Convalescent action of menthol against T-2 mycotoxin-induced toxicity: An in vitro study with HaCaT cells.

Only T-2 mycotoxin is emitted as an aerosol and is the most toxic fungal secondary metabolite among mycotoxins. In its clinical condition, the skin is severely irritated and painful due to lesions and alimentary toxic aleukia. Herein, we have assessed various bioactive molecules, viz. kaempferol, menthol, curcumin, and quercetin, against T-2-induced toxicity in HaCaT cells. Menthol offered exceptional protection, protecting 92% of HaCaT cells after exposure to 300 nM T-2 and reducing LDH leakage by up to 42%. Its pre-treatment provided considerable protection against T-2 toxicity, as evidenced by the assessment of mitochondrial membrane potential. Propidium iodide staining revealed a cell cycle halt at the G1, S, and M phases and a significant increase in the sub-G1 percentage in T-2-challenged cells, indicating cell death. However, pre-treatment with menthol promoted cell cycle progression in cells exposed to T-2. Immunoblotting results demonstrated that menthol resulted in a discernible down-regulation of i-NOS expression in T-2-challenged HaCaT cells.

Silk sericin conjugated magnesium oxide nanoparticles for its antioxidant, anti-aging, and anti-biofilm activities.

The Silk sericin protein was conjugated with magnesium oxide (MgO) nanoparticles to form SS-MgO-NPs . UV, XRD, FTIR, SEM, DLS, and EDX were used to confirm the formation of SS-MgO-NPs. The absorption band of SS-MgO-NPs using UV-visible spectra was observed at 310 nm, with an average size of the nanoparticles was 65-88 nm analyzed from DLS. The presence of alcohol, CN, and CC, alkanes, alkenes, and cis alkenes, in silk sericin, is confirmed by FT-IR and may act as a stabilizing agent. Later SS-MgO-NPs were evaluated for antioxidant, antibacterial, anti-biofilm, ,anti-aging, and anticancer properties. The SS-MgO-NPs inhibited the formation of biofilm of Pseudomonas aeruginosa and Bacillus cereus. The blood compatibility of SS-MgO-NPs, delaying coagulation was observed using human, blood, and goat blood samples. The SS-MgO-NPs exhibited significant anticancer activity on MCF-7 (IC50 207.6 µg/mL) cancer cell lines. Correspondingly, SS-MgO-NPs demonstrated dose-dependent inhibition of the enzymes in the following order collagenase > elastase > tyrosinase > hyaluronidase, with IC50 values of 75.3, 85.3, 133.6, and 156.3 µgmL-1, respectively. This exhibits the compoundposses anti-aging properties. So, in in vitro settings, SS-MgO-NPs can be used as an antibacterial, anti-aging, and anticancer agent. Additionally, in vivo research is necessary to validate its therapeutic applications.

T-2 toxin induces dermal inflammation and toxicity in mice: The healing potential of menthol.

According to the World Health Organization and the Food and Agricultural Organization of the United Nations, T-2 is one of the most harmful food-toxic chemicals, penetrates intact skin. The current study examined the protective benefits of menthol topical treatment on T-2 toxin-induced cutaneous toxicity in mice. Lesions were observed on the skin of the T-2 toxin-treated groups at 72 and 120 h. The T-2 toxin (2.97 mg/kg/bw)-treated group developed skin lesions, skin inflammation, erythema, and necrosis of skin tissue in contrast to the control group. Our findings reveal that topical application of 0.25% and 0.5% MN treated groups resulted in no erythema or inflammation, and normal skin was observed with growing hairs. The 0.5% MN administered group demonstrated an 80% blister and erythema healing effect in in vitro tests. In addition, MN dose-dependently suppressed ROS and lipid peroxidation mediated by the T-2 toxin up to 120%. Histology discoveries and the immunoblotting investigations with the downregulation of i-NOS gene expression confirmed the validity of menthol activity. Further molecular docking experiments of menthol against the i-NOS protein demonstrated stable binding efficacy with conventional hydrogen bond interactions, indicating compelling evidence of menthol's anti-inflammatory effects on the T-2 toxin-induced skin inflammation.

