Background: The rapid growth of COVID-19 infections may result in second wave of infection and an overwhelmed health care providing systems. Ledipasvir and sofosbuvir can be a good choice for management of COVID-19 patients. Development of simple, sensitive, and rapid assay for simultaneous determination of ledipasvir / sofosbuvir to investigate their pharmacokinetic parameters in human plasma, and aid in therapeutic drug moitoring in COVID-19 patients seems to be essential. Besides, its application in bioequivalence study of ledipasvir 90mg / sofosbuvir 400mg film coated tablets generic and reference products to ensure bioanalytical method reliability. Methods: After extraction of ledipasvir and sofosbuvir from human plasma, it was chromatographed with mobile phase consisting of ammonium formate pH 2.8 : acetonitrile (10 : 90 V/V) at flow rate 0.55ml/min, ESI positive mode, and m/z 889.8130.1, 530.3243.1, 739.4565.3 for ledipasvir, sofosbuvir and daclatasvir (internal Standard) respectively. The bioequivalence study was conducted in a partial replicated crossover design invovlving 36 volunteers. The criteria used to assess bioequivalence of the two products were AUC 0-t, AUC 0-inf, Cmax, and Tmax for sofosbuvir, and AUC 0-72, Cmax, and Tmax for ledipasvir. Results: The described method of analysis showed that the average recovery of Ledipasvir and Sofosbuvir from human plasma was 95.180%, and 94.721%. The limit of quantitation was 0.1ng/ml for both drugs, and the correlation coefficient (r2) was equal to 0.999 for ledpasvir and sofosbuvir. Statistical analysis (ANOVA) of the measured parameters showed that there was no significant difference between the two products. Conclusion: The LC/MS/MS method presented is direct, simple, reproducible, sensitive, and linear for determination of ledipasvir / sofosbuvir in plasma, and is adequate for its clinical pharmacokinetic studies, and use in therapeutic drug monitoring. Besides the generic product was found to be biologically equivalent to the reference product regarding their kinetic behavior.

Background: The liver is the largest gland that plays a role in the plant metabolism and the removal of toxins from the body. Achillea millefolium is familiar herb in traditional medicine. Objective: to investigation the effect of achillea millefolium extract in experiment rats those exposed to hepatic damage by carbon tetrachloride. Methods: Achillea millefolium was collected in the province of Ibb, Yemen, and extracted by maceration method, then physical and phytochemical evaluation were performed for the extract. Finally, evaluation the effect of extract on liver function tests were done on twenty-one female rats were divided into seventh groups, two extract doses 100 mg/kg and 200 mg/kg were used, CCl4 was used for inducer liver toxicity, and liv52 drug used as positive control. Results: the extract has worthy hepatoprotective activity against CCl4 and the groups treated only Achillea millefolium extract as 100mg and 200mg the histological sections no showed any histopathological changes exaggerated from the normal in liver. Also, GPT, GOT, and ALP levels increased with CCl4 treatment but these liver enzyme levels were reduced when treated the rats by concentration 200mg/kg of extract more than by concentration 100mg/kg. Conclusion: the extract of Achillea millefolium has good hepatoprotective activity, may due to presence of flavonoids.

Curry leaves are an important part of spicing up dishes, thus used for garnishing as well as a taste enhancer. Apart from its culinary uses, it has a vast number of therapeutic applications in medicinal as well as cosmetic uses. Curry leaves, biologically named as Murraya koenigii which belongs to family Rutaceae are also called as Meethi Neem or Karipatta or Sweet Neem Leaves. It has a characteristic aroma. It is an important herb mainly of Asian origin. The present review elaborates the description of curry leaves, its chemical composition and about the bioactive compound β-caryophyllene present in it. β-caryophyllene is a sesquiterpene, it has properties such as inhibition of melanogenesis and can reduce melanin synthesis. Curry leaves cream is formulated for the purpose of reduction of dark spots due to presence of β-caryophyllene present in curry leaves. The product should be safe for regular use and must be cosmetically acceptable.

