Autism or autism spectrum disorder (ASD) is a lifelong developmental disorder that impairs the ability of individuals to communicate and interact with the world around them. Autism impacts the nervous system and is considered as a syndrome with multiple non-genetic and genetic causes [1]. Autism affects the wide spectrum of developmental disorders characterized majorly by impairments in three behavioral domains such as lack of social interaction; impairment in language, communication, or creative play; and lack of interest in a range of personal and educational activities [2,3]. The range and severity of symptoms associated with autism varies from individual to individual depending on the severity of disorder. The most common symptoms are repetitive or ritualistic behavior, hand flapping, spinning or running in circles, excessive fears, self-injury such as head banging or biting, aggression, insensitivity to pain, temper tantrums, and sleeping and eating disturbances [4,5]. In addition, individuals with autism often have abnormal responses to sounds, touch, or other sensory stimulation [4,5]. Early recognition of autism behavior, parenting educational programs for autism management are the keys to reduce symptoms and to support development and learning of patients with autism [6,7].             Autism is one of the most common neurological developmental disabilities that generally manifests by the age of three and continues throughout life [8,9]. The nation with the highest rate of diagnosed autism in all over the globe is Qatar, and the nation with the lowest rate is France [10]. In Australia, autism was recently estimated in 1% of all Australians, which is similar to the rest of the world [10-12]. In 2018, 205,200 Australians were reported with autism and this number was 25.1% more as was reported in 2015 [11,12]. Importantly, the prevalence of autism was reported to be four times more in males as compared with females [10] but the reason(s) associated with this prevalence is still largely unexplored. It has now been suggested that autism is a genetic disorder and poor parenting plays a fundamental role in its onset [13-15]. In support of this, recent studies investigated that several individuals from the same family have genetic predisposition to autism [16-18]. It has now been established that the genetic level of diagnosable autism such as cytogenetic abnormalities, single-gene defects such as tuberous sclerosis complex, fragile X syndrome, and other rare diseases all together account only less than 10% of autism cases [19]. Therefore, studies at genetic level are still immature and need to be further explored. Studies also point out that several regions have been affected due to the autism onset, particularly at the stage of early fetal brain development [20,21]. In addition, several epidemiologic studies indicate that environmental factors such as toxic exposures, teratogens, perinatal insults, and prenatal infections have also been associated with this neurological disorder [22]. Moreover, people from all over the globe believed that the immunization with the measles-mumps-rubella vaccine has been associated with autism onset but studies at molecular levels failed to prove this assumption [23]. Now it has been well established that autism has been associated by multiple factors, therefore it is suggested that it needs to be treated during a childhood as untreated autism cases are difficult to treat at their later stages of life, therefore the best treatment begins early during the preschool years. Although a variety of drugs are available for the treatment of autism based on the specific symptoms, parent education about the behavioral therapies play a fundamental therapeutic role in treating their children with autism. Multiple studies suggested that poor parenting results in epilepsy in about one third of autistic children [24,25]. Therefore, intensive educational therapeutic programs for parents are extremely important for the treatment of patients with autism at childhood level so that every autistic child should get the best opportunity to develop the skills that are needed to live the best life.

Objectives: In this study, we implemented a structure-based virtual screening (VS) protocol in search of natural bioactive compounds in Clitoria ternatea that could inhibit the viral M pro . Methods : A library of twelve main bioactive compounds in Clitoria ternatea was created from PubChem database by minimizing ligand structure in PyRx software to increase the ligand flexibility. Molecular docking studies were performed by targeting M pro (PDB ID: 6lu7) via Discovery Studio Visualiser and PyRx platforms. Top hits compounds were then selected to study their ADMET and druglikeness properties via pkCSM pharmacokinetics tool to understand the stability, interaction, conformational changes, and pharmaceutical relevant parameters. Results: This investigation found that, in the molecular docking simulation, four bioactive compounds (procyanidin A2 (-9.3 kcal/mol), quercetin-3-rutinoside (-8.9 kcal/mol), delphinidin-3-O-glucoside (-8.3 kcal/mol) and ellagic acid (-7.4 kcal/mol)) showed producing the strongest binding affinity to the M pro of SARS-CoV-2, as compared to positive control (N3 inhibitor) (-7.5 kcal/mol). These binding energies were found to be favorable for an efficient docking and resultant. Additionally, the stability of quercetin-3-rutinoside and ellagic acid is higher without any unfavourable bond. The ADMET and druglikeness of these two compounds were found that they are considered an effective and safe COVID-19 inhibitors through Lipinski’s Rule, absorption, distribution, metabolism and toxicity properties. Conclusion: From these results, it was concluded that Clitoria ternatea possess potential therapeutic properties against COVID-19.

Objectives: Diaphragm is dome-shaped fibro-muscular assembly, composed of central tendon surrounded by peripheral muscle fibers. It plays a significant role in respiration and maintenance of lumber spine stability. Any condition that interferes with diaphragmatic innervation, contractile muscle function or mechanical coupling to chest wall can cause diaphragm dysfunction; which is usually manifests as elevation at chest radiography. Functional imaging with M-mode ultrasonography has been used in assessment of diaphragm kinetics in a variety of normal and pathological conditions. In this study; we evaluate the departmental ultrasound accuracy in diaphragm motion assessment and compare its results with other institutional parameters.   Methods: We retrospectively reviewed the recorded laboratory investigation and chest radiograph of 163 pediatric patients. A total of 131 patients met clinical inclusion criteria for our study, patients under age of 14 years having clinical suspicion of diaphragmatic dysfunction. Patients having neuromuscular blockers, surgical plication and phrenic nerve pacing were excluded. The mean age was 1.6 (SD 2.6) years and there were 44.3% of male and 55.7% of female patients. Results: The data demonstrated that ultrasonography is a highly sensitive and specific diagnostic tool compared to X-ray and laboratory investigation and clinical suspicion. The second-best results were obtained by X-ray and less accurate results were obtained by laboratory investigation. Conclusion: In proper sonographic technique; diaphragmatic ultrasound appears to be a valid and reliable diagnostic too; for diaphragmatic dysfunction. Diaphragm ultrasound may act as an imaging tool guiding rehabilitation success in diaphragmatic dysfunction cases.

