Neurotrophic Factor Mediated Neurorestorative Effect of Pongamia pinnata Against Transient Cerebral Hypoperfusion and Reperfusion in Rats: Preliminary Histological and Molecular Level Evidence / Efecto Neurorestaurador Mediado por Factor Neurotrófico de Pongamia pinnata Contra la Hipoperfusión y Reperfusión Cerebral Transitoria en Ratas: Evidencia Preliminar de un Estudio a Nivel Histológico y Molecular

SUMMARY: Stroke is the leading cause of acquired physical disability in adults and second leading cause of mortality throughout the world. Treatment strategies to curb the effects of stroke would be of great benefit. Pongamia pinnata is a recent attraction in medicine, owing to its abundant medicinal benefits with minimal side effects. The present study aimed to examine acute and subacute effect of Pongamia pinnata leaf extract on transient cerebral hypoperfusion and reperfusion (tCHR) in Wistar rats. 24 adult Wistar rats (12 each for acute and subacute study) were divided in to four groups each viz normal control group, tCHR + NS group, tCHR + 200mg/kg bw and tCHR + 400mg/kg bw groups. Cerebral ischemia induction was carried out by bilateral common carotid artery occlusion and reperfusion. Ethanolic extract of Pongamia pinnata leaves were orally administered for 7 days and 21 days after the surgical procedure for acute and subacute study respectively. Behavioural analysis, histological assessment, and estimation of mRNA levels of HIF-1, GDNF, BDNF and NF-kB were performed. In both acute and subacute study, there was significant improvement in the beam walking assay, neuronal count, decreased neuronal damage in histological sections and higher mRNA expression of BDNF and GDNF in the treatment groups. There was no significant difference in the expression of HIF1 and NF-kB. Thus, Pongamia pinnata has excellent neurorestorative property reversing many of the effects of ischemic stroke induced by tCHR in rats with the underlying mechanism being an improvement in the expression of neurotrophic factors GDNF and BDNF.

El ataque cerebrovascular es la principal causa de discapacidad física adquirida en adultos y la segunda causa de mortalidad en todo el mundo. Las estrategias de tratamiento para frenar los efectos del ataque cerebrovascular serían de gran beneficio. Pongamia pinnata es una atracción reciente en la medicina, debido a sus abundantes beneficios medicinales con mínimos efectos secundarios. El presente estudio tuvo como objetivo examinar el efecto agudo y subagudo del extracto de hoja de Pongamia pinnata sobre la hipoperfusión y reperfusión cerebral transitoria (tCHR) en ratas Wistar. Se dividieron 24 ratas Wistar adultas (12 cada una para el estudio agudo y subagudo) en cuatro grupos, el grupo control normal, el grupo tCHR + NS, los grupos tCHR + 200 mg/kg de peso corporal y tCHR + 400 mg/kg de peso corporal. La inducción de la isquemia cerebral se llevó a cabo mediante oclusión y reperfusión bilateral de la arteria carótida común. El extracto etanólico de hojas de Pongamia pinnata se administró por vía oral durante 7 días y 21 días después del procedimiento quirúrgico para estudio agudo y subagudo respectivamente. Se realizaron análisis de comportamiento, evaluación histológica y estimación de los niveles de ARNm de HIF-1, GDNF, BDNF y NF-kB. Tanto en el estudio agudo como en el subagudo, hubo una mejora significativa en el ensayo de desplazamiento del haz, el recuento neuronal, una disminución del daño neuronal en las secciones histológicas y una mayor expresión de ARNm de BDNF y GDNF en los grupos con tratamiento. No hubo diferencias significativas en la expresión de HIF1 y NF-kB. Por lo tanto, Pongamia pinnata tiene una excelente propiedad neurorestauradora que revierte muchos de los efectos del ataque cerebrovascular isquémico inducido por tCHR en ratas, siendo el mecanismo subyacente una mejora en la expresión de los factores neurotróficos GDNF y BDNF.

