Silicone based water-in-oil emulsion fortified with anthocyanin: In-vitro, in-vivo study

Skin care formulations with antioxidants are being widely explored for their benefits to human skin. The purpose of this study was to formulate a stable w/o emulsion containing anthocyanin derived from Malus dosmestica fruit extract and to further explore its beneficial effects on normal human skin. Anthocyanin was extracted using various solvents from the peel of Malus dosmestica fruit. w/o creams containing anthocyanin has been prepared and systematically characterized for various physiochemical properties in terms of stability at varying conditions of storage. An efficacy study has been carried out on 12 male healthy Asian subjects to determine effects of anthocyanin on skin melanin, erythema, skin moisture, trans-epidermal water loss (TEWL) and on skin sebum. Solvent system containing methanol/acetone/water (3.5: 3.5: 3 v/v/v) including 1% formic acid established a best recovery of anthocyanin from fruit peel. W/O emulsions presented promising stability profile when kept at different storage conditions over 90 days period. All skin parameters studied, anthocyanin has been found more efficacious (p<0.05) for its effects on skin melanin and erythema content of skin. It has been shown that a topical application of anthocyanin derived from Malus domestica has substantial potential for human skin system and needs some patient oriented studies could warrant its potential for damaged skin.

Effect of Displacement on Adherence to TB Treatment: An Observational Study in TB Patients from Internally Displaced Persons of Pakistan

Objective:

This study was aimed to investigate TB patients adherence and treatment outcomes among internally displaced patients in comparison with adjacent settled areas.

Methods:

The study was designed as an observational cross-sectional study among the TB patients of internally displaced populations (IDPs) of North Waziristan Agency (NWA) and adjacent settled areas of Bannu and Lakki Marwat (NIDPs). Based on the study inclusion and exclusion criteria 330 patients fullfilled the inclusion criteria and were assigned equally to both IDPs and NIDPs study groups. Odds ratio (OR) with 95% confidence interval was calculated and p-values, 0.05 were considered statistically significant.

Results:

The treatment outcomes with the status of “cured” and “completed treatment” were better among NIDPs as compared to IDPs. Patients with treatment outcome status of “defaulted treatment”, “without documentary evidence, and “failure” were high in IDPs as compared to NIDPs. Adherence to TB treatment was better among NIDPs (50.9%) as compared to IDPs (39.4%). The patients showing non-adherence to TB treatment were more among IDPS (27.3%) than NIDPs (10.9%).

Conclusion:

Overall results of this study revealed a poor adherence to the TB treatment medications with an odds ratio of 0.286, (p<0.05) among IDPs as compared with NIDPs.

Knowledge, Attitude, and Practice on Antibiotics and Its Resistance: A Two-Phase Mixed-Methods Online Study among Pakistani Community Pharmacists to Promote Rational Antibiotic Use

Antibiotic resistance (ABR) is an emerging global threat to public health. Substantial evidence has indicated that community pharmacists (CPs) can play a critical role in managing the ever-increasing threat of antibiotic resistance. This study aimed to determine the knowledge, attitude, and practices of CPs (n = 180) towards antibiotics and antibiotic resistance as well as to improve the rational use of antibiotics. A two-phase mixed-methods (quantitative and qualitative) online study was conducted in Pakistan from August 2019 to March 2020 by using validated questionnaires and semi-structured interview data. Different statistical methods were used to tabulate the quantitative data, whereas inductive thematic analysis was conducted to categorize themes from the qualitative data and to draw conclusions. Approximately 64.4% of the CPs were male (mean: 29–33 years old). Overall, CPs had good knowledge of and were familiar with multidrug-resistant organisms and their roles in ABR (65.6%, median = 1, and IQR = 1), although their knowledge was poor in differentiating some antibiotic groups with their respective ABR patterns (31.1%, median = 1, and IQR = 1). Most CPs have a positive attitude towards antibiotics, with most (90.0%) identifying ABR as a critical issue in public health (median = 1 and IQR = 0). Overall, CPs’ practices towards antibiotics were somewhat acceptable, where they leaned towards educating patients about the rational use of antibiotics (52.8%, median = 1, and IQR = 1). The two main themes discovered (antibiotics and counseling of patients) were related to self-medication, while educational intervention is the main subtheme. ABR is multifactorial, with subthemes related to budget, time constraints, incompetent staff, the absence of CPs, the lack of training, and the enforcement of laws and regulations being the needs of the hour in Pakistan. Effective antibiotic stewardship programs, patient education, and awareness campaigns about antibiotics and ABR along with training of the CPs are important factors that have to be addressed in a timely manner.