Objective: We studied the presence of mutations in the chromosomal quinolone resistance-determining regions (QRDRs) of the fluoroquinolone targets gyrA and parC genes and detected the carbapenem resistance (CR) encoding genes among A. baumannii and E. coli isolates from catheter-related bloodstream infections (CRBSIs). Methodology: The study included 39 non-duplicate isolates of A. baumannii (14/39, 35.9%) and E. coli (25/39, 64.1%) isolated from 128 confirmed CRBSIs cases. Antimicrobial susceptibility testing was performed, followed by an evaluation of biofilm formation using the tissue culture plate method. The carbapenemase encoding genes were detected by multiplex polymerase chain reaction (PCR). The mutations in QRDRs of gyrA and parC genes were determined by singleplex PCR amplification followed by DNA sequencing and BlastN analysis in the GenBank database. DNA and the translated amino acid sequences were analyzed using the Mega7 bioinformatics tool. Results: MDR E. coli and A. baumannii isolates harboured CR encoding genes and combined gyrA and parC genes mutation. The specific substitutions observed in GyrA were Cys173Arg, Cys174Gly, Asp80Val, Tyr178ASP, Tyr84Gly, Glu85Lys, Ser172Leu, and Asp176Asn, while the specific substitutions observed in the ParC amino acid sequence were point mutation 62 Arg, Phe60Leu, Ils66Val, and Gln76Lys. Point mutation 62Arg was detected in two A. baumannii isolates, whereas Ser172Leu mutation was observed in two E. coli isolates. Conclusion: The presence of new single and multiple mutations in QRDR causes the emergence of MDR E. coli and A. baumannii infections in CRE in Egypt, requiring further investigation in Gram-negative bacteria.

Objective : The study aimed to determine the anti-diarrheal and anti-inflammatory activities of hydroethanolic extract of ripe Annona muricata fruit pulp (HEAMP) on Wistar rats. Methods: Fifty male Wistar rats were divided into five groups, each for the diarrhea and inflammatory phases. Groups A and B 10 mL/kg of distilled water and 2 mL of castor oil, Groups C, D, and E received 2 mL of castor oil + extract (150, 300, and 600 mg/kg). Groups A and B received 10 mL/kg of distilled water and 0.1 mL of egg white. Groups C, D, and E received the (0.1 mL) egg white and extract (150, 300, and 600 mg/kg). Data were analyzed using SPSS (25) using ANOVA followed by post hoc least significant difference, presented as mean ± standard error of the mean, and values considered significant at P < 0.05. Results: The acute toxicity test of HEAMP is above 5000 mg/kg and rich in flavonoids, saponins, and proteins, with carbohydrates and tannins, and glycosides at moderate levels. Steroids, alkaloids, amino acids, and triterpenoids were absent. Furthermore, 30 min after diarrhea induction, the treated groups significantly increased (P = 0.012) in fecal count compared to Group A. Compared to Group B, the treated groups had a significant decrease in the fecal count at 60, 90, 120, and 150 min. At 30-min, there was a significant increase (P = 0.000) in paw-size in the treated groups compared to Group A. The treated groups had significantly lower edematous paw-size levels from 60 to 150 min compared to Group B. Conclusion: The HEAMP had anti-diarrheal and anti-inflammatory properties and is safe for consumption.

Objective: Urinary bladder cancer (UBC) is the fourth most common cancer among men and tenth most common cancer in women. This study investigated an association of IL-17A promoter region SNP-rs2275913 with urinary bladder cancer in Pakistani population. Methods: Population based study was designed with 127 UBC patients and 100 healthy individuals. Only UBC Patients were included and other diseases hepatitis or any other malignancy/cancer were excluded from the study. PCR-RFLP technique was used to genotype the rs2275913 SNP in patients and control. Linear regression analysis was performed on the genotype data and allelic frequency data. Online statistical tool was used to calculate ratio of odds. Results: Linear regression analysis showed that there was no association between rs2275913 SNP and UBC patients in the dominant model (OR=0.815, CI=0.415-1.6), recessive model (OR=0.389, CI=0.014-5.565), co-dominant model (OR=0.376, CI=0.013-5.420) and (OR=0.855, CI=0.427-1.713). Moreover, among the UBC samples, low grade non-muscle invasive UBC samples dominant model (OR=0.722, CI=0.316-1.637), recessive model (OR=0.000, CI=0.000-5.864), co-dominant model (OR=0.864, CI=0.030-12.668) and (OR=0.788, CI=0.341-1.806) did also not show any association. When same analysis was performed for high grade muscle invasive UBC, dominant (OR=0.936, CI=0.403-2.155), recessive model (OR=0.875, CI=0.031-12.696) and co-dominant model (OR=0.864, CI=0.030-12.668,) and (OR=0.942, CI=0.394-2.232) did not show any association. Conclusions: Results revealed that, rs2275913 did not show any associated with the high risk of UBC in Pakistani population. Some limitations of the studies is firstly, the samples size and other is detailed information on UBC and role of inflammation.

This case report is about a 19-month-old boy, product of an in vitro fertilization twin pregnancy and born to young non-consanguineous parents, who presented with speech and motor developmental delay. Upon genetic evaluation, he was found to have the rare variant XXXYY of Klinefelter syndrome.