Nanomagnet-facilitated pharmaco-compatibility for cancer diagnostics:Underlying risks and the emergence of ultrasmall nanomagnets / 药物分析学报

Cancer therapy is a fast-emerging biomedical paradigm that elevates the diagnostic and therapeutic po-tential of a nanovector for identification,monitoring,targeting,and post-treatment response analysis.Nanovectors of superparamagnetic iron oxide nanoparticles(SPION)are of tremendous significance in cancer therapy because of their inherited high surface area,high reactivity,biocompatibility,superior contrast,and magnetic and photo-inducibility properties.In addition to a brief introduction,we summarize various progressive aspects of nanomagnets pertaining to their production with an emphasis on sustainable biomimetic approaches.Post-synthesis particulate and surface alterations in terms of pharmaco-affinity,liquid accessibility,and biocompatibility to facilitate cancer therapy are highlighted.SPION parameters including particle contrast,core-fusions,surface area,reactivity,photosensitivity,photodynamics,and photothermal properties,which facilitate diverse cancer diagnostics,are discussed.We also elaborate on the concept of magnetism to selectively focus chemotherapeutics on tumors,cell sorting,purification of bio-entities,and elimination of toxins.Finally,while addressing the toxicity of nanomaterials,the advent of ultrasmall nanomagnets as a healthier alternative with superior properties and compatible cellular in-teractions is reviewed.In summary,these discussions spotlight the versatility and integration of multi-tasking nanomagnets and ultrasmall nanomagnets for diverse cancer theragnostics.

A Prospective Study of the Demographic Pattern and Site of Perforation of Non-traumatic Hollow Viscus Perforation Peritonitis in Vindhya Region

Background: Perforation peritonitis is a commonly encountered surgical emergency and it is defined as inflammation of theserosal membrane that lines the abdominal cavity and the visceral organs. The aim of this study is to analyze the demographicpattern and site of perforation of non-traumatic hollow viscus perforation peritonitis in Vindhya region.Materials and Methods: A total of 209 cases were studied with hollow viscus perforation peritonitis admitted in the surgicalwards in Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa (MP), India, in the period fromJune 1, 2018, to May 31, 2019. All necessary investigations were carried out. X-ray, Ultrasonography abdomen, and bloodinvestigations were done. The patient underwent emergency exploratory laparotomy and a careful record of pre-operative andpost-operative findings was made and was carefully filled in the pro forma. All the patients were advised to attend the surgicaloutpatient department for follow-up.Results: Of 10,887 patients admitted to Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa(MP), India, from June 1, 2018, to May 31, 2019, in which non-traumatic hollow viscus perforation peritonitis was diagnosedin 209 patients (1.9%), among which most of the patients were male (177) and rest were female (32). Most of the patientsbelonged to the low-socio-economic status of 21–40 years of the age group. From this study, the duodenum was found to bethe most common site of perforation, followed by stomach.Conclusion: Patients were admitted in the Department of Surgery, Shyam Shah Medical College and Sanjay Gandhi HospitalRewa, the Vindhya region in the Madhya Pradesh, patients diagnosed as a case of non-traumatic hollow viscus perforationperitonitis were included in the study. The majority of the patients of the perforation peritonitis belonged to 21–40 years ofage group. 41–60 years of age group was the second most common age group of patients who presented with perforationperitonitis with a male-to-female ratio of 5.5:1. The most common site of perforation was duodenum followed by gastric andappendicular and the least common site of perforation was colon.

