Novel Hydrophilic Oligomer-Crosslinked Gelatin-Based Hydrogels for Biomedical Applications

Gelatin-based hydrogels have shown good injectability and biocompatibility and have been broadly used for drug delivery and tissue regeneration. However, their low mechanical strengths and fast degradation rates must be modified for long-term implantation applications. With an aim to develop mechanically stable hydrogels, reactive anhydride-based oligomers were developed and used to fabricate gelatin-based crosslinked hydrogels in this study. A cascade of hydrophilic oligomers containing reactive anhydride groups was synthesized by free radical polymerization. These oligomers varied in degree of reactivity, comonomer composition, and showed low molecular weights (M_n < 5 kDa). The reactive oligomers were utilized to fabricate hydrogels that differed in their mechanical strengths and degradation profiles. These formulations exhibited good cytocompatibility with human adipose tissue-derived stem cells (hADCs). In conclusion, the reactive MA-containing oligomers were successfully synthesized and utilized for the development of oligomer-crosslinked hydrogels. Such oligomer-crosslinked gelatin-based hydrogels hold promise as drug or cell carriers in various biomedical applications.

A Cross-Sectional Analysis of Knowledge, Beliefs and Practices Regarding Traditional Medicine Use among Pharmacy Students of Different Private and Government Universities of Lahore, Pakistan

Background: Students’ understanding regarding traditional medicine is a part of pharmacy curriculum. In Pakistan, be it students or healthcare professionals, little is known about the general importance of traditional medicine. Objectives: The aim of this study is to assess the students, enrolled in Doctor of Pharmacy Program, regarding their beliefs, knowledge and practices for use of medicinal plants. Methodology: The questionnaires were distributed among the Doctor of Pharmacy (Pharm-D) students. The data was analyzed using SPSS software (IBM, version. 22) and different statistical tests were applied, including descriptive analysis, t-test and Pearson chi squared test. Results: Total 254 responses were obtained in the study. While the outcome indicates that the majority of the participants (n=237: 93.3%) acknowledge the usefulness of traditional medicine. 151 (59.4%) participants believed that the traditional medicine is safe but 103 (40.6%) concerned about the side effects of herbal remedies. 187 (73.6%) reported the use of some type of medicinal plants in their life. Easy availability of traditional medicine was reported by 186 (73.2%) participants and 176 (69.3%) claimed the medicinal plants as inexpensive alternatives. The physician was kept informed about the concomitant administration of herbal with allopathic medicine in only 43 (16.9%). Stomach pain (14.17%) was most common sickness for which participants utilized traditional treatment, followed by cough (12.6%) and flu (10.63%). Mint (10.24%) was found to be the most commonly used medicinal plant, followed by aloe (9.84%) and ginger (7.48%). Conclusion: Detailed studies are still required to evaluate not only the students but also health care professionals about their understanding, prescribing practice and dealing with patients already using medicinal plants. This will help in improved management of the disorders and may lead further advancement in the field of natural product research and cutting off ill effects of allopathic treatment. Bangladesh Journal of Medical Science Vol. 21 No. 02 April’22 Page : 323-334

Skin needling with 100% trichloroacetic acid vs. needling with bleomycin in the treatment of recalcitrant cutaneous warts

The treatment of warts has always been a challenging prospect for dermatologists. In some cases, these warts can become resistant or recalcitrant to treatment. Although a plethora of therapeutic and destructive options is available for wart management, to date no treatment has been found to be completely effective because none of the agents induce specific antiviral immunity. We conducted a study to evaluate the efficacy and safety of skin needling with topical 100% trichloroacetic acid (TCA) against the same type of skin needling with bleomycin in patients with recalcitrant cutaneous warts. In total, 33 (63.5%) patients in the TCA group and 35 (81.4%) in the bleomycin group had complete clearance of all the warts, which was not statistically significant (P = 0.13). There was also no statistically significant difference between the treated and untreated warts in the bleomycin group, whereas in the TCA group there was a significantly higher response rate in the treated warts. The most common adverse event (AE) in both groups was transient procedure site pain. We found that the use of needling plus TCA leads to a faster resolution of warts compared with needling plus bleomycin, with a comparable safety profile. Additionally, we found that TCA is superior to bleomycin for management of multiple warts. However, needling with either TCA or bleomycin has excellent and fairly comparable efficacy, and these methods should be used for the management of multiple or recalcitrant warts, as they have minimal AEs and recurrence rates.