Evaluation of change in knowledge and attitude about noise and its effect on hearing: post awareness programme among adolescents in Varkala, Thiruvananthapuram district, Kerala

Background: There are significant literature evidence across the globe and in India, regarding the effects of recreational noise exposure among young adults and college students, but there is a dearth of literature support regarding its effects among the students of senior grade studying in Indian subcontinent. Since the awareness among school students help in the early preventive measures and hearing conservation, studies must focus on these population to reduce the burden of recreational noise-induced hearing loss on our future generation. This study aims to evaluate the change in knowledge and attitude about noise and its effect on hearing: Post awareness programme among adolescents in Varkala, Thiruvananthapuram district, Kerala. Method: A survey was conducted among the school students within the age group 16-18 years. A questionnaire containing questions related to knowledge and attitude towards noise and its effect on hearing was developed and distributed to the students prior to and after an awareness program making use of a visual awareness material. Wilcoxon signed rank test was used for pre and post comparison. Results: The p value of each aspect related to the knowledge and attitude is less than the significance level, so we can say that there is a significant change in the level of knowledge and attitude after the awareness program. Conclusions: The study highlighted low pre-awareness levels among participants regarding noise's impact on hearing. The awareness program effectively improved understanding, emphasizing its importance for all age groups in dispelling misconceptions and fostering positive attitudes.

A survey of the knowledge, attitude, and practice of using probiotics for oral health among dental students in Kerala

Background: Widespread prevalence of dental caries, particularly in developing countries, poses a major public health challenge. Traditional approaches using fillings and remineralizing agents have limitations. Probiotics offer a potentially self-administered, multifaceted alternative for both preventing and managing caries, with additional health benefits beyond oral health. Methods: A cross-sectional study with a validated questionnaire was conducted among 308 final-year students and 292 interns from dental colleges in Kerala. Data were analyzed using descriptive and inferential statistics. Results: Over 74% of interns and final-year students recognized probiotic benefits. Awareness about prebiotics was limited in both groups (59.7% and 62.3%, respectively). Notably, 65.6% of students and 72.6% of interns demonstrated knowledge about the probiotic potential of streptococcus strains. Almost 43% of students and 55% of interns reported current or past probiotic use and recommendations. A substantial majority in both groups (over 87%) expressed willingness to try recommended probiotic products. Notably, 47.4% of final-year students and 44.5% of interns had not used probiotics therapeutically, with gastrointestinal issues being the primary indication for those who did. Conclusions: High awareness of probiotics with knowledge gaps in certain areas (e.g., prebiotics) was observed. The majority showed a willingness to utilize probiotics in their practice. Educational interventions focused on these areas could equip dental professionals to provide informed advice and recommendations about probiotics to their patients.

Metabolic syndrome in children with overweight and obesity: a hospital based cross sectional study

Background: Objective of the research was to study metabolic syndrome (MS) in children with overweight and obesity.Methods: A cross sectional descriptive study was carried out on 264 children aged 3-16 years with overweight and obesity attending the endocrinology clinic of a tertiary care hospital in South India from January 2016 to March 2018. Children with and without MS were compared.Results: Out of 264 children with overweight or obesity, 80 had MS (30.3%). Among children with obesity, proportion of patients with MS (40.5% versus 24.2%, p=0.012), hypertriglyceridemia (54.8% versus 37.5%, p=0.013), low high density lipoprotein cholesterol (HDL-C) (42.9% versus 28.1%, p=0.027) and dyslipidemia (78.6% versus 59.4%, p=0.004) were higher among girls versus boys. Proportion of patients with elevated systolic blood pressure (BP) (18.8% versus 4.3%, p<0.0001), elevated diastolic BP (34.5% versus 5.4%, p<0.0001), impaired fasting glucose (16.2% versus 7.6%, p=0.033), hypertriglyceridemia (85% versus 26.6%, p<0.0001), low HDL-C (75% versus 15.2%, p<0.0001) and dyslipidemia (97.5% versus 57.1%, p<0.0001) were higher in those with MS versus those without.Conclusions: MS noted in younger children with overweight and obesity in the current study is concerning as these children are at increased risk for hypertension, type 2 diabetes and cardiovascular disease in early adulthood leading to huge economic burden on the country. It is therefore of utmost importance to take necessary steps to identify these children, manage obesity effectively before MS sets in and initiate preventive measures thereby ensuring a healthy young generation in the coming years.