A Clinical Study on Post-operative Outcome in Perforation Peritonitis Patients with Reference to the History of Nonsteroidal Anti-inflammatory Drugs Use

Background: Perforation peritonitis is a commonly encountered surgical emergency and it is defined as inflammation of the serosal membrane that lines the abdominal cavity and the visceral organs. The objective of this study is to predict a correlation between post-operative outcomes in perforation peritonitis patients with reference to the history of nonsteroidal anti-inflammatory drugs (NSAIDs) use. Materials and Methods: A total of 209 cases were studied with hollow viscous perforation peritonitis admitted in the surgical wards in Sanjay Gandhi Memorial Hospital associated with S. S. Medical College, Rewa (M.P.), India, in the period from June 1, 2018, to May 31, 2019. All necessary investigations were carried out. X-ray, ultrasonography abdomen, and blood investigations were done. Patient underwent emergency exploratory laparotomy and a careful record of pre-operative and post-operative findings was made and was carefully filled in the pro forma. All the patients were advised to attend surgical OPD for follow-up. Results: Most of the patients (73.2%) of perforation peritonitis had a history of NSAID intake, out of which 81.6% recovered from the disease while mortality rate in perforation peritonitis associated with NSAID use was found to be 18.4%. Those patients with no history of NSAID use (26.8%) had a mortality rate of 9% while 91% of patients of perforation peritonitis were recovered from the disease. Conclusion: In this study, it is concluded that the outcome of the patients of the perforation peritonitis is not dependent on the history of NSAIDs use, but NSAIDs abuse is one of the etiological factors in the pathogenesis of the perforation peritonitis

A Comparative Study of Chest X-ray and Chest High-resolution Computed Tomography in Blunt Trauma Chest Patients

Introduction: Computed tomography (CT) scan is an accurate tool for the detection of injuries in a trauma setting and is able to find the injuries that were occult in chest X-ray (CXR). In past years, the utility of CT scan was limited to severe trauma injuries but now is used in less severely injured trauma patients. The study aimed to compare the efficacy of CXR and chest CT scans in patients with chest trauma. Materials and Methods: The present study was conducted in the Department of Surgery of Medical Institute. For the study, we prospectively view the previous medical records of the patients who were admitted in our surgical ward for blunt chest trauma and received both CXR and high resolution CT chest scans. A total of 95 patients were included in the study. Data regarding the study were collected. Results: Out of 95 patients, 79 were males and 16 females. The mean age of the patients was 32.42 years ranging from 2 to 90 years. The most common cause for blunt trauma to the chest according to our results was a road traffic accident. We observed that CT scan is more accurate as compared to CXR in the detection of certain cases such as sternum fracture, rib fracture, scapula fracture, lung contusion, hemothorax, and pneumothorax. Conclusion: Chest CT scan is highly sensitive in the detection of thoracic injuries following blunt chest trauma. In day-to-day practice, CT scan is better in visualizing as sternum fracture, rib fracture, scapula fracture, lung contusion, hemothorax, and pneumothorax

Antibiotic sensitivity profile and resistance of microorganisms isolated from south Indian population, a hospital based study at Velappanchavady, Chennai, India

Background: Increasing rates of antibiotic drug resistance has been noted in recent times and this adversely affects the prognosis and outcomes of patients. There is a greater need for local resistance prevalence data in order to guide empirical prescription and to identify areas in which medical need for newer antimicrobial agents is greater.Methods: A prospective hospital based observational study was carried out to determine antibiotic sensitivity profile and resistance pattern of microorganisms. Samples were collected from urinary tract infections, while cultures from blood stream infections, sputum samples and Serology. Antibiotic susceptibility was determined by the standard disc diffusion method. Data interpretation was based on CLSI, 2017 guidelines for antimicrobial susceptibility testing.Results: The predominant isolates from the samples were, Staphylococcus aureus (16.7%) 67, K. pneumoniae (11.5%) 46, E. coli (29.4%) 118, P. aeruginosa (6%) 24. Escherichia coli, the most common causative organism showed high resistance to commonly used drugs such as Ampicillin (60.1%) 71, Amoxicillin (53.4%) 63, Amoxicillin-clavulanic acid (44.1%) 52 and Nalidixic acid (53.4%) 63. E. coli was found to be most sensitive to Amikacin (51.7%) 61, Piperacillin (69.5%) 82, Norfloxacin (61.9%) 73, Meropenem (76.3%) 90 and Imipenem (68.6%) 81. Klebsiella was most sensitive to 30 (65.2%) ofloxacin, 31 (67.4%) ciprofloxacin followed by 24 (52.2%) ceftriaxone and least sensitive to 7 (15.2%) Amoxicillin and 12 (26.1%) Ampicillin.Conclusions: Among commonly used antibiotics resistance to Penicillins (Ampicillin, Amoxicillin) was highest. Resistance to Fluoroquinolones (Cipro?oxacin) was seen in majority of the patients. Among broad spectrum antibiotics Imipenem, Meropenem resistance was seen in lesser proportion of the patients.

