Ecofriendly fabrication of cobalt nanoparticles using Azadirachta indica (neem) for effective inhibition of Candida-like fungal infection in medicated nano-coated textile

This study involves the formulation of cobalt nanoparticles by means of ethanolic Azadirachta indica (neem) extract (CoNP@N). Later, the formulated buildup was incorporated into cotton fabric in order to mitigate antifungal infection. Optimization of the formulation was carried out by considering the effect of plant concentration, temperature, and revolutions per minute (rpm) used, through design of the experiment (DOE), response surface methodology (RSM), and ANOVA of the synthetic procedure. Hence, graph was potted with the aid of effecting parameters and the related factors (size of particle and zeta potential). Further characterization of nanoparticles was performed through scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Attenuated total reflection-Fourier transform infrared (ATR-FTIR) was considered for the detection of functional groups. The structural property of CoNP@N was calculated with the aid of powder X-ray diffraction (PXRD). The surface property was measured with the use of a surface area analyzer (SAA). The values of Inhibition concentration (IC50) and zone of inhibition (ZOI), were calculated, so as to determine the antifungal property against both the strains (Candida albicans, MTCC 227and Aspergillus niger, MTCC 8652). The further nano-coated cloth was subjected to a durability test, and hence the cloth was washed (through the purpose of time 0; 10; 25; and 50 washing cycles), and then its anti-fungal operation to a couple of strains was retained. Primarily, 51 μg/ml of cobalt nanoparticles incorporated on the cloth was retained but after 50 washing cycles in 500 ml of purified water, the cloth showed more efficiency contrary to C. albicans than towards A. niger.

Protective face mask: an effective weapon against SARS-CoV-2 with controlled environmental pollution

Masks are face coverings that give protection from infectious agents, airborne pathogens, bacteria, viruses, surgical fog, dust, and other chemical hazards by acting as a barrier between the wearer and the environment. In the COVID-19 pandemic, this major personal protective equipment's became essential part of our daily life. The aim of this review is to analyze and discuss the different types of masks with their pros and cons, manufacturing procedures, evaluation criteria, and application with some of the sterilization process for reuse and smart mask. The review used a thorough examination of the literature to analyze the preventive effects of surgical, N95, smart mask, and potential environmental damage from those masks. Several studies and evidence were also examined to understand the efficiency of different mask on different environment. N95 respirators are capable of filtering out non-oil-based 95% air-born particles, and surgical masks act as a protective barrier between the wearer and the environment. The application of spoon bond and melt blown techniques in the fabrication process of those masks improves their protective nature and makes them lightweight and comfortable. But the high demand and low supply forced users to reuse and extend their use after sterilizations, even though those masks are recommended to be used once. Universal masking in the SARS-COV-2 pandemic increased the chance of environmental pollution, so the application of smart masks became essential because of their high protection power and self-sterilizing and reusing capabilities.

Incidence of post vitrectomy endophthalmitis in India - A multicentric study by VRSI study Group

INTRODUCTION

The incidence of post vitrectomy endophthalmitis (PVE) is reported to be between 0.02 and 0.84%. Resterilization of single use instruments is a common practice amidst developing countries to make it more affordable to the patients by reducing the cost of the surgery and also reduce the environmental hazard. The aim of our study is to evaluate the incidence of PVE amidst existing sterilization practices of reused instruments in multiple vitreoretinal centres in India.

METHODOLOGY

Centres with an endophthalmitis tracking system were invited to participate in a survey. Twenty-five centres were sent a questionnaire via email. The questionnaire included details about the institution, number of vitrectomies performed in a year, sterilization practices followed pre-operatively, intraoperatively and postoperatively, incidence of endophthalmitis and instrument reuse policies.

RESULTS

A total of 29 cases of endophthalmitis were reported out of the 47,612 vitrectomies performed across various centres. The mean incidence of endophthalmitis was 0.06%. There was no difference in the rates of endophthalmitis based on various pre-operative, intraoperative or postoperative prophylactic measures. Nearly 80% of the centres change most of the instruments after every case, while the rest reused. The mean number of times a cutter was being reused until discarded was 4.7. Nearly 76% followed a performance-based protocol, and the remaining 24% had a fixed protocol for the number of times an instrument can be reused before discarding it.

CONCLUSION

PVE rates are not significantly different in India despite the multiuse of single use instruments. The purpose of this paper is not to suggest an alternate protocol but to creating one in the future with these results in mind, to rationalise the use of single use instruments, make VR surgery more affordable and also have a positive impact on the carbon footprint of consumables in surgery.