Synergistic impact of cellulose nanocrystals with multiple resins on thermal and mechanical behavior

The cellulose nanocrystals (CNCs) surface modified with phenolic and acrylic resins were investigated for different properties such as thermally stability and adhesive property, the mechanical properties of CNCs and interactions of the resulting materials at a micro-level are very important. Phenolic resins are of great interest due to their smooth structure, low thermal conductivity and good thermal insulation. However, the high spray rates and poor mechanical properties limit its use for external insulation of buildings. Acrylic resins are used as a matrix resin for adhesives and composites due to their adhesion, mechanical properties, and their good chemical resistance. The brittleness of acrylic resins makes them less attractive than the structural materials, being much harder. For this reason, most of the resins are modified with suitable elastomers, which act as hardeners. Therefore, treatment of these compounds is necessary. In this research paper, the effect of CNCs surface on phenolic and acrylic resins were investigated to obtain an optimized surface using three different weight (wt%) ratios of CNCs. Scanning electronic microscopy (SEM), X-rays diffraction (XRD), Thermogravimetric analysis (TGA) and Fourier transform infrared spectroscopy (FTIR) were used to characterize the structure, and investigate different properties of CNCs. Furthermore, the Zwick/Roell Z020 model was used to investigate the adhesion properties of the phenolic and acrylic resins with CNCs.

Occurrence, associated risk factors, and treatment of surgical site infections in Pakistan

Globally, surgical site infections are one of the common infections which lead to a large amount of mortality and morbidity in postsurgical care. The risk for surgical site infection is multidimensional which includes mainly; patient, surgery, and hospital-related factors. This study is aimed to determine the burden of SSIs along with contributed risk factors. A prospective observational cross-sectional study was conducted in one of the largest public-sector hospitals in Pakistan. A total of 412 patients were recruited in the study with full consent and monitored for 30 days after surgery with direct and indirect surveillance. Overall, in seven different surgical procedures the incidence (29.8%) rate of SSI was observed; in appendectomy ( n = 17, 4.1%), exploratory laparotomy ( n = 51, 12.6%), laparoscopic cholecystectomy ( n = 12, 2.90%), mesh repair ( n = 17, 4.01%), thyroidectomy (5, 1.2%), transurethral resection of the prostate ( n = 11, 2.6%), and transurethral resection of the bladder (10, 2.4%). The average SSI rate in every single procedure was about 18 (4.27%) per surgical procedure out of 123 (29.85%) SSI cases. Types of SSI identified were superficial, deep incisional and organ/space ( n = 76, 18.4%, n = 23, 5.5%, and n = 24, 5.7%). Incidence of SSIs during admission, at readmission, and post-surveillance cases were ( n = 50, 12.1%, n = 25, 6.0% and n = 48, 11.6%). Associated risk factors found contributed to the incidence of SSI ( p < 0.05). Pre-operative ( n = 348, 84.5%) and 6 (1.5%) surgical patients did not received the post-operative antibiotics. The P. aeruginosa ( n = 15, 12.1%) and S. aureus (13, 10.5%). Cefoperazone and sulbactam were the most prescribed antibiotics. Associated risk factors and treatment outcomes of surgical patients have a direct association with the incidence of SSI. Hospital-based antimicrobial stewardship, implementation of surgical guidelines, patient care, and education are needed to develop at wards level in hospitals.

Pharmacovigilance and incidence of adverse drug reactions in hospitalized pediatric patients: a mini systematic review

Background

Pharmacovigilance is an identifying and responding process against an adverse drug reaction (ADRs) problem encountered in the drug administration. ADRs are among the common reasons for morbidity and fatality in pediatrics throughout the globe.

