Background: The rapid emergence of multidrug-resistant (MDR) bacterial pathogens has severely limited therapeutic options. Antimicrobial peptides (AMPs) represent a promising alternative class of agents because of their rapid bactericidal action and relatively low propensity for resistance development. This study evaluated three newly designed cationic amphipathic peptides (AMP-NV1, AMP-NV2 and AMP-NV3) as potential therapeutic candidates against clinically relevant MDR bacteria. Materials and Methods: Peptides were synthesised by solid-phase Fmoc chemistry and purified to >95 % purity. Minimum inhibitory and bactericidal concentrations (MIC/MBC) were determined against a panel of MDR isolates including methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum β-lactamase-producing Escherichia coli, carbapenem-resistant Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii. Time-kill kinetics, biofilm inhibition and eradication, membrane permeabilisation, haemolysis, cytotoxicity toward mammalian cells, checkerboard synergy with conventional antibiotics, serial-passage resistance induction, and efficacy in a murine thigh-infection model were assessed. Results: AMP-NV2 exhibited the broadest and most potent activity, with MIC values of 2–8 µg ml−1 against all tested MDR strains. Unexpectedly, AMP-NV2 retained full potency under high-salt and serum conditions and showed slower resistance development than ciprofloxacin over 20 serial passages. An unanticipated finding was the strong synergistic interaction of AMP-NV2 with colistin against carbapenem-resistant P. aeruginosa (FICI ≤ 0.25). Haemolysis remained below 5 % at 128 µg ml−1 and cytotoxicity toward HaCaT and HEK293 cells was minimal (IC50 > 256 µg ml−1). In the murine thigh model, AMP-NV2 reduced bacterial burden by 3.1–3.8 log10 CFU relative to vehicle controls. Conclusions: AMP-NV2 combines potent, broad-spectrum activity against MDR pathogens with favourable selectivity, salt/serum stability and synergistic potential. These properties position it as a strong candidate for further preclinical development as an alternative or adjunctive therapeutic agent for multidrug-resistant bacterial infections.

The objective of this study was to determine and compare the in vitro antibacterial susceptibility of 1008 Pseudomonas aeruginosa isolates obtained from 2800 clinical specimens received at a large hospital setting at Karachi, Pakistan between January 2008 and September 2008. Despite the widespread availability of antibiotics, it remains the most common bacterial infection in the humans. A total of 2800 clinical specimens were analysed for isolation and identification using standard isolation techniques mentioned in ASM’s Clinical Microbiology Manual [1]. Finally, 1008 found to be significant with Pseudomonas aeruginosa (36%), and subjected to antibiotic susceptibility testing in accordance with Kirby and Bauer disc diffusion method [2] and CLSI/NCCLS guidelines 2003 & 2007[8,9] , The isolated pathogens showed resistant to Amikacin (08%), Ceftriaxone(15%), Cefotaxime (16%), Sulzone (Cefapeozone+Sulbactum) (07%), Meropenam (08%), Ciprofloxacin (11%), and Fosfomycin (18%). The results showed considerable variability in the size of zone of inhibition depending on which antibiotic was used. This study also reveals that resistance is developing to Imipenem, and Pseudomonas aeruginosa still remains an important cause of nosocomial infections.

Human nutrition is a poorly understood aspect of medical care. The nutritional state of patients is an essential component of overall treatment yet doctors have a poor understanding of this field of medicine. This review will highlight aspects of identifying malnutrition by nutritional screening and nutritional assessment. Generalized nutritional support and treatment options available in specific disease processes will also be discussed.

