The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

Harrison's Principles of Internal Medicine

LEARNING The objectives of BIOS 781 are to present: OBJECTIVES: 1. basic population and quantitative genetic principles, including classical genetics, chromosomal theory of inheritance, and meiotic recombination 2. an exposure to QTL mapping methods of complex quantitative traits and linkage methods to detect co-segregation with disease 3. methods for assessing marker-disease linkage disequilibrium, including case-control approaches 4. methods for genome-wide association and stratification control.

Genetic Data Analysis

Fluoride is known to occur at elevated concentrations in a number of parts of the world where it can be a significant cause of disease. The primary focus of Fluoride in Drinking Water is the prevention of adverse health effects from excessive levels of fluoride in drinking water. The book fills the urgent need, identified for updating the WHO Guidelines for Drinking-water Quality, for information on the occurrence of fluoride, its health effects, ways of reducing excess levels and methods for analysis of fluoride in water. The draft document, produced by a working group of experts convened to consider protection from fluoride and its control, was issued for extensive review and consultation. The resultant book, which incorporates the comments received, was further peer review by experts in developed and developing countries. It is aimed at a wide range of individuals, including health workers and sanitary engineers who may require a broad introduction to the subject with more detailed guidance in some specific areas. Fluoride in Drinking-water will be an invaluable reference source for all those concerned with the management of drinking-water containing fluoride and the health effects arising from its consumption, including water sector managers and practitioners as well as health sector staff at policy and implementation levels. It will also be of interest to researchers, students, and development workers and consultants. Contents Introduction Environmental occurrence, geochemistry and exposure Human health effects Guidelines and standards Removal of excessive fluoride Analytical methods Country data on dental and skeletal fluorosis associated with exposure to fluoride through drinking water Appendix: Indices of severity of dental fluorosis

Fluoride in Drinking-Water

Differently substituted flavanones were isolated from Leguminosae and their antibacterial activity was comparatively studied against methicillin-resistant Staphylococcus aureus (MRSA). The minimum inhibitory concentrations (MICs) of phytochemical flavanones to clinical isolates of MRSA were determined by a serial agar dilution method. The structure-activity relationship has indicated that 2',4'- or 2',6'-dihydroxylation of the B ring and 5,7-dihydroxylation of the A ring in the flavanone structure are important for significant anti-MRSA activity and that substitution with a certain aliphatic group at the 6- or 8-position also enhances the activity. Among the thirteen flavanones tested, tetrahydroxyflavanones with these structural characteristics isolated from Sophora exigua and Echinosophora koreensis showed intensive activity to inhibit the growth of all MRSA strains at 3.13-6.25 micrograms/ml. The present hydroxyflavanones would be useful in the phytotherapeutic strategy against MRSA infections.

Comparative Study on the Antibacterial Activity of Phytochemical Flavanones against Methicillin-resistant Staphylococcus aureus.

Infectious diseases remain one of the leading causes of morbidity and mortality worldwide. The WHO and CDC have expressed serious concern regarding the continued increase in the development of multidrug resistance among bacteria. Therefore, the antibiotic resistance crisis is one of the most pressing issues in global public health. Associated with the rise in antibiotic resistance is the lack of new antimicrobials. This has triggered initiatives worldwide to develop novel and more effective antimicrobial compounds as well as to develop novel delivery and targeting strategies. Bacteria have developed many ways by which they become resistant to antimicrobials. Among those are enzyme inactivation, decreased cell permeability, target protection, target overproduction, altered target site/enzyme, increased efflux due to over-expression of efflux pumps, among others. Other more complex phenotypes, such as biofilm formation and quorum sensing do not appear as a result of the exposure of bacteria to antibiotics although, it is known that biofilm formation can be induced by antibiotics. These phenotypes are related to tolerance to antibiotics in bacteria. Different strategies, such as the use of nanostructured materials, are being developed to overcome these and other types of resistance. Nanostructured materials can be used to convey antimicrobials, to assist in the delivery of novel drugs or ultimately, possess antimicrobial activity by themselves. Additionally, nanoparticles (e.g., metallic, organic, carbon nanotubes, etc.) may circumvent drug resistance mechanisms in bacteria and, associated with their antimicrobial potential, inhibit biofilm formation or other important processes. Other strategies, including the combined use of plant-based antimicrobials and nanoparticles to overcome toxicity issues, are also being investigated. Coupling nanoparticles and natural-based antimicrobials (or other repurposed compounds) to inhibit the activity of bacterial efflux pumps; formation of biofilms; interference of quorum sensing; and possibly plasmid curing, are just some of the strategies to combat multidrug resistant bacteria. However, the use of nanoparticles still presents a challenge to therapy and much more research is needed in order to overcome this. In this review, we will summarize the current research on nanoparticles and other nanomaterials and how these are or can be applied in the future to fight multidrug resistant bacteria.

/pdf/nano-strategies-to-fight-multidrug-resistant-bacteria-a-31jw0w0kam.pdf

Nano-Strategies to Fight Multidrug Resistant Bacteria-"A Battle of the Titans".

Cassia occidentalis L.: a review on its ethnobotany, phytochemical and pharmacological profile.

