Gerodermia Osteodysplastica (GO), associated with a GORAB gene mutation, is a rare genetic disorder characterized by severe connective tissue abnormalities, including skin laxity, osteopenia, and premature aging features. Anesthetic and perioperative management in these patients presents significant challenges due to skin fragility, skeletal vulnerability, and nutritional deficiencies. Individualized, multidisciplinary care is essential to prevent iatrogenic complications. We report the anesthetic management of an 8 kg, 2-year-old male child with a confirmed GORAB gene mutation (NM_152281.3) scheduled for bilateral orchiopexy. The child presented since birth with skin atrophy, reduced subcutaneous fat, malnutrition, and low BMI. A multidisciplinary preoperative plan was crucial, and nutritional optimization was initiated. Specific measures for tissue protection included adhesive-free monitoring (silicone electrodes) and gel supports at pressure points to prevent injury. Anesthesia was induced with sevoflurane. Airway management utilized a video laryngoscope for intubation, and spinal anesthesia was administered post-intubation for superior analgesia. Intraoperative care focused on maintaining normothermia, neutral positioning, and careful handling to mitigate the risk of iatrogenic fractures due to osteopenia. Conclusion: Postoperative recovery was uneventful, and skin integrity was perfectly preserved. Anesthetic management of pediatric patients with GORAB mutations demands meticulous planning and a tailored approach focused on skin and bone protection to ensure a safe perioperative course. Keywords: Gerodermia osteodysplastica; GORAB mutation; pediatric anesthesia; perioperative management; skin fragility; osteopenia; nutritional optimization; orchiopexy; sevoflurane induction
Background: Hemoglobin D-Punjab (Hb D-Punjab, also known as Hb D-Los Angeles) is an uncommon structural β-globin variant that is typically clinically silent in the heterozygous state and is not associated with iron deficiency. Recurrent iron deficiency anemia (IDA) despite appropriate oral and intravenous iron replacement warrants a comprehensive evaluation for chronic blood loss, malabsorption, nutritional deficiency, and coexisting hematologic disorders. With the increasing use of incretin-based therapies such as tirzepatide for obesity management, reduced dietary intake has emerged as a potential contributor to micronutrient deficiencies in susceptible individuals. Case Presentation: A 47-year-old woman presented with persistent microcytic hypochromic anemia and recurrent depletion of iron stores despite repeated courses of oral and intravenous iron therapy. Serial laboratory investigations demonstrated hemoglobin values ranging from 11.78 to 13.2 g/dL, with persistent microcytosis (MCV 72.7–77.1 fL), relatively elevated red blood cell counts (4.82–5.42 ×10¹²/L), and recurrently low ferritin levels (as low as 3.1 ng/mL). Hemoglobin electrophoresis demonstrated heterozygous Hb D-Punjab trait (Hb D 40.4%), while persistent microcytosis with a relatively elevated red blood cell count suggested possible coexisting α-thalassemia trait. Evaluation excluded celiac disease, thyroid dysfunction, vitamin B12 deficiency, and gynecological pathology. The patient denied gastrointestinal symptoms but had not undergone endoscopic gastrointestinal evaluation. She had been receiving tirzepatide for weight management, raising the possibility that prolonged appetite suppression and reduced dietary iron intake may have contributed to recurrent iron deficiency, although a causal relationship cannot be established. Conclusion: This case highlights the importance of confirming true biochemical iron deficiency rather than attributing anemia to an incidental hemoglobin variant. Recurrent IDA despite adequate iron replacement requires systematic evaluation for gastrointestinal blood loss, nutritional deficiency, malabsorption, gynecological disorders, and coexisting hematologic conditions. As incretin-based therapies become increasingly used for obesity management, clinicians should remain aware of the potential for nutritional deficiencies in susceptible patients and ensure appropriate clinical and nutritional follow-up. Keywords: Hemoglobin D-Punjab; Iron deficiency anemia; Tirzepatide; Obesity; Hemoglobinopathy; Microcytic anemia; α-thalassemia trait
Etodolac is a non-steroidal anti-inflammatory drug (NSAID) used for the management of pain and inflammatory disorders. Although conventional oral administration provides effective systemic exposure, the relatively short terminal half-life and rapid gastrointestinal transit may necessitate repeated administration and may produce fluctuating drug concentrations. Gastroretective drug delivery systems (GRDDS), particularly floating oral in-situ gels, provide an attractive approach for prolonging gastric residence and regulating drug release. This review and experimental framework focus on the development of a floating oral in-situ gel of etodolac using suitable hydrophilic and ion-responsive polymers. The formulation is designed to remain in the stomach by generating a low-density, gelled structure following contact with gastric fluid. Sodium alginate, gellan