Patient profile based management approach for Optimal Treatment of Angina: a consensus from India cases

Chronic stable angina (CSA) is an incapacitating disorder. The pain can hinder the routine chores of an individual and significantly impact one’s quality of life (QoL). However, the good news is that this can be treated and the QoL can be improved. The key to apt management lies in the accurate early diagnosis of this condition, followed by a detailed evaluation and accordingly planned management, which should be regularly revised and be backed by an adequate follow-up. OPTA-OPtimal Treatment for chronic stable Angina-is an educational initiative to assist the clinicians in India with screening and diagnostic tools, strengthened by updated guideline-directed management to ensure satisfactory patient outcomes. OPTA aims to improve clinical outcomes by providing optimized pharmacotherapy for patients with stable angina. This expert consensus document intends to provide information for better understanding of the condition by clinicians and to ensure an early, accurate diagnosis, followed by optimal management of angina. For better clinical and practical understanding of Indian clinical scenario, the most commonly encountered patient profiles are briefly described here. These inputs and an extensive literature review were blended to develop the recommendations for clinicians across the country. An attempt is made to include clinical recommendations that meet the needs of the majority of patients in most circumstances in the Indian scenario. However, the ultimate judgment regarding individual case management should be based on clinician’s discretion. This expert consensus document is not a substitute for textbooks and/or a clinical judgment.

Diagnostic utility of heart type fatty acid binding protein (H-FABP) versus cardiac troponin I in myocardial infarction

Background: Acute myocardial infarction (AMI) management is one of the therapeutic challenges faced by the emergency physician. In the field of investigational cardiology advancements, the search of superior cardiac biomarkers has led to the discovery of sensitive biomarkers which help in the early confirmation of MI as timely intervention is the primary goal in acute coronary syndrome (ACS). Present study was aimed to evaluate the diagnostic performance of the novel biomarker H- FABP in patients with AMI especially in ST elevation MI (STEMI) and comparison of its diagnostic accuracy with the other biomarkers.Methods: We studied 66 patients with persistent STEMI presenting within 12 hours of symptom to the department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital (SMVMCH), Puducherry. Quantitative and qualitative estimation and analysis of serum biomarkers of acute myocardial infarction such as CK-MB, cardiac Troponin I (cTnI) and H-FABP were done.Results: The sensitivity and specificity of H-FABP were 80.7 and 88.9% respectively. The positive percentage of the serum biomarkers among these patients were 64%, 65%, 86% for CK-MB, cardiac troponin I, and H-FABP respectively. The area under the curve was observed to be 0.695, with 95% confidence interval (0.514-0.876) at the optimum cut-off value of 7.0ng/ml for H-FABP.Conclusions: H-FABP the novel biomarker, because of its early appearance in the blood stream and due to its superior sensitivity and specificity compared to Troponin I and CK-MB can be used in the early diagnosis of acute ST elevation Myocardial Infarction

Cardiovascular morbidity and dyslipidemia in chronic kidney disease: a cross-sectional study