Response of Tomato Quality and Yield to Elevated Temperatures under Controlled Environment

The experiment was carried out during 2020-2021 at the Department of Plant Physiology, College of Agriculture, Vellayani, Kerala Agricultural University. The experiment was carried out with the aim of characterization of contrasting tomato genotypes for high temperature tolerance under high temperature condition and control condition to identify key quality and yield traits controlling high temperature tolerance in tomato. The experiment was designed in completely randomized design (CRD) with 2 treatment levels- control and high temperature conditions (36+/-2oC) wherein 3 tolerant and 3 susceptible genotypes were selected for the study. These genotypes were selected from the summer varietal screening experiment performed during the summer months of 2021 from March to May. The best performing genotypes were selected in terms of pollen viability, leaf membrane thermo-stability, chlorophyll fluorescence, number of fruits, fruit set %. One set of treatment was maintained under ambient condition and the other set with high temperature stress was maintained under polyhouse facility from transplanting stage to the harvesting stage. The quality parameters and yield traits were analysed at the harvesting stage of the crop. From this study it can be understood that many of the quality parameters like lycopene content, total sugars, flavanol content was found decreasing in both tolerant and susceptible genotypes but the extend of this reduction was considerate in tolerant ones. In case of ascorbic acid content and firmness of fruit at the time of ripening these were found to be improved in heat stress (HS) conditions. Yield related qualities like number of fruits, yield per plant, and root-shoot ratio was found decreasing whereas root dry weight, total dry weight and intensity of fruit drop and flower drop was increased under HS. Therefore, this study focused on tomato genotypes reported to be resilient to high-temperature stress, and comparing them to the susceptible cultivars under stress and control settings for analyzing the variations in terms of quality and yield traits in tropical hot climate regions of India. The study performed here highlights the possibility for future breeding programs utilizing the key quality and yield traits enhancing thermo-tolerance in tomato and to develop new genotypes that can combine good yield performances and fruit nutritional quality at high temperatures.

Effect of Weather Parameters on of Pests and Diseases in Groundnut and Castor in Salem District of Tamil Nadu, India

The roving survey on the incidence of pests and diseases in groundnut and castor was conducted from August, 2020 to March 2021 in Salem district at fortnight intervals revealed that, in groundnut , leaffolder (20.38%), cutworms S. litura (1.63/20 pls), thrips (10.69/20 pls), leaf spot (15.25%) and root rot (6.31%) , similarly in castor pests, whiteflies (23.06/20 pls), A. janata (8.38/20 pls), S. litura (10.19/ 20 pls), thrips (11.63 / 20 pls), C. punctiferalis (7.25/20 pls), alternaria blight (17.56%) and botrytis rot (4.19%) were found feeding /infecting on different parts of the crops. The correlation with weather parameters indicated, positive correlation of rainfall, relative humidity and wind speed on incidence of leaffolder (0.47998, 0.311421 and 0.339961) but rainfall and relative humidity increased root rot (0.433059 and 0.393255) whereas, maximum temperature influenced high infection of leafspot (0.67911) in groundnut. The whiteflies incidence in castor was positively correlated with (0.490967) and rainfall (0.389125) whereas, lepidopteran pests by relative humidity (0.61212) and rainfall (0.49415). The thrips and botrytis rot were influenced by relative humidity and rainfall rot (0.65914 and 0.77965, 0.57456 and 0.82709). But natural enemies in groundnut and castor had non-significant correlation with weather parameters.

Acceptance and awareness regarding influenza vaccine among healthcare workers in a tertiary care centre, Kerala

Background: The seasonal Influenza is a contagious respiratory illness. The most important step in preventing flu is to get a flu vaccination each year along with everyday preventive actions. The objective of this research was to study the acceptance and awareness of Influenza vaccine among health care workers of a tertiary care centre, Kerala and to explore the preventive practices. Methods: This study was a hospital based cross sectional study conducted among 204 health care workers in a tertiary centre in Kerala. A simple random sampling technique was adopted. Data was collected using self-administered pretested semi structured questionnaires. Results: 165 (80.9%) are aware of the Influenza vaccine while 39 (19.1%) are not aware of the Influenza vaccine. 30 (14.7%) has received at least one dose of Influenza vaccine in last five years while 174 (85.2%) has not received the vaccine. 161(78.9%) says they are willing to get vaccinated against Influenza while 43(21.1%) are not willing to get vaccinated. Conclusions: Even though there is good awareness about Influenza vaccine, the number of vaccine recipients is less than ideal. However, majority are willing to take Influenza vaccine in the future which shows good acceptance.

