56±0.24 in Group B, and 5.06±0.21 in Group C (P less then 0.001). The mean number of days of ICU stay was 6.69±0.21 in Group A, 8.46±0.57 in Group B, and 9.70±0.64 in Group C (P less then 0.001). The infants in Group A had a greater survival rate (97.0%) than those in Group B (94.1%) and Group C (78.4%) (P=0.042). Conclusion ASO in infants with simple TGA can be done within the first week of life with satisfactory outcomes and survival. The Asiatic pit vipers from the complex are medically important venomous snakes. These pit vipers are often associated with snakebite that leads to fatal coagulopathy and tissue necrosis. The cytotoxic venoms of spp.; however, hold great potential for the development of peptide-based anticancer drugs. This study investigated the cytotoxic effect of the venom from , the mangrove pit viper (also known as shore pit viper) which is native in Malaysia, across a panel of human cancer cell lines from breast, lung, colon and prostate as well as the corresponding normal cell lines of each tissue. The venom exhibited dose-dependent cytotoxic activities on all cell lines tested, with median inhibition concentrations (IC ) ranging from 0.42 to 6.98 µg/mL. The venom has a high selectivity index (SI = 14.54) on breast cancer cell line (MCF7), indicating that it is significantly more cytotoxic toward the cancer than to normal cell lines. Furthermore, the venom was fractionated using C reversed-phase high-performance liquid chromatography and the anticancer effect of each protein fraction was examined. Fraction 1 that contains a hydrophilic low molecular weight (approximately 7.5 kDa) protein was found to be the most cytotoxic and selective toward the breast cancer cell line (MCF7). The protein was identified using liquid chromatography-tandem mass spectrometry as a venom disintegrin, termed purpureomaculin in this study. Taken together, the findings revealed the potent and selective cytotoxicity of a disintegrin protein isolated from the Malaysian venom and suggested its anticancer potential in drug discovery.Taken together, the findings revealed the potent and selective cytotoxicity of a disintegrin protein isolated from the Malaysian T. purpureomaculatus venom and suggested its anticancer potential in drug discovery. Beta-cardiotoxin (β-CTX), the three-finger toxin isolated from king cobra ( ) venom, possesses β-blocker activity as indicated by its negative chronotropy and its binding property to both β-1 and β-2 adrenergic receptors and has been proposed as a novel β-blocker candidate. Previously, β-CTX was isolated and purified by FPLC. Here, we present an alternative method to purify this toxin. In addition, we tested its cytotoxicity against different mammalian muscle cell types and determined the impact on cardiac function in isolated cardiac myocyte so as to provide insights into the pharmacological action of this protein. β-CTX was isolated from the crude venom of the Thai king cobra using reverse-phased and cation exchange HPLC. cellular viability MTT assays were performed on mouse myoblast (C2C12), rat smooth muscle (A7r5), and rat cardiac myoblast (H9c2) cells. Cell shortening and calcium transient dynamics were recorded on isolated rat cardiac myocytes over a range of β-CTX concentration. Purified β-Cnd depression of cardiac contractility by this protein. These data are useful to aid future development of pharmacological agents derived from β-CTX. An acute onset central pathology without any clear neurological symptoms may mimic peripheral vestibular problem in an emergency setting. A 54-year-old man suddenly developed dizziness without any cranial nerve symptoms, paresis, cerebellar signs or sensory disturbances except upbeat positional nystagmus at multiple provoked positions which alerted for a possible acute central pathology. An instantaneous magnetic resonance imaging and angiography studies further showed obstruction of the left internal carotid artery above the bifurcation. The patient's subsequent prognosis was consistent with good recovery following anti-coagulant therapy. A follow-up MRI and angiography showed resolution of thrombosis. It should be kept in mind that positional nystagmus is likely to occur in central pathologies. Differentiation between benign paroxysmal positional vertigo and central positioning nystagmus is critical.It should be kept in mind that positional nystagmus is likely to occur in central pathologies. Differentiation between benign paroxysmal positional vertigo and central positioning nystagmus is critical.We present a very rare case of tophaceous gout of the middle ear causing conductive hearing loss, with special emphasis on Computed Tomography presentation.Acquired atresia of the external auditory canal (EAC) is a rare cause of conductive hearing loss. It has been traditionally classified into 4 categories traumatic, post-operative, neoplastic and inflammatory. Post-inflammatory acquired auditory canal atresia is thought to be the result of chronic and repetitive infectious bouts affecting the auditory canal. Nevertheless, the underlying pathophysiology of this disorder is yet to be fully elucidated. Current data fail to clearly state the impact that certain underlying systemic disorders may have on the EAC. The possible association to metabolic disturbances such as iron deficiency is also emphasized. In the light of these findings, this analysis can be used to improve the classification of this entity thereby standardizing the assessment of therapeutic approaches.To investigate how much gain variation is required from prescription to effect tinnitus percept, and if this revised prescription affects speech recognition. Twenty participants who experienced catastrophic tinnitus even after fitted with hearing aid were included. MK-1775 Participants were grouped based on their tinnitus pitch and the prescriptive formula used to fit hearing aid. They were evaluated for handicap from tinnitus using Tinnitus Handicap Inventory (THI). Hearing aid was programmed using either NAL- NL2 or DSL (I/o) v5 prescriptive formula and gain at tinnitus pitch was adjusted till the tinnitus get suppressed. SNR 50 was determined soon after fitted with hearing aid and 30 days of hearing aid use. Further, THI and international outcome inventory for hearing aid (IOI-HA) were determined after 30 days of hearing aid use. A significant higher gain adjustment was needed at tinnitus pitch to reduce tinnitus precept using NAL- NL2 than DSL (I/o) v5 prescriptive formula. Further, SNR 50 was not affected by either tinnitus pitch or revised prescription formulas.