Green synthesized cobalt nanoparticles from Trianthema portulacastrum L. as a novel antimicrobials and antioxidants

Trianthema portulacastrum is a dietary and medicinal plant that has gained substantial importance due to its pharmacological properties. This plant was used for its various healing properties since the ancient period in ayurvedic system of medicine. The green synthesis technique is an eco-friendly as well as cost effective technique which can produce more biocompatible nanoparticles when compared with those fabricated by physio-chemical methods. Therefore, nanoparticles produced by green synthesis are credible alternatives to those which are produced by conventional synthesis techniques. This research mainly aims to produce nanoparticles with the methanolic leaf extract of T. portulacastrum. The optimized nanoparticles were further analyzed for anti-fungal, anti-bacterial and antioxidant properties. Disk diffusion assay was used for the determination of the antimicrobial property and on the other hand, DPPH radical scavenging assay as well as hydrogen peroxide scavenging activity proved the antioxidant property of the formulation. The study revealed that Escherichia coli (gram negative strain) shows greater zone of inhibition when compared with Bacillus subtilis (gram positive bacteria). The nanoparticles have also been reported to show significant anti-fungal activity against the strains of Aspergillus niger and Fusarium oxysporum which proves its desirability for its further use against both bacterial as well as fungal infections. The novel formulation can be explored dually as antimicrobial and antioxidant agent.

Vitreous hemorrhage - Causes, diagnosis, and management

Vitreous hemorrhage is associated with a myriad of conditions such as proliferative diabetic retinopathy, proliferative retinopathy following vascular occlusion and vasculitis, trauma, retinal breaks, and posterior vitreous detachment without retinal break. Multiple pathological mechanisms are associated with development of vitreous hemorrhage such as disruption of abnormal vessels, normal vessels, and extension of blood from an adjacent source. The diagnosis of vitreous hemorrhage requires a thorough history taking and clinical examination including investigations such as ultra-sonography, which help decide the appropriate time for intervention. The prognosis of vitreous hemorrhage depends on the underlying cause. Treatment options include observation, laser photo-coagulation, cryotherapy, intravitreal injections of anti-vascular endothelial growth factor, and surgery. Pars plana vitrectomy remains the cornerstone of management. Complications of vitreous hemorrhage include glaucoma (ghost cell glaucoma, hemosiderotic glaucoma), proliferative vitreoretinopathy, and hemosiderosis bulbi.

Cross linked alginate beads of montelukast sodium coated with eudragit for chronotherapy: statistical optimization, in vitro and in vivo evaluation

BACKGROUND

Chronotherapy is the administration of medication according to the biological rhythm to maximize pharmacological effects and minimize side effects. The objective of the current investigation is to prepare delayed-release beads (DRBs) containing montelukast sodium (MKS) for chronotherapy of asthma.

METHODS

Delayed-release beads of alginate were prepared using a simple method, i.e., ionotropic gelation. The effect of cross-linking agents (zinc or calcium ions) and the concentration of chitosan on the properties of the beads were investigated. The prepared beads were coated by a polymer having pH-independent solubility, i.e., Eudragit RSPO and Eudragit RLPO in different ratios to achieve the desired lag time of 4-5 h. Beads were evaluated for surface morphology, practical yield, encapsulation efficiency, XRD, and in vitro release study. The pharmacokinetic study was carried out in New Zealand white male rabbits.

RESULTS

There are no major differences in the drug release profile observed between Ca++ & Zn++ cross-linked beads. Although, a slight slow release was seen in the case of chitosan reinforced beads. MKS releases from cross-linked alginate beads were slightly altered with sodium alginate concentration, cross-linking time, and talc. At a higher concentration of alginate, slow drug release was observed whereas the addition of talc to alginate increased the release rate. The in vitro release study shows that the optimal formulation of DRBs has a lag time (4.5 h) and the release at 6 h is 74.9%. In vivo pharmacokinetic study of the beads has shown Tmax at 7 h with an initial lag time of 4 h. Concluion: The prepared cross-linked beads when dosed at sleep time may deliver Montelukast Sodium when required to relief from early morning symptoms in asthmatic patients.

Presumed Natural History of Combined Hamartoma of the Retina and Retinal Pigment Epithelium

PURPOSE

To correlate structural changes of combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) with patient age.

DESIGN

Retrospective study.

PARTICIPANTS

Fifty eyes of 49 patients (age range, 1-74 years) with CHRRPE studied at 9 tertiary vitreoretinal institutions.

METHODS

We analyzed the clinical findings with respect to lesion topography and pigmentation as well as investigated the OCT findings regarding the thickness, vitreoretinal interface, outer plexiform layer distortion, ellipsoid zone disruption, and retinal pigment epithelium-Bruch's membrane complex involvement of CHRRPE.

