Analysis of Fracture Midshaft Clavicle Treated by Intramedullary Device Versus Conservative

Clavicle fractures account for about 2.6 to 4 % of all fractures. The best method to treat the displaced midshaft fracture of the clavicle remains a topic of debate. Although there is a large number of studies published about this topic, it is still relatively unknown as to which modality provides better long term functional outcomes and low complications rates. In our study, we have analyzed midshaft clavicle fracture treated with intramedullary device versus conservatively in terms of clinical, functional and radiological outcomes. The mean age of the patients in our study was 35.766 years. Male: Female ratio was 5.0:1.0. The mean time interval between injury and intervention was 2.1 days. Out of 30 patients, 11 patients (36.666%) had left sided fractures, while 19 patients (63.333%) had right sided fractures. Out of 30 patients, 12 patients (40%) had type 2B1 fracture according to Robinson's classification, followed by type 11 patients (36.666%) type 2B2, 6 patients (20%) type 2A1 and 1 patient (3.333%) type 2A2 fracture. Inoperative group, the mean Constant and Murley score before the intervention, at 1 month follow up, 3 months follow up and at 6 months follow up were 47.46, 76.73, 82.8 and 90.73, while in a conservative group, it was 47.53, 71.66, 79.2 and 89.46 respectively. Inoperative group, the mean Q-DASH score before the intervention, at 1 month follow up, 3 months follow up and at 6 months follow up were 29.33, 19.33, 16.86 and 13.8, while in a conservative group, it was 31.266, 22.533, 18.8 and 15.66 respectively. The final outcome, on the basis of the final Constant and Murley score in 13 patients (43.33%), was excellent, 11 patients (36.66%) was good and 6 patients (20%) was fair. Inoperative group, complications were seen in 6 patients (40%), while in the conservative group, complications were seen in 10 patients (66.66%). Thus, the functional, clinical and radiological outcome of the patients managed surgically with an intramedullary device was significantly better when compared with patients treated conservatively.

A New Second-Derivative Spectrophotometric Method for the Determination of Vildagliptin in Pharmaceutical dosage form

An accurate derivative spectrophotometric method was developed and validated for the determination of dipeptidyl peptidase inhibitor vildagliptin in the pharmaceutical dosage form. The second derivative of the UV spectra has enabled the estimation of vildagliptin absorbance at 217 nm without any interferences. Linearity, precision, accuracy, detection (LOD), and quantification (LOQ) limits were established for method validation. Calibration curve was linear in the range of 10-60 µg/mL with a regression coefficient of 0.998. The method was validated as per the International Conference on Harmonization (ICH Q2 (R1)). The limit of detection and the limit of quantification were found to be 2.06 µg/mL and 6.25 µg/mL, respectively. Intra and interday precision data illustrated that the method has acceptable reproducibility as the percentage relative standard deviation (RSD) was less than 2 %, which indicates the precision of the method. The recovery was 98.39 % by the standard addition method. The percentage assay of vildagliptin was 98.06 % which showed good applicability. The following results indicate that the procedure is accurate, precise, and reproducible while being simple and less time-consuming. The method was demonstrated to be adequate for routine analysis in quality control.

Prescription Pattern of Antimicrobial Agents in Various Dental Clinics at Malabar Region of Kerala, South India

Antimicrobial agents (AMAs) are among the most commonly prescribed drugs in dental practice. However inappropriate prescribing and irrational use of antimicrobial agents without prior culture and sensitivity tests, inadequate duration, dosing etc. have been identified as major factors contributing to the emergence of antibiotic resistance, which is an ongoing challenge in all over the world. A total of 1900 patients were screened and out of which 1748 patients were selected based on the inclusion and exclusion criteria for the study after taking consent. This study shows that the majority of patients attended in these clinics were female, 1020 (58.35%) and majority of patients (717) comes under age group 21-40 (41.02%) followed by age group by ≤ 20 (32.43%). This study established that most commonly recommended antimicrobial agents were amoxicillin, followed by amoxicillin-clavulanate and metronidazole. The antimicrobial agents like Ciprofloxacin, Cefixime, Tetracyclines, Azithromycines were also used but in less extent. This study also revealed that the selection of antimicrobials was not confirmed with culture and sensitivity tests in all cases, which may negatively influence bacterial resistance profile.