Chronically ill patients with neurodegenerative, neurobehavioral and psychiatric diseases commonly have systemic and central nervous system bacterial and viral infections. In addition, other chronic illnesses where neurological manifestations are routinely found, such as fatiguing and autoimmune diseases, Lyme disease and Gulf War illnesses, also show systemic bacterial and viral infections that could be important in disease inception and progression or in increasing the number and severity of signs and symptoms. Evidence of Mycoplasma species, Chlamydia pneumoniae, Borrelia burgdorferi, human herpesvirus-1, -6 and -7 and other bacterial and viral infections revealed high infection rates in the above illnesses that were not found in controls. Although the specific roles of chronic infections in various diseases and their pathogeneses have not been carefully determined, the data suggest that chronic bacterial and/or viral infections are common features of progressive chronic diseases Abbreviations: Ab beta amyloid; AD Alzheimer’s disease; ADHD attention-deficit/hyperactivity disorder; ALS amyotrophic lateral sclerosis; ASD autism spectrum disorders; EBV Epstein-Barr virus; CFS chronic fatigue syndrome; CFS/ME chronic fatigue syndrome/myalgic encephalomyopathy; CI confidence interval; CMV cytomegalovirus; CSF cerebrospinal fluid; CNS central nervous system; ELISA enzyme linked immunoabsorbant assay; GWI Gulf War illnesses; HHV human herpes virus; HSV herpes simplex virus; PCR polymerase chain reaction; PD Parkinson’s disease

Autistic Spectrum Disorders are neurodevelopmental disorders which are classified under the label of Pervasive Developmental disorders. As many as six in every thousand children may be affected by an autistic spectrum disorder. These children exhibit impairment in communication, socialization and restricted and repetitive interests, movements and activities. This article will discuss the distinction between autism, Asperger’s Syndrome and Pervasive Developmental Disorder and give an outline of a comprehensive assessment procedure. Assessment should include a history of the child’s development, observation, school report and a profile of the child’s strengths and weaknesses. However, it is important that potential differential diagnoses as well as conditions associated with autism are also considered. Many theories about the causes of autism have been suggested, including the MMR vaccine. Recent research has suggested that there is no link between the vaccine and autism. There is no cure for autism, but intervention and management techniques should be aimed at educating parents and carers about the disorder and behavioural interventions to aid the child’s skills development

Barrett’s Oesophagus (BO) describes a histological abnormality of the lower oesophagus widely accepted to be associated with gastro-oesophageal reflux disease (GORD). The nature of this disease has been a subject of debate since its description by Tileston in 1906 as peptic ulceration of the oesophagus. Barrett himself initially theorised that the abnormal oesophagus was in fact stomach that had been pulled into the chest by a congenitally short oesophagus (1). This idea was ultimately challenged as the area in question lacked a peritoneal covering, contained submucosal glands and muscularis propria characteristic of the oesophagus (2). In 1976, Paull et al described a distinctive type of intestinal metaplasia the investigators    called               "specialized columnar epithelium”. Specialised intestinal metaplasia is now widely accepted to be the hallmark of BO with its presence predisposing to dysplasia and cancer regardless of its location within the oesophagus (3).

Contrary to the period in 1993, when the United States (US) President Bill Clinton failed to gain any traction on his healthcare reform, the current President, Barack H Obama, has been able to embark on historic healthcare reform. This is because major stakeholders agree that US healthcare is in crisis and requires major reform. Businesses and consumer groups have joined the insurance industry, pharmaceutical industry, and physician groups in asking for this healthcare reform that would blunt the rapidly escalating costs and provide healthcare for all Americans. While the number of uninsured Americans increased from 39.8 million in 2001 to 46.3 million in 2008, the National Health Expenditure (NHE) grew from 7.2% of the gross domestic product (GDP) in 1970 to 16% in 2005 ¹. This growth is projected to climb further to 19.5% in 2016. To put these figures into perspective, the US is projected to spend almost $13 trillion on healthcare over the ten years from 2010 to 2019 if the current trend continues². Add to that the number of bankruptcies filed in the US due to healthcare expenses. Himmelstein and colleagues have recently demonstrated that of all the bankruptcies filed in the US in 2007, 62.1% were due to medical reasons as opposed to 46.2% in 2001 and only 8% in 1981³.