MAIN OUTCOME MEASURES

Clinical and imaging findings of CHRRPE at different ages.

RESULTS

Analysis of 50 CHRRPE patients revealed that younger patients were more likely to demonstrate partial thickness involvement of the retina (P = 0.009) with predominantly inner retinal layer involvement (P = 0.04). The inverse was true for older patients with CHRRPE. In addition, older patients more commonly showed pigmentary changes. Eyes with CHRRPE were more likely to show an increase in central macular thickness independently of tumor location.

CONCLUSIONS

Based on these findings, we believe that CHRRPE typically begins in the inner retina and continues toward the outer retina over time, with increase in central macular thickness, despite the location of the tumor.

Safety and efficacy of Razumab™ (world's first biosimilar ranibizumab) in wet age-related macular degeneration: a post-marketing, prospective ASSET study

BACKGROUND

Razumab™ (world's first biosimilar ranibizumab) is approved for several macular disorders including wet age-related macular degeneration (AMD). We evaluated the safety and efficacy of biosimilar ranibizumab in wet AMD.

METHODS

This prospective, multicentre, rAnibizumab bioSimilar Safety Efficacy postmarkeTing (ASSET) study enrolled patients aged ≥ 50 years with wet AMD having best-corrected visual acuity (BCVA) between 20/40 and 20/320. The patients received intravitreal biosimilar ranibizumab 0.5 mg every 4 weeks for 24 weeks. Safety endpoints included the incidence of adverse events (AEs), serious AEs (SAEs), and immunoreactivity after 6 months. The efficacy endpoints were the proportion of patients who lose fewer than 15 letters, increase in BCVA, change in central retinal thickness (CRT), and change in Visual Function Questionnaire-25 (VFQ-25) score, from baseline to 24 weeks.

RESULTS

Of the 126 enrolled patients, majority (95.24%) of the patients received all 6 doses of biosimilar ranibizumab (total 3 mg). Nineteen AEs were reported (n = 16; 12.7%); majority (78.9%) were mild. There were no serious AEs reported, except one AE of death which was unrelated to the study drug. None of the patients discontinued the study due to an AE. The most common ocular AE was increase in intraocular pressure (4 events) and non-ocular AE was pyrexia (5 events). A total of 7.9% (10/126) patients prior to dosing and 7.1% (9/126) patients post-treatment were positive for anti-ranibizumab antibodies. No AEs suggestive of immunogenicity were noted. At 24-weeks, 97.60% patients in the intent-to-treat (ITT) population (N = 125) and 97.41% patients in the per-protocol (PP) population (N = 116) lost < 15 letters from baseline visual acuity. In the ITT and PP populations, 31.20% and 32.76% patients, respectively, showed improved visual acuity by ≥ 15 letters. Significant improvements in BCVA (mean difference: 8.8, 9.2, p < 0.001 for ITT, PP) and VFQ-25 (8.5, 9.2, p < 0.001 for ITT, PP) were seen; CRT reduced significantly (125 µm, 119.3 µm, p < 0.001 for ITT, PP).

CONCLUSION

Razumab™ (world's first biosimilar ranibizumab) was well-tolerated without new safety concerns and significantly improved visual acuity in wet AMD patients. Trial registration CTRI/2016/03/006739. Registered 18 March 2016-Prospectively registered, http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=13141&EncHid=&userName=2016/03/006739.

Antidepressant activity of Spathodea campanulata in mice and predictive affinity of spatheosides towards type A monoamine oxidase

The antidepressant activity of Spathodea campanulata flowers was evaluated in mice and in silico. When tested at doses of 200 and 400 mg/kg, the methanol extract of S. campanulata (MESC) showed dose-dependent antidepressant activity in the force swim test (FST), tail suspension test (TST), lithium chloride-induced twitches test and the open field test. In FST and TST, animals treated with MESC demonstrated a significant decrease in the immobility period compared to the control group. The lithium chloride-induced head twitches were significantly reduced following administration of MESC. The latter, at the dose of 400 mg/kg, also significantly reduced locomotor activity. Following administration of MESC, changes in the levels of serum corticosterone, and of norepinephrine, dopamine, serotonin, 4-hydroxy-3-methoxyphenylglycol (MHPG), 4-dihydroxyphenylacetic acid (DOPAC), and 5-hydroxyindoleacetic acid (5-HIAA) were measured in different brain regions using HPLC. The presence of spatheoside A (m/z 541) and spatheoside B (m/z 559) in MESC was detected using HPLC/ESI-MS. These two iridoids demonstrated a high predictive binding affinity for the active site of the type A monoamine oxidase (MAO-A) enzyme with scores of 99.40 and 93.54, respectively.  These data suggest that S. campanulata flowers warrants further investigation as a source of novel templates for antidepressive drugs.

