Assessing Ethnic Traditional Knowledge,Biology and Chemistry of Lepidium didymum L., Lesser-Known Wild Plants of Western Himalaya

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - Tribal communities have a long history of association living in close contact with nature as herdsmen, and...     

Single versus double burr hole drainage of chronic subdural hematomas. A study of 267 cases

A spectrum of surgical techniques has been used in the management of chronic subdural hematomas. Single burr hole and double burr hole drainage are among the commonest techniques. A retrospective analysis of 267 patients with chronic subdural hematomas treated surgically by either single or double burr holes was performed. Recurrence rates of subdural hematomas treated either with single or double burr holes were not significantly different (χ²; p > 0.05). Thus, the number of burr holes does not affect the post-operative recurrence rate of chronic subdural hematomas. Both techniques are equally effective treatments.     

Anticancer and apoptotic activity in neuroblastoma SK-N-SH using phospholipid extract from bone of Scomberomorus niphonius

Among various types children's health challenges, neuroblastoma is the most serious solid neoplasm forming outside the cranium. Scomberomorus niphonius is a valuable edible fish that has been widely used for a meal. In this study, we obtained phospholipid extract from the bone of S. niphonius with the supercritical CO₂ extraction method and tested anticancer activity with a cell viability assay. The phospholipid showed anticancer activity on neuroblastoma SK-N-SH cells, and the anticancer activity was presented with an IC₅₀ of 710.25 ± 28.31 μg/ml, but did not show a significant toxicity on HUVEC cell lines. Western blot was used to detect signaling proteins; Bak, caspase-9, caspase-8, caspase-3, Bax, and IκBα were increased, whereas IKKβ and NFκB were downregulated in experimental groups compared to untreated groups. Gene expression was revealed by RT-qPCR, and the fold ratio of Apaf-1, cytochrome-c, caspase-9, caspase-3, and Bax genes' expression was raised in treated groups, implying apoptosis. Gel electrophoresis revealed that the experimental groups had more fragmented DNA than the control group. The study shows that a phospholipid extract from S. niphonius' bone could be used as a biological origin of anticancer activity in neuroblastoma SK-N-SH cells.     

Role of Sirolimus in Advanced Kaposiform Hemangioendothelioma

Kaposiform hemangioendothelioma (KHE) is an infiltrative vascular tumor that classically presents in infancy. Management typically focuses on treating Kasabach–Merritt phenomenon (KMP), a disorder of severe and at times life‐threatening platelet trapping. However, the morbidity of KHE extends beyond KMP. The infiltrative nature of the tumor can lead to long‐term disability and often makes complete surgical resection impossible. We report the case of a 10‐year‐old boy with a KHE of his right distal thigh who was unable to walk without assistance due to fibrotic change and right knee contracture. He had no laboratory evidence of KMP at the time of representation. Rapamycin was started in hopes of reducing the tumor burden. Within 2 months of therapy, fibrotic areas softened, his contracture nearly resolved, and there was marked improvement in his mobility. Rapamycin has been previously reported to be effective in managing cases of KHE complicated by KMP. Our report emphasizes the role for rapamycin in the treatment of KHE in the absence of KMP through the inhibition of vasculogenesis and fibrotic pathways.     

Neutrophilic urticarial dermatosis as a presenting feature of systemic juvenile idiopathic arthritis

This report describes a case of chronic neutrophilic urticarial dermatosis as a presenting feature of systemic juvenile idiopathic arthritis. When encountered in children, neutrophilic urticarial dermatosis should raise suspicion of autoimmune or autoinflammatory disease.     

Acquired acrodermatitis enteropathica due to zinc‐depleted parenteral nutrition

Well‐known causes of zinc deficiency, also referred to as acrodermatitis enteropathica (AE), include defects in intestinal zinc transporters and inadequate intake, but a rare cause of acquired zinc deficiency discussed here is an iatrogenic nutritional deficiency caused by parenteral nutrition administered without trace elements. While zinc‐depleted parenteral nutrition causing dermatosis of acquired zinc deficiency was first reported in the 1990s, it is now again relevant due to a national vitamin and trace element shortage. A high index of suspicion may be necessary to diagnose zinc deficiency, particularly because early clinical findings are nonspecific. We present this case of acquired zinc deficiency in a patient admitted to a pediatric intensive care unit for respiratory distress and atypical pneumonia, who subsequently developed a severe bullous eruption due to iatrogenic zinc deficiency but was treated effectively with enteral and parenteral zinc supplementation, allowing for rapid re‐epithelialization of previously denuded skin.     

Food as Medicine for Secondary Prevention of Cardiovascular Events Following an Acute Coronary Syndrome

Cardiovascular disease is the leading cause of death in men and women in the USA. Once a patient experiences an acute coronary syndrome (ACS), they are at increased risk for hospital readmission within 30 days and 6 months after discharge and more importantly, they have worse survival. Hospital readmissions lead to poor clinical outcomes for the patient and also significantly increase healthcare costs due to repeat diagnostic evaluation, imaging, and coronary interventions. The goal after hospital discharge is to modify cardiovascular (CV) risk factors including hypertension, hyperlipidemia, and diabetes to prevent repeat coronary events; however, drug therapy is only one aspect. Several diets have been shown to decrease weight and reduce these risk factors over short durations; however, most people typically cannot sustain their diet and regain the weight. The Intelligent Quisine (IQ) diet is a prepared meal plan that was designed to meet the American Heart Association and American Diabetes Association nutritional guidelines and simplify the daily consumption of a nutritionally complete, calorie conscious meal. The IQ diet has been shown to significantly reduce blood pressure, cholesterol levels, glucose levels, and weight over a 10-week period. Additional studies have shown that patients are able to remain compliant on the diet for a year and maintain the reduction of their CV risk factors. If patients are consistent with a healthy calorie conscious and nutritionally complete diet modifying CV risk factors long term, then food could be as powerful in reducing CV events as evidence-based drug therapy. There is a need to begin conceptualizing food as medicine. To this end, it is time for a randomized control trial implementing the IQ diet versus current standard dietary recommendations in a large number of patients and measuring hard CV endpoints. Many readmissions can be avoided with proper patient education and support emphasizing lifestyle modifications such as eating healthy and smoking cessation on a foundation of optimal medical therapy.