Cyclophosphamide (CTX) is an alkylating agent commonly used to treat malignancies and immune-mediated inflammatory nonmalignant processes. It is used off-label for multiple sclerosis (MS) treatment as a disease-modifying therapy (DMT). Acute adverse effects include bone marrow suppression, hemorrhagic cystitis, nausea, vomiting, and hair loss. Hepatotoxicity with high dose CTX is well recognized but low dose CTX induced hepatitis has rarely been described. We report a case of a 28-year-old woman with MS who developed acute icteric hepatitis within 8 weeks of receiving low dose intravenous CTX and methylprednisolone (MP). Liver biopsy showed liver cell necrosis. CTX and steroid treatment were discontinued, and her symptoms and laboratory tests improved. Steroids were reintroduced without relapse; the evolution was favorable with liver enzymes normalization. To the best of our knowledge, this is the first report of acute cholestatic hepatitis developing after administration of low-dose CTX in MS patient. We may suggest that baseline liver function tests and periodic assessment should be monitored during CTX treatment.

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This study is to investigate the antimicrobial activity of leaves of four varieties of Mangiferaindica L., Anacardiaceae, by 4 different solvents (Ethanol 70%, acetone, boiling water and water at 37C°). These extracts were tested for their inhibitory effects using the agar diffusion method at different concentrations (10% and 20%) on nine bacterial strains, five of them are gram-negative (S. typhimurium, S. cerro, Sh. dysenteriae, E.coli and P. mirabilis) and the remaining four are gram-positive (B. cereus, B. lichiniformis, Staph. aureus and L. monocytogenes). The study demonstrated that gram-positive bacteria are more susceptible than gram-negative. It was found that Staph. aureus is the most sensitive pathogen compared to the others, it exhibited the largest inhibition zones in all extracts which reached to maximum with ethanolic extract to give 28mm. Shigelladysenteriae, Echerichia coli and Proteus mirabilis gave a weak response with water 37°C and boiled water extracts of Alphonso leaves at 20% (w/v) concentration, acetone extracts at 20% (w/v) concentration affected Sh. dysenteriae, E.coli and P. mirabilis with zones of inhibition (13, 16 and 12 mm) respectively, also Ethanol extracts at 20% (w/v) concentration affected these strains with zones of inhibition which were 14, 9, and 13mm respectively. Salmonella typhimurium showed no inhibition effects by water 37°C, but with boiled water extracts of Kiett leaves, showed that inhibition zone of 12 mm was formed at 20% (w/v) concentration ,while acetone extracts of Alphonso leaves at 10 and 20% (w/v) concentrations inhibition zones of 9 and 12 mm respectively were formed and ethanol extracts of Alphonso leaves at 10 and 20% (w/v) concentrations afforded inhibition zones of 8 and 11 mm respectively were formed .L. monocytogenes inhibited by all Alphonso leave extractes with maximum inhibition zone 25 mm with 10% (w/v) concentrations acetone and 20% (w/v) concentrations ethanol extracts. It was found that, Alphonso leaves were a source of natural antimicrobial agent in boiled water, acetone and ethanol extracts at 20% (w/v) concentrations and as additive of processed food as natural preservative, these extracts showed inhibition zone diameters near to the antibiotic ciprofloxacin.

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Gastrointestinal stromal tumours (GISTs) are the most common primary mesenchymaltumour of gastro-intestinal tract. Typically, they occur as solitary lesions. Their occurrence as disseminated intra-abdominal tumoursis considered an exceptional event. We report a case of 62 years old male who presented with large abdominal lump. Computed tomography scan showed many hypoattenuating lesions and multiple extrahepatic lesions with same behavior patterns in the coeliomesenteric and retroperitoneal spaces. The diagnosis of GIST was confirmed by immune-histochemical study of the biopsy material. Patient was started on Imatinib therapy. Computed tomography scan done 6 months later showed an decrease in size and lesions number.

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Deficiency of lysosomal enzyme glucocerebrosidase leads to Gauchers disease which is the most common sphingolipidosis. A non-neuronopathic form of gauchers disease as a result of sapocin-C deficiency is a rare entity. Sapocin-c is required for degradation of glucosylseramide and its deficiency results in an atypical form of Gauchers disease. Neonatal cholestasis is defined as a prolonged elevation of conjugated bilirubin beyond 14 days of life. We hereby present a 10 month old male child who presented with neonatal cholestasis due to sapocin-C deficiency, which is the first rare case being reported in literature.

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The T2D is by far the most common form of diabetes in the world. The development of diabetes is usually characterized by frequent and disabling complications. Pre-diabetes is the bed of type 2 diabetes (T2D). T2D often associates insulin resistance and insulinopenia. Insulin resistance which is associated at intolerance of glucose is the main characteristic of pre-diabetes. On the basis of these data, we wanted to study the metabolic characteristics of carbohydrate intolerant subjects to assess the risk of type 2 diabetes. The results of our study shows that all elements of the carbohydrate balance are in favor of an alteration of glycoregulation. Pre-diabetes therefore constitutes a risky metabolic profile and it is imperative to have an effective strategy to prevent or delay the transition from pre-diabetes to diabetes.

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