Multifunctional Green Synthetic Hematite (α-Fe2O3) Nanoparticles Mediated by Camellia Sinensis (Indian Tea Plant) Extracts towards Antioxidant and Antiproliferative Activities against MCF-7 Cell Lines

Among nanoparticles used for medical applications, Camellia Sinensis Nanoparticles (CSNPs) are among the least investigated. This study was undertaken to develop CSNPs by green synthesis using Camellia sinensis tea (Theaceae) plant extract to produce the NPs. The Camellia sinensis, Indian tea plant used from ancient time to increase appetite. Other medicinal uses have also been employed for the synthesis of super paramagnetic α Fe2O3 nanoparticles (NPs). The plant extracts revealed the phenolic groups bifunctional nature and capping nature through the –OH bonding over the nanoparticles (NPs) surface. The prepared nanoparticles (NPs) shows α-Fe2O3 phase among iron oxides and spherical morphology with an average size around 5 nm. The magnetic measurements proved the superparamagnetic behaviour of NPs with non-saturating MS value of 8.5 emu/g at room temperature (300 K). The CSNPs were characterized by UV-V is spectroscopy and X-ray Diffractometry, and evaluated with Transmission Electron Microscopy (TEM), Scanning Electron Microscopy (SEM) and Fourier Transform Infrared (FTIR). The CSNPs were spherical (size 7-20 nm) and contained phenols and flavonoids acquired from the Camellia sinensis extract. CSNPs has good 1-Diphenyl-2-Picrylhydrazyl (DPPH), OH, and NO scavenging properties. MTT assay showed that CSNPs (IC50 = 0.006 μM) were more antiproliferative toward the human MCF-7 cells than the Camellia sinensis tea extract (IC50 = 0.894 μM), Gemcitabin (IC50 = 2.133 μM). The anticancer cell effects of CSNPs on MCF 7 are mediated through the induction of apoptosis and G2/M cell-cycle arrest.

Retinal Pigment Epithelium Tear Following Aflibercept for Exudative Macular Degeneration Tachyphylactic to Anti-Vascular Endothelial Growth Factor A Agents

Purpose: To report two cases of retinal pigment epithelium (RPE) tears following treatment with aflibercept of exudative macula degeneration associated with pigment epithelial detachment (PED) tachyphylactic to antivascular endothelial growth factor (VEGF) A agents such as bevacizumab or ranibizumab.Methods: Retrospective case series of patients with exudative macular degeneration with PED who were managed with anti-VEGF A agents that developed RPE tear following the first aflibercept injection. The patients were followed with optical coherence tomography and fluorescein angiography.Results: In our two cases, RPE tear developed after being switched from bevacizumab or ranibizumab to treatment with aflibercept. Both cases were rescued with monthly ranibizumab injections. In each case vision and macular edema improved with continued treatment.Conclusion: RPE tears may occur following injection with aflibercept for treatment of exudative AMD tachyphylactic to bevacizumab or ranibizumab. Continued anti-VEGF treatment can be effective rescue therapy.

The Impact of Family Support on Medication Adherence and Glycemic Control of Type 2 Diabetes Outpatients in a Nigerian Tertiary Hospital

Background: Diabetes management rarely target family support as a means of promoting diabetes self-care behaviour among adults. The potential influence of family member on individuals with Type 2 diabetes has not been fully explored. The study aims to examine the impact of family support on medication adherence and glycemic control of their Type 2 diabetes out-patients in a tertiary hospital.Methods: The study was a prospective cross-sectional survey conducted on Type 2 diabetes out-patients attending endocrinology clinic at the University of Nigeria Teaching Hospital (UNTH) between October 2013 and April 2014. The Diabetes Family Behavioral Checklist (DFBC-13) was used to assess family support while the MMAS-8 (Morisky medication Adherence Scale) was used to assess medication adherence. Fasting blood glucose readings were obtained from patients’ case files.Data were analysed using SPSS (Statistical package for social sciences) version 16 and level of statistical significance set at p<0.05. Result: A total number of 250 patients were assessed. The mean score for family support was 42 of 65 (range 13 to 65). Family support score (diet, glucose, exercise, diabetic self-care) associated with educational status (socio-demographic characteristics) r = 0.171** p = 0.007. Family support was inversely correlated to adherence and glycemic control (-0.161**, P = 0.011, r = -0.098, p = 0.147) respectively. Medication adherence was low as only 1.6% of the respondents adhered to their medication.Conclusion: Family support had little influence on medication adherence and glycemic control.