The impact of yeast fermentation on dough matrix properties.

BACKGROUND: Most studies on dough properties are performed on yeastless dough to exclude the complicating, time-dependent effect of yeast. Baker's yeast, however, impacts dough matrix properties during fermentation, probably through the production of primary (CO2 and ethanol) and secondary (glycerol, acetic acid and succinic acid) metabolites. The aim of this study is to obtain a better understanding of the changes in yeasted dough behavior introduced by fermentation, by investigating the impact of yeast fermentation on Farinograph dough consistency, dough spread, Kieffer rig dough extensibility and gluten agglomeration behavior in a fermented dough-batter gluten starch separation system. RESULTS: Results show that fermentation leads to a dough with less flow and lower extensibility that breaks more easily under stress and strain. The dough showed less elastic and more plastic deformation behavior. Gluten agglomerates were smaller for yeasted dough than for the unyeasted control. CONCLUSION: These changes probably have to be attributed to metabolites generated during fermentation. Indeed, organic acids and also ethanol in concentrations produced by yeast were previously shown to have similar effects in yeastless dough. These findings imply the high importance of yeast fermentation metabolites on dough matrix properties in industrial bread production. © 2015 Society of Chemical Industry.

The implementation of ZnS-SnS BM NPs for phenanthrene degradation: An adsorptive photocatalyst approach and its toxicity studies in adult zebrafish.

Phenanthrene is a persistent organic pollutant released by numerous industries. The purpose of the study is to construct a batch reactor for phenanthrene degradation using a bimetallic (BM) ZnS-SnS nanoparticle as a photocatalyst. ZnS-SnS BM NPs were used as a photocatalyst, employed from precursors Zinc acetate dihydrate and tin (II) chloride dihydrate, with crystalline cubic-shaped particle sizes. ZnS-SnS BM NPs were utilized in batch adsorption assays to assess the impact of phenanthrene degradation parameters on various PAHs (Polycyclic aromatic hydrocarbons) concentrations, pH levels, and irradiation sources. Adsorption kinetic and isotherm tests revealed that the pseudo-first order kinetic model, pseudo-second order kinetic model, and Langmuir isotherm model all fit effectively with the effective phenanthrene degradation using ZnS-SnS BM NPs. The degraded product were analyzed for GC-MS, revealing that organic pollutant phenanthrene was converted into harmless by-products like n-hexadecenoic acid, oleic acid, and octadecanoic acid. The toxicity of phenanthrene was observed to decrease with an increase in ZnS-SnS BM NPs concentration. ZnS-SnS BM NP concentration of 150 µg/mL, the zone of inhibition values was recorded highest zone of inhibition (19 ± 1.2 mm) against the strains S. epidermis followed by B. cereus and Clostridium spp. Further adult zebrafish were found to be less toxic to ZnS-SnS BM NPs after 96 h of exposure, with an LD50 of 100 µg/L. The toxicity escalated as concentrations increased. Behavior test showed normal swimming, learning, and memory in open tank and T-maze tests, while 100 µg/L showed pausing/frozen time in zebra fish therefore low doses are considered safe. Hence by employing ZnS-SnS BM NPs can be engaged in waste water treatment for PAH degradation.

Surgical exposure for vitrectomy in retinopathy of prematurity.

Our purpose was to evaluate the efficacy of lateral canthotomy, sub-tenon anesthesia injection, and the use of modified speculum for gaining adequate surgical exposure during surgery for retinopathy of prematurity (ROP). Fourteen eyes of 10 consecutive patients undergoing microincisional vitrectomy surgery (MIVS) for stage 4 and stage 5 ROP were included. There was a significant widening of the palpebral fissure height and length using this technique. No patient developed a lens injury during the surgery. All the canthotomy incisions completely healed at a four-week follow-up visit. This is a safe and effective technique for increasing surgical exposure in cases of ROP requiring vitrectomy.