gum, hydroxypropyl methylcellulose (HPMC) and suitable gas-generating agents can be investigated to achieve rapid gelation, adequate floating ability, appropriate viscosity and sustained drug release. Important formulation and evaluation parameters include appearance, pH, viscosity, gelation characteristics, floating lag time, total floating duration, drug content, swelling, in-vitro dissolution, release kinetics and stability. Optimization of polymer concentration and polymer combinations is essential because viscosity, gel strength, buoyancy and drug diffusion are interdependent. A well-designed etodolac floating in-situ gel may provide prolonged gastric residence and controlled drug delivery, although in-vivo gastric-retention and pharmacokinetic studies are required to establish its clinical advantage. Keywords: Etodolac; Floating in-situ gel; Gastroretective drug delivery; Sodium alginate; Sustained release
Benzimidazole is a privileged nitrogen-containing fused heterocyclic scaffold that has attracted considerable interest in medicinal and pharmaceutical chemistry because of its structural versatility, favorable physicochemical properties and broad biological profile. The benzimidazole nucleus comprises a benzene ring fused with an imidazole ring containing two nitrogen atoms, providing multiple sites for structural modification and interaction with biological targets. This review summarizes recent advances in the synthesis, characterization, antimicrobial evaluation and antioxidant potential of benzimidazole derivatives, with particular emphasis on structure-activity relationships (SAR). Classical synthetic approaches mainly involve the condensation of o-phenylenediamine with aldehydes, carboxylic acids and related carbonyl compounds, whereas modern methodologies increasingly employ microwave irradiation, solvent-free conditions, recyclable catalysts, nano-catalysts, photocatalysis, mechanochemistry and other green-chemistry strategies. Structural characterization is commonly performed using Fourier-transform infrared spectroscopy (FTIR), ^1H and ^13C nuclear magnetic resonance (NMR), mass spectrometry, elemental analysis, ultraviolet-visible spectroscopy and, where appropriate, single-crystal X-ray diffraction. Benzimidazole derivatives demonstrate promising antibacterial and antifungal activities against diverse pathogens. Their antioxidant potential is commonly evaluated using DPPH, ABTS, FRAP and lipid-peroxidation assays. Overall, benzimidazole provides a versatile platform for developing multifunctional antimicrobial and antioxidant agents, although standardized biological protocols, mechanistic validation, selectivity assessment, pharmacokinetic studies and in vivo investigations remain necessary for successful therapeutic translation. Keywords: Benzimidazole; Heterocyclic chemistry; Antimicrobial activity; Antioxidant activity; Structure-activity relationship
Hakim Abdul Hameed (14 September 1908–22 July 1999) occupies a distinguished place in the modern history of Unani medicine, pharmaceutical development, education, research, philanthropy, and institution-building in India. Although he is widely remembered as an eminent Hakim and the principal architect of the modern Hamdard movement, his historical significance extends far beyond clinical medicine. He transformed Hamdard from a traditional Unani dispensary into a modern indigenous pharmaceutical institution, introduced mechanised manufacturing and laboratory-based quality control, reorganised Hamdard as a Waqf, and directed its resources towards education, healthcare, research, culture, and social welfare. His most enduring achievement was the creation of an interconnected institutional ecosystem in which medicine, pharmacy, nursing, hospitals, historical research, Islamic studies, literature, employment guidance, and higher education were conceived as mutually reinforcing components of social development. Several institutions established or supported under his leadership were subsequently brought together to form Jamia Hamdard, which was declared a Deemed-to-be University by the Government of India on 10 May 1989. This article examines Hakim Abdul Hameed's life, education, and medical career, contribution to the modernization of Unani medicine, pharmaceutical innovation, Waqf philosophy, educational initiatives, research institutions, cultural patronage, social welfare activities, and the establishment of Jamia Hamdard. It also critically evaluates his institutional model and discusses its relevance to contemporary Unani medicine and healthcare education. The article argues that Hakim Abdul Hameed's greatest contribution was not merely the expansion of a pharmaceutical enterprise but the conversion of professional success into a durable system of education, research, healthcare, and public service. Objective: To review Hakim Abdul Hameed’s contributions to the modernization and development of Unani medicine, with emphasis on pharmaceutical development, education, research, healthcare, philanthropy, and institution-building, particularly the establishment of Jamia Hamdard. Keywords: Unani Medicine; Jamia Hamdard; Pharmaceutical Industry; Medical Education, History of Medicine; Philanthropy;