The antioxidant activity of seaweed salt from Sargassum polycystum in Sprague-Dawley male White rats

Seaweed has many health benefits and has been the potential raw material for making low sodium and high potassium healthy salt. Sargassum polycystum is widely used as a low-sodium functional salt, which has a strong antioxidant capacity. However, it's in vivo potential is unknown. This research was a purpose to determine the antioxidant activity of SOD and catalase enzymes in seaweed salt through in vivo test in Sprague-Dawley rats. To achieve this, salt was produced from S. polycystum flour and distilled water at a ratio of 1:10 and heated at 40°C for 10 minutes, using a water bath. The mixture was stirred using 500 mesh nylon cloth and filter paper, then dried with an oven at 60°C for 30 hours. In vivo research method was then adopted using 20 male Sprague-Dawley rats, which were divided into 5 treatment groups. The analysis used was the treatment of commercial and seaweed salt, Sargassum polycystum, and plain water (aquades) in the test animals with 4 replications, which include each treatment group consisting of 4 Sprague-Dawley rats. Data were analyzed using Analysis of variance (ANOVA) from Statistical Package for Social Sciences (SPSS) software. S. polycystum salt had a Sodium (Na) and Potassium (K) ratio of 0.38 and NaCl content of 49.05%. The antioxidant activity of SOD and catalase enzymes ranged between 54.09–73.40 U/mL and 0.67 – 0.79 U/mL, respectively. These values indicate that the application of S. polycystum salt is able to balance the antioxidant activity of SOD and catalase. In addition, seaweed salt has the potential to reduce cell damage due to free radicals.

Impact of Clinical Pharmacist Interventions in Management of Diabetes in Primary Care in Saudi Arabia

The study aimed to identify the impact and effectiveness of clinical pharmacist intervention on the management and overall quality of life of diabetic patients. Two cross-sectional studies using SF36 Health Survey, involving physicians and pharmacists at the Ambulatory Care Department in Riyadh, Saudi Arabia. Diabetic patients showed significant improvements in their QoL in terms of general health, energy and fatigue, pain scores, and social, emotional, and physical functions. Moreover, PC was found to have a significant impact on diabetes related QoL along with various outcome indicators, such as HbA1c, random blood sugar, and lipid profile in such patients. Additionally, satisfactory knowledge, good practice in identifying prescription errors were found among pharmacists. This study reveals that clinical pharmacists are valuable members of interdisciplinary primary care teams in ambulatory care. This can positively impact glycemic control in patients with type 2 diabetes and improve their quality of life. Also, the current study presented that a satisfactory extent of pharmaceutical care by an ambulatory clinical pharmacist was effective in improving HbA1c in patients with diabetes. A clinical pharmacist in ambulatory care was found to be eminent and of an added value to the patients, physicians, and healthcare team.

Effect of nori, a combination of turmeric (Curcuma longa) and gotu kola (Centella Asiatica) on blood pressure, modulation of ACE, eNOS and iNOS gene expression in hypertensive rats

Hypertension is a major risk factor for causing life-threatening cardiovascular diseases such as myocardial infarction, coronary heart failure, kidney failure, and stroke. Its cases continue to increase worldwide and it is estimated that 1.56 billion adults would live with the condition in 2025. Therefore, this study aims to examine the antihypertensive effect of nori supplement prepared with a combination of turmeric (Curcuma longa) and gotu kola (Centella Asiatica) on L-NAME-induced and non-induced rats. It was conducted for 28 days on 25 wistar rats that were randomly assigned to the negative, positive, comparison, supplement, and test control groups. CODA was then used in measuring the blood pressure of the rats, while ECG and PPG sensors were utilized for arterial stiffness assessment, as well as for spatial QRS-T and heart rate analysis. Additionally, serum NO levels were measured using griess reagents by spectrophotometric λ540 nm. At the same time, the gel-based PCR semi-quantitative method was used in assessing the activity of ACE, including eNOS and iNOS gene expression. The results showed that nori preparations which contained a combination of 5% turmeric and gotu kola in a feed mixture, had an antihypertensive effect. The effect was characterized by a decrease in systolic, diastolic, and mean arterial blood pressure, as well as heart rate, arterial stiffness, and spatial QRS-T. Additionally, it occurred due to increased NO availability, which resulted from eNOS expression as well as a decrease in iNOS and ACE expression.