A Cost-Effective Novel Method of Preparing Plastinated Specimens of Brain

The human bodies and organs have traditionally been preserved using formalin solution, although it irritates the eyes, nose and throat. Plastination is an unique and expensive method for preserving biological samples that can be used in teaching and research. Therefore, the goal of the current study was to prepare a costeffective solution using thermocol to plastinate the brain specimens as a supplement for teaching and research. Two human brains were used in this pilot research project. According to standard procedures, the brains were first fixed in 10% formaldehyde, sectioned horizontally, sagittally and coronally dehydrated in acetone, and then immersed in the plastination solution at room temperature and pressure. Then the specimens were airdried at room temperature. A team of 62 Anatomists and Pathologists assessed the quality of the specimens using a self-developed grading scale. The grading was provided based on the specimens’ clarity, stability, aesthetic look, colour and smell. Statistical analyses was performed using SPSS software, Kruskal Wallis test showed that the lowest mean score was 4.04 provided for colour and highest mean score was 5 provided for the smell with a statistically significant p<0.001. Thus our plastinated specimens were of good quality, durable and handlefriendly. Our study demonstrated that the cost-effective plastination solution (CEPS) procedure is an inexpensive and efficient way to create plastinated specimens that are appropriate for teaching neuroanatomy.

Consensus Statement of the Neurodevelopmental Pediatrics Chapter of Indian Academy of Pediatrics (IAP) on the Management of Children With Down Syndrome

Justification: The diagnosis of Down syndrome (DS) is easily made clinically but the management is multi-disciplinary and life-long. There is no standard protocol available for its management in India. Process: A committee was formed under the Indian Academy of Pediatrics (IAP) chapter of Neuro developmental pediatrics consisting of 20 experts working in the related field. The various aspects of the condition were discussed and allotted to the concerned experts related for preparing the guidelines. The material received was collated to form a set of guidelines, which were reviewed by the committee, and a consensus statement made. The guidelines were then approved by the chapter, and by the IAP. Objectives: To define the condition and to look into the various aspects of antenatal and postnatal diagnosis. To explain briefly about the involvement of the various systems that are involved and formulate recommendations for management. To recommend early and sustained interventional therapies to enable children with DS lead an independent life. Recommendations: The stress on bio-psycho-social strategy for the management of children with DS is reiterated, and the need for a medical, social and rights model is recommended after each section. The age-wise recommendations are also highlighted in addition to the recommendations under each system.

THE IMMEDIATE EFFECT OF TRATAKA ON EXECUTIVE FUNCTIONS AMONG ADULTS

Background: There is evidence to suggest that lack of physical activity, a common experience among adults, can negatively impact executive functions such as attention, memory, and decision making. Trataka can improve eye deformity, executive ability, willpower, and relaxation. Trataka may also have a protective effect on the brain, reducing inflammation and the risk of neurodegenerative diseases. The immediate effect of Trataka on executive Aim of the study: Material & methods: function among adults. Forthy healthy Adults to observe the immediate effects of thirty minute trataka regimen for one day. Participants were recruited through convenient sampling and were between the ages of 18-40. The study used a single group pre-post design. After single trataka session Results: showed that 11.59% significant increase (P< 0.05) in total attempted score on DLST. Similarly, there was 11.48% significant increase (P = 0.05). and there was 16.6% increase in (P> 0.05) in wrong attempt scores. After single trataka session it showed that 22.48% significant increase (P< 0.01) in total attempted score on SLCT. Similarly, there was 22.71% significant increase (P = 0.01) in NS. However, there was 70.58% reduction in wrong attempt score which was highly significant (P = 0.001). the available evi Conclusion: dence suggests that the practice of single session trataka has a positive on executive function among adults.

MICROBIOLOGICAL PROFILE OF EXPLANT CULTURES FROM INFECTED AND NON–INFECTED SURGICAL PATIENTS AND CORRELATION WITH SURGICAL SITE INFECTION

