Frequency of Local Treatment in Carpal Tunnel Syndrome during Pregnancy

Background and Aim: The most common entrapment neuropathy is carpal tunnel syndrome (CTS). Carpal tunnel syndrome is caused by median nerve compression at the wrist joint. Idiopathic carpal tunnel syndrome is the most common cause. Among the other physiologic causes of carpal tunnel syndrome (wrist trauma, diabetes, hypothyroidism, rheumatoid arthritis, occupation, contraception, and pregnancy), pregnancy is the most common. The objective of the present study was to determine the frequency of local treatment in carpal tunnel syndrome during pregnancy. Materials and Methods: This cross-sectional study was carried out on 45 pregnant women with carpal tunnel syndrome in the departments of Neurology and Gynaecology, Ayub Teaching Hospital, Abbottabad from May 2020 to April 2021. Individuals who met the inclusioncriteria were enrolled in this study. Ethical approval and consent forms were taken from the participants. All the patients were treated with local treatment (dexamethasone acetate 4 mg and lidocaine 0.5 ml) under the carpal tunnel syndrome. Before and after 3 weeks of local injection, median nerve electro physiologic parameters through sensory nerve conduction velocity (SNCV), sensory latency (DSL), pain intensity (visual analog scale or VAS) and distal motor latency (DML) were all noted. Results: The mean age of the patients was 29± 5.3 years while mean weight gain was 13.2 ± 4.9 kg. The third trimester was the mostfrequent pregnancy trimester with carpal tunnel syndrome. Before and after 3weeks, the average pain score of injected dexamethasone acetate was 8.65 ±0.89 and 4.29 ± 0.74 respectively (p-value < 0.005). Additionally, the median nerve SNCV transcarpalwas 32.9 ±7.1 and 25.1 ± 7.2 m/s (p-value = 0.001); while DSL median nerve was4.87±0.81 ms and 4.1±0.62. Lastly, the DML of the median nerve before and after 3weeks of local treatment was 5.2±1.03 and 4.69±0.54 ms respectively. Conclusion: Pain intensity and electrophysiological factors were considerablyimproved after local treatment dexamethasone acetate injection. Encouraging results have been offered for carpal tunnel syndrome with minimum invasive treatment in pregnant women. Keywords: Carpal tunnel syndrome, Pain intensity, local treatment

The study of Yangyinyiqi mixture anti bleomycin-induced pulmonary fibrosis on rats by intervening matrix metalloproteinase-9 and tissue inhibitors of matrix metalloproteinases-1

To investigate effectsof Yangyinyiqi Mixture on pulmonary fibrosis caused by bleomycin. SD ratswere divided randomly into: model group(distilled water,1 mL·0.1 kg-1), dexamethasone acetate group(dexamethasone acetate, the dosage was reduced gradually), low-dose group(Yangyinyiqi Mixture, 11 g·kg-1), moderate-dose group(Yangyinyiqi Mixture, 22 g·kg-1), high-dose group (Yangyinyiqi Mixture, 44 g·kg-1) and control group(distilled water, 1 mL·0.1 kg-1). Yangyinyiqi Mixture and dexamethasone acetate were intragastrically administrated. Lung tissue was collected for histopathological examination. Compared with control group, collagen markedly increased andHYP content significantly increased on 7th day in model group (p<0.01). On 28th day, collagen was diffusely deposited, alveolar was destroyed, and HYP content significantly increased (p<0.01). Compared with model group, bleomycin-induced suffering injury caused MMP-9 expression levels to rapidly increase (7and 14 days, p<0.01). TIMP-1 markedly increased (7and 14 days, p<0.01) and stayed at a high levelto28th day. Yangyinyiqi Mixture exerted an effect against pulmonary fibrosis, which could involved prevention of collagen deposition through inhibitingMMP-9 and TIMP-1 expression.

