Drug Delivery Systems for Personal Healthcare by Smart Wearable Patch System.

Smart wearable patch systems that combine biosensing and therapeutic components have emerged as promising approaches for personalized healthcare and therapeutic platforms that enable self-administered, noninvasive, user-friendly, and long-acting smart drug delivery. Sensing components can continuously monitor physiological and biochemical parameters, and the monitoring signals can be transferred to various stimuli using actuators. In therapeutic components, stimuli-responsive carrier-based drug delivery systems (DDSs) provide on-demand drug delivery in a closed-loop manner. This review provides an overview of the recent advances in smart wearable patch systems, focusing on sensing components, stimuli, and therapeutic components. Additionally, this review highlights the potential of fully integrated smart wearable patch systems for personalized medicine. Furthermore, challenges associated with the clinical applications of this system and future perspectives are discussed, including issues related to drug loading and reloading, biocompatibility, accuracy of sensing and drug delivery, and largescale fabrication.

Dyslipidemia among Patients with Type 2 Diabetes Mellitus Visiting a Tertiary Care Centre.

Introduction: A triad of lipid and lipoprotein metabolism is known as dyslipidemia. Dyslipidemia is one of the major risk factors for cardiovascular diseases in diabetes mellitus which is a leading cause of morbidity and mortality worldwide. The aim of the study was to find out the prevalence of dyslipidemia among patients with type 2 diabetes mellitus visiting a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in a tertiary care centre among patients with type 2 diