Synthesis of rutin derivatives to enhance lipid solubility and development of topical formulation with a validated analytical method

Background: Rutin is available on the market as a topical formulation for the treatment of several conditions, such as internal bleeding, hemorrhoids, and varicose veins. However, these gels have low solubility and limited bioavailability due to their decreased lipid solubility. Objective: In this study, we aimed to synthesize potentially novel lipophilic rutin prodrugs. The suggested library of these rutin prodrugs includes changing the solubility profile to facilitate rutin transport across biological barriers, thereby improving drug delivery through topical application. Methods: Six rutin derivatives were synthesized based on the ester prodrug strategy. The synthesized compounds were formulated as topical ointments, and their permeability via Franz diffusion was measured. An ultraviolet (UV) analytical method was developed in our laboratories to quantify rutin derivatives both as raw materials and in final dosage forms. The analytical method was then validated. Result: The results of Franz diffusion analyses showed that transdermal permeability increased by 10_Fo.jpgl height=""d for decaacetylated rutin compared to the other esterified rutins. A simple analytical method for the analysis of the formulated rutin ester was developed and validated. Moreover, the formulated ointment of decaacetylated rutin in our research laboratory was found to be stable under stability accelerated conditions. Synthesis of potentially more lipophilic compounds would yield novel rutin prodrugs suitable for topical formulation. Conclusion: This project provides a synthetic approach for many similar natural products. The research idea and strategy followed in this research project could be adapted by pharmaceutical and herbal establishments.

Trichinosis in the Rostov oblast

In the Russian Federation, cases of infection with trichinosis in a population of people or animals are annually recorded. Trichinosis is intestinal and tissue helminthiasis of humans and a number of mammals, caused all over the world by nematodes. A person becomes infected with the parasite by eating meat containing live encapsulated Trichinella larvae. Mating takes place in the gastrointestinal tract, fertilized females are introduced into the intestinal mucosa with their anterior thinned ends. The clinical picture of trichinosis is accompanied by the development of myositis, degeneration of muscle fibers, and multiple edema. Deaths are not uncommon due to necrotic ulcerative lesions of the intestine and internal bleeding.

The Role of Matrix Metalloproteinases in Endometriosis: A Potential Target

Endometriosis is a condition that is influenced by hormones and involves stroma and glands being found outside the uterus; there are increases in proliferation, invasion, internal bleeding, and fibrosis. Matrix metalloproteinases (MMPs) have been suggested to be crucial in the progression of invasion. The MMP family includes calcium-dependent zinc-containing endopeptidases, some of which not only affect the process of cell invasion but also participate in other physiological and pathological processes, such as angiogenesis and fibrosis. MMPs act as downstream-targeted molecules and their expression can be regulated by numerous factors such as estrogen, oxidative stress, cytokines, and environmental contaminants. Given their unique roles in endometriosis, MMPs may become effective biomarkers of endometriosis in the future. In the present review, we summarize the current literature on MMPs regarding their classification, function, and potential value for endometriosis, which may contribute to our knowledge of MMPs and MMP-targeted interventions.

The Spiked Helmet Sign Predicting a Poor Outcome in a Patient with Non-Myocardial Infarction ST-Segment Elevation

Spiked helmet sign is a novel electrocardiogram marker that reflects a poor prognosis, and may mimic myocardial infarction, especially in patients with an acute alteration of mental status or out-of-hospital cardiac arrest. In cases where a spiked helmet sign is missed, there may be a delay in surgical intervention for the underlying conditions because of unnecessary cardiac catheterization. In addition, antiplatelet agents for acute coronary syndrome in such cases can lead to catastrophic complications. Therefore, early recognition of spiked helmet sign is useful for timely correction of the underlying disease and prevention of poor outcomes. Herein, we describe a rare case of a patient with internal bleeding and subarachnoid hemorrhage presenting with spiked helmet sign on an electrocardiogram.