Unilateral Autoimmune Encephalitis: A Case Report on a Rare Manifestation of Myelin Oligodendrocyte Glycoprotein Antibody Disease.

Myelin oligodendrocyte glycoprotein (MOG)-associated disease (MOGAD) is a rare, antibody-mediated inflammatory demyelinating disorder of the central nervous system (CNS) that has varying phenotypes. FLAIR (fluid-attenuated inversion recovery)-hyperintense Lesions in Anti-MOG-associated Encephalitis with Seizures (FLAMES) is a much rarer manifestation of cortical encephalitis encountered in MOGAD. We report a rare case of a nine-year-old girl who presented with a drop in her academic performance and right-sided Epilepsia partialis continua. Magnetic resonance imaging (MRI) of the brain detected evidence for unilateral (left) cortical encephalitis with peri-ictal juxtacortical edema. An electroencephalogram revealed a hemi-generalized poly spike and wave discharges in the left hemisphere, several of which correlated with myoclonic jerks. The cerebrospinal fluid (CSF) analysis was normal. Autoimmune workup resulted in a positive serum MOG-immunoglobulin G (IgG), which confirmed the diagnosis of FLAMES. The child showed an excellent clinical response to intravenous methylprednisolone and intravenous immunoglobulins therapy.

Krill's Disease: A Newer Management Option.

Purpose: To report a case of a young female who presented with scotoma in the right eye for few days. Case Report: Krill's disease or acute retinal pigment epithelitis (ARPE) is a self-limiting retinal disease with no specific treatment. Typical clinical and imaging features helped us to diagnose her with ARPE. Intravenous methylprednisolone (IVMP), which gives a rapid anti-inflammatory response, was advised. An SD-OCT scan post-injection showed a reduction in hyperreflectivity and height of lesion at day 3 and near total resolution by day 5. Conclusion: This case suggests rapid resolution of ARPE with the use of IVMP.

An endophytic fungus, Penicillium simplicissimum conjugated with C60 fullerene for its potential antimitotic, anti-inflammatory, anticancer and photodegradation activities.

In the present study, endophytic fungus, Penicillium simplicissimum isolated from Loranthus micranthus was used to analyze phytochemical studies by qualitative and GC-MS methods. The endophytic fungus P. simplicissimum yielded novel compound penisimplicissin identified through GC-MS studies. Further, P. simplicissimum was conjugated with C60 fullerene nanoparticles (Ps-FNPs) were verified using UV-vis spectra, XRD, FTIR, DLS, EDX and SEM. Ps-FNPs was confirmed using UV-visible spectra with a peak at 260 nm. The IR bands were recorded at 2085, 1428, 1181, 661, 652, 644, 628, and 604 cm-1. The Ps-FNPs treated cells showed a nucleolar shrinkage and cell arrest atprophase, binuclear and multinucleolar cells, a chromosomal bridge and diversion at anaphase was observed, whereas, chromosomal fragment and abnormal distribution at metaphase stage. The Ps-FNPs exhibited a noteworthy anticancer activity on lung cancer cell line H1975 through cytotoxicity. The cytotoxicity was induced by increasing caspase-3, 7, and 9 activities and also showed highest inhibition in xanthine oxidase and COX-II assay proved good anti-inflammatory activity. Ps-FNPs have been extensively studied for photocatalytic activity test against Rhodamine B, Methylene blue and nigrosine showed potential dye degradation in the presence of sunlight proved to be novel photocatalysts. With all the results recorded, Ps-FNPs also have a synergetic effect having on anti-mitotic, anticancer, anti-inflammation potential and photocatalytic degradation of dyes. Hence, the conjugated Ps-FNPs could be one of the potent nano-drug formulations in future. Thus, the present study gives a clear idea of the multifaceted therapeutic and photocatalytic applications.