Tacrolimus Pharmacokinetics in Living-Donor and Deceased-Donor Liver Transplant in Saudi Patients

Introduction: Tacrolimus is a macrolide immunosuppressant. It has a narrow therapeutic index and serious side effects which necessitate monitoring of tacrolimus blood concentration. The trough concentration of the drug may also differ based on the type of liver transplant. This study was conducted to investigate differences in pharmacokinetics between transplant types and to determine tacrolimus population pharmacokinetic in liver transplant recipients in Saudi Arabia. Method: Patients on tacrolimus, as the main immunosuppressant, who underwent liver transplant throughout2012-2014 were retrospectively studied. Demographic characteristic, tacrolimus blood trough concentrations, liver, renal, biochemistry, and hematology lab results were all collected. The pharmacokinetic parameters were estimated assuming one compartment model. Results: Tacrolimus pharmacokinetic parameters were found to be as following; elimination rate constant () 0.094 ± 0.0123, apparent volume of distribution () 112.48±63.033 L/hr, elimination half-life () 7.46± 1.01 hr and apparent total body clearance () 10.27± 5.69 L/hr (mean ± SD). Statistically significant difference was found between living-donor and deceased-donor liver transplant with respect to apparent clearance and apparent volume of distribution. Living-donor liver transplant recipients have apparent volume of distribution of 97.39±47.00 L (mean ± SD) and an apparent clearance of 8.89±4.24L/hr (mean± SD). On the other hand, deceased-donor liver transplant has an apparent clearance of 12.97±7.09L/hr (mean ± SD) and an apparent volume of distribution of 142.17± 78.65 L (mean ± SD). Conclusions: Tacrolimus pharmacokinetics parameters were accurately determined in liver transplant recipients in Saudi Arabia. The results of the present study can be clinically used in the therapeutic drug monitoring of tacrolimus in the individualization of drug dosage and taking the appropriate clinical decisions to prevent allograft rejection.

Pharmacological Options for Viral Induced Hemorrhagic Cystitis Management: A Review of the Literature

Background: Viral induced hemorrhagic cystitis (VIHC) is very common among patients who become immunocompromised following organ transplantation. However, there is neither consensus on the standard of care nor clear guidelines to aid in clinical decision making when treatment VIHC. This review discusses currently available pharmacologic agents, presents investigational drug therapies, and outlines alternative treatment options that could be effective against VIHC.Recent findings: Letermovir is a novel antiviral agent approved for CMV prophylaxis in patients post-hematopoietic stem cell transplantation (HSCT). Although no studies have yet been conducted in patients with VIHC, this new antiviral agent shows promise in preventing emergence of CMV in patients after HSCT. Additionally, newer studies addressing the efficacy of brincidofovir, an experimental drug derived from cidofovir, against CMV infection may provide preliminary evidence for brincidofovir’s role in therapy and therefore warrant further investigation.Conclusion: Polyoma BK virus (BKV), cytomegalovirus (CMV), and adenovirus (ADV) are the primary culprits for HC occurrence in patients undergoing renal transplantation or allogeneic HSCT. CMV-associated HC could be prevented or treated by ganciclovir and valganciclovir because these agents’ effectiveness has been clearly established in other non-HC infections related to CMV. ADV-associated HC could be mitigated by brincidofovir and ribavirin, however the high toxicity associated with these agents may be a limiting factor for their use. BKV-associated HC is best managed by cidofovir and leflunomide, but not by fluoroquinolones. Finally, intravesicular instillation should be preferred in patients who experience toxicities associated with systemic use of antivirals.

Application of Molecularly Structured Ben Oil in Gentamicin Entrapped Lipospheres

Objective: To formulate extended release gentamicin-entrapped lipospheres using natural lipids from Irvingia wombolu (IWF) and Moringa oleifera seed (MO) popularly known as Ben oil. Methods: Different lipid combinations including IWF and Phospholipon 90H (P90H) and IWF and MO were employed in the formulation of lipospheres. The formulations were analysed for particle size, encapsulation efficiency (EE), pH stability and antimicrobial studies amongst other tests. Also the in vitro release properties were studied in Phosphate buffer pH 7.2. Results: High EE of up to 90 % were obtained for the various LM combinations. The pH was stable over 30 days and the formulations showed about 93 % release of gentamicin at 12 h. Lipospheres formulated with MO matrices showed synergism in the microbial inhibition than other formulations. Conclusion: Natural lipids from Irvingia wombolu and Moringa oleifera seed could be used in formulating oral extended release gentamicin lipospheres.

