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

Nanoparticulate material delivery to plants

In recent times, focus on plant research has increased all over the world. Centella asiatica is an important medicinal herb that is widely used in the orient and is becoming popular in the West. Triterpenoid, saponins, the primary constituents of Centella asiatica are manly believed to be responsible for its wide therapeutic actions. Apart from wound healing, the herb is recommended for the treatment of various skin conditions such as leprosy, lupus, varicose ulcers, eczema, psoriasis, diarrhoea, fever, amenorrhea, diseases of the female genitourinary tract and also for relieving anxiety and improving cognition. The present review attempts to provide comprehensive information on pharmacology, mechanisms of action, various preclinical and clinical studies, safety precautions and current research prospects of the herb. At the same time, studies to evaluate the likelihood of interactions with drugs and herbs on simultaneous use, which is imperative for optimal and safe utilization of the herb, are discussed.

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Pharmacological review on Centella asiatica: A potential herbal cure-all

Metal nanoparticles have been studied and applied in many areas including the biomedical, agricultural, electronic fields, etc. Several products of colloidal silver are already on the market. Research on new, eco-friendly and cheaper methods has been initiated. Biological production of metal nanoparticles has been studied by many researchers due to the convenience of the method that produces small particles stabilized by protein. However, the mechanism involved in this production has not yet been elucidated although hypothetical mechanisms have been proposed in the literature. Thus, this review discusses the various mechanisms provided for the biological synthesis of metal nanoparticles by peptides, bacteria, fungi, and plants. One thing that is clear is that the mechanistic aspects in some of the biological systems need more detailed studies.

Mechanistic aspects in the biogenic synthesis of extracellular metal nanoparticles by peptides, bacteria, fungi, and plants

The bactericidal efficiency of various positively and negatively charged silver nanoparticles has been extensively evaluated in literature, but there is no report on efficacy of neutrally charged silver nanoparticles. The goal of this study is to evaluate the role of electrical charge at the surface of silver nanoparticles on antibacterial activity against a panel of microorganisms. Three different silver nanoparticles were synthesized by different methods, providing three different electrical surface charges (positive, neutral, and negative).The antibacterial activity of these nanoparticles was tested against gram-positive (i.e., Staphylococcus aureus, Streptococcus mutans, and Streptococcus pyogenes) and gram-negative (i.e., Escherichia coli and Proteus vulgaris) bacteria. Well diffusion and micro-dilution tests were used to evaluate the bactericidal activity of the nanoparticles. According to the obtained results, the positively-charged silver nanoparticles showed the highest bactericidal activity against all microorganisms tested. The negatively charged silver nanoparticles had the least and the neutral nanoparticles had intermediate antibacterial activity. The most resistant bacteria were Proteus vulgaris. We found that the surface charge of the silver nanoparticles was a significant factor affecting bactericidal activity on these surfaces. Although the positively charged nanoparticles showed the highest level of effectiveness against the organisms tested, the neutrally charged particles were also potent against most bacterial species.

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The effect of charge at the surface of silver nanoparticles on antimicrobial activity against gram-positive and gram-negative bacteria: a preliminary study

Nanotechnology is expected to open some new aspects to fight and prevent diseases using atomic scale tailoring of materials. The ability to uncover the structure and function of biosystems at the nanoscale, stimulates research leading to improvement in biology, biotechnology, medicine and healthcare. The size of nanomaterials is similar to that of most biological molecules and structures; therefore, nanomaterials can be useful for both in vivo and in vitro biomedical research and applications. The integration of nanomaterials with biology has led to the development of diagnostic devices, contrast agents, analytical tools, physical therapy applications, and drug delivery vehicles. In all the nanomaterials with antibacterial properties, metallic nanoparticles are the best. Nanoparticles increase chemical activity due to crystallographic surface structure with their large surface to volume ratio. The importance of bactericidal nanomaterials study is because of the increase in new resistant strains of bacteria against most potent antibiotics. This has promoted research in the well known activity of silver ions and silver-based compounds, including silver nanoparticles. This effect was size and dose dependent and was more pronounced against gram-negative bacteria than gram-positive organisms.