Background: CKD is a risk factor for CVD and dyslipidemia is an important co-morbidity associated with both. CKD can lead to variations in lipid profile which can lead to atherosclerosis and thereby increase the risk for CVD.Objective was to analyse the clinical and diagnostic cardiovascular features of CKD patients and the associated variations in their lipid profile.Methods: This prospective study was conducted from May 2015 to May 2017 among 100 patients attending to Medicine department with documented biochemical and sonographic evidence of chronic kidney disease. The included participants were subjected to routine blood investigations including lipid profile and cardiovascular evaluation which included electrocardiography (ECG), chest X-ray and M-mode 2-Dimensional echocardiography. Data was recorded in a proforma and the results were analysed statistically.Results: The study included 100 patients with chronic kidney disease, majority (n=42, 42%) of them belonging to the 40-50 years age group. There was similar (p=0.78) representation of males and females in the study. Significantly (p=0.02) higher number (n=58) of alcoholics were present among the CKD patients. Significantly (p=0.04) higher proportion of patients with CKD had high TG (36%) and low HDL (30%) levels. Majority (58%) had CVD morbidity and Left ventricular hypertrophy was a characteristic feature in majority (n=15%) of the CKD patients as evaluated by ECG and ECHO.Conclusions: The study documented the association of CVD and dyslipidemia with CKD. It also revealed ECG and ECHO changes in CKD patients which can be useful predictors in determining the progression of the CVD complications in CKD.

Prevalence of metabolic syndrome in urban low socioeconomic group patients with symptomatic coronary artery disease

Introduction: Sedentary lifestyle, low fiber, high fat and energy-rich foods have penetrated even the rural India in the name of globalization. All these will come not without cost. India is now facing the paradox of malnutrition on one hand and epidemic of obesity on the other. Indians three times higher risk of developing Coronary Artery Disease (CAD) compared to Chinese and are 20 times more likely to die due to CAD compared to native black or white South Africans. The aim of the study: To find out the prevalence of Central Obesity, Hypertension, Impaired Fasting Glucose or Diabetes mellitus, Hypertriglyceridemia and low HDL cholesterol and to analyze the differences in their prevalence among the age groups, sex, social class and chronic and acute coronary syndromes. Materials and methods: All patients belonged to a low socioeconomic group attended medical outpatient department or those who were getting admitted medical ward of Govt. Dharmapuri Medical College, Dharmapuri with coronary artery disease (CAD) were included. Results: Mean of age for males (CI: 55.49± 22years) and females (CI: 51.87±24.7years) lied within one standard deviation from the sample mean. 59 patients (52.2%) had central obesity. 64.2% patients in age group <40 years, 41.4% in age group 40-60 years and 72.4% in age group >60 years had central obesity. This increase in the prevalence of central obesity among younger (<40 year) and older age group (>60 years) was significant. 84 patients (74.34%) had hypertension. 71.43% patients in age group <40 years, 77.14% in age group 40-60 years and 68.96% in age group >60 years had hypertension. There was no significant difference in prevalence of hypertension among age group.57 patients (50.44%) had diabetes or IFG. 50% patients in age group <40 years, 40% in age group 40-60 G. Indhumathi, K. Suresh Kumar. Prevalence of metabolic syndrome in urban low socioeconomic group patients with symptomatic coronary artery disease. IAIM, 2018; 5(3): 15-22. Page 16 years and 75.86% in age group >60 years had diabetes or IFG. This increase in the prevalence of Diabetes and IFG among younger (<40 year) and older age group (>60 years) was significant. 48 patients (42.48%) had hypertriglyceridemia. 50% patients in age group <40 years, 32.86% in age group 40-60 years and 62% in age group >60 years had hypertriglyceridemia. 54 patients (47.78%) had metabolic syndrome. 50% patients in age group <40 years, 37.14% in age group 40-60 years and 72.41% in age group >60 years had metabolic syndrome. This increase in the prevalence of metabolic syndrome among younger (<40 year) and older age group (>60 years) is significant (X 2 - 10.25, p=.006). Conclusion: The result of the present study suggests that in urban patients who live below poverty line with symptomatic coronary artery disease there in the increased prevalence of metabolic syndrome, central obesity, hyperglycemia, hypertension, and dyslipidemia. The higher prevalence particularly noticeable in those with the premature coronary artery disease and that might have resulted in earlier onset of CAD in them.