INTRODUCTION Surgical site infections (SSI) are one of the terrifying nosocomial infections that affecting surgical patients and cause a compromise to the quality of health care provided in the hospital. Nearly 5% of people who undergo surgeries might develop SSI, which can have serious consequences and even be deadly. To identify the microbiological profile of explant AIM: culture from suture materials and its correlation in development of SSI in the same patient. Infected and non-infected METHODOLOGY: suture materials that were removed aseptically from the patients were collected and transported to the Microbiology laboratory in sterile BHI broth.With the isolated colonies obtained. Identification was performed by standard microbiological technique and antimicrobial susceptibility testing was done. The culture reports of the swab collected from the pus/ exudate from the surgical site and the suture were compared. This was a prospective cross sectional study for a duration of 6 months. A sum of 190 isolates RESULTS: were obtained from 182 suture samples. 156(86%) suture materials had growth [monomicrobial (70%) polymicrobial growth (16%)] while 26(14%) had no growth. 7 different suture materials were employed in this study. Isolated organisms were gram positive bacilli (n=20), gram positive cocci (n=82), gram negative bacilli (n=87) and fungi (n=1). Escherichia coli, Klebsiella pneumoniae (n=19) and CONS (n=71) were commonly isolated gram negative organisms. The least common organism grown colonizing the suture material was Klebsiella oxytoca, Citrobacter species, Candida species, Enterococcus faecalis and Enterococcus species (n=1, 0.5%). Isolates like Escherichia coli (n=5), Klebsiella pneumoniae (n=2) and Acinetobacter species, Staphylococcus aureus (n=1) were found to have multiple drug resistance in the suture thread culture. SSI was seen eight cases (4.3%) and in two of them, the microorganism isolated from the surgical site and suture material was identical. Out of 190 isolates in this study, 96 DISCUSSION isolates (CONS-71, Streptococcus-4, Diphtheriods-2, Aerobic spore bearers-18, Candida-1) were members of normal flora of the skin which shows 50.5% of the suture materials were colonized by normal flora. The current study shows that ability of bacteria to adhere varies between different suture materials. Overall, the adhesion of bacteria to 3-0 Ethilon (10.4%) was found to be lower compared to 3-0 vicryl No 1,3 Prolene, 2-0 Ethilon and Silk. Suture thread must be taken out as soon as possible since opportunistic infections could result from the skin's regular flora.

HISTOLOGICAL VARIANTS OF BLADDER TUMORS : DIAGNOSTIC, PROGNOSTIC AND THERAPEUTIC IMPLICATIONS – A CASE SERIES

Bladder cancer is one of the leading malignancies in the world associated with signi?cant morbidity and mortality. About 80% of a bladder cancer is urothelial variant, remaining 20% will have a divergent histological presentation. The pathophysiological study of these variants has recently increased because the therapeutic approach is not uniform for all variants. These variants have important diagnostic, prognostic and therapeutic implications. A molecular and genetic study of these variants will allow them to be better de?ned. Here we present four cases of Histological variants of bladder tumors with varying presentations in the department of urology, Madurai medical college, which is studied over the period of one year (2022-2023).

Predicting Short-term Readmission in Hospitalized Patients with Acute Heart Failure: The Use of 6-minute Walk Test at Discharge

Background: Hospitalization is an important landmark in the history of heart failure. Patients admitted for acute heart failure have a high chance of readmission. We require predictors which can foresee readmission. Functional capacity assessment by the 6-minute walk test is one such predictor. Objectives: To compare the mean 6-minute walk distance among acute heart failure patients readmitted within 30 days, those readmitted within 60 days, those readmitted within 90 days, and those not readmitted at 90 days following discharge after the first admission. Methodology: This is a follow-up study conducted in Madras Medical College from March 2021 to August 2021. The study included patients who were admitted for the first time in their life for acute heart failure. The clinical details were noted, and the patients were managed as per standard protocols. Before discharge, a 6-minute walk test was performed. The patients were followed up at the end of 30, 60, and 90 days. Results: 25% of the patients had one readmission at the end of 90 days. Majority of readmissions occurred at the end of 30 days. A low 6-minute walk distance at discharge was a significant predictor of readmission at the end of 30 days. A distance of 200 m was a reasonable cutoff in our population. A lower time walked was also a significant predictor of readmission at the end of 30 days. A slower walking speed was also a significant predictor of readmission at the end of 30 days. Some other parameters such as a longer duration of stay, a longer duration of intravenous (IV) diuretic requirement, discharge respiratory rate, and lower serum albumin at admission were also significant predictors of readmission at the end of 30 days.