Background: The auricle is a complex part of the sensory organ, and is made of cartilage that is covered with skin. Its function is to capture sound. This study was aimed at knowing the auricular dimensions in Okrika tribe in Rivers state. Methods: Auricular parameters from 401 Okrika indigens from 18 years and above were measured using standard Vernier calliper. The Parameters were ear height (EH), ear width (EW), lobular height (LH) and the lobular width (LW) for both right and left ears with the head of the subject in Frankfort horizontal plane. Results: Data was analyzed using SPSS version 23.0. All the measured parameters were higher in males compared to females in both left and right ears, implying sexual dimorphism. The mean values of all measured parameters in males were higher on the right compared to the left. Except ear index (T = 0.83; P = 0.41), side differences were observed in all other parameters at P < 0.05. Hence auricular parameters are said to be asymmetrical. In females, the mean values of all measured parameters were higher on the right compared to the left. Except ear index (T = 0.95; P = 0.34) and lobular index (T = 1.30; P = 0.19), side differences were observed in all other parameters at P < 0.05. Conclusion: In this study, we observed that all measured parameters were higher in the right ear than in the left and also larger in males than females. This sex related differences were said to be sexually dimorphic. Therefore this study has provided anthropometric data for the okrika tribe, which will be useful in forensic science and ear reconstructive surgeries.

Herpes Zoster Ophthalmicus (HZO), also known as Ophthalmic Zoster, caused by the reactivation of the Varicella Zoster Virus (VZV), VZV reactivation commonly affects the ophthalmic division of the trigeminal nerve and subsequently the eye. HZO is considered an ophthalmologic emergency. The most common complication of HZO is postherpetic neuralgia (PHN). HZO is a diagnosed based on history and cutaneous findings. Antivirals medications such as acyclovir, valacyclovir and famciclovir remain the mainstay of therapy for HZO. HZO represents approximately 10 to 25% of all cases of herpes zoster. Here, we report an interesting case of HZO and it's complication PHN in a 61 years old male patient.

Background: Piperacillin/Tazobactam(Pip/Taz) is a broad-spectrum antibacterial covering aerobic, and anaerobic microorganisms. Pip/Taz plays a major role in treating sepsis, respiratory infection, and intraabdominal infection. Many studies showed inappropriate use of Pip/Taz might increase the risk of resistance. This study aimed to evaluate the appropriateness use of Pip/Taz prescribing in pediatric patients in Peidatric Intensive Care Unit (PICU) at a major tertiary hospital. Method: A retrospective and observational study was conducted to evaluate the appropriateness use of Pip/Taz in PICU. The study included all neonates and pediatrics less than 14 years old in the PICU setting who had received at least dose of Pip/Taz during their admission for the period between Jan 2020 and Jan 2021. Assessment of antimicrobial appropriateness was evaluated according to Infectious Diseases Society of America (IDSA) guidelines. Data were retrieved from the hospital’s Electronic Medical Records (EMRs) and exported to Excel spreadsheet. Results: Of 124 Pip/Taz prescriptions, 34% were inappropriate. The common indications for using Pip/Taz empirically were with sepsis and suspecting of pneumonia. The reasons for inappropriate use of Pip/Taz were due to continue using the drug based on clinical condition even the results of cultures had no growth of organisms 71%, then starting the drug without taking culture 14%, then the drug continued without justification despite culture resulted with no growth 10%, and finally continued without following sensitivity 5%. Conclusion: This study showed that there was inappropriate use of Pip/Taz at PICU. The inappropriate use was attributed to not following the lab results, culture sensitivity and not requesting microbiology culture.

Nowadays, skin disorders are considered very common affecting millions of people worldwide. Ageing, genetic, environmental factors and traumatic injuries are various factors that can lead to several skin disorders. Skin disorders are broadly classified as bacterial, viral, fungal and some other types as well. Some common diagnostic tests relevant for skin disorders include biopsy, scraping, culture, wood light, diascopy and specific skin tests. Medical therapy and physical therapy are the treatment modalities available for skin disorders. Medical therapy includes topical and systemic treatments while physical therapy consists of cryotherapy, phototherapy, photodynamic therapy, lasers and surgery. Topical drugs are the mainstay of treating skin disorders. Systemic drugs are taken directly by oral route or by parenteral route and are distributed throughout the body. The following categories of drugs are divided under topical therapy that includes cleansing agents, protective agents, moisturizing agents, drying agents, anti-itch agents, anti-inflammatory agents, anti-infective agents and keratolytics.