Gasification kinetics of date palm seed using carbon dioxide

Gasification is a well-known reaction owing to its relevance to generation of sustainable energy from biomass and development of porous carbons. The present paper attempts to experimentally investigate the kinetics of palm shell char gasification using carbon dioxide [CO[2]] in a controlled environment using Thermo Gravimetric Analyzer [TGA] at temperatures ranging from 800 to 1000°C. A relevant kinetic model representing the experimental data was identified by fitting the experimental data with popular semi empirical kinetic models such as Linear Model [LM], Volume Reaction Model [VRM], Shrinking Core Model [SCM], and Random Pore Model [RPM]. The model kinetic parameters were evaluated by minimizing the sum of root mean square error [RMSE]. Among the models tested the RPM exhibited very close adherence to the experimental data evidenced from the minimum RMSE of 0.0046. The ability of the RPM model to represent the gasification kinetics was attributed to its ability to account for the pore growth during initial stages of gasification and destruction of pores due to coalescence in later stages of gasification. The rate of reaction increased with increase in temperature and activation energy was found to be 64.5 KJ/mol

Formulation design, in vitro evaluation and stability studies on mucoadhesive buccal films of anti-anginal calcium channel blocker.

Diltiazem hydrochloride has poor oral bioavailability, easily undergo first passage effect in the liver. Hence, an attempt was made to prepare and evaluate mucoadhesive buccal films containing diltiazem hydrochloride by employing HPMC, eudragit, ethyl cellulose alone and in combination with PVP. The I.R and DSC studies showed that there was no interaction between drug and the utilized polymer. The prepared mucoadhesive buccal films showed uniform thickness, weight, folding endurance, surface pH, drug content and swelling index. The drug content of all the formulation was found to be uniform. In vitro drug release studies indicated that the films prepared with HPMC (3%) and ethyl cellulose (4%) has shown fast and slow release respectively. The formulations incorporated with SLS and sodium glycocholate indicated significant drug release from F11 and F15. Later the in-situ diffusion studies using goat cheek pouch showed faster drug release from film with 1% (SLS). About 93.04% and 91.83% of drug release profile were observed during in situ diffusion studies at the end of 9hrs and 18 hrs respectively. The formulated films were stable during stability studies at 45ºC and 75%RH with respect to drug content.

Anti-microbial principles of selected remedial plants from Southern India

<p><b>OBJECTIVE</b>To examine the anti-bacterial activity of leaf extracts of Morus alba L. (Moraceae) and Piper betel L. (Piperaceae), and seed extracts of Bombax ceiba L. (Borabacaceae).</p><p><b>METHODS</b>We have partially purified plant extracts by solvent extraction method, and evaluated the effect of individual fractions on bacterial growth using Escherichia coli (E. coli), Pseudomonas aeruginosa (P. aeruginosa) and Staphylococcus aureus (S. aureus) bacterial strains.</p><p><b>RESULTS</b>Compared with Morus and Bombax fractions, Piper fractions showed significant growth inhibition on all the three types of bacteria studied. The EtOAc-hexane fractions of Piper leaves exhibited significant anti-bacterial activity with minimum inhibitory concentrations (MIC) of 50 µg/mL culture against both gram-positive and gram-negative bacteria. The EtOAc-fractions I, II, and IV inhibited bacterial colony formation on soft agar in addition to growth inhibition. A combination treatment of piper fractions with ampicillin resulted in significant growth inhibition in E. coli and P. aeruginosa, and combination with anticancer drug geldanamycin (2µg/mL) showed selective growth inhibition against P. aeruginosa and S. aureus. Three major compounds, i.e., eugenol, 3-hexene-ol and stigmasterol, were primarily identified from Piper betel leaf extractions. Among the individual compounds, eugenol treatment showed improved growth inhibition compared with stigmasterol and 3-hexene-ol.</p><p><b>CONCLUSIONS</b>We are reporting potential anti-bacterial compounds from Piper betel against both gram-positive and gram-negative bacteria either alone or in combination with drug treatment.</p>

Management of pain in leukemic children using the WHO analgesic ladder.

