Our hypothesis is that diabetes leads to loss of diurnal oscillatory rhythms in gut microbiota altering circulating metabolites. We performed an observational study where we compared diurnal changes of the gut microbiota with temporal changes of plasma metabolites. Metadata analysis from bacterial DNA from fecal pellets collected from 10-month old control (db/m) and type 2 diabetic (db/db) mice every 4 h for a 24-h period was used for prediction analysis. Blood plasma was collected at a day and night time points and was used for untargeted global metabolomic analysis. Feeding and activity behaviors were recorded. Our results show that while diabetic mice exhibited feeding and activity behavior similar to control mice, they exhibited a loss of diurnal oscillations in bacteria of the genus Akkermansia, Bifidobacterium, Allobaculum, Oscillospira and a phase shift in the oscillations of g.Prevotella, proteobacteria, and actinobacteria. Analysis of the circulating metabolites showed alterations in the diurnal pattern of metabolic pathways where bacteria have been implicated, such as the histidine, betaine, and methionine/cysteine pathway, mitochondrial function and the urea cycle. Functional analysis of the differential microbes revealed that during the day, when mice are asleep, the microbes of diabetic mice were enriched in processing carbon and pyruvate metabolic pathways instead of xenobiotic degradation as was observed for control mice. Altogether, our study suggests that diabetes led to loss of rhythmic oscillations of many gut microbiota with possible implications for temporal regulation of host metabolic pathways.

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Atopic Dermatitis (AD) is a common chronic inflammatory skin disorder with a constellation of symptoms. Currently, there are numerous therapies in various phases of drug development that target the pathogenesis of AD. Areas covered: Our paper aims to examine small molecule therapies and other novel agents registered for clinical trial in the phase II and mainly phase III stages of development. A literature search using PubMed as well as Clinicaltrials.gov was conducted. Clinical trial evidence of these novel agents was compiled and assessed. Both topical and oral novel therapies with diverse range of mechanistic action are currently being studied, with varying success. These include phosphodiesterase-4 inhibitors, boron molecules, Janus kinase inhibitors, cannabinoid receptors agonists, kappa-opioid receptor agonists. A variety of compounds with yet undisclosed or unknown mechanisms of action are also being studied. Expert opinion: Further research through extensive clinical trials will allow for more information about these targeted therapies and their potential place in the treatment algorithm of AD. Due to the success of such therapies in treating a spectrum of chronic inflammatory diseases, we remain hopeful that the successful development of targeted therapy for AD lies ahead.

Background: Scald injuries among children are a significant cause of mortality and morbidity. This is compounded by the additional risk factors such as poverty, higher birth order and urban slums which are seen in developing countries. But very few studies are available regarding the burden of this issue. This study seeks to assess the same. Methods: A prospective observational study was conducted in a tertiary care hospital for one year.A total of 66 children less than 12 years of age were included. Their demographic profile and treatment outcome were studied. Results: Most participants were less than 10 years old and almost half had first degree burns. Hot water scalds were the most common etiology followed by household liquid foods such as sambar and kanji. Most burns affected the front of the body. Silver nitrodiazine was the most common treatment followed by collagen application and open dressing. After treatment 81.5% improved. The mortality was 16.7%. Conclusions: Scald injuries are a common cause of morbidity among young children. Most incidents occur at home and are preventable. This indicates the need for parental education and the child safety measures for reducing mortality and morbidity due to scalds.

We report a case of an asymptomatic 65-year-old male who on routine eye examination had anterior dislocation of an intraocular lens (IOL) implant placed 23 years prior. Ten months prior to presentation, the patient had cardiac surgery complicated by cardiac arrest requiring chest compressions. Dislocation of an intraocular lens is a rare complication of cataract surgery. One of the causative factors for haptic breakage in our case was the polyimide haptic material. Polyimide has been shown to become brittle over time in warm and moist environments such as the human eye. This case demonstrates a case of late IOL dislocation chest compressions and, to the best of our knowledge, the first such case reported in the literature.

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Background: To date, there are very few studies of Hirschsprung’s disease. Hence, the study was conducted to profile Hirschsprung’s disease in a tertiary care setting.Methods: This is a retrospective observational study that evaluated the admitted patients with Hirschsprung’s disease in the pediatric surgery department. Biopsy was taken from the patient in the form of the full thickness of intestine, seromuscular biopsy, resection from the colostomy site when doing closure and or appendix was taken and subjected to histopathological study with routine eosin and haematoxylin stain.Results: Among the study population, 21(28.8%) children were aged less than one month, and only 10(13.7%) were aged 11 years and above. There were 45(61.6%) participants were male and 28(38.4%) female. Most common biopsy site was appendix in 33(46.2%), followed by Ileum full-thickness biopsy in 6(8.2%) , Ileum Seromuscular biopsy in 5(6.8%%) ,Colon full-thickness biopsy in 4(5.6%) subjects. Among the 73 participants, 46(63%) were clinically suspected cases, and the remaining 27(36.9%) were clinically established cases. Among clinically suspected, the majority (50.7%) had ganglionic cells only in proximal segments.Conclusions: the Hirschsprung's disease diagnosis was established mostly in younger males.

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