Effect of remdesivir on adverse kidney outcomes in hospitalized patients with COVID-19 and impaired kidney function.

BACKGROUND: Chronic kidney disease (CKD) is an important risk factor for mortality from COVID-19. Remdesivir has been shown to shorten time to recovery in patients with severe COVID-19. However, exclusion of patients with severe kidney function impairment in clinical trials has led to concerns about kidney safety of remdesivir in patients with pre-existing kidney disease. METHODS: Retrospective propensity score matched cohort study of hospitalized patients with COVID-19 admitted with estimated glomerular filtration rate (eGFR) between 15 - 60 mL/min/1.73m2. Remdesivir-treated patients were 1:1 matched to historical comparators admitted during the first wave of COVID-19 (between March-April 2020) prior to emergency use authorization of remdesivir using propensity scores accounting for factors predicting treatment assignment. Dependent outcomes included in-hospital peak creatinine, incidence of doubling of creatine, rate of kidney replacement therapy initiation and eGFR among surviving patients at day 90. RESULTS: 175 remdesivir-treated patients were 1:1 matched to untreated historical comparators. Mean age was 74.1 (SD 12.8), 56.9% were male, 59% patients were white, and the majority (83.1%) had at least one co-morbidity. There were no statistically significant differences in peak creatinine during hospitalization (2.3mg/dL vs. 2.5 mg/dL, P = 0.34), incidence of doubling of creatinine (10.3% vs. 13.1%, P = 0.48), and rate of kidney replacement therapy initiation (4.6% vs. 6.3%, P = 0.49) in remdesivir-treated patients versus matched untreated historical comparators, respectively. Among surviving patients, there was no difference of the average eGFR at day 90 (54.7 ± 20.0 mL/min/1.73m2 for remdesivir-treated patients vs. 51.7 ± 19.5 mL/min/1.73m2 for untreated comparators, P = 0.41). CONCLUSIONS: Remdesivir use in patients with impaired kidney function (eGFR between 15 - 60 mL/min/1.73m2) who present to the hospital with COVID-19 is not associated with increased risk of adverse kidney outcomes.

Phosphorylation of p53 by IkappaB kinase 2 promotes its degradation by beta-TrCP.

Functional inactivation of p53 and constitutive activation of the NF-kappaB pathway has been associated with several human cancers. In this study, we show that IkappaB kinase 2 (IKK2/IKKbeta), which is critical for NF-kappaB activation, also phosphorylates p53. Phosphorylation of p53 at serines 362 and 366 by IKK2 leads to its recruitment to and ubiquitination by beta-TrCP1. Degradation of ubiquitinated p53 is independent of Mdm2, because it occurs in both wild-type and Mdm2(-/-) cells. SiRNA-mediated reduction in the levels of beta-TrCP1 and other members of the SCF(beta-TrCP1)E3 ubiquitin ligase complex or overexpression of a dominant negative form of beta-TrCP1 enhances p53 stability. Substitutions at Ser-362 and 366 of p53 by alanines (p53 AA) result in reduced phosphorylation of p53 by IKK2, decreased association with beta-TrCP1, and thus increased stability of p53 and expression of p53 target genes such as p21, altering the G1 phase of the cell cycle. Our results identify IKK2 and beta-TrCP1 as novel regulators of the p53 pathway and suggest that blocking of IKK2 and beta-TrCP1 could be a means of regulating p53 stability and thereby modulating its biological activity.

Intrathecal Nalbuphine and Dexmedetomidine as Adjuvants to Bupivacaine versus Plain Bupivacaine for Orthopedic Surgeries under Subarachnoid Block: A Comparative Study.

