Lipid Nanocapsule: A Novel Approach to Drug Delivery System Formulation Development

Nanocapsules are polymeric nanoparticles encased in a polymeric coating composed of a predominantly non-ionic surfactant, macromolecules, phospholipids, and an oil core. Lipophilic drugs have been entrapped using various nanocarriers, including lipid cores, likely lipid nanocapsules, solid lipid nanoparticles, and others. A phase inversion temperature approach is used to create lipid nanocapsules. The PEG (polyethyleneglycol) is primarily utilised to produce nanocapsules and is a critical parameter influencing capsule residence time. With their broad drug-loading features, lipid nanocapsules have a distinct advantage in drug delivery systems, such as the capacity to encapsulate hydrophilic or lipophilic pharmaceuticals. Lipid nanocapsules, as detailed in this review, are surface modified, contain target-specific patterns, and have stable physical and chemical properties. Furthermore, lipid nanocapsules have target-specific delivery and are commonly employed as a marker in the diagnosis of numerous illnesses. This review focuses on nanocapsule synthesis, characterisation, and application, which will help understand the unique features of nanocapsules and their application in drug delivery systems.

Mechanism-based Suppression of Cancer by Targeting DNA-Replicating Enzymes

The human genetic structure undergoes continuous wear and tear process due to the mere presence of extrinsic as well as intrinsic factors. In normal physiological cells, DNA damage initiates various checkpoints that may activate the repair system or induce apoptosis that helps maintain cellular integrity. While in cancerous cells, due to alterations in signaling pathways and defective checkpoints, there exists a marked deviation of error-free DNA repairing/synthesis. Currently, cancer therapy targeting the DNA damage response shows significant therapeutic potential by tailoring the therapy from non-specific to tumor-specific activity. Recently, numerous drugs that target the DNA replicating enzymes have been approved or some are under clinical trial. Drugs like PARP and PARG inhibitors showed sweeping effects against cancer cells. This review highlights the mechanistic study of different drug categories that target DNA replication and thus depicts the futuristic approach of targeted therapy.

Spina bifida occulta with the persistent spinous process in living: A three-dimensionally reconstructed sacrum from computed tomographic imaging

Background

Here we aim to report the persistent spinous process in the 'pan sacral type' of spina bifida occulta in an asymptomatic male and discuss its clinical significance. The presence of this type of dorsal wall defect with a bony spur attached to it has never been described in the literature to the best of our knowledge after extensive literature search. Our work presents the first anatomic description where the spinous and paraspinous cleft are seen in a sacrum of a live subject.

Case Report

During a morphometric study of the sacra, normal subject computed tomography imaging (CT) was procured from the Department of Radio-diagnosis. A three-dimensional (3D) image of the sacrum was created using Dicom to Print and Geomagic freeform plus software. A complete dorsal wall defect was observed in a 3D reconstructed sacrum of an adult male. The sacral canal was converted into a groove with a bony spur hanging in the centre. The longitudinal bony spur attached to the lamina was the persistent spinous process.

Conclusion

Such congenital defects are clinically significant for the anaesthetist during caudal epidural block and for orthopaedic surgeons before any surgical procedure. It may be misdiagnosed as an abnormal bony injury on CT. Thus, it is essential to ensure that patients with congenital anomalies are not treated unnecessarily for spinal fractures.

Recent Advances in Research and Management of Human Monkeypox Virus: An Emerging Global Health Threat

In 2003, the United States saw an epidemic of monkeypox that was later traced back to rodents of West Africa infected with the monkeypox virus (MPXV). Disease in the United States seemed less severe than the smallpox-like disease in the Democratic Republic of the Congo (DRC). In this study, researchers analyzed data from Central Africa: two distinct MPXV clades were confirmed by sequencing the genomes of MPXV isolates from Western Africa, the United States, and Central Africa. By comparing open reading frames across MPXV clades, scientists can infer which virus proteins might account for the observed variation in pathogenicity in humans. Monkeypox can be prevented and controlled with a better understanding of MPXV's molecular etiology and epidemiological and clinical features. In light of the current outbreaks worldwide, we provide updated information on monkeypox for medical professionals in this review.

