Saponin administration replenished depleted hepatic glutathione and superoxide dismutase by improving the antioxidant status of the liver and liver function enzymes. These effects substantiate protection of cellular phospholipids from peroxidative damage induced by highly reactive toxic intermediate radicals formed during biotransformation of CCl4.Conclusion: The above findings lead to the conclusion that the saponin fraction of S. mukorossi has a protective capability both in vitro on primary hepatocyte cultures and in vivo in a rat model of CCl4-mediated liver injury. Hence, we suggest that the inclusion of this S. mukorossi fruit pericarp in the management of liver disorders is justified.Keywords: Sapindus mukorossi, total saponin content, hepatoprotective

Sudharshan Reddy D1, Muchandi IS2, Srinivasa Rao A3, Pradeep HA1, Ravi Kumar K1, Srinivasa Rao M1, Mohammed Ibrahim11Nizam Institute of Pharmacy, Hyderabad, Andhra Pradesh, India; 2HSK College of Pharmacy, Bagalkot, Karnataka, India; 3Bhaskar College of Pharmacy, Hyderabad, Andhra Pradesh, IndiaAbstract: The roots of Holostemma annularis K. Schum (Asclepiadacae) are used in traditional medicine to treat diabetes. This medicinal plant, widely used in more than 34 ayurvedic preparations, was evaluated in a high fructose diet in induced insulin resistance and in C57BL/6J ob/ob diabetic mice for its antidiabetic activity. Graded doses of both chloroform and methanolic extracts of the roots of H. annularis were administered to normal and experimental diabetic rats for 21 days. Serum glucose, triglycerides, cholesterol levels and total protein in urine were analyzed. Significant results were observed in the estimated parameters. These data justify the use of the plant in the treatment of diabetes mellitus and is a potential source for the isolation of new active agents for diabetes mellitus.Keywords: Holostemma annularis, high fructose diet, antihyperglycemic, C57BL/6J ob/ob mice

Competing Interests: The authors report no conflicts of interest.

Background: Surgical resection is a mainstay of treatment in high-risk neuroblastoma (HR-NB), but there exists wide variability in perioperative management practices. The aim of this study was to evaluate two standardized adult perioperative enhanced recovery practices (ERPs) in pediatric patients undergoing open resection of abdominal HR-NB., Methods: All patients with abdominal HR-NB surgically resected at a free-standing children's hospital between 12/2010 and 7/2020 were retrospectively reviewed. Perioperative ERPs of interest included avoidance of routine nasogastric tube (NGT) use and the use of neuraxial anesthesia. Primary outcomes included time to enteral intake, urinary catheter use, opioid utilization, and length of stay (LOS)., Results: Overall, 37 children, median age 33 months (IQR: 20-48 months), were identified. Avoidance of an NGT allowed for earlier feeding after surgery ( P = .03). Neuraxial anesthesia use more frequently required an indwelling urinary catheter ( P < .01) for a longer duration ( P = .02), with no difference in total opioid utilization ( P = .77) compared to patients without neuraxial anesthesia. Postoperative LOS was unaffected by avoidance of routine NGT use ( P = .68) or use of neuraxial anesthesia ( P = .89)., Conclusion: Children undergoing open resection of abdominal HR-NB initiated diet sooner when an NGT was not left postoperatively, and the need for a urinary catheter was significantly higher in patients who received neuraxial anesthesia. However, these two ERP components did not decrease postoperative LOS. To optimize the postoperative management of NB patients, postoperative NGTs should be avoided, while the benefit of neuraxial anesthesia is less clear as it necessitates the placement of a urinary catheter without decreasing opioid utilization., Competing Interests: Declaration of Conflicting InterestsThe author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: AI chatbots are being increasingly used in healthcare settings. There is growing interest in using AI to assist in patient education. Currently, extensive healthcare information is found online but is often too complex to understand. Our objective is to determine if physicians can recommend the free version of ChatGPT version 3.5 (OpenAI, San Francisco, CA, USA) for patients to simplify text from the American Academy of Ophthalmology (AAO) in English and Spanish. This version of ChatGPT was assessed in this study due to its increased accessibility across various patient populations., Methods: Fifteen articles were chosen from AAO in both languages and simplified with ChatGPT 10 times each. The readability of original and simplified articles was assessed with the Flesch Reading Ease and Gunning Fog Index for English and Fernández Huerta, Gutiérrez, Szigriszt-Pazo, INFLESZ, and Legibilidad-µ for Spanish. Grade levels to assess readability were calculated with Flesch Kincaid Grade Level and Crawford Nivel-de-Grado. Mean, standard deviation, and two-tailed t-tests were performed to assess differences before and after simplification., Results: Average grade levels before and after simplification were as follows: English 8.43±1.17 to 8.9±2.1 (p=0.41) and Spanish 5.3±0.34 to 4.1±1.1 (p=0.0001). Spanish articles were significantly simplified per Legibilidad-µ (p=0.003). No significant difference was noted for other scales., Conclusions: The readability of AAO articles in English worsened without significance but significantly improved in Spanish. This may result from simpler syllable structures and a lesser overall vocabulary in Spanish. With increased testing, physicians can recommend ChatGPT for Spanish-speaking patients to improve health literacy., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Sudharshan et al.)