Application of Nanoemulsion in Tuberculosis Treatment

Tuberculosis is commonly called TB and considered to be the most contagious disease. This disease is caused by a causative agent known as Mycobacterium tuberculosis within the host body cells. Emergence incidence of XDR and MDR of tuberculosis are due to high dose intake and prolonged treatment of antibiotics. In this era, only one vaccine called as BCG is available which is ineffective against infected tuberculosis adults. Though several antibiotics have been produced to overcome drug resistance and even enhance the patient compliance towards treatment and reduce the treatment regimen, we require a novel strategy that can improve the potency of therapeutic synthetic drugs. This approach can be achieved by the application of nanotechnology associated with conventional therapy. Nanotechnology has attributed the promising effects associated with optimized treatment against chronic diseases. This novel technology has the ability to reduce the dose frequency and even resolves the poor patient compliance.

Immune Response to anti-HBs Antibodies in Health Workers Following Hepatitis B Vaccination

According to Regulation No. 53 of 2015 of the Minister of Health of the Republic of Indonesia, a high risk of HBV infection in health workers is a problem that requires attention, and vaccination knowledge is critical to reducing these risk factors. Furthermore, because some people do not produce a sufficient antibody-forming (anti-HBs) response to HBsAg, testing for evidence of protective immunity against hepatitis B vaccination is required (Hepatitis B Surface Antigen). The purpose of the study was to determine the mapping of the characteristics of anti-HBs antibodies response after hepatitis B vaccination in health workers in terms of age, gender, ethnicity, smoking habits, obesity, vaccination frequency, last time of vaccination. Sixty vaccinated health workers were used to creating the research sample. Anti-HBs levels/titers in serum were measured using the Enzyme-Linked Immunosorbent Assay (ELISA) method, and a questionnaire was used to compile the data for this study. Age, gender, smoking, obesity, and vaccination dose were all used to map the outcomes of the anti-HBs antibody immune response study. Anti-HBs antibody response in health workers was graded as poor in 36 people (60%) and strong in 24 (40%). Regarding ethnic origin, lifestyle, obesity, and vaccination dose (frequency), there was no significant link between post-vaccination anti-HBs antibody response in health workers. In terms of age and gender, there is a strong association between post-vaccination anti-HBs antibody responses in health workers. Low antibody titers should be revaccinated to enhance anti-HBs titers, and health workers who smoke should quit because it reduces the levels of anti-HBs titers produced clinically.

Investigation on the Effect of Dose, Frequency and Duration of Allergen Exposure on Development of Staphylococcal Infections in a Chronic Model of Canine Atopic Dermatitis

Canine atopic dermatitis (CAD) is chronic and frequently complicated by Staphylococcal infections. Understanding the role of allergen dose, frequency and duration of exposure in triggering infections requires a model. Most models elicit acute inflammation and do not mimic real-life disease. Here we describe the effects of allergen exposures on development of infections in a model of chronic CAD. Diagnosis of pyoderma was based on clinical signs and consistent cytology. Study 1 evaluated the role of duration of exposure keeping the daily dose constant (25 mg/day). The one-week protocol involved three exposures, 3 days in a row. The one-month protocol involved twice-weekly challenges for 4 weeks. The three-month protocol involved twice-weekly challenges for 12 weeks. Study 2 evaluated different daily doses while keeping constant the total weekly dose (25 mg) and duration (3 weeks). Low-dose used 5 mg/day for 5 days, each week. High-dose used 12.5 mg/day twice-weekly. In Study 1, the longer the exposure, the more dogs developed pyoderma (6/9 in the three-month study, 2/9 in the one-month and 0 in the one-week). In Study 2, low-dose daily exposure caused more infections (5/8) than high-dose infrequent exposure (0/8). It is concluded that low-grade, daily exposure for a long time is most relevant for development of staphylococcal infections.

Use of Neuromuscular Electrical Stimulationfor Swallowing Habilitation in High-Risk Infants: A Survey of Clinical Practice

Purpose: The purpose of this clinical focus article was to identify clinical practice patterns of speech-language pathologists (SLPs) who use neuromuscular electrical stimulation (NMES) with the high-risk infants, specifically, the modality treatment parameters and physiological rationale. Method: An online survey was disseminated to query use of NMES by licensed SLPs who routinely address swallowing habilitation in high-risk infants. Results: Eleven of the 40 practicing SLPs who completed the survey indicated they have used NMES on neonates and infants. Most survey respondents reported not using NMES with infants. Of the SLPs who used this modality, over half reported they relied on clinical judgment for determination of NMES dose, frequency of treatments, electrode placement, and discharge determination. While SLPs acknowledged that little empirical evidence is available, those who used this modality indicated that the American Speech-Language-Hearing Association should support this modality in infants. Conclusions: Reliance on clinical judgment, as indicated by SLPs who use NMES on high-risk infants, is not consistent with the evidence-based practice triad, which encourages the use of high-quality peer-reviewed published evidence to inform clinical decision-making. Additional basic and applied research is needed to support use of NMES as a therapeutic modality in infants.