Recent Developments in the Study of the Microenvironment of Cancer and Drug Delivery

Cancer is characterized by disrupted molecular variables caused by cells that deviate from regular signal transduction. The uncontrolled segment of such cancerous cells annihilates most of the tissues that contact them. Gene therapy, immunotherapy, and nanotechnology advancements have resulted in novel strategies for anticancer drug delivery. Furthermore, diverse dispersion of nanoparticles in normal stroma cells adversely affects the healthy cells and disrupts the crosstalk of tumour stroma. It can contribute to cancer cell progression inhibition and, conversely, to acquired resistance, enabling cancer cell metastasis and proliferation. The tumour's microenvironment is critical in controlling the dispersion and physiological activities of nano-chemotherapeutics which is one of the targeted drug therapy. As it is one of the methods of treating cancer that involves the use of medications or other substances to specifically target and kill off certain subsets of malignant cells. A targeted therapy may be administered alone or in addition to more conventional methods of care like surgery, chemotherapy, or radiation treatment. The tumour microenvironment, stromatogenesis, barriers and advancement in the drug delivery system across tumour tissue are summarised in this review.

Promises of Molecular Pharmaceutics in the Development of Novel Drug Delivery Formulations

Abstract:

Molecular pharmaceutics play a critical role in the drug delivery system, representing the direct interconnection of drug bioavailability with its molecular form. There is a diversity in the molecular structures by which it affects its properties, such as amorphous form, crystalline form, partialamorphous molecular dispersion, and disordered state. The active pharmaceutical ingredient (API) and the excipients utilized in the formulation process contain various divergent modes used in the formulation process. They include better formulations of any type to obtain good quality pharmaceutical products. This review reveals how the molecular states affect the API and are important in maintaining the quality of dosage forms. Furthermore, the physio-chemical properties of the components and various pharmaceutical approaches employed in the formulation of dosage forms are studied from the point of view of molecular pharmaceutics

Effect of Temperature on Oxymyoglobin and Metmyoglobin Denaturation Properties

ObjectivesPremature browning is a condition where the interior of patty/steak will appears fully cooked before the temperature necessary to kill foodborne pathogens is reached. Previous research reported that approximately 50% of ground beef retailed in the US is susceptible to premature browning. Myoglobin form present in the interior of steak or patties determines the cooked color appearance. Although previous studies noted that myoglobin denaturation is primarily responsible for the cooked color appearance, limited knowledge is currently available about the effect of temperature on oxymyoglobin and metmyoglobin denaturation properties. The objective of the current study was to determine the effects of myoglobin forms on thermal stability using circular dichroism spectroscopy.Materials and MethodsOxymyoglobin and metmyoglobin solutions at pH 5.6 in 50 mM sodium phosphate buffer were incubated in a continuous heat increment water bath for 10 min. At specific temperature points (65, 71, 73, and 76°C), myoglobin denaturation was determined by changes in myoglobin concentration and by protein unfolding (fluorescence and absorbance) methods. The myoglobin thermal stability was also determined by circular dichroism spectroscopy. Changes in secondary protein structure were determined every 2°C from 52 to 92°C. The data were analyzed as completely randomized using the Mixed Procedure of SAS. A significance level of 0.05 was used to determine differences between means.ResultsOxymyoglobin had greater (p < 0.05) unfolding (as indicated by absorbance changes) than metmyoglobin at all temperatures. However, at 65, 71, and 73°C there were no differences (p > 0.05) in fluorescence intensities between myoglobin forms. Circular dichroism spectroscopy indicates that oxymyoglobin is more heat labile than metmyoglobin.ConclusionThe results indicate that oxymyoglobin had greater denaturation and unfolding than metmyoglobin. Use of appropriate myoglobin denaturation quantification technique will help characterize premature browning.

Vertebral arteries bilaterally passing through stellate (cervicothoracic) ganglion

Vertebral artery is a branch of the first part of subclavian artery. Vertebral artery arising from the aortic arch most commonly presents on the left side. The cervical part of sympathetic trunk is closely related to the vertebral artery in the cervical region. Though lots of variations regarding anomalous origin, course of vertebral artery is reported in the literature, here we present a rare anomaly in which vertebral artery after originating from aortic arch is passing through stellate ganglia and it enters into the transverse foramina of higher cervical vertebra (C5). Such variation should be kept in mind by anaesthetist during stellate ganglion block in order to relieve intractable pain in central nervous system lesion. Surgeons should keep this anomaly in mind during cervical spine surgery otherwise vertebral artery may get injured leading to haemorrhage.

