The anti-fungal effect of miconazole and miconazole-loaded chitosan nanoparticles gels in diabetic patients with Oral candidiasis-randomized control clinical trial and microbiological analysis

BACKGROUND

Oral thrush is the most common occurring fungal infection in the oral cavity in uncontrolled diabetic patients, it is treated by various antifungal drugs according to each case. This study aimed to evaluate the therapeutic effects of topical application of miconazole and miconazole-loaded chitosan nanoparticles in treatment of diabetic patients with oral candidiasis.

METHODS

In this randomized controlled clinical trial. A total of 80 diabetic patients presenting with symptomatic oral candidiasis were randomly assigned into two treatment groups: miconazole and miconazole-loaded chitosan nanoparticles. The patients were treated for 28 days, and clinical assessments were conducted at baseline, 7, 14, 21 and 28 days. Clinical parameters, including signs and symptoms of oral candidiasis were evaluated and microbiological analysis was performed to determine the Candida species and assess their susceptibility to the antifungal agents. Statistical analysis was done to the categorical and numerical data using chi-square test and Kruskal Wallis test.

RESULTS

The antifungal efficacy between the miconazole and miconazole-loaded chitosan nanoparticles (CS-MCZ) groups insignificant difference (P >  0.05) was observed. Both treatment modalities exhibited comparable effectiveness in controlling oral candidiasis symptoms and reducing Candida colonization as miconazole-loaded chitosan nanoparticles group showed a significant difference in the clinical improvement in respect of both signs and symptoms from baseline (70%) until the end of study at 28 days (5%) (P <  0.05) Moreover, miconazole-loaded chitosan nanoparticles, there was a significant reduction in the number of colonies forming units of Candida albicans from baseline until the end of the study at 28-day with P value <  0.000.

CONCLUSIONS

This randomized controlled clinical trial and microbiological analysis demonstrate that both miconazole and miconazole-loaded chitosan nanoparticles are effective in the treatment of oral candidiasis in diabetic patients with no adverse reactions.

TRIAL REGISTRATION

NCT06072716 with first registration first registration in 10/10/2023.

Syringeable atorvastatin loaded eugenol enriched PEGylated cubosomes in-situ gel for the intra-pocket treatment of periodontitis: statistical optimization and clinical assessment

Atorvastatin calcium (ATV) is a well-known anti-hyperlipidemic drug currently being recognized for possessing an anti-inflammatory effect. Introducing it as a novel remedy for periodontitis treatment necessitates developing a syringeable modified delivery system capable of targeting inflammation within the periodontal pockets. Thus, a 3³ Box-Behnken design was used to generate eugenol enriched PEGylated cubosomes. Based on the desirability function, the optimized formulation (OEEPC) was selected exhibiting a solubilization efficiency (SE%) of 97.71 ± 0.49%, particle size (PS) of 135.20 ± 1.11 nm, polydispersity index (PDI) of 0.09 ± 0.006, zeta potential (ZP) of -28.30 ± 1.84 mV and showing a sustained drug release over 12 h. It displayed a cubic structure under the transmission electron microscope, furthermore, it was stable upon storage for up to 30 days. Hence, it was loaded into an optimum syringeable in-situ gel (ISG) which displayed the desired periodontal gelation temperature (34 ± 0.70 °C) and an adequate gelation time (46 ± 2.82 sec), it also released approximately 75% of the drug within 72 h. Clinical evaluation of the ISG showed a promising percentage reduction of about 58.33% in probing depth, 90% in the bleeding index, 81.81% in the plaque index, and 70.21% in gingival levels of transforming growth factor-β1. This proved that the formulated syringeable intra-pocket delivery system of ATV is an efficient candidate for diminishing inflammation in periodontitis.

The Influence of Low-Level Laser Therapy on CBCT Radiographic and Biochemical Profiles of Type II Controlled Diabetic Patients After Dental Implant Insertion: A Randomized Case-Control Study

Background Low-level laser treatment (LLLT) was thought to increase bone quality during osseointegration when combined with dental implants. However, there is no sufficient information on its impact on dental implants in diabetics. Osteoprotegerin (OPG) has been described as a marker for bone turnover to determine implant prognosis. The current research aims to evaluate the effect of low-level laser therapy (LLLT) on bone density (BD) and osteoprotegerin levels in peri-implant crevicular fluid (PICF) in type II diabetic patients. Methods This study comprised 40 individuals with type II diabetes mellitus (T2DM). Implants were randomly placed in 20 non-lasered T2DM patients (control) and 20 lasered T2DM patients (LLLT group). At the follow-up stages, BD and OPG levels in the PICF were evaluated in both groups. Results Significant variations were shown among control and LLLT groups concerning OPG level and BD (p≤0.001). OPG was significantly decreasing with follow-up points (p≤0.001). There was a significant decrease in OPG with time in both groups with a higher decrease in the control group. Conclusion LLLT is promising in controlled T2DM patients due to its outstanding influence on BD and estimated crevicular levels of OPG. Regarding its clinical significance, LLLT significantly improved bone quality during osseointegration on dental implants in T2DM. LLLT is considered potentially important for T2DM patients during implant placement. Trial registration The study was registered on ClinicalTrial.gov under registration number NCT05279911 (registration date: March 15, 2022) (https://clinicaltrials.gov/ct2/show/NCT05279911).