Background: In long bone surgeries, the severity of pain is more, demanding good intraoperative anesthesia, and prolonged postoperative analgesia. This is achieved in spinal anesthesia with adjuvants to local anesthetics, which act synergistically. Aims: The aim of this study was to compare the efficacy of nalbuphine and dexmedetomidine as adjuvants to bupivacaine versus bupivacaine alone in lower limb orthopedic surgeries under the subarachnoid block (SAB). Settings and Design: This is a prospective, randomized, double-blind control study conducted on 60 patients belonging to the American Society of Anesthesiologists physical status Classes I and II, undergoing lower limb orthopedic surgeries under SAB. Materials and Methods: Sixty patients were divided into three groups by computer-generated randomization. Group A received 2.7 mL of 0.5% hyperbaric bupivacaine with 1.5 mg nalbuphine, Group B received 2.7 mL of 0.5% hyperbaric bupivacaine with 10 µg dexmedetomidine, and Group C received 2.7 mL of 0.5% hyperbaric bupivacaine with 0.5 mL of normal saline (total volume made to 3.2 mL in all groups with normal saline). Time of onset of block, duration of sensory, and motor blocks were noted. Changes in hemodynamic parameters, postoperative first rescue analgesia requirement, and side effects were recorded. Statistical Analysis Used: Data were analyzed using SPSS 22 version software. P < 0.05 was considered statistically significant. Results: There was no significant difference in the onset of sensory or motor blocks in the three groups. However, the time taken for regression of sensory block was longer in Group B that was statistically significant. Conclusion: Intrathecal dexmedetomidine acts as a better adjuvant with bupivacaine in providing quality anesthesia, prolonged sensory and motor block, and good postoperative analgesia with less incidence of adverse effects compared to nalbuphine and bupivacaine alone.

Efficacy of diode lasers in oral verrucous hyperplasia: A case series.

Oral verrucous hyperplasia (OVH) is a potentially malignant lesion that may transform into an oral cancer. Cases without local metastases can be conservatively managed with local excision, laser therapy, photodynamic therapy, chemotherapy, etc. The aim of this article is to present a case series showing treatment outcomes of OVH excised with laser. A total of 5 cases of OVH diagnosed histologically were included. All the 5 cases were excised using a diode laser and the specimen was sent for histopathological examination. Histopathological examination of excisional biopsy specimen with adjacent normal epithelium result has shown to be verrucous hyperplasia excluding the chance of verrucous carcinoma in any of the case. All the 5 cases were followed up for 18 months. All the 5 patients have shown excellent healing and epithelialization by 1 month and have shown full range of healing by the end of 3rd month. There were no complications reported over a follow up period of 18 months. Verrucous hyperplasia is a challenging pathological state for success after excision. A high degree of chance for recurrence and scarring of the tissue compromises treatment outcomes. In our experience use of diode laser for excision has shown satisfactory healing with minimal scarring and there were no cases of recurrence after 18 months follow up.

A report on successful introduction of tele mental health training for primary care doctors during the COVID 19 pandemic.

Treatment gaps of 60-70%, reflecting, amongst many other factors, Human Resources shortfalls means that 150 million India never accessed mental healthcare. In Punjab, mental health training is required in primary health centers. A short-term synchronous training was conceptualized by the National Institute of Mental Health and Neurosciences. A total of 114 primary care doctors participated for the training. Substantial positive changes in knowledge, attitudes and practices were noted. Task sharing and capacity building initiatives can be undertaken during the pandemic to meet the demand for mental healthcare service delivery.

The Legality and Ethical Issues of Certifying Laypersons as Mental Health Counselors in India.