Comparison of single-incision laparoscopic high anterior resection with standard laparoscopic high anterior resection

AIM

Single-incision laparoscopic surgery (SILS) is gaining momentum. The aim of the present study was to compare the outcome of SILS for high anterior resection with that of standard laparoscopic resection (StdLS).

METHOD

Patients undergoing laparoscopic high anterior resection were prospectively entered into an institutional approved database. Patients treated with SILS were compared with those undergoing StdLS.

RESULTS

Between April 2000 and April 2009, 327 (143 cancer) consecutive unselected patients underwent StdLS; there were three (1%) conversions and 12 (3.6%) covering ileostomies. After April 2009, 55 (29 cancer) consecutive, unselected patients underwent SILS; there were two conversions to a three-port technique (3.6%), no conversions to open resection and two (3.6%) covering ileostomies. There were no significant differences in age, sex, body mass index, hospital of operation or American Society of Anesthesiology (ASA) grade between the two groups. The operating time for SILS was significantly shorter (113 ± 44 min for StdLS vs 79 ± 37 min for SILS; P < 0.0001). SILS patients tolerated a normal diet earlier [10 (2-24) h for SILS vs 18 (2-96) h for StdLS] and were discharged faster [1 (1-8) days for SILS vs 3 (1-24) days for StdLS]. There were no significant differences in return to theatre, readmissions or 30-day mortality.

CONCLUSION

SILS for high anterior resection is feasible, safe and quicker to perform than standard three-port laparoscopic colectomy. It seems to be associated with a faster recovery and earlier discharge.

Laparoscopic surgery for recurrent ileocolic Crohn's disease is as safe and effective as primary resection

AIM

The safety and short-term outcome of laparoscopic surgery for recurrent ileocolic Crohn's disease was compared with the outcome following primary resection.

METHOD

Between June 2002 and June 2010, 59 consecutive unselected patients (30 of whom had recurrent disease) underwent laparoscopic ileocolic resection. Four primary resections and one revision were performed as a single incision laparoscopic surgery (SILS) procedure.

RESULTS

There was no difference between the two groups in terms of age, body mass index, American Society of Anesthesiology (ASA) grade or the presence or absence of fistulating disease. The median operating time was significantly longer for the revision group (125 min vs 85 min; P < 0.001). The rate of conversion was 8.5%, morbidity was 20% and mortality was 0% (P = not significant between groups). Risk factors for conversion included a complex fistula, fibrosis and the need to carry out multiple stricturoplasty. Patients in whom surgery was converted had a longer hospital stay and a higher morbidity (40%). The median hospital stay was 3 days, the return to theatre rate was 5% and the re-admission rate was 5% (P = not significant between groups).

CONCLUSION

Laparoscopic surgery for recurrent ileocolic Crohn's disease is safe and can lead to significant short-term benefit, including earlier discharge. Conversion increases the length of stay in hospital and the overall morbidity.

An FTO variant is associated with Type 2 diabetes in South Asian populations after accounting for body mass index and waist circumference

AIMS

A common variant, rs9939609, in the FTO (fat mass and obesity) gene is associated with adiposity in Europeans, explaining its relationship with diabetes. However, data are inconsistent in South Asians. Our aim was to investigate the association of the FTO rs9939609 variant with obesity, obesity-related traits and Type 2 diabetes in South Asian individuals, and to use meta-analyses to attempt to clarify to what extent BMI influences the association of FTO variants with diabetes in South Asians.

METHODS

We analysed rs9939609 in two studies of Pakistani individuals: 1666 adults aged ≥40 years from the Karachi population-based Control of Blood Pressure and Risk Attenuation (COBRA) study and 2745 individuals of Punjabi ancestry who were part of a Type 2 diabetes case-control study (UK Asian Diabetes Study/Diabetes Genetics in Pakistan; UKADS/DGP). The main outcomes were BMI, waist circumference and diabetes. Regression analyses were performed to determine associations between FTO alleles and outcomes. Summary estimates were combined in a meta-analysis of 8091 South Asian individuals (3919 patients with Type 2 diabetes and 4172 control subjects), including those from two previous studies.