Cognitive decline among older adults who developed acute coronary syndrome during hospitalization for non-cardiac illness

Background: Atypical presentations of acute coronary syndrome (ACS) delay its recognition and treatment in the elderly patients. Functional decline and delirium which are common to the elderly during hospitalization, leads to cognitive impairment and poor health outcomes. Steps taken for its prevention is usually not considered the top priority by the cardiologist. The present study was conducted to identify cognitive decline among elderly patients who developed ACS during hospitalization for noncardiac illness and their outcome. Materials and Methods: Three hundred and ten elderly patients above 60 years of age with ACS were included from June 26, 2020 to October 13, 2020. Subjects were divided into those admitted primarily due to an ACS (Group I, n = 94) and those developing ACS following admission for noncardiac illness (Group II, n = 216). Co-morbidities, medications, investigations, management, clinical outcome, and Montreal Cognitive Assessment scale were compared between the two groups at the time of admission, after 30 days and after 6 months. Results: Majority of the subjects were admitted due to acute kidney injury (27.1%) in Group II and had a non-ST elevation ACS (90.2%). Optimum management was given to a lesser extent due to the clinical condition of these patients. Poor clinical outcome, cognitive impairment during hospitalization and cognitive decline during follow-up was more in Group II. Conclusion: Clinicians must be vigilant for the development of cognitive impairment and cognitive decline when an elderly patient is admitted to the hospital, as early detection and optimum management provides better clinical and cognitive outcome.

A Novel Combined Anesthetic Technique to Improve the Surgical Working Conditions of Lumbar and Thoracolumbar Spine Surgery from a Spine Surgeon’s Perspective: A Prospective Randomized Controlled Study

Methods@#A prospective randomized study of 76 patients who underwent lumbar and thoracolumbar surgeries was conducted by randomly allocating patients into three anesthetic groups: GA alone, GA with spinal anesthesia (SA), and GA with erector spinae plane block (ESPB) by the allocation concealment method to avoid selection bias. The working conditions were assessed by the same operating surgeon who was blinded by the type of anesthesia to eliminate the assessment bias. Muscle relaxation and surgical field were compared among the three groups along with other hemodynamic parameters to identify any significant differences. @*Results@#Significantly better muscle relaxation, surgeon satisfaction, postoperative analgesia, and blood pressure (BP) were observed in the GA+RA when compared to GA alone (p 0.05). Complications were only observed in the GA+SA group (19%). @*Conclusions@#The study results suggest that the addition of RA to GA may provide better working conditions and surgeon’s satisfaction by improving relaxation of the erector spinae in addition to decreasing the BP and postoperative pain in contrast to the use of GA alone. The combined GA and ESPB techniques may be a viable anesthetic alternative to provide better working conditions for surgeons.

Effect of Prunetin on Streptozotocin-Induced Diabetic Nephropathy in Rats - a Biochemical and Molecular Approach

In the modern era, chronic kidney failure due to diabetes has spread across the globe. Prunetin (PRU), a component of herbal medicines, has a broad variety of pharmacological activities; these may help to slow the onset of diabetic kidney disease. The anti-nephropathic effects of PRU have not yet been reported. The present study explored the potential nephroprotective actions of PRU in diabetic rats. For 28 days, nephropathic rats were given oral doses of PRU (20, 40, and 80 mg/kg). Body weight, blood urea, creatinine, total protein, lipid profile, liver marker enzymes, carbohydrate metabolic enzymes, C-reactive protein, antioxidants, lipid peroxidative indicators, and the expression of insulin receptor substrate 1 (IRS-1) and glucose transporter 2 (GLUT-2) mRNA genes were all examined. Histological examinations of the kidneys, liver, and pancreas were also performed.The oral treatment of PRU drastically lowered the blood glucose, HbA1c, blood urea, creatinine, serum glutamic-oxaloacetic transaminase, serum glutamic pyruvic transaminase, alkaline phosphatase, lipid profile, and hexokinase. Meanwhile, the levels of fructose 1,6-bisphosphatase, glucose-6-phosphatase, and phosphoenol pyruvate carboxykinase were all elevated, but glucose-6-phosphate dehydrogenase dropped significantly. Inflammatory marker antioxidants and lipid peroxidative markers were also less persistent due to this administration. PRU upregulated the IRS-1 and GLUT-2 gene expression in the nephropathic group.The possible renoprotective properties of PRU were validated by histopathology of the liver, kidney, and pancreatic tissues. It is therefore proposed that PRU (80 mg/kg) has considerable renoprotective benefits in diabetic nephropathy in rats.