Nanotechnology in medicine and antibacterial effect of silver nanoparticles

Centella asiatica is a herb used since ancient times in Ayurveda to improve cognitive functioning. The current study is aimed at managing mild cognitive impairment (MCI) and other age-related problems in elderly. MCI is a problem which may convert into Alzheimer’s disease in later stages. Although the concept of MCI is based on the presence of specific cognitive deficits, several studies show that subjects with MCI can develop depression and disruptive behaviour (e.g agitation, aggression). The present study was conducted in sixty elderly subjects of age group 65 and above with written consent, registered at the geriatric out patient clinic at S.S. Hospital, BHU. The Diagnostic tool used in this study was Mini Mental State Examination. Also, parameters like Activities of Daily Living, Instrumental Activities of Daily living and Yesavage Geriatric Depression scale were used to monitor the subjects. Centella asiatica aqueous extract was prescribed in a dose of 500mg twice a day (1000 mg daily) for 6 months. A favourable improvement was observed in MCI along with other problems like Hypertension, insomnia, loss of appetite, constipation.

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Effect of centella asiatica on mild cognitive impairment (mci) and other common age-related clinical problems

Angiotensin-converting enzyme (ACE) is the key enzyme of the renin angiotensin system (RAS) which maintains the blood pressure homeostasis in our body. The association of the ACE insertion/deletion (I/D) polymorphism with essential hypertension has been demonstrated by many studies. The purpose of the present study is to investigate the association of the insertion/deletion polymorphism of the ACE gene with hypertension and additive diseases in North Indian population. In total, 222 hypertensive and 218 normotensive adults participated in this hospital-based study. Anthropometric measures, lipids profiles, blood glucose, and blood pressure (BP) measures were collected from participants. ACE I/D polymorphism was determined by using insertion-specific amplification. The mean ages of study groups were 50.35 ± 12.40 and 47.32 ± 11.94 for cases and controls, respectively. Significant differences were observed in the frequencies of DD, ID, and II genotypes among the hypertensive and normotensive groups which were found to be 29.7%, 38.7%, and 31.5% vs. 53.7%, 23.4%, and 22.9%, respectively. It has been observed that the ACE ID genotype was significantly (p < 0.05) higher in hypertensive subjects, whereas, the DD genotype was significantly (p < 0.05) higher in control subjects. A strong association was found between cardiovascular diseases (CVDs) and ID genotype [p = 0.017, odds ratio (OR) = 3.091, 95% confidence interval (CI) = 1.224-7.807]. ID [p = 0.002, OR = 2.020, 95% CI = 1.281-3.185] and II [p = 0.032, OR = 1.677, 95% CI = 1.044-2.694] genotypes are more prone to diabetes with hypertension. This finding suggests that ACE insertion/deletion polymorphism is associated with hypertension and additive diseases in North Indians.

Angiotensin-converting enzyme gene I/D polymorphism increases the susceptibility to hypertension and additive diseases: A study on North Indian patients.

Alzheimer’s disease (AD) is the most common cause of dementia among people of age 65 and older. The diagnosis of sporadic AD is based on clinical exclusion criteria and is only definite at necropsy. So, biochemical markers for AD would be of great value for its early diagnosis. During the last decade, research efforts have focused on developing cerebrospinal fluid (CSF) biomarkers for AD. The diagnostic performance of the CSF biomarkers: Tau protein, the 42-amino acid form of beta amyloid (Aβ42) and Amyloid Precursor Protein are of great importance. One possible biomarker for Alzheimer’s is amyloid beta-derived diffusible ligands (ADDL). The correlation of CSF ADDL levels with disease state offers promise for improved AD diagnosis and early treatment. This is made possible by combining ADDL-specific monoclonal antibodies with an ultrasensitive, nanoparticle-based protein detection strategy termed biobarcode amplification (BCA). This review article explains how this BCA strategy makes clever use of nanoparticles as DNA carriers to improve the sensitivity of detection of Alzheimer’s biomarker.

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Nanotechnology for alzheimer's disease detection

ered at home by spontaneous vaginal delivery. At birth, all were noted to have small penises, with the urethral opening at the tip. The scrotum was small and empty in all of them. They were reared as males, and all had apparently normal growth and development. The two older brothers had male psychosexual orientation. At 13 years of age, the oldest child developed progressive enlargement of the breasts, but failed to develop secondary sexual characteristics (i.e., facial hair, voice change, acne, or genital growth.) Family histories of both father and mother were noncontributory. The patient’s only sister is an 18year-old, normal female; in addition, there is one brother, age 6 years, who has normal testes and normal penile length. The relevant physical findings of the three children are listed in

Shinjini Singh

Papers

Nanotechnology in medicine and antibacterial effect of silver nanoparticles

Effect of centella asiatica on mild cognitive impairment (mci) and other common age-related clinical problems

Angiotensin-converting enzyme gene I/D polymorphism increases the susceptibility to hypertension and additive diseases: A study on North Indian patients.

Nanotechnology for alzheimer's disease detection

Bilateral Congenital Anorchia in Three Siblings