RESULTS

In the 4411 Pakistani individuals from this study, the age-, sex- and diabetes-adjusted association of FTO variant rs9939609 with BMI was 0.45 (95%CI 0.24-0.67) kg/m(2) per A-allele (P=3.0 × 10(-5) ) and with waist circumference was 0.88 (95% CI 0.36-1.41) cm per A-allele (P=0.001). The A-allele (30% frequency) was also significantly associated with Type 2 diabetes [per A-allele odds ratio (95%CI) 1.18 (1.07-1.30); P=0.0009]. A meta-analysis of four South Asian studies with 8091 subjects showed that the FTO A-allele predisposes to Type 2 diabetes [1.22 (95%CI 1.14-1.31); P=1.07 × 10(-8) ] even after adjusting for BMI [1.18 (95%CI 1.10-1.27); P=1.02 × 10(-5) ] or waist circumference [1.18 (95%CI 1.10-1.27); P=3.97 × 10(-5) ].

CONCLUSIONS

The strong association between FTO genotype and BMI and waist circumference in South Asians is similar to that observed in Europeans. In contrast, the strong association of FTO genotype with diabetes is only partly accounted for by BMI.

Plant codon optimized cry genes of Bacillus thuringiensis can be expressed as soluble proteins in Escherichia coli BL21 Codon Plus strain as NusA-Cry protein fusions

For optimal expression of delta-endotoxins from Bacillus thuringiensis in plants, preferential changes in the codon sequences, and reduction in overall AT content in the nucleotide sequence of the genes is important. Reports suggest that sequences with such modifications cannot be overexpressed in bacteria. We report here that the modified genes can be overexpressed in a strain of Escherichia coli carrying extra tRNA genes for some of the codons occurring at high frequency in plant genes and less preferred in E. coli. We also demonstrate that proteins when expressed as fusion products with NusA protein, are obtained as soluble fraction rather than in inclusion bodies. This allows easy and accurate LC50 analysis on insect pests.

Slow desiccation leads to high-frequency shoot recovery from transformed somatic embryos of cotton (Gossypium hirsutum L. cv. Coker 310 FR)

In Agrobacterium-mediated genetic transformation of cotton (Gossypium hirsutum L. cv. Coker 310FR) the frequency at which somatic embryos were converted to plantlets was significantly improved by subjecting the embryos to slow physical desiccation. We used Agrobacterium strain GV3101 containing the binary vector pGSFR with the nos-nptII gene for in vitro selection and the 35S gus-int fragment as a reporter to optimize the transformation protocol. Although the concentration of kanamycin was reduced during embryogenesis and embryo maturation, even at the lower levels somatic embryos were predominantly abnormal, showing hypertrophy and reduced or fused cotyledons or poor radicle ends. A majority of these embryos (more than 75%) were beta-glucuronidase (GUS)-positive. Embryos with an abnormal appearance showed a very poor conversion to plantlets. However, these embryos, when subjected to slow physical desiccation followed by transfer to fresh medium, regenerated single or multiple shoots from the cotyledonary end. These shoots could be grafted on wild-type seedling stocks in vitro, which, following their transfer to soil, developed normally and set seeds. Regenerated plants tested positive for the transgene by Southern analysis. An overall scheme for the high-frequency production of cotton transgenics from both normal and abnormal appearing somatic embryos is presented.

Sleep disorders: a risk factor for pseudotumor cerebri?

OBJECTIVE

To determine whether sleep-related breathing disorders are common in patients with idiopathic intracranial hypertension.

MATERIALS AND METHODS

Medical records of 53 patients with idiopathic intracranial hypertension from a tertiary center neuroophthalmology practice were reviewed. Thirty-seven patients were identified who had a history of snoring, difficulty sleeping, or daytime somnolence. The data from polysomnograms were tabulated to determine the frequency of apneas, hypopneas, and arousals.

RESULTS

Fourteen of 37 patients with idiopathic intracranial hypertension and symptoms of sleep disturbance underwent polysomnography. There were two men and 12 women varying in age from 24 to 58 years (mean, 39.4 +/- 11.9). These patients were obese with body mass indexes varying from 33.0 to 63.2 (mean, 46.0 +/- 9.5). A diagnosis of sleep apnea was made in six and upper airway resistance syndrome in seven patients.

CONCLUSIONS

Sleep-related breathing problems were common in our patients with idiopathic intracranial hypertension. Obesity was common in these patients and may be playing a causative role in sleep apnea and idiopathic intracranial hypertension. It is suggested that idiopathic intracranial hypertension patients who have symptoms of sleep disturbance should be further evaluated for the presence of sleep-related breathing problems.