Background: The burden of mental health conditions and consequent disability impacts are felt most in low- and middle-income settings. These settings are constrained by the limited availability of resources to provide even essential aspects of mental health care (MHC). Task shifting and sharing interventions have shown promise in delivering community-based MHC across such low-resource settings. Some counseling tasks such as friendship bench interventions have been successfully shifted to laypersons. However, ethical and legal concerns regarding laypersons' incorporation in MHC delivery systems have not been examined. Purpose: To examine the ethical and legal concerns surrounding the certification of laypersons as community-based mental health counselors. Method: We undertook an academic review of various legislations pertinent to MHC service delivery and the certification of allied health care professionals to inform on acceptable and tenable strategies toward incorporating such a task-shifted intervention. Conclusion: Scaling up the training of human resources to address access problems can be the first step in addressing the MHC access and treatment gaps. The certification of laypersons as community-based mental health counselors, although legally tenuous, can be pioneered by tertiary-level MHC institutions. This certification has sound ethical justification and is a progressive step toward realizing universal mental health coverage.

Green fabrication of silver nanoparticles using Chloroxylon swietenia leaves and their application towards dye degradation and food borne pathogens.

Green synthesized silver nanoparticles (AgNPs) are becoming an important candidate for bioremediation and biomedical applications. But in recent trends, more focus is given towards degradation of dyes and application against food pathogens. The synthesis of efficient AgNPs depends on the selection of potential biological material for synthesis. Therefore, in the present study, AgNPs were synthesized using Chloroxylon swietenia. The synthesis AgNPs was confirmed by the formation of dark brown precipitate. Further physicochemical characterization performed using XRD, FTIR, SEM and DLS showed the formation of crystalline structure, presence of functional group from the C. swietenia, dispersed spherical and rod-shaped nanoparticles (6.9 nm) and possess good stability due to the negative partial charges. The dye degrading efficacy of Chloroxylon swietenia mediated synthesized AgNPs (C-AgNPs) was >95%, 90% and >90% tested against Congo red (CR), Coomassie blue (CB) and crystal violet (CV) dye, respectively withing 24 h of treatment under optimum conditions. The antibacterial activity of C-AgNPs (10 mg/mL) was analysed against Staphylococcus nepalensis (3.03 ± 0.35 cm), Staphylococcus gallinarum (2.96 ± 0.15 cm), Bacillus subtilis (2.86 ± 0.23 cm), Enterococcous faecalis (2.8 ± 0.30 cm) and Pseudomonas stuteria (2.06 ± 0.25 cm) using Disc diffusion method, Minimum inhibitory concentration (MIC) and Minimum bactericidal activity (MBC). Therefore, the present study is the first and foremost report on C-AgNPs application as dye degrading and antibacterial agents against food dyes and pathogens. This will provide a major strategy to unveil the complications in food and packaging industries worldwide.

BEVACIZUMAB FOR POST VITRECTOMY CYSTOID MACULAR EDEMA IN A SILICONE OIL-FILLED EYE.

PURPOSE: To report the safety and efficacy of intravitreal bevacizumab (IVB) in a case of cystoid macular edema (CME) in a silicone oil-filled eye. METHODS: A man, aged 51 years, reported with poor visual improvement in the right eye (RE) after pars plana vitrectomy with oil injection performed 2 months back for a pseudophakic, macula-off rhegmatogenous retinal detachment. His best-corrected visual acuity in the RE was counting fingers 2 m. Fundus examination of the RE showed a silicone oil-filled eye with attached retina, and CME was confirmed on spectral-domain optical coherence tomography. He was advised to undergo IVB injection, which was given a few days later. RESULTS: One week after IVB, the central macular thickness had decreased to 437 µ m. Seven weeks later, the macular edema subsided completely with a final central macular thickness of 219 µ m. His vision improved by seven lines to 6/24 and was stable for another 2 months. He underwent removal of silicone oil after 3 months, wherein his visual acuity improved further by one line to 6/18. DISCUSSION: This case demonstrates the use IVB for CME in a silicone oil-filled eye. It was found that IVB was safe and effective in CME associated with a silicone oil-filled eye.

Biomimicking Nature-Inspired Design Structures-An Experimental and Simulation Approach Using Additive Manufacturing.