Clitoria ternatea Mediated Synthesis of Graphene Quantum Dots for the Treatment of Alzheimer's Disease

The main purpose of the present study was to synthesize graphene quantum dots (GQDs)from the flowers of Clitoria ternatea with the help of one-pot microwave-assisted green synthesis for the treatment of Alzheimer's disease. Further, the synthesized graphene quantum dots show a particle size of 10 nm ±1.3, a PDI of 0.354 ± 1.8, and a ζ potential of -46 ± 0.4, indicating the good stability of the quantum dots. With the help of scanning electron microscopy (SEM) and transfer electron microscopy (TEM) examination, the surface microscopic behavior of the synthesized quantum dots was determined. The presence of functional groups in the quantum dots was determined by Fourier-transform infrared spectroscopy (FTIR) study, the chemical state information on the sample was determined with the help of X-ray photoelectron spectroscopy (XPS), and the surface area of the dots was determined with the help of a surface area analyzer. With the help of a radial arm maze and water morris maze assay, the learning and memory capacity of the quantum dots was assessed, and the results show that the ctGQDs significantly decreased the transfer latency to reach the baited arm in 10.37 ± 1.65 s or to the hidden platform in 18.42 ± 0.99 s in 7 days. The synthesized quantum dots show more inhibition of the acetyl cholinesterase enzyme, i.e., 86.32 ± 1.52%, as compared to that of pure donepezil, i.e., 72.46 ± 2.21%. ctGQDs considerably increased the level of glutathione and protein and decreased the level of lipid peroxide and nitric oxide. The histopathological image of ctGQDs shows more preservation of small pyramidal cell and treats the disorganization of the cells. These results suggest that the quantum dots significantly crossed the blood-brain barrier since they were small in size and were effective in reducing Alzheimer-like symptoms in rodents, and thus, it can be concluded that Clitoria ternatea flowers can be used as an adjuvant in the treatment of Alzheimer's.

Herbal ethosomal gel containing luliconazole for productive relevance in the field of biomedicine

This study includes development, characterization, and optimization of herbal ethosomal formulation. The aim of the present study is to develop drug loaded ethosomes capped with Azadirachta indica (neem) which, was further incorporated in Carbopol 934 K thereby, resulting in the formation of ethosomal gel. The formulation is aimed to express effective treatment against fungal infection. The build was formulated using drug (Luliconazole), soyalecithin, ethanolic neem extract and propylene glycol. In total nine ethosomal, formulations of distinct concentrations of ingredients were processed, to determine out the optimized formulation among the all. Further the prepared drug loaded ethosomes were subjected to various evaluation parameters like particle size, zeta potential, polydispersity index (PDI) and % entrapment efficiency. For the evaluation of its surface morphology, transmission electron microscopy was executed whereas, atomic force microscopy was carried out which contributes in detail and depth information of surface morphology. For the analysis of thermal behavior Thermal gravimetric analysis graph was obtained for luliconazole, soyalecithin, neem extract, physical mixture and optimized formulation (LF5). Attenuated total internal reflection Fourier transforms infra-red spectroscopy was performed for luliconazole, soyalecithin, neem extract, physical mixture, and optimized formulation (LF5) to examine the interaction between the drug and the excipients. Viscosity, pH, spreadability and extrudability of the ethosomal gel were calculated to determine the suitability of the formulation for topical application. In vitro drug permeation study and antifungal activity was executed out with the aid of Wistar albino rat skin model and tube dilution assay respectively. The complete study wrap up, that this herbal ethosomal approach provides advanced sustained and targeted delivery of luliconazole. On analyzing the results, ethosomal formulation LF5 was found to be optimized one, due to its optimum concentration of soyalecithin (300 mg) and ethanol (35%). Hence it has maximum entrapment efficiency of 86.56 ± 0.74%. Optimum vesicle size, zeta potential, and PDI were found to be 155.30 ± 1.2 nm, - 42.20 ± 0.3 mV, and 0.186 ± 0.07 respectively. In vitro drug permeation study expresses release of 83.45 ± 2.51 in 24 h whereas; the in vivo activity proved that LF5 is more active and effective against Candida parapsilosis in comparison to Aspergillus niger. In the end, it was estimated that ethosomal suspension and lyophilized ethosomal suspension was utmost stable at 4 °C/60 ± 5 RH. The complete study clearly indicates that the buildup of ethosomal formulation with luliconazole and neem extract show synergistic effect thereby, expressing excellent result against the treatment of fungal infection.