Background: Allergic bronchopulmonary aspergillosis (ABPA) is an immunological disorder caused by hypersensitivity to Aspergillus fumigatus, frequently complicating asthma in children. However, limited data are available regarding its clinical profile and management in pediatric populations in India.

Objective: This study investigates the clinical features, diagnostic findings, and therapeutic outcomes of ABPA in children with asthma across three tertiary care centers in India.

Methods: A prospective, multicenter observational study was conducted between January 2020 and December 2023, including children aged 6–18 years with asthma and ABPA. Data on clinical presentation, laboratory parameters, imaging findings, and treatment responses were collected and analyzed.

Results: Of 120 enrolled children, uncontrolled asthma was present in 65%, central bronchiectasis in 55%, and recurrent pulmonary infiltrates in 70%. Elevated total IgE levels (>1,000 IU/mL) and positive Aspergillus fumigatus-specific IgE were observed in all cases. Treatment with corticosteroids and itraconazole led to symptom resolution in 78%, although relapses occurred in 22%.

Conclusion: This study emphasizes the importance of early diagnosis and standardized treatment of ABPA in asthmatic children to prevent long-term pulmonary complications.

Background: Preeclampsia is a major hypertensive disorder in pregnancy, contributing significantly to maternal and fetal morbidity and mortality worldwide.Objective:To assess the diagnostic accuracy and clinical applications of Placental Growth Factor (PlGF) in predicting preeclampsia among pregnant women. Method: A cross-sectional study was conducted at Barasat Government Medical College, Kolkata, from January 2023 to December 2023. A total of 100 pregnant women presenting after 20 weeks of gestation were enrolled. Serum PlGF levels were quantified using enzyme-linked immunosorbent assay (ELISA). Participants were categorized into preeclamptic (n=30) and normotensive (n=70) groups based on standard clinical criteria. Diagnostic performance of PlGF was evaluated by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic (ROC) curve. Additionally, logistic regression analysis was performed to determine the independent association of PlGF with preeclampsia. Result: Among the 100 patients, 30 (30%) were diagnosed with preeclampsia. The mean PlGF level was significantly lower in the preeclamptic group (100 ± 20 pg/mL) compared to the normotensive group (300 ± 50 pg/mL, p<0.001). PlGF demonstrated a diagnostic accuracy of 85%, with a sensitivity of 90%, specificity of 80%, PPV of 75%, and NPV of 92%. The ROC analysis yielded an area under the curve (AUC) of 0.88 (95% CI: 0.81-0.95), indicating high diagnostic performance. Logistic regression revealed that low PlGF levels were independently associated with preeclampsia (Odds Ratio = 5.2, 95% CI: 2.1-12.8, p=0.001). Furthermore, cost-effectiveness analysis suggested that incorporating PlGF testing into routine prenatal care could reduce overall healthcare expenditures by approximately 20%, primarily through early detection and timely intervention. Conclusions: Placental Growth Factor is a highly accurate biomarker for predicting preeclampsia, offering substantial clinical benefits in early diagnosis and management. Its integration into prenatal screening protocols can enhance maternal and fetal outcomes while optimizing healthcare resources.

Background: Actaea racemosa (Black Cohosh) is traditionally used for the treatment of menopausal symptoms such as hot flushes, night sweats and hormonal imbalances. The bioactive ingredients of the plant (alkaloids, flavonoids and phenolic acids) are believed to be responsible for its therapeutic effect as an herbal remedy. Nevertheless, more in-depth understanding of these compounds and the manner by which they can potentially help medicine are important moving-forward to justify this plant for modern medical use.

METHOD: This research presented a systematic phytochemical screening and isolation of bioactive compounds from Actaea racemosa. Maceration, percolated and hydrodistillation were the extraction methods used to detect and identify major compounds. Tests for alkaloids, flavonoids and phenolic acids together with other pharmaceutically useful constituents were also conducted through well known standard phytochemical procedures.

Results: This study confirmed reports of alkaloids, flavonoids and phenolic acids in these extracts consistent with the traditional use of Actaea racemosa for menopause. With the estrogenic, anti-inflammatory and antioxidant properties these compounds have they provide positive affects in decreasing all of those menopausal symptoms. Also, potential indications beyond menopause could be considered based on the bioactive compounds identified that may have relevance to inflammation and oxidative stress-related conditions.

Conclusion: This study validates that Actaea racemosa contains therapeutically pertinent bioactive constituents, thereby confirming its traditional use in treating menopausal symptoms. Research, to elucidate its complete medicinal profile especially in anti-inflammatory and antioxidant capacities. Actaea racemosa could have wider therapeutic applications in modern African herbal medicine provided we first advance our knowledge on how it works.