The exploration of nanoscale materials for their therapeutic potential against emerging and re-emerging infections has been increased in recent years. Silver nanoparticles (AgNPs) are known to possess antimicrobial activities against different pathogens including viruses and provide an excellent opportunity to develop new antivirals. The present study focused on biological synthesis of AgNPs from Andrographis paniculata, Phyllanthus niruri, and Tinospora cordifolia and evaluation of their antiviral properties against chikungunya virus. Synthesized plants AgNPs were characterized to assess their formation, morphology, and stability. The cytotoxicity assays in Vero cells revealed that A. paniculata AgNPs were most cytotoxic with maximum non-toxic dose (MNTD) value of 31.25 μg/mL followed by P. niruri (MNTD, 125 μg/mL) and T. cordifolia AgNPs (MNTD, 250 μg/mL). In vitro antiviral assay of AgNPs based on degree of inhibition of cytopathic effect (CPE) showed that A. paniculata AgNPs were most effective, followed by T. cordifolia and P. niruri AgNPs. The results of antiviral assay were confirmed by cell viability test using 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) dye, which revealed that A. paniculata AgNPs inhibited the virus to a maximum extent. The cell viability of CHIKV-infected cells significantly increased from 25.69% to 80.76 and 66.8%, when treated with A. paniculata AgNPs at MNTD and ½MNTD, respectively. These results indicated that use of plants AgNPs as antiviral agents is feasible and could provide alternative treatment options against viral diseases which have no specific antiviral or vaccines available yet.

Green synthesis of silver nanoparticles from medicinal plants and evaluation of their antiviral potential against chikungunya virus.

Plants have traditionally been used as a source of medicine in India by indigenous people of different ethnic groups inhabiting various terrains for the control of various ailments afflicting human and their domestic animals. The indigenous community of snake charmers belongs to the 'Nath' community in India have played important role of healers in treating snake bite victims. Snake charmers also sell herbal remedies for common ailments. In the present paper an attempt has been made to document on ethno botanical survey and traditional medicines used by snake charmers of village Khetawas located in district Jhajjar of Haryana, India as the little work has been made in the past to document the knowledge from this community. Ethno botanical data and traditional uses of plants information was obtained by semi structured oral interviews from experienced rural folk, traditional herbal medicine practitioners of the 'Nath' community. A total of 42 selected inhabitants were interviewed, 41 were male and only one woman. The age of the healers was between 25 years and 75 years. The plant specimens were identified according to different references concerning the medicinal plants of Haryana and adjoining areas and further confirmation from Forest Research Institute, Dehradun. The present study revealed that the people of the snake charmer community used 57 medicinal plants species that belonged to 51 genera and 35 families for the treatment of various diseases. The study has brought to light that the main diseases treated by this community was snakebite in which 19 different types of medicinal plants belongs to 13 families were used. Significantly higher number of medicinal plants was claimed by men as compared to women. The highest numbers of medicinal plants for traditional uses utilized by this community were belonging to family Fabaceae. This community carries a vast knowledge of medicinal plants but as snake charming is banned in India as part of efforts to protect India's steadily depleting wildlife, this knowledge is also rapidly disappearing in this community. Such type of ethno botanical studies will help in systematic documentation of ethno botanical knowledge and availing to the scientific world plant therapies used as antivenin by the Saperas community.

/pdf/indigenous-knowledge-of-medicinal-plants-used-by-saperas-2oclzjted5.pdf

Indigenous knowledge of medicinal plants used by Saperas community of Khetawas, Jhajjar District, Haryana, India.

In vitro antioxidant activity and total phenolic content of endophytic fungi isolated from Eugenia jambolana Lam.

Pseudomonas aeruginosa infection is a leading cause of morbidity and mortality in burn and immune-compromised patients. In recent studies, researchers have drawn their attention towards ecofriendly synthesis of nanoparticles and their activity against multidrug resistant microbes. In this study, silver nanoparticles were synthesized from aqueous extract of Phyllanthus amarus. The synthesized nanoparticles were explored as a potent source of nanomedicine against MDR burn isolates of P. aeruginosa. Silver nanoparticles were successfully synthesized using P. amarus extract and the nature of synthesized nanoparticles was analyzed by UV-Vis spectroscopy, transmission electron microscopy, energy dispersive X-ray spectroscopy, dynamic light scattering, zeta potential, X- ray diffraction and fourier transform infra-red spectroscopy. The average size of synthesized nanoparticles was 15.7, 24±8 and 29.78 nm by XRD, TEM and DLS respectively. The antibacterial activity of AgNPs was investigated against fifteen MDR strains of P. aeruginosa tested at different concentration. The zone of inhibition was measured in the range of 10±0.53 to 21±0.11mm with silver nanoparticles concentration of 12.5 to 100 µg/ml. The zone of inhibition increased with increase in the concentration of silver nanoparticles. The MIC values of synthesized silver nanoparticles were found in the range of 6.25 to12.5 µg/ml. The MIC values are comparable to the standard antibiotics. The present study suggests that silver nanoparticles from P. amarus extract exhibited excellent antibacterial potential against multidrug resistant strains of P. aeruginosa from burn patients and gives insight of their potential applicability as an alternative antibacterial in the health care system to reduce the burden of multidrug resistance.

/pdf/green-silver-nanoparticles-of-phyllanthus-amarus-as-an-1acjbrs4sh.pdf

Jaya Parkash Yadav

Papers

Cassia occidentalis L.: a review on its ethnobotany, phytochemical and pharmacological profile.

Green synthesis of silver nanoparticles from medicinal plants and evaluation of their antiviral potential against chikungunya virus.

Indigenous knowledge of medicinal plants used by Saperas community of Khetawas, Jhajjar District, Haryana, India.

In vitro antioxidant activity and total phenolic content of endophytic fungi isolated from Eugenia jambolana Lam.

Green silver nanoparticles of Phyllanthus amarus: as an antibacterial agent against multi drug resistant clinical isolates of Pseudomonas aeruginosa