Use of Ketamine to Treat Depressive Symptoms in Schizoaffective Disorder

The use of subanesthetic ketamine infusions in treatment resistant depression and bipolar depression is becoming more common. Subanesthetic doses of ketamine cause the patient to dissociate, which was initially considered a side effect of this treatment; it is believed to play a role in a patient’s clinical improvement. Researchers attribute this result to an increase in brain-derived neurotrophic factor, a growth factor that stimulates the formation of new synaptic connections. Due to its psychogenic affect, ketamine treatment is less suitable for patients who experience mood disorders with psychotic features. Although symptomatic hallucinations seemingly conflict with the dissociative effects of ketamine, treatment of a patient with depressive type schizoaffective disorder revealed significant improvements in his depressive symptoms, demonstrating ketamine’s potential to be safely administered to patients with a variety of complex disorders.

Effect of Juglan Regiaon Patients Having Metabolic Syndrome: A Controlled Feeding Trial

Metabolic syndrome is a cluster of disorders diagnosed simultaneously in an individual. The percentage of individuals affected from this syndrome is escalating around the globe as well as in Pakistan mainly due to more consumption of energy dense foods and sedentary lifestyle. Dietary modification with nutrient dense foods is a globally adapted strategy to reduce the complexity of this issue. This present project has been designed to see the impact of nutrient dense walnuts consumption on selective biomarkers in human subjects. The screening of human subjects was done by taking the anthropometric measurements, lipid profile, blood glucose level and blood pressure whereas the dietary pattern of patients was collected by validated food frequency questionnaire. The proximate analysis of walnuts was also done. Twenty patients were selected and divided into two groups randomly. Experimental group consumed walnuts daily for 8 weeks and placebo group consumed the diet without walnut. Selective physical parameters included BMI was performed at the regular basis whereas, the blood samples were collected at 1st , 4th and 8th week of the study period followed by the evaluation of serum triglyceride and high density lipoprotein cholesterol level. Walnuts were found to be high in fat content i.e 64.6% and also contained all other important nutrients as moisture (3.9%), ash (1.5%), protein (15.3%), fiber (1.5%) and nitrogen free extract (10.7%). Walnuts reduced triglycerides significantly and HDL was also raised significantly. No significant change was observed in BMI. Statistical analysis was employed to draw the conclusive outcomes of the research studies.

Current Strategies of Quetiapine Fumarate Delivery in Management of Bipolar Disorder and Schizophrenia

Bipolar disorder is psychological illness with periodic episodes of mania and depression. Schizophrenia is a complex mental disorder identified by delusions, hallucinations, disorganized behavior, impaired cognitive ability, disorganized speech and sudden change in personality. In both the diseases quetiapine fumarate (QF) drug is worth important in today’s scenario. This review gives complete QF drug profile along with mechanism of action. Quetiapine alone is successful for acute bipolar depression and the prevention of mania/hypomania switching. Literature survey section of this review gives information about quetiapine in different dosage form. By this review one can explore the scale up of quetiapine fumarate not only with immediate release and sustained release dosage form but also with novel drug delivery system like solid lipid nanoparticle and nanostructured lipid carrier.

Formulation Development and Evaluation of Rosuvastatin Sustained Release Tablets

Purpose: The main objective of present research investigation is to formulate the sustained release formulation of Rosuvastatin. Rosuvastatin, an antihyperlipidemic agent, belongs BCS class-II agent.Methods: The SR tablets of Rosuvastatin were prepared employing different concentrations of HPMCK4M and SCMC in different combinations by Direct Compression using 32 factorial design. The concentration of Polymers , HPMCK4M and SCMC required to achieve the desired drug release was selected as independent variables, X1 and X2 respectively whereas, time required for 10% of drug dissolution (t10%), 50% (t50%), 75% (t75%) and 90% (t90%) were selected as dependent variables.Results and Discussion: Totally nine formulations were designed and are evaluated for hardness, friability, thickness, % drug content, In-vitro drug release. From the Results it was concluded that all the formulation were found to be with in the Pharmacopoeial limits and the In-vitro dissolution profiles of all formulations were fitted in to different Kinetic models, the statistical parameters like intercept, slope & regression coefficient were calculated. Polynomial equations were developed for dependent variables. Validity of developed polynomial equations were verified by designing 2 check point formulations (C1, C2). According to SUPAC guidelines the formulation (F4) containing 30 mg of HPMCK4M and 40 mg of SCMC, is the most similar formulation (similarity factor f2= 89.561, dissimilarity factor f1= 1.543 & No significant difference, t= 0.0056) to marketed product (CRESTOR).Conclusion: The selected formulation (F4) follows Zero order, Higuchi’s kinetics, and the mechanism of drug release was found to be Non-Fickian Diffusion (n= 0.963).