Curcumin therapy: Immune booster in present and post-pandemic (COVID-19) Era

COVID-19 pandemic, which has traumatized the world population, in principle, is an inflammatory lung disease secondary to SARS-COV2 virus infection. Inflammatory lung injury progressing to Acute Respiratory Distress Syndrome (ARDS) is a recognized clinical feature of the disease. Inflammatory cytokines released in response to COVID-19 activate the transcription factor - the nuclear factor-қB (NF-қB) and series of pro-inflammatory cytokines, which are responsible for lung injury. Accurate yet precise treatment of coronavirus disease still remains inconclusive, and intervention is mainly symptomatic treatment, respiratory support, antiviral therapies and vaccination. Currently, the major focus of therapy is on reducing lung inflammation by elevating the host immunity. In this scenario, NF-қB inhibition can be conceptualized as a promising approach to down-regulate the overproduction of cytokines, such that inflammatory lung tissue injury could be prevented in COVID-19 infected patients. Towards this, curcumin from Curcuma longa (Turmeric) would play a vital role in the intervention and suppress NF-қB activation via translocation of p65 into the nucleus. Moreover, Curcumin is a proven therapeutic agent against various inflammatory pathologies as it also has the potential to inhibit the expression of certain genes that are critical for the regulation of inflammation. Keeping this phenomenon and the current medical significance in view, we have explored and computed the anti-inflammatory properties of curcumin to develop it as a potent therapeutic agent to prevent NF-қB induced lung tissue injury in COVID-19 with the main goal of elevating immunity in the post-covid-19 situations as well as in healthy human beings.

Anti-inflammatory effect of Helix aspersa extracts in sephadex-induced model of lung inflammation: possible modulation of neutrophils

The focus of our study is to compare the anti-inflammatory effect of extracts prepared from Algerian mollusk called Helix ,on induced lung inflammation in rats: aqueous AE, HE and organic OE extracts. Animals were classified into six groups: control group T was instilled with NaCl (0.9%) in the trachea, negative control group was instilled with in trachea (5mg//Kg), positive control group was instilled with and treated with an anti-inflammatory drug, groups SAE, SHE and SOE were instilled with and treated with aqueous, and organic extracts respectively (4mg//Kg). 24h after instillation, we sacrificed animals, blood samples and fluid lavage (BALF) were collected. Lungs were for investigation. We measured activity (MPO) in BALF. Results showed induces a massive in lungs. HE and OE decreased leukocyte count in BALF and blood. AE increased leukocyte count in blood and decreased it in BALF. The three extracts decreased MPO activity in BALF, reduced number of inflammatory cells in the and protected lung from beads injuries. Both AE and HE reduced edema in lung. We conclude that treatment with Helix had an anti-inflammatory effect on inflammation.

Hyperbaric Oxygen Therapy and Its Suitability as an Adjuvant for Treatment of Covid-19 Patients: A Review

The outbreak of the SARS CoV2 ' pandemic' is believed to have originated in Wuhan in 2019 as a spread from bats to humans. It is a highly communicable infection-causing rapid human to human transmission of the virus by virtue of its infectious and nature. The virus has affected millions of people worldwide, with numbers still rising with each passing day. Depleting oxygen saturation levels is amongst the prime concerns in the majority of infected patients. Nasal prongs, face masks, mechanical ventilation and membrane (ECMO) are the commonly used modes of oxygen delivery in such patients. These methods though mostly successful, at times fail to restore the depleting oxygen levels to normal. oxygen therapy (HBOT) involves the administration of 100% O2 in a special chamber whose pressure is maintained at a level greater than 1 ATP. The main purpose for raising the pressure within the chamber is that as the atmospheric pressure increases, the saturation levels of oxygen in the blood also increase, which eventually result in increased overall tissue oxygenation. This article provides a systematic and wholesome review on the basic principle of oxygen therapy, its effects on the body at a microscopic and macroscopic level, its various uses and its suitability as an for the treatment of select COVID-19 infected patients.

Scapulectomy for Fibromatosis – Ocological and Functional Outcomes

Aggressive fibromatosis is a locally invasive tumor that does not metastasize. Only few cases of scapulectomy for fibromatosis of scapular muscles are reported in the world literature. We present two consecutive cases of scapulectomy done for fibromatosis of periscapular muscles at the Department of Surgical Oncology in our centre between 2014 and 2019. One patient underwent subtotal scapulectomy by posterior approach and the other patient underwent scapulectomy below spine of scapula by combined anterior and posterior approach. The follow-up period of both the patients was 5 years. One patient developed recurrence after 9 months of surgery dealt by re-resection followed by adjuvant radiation. The modified Musculoskeletal Tumor Society (MSTS) score for scapular surgery was 20 in the first patient and 22 in the second patient. Both of them are able to carry out normal regular activities with the compensation from the opposite upper limb. Scapulectomy for symptomatic fibromatosis of the scapular muscles gives acceptable functional results and good disease-free interval. Scapulectomy should be considered as part of resection for better tumor clearance in fibromatosis involving muscles around the scapula. Further studies are needed to evaluate and validate the need for radical surgery in this setting.