Defensive medicine, the practice of excessive or unnecessary interventions to protect healthcare providers from legal liability, is prevalent in high-risk specialties like cardiology. This paper explores the dynamics of defensive medicine in cardiac care, highlighting its causes, legal frameworks, ethical dilemmas, and potential impacts. Defensive practices, driven by fear of malpractice litigation, blur the line between optimal patient care and legal self-protection, leading to increased healthcare costs and ethical challenges. Legal frameworks, while designed to safeguard patient and provider rights, inadvertently contribute to defensive behavior, with cardiology being notably affected. Ethical concerns arise as defensive strategies prioritize litigation avoidance over patient welfare, complicating the doctor-patient relationship and undermining professional integrity. Case studies reveal the pervasive fear of litigation and the varied approaches to managing defensive communication and accountability in practice. The paper concludes with recommendations for legal reforms, educational initiatives, and a shift towards patient-centered care. Collaborative efforts among healthcare professionals, legal experts, and policymakers are essential to mitigate defensive medicine's adverse effects and promote a balanced, trust-driven healthcare system. Future research is needed to explore the relationship between defensive practices and health outcomes, particularly in cardiology, aiming to foster a paradigm shift toward ethical, patient-focused care.

Metformin is an oral antihyperglycemic drug used mainly as a first line of treatment for type 2 diabetes mellitus (T2DM), it was also taken into consideration as a potential therapy in several other diseases and conditions. Metformin was initially obtained from the plant Galega officinalis, popularly known as French lilac, and this drug has been part of ancient medical practices since medieval times. This review discourses the mechanism of action through which metformin exerts its beneficial effects through its action on AMP-activated protein kinase (AMPK); it also considers relevant pathways modulated by metformin and how this relates to glucose homeostasis. We also place emphasis on evidence from the most recent clinical studies supporting its therapeutic role in improving renal function, reducing cardiovascular risk factors, and attenuating certain cancers. The new reports that imply life-span extension through metformin-induced metabolic reprogramming have driven much interest in the potential use of the drug as an anti-aging agent. Understanding the pleiotropic effects of metformin may provide a basis to exploit them for the therapeutic use beyond T2DM. This review hi lights both direct and indirect mechanisms whereby metformin exerts its beneficial effects beyond its original indication of T2DM, while discussing possible future replacements for this drug.

Scabies, a highly contagious dermatologic condition caused by the Sarcoptes scabiei mite, affects millions globally, particularly in resource-poor regions. The disease leads to severe itching, skin lesions, and complications such as secondary bacterial infections, including septicaemia, and systemic conditions like heart and kidney disease. Scabies is increasingly recognized as a neglected tropical disease by the World Health Organization (WHO), with its highest burden in tropical and impoverished areas. Diagnosis is challenging due to its similarity to other skin conditions, and treatment resistance is emerging in scabies mites, making effective management difficult. Current treatments, including topical permethrin and systemic ivermectin, are effective but may be costly or difficult to access in endemic regions. This manuscript reviews the epidemiology, pathogenesis, challenges in diagnosis, treatment resistance, and emerging therapeutic options for scabies. It highlights the need for improved diagnostic methods, alternative therapies, and a more robust global effort to control the disease, especially in high-risk populations.

Mouth ulcers are a common condition that can cause significant pain and discomfort, often leading individuals to alter their food choices while the healing process takes place. Two of the most prevalent causes of oral ulcerations are local trauma (such as accidental biting or injury to the mouth) and aphthous stomatitis (commonly known as canker sores). This review aims to explore the underlying causes of mouth ulcers, along with the factors that contribute to their development. Herbal medicine plays a crucial role in primary healthcare due to its cultural acceptability, compatibility with the human body, and minimal side effects. This review highlights several herbal remedies used for treating mouth ulcers, including Aloe vera, Guava, Capsicum annum, Papaya, Glycyrrhiza glabra, Turmeric, and Noni fruit. For each of these plants, we examine their biological source, botanical family, morphology, chemical constituents, and their therapeutic uses.

Acute coronary syndrome (ACS) is a major cause of morbidity and mortality worldwide, with complex pathophysiology involving inflammation, infection, and microbial dysbiosis. This study aims to evaluate the role of serum biomarkers, gut microbiota composition, and pathogenic infections in predicting cardiovascular outcomes in ACS patients. A cohort of 200 patients diagnosed with ACS was monitored over 12 months. Serum biomarkers, including high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and troponins, were measured at baseline and during follow-up. Gut microbiota analysis was performed using 16S rRNA sequencing, and pathogenic infections were assessed by blood cultures and PCR. The results revealed significant associations between elevated biomarkers and adverse cardiovascular events. Altered gut microbiota, with reduced microbial diversity and increased pro-inflammatory species, was strongly linked to poorer outcomes. Furthermore, pathogenic infections, particularly those caused by Gram-negative bacteria, were prevalent in ACS patients and correlated with adverse cardiovascular events. This study underscores the importance of integrating serum biomarkers, gut microbiota analysis, and infection status in predicting cardiovascular outcomes in ACS patients