Whether it is a plant- or animal-based bio-inspiration design, it has always been able to address one or more product/component optimisation issues. Today's scientists or engineers look to nature for an optimal, economically viable, long-term solution. Similarly, a proposal is made in this current work to use seven different bio-inspired structures for automotive impact resistance. All seven of these structures are derived from plant and animal species and are intended to be tested for compressive loading to achieve load-bearing capacity. The work may even cater to optimisation techniques to solve the real-time problem using algorithm-based generative shape designs built using CATIA V6 in unit dimension. The samples were optimised with Rhino 7 software and then simulated with ANSYS workbench. To carry out the comparative study, an experimental work of bioprinting in fused deposition modelling (3D printing) was carried out. The goal is to compare the results across all formats and choose the best-performing concept. The results were obtained for compressive load, flexural load, and fatigue load conditions, particularly the number of life cycles, safety factor, damage tolerance, and bi-axiality indicator. When compared to previous research, the results are in good agreement. Because of their multifunctional properties combining soft and high stiffness and lightweight properties of novel materials, novel materials have many potential applications in the medical, aerospace, and automotive sectors.

Gastroprotective Properties of Karanjin from Karanja (Pongamia pinnata) Seeds; Role as Antioxidant and H, K-ATPase Inhibitor.

Plant extracts are the most attractive sources of newer drugs and have been shown to produce promising results for the treatment of gastric ulcers. Karanjin, a furano-flavonoid has been evaluated for anti-ulcerogenic property by employing adult male albino rats. Karanjin (>95% pure) was administered to these rats in two different concentrations, that is, 10 and 20 mg kg(-1) b.w. Ulcers were induced in the experimental animals by swim and ethanol stress. Serum, stomach and liver-tissue homogenates were assessed for biochemical parameters. Karanjin inhibited 50 and 74% of ulcers induced by swim stress at 10 and 20 mg kg(-1) b.w., respectively. Gastric mucin was protected up to 85% in case of swim stress, whereas only 47% mucin recovery was seen in ethanol stress induced ulcers. H(+), K(+)-ATPase activity, which was increased 2-fold in ulcer conditions, was normalized by Karanjin in both swim/ethanol stress-induced ulcer models. Karanjin could inhibit oxidative stress as evidenced by the normalization of lipid peroxidation and antioxidant enzyme (i.e., catalase, peroxidase and superoxide dismutase) levels. Karanjin at concentrations of 20 mg kg(-1) b.w., when administered orally for 14 days, did not indicate any lethal effects. There were no significant differences in total protein, serum glutamate pyruvate transaminase, serum glutamate oxaloacetate transaminase and alkaline phosphatase between normal and Karanjin-treated rats indicating no adverse effect on major organs. During treatment schedule, animals remained as healthy as control animals with normal food and water intake and body weight gain.

Development and validation of patient information leaflet for coronary heart disease patients.

BACKGROUND: Patient information leaflets (PILs) are effectively used to improve the patient's knowledge about medications, disease, diet, and lifestyle modifications. AIM: This study aims to develop and evaluate PILs for coronary heart disease patients. MATERIALS AND METHODS: Primary, secondary, and tertiary resources were used to develop PILs. The developed PILs were validated by four doctors, four academic pharmacists, and one dietician. PILs design and layout was prepared using barker able leaflet design (BALD) criteria. PILs readability was assessed using the Flesch Reading Ease test (FRE), Flesch-Kincaid Grade Level (FKGL), and user readability methods. User opinion on PILs content and design was obtained from patients. RESULTS: The FRE and FKGL readability scores were 61.5 and 7.4, respectively. The BALD criteria scores for English, Kannada, and Malayalam PILs were 28, 27, and 26, respectively. The overall user testing readability means scores had significantly improved from 45 to 79.30. Nearly 82.55% of patients rated the PILs as good design and content. CONCLUSION: The developed leaflet met the standard criteria for easy reading and comprehension. The majority of the patients gave good opinion on the content and design of the PILs.