Attention deficit hyperactivity disorder in adults and obstructive sleep apnea

Attention deficit hyperactivity disorder (ADHD) is a common childhood illness with a prevalence between 3% and 16%. It is characterized by hyperactivity, impulsiveness, impairment in academic, social, and occupational functioning, short attention span, and onset of symptoms before age 7 years. In some patients, this illness can persist into adulthood. Obstructive sleep apnea (OSA) is a common disorder affecting 3% of the population and is characterized by hypersomnolence, snoring, disturbed sleep, and cognitive dysfunction. Some studies have suggested an association between OSA and ADHD in children. Because of the overlap of symptoms, patients with OSA may be considered to have ADHD. Significant improvement in symptoms has been reported with the use of continuous positive airway pressure in patients with OSA. We present reports of three adults who were being treated for ADHD and were found to have OSA.

Recurrent giant cell reparative granuloma of hard palate: role of Tc-99m-MDP three-phase bone scan

A 42-year-old female presented with pain in the hard palate following surgical curettage for giant cell reparative granuloma. Radiographs of the face at this time did not reveal any abnormality. The surgeons' query was to differentiate fibrosis from recurrence before considering her for recurettage. The three-phase bone scan helped in establishing the diagnosis of recurrence, which was confirmed after histological examination of the curettaged tissue.

Hour-to-hour variability of oxygen saturation in sleep apnea

STUDY OBJECTIVES

Methods used to express the severity of oxygen desaturation during polysomnography include the average oxygen saturation (AO2), lowest oxygen saturation (LO2), and the percent of the total time with oxygen saturation level lower than 90% (T<90%). We wanted to determine which one of these methods is least variable during different hours of monitoring.

DESIGN

Prospective, observational study.

SETTING

Sleep center at a medical university.

PATIENTS

One hundred fifty patients with apnea-hypopnea index from 5 to 130.

MEASUREMENTS

AO2, LO2, and T<90% were calculated during each of the 8 h of polysomnography. Data for each hour were compared and the Cronbach alpha coefficients were calculated.

RESULTS

There was a high degree of correlation among the three methods as well as between each method and the severity of sleep apnea. The mean+/-SD values for each method were as follows: AO2, 92.7+/-5.6; LO2, 68.5+/-19.3; and T<90%, 15.7+/-24.2. The alpha coefficients for these methods were AO2, 0.98; LO2, 0.88; and T<90%, 0.98. In all methods, the data of the first hour were significantly different from the data of the subsequent hours.

CONCLUSION

Both AO2 and T<90% methods show less hour to hour variability compared with LO2, and there is more variability in the first hour. Since the AO2 values >90% may not convey the severity of O2 desaturation, T<90% may be the best method of expressing oxygen saturation changes during polysomnography.

Sleep apnea, sleep disorders, and hypothyroidism

The symptoms of hypothyroidism are protean and include apathy, somnolence, lethargy, personality change, and intellectual deterioration. Many of these symptoms may be related to hypothyroid-induced sleep disorders. Hypothyroidism is associated with abnormal ventilatory drive, abnormal sleep architecture, and sleep apnea. Central, obstructive, and mixed patterns of sleep apnea are commonly observed in hypothyroidism. A case of severe sleep apnea in a grossly myxedematous patient who improved dramatically following thyroid replacement alone is presented. Myxedema is a reversible cause of sleep apnea, and thyroid function testing should be considered in its diagnostic work-up.

Sleep apnea: morbidity and mortality of surgical treatment

We have analyzed the complications in 132 patients who had surgical treatment of sleep apnea or excessive snoring. In this series there were 34 (26%) complications and two patients (1.5%) died. Complications related to uvulopalatopharyngoplasty in 126 patients included rhinolalia (2%) and oropharyngeal hemorrhage (6%). In the 41 patients who had tracheostomy, complications included hemorrhage from tracheostomy (5%), tracheomalacia (5%), peristomal infection (15%), tracheostomy tube intolerance (Montgomery tube 100%, Shiley tube 7%), pneumonia (2%), hypoxia necessitating emergency tracheotomy (2%), and other perioperative complications.

Ocular trauma among children in western Nepal: agents of trauma and visual outcome

DOI: 10.3126/nepjoph.v2i2.3726 Nep J Oph 2010;2(2) 164-165