Main body

A systemic review of the previous 10 years (2010–2019) published studies were taken into consideration to describe observational studies on ADRs and to determine the incidence and characteristics of ADRs in pediatrics. Electronic relevant literature was searched in PMC, PubMed, Google Scholar, and OvidSP databases using MESH heading and text words. The titles, text, and abstracts were checked for patients below 18 years of age, nature of ADRs, observational studies (prospective or retrospective), and maximum information was recorded to count their frequency. The studies which discussed specific or particular drug exposures were not selected in this review. Of the 36,689 titles retrieved, 27 studies were selected for full-text review. Ten observational studies were added in the final review. Observational studies on pediatric were carried out in seven distinct nations. The predominant study design within observational methodological studies was prospective (n = 5, 50%). The overall average occurrence of ADRs incidence was 9.52%. ADRs reporting in male patients (54.6%) were more than females (45.4%). The severe types of ADRs were reported in four studies. Anti-microbials were the most common class of drugs related to ADRs.

Conclusion

This systematic review reveals that ADRs in pediatrics are serious public health problems. Periodic drug surveillance studies are mandatory for the safe and appropriate usage of medicines in pediatrics.

Knowledge, attitude and practices among consumers toward antibiotics use and antibiotic resistance in Swat, Khyber-Pakhtunkhwa, Pakistan

Objective: Inappropriate use of antibiotics is one of the main causes of antibiotic resistance around the globe. The present study was aimed to assess the knowledge, attitude, and practices toward antibiotics and antibiotic resistance among consumers. Methods: A cross-sectional study was conducted from April 2019 to September 2019. The participants visiting community pharmacies to buy the antibiotics were approached by data collectors. The descriptive analysis, Kruskal Wallis, and Mann-Whitney statistical tests were used for data analysis through SPSS. Results: 399 participants at three pharmacies with male (n = 352, 88.2%), age (years) group between 34 to 41(n = 138, 34.6%), uneducated (n = 128, 32.1%), and higher education (n = 76, 19.0%) level of the participants were noted. Poor to moderate knowledge were observed; participants were unaware of the risk and misuse of antibiotics at all three pharmacies. By some means, a positive attitude noted, but the storage of antibiotics at home (Median = 2, IQR = 2) was preferred to use when needed. Most of the respondents didn't follow the actual dosage regimen as prescribed (n = 266, 66.7%, p < 0.05). Conclusion: A lack of knowledge and malpractices toward antibiotics use among consumers were observed. Education and awareness of the public about antibiotic resistance is the need of the hour.

Adhesive properties of bio-based epoxy resin reinforced by cellulose nanocrystal additives

The adhesive properties of a self-prepared bio-based epoxy resin with native cellulose nanocrystals (CNCs) are evaluated in this article. The porosity of actual CNCs is high. The most promising finding is the acquisition of high tensile modulus. The addition of CNC composites significantly increased the tensile modulus at lower wt.%, and the maximum crystallinity of CNCs was obtained. Bearing in mind the advantages of CNCs, scanning electron microscopy (SEM) showed a uniform distribution of concentrated CNCs. Clusters were formed at higher CNCs ratios, and the composite matrix content with high CNCs produced good expansion, low crystallinity, and increased elongation. Our analysis showed that the original CNCs were more evenly distributed in the self-prepared bio-based epoxy resin, which enhanced transformation, supported by improved dispersion of native CNCs. The presence of native CNCs greatly improved and enhanced the bonding performance of the bio-based epoxy resin in the interface area. Enhancing the mechanical properties of native CNCs has broad application prospects in environmental areas. This suggests that the widespread use of native CNCs in environmental engineering applications is feasible, especially in terms of adhesives properties.

Synthesis of Carboxymethyl Starch-Bio-Based Epoxy Resin and their Impact on Mechanical Properties

In the current research, we observed numerous suggestions are promoting the use of bio-based epoxy resins, replacing the petroleum-based products like Diglycidyl ether of bisphenol A type epoxy resin DGEBA. With the passage of time, the impending challenges include preparation of environmentally-friendly epoxy with minimum toxic side effect and improved properties. Therefore, we describe a very useful method for preparing new silicone-bridged dimethyl siloxane monomers in high quantity, derived from naturally occurring eugenol. By putting the methyl siloxane, computed with different chain lengths into their molecular backbone. Such epoxy monomers have different molecular structure with high purity. This dimethyl siloxane epoxy, with lower viscosity than commercial DGEBA epoxy, has superior thermal properties, which were evaluated using differential scanning calorimetry DSC. Modification of CMS increases the hydrophilicity. Bio-based epoxy (self-prepared) resin improved adhesive properties, with the help of modified CMS. This study presents a very easy and effective chemical modification to enhance interfacial adhesion composites with superior properties.

Investigation of nepetolide as a novel lead compound: Antioxidant, antimicrobial, cytotoxic, anticancer, anti-inflammatory, analgesic activities and molecular docking evaluation

In the present study, we describe various pharmacological effects and computational analysis of nepetolide, a tricyclic clerodane-type diterpene, isolated from Nepeta suavis. Nepetolide concentration-dependently (1.0-1000 µg/mL) exhibited 1,1-diphenyl,2-picrylhydrazyl free radical scavenging activity with maximum effect of 87.01 ± 1.85%, indicating its antioxidant potential, as shown by standard drug, ascorbic acid. It was moderately active against bacterial strain of Staphylococcus aureus. In brine shrimp's lethality model, nepetolide potently showed cytotoxic effect, with LC50 value of 8.7 µg/mL. When evaluated for antitumor activity in potato disc tumor assay, nepetolide exerted tumor inhibitory effect of 56.5 ± 1.5% at maximum tested concentration of 1000 µg/mL. Nepetolide at 20 mg/kg reduced carrageenan-induced inflammation (P < .001 vs. saline group) in rat paw. Nepetolide dose-dependently (100-500 mg/kg) decreased acetic acid evoked writhes, as exhibited by diclofenac sodium. In-silico investigation of nepetolide was carried out against cyclooxygenase-2, epidermal growth factor receptor and lipoxygenase-2 targets. Virtual screening through Patchdock online docking server identified primarily hydrophobic interactions between ligand nepetolide and receptors proteins. Enhanced hydrogen bonding was predicted with Autodock showing 6-8 hydrogen bonds per target. These results indicate that nepetolide exhibits antioxidant, antibacterial, cytotoxic, anticancer, anti-inflammatory and analgesic activities and should be considered as a lead compound for developing drugs for the remedy of oxidative stress-induced disorders, microbial infections, cancers, inflammations and pain.

Nanosilver: new ageless and versatile biomedical therapeutic scaffold

Silver nanotechnology has received tremendous attention in recent years, owing to its wide range of applications in various fields and its intrinsic therapeutic properties. In this review, an attempt is made to critically evaluate the chemical, physical, and biological synthesis of silver nanoparticles (AgNPs) as well as their efficacy in the field of theranostics including microbiology and parasitology. Moreover, an outlook is also provided regarding the performance of AgNPs against different biological systems such as bacteria, fungi, viruses, and parasites (leishmanial and malarial parasites) in curing certain fatal human diseases, with a special focus on cancer. The mechanism of action of AgNPs in different biological systems still remains enigmatic. Here, due to limited available literature, we only focused on AgNPs mechanism in biological systems including human (wound healing and apoptosis), bacteria, and viruses which may open new windows for future research to ensure the versatile application of AgNPs in cosmetics, electronics, and medical fields.

An overview on phase variation, mechanisms and roles in bacterial adaptation

In nature, bacteria are exposed to multiple stress conditions posing threat to their life. However, bacteria evolve constantly and employ myriad of genetic and phenotypic strategies for successful survival. One such adaptive process is phase variation - a random, frequent and reversible ON/OFF switching of contingency genes generating phenotypical variations within the bacterial population. Pathogenic and commensal bacteria make use of this heritable process as a tool for adaptation, generating intra-strain diversity and immune evasion. Unveiling molecular basis of this aspect of bacterial pathogenesis is vital in yielding significant implications to understand health and diseases. The current review was planned to overview this hot topic of research, its molecular basis and biological significance.

Spasmolytic and Ca++ Channel Blocking Potential of Nepetolide: Isolated from Nepeta Suavis

Nepeta suavis is used in traditional medicine for treatment of abdominal spasm (colic). The tricyclic clerodane type diterpene, nepetolide, isolated for the first time from Nepeta suavis. was evaluated for Ca++ antagonist and antispasmodic activities. When studied in isolated rabbit jejunum, nepetolide caused concentration-dependent (0.03–100 μM) relaxation of spontaneous and high K+ (80 mM)-induced contractions, like that caused by verapamil, indicating that nepetolide exhibits spasmolytic activity, possibly mediated through Ca++ channel blocking action, which provides scientific explanation for the medicinal application of Nepeta suavis as an antispasmodic agent.

Spasmolytic and Ca++ Channel Blocking Potential of Nepetolide: Isolated from Nepeta suavis

Nepeta suavis is used in traditional medicine for treatment of abdominal spasm (colic). The tricyclic clerodane type diterpene, nepetolide, isolated for the first time from Nepeta suavis, was evaluated for Ca++ antagonist and antispasmodic activities. When studied in isolated rabbit jejunum, nepetolide caused concentration-dependent (0.03-100 μM) relaxation of spontaneous and high K+ (80 mM)-induced contractions, like that caused by verapamil, indicating that nepetolide exhibits spasmolytic activity, possibly mediated through Ca++ channel blocking action, which provides scientific explanation for the medicinal application of Nepeta suavis as an antispasmodic agent.

Assessing the complications and effectiveness of open carpal tunnel release in a tertiary care centre in a developing country

INTRODUCTION

Open surgical release for carpal tunnel syndrome is not devoid of complications and its quantitative assessment with the Boston questionnaire in a developing country had not been conducted, where, lack of facilities and surgical technique can influence the outcome.

PRESENTATION OF CASE

This was a prospective study in which all cases of carpal tunnel syndrome undergoing open release between June 2007 and June 2012 and who returned for follow up were included. Each patient was requested to fill out the Boston questionnaire twice both pre and post op at 3 months. All complications were recorded as well as bio-data of patients and co morbidities. Follow up was at 2 weeks and at 3 months. Those reporting complications at 3 months were further followed up until 6 months. 373 patients were included in the study. Twenty four patients developed complications. Of these, 12 experienced pain resulting from reflex sympathetic dystrophy. Three patients developed wound dehiscence, 2 cases acquired infections, 4 patients developed immediate post-operative haemorrhage and in 3 patients there was late recurrence of median nerve compression. The symptom severity score pre-operatively was 3.30 (±0.60) and it improved to 1.65 (±0.75) post-operatively indicating a significant change (p<0.0001). The preoperative functional status score was 2.58 (±0.75) and post-op it became 1.60 (±0.80) again implying a good improvement with an effect size of 1.3.

DISCUSSION

All of the complications produced were well managed. The complication incidence was low. The open release procedure produced good improvement in hand function and in decreasing the symptom severity.

CONCLUSION

Conducting open release for carpal tunnel syndrome in a tertiary referral centre in a developing country offers a good outcome.

Ajuganane: a new phenolic compound from Ajuga bracteosa

Phytochemical investigation of Ajuga bracteosa Wall ex Benth. (Labiatae) resulted in the isolation of a new phenolic compound, ajuganane (1) and three known compounds, 3,4'-dihydroxy-3,6,7-trimethoxyflavone, 7-hydroxy-3,6,3',4'-tetramethoxyflavone and ursolic acid. The structure of the new compound was elucidated by detailed spectroscopic (1H, 13C NMR, COSY, HMQC, HMBC), and HR-EI-MS analysis.

Ajuganane: A New Phenolic Compound from Ajuga bracteosa

Phytochemical investigation of Ajuga bracteosa Wall ex Benth. (Labiatae) resulted in the isolation of a new phenolic compound, ajuganane (1) and three known compounds, 3,4′-dihydroxy-3,6,7-trimethoxyflavone, 7-hydroxy-3,6,3′,4′-tetramethoxyflavone and ursolic acid. The structure of the new compound was elucidated by detailed spectroscopic (1H, 13 C NMR, COSY, HMQC, HMBC), and HR-EI-MS analysis.

Phlomeoic acid: a new diterpene from Phlomis bracteosa

A new tricyclic clerodane-type diterpenoid, trivially named phlomeoic acid (1), was isolated from the methanolic extract of Phlomis bracteosa, together with two known compounds, ursolic acid and glutinol, isolated for the first time from this species. Their structures were elucidated by means of spectroscopic and mass spectrometric techniques and comparison with literature data.

Phlomeoic acid: A New Diterpene from Phlomis bracteosa

A new tricyclic clerodane-type diterpenoid, trivially named phlomeoic acid (1), was isolated from the methanolic extract of Phlomis bracteosa, together with two known compounds, ursolic acid and glutinol, isolated for the first time from this species. Their structures were elucidated by means of spectroscopic and mass spectrometric techniques and comparison with literature data.