Small-bowel capsule endoscopy (SBCE) is used widely because of its non-invasive and patient-friendly nature. SBCE can visualize entire small-intestinal mucosa and facilitate detection of small-intestinal abnormalities. Indications for SBCE are obscure gastrointestinal bleeding, Crohn’s disease, small-intestinal polyps, tumors and celiac disease. Materials and methods: We report a study from September 2018 to February 2022, including 59 patients who underwent SBCE type PillCam SB3®. All our patients previously had a normal endoscopic assessment (oesogastro-duodenal fibroscopy and ileo-colonoscopy). CT enterography and MR enterography realized in 54.2% of cases were normal. The preparation used is PEG (2l the day before and 0.5l after ingesting the capsule) with clear broth the day before the examination and 10 days off oral iron if taken. Results: The mean age was 53.9 years, with a female predominance (sex ratio: 0.52). 16.9% of the patients had a history of heart disease, 8.4% are chronic renal failure, 5% are followed for Crohn's disease and 3.3% for celiac disease. 10.1% of patients were on anticoagulants and 5% on antiplatelet agents. The indication for SBCE was Obscure gastrointestinal bleeding (OGIB) in 86,3%, Crohn's disease (CD) in 5%, celiac disease in 3,3%, chronic diarrhea in 3,3%, and unexplained edematoascites syndrome in 1,6%. SBCE found small bowel angiodysplasia lesions in 40.6% of patients, small bowel inflammatory lesions in 15% of patients, a submucosal tumor appearance in 6.7% of patients and active small bowel bleeding in 5% patients. The examination did not objectivate small bowel lesion in 25.4% of patients. Non-small bowel lesions have been demonstrated in the form of gastric (16.9% of cases) and cecal (10.1% of cases) angiodysplasia responsible for OGIB. Conclusion: In our study, SBCE showed lesions in 74,6% of cases; dominated by angiodysplasia followed by inflammatory lesions and submucosal tumors and whose indication was essentially OGIB. Enteroscopy with biopsies or with therapeutic gesture, remains essential in the management of these patients.

Introduction: The CTS is one of the clinical syndromes, it was experienced by the patients from numbness, tingling, burning and or pain associated with localized compression of the median nerve at the wrist. Median nerve with the carpel tunnel (CTS) is localized and it was compressed in median nerve, resulting in mechanical compression and local ischemia has been associated with age and sex matched control. Objective: To assess The Relationship between Nerve Conduction Study and Clinical Grading of Carpal Tunnel Syndrome in Bangladesh Population. Methods: A prospective study was conducted at Department of Neurology, Uttara Adhunik Medical College Hospital (UAMCH), Uttara, and Dhaka, Bangladesh from January to December 2021. A total 100 case were prospectively observed for the period of six months 50 patients’ with symptoms consistent with CTS and 50 age and sex matched healthy control subjects were examined. Based on clinical assessment, the study patients were divided into 03 groups with mild CTS, moderate CTS and severe CTS respectively as per Mackinnsons classification. The relationship between the clinical severity grade and various nerve conduction study parameters were correlated. The study was correlated with age and gender matched control intervention and we extrapolate the any significant correlation between the clinical grades and various attributes of study traits. All the traits were carefully assessed by using logistic regression analysis and Fisher F- test statistics. Results: Out of 50 patients with symptoms consistent with CTS and 50 age and sex matched healthy control subjects were examined. The Left hand was involved in 11patients; right hand in 19 patients & 20 patients had involvement of both hands. Numbness and tingling of hand and first three fingers was the most common presenting symptom. Phalens test was positive 30 (60.0%) of our patients. 7(14.0%) pts had hypothyroidism, 10(20%) patients showed raised DM and 4(8.0%) patients showed lipid profile abnormalities. Both male and female sex ratio was 1:3. All cases were considered for the study. The distal motor latency was significantly correlated with different age group of the population and CMAP and conduction velocity not shows any significant relation with clinical severity of CTS. Since, the median sensory latency and nerve conduction velocity seen in study population and well apprehension with clinical different grading of CTS. Conclusion: Summing of the results concludes that, the sensory conduction appears to be more sensitive (95%) AUC 0.89 and significantly correlated when compared to motor conduction attributes, the correlation besides with clinical severity of CTS apart from gender and age matched cases.