Early Introduction of Multi-Allergen Mixture for Prevention of Food Allergy

The incidence and prevalence of food allergy (FA) are increasing. While several studies have established the safety and efficacy of early introduction of single allergens in infants for the prevention of FA, the exact dose, frequency, and number of allergens that can be safely introduced to infants particularly in those at high or low risk of atopy are still unclear. This 1-year study evaluated the safety of early introduction of single foods (milk, egg, or peanut), vs. two foods (milk/egg, egg/peanut, milk/peanut), vs. multiple foods (milk/egg/peanut/cashew/almond/shrimp/walnut/wheat/fish/soy at low, medium, or high doses) vs no early introduction in infants between 4-6 months of age. At the end of the study, they were evaluated for plasma biomarkers associated with food reactivity with standardized blood tests. Two to four years after the start of the study, participants were evaluated by standardized food challenges. The serving sizes for the single, double, and low dose mixtures were 300 mg total protein per day. The serving sizes for the medium and high dose mixture was 900 mg and 3000 mg total protein, respectively. Equal parts of each protein were used for double or mixture foods. All infants were breastfed until at least 6 months of age. Results demonstrate that infants at either high or low risk for atopy were able to tolerate early introduction of multiple allergenic foods with no increases in any safety issues, including eczema, FA, or food protein induced enterocolitis. The mixtures of foods at either low, medium, or high doses demonstrated trends for improvement in food challenge reactivity and plasma biomarkers compared to single and double food introductions. The results of this study suggest that early introduction of foods, particularly simultaneous mixtures of many allergenic foods is efficacious for preventing FA and can occur safely.

Phytoconsitutents As Bioenhancers: A Review

Bio-enhancers are the compounds that enhance the bioavailability of active pharmaceutical ingredients without itself having any pharmacological action. Most of them are of natural origin and do not have any side effects. They enhance the bioavailability by influencing variety of mechanisms involved in the drug action like penetration enhancement, improving metabolism, enzyme inhibition, drug targeting etc. Use of these compounds help to reduce the dose frequency which in turn reduces drug retention in turn causing the toxicity and it also helps in developing cost-effective products. Present days these are widely used to enhance the bioavailability of anti-bacterial, anti-viral, antibiotic, anticancer, anti-inflammatory, cardiovascular drugs etc and effective drug targeting. The present review is designed to emphasize the importance of certain phytoconstituents working as bio-enhancers, their classification and different mechanisms of their activity.

The Effect of Pharmacist-Led Intervention on Surgical Antibacterial Prophylaxis (SAP) at an Orthopedic Unit

Perioperative antibiotic use is a common reason for antibiotic misuse. Evidence suggests that adherence to SAP guidelines may improve outcomes. The purpose of this study was to analyze the impact of pharmacist-led antibiotic stewardship interventions on SAP guideline compliance. The study was conducted at an Orthopedic Department of a tertiary care medical center. SAP compliance and antibiotic exposure in the pre-intervention and intervention period was compared using chi-square, Fisher exact, and Mann-Whitney tests, as appropriate. Prophylactic antibiotic use in orthopedic joint arthroplasties (overall guideline adherence: agent, dose, frequency, duration), clinical outcomes (length of stay-LOS, number of surgical site infections-SSIs), antibiotic exposure and direct antibiotic costs were compared between pre-intervention and intervention periods. Significant improvement in mean SAP duration (by 42.9%, 4.08 ± 2.08 vs. 2.08 ± 1.90 days, p ˂ 0.001), and overall guideline adherence regarding antibiotic use (by 56.2%, from 2% to 58.2%, p ˂ 0.001) were observed. A significant decrease was observed in antibiotic exposure in SAP (by 41%, from 6.07 ± 0.05 to 3.58 ± 4.33 DDD/patient, p ˂ 0.001), average prophylactic antibiotic cost (by 54.8%, 9278.79 ± 6094.29 vs. 3598.16 ± 3354.55 HUF/patient), and mean LOS (by 37.2%, from 11.22 ± 6.96 to 7.62 ± 3.02 days, p < 0.001); and a slight decrease in the number of confirmed SSIs was found between the two periods (by 1.8%, from 3% to 1.2%, p = 0.21). Continuous presence of the clinical pharmacist led to significant improvement in SAP guideline adherence, which was accompanied by decreased antibiotic exposure and cost.

Nanovaccine Delivery Approaches and Advanced Delivery Systems for the Prevention of Viral Infections: From Development to Clinical Application

Viral infections causing pandemics and chronic diseases are the main culprits implicated in devastating global clinical and socioeconomic impacts, as clearly manifested during the current COVID-19 pandemic. Immunoprophylaxis via mass immunisation with vaccines has been shown to be an efficient strategy to control such viral infections, with the successful and recently accelerated development of different types of vaccines, thanks to the advanced biotechnological techniques involved in the upstream and downstream processing of these products. However, there is still much work to be done for the improvement of efficacy and safety when it comes to the choice of delivery systems, formulations, dosage form and route of administration, which are not only crucial for immunisation effectiveness, but also for vaccine stability, dose frequency, patient convenience and logistics for mass immunisation. In this review, we discuss the main vaccine delivery systems and associated challenges, as well as the recent success in developing nanomaterials-based and advanced delivery systems to tackle these challenges. Manufacturing and regulatory requirements for the development of these systems for successful clinical and marketing authorisation were also considered. Here, we comprehensively review nanovaccines from development to clinical application, which will be relevant to vaccine developers, regulators, and clinicians.

Vaccination against pneumococcal infections in children with chronic heart failure

In current conditions, the most effective method of preventing pneumococcal infections (PI) is vaccination, which can significantly reduce the incidence and mortality from pneumococcus and reduce the level of antibiotic resistance. The use of pneumococcal conjugate vaccines has reduced the incidence of invasive PIs in vaccinated children and unvaccinated populations. This is especially true for children with severe somatic pathology, including those with various forms of heart failure (HF). The data show that vaccination of sick HF children can be a clinically effective intervention to improve the treatment results of circulatory failure and improve patients’ quality of life. However, questions regarding the optimal timing of vaccination of sick children with heart failure, dose, frequency and strategies of vaccine introduction still need to be resolved. Data on the pathophysiology of cardioprotection provision during effective vaccination against PI, influenza and COVID-19 in cardiac pathology are summarized. The authors recommend providing conditions for effective vaccine prevention of PI in children with heart failure.