Nanostructural Arrangements and Surface Morphology on Ureasil-Polyether Films Loaded with Dexamethasone Acetate

Ureasil-Poly(ethylene oxide) (ureasil-PEO500) and ureasil-Poly(propylene oxide) (u-PPO400) films, unloaded and loaded with dexamethasone acetate (DMA), have been investigated by carrying out atomic force microscopy (AFM), ultrasonic force microscopy (UFM), contact-angle, and drug release experiments. In addition, X-ray diffraction, small angle X-ray scattering, and infrared spectroscopy have provided essential information to understand the films’ structural organization. Our results reveal that while in u-PEO500 DMA occupies sites near the ether oxygen and remains absent from the film surface, in u-PPO400 new crystalline phases are formed when DMA is loaded, which show up as ~30–100 nm in diameter rounded clusters aligned along a well-defined direction, presumably related to the one defined by the characteristic polymer ropes distinguished on the surface of the unloaded u-POP film; occasionally, larger needle-shaped DMA crystals are also observed. UFM reveals that in the unloaded u-PPO matrix the polymer ropes are made up of strands, which in turn consist of aligned ~180 nm in diameter stiffer rounded clusters possibly formed by siloxane-node aggregates; the new crystalline phases may grow in-between the strands when the drug is loaded. The results illustrate the potential of AFM-based procedures, in combination with additional physico-chemical techniques, to picture the nanostructural arrangements in polymer matrices intended for drug delivery.

Biopharmaceutical Assessment of Dexamethasone Acetate-Based Hydrogels Combining Hydroxypropyl Cyclodextrins and Polysaccharides for Ocular Delivery

We previously developed two optimized formulations of dexamethasone acetate (DXMa) hydrogels by means of special cubic mixture designs for topical ocular administration. These gels were elaborated with hydroxypropyl-β-CD (HPβCD) and hydroxypropyl-γ-CD (HPγCD) and commercial hydrogels in order to enhance DXMa water solubility and finally DXMa’s ocular bioavailability and transcorneal penetration. The main objective of this study was to characterize them and to evaluate in vitro, ex vivo, and in vivo their safety, biopermanence, and transcorneal permeation. Gels A and B are Newtonian fluids and display a viscosity of 13.2 mPa.s and 18.6 mPa.s, respectively, which increases their ocular retention, according to the in vivo biopermanence study by PET/CT. These hydrogels could act as corneal absorption promoters as they allow a higher transcorneal permeation of DXMa through porcine excised cornea, compared to DEXAFREE® and MAXIDEX®. Cytotoxicity assays showed no cytotoxic effects on human primary corneal epithelial cells (HCE). Furthermore, Gel B is clearly safe for the eye, but the effect of Gel A on the human eye cannot be predicted. Both gels were also stable 12 months at 25 °C after sterilization by filtration. These results demonstrate that the developed formulations present a high potential for the topical ocular administration of dexamethasone acetate.

Efficient Treatment of Atherosclerosis by Dexamethasone Acetate and Rapamycin Co-Loaded mPEG-DSPE Calcium Phosphate Nanoparticles

Atherosclerosis (AS) is one of the leading causes of vascular disease, producing high morbidity and mortality in many countries. Autophagy plays an important role when cells are facing serious circumstances, such as oxidative stress induced by Ox-LDL (oxidized low-density lipoprotein). Recent studies have revealed that DEX (dexamethasone acetate) and RAPA (rapamycin) exhibit efficient AS therapeutic ability by protecting endothelial cells and killing foam cells, respectively. Herein, we hypothesize that combining DEX and RAPA together in a specific nanocarrier system can achieve better AS therapy while limiting harmful effects. As a proof of concept, DEX and RAPA coloaded mPEG2k-DSPE calcium phosphate (CaP) nanoparticles (DR-NPs) were prepared by using a biomineralization method. DR-NPs increased HUVEC survival and induced foam cell apoptosis in vitro, which were correlated with autophagy activity. DR-NPs efficiently aggregated at AS plaques in the carotid artery and abdominal artery in ApoE– / – mice 24 h after i.v. injection. Moreover, DR-NPs exhibited excellent plaque regression ability, with smaller necrotic cores and lipid core areas observed after in vivo treatment. Furthermore, the function of vascular endothelial cells was largely promoted, as evidenced by the dramatically decreased expression levels of adhesion factors, such as MMP-2, MMP-9 and ICAM-1. Consequently, DR-NPs can act as an effective AS therapeutic agent and broaden the AS therapeutic approach by inducing autophagy.