The Trend of Organic Based Nanoparticles in the Treatment of Diabetes and Its Perspectives

Diabetes is an untreatable metabolic disorder characterized by alteration in blood sugar homeostasis, with submucosal insulin therapy being the primary treatment option. This route of drug administration is attributed to low patient comfort due to the risk of pain, distress, and local inflammation/infections. Nanoparticles have indeed been suggested as insulin carriers to allow the drug to be administered via less invasive routes other than injection, such as orally or nasally. The organic-based nanoparticles can be derived from various organic materials (for instance, polysaccharides, lipids, and so on) and thus are prevalently used to enhance the physical and chemical consistency of loaded bioactive compounds (drug) and thus their bioavailability. This review presents various forms of organic nanoparticles (for example, chitosan, dextron, gums, nanoemulsion, alginate, and so on) for enhanced hypoglycemic drug delivery relative to traditional therapies.

An unusual case of symmetric quadruple limb fractures / 中华创伤杂志(英文版)

A 19-year-old man had an accidental fall from the 2nd floor and sustained multiple injuries. On radiological evaluation, the patient had symmetrical quadruple limb involvement with bilateral humerus shaft, bilateral olecranon, bilateral femur shaft, and bilateral patella fractures. The patient was actively managed using damage control orthopaedics, and a sequence of skeletal fixation was planned based on the hemodynamic stability and periodical serum lactate assessment. Symmetrical quadruple limb fractures are very rare, which could be associated with higher mortality. A meticulous clinical evaluation, periodical blood parameter assessment and strict adherence to the principles of damage control orthopaedics can be conducive to prevent life-endangering complications.

Bone marrow stem cells incubated with ellipticine regenerate articular cartilage by attenuating inflammation and cartilage degradation in rabbit model

Background@#Ellipticine (Ellip.) was recently reported to have beneficial effects on the differentiation of adipose-derived stem cells into mature chondrocyte-like cells. On the other hand, no practical results have been derived from the transplantation of bone marrow stem cells (BMSCs) in a rabbit osteoarthritis (OA) model. @*Objectives@#This study examined whether autologous BMSCs incubated with ellipticine (Ellip.+BMSCs) could regenerate articular cartilage in rabbit OA, a model similar to degenerative arthritis in human beings. @*Methods@#A portion of rabbit articular cartilage was surgically removed, and Ellip.+BMSCs were transplanted into the lesion area. After two and four weeks of treatment, the serum levels of proinflammatory cytokines, i.e., tumor necrosis factor α (TNF-α) and prostaglandin E2 (PGE2), were analyzed, while macroscopic and micro-computed tomography (CT) evaluations were conducted to determine the intensity of cartilage degeneration.Furthermore, immuno-blotting was performed to evaluate the mitogen-activated protein kinases, PI3K/Akt, and nuclear factor-κB (NF-κB) signaling in rabbit OA models. Histological staining was used to confirm the change in the pattern of collagen and proteoglycan in the articular cartilage matrix. @*Results@#The transplantation of Ellip.+BMSCs elicited a chondroprotective effect by reducing the inflammatory factors (TNF-α, PGE2) in a time-dependent manner. Macroscopic observations, micro-CT, and histological staining revealed articular cartilage regeneration with the downregulation of matrix-metallo proteinases (MMPs), preventing articular cartilage degradation. Furthermore, histological observations confirmed a significant boost in the production of chondrocytes, collagen, and proteoglycan compared to the control group. Western blotting data revealed the downregulation of the p38, PI3K-Akt, and NF-κB inflammatory pathways to attenuate inflammation. @*Conclusions@#The transplantation of Ellip.+BMSCs normalized the OA condition by boosting the recovery of degenerated articular cartilage and inhibiting the catabolic signaling pathway.

Orally Disintegrating Film: A Review of Its Formulation and Manufacturing Method

@#Oral route drug delivery system is still considered as the most convenient and patient friendly drug delivery route. Over the decades, many research has been performed to improve the functionality oral dosage form. Orally disintegrating film (ODF) is a newer oral drug delivery system, which is in the form of a thin film that will disintegrate in the oral cavity within a matter of seconds. The aim of this review paper is to recap ODF, its benefits, formulation contents and manufacturing method. With more research and development work has been conducted on ODF, the dosage form is expected to be manufactured and scaled up to be commercializable products to be sold in the market.