Diagnostic Accuracy of CT Scans in Blunt Abdomical Trauma

Background and Aim: Blunt abdominal trauma may lead to a serious situation that necessitates prompt diagnosis and treatment. The intra-abdominal injury effective diagnosis is difficult in patient’s management in such cases. The present study aims to evaluate the diagnostic accuracy of computed tomography scans in active internal bleeding following abdominal trauma. Materials and Methods: This cross-sectional study was carried out on 84 blunt abdominal trauma patients in the Department of Radiology Hayatabad Medical Complex, Peshawar for duration of six months from January 2021 to June 2021. All the patients with no clinical manifestations underwent diagnostic CT scans. Those who had a positive CT scan underwent laparotomy. The remaining patients were monitored for 24 hours and were discharged in case of no serious issues. Demographic details, patient information, trauma mechanism, CT scan indications, and findings, and laparotomy results were recorded. Regarding injured organs, specificity, sensitivity, and diagnostic accuracy of CT scans were determined. For individual cases, CT scans specificity, sensitivity, and accuracy were calculated. SPSS version 20 was used for data analysis. Results: This study included 84 patients, out of which 73 (86.9%) were male and 11(13.1%) were female. Patients aged 20-40 years were more prevalent 47 (56%), followed by those aged over 40 years were 20 (23.8%) and 10 to 19 years old were 17 (20.2%). Liver and spleen injuries had the highest CT scan sensitivity of 87.5% and 96.7% respectively. On the other hand, The CT scan's specificity was high in the injured kidneys (94%) and retroperitoneal hematoma 97.3% compared to other organ’s injuries. The diagnostic accuracy of CT scans in the identification of liver, kidney injuries, spleen, and retroperitoneal hematoma injuries was 93.7%, 92.3%, 96.2%, and 92.3% respectively. Conclusion: Our study found that CT scans are capable of detecting a wide range of injuries. CT scans are exceptionally valuable for assessing blunt abdominal injuries with active internal bleeding patients Furthermore, CT investigation is quick and extensively accessible. CT can produce high-resolution images with MPR and scanning protocol. Keywords: Diagnostic Accuracy; Abdominal Trauma Injuries, Computed Tomography (CT)

Errors in the diagnosis of ectopic pregnancy

The clinical picture of an acutely interrupted ectopic pregnancy is quite clearly outlined. It is composed of symptoms characteristic of pregnancy, internal bleeding and shock.

Oral Healthcare and Idiopathic Thrombocytopenic Purpura: Early Recognition, Dental Management and Case Report

A 47-year-old Caucasian man, in good general, oral and periodontal health, presented with a non-bleeding bluish lesion on the back of his tongue, presumably due to an ecchymotic area of traumatic origin which was left untreated. The day after, other ecchymotic-type lesions on the mucous membranes of the cheeks and the upper lip, a bleeding lesion at the apex of the tongue and gingivorrhagia, along with petechiae on the back, scalp, lower limbs and feet, occurred, with rapid clinical deterioration, requiring immediate hospitalization. Oral, dermatological, and hematological evaluations lead to idiopathic thrombocytopenic purpura (ITP) diagnosis and hydrocortisone prescription, with a complete recovery in the next few days.The presented case of ITP, with early intra-oral manifestations,aimed both to emphasize the role of oral healthcare workers in theearly recognition of ITP, which may be especially relevant for those cases with extremely fast platelet depletion, high risk of internal bleeding and consequent potentially fatal complications, and in the differential diagnosis of the diseasethat may be aided by the diagnostic protocol described, and to provide dentists with recommendations on oral care management of cases ofITP, both in dental and multi-disciplinary settings.

On the symptomatology of internal bleeding during ectopic pregnancy

In addition to the typical signs, what are the pallor of the skin and mucous membranes, frequent, weak pulse, fainting, etc., internal bleeding that occurs as a result of rupture of the fetus during an ectopic pregnancy is accompanied by other, no less characteristic phenomena from various systems organism, which sometimes make it possible to timely confirm or establish a diagnosis and differentiate this suffering from other similar painful conditions.