A progressive degradation of the brain’s structure and function, which results in a reduction in cognitive and motor skills, characterizes neurodegenerative diseases (NDs) such as Alzheimer’s disease (AD), Parkinson’s disease (PD), Amyotrophic lateral sclerosis (ALS), and Huntington’s disease (HD). The morbidity linked to NDs is growing, which poses a severe threat to human being’s mental and physical ability to live well. The gut-brain axis (GBA) is now known to have a crucial role in the emergence of NDs. The gut microbiota is a conduit for the GBA, a two-way communication system between the gut and the brain. The myriad microorganisms that make up the gut microbiota can affect brain physiology by transmitting numerous microbial chemicals from the gut to the brain via the GBA or neurological system. The synthesis of neurotransmitters, the immunological response, and the metabolism of lipids and glucose have all been demonstrated to be impacted by alterations in the gut microbiota, such as an imbalance of helpful and harmful bacteria. In order to develop innovative interventions and clinical therapies for NDs, it is crucial to comprehend the participation of the gut microbiota in these conditions. In addition to using antibiotics and other drugs to target particular bacterial species that may be a factor in NDs, this also includes using probiotics and other fecal microbiota transplantation to maintain a healthy gut microbiota. In conclusion, the examination of the GBA can aid in understanding the etiology and development of NDs, which may benefit the improvement of clinical treatments for these disorders and ND interventions. This review indicates existing knowledge about the involvement of microbiota present in the gut in NDs and potential treatment options.

The purpose of the study was to examine the urinary levels of kidney injury molecule-1 (KIM-1) and angiopoietin-like protein-4 (ANGPTL-4) in individuals with diabetic kidney disease (DKD) and their association with established DKD diagnostic markers such as albuminuria and estimated glomerular filtration rate (eGFR). Levels of ANGPTL-4 and KIM-1 were estimated in urine samples. A total of 135 participants were recruited into three groups: 45 diabetes type 2 patients in the control group and 90 DKD patients in two disease groups. Concentrations of ANGPTL-4 and KIM-1 were conclusively related to the urinary albumin–creatinine ratio (UACR). Also, the levels of both ANGPTL-4 and KIM-1 were negatively associated with the eGFR. Multivariable Poisson regression analysis showed that urinary ANGPTL-4 (PR: 3.40; 95% CI: 2.32 to 4.98; p < 0.001) and KIM-1 (PR: 1.25; 95% CI: 1.14 to 1.38; p < 0.001) were prevalent in DKD patients. Receiver operating characteristic (ROC) analysis of urinary ANGPTL-4 and KIM-1 in the combined form resulted in an area under curve (AUC) of 0.967 (95%CI: 0.932–1.000; p < 0.0001) in the microalbuminuria group and 1 (95%CI: 1.000–1.000; p < 0.0001) in the macroalbuminuria group. The association of urinary levels of ANGPTL-4 and KIM-1 with UACR and eGFR and significant prevalence in the diabetic kidney disease population illustrates the diagnostic potential of these biomarkers.

Patients with COVID-19 may develop higher susceptibility to fungal co-infections. Mucormycosis is a rare and often life-threatening disease caused by vascular invasion by hyphae, leading to thrombosis and necrosis. Mucormycosis has been the cause of morbidity and mortality in transplant, ICU and immunodeficient individuals over a long period of time, but in India, a rapid increase in the number of cases seen in unexpected patients with Covid-19, which is a major concern. Covid-19 patients, already immunocompromised with underlying condition, had been exposed to severe Covid-19 infection and been using steroids, were at greater risk of developing mucormycosis. Out of ten cases reported by Sir Ganga Ram Hospital, Delhi India in December2020, five succumbed to mucormycosis. Another unique feature reported in mucor patients was age, most were elderly with ages between 45 to 60 years. The mortality rate is currently estimated at 50% in India. Symptoms such as nasal congestion, swelling of the eye or cheeks and dark brown crusts inside the nose should be reported immediately and anti-fungal treatment should be started.

Drug-induced vasculitis can be defined as inflammation of blood vessels triggered by a spectrum of drugs. It presents not only with a localized skin rash but also may involve the internal organ systems, including the gastrointestinal tract, kidneys, lungs, central nervous system, and joints. Here, we report the case of a 60-year-old woman who developed purpuric pruritic rashes on bilateral lower limbs and buttocks after the ingestion of sulphasalazine. The patient took the prescribed regimen for 14 days while experiencing an adverse drug reaction. At the follow-up visit, the patient was admitted and treated with methylprednisolone monotherapy with 32 mg/day for the first 3 days and after that, methylprednisolone 16 mg for the next 3 days. The rashes resolved after 6 days. Clinicians should ascertain the patient knowledge of how and when to obtain urgent care as the patient may experience ill effects after taking prescribed treatment. Timely advice may save patients’ costs of admission and treatment to manage adverse events.

To date, no standard drug therapy has proven effective to counter COVID-19 disease. There are only hit and trial based on assumptions and weak evidence that are directing prescribing practices for asymptomatic to symptomatic and serious cases of COVID-19. ICMR being the apex body, responsible for framing the guidelines for the management of disease in India has not yet approved the use of combination doxycycline and ivermectin in the prophylaxis or treatment of Covid-19 cases but being used in the treatment of COVID-19 infection. Their adverse drug reactions individually are well known among scientific community. Doxycycline ADRs range from gastrointestinal, urogenital, neuropsychiatric, respiratory, nervous system to skin and appendages. We have reported a case of doxycycline induced drug allergy (rashes) all over the trunk and legs as a result of self-medication. The event happened after a female patient had complaints of persistent fever and weakness consumed doxycycline and ivermectin on her friend's advice and developed rashes on her trunk and legs. The above ADE is very mild but alarming for the medical fraternity that warrants strict compliance with the electronic/text/online prescription. The usage of doxycycline and ivermectin in the treatment of COVID-19 disease, as an indication of treatment should not be considered prior to any concrete evidence or issuance of treatment, guidelines by the apex body in India.