Objective. To ascertain the effectiveness of WHO analgesic ladder in pain management in children with leukemia. Methods. Children with leukemia who were referred to a pain and palliative care clinic attached to the Department of Pediatrics of a medical teaching hospital during a period of 6 months, were included in the study. Results. Thirty nine (39) children, who constituted 64% of children on treatment for leukemia, required referral to pain and palliative care services during the study period. Of these 92% had Acute Lymphocytic Leukemia (ALL) and 8% had Acute Non Lymphocytic Leukemia (ANLL). 95% of children had nociceptive pain and 5% had neuropathic pain. Step – 1 analgesia was effective in 12 (31%) children and 21 (54%) could be managed with Step – 2 analgesia. Step – 3 analgesia was required in only 6 (15%) children. Step 3 analgesia was required in children with neuropathic pain and bone pain. Conclusions. WHO analgesic ladder is effective in managing pain in children with leukemia. Majority of cases of cancer pain in children could be managed by the treating physician using non-opioids, weak opioids and adjuvants as per the WHO guidelines. Children with bone pain and neuropathic pain may require referral to specialist services and use of strong opioids like morphine. The study emphasizes the need for establishing specialist pain management services in all centres where children with cancer are treated.

Local anti-inflammatory and anti-nociceptive activities of coldenia procumbens linn.

The ethanolic extract of the leaves of Coldenia procumbens Linn, was studied in Swiss albino mice against 12-O-tetradecanoylphorbol-13-acetate [TPA] and arachidonic acid [AA] induced inflammatory response, while the analgesic effect was studied using the acetic acid-induced writhing in mice and formalin-induced nociception. The ethanolic extract produced dose dependent anti-inflammatory activity against the pathogens. It also showed an inhibitory effect on pain caused by acetic acid in mice and reduced pain episodes induced by formalin. The results indicated that the ethanolic extract produced significant [P<0.05] anti-inflammatory and anti-nociceptive activity when compared with the standard and untreated control

Newer therapies for asthma: a focus on anti-IgE.

The prevalence of asthma and other allergic disorders has been on the increase not only in the western world but also in the developing countries. This increasing prevalence has lead research into the discovery and development of various new therapeutic strategies. The improved understanding about the pathophysiology of asthma has prompted the developments of novel molecules to tackle this problem. These include newer phosphodiesterase inhibitors, cytokine modulation strategies, allergen immunotherapy, and anti-IgE. Immunoglobulin E plays a major role in airway inflammation in asthma. Omalizumab, a novel humanised monoclonal antibody directed against the high affinity FcepsilonRI portion of the IgE has shown a lot of promise in the control of asthma symptoms and as a steroid sparing agent in the management of allergic asthma. This new molecule has an excellent safety profile and could play an important role in the management of patients with severe asthma. This review gives a brief overview of the newer therapies under investigation with special reference to omalizumab in the treatment of allergic asthma.

role of calcium channel blockers in treatment of coronary artery disease

Calcium antagonists are useful adjuvant therapy in the management of patients will coronary artery disease. All the three classes of calcium channel blockers [CCB] are safe and effective in chronics stable angina. In unstable angina, CCB complement the actions of nitrates, aspirin, and betablockers. Asymptomatic [silent] myocardial ischemia and total ischemic burden are reduced by CCB,when used alone, nifedipine is deleterious in acute myocardial infarction [AMI] and unstable angina and has no role in secondary prophylaxis after AMI. Diltiazem of verapamil may be considered for secondary prophylaxis, if betablockers are contraindicated, ventricular functions are good and in the patient with non Q wave myocardial infarction