Immunomodulatory Therapy for Giant Cell Myocarditis: A Narrative Review.

Giant cell myocarditis (GCM) is a rare, often rapidly progressive, and potentially fatal disease because of myocardium inflammation due to the infiltration of giant cells triggered by infectious as well as non-infectious etiologies. Several studies have reported that GCM can occur in patients of all ages but is more commonly found in adults. It is relatively more common among African American and Hispanic patients than in the White population. Early diagnosis and treatment are critical. Electrocardiogram (EKG), complete blood count, erythrocyte sedimentation rate, C-reactive protein, and cardiac biomarkers such as troponin and brain natriuretic peptide (BNP), echocardiogram, cardiac magnetic resonance imaging (MRI), myocardial biopsy, and myocardial gene profiling are useful diagnostic tools. Current research has identified several potential biomarkers for GCM, including myocarditis-associated immune cells, cytokines, and other chemicals. The standard of care for GCM includes aggressive immunosuppressive therapy with corticosteroids and immunomodulatory agents like rituximab, cyclosporine, and infliximab, which have shown promising results in GCM by balancing the immune system and preventing the attack on healthy tissues, resulting in the reduction of inflammation, promotion of healing, and decreasing the necessity for cardiac transplantation. Without immunosuppression, the chance of mortality or cardiac surgery was 100%. Multiple studies have revealed that a treatment combination of corticosteroids and immunomodulatory agents is superior to corticosteroids alone. Combination therapy significantly increased transplant-free survival (TFS) and decreased the likelihood of heart transplantation, hence improving overall survival. It is important to balance the benefits of immunosuppression with its potentially adverse effects. In conclusion, immunomodulatory therapy adds significant long-term survival benefits to GCM.

Nanocarriers for Smart Therapeutic Strategies to Treat Drug-Resistant Tumors: A Review.

Combination therapy has become much more effective in treating cancer because it produces combinatorial anticancer results, lowers specific drug-related toxicities, and inhibits multidrug resistivity through several modes of action. Combined drug delivery (CDD) to cancerous tissues, primarily based on nanotechnology, has developed as a viable method in recent years, surpassing various biomedical, biophysical, and biological obstacles that the body erects to prevent antitumor drugs from reaching their target tissues. In a combined strategy, the prolonged, regulated, and targeted administration of chemotherapeutic medicines improves therapeutic anticancer benefits while reducing drug-related adverse effects. CDD systems have several advantages over traditional drug systems, such as improved solubility, higher permeability for traveling through biomembranes, a significantly longer half-life to expand the treatment time, and low cytotoxicity. CDDs are mostly used to treat neurological, cardiovascular, neoplastic, infectious, and inflammatory diseases. Many CDDs are designed to enhance hydrophilicity to improve transportation inside or across biomembranes, particularly the cornea and skin. CDDs could be delivered to particular cells, organs, or tissues, resulting in increased bioavailability. The most widely utilized nanocarriers for CDDs of anticancer medicines are summarized in this review. This study also covers the chemical or enzymatic decomposition of CDDs and their bioactivity and pharmacokinetics. Additional clinical trials will enhance the usefulness of CDDs in treating drug-resistant tumors.

A Review of Multifunction Smart Nanoparticle based Drug Delivery Systems.

Cancer nano-therapeutics are rapidly evolving and are often used to overcome a number of concerns with traditional drug delivery methods, including non-specific drug targeting and distribution, low oral bioavailability, and poor hydrophilicity. Modern nano-based targeting techniques have been developed as a result of advances in nano vehicle engineering and materials science, which may bring people with cancer a new hope. Clinical trials have been authorized for a number of medicinal nanocarriers. Nanocarriers with the best feasible size and surface attributes have been developed to optimize biodistribution and increase blood circulation duration. Nanotherapeutics can carry preloaded active medicine towards cancerous cells by preferentially leveraging the specific physiopathology of malignancies. In contrast to passive targeting, active targeting strategies involving antigens or ligands, developed against specific tumor sites, boost the selectivity of these curative nanovehicles. Another barrier that nanoparticles may resolve or lessen is drug resistance. Multifunctional and complex nanoparticles are currently being explored and are predicted to usher in a new era of nanoparticles that will allow for more individualized and customized cancer therapy. The potential prospects and opportunities of stimuli-triggered nanosystems in therapeutic trials are also explored in this review.

Effects of inflow of inpatients attendants at a tertiary care hospital--a study at civil hospital Karachi.

OBJECTIVE: To assess the trend of attendants accompanying inpatients and its effect on a tertiary care hospital in Karachi. METHODS: A cross sectional study was carried out at CHK, through interview-based questionnaires targeting three groups of interest viz. patients admitted in the wards and stable enough to answer questions appropriately, attendants residing at CHK premises and heads of hospital departments or administrative Resident Medical Officers. RESULTS: Out of 281 patients, 149 (53.03%) had only one attendant staying with them, 74 (26.34%) had two, 39 (13.88%) had more than two and 19 (6.76%) had none. Out of 240 attendants, 204 (85%) planned to stay within the hospital till discharge of their patient while 24 (10%) till a week and 12 (5%) for two weeks. Out of 21 administrative heads, 18 (85.71%) faced problems due to presence of extra attendants and 3 (14.29%) did not. However, all 21 (100%) agreed that there were risks associated with presence of too many attendants; which were financial burden 13 (61.9%), infections 14 (66.67%), physical violence 11 (52.38%), disturbance of hospital sanctity 13 (61.91%), and crimes 10 (47.62%). CONCLUSION: Our study suggested that there was a significant trend for patients to be accompanied by multiple attendants at CHK. Although hospital did not have to provide food and shelter to them, but their presence in large numbers was in violation to hospital protocols. In view of the hospital administration multiple attendants caused hindrance in duties of staff and posed infections and security risks.