Association between Administration of Systemic Corticosteroids and the Recovery of Olfactory and/or Gustatory Functions in Patients with COVID-19: A Prospective Cohort Study

AIM: This study is a prospective cohort study aimed to assess the effect of systemic corticosteroids administration time in the recovery of gustatory and olfactory sensations dysfunction (ageusia and anosmia) in COVID-19 patients. MATERIALS AND METHODS: Sixty-seven COVID-19 patients with symptoms of ageusia and anosmia were recruited (that their COVID infection was confirmed using polymerase chain reaction). Daily 10 mg of systemic corticosteroids were prescribed in the 1st week and then reduced to 5 mg in the 2nd week to all the patients to observe taste and smell sensation recovery. All data were recorded and then analyzed. Patients were then grouped into two groups (early and late groups) according to the duration of their taste and smell dysfunction. RESULTS: Regression analysis showed that early corticosteroid administration resulted in a significant decrease in recovery time of ageusia and anosmia (0.27 [0.2–0.35], p < 0.001). Patients in the early administration group (<1 week) showed faster improvement in regaining taste and smell functions than in the late administration group (>1 week) with significant difference (p < 0.001). CONCLUSIONS: The use of systemic corticosteroids in early phases of covid-19 infection help in faster recovery of ageusia and anosmia.

The effect of a single dose of mifepristone (RU486) on the fine structure of the human endometrium during the early luteal phase

This study examined the fine structure of the human endometrial glandular epithelium after the administration of a single dose of RU486 (mifepristone), given in the early luteal phase. The drug was administered on days 2, 3, 5 and 6 after the luteinizing hormone peak (LH + 0). Biopsies were performed on days LH + 5, 6, 8 and 9. These were compared with control biopsies taken on corresponding days. Qualitatively, the main cytological effect of the RU486 was on the secretory apparatus and on the polarity of the cell. The formation of the nuclear channel system was also affected by the drug. A two-way analysis of variance on cell and nuclear volume data revealed no significant effect of day of biopsy, condition or interaction. Mitochondrial volume and secretory apparatus volume data revealed a significant effect of day of biopsy and interaction term; mitochondrial volume at LH + 5 was 95.9 +/- 25.3 microm3 (mean +/- SD) for control and 57.7 +/- 31.9 microm3 for RU486-treated epithelium. The volume of the secretory apparatus in the treated group was smaller on days LH + 5 and 6 (14.6 +/- 4.2 microm3, 6.41 +/- microm3) when compared to day-matched control biopsies (35.9 +/- 10.5 microm3, 41.7 +/- 26.4 microm3). RU486 administration in the early luteal phase disrupted the secretory activity of the cells. These findings provide an insight into the cellular mechanisms of progesterone receptor blockade in the peri-implantation period.

[Free carbohydrate content of the cortex and nucleus of bovine lenses as a function of ageing (author's transl)]

The determination of the products of the sorbitol pathway and of inositol in the equator and nucleus of bovine lenses of different ages, performed by gas-chromatographic analyses, is described. Independent of age, the proportion of glucose, sorbitol, and fructose is higher in the equatorial part than in the nucleus. The proportion of inositol is about 3 mg/1 g lens fresh weight in the equator, and about 2 mg/1 g lens fresh weight in the nucleus, and seems to decrease slightly with ageing.

Chemical composition of the aqueous humor of bovine eyes dependent on predetermined time upon removal

The content of several carbohydrates [glucose (alpha and beta), inositol, fructose, galactose] and aminoacids in the aqueous of bovine lenses was measured in dependence on time after globe puncture, using the method of gas liquid chromatography (carbohydrates) and ion exchange chromatography (amino acids). The contents of the investigated compounds show distinct postmortal changes. Aqueous humor which had been obtained immediately after enucleation of the bovine eyes and kept at 37 degrees C for different periods of time (1-8 h) showed for the carbohydrates investigated a decrease in fructose concentration, whereas almost all amino acid concentrations were increased, with the exception of leucine, tyrosine, and arginine, which were decreased.