A comprehensive review on gout: The epidemiological trends, pathophysiology, clinical presentation, diagnosis and treatment

The current review was planned to assess updated knowledge about gout and to highlight the various areas which need to be focussed upon for better healthcare. Relevant articles published in English language were reviewed by utilising various databases including Google Scholar, Springer Link, Science Direct and MEDLINE. Data revealed a precipitating number of gout cases from the developed countries, while the developing countries on the other hand were found to be faced with an even higher threat. The risk factors and pathophysiology of gout are immaculate and clearly established. Hence, appropriate measures can be explored and worked on to pinpoint diagnosis, and economical treatment. In order to lessen the elevated global health burden along with revolutionising the patient's quality of life, an immediate action is required in certain aspects, like the adoption of a healthy modified lifestyle, a reduction in exposure to risk factors, robust prophylactic measures, bettering awareness, and an approach to early diagnosis followed by optimal treatment protocols.

Cytotoxic and antiviral potentials of Euphorbia milii var. splendens leaf against Peste des petits ruminant virus

Purpose: To determine the cytotoxic and antiviral potentials of Euphorbia milii var. splendens leaf against Peste des petits ruminants virus (PPRV). Methods: The methanol extract, as well as n- hexane, chloroform, ethyl acetate, and n- butanol fractions of E. milii leaves were screened for cytotoxic and antiviral activities against PPRV using Vero cell line and 3-(4,5-dimethylthiazol-2-yl)-2,diphenyltetrazolium bromide (MTT) assay. Results: Non-cytotoxic concentrations with cell survival rate (CSP) greater than 50 % were considered virucidal. Methanol extract and fractions produced significant (p < 0.05) effects at all test concentrations against PPRV. The 50 % cytotoxic concentration (CC50) calculated was ≤ 25 µg/mL for extract and fractions. In antiviral assay, ethyl acetate, n-hexane, and n-butanol fractions at all test concentrations ranging from 1.56 - 800 µg/mL were non-virucidal; even at their non-cytotoxic concentrations these fractions did not show antiviral activities. However, the methanol extract and its chloroform fractions showed significant (p < 0.05) virucidal potential. Conclusion: The results suggest that further isolation of antiviral constituents from the fractions may open new horizons for the development of new antiviral agents.

Limited responsiveness related to the minimal important difference of patient-reported outcomes in rare diseases

OBJECTIVES

To explore the responsiveness of patient-reported outcomes (PROs) in interventional studies involving patients with rare lysosomal storage diseases (LSDs).

STUDY DESIGN AND SETTING

We searched eight databases for experimental and nonexperimental studies. Pairs of trained reviewers independently screened articles and subsequently extracted data from the eligible studies. Among studies with 10 or more patients using a valid PRO, we assessed the responsiveness of PROs based on a reanalysis of the data using minimal important difference estimates. Our analyses focused on statistically significant within-group differences in PROs for observational studies or the statistically significant between-group differences in PRO scores for controlled studies.

RESULTS

Of 2,679 unique records, 62 interventional studies addressing patients with Fabry (55%), Gaucher (19%), Pompe (16%), and mucopolysaccharidoses (11%) proved eligible. The most frequently used PROs were the Short-Form-36 (25 studies), Brief Pain Inventory (20 studies), EuroQoL-5D (9 studies), and the Fatigue Severity Scale (6 studies). Observational studies suggest that PROs sometimes detect significant within-group changes when present. Randomized trials raise questions regarding the responsiveness of PROs to small differences between groups.

CONCLUSIONS

Most studies have relied on generic PROs to evaluate quality of life and symptoms in patients with rare LSDs. PROs appear more responsive in observational studies than randomized trials.

Management of Central Poststroke Pain

Background and Purpose—

Central poststroke pain is a chronic neuropathic disorder that follows a stroke. Current research on its management is limited, and no review has evaluated all therapies for central poststroke pain.

Methods—

We conducted a systematic review of randomized controlled trials to evaluate therapies for central poststroke pain. We identified eligible trials, in any language, by systematic searches of AMED, CENTRAL, CINAHL, DARE, EMBASE, HealthSTAR, MEDLINE, and PsychINFO. Eligible trials (1) enrolled ≥10 patients with central poststroke pain; (2) randomly assigned them to an active therapy or a control arm; and (3) collected outcome data ≥14 days after treatment. Pairs of reviewers, independently and in duplicate, screened titles and abstracts of identified citations, reviewed full texts of potentially eligible trials, and extracted information from eligible studies. We used a modified Cochrane tool to evaluate risk of bias of eligible studies, and collected patient-important outcomes according to recommendations by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials. We conducted, when possible, random effects meta-analyses, and evaluated our certainty in treatment effects using the Grading of Recommendations Assessment, Development, and Evaluation System.

Results—

Eight eligible English language randomized controlled trials (459 patients) tested anticonvulsants, an antidepressant, an opioid antagonist, repetitive transcranial magnetic stimulation, and acupuncture. Results suggested that all therapies had little to no effect on pain and other patient-important outcomes. Our certainty in the treatment estimates ranged from very low to low.

Conclusions—

Our findings are inconsistent with major clinical practice guidelines; the available evidence suggests no beneficial effects of any therapies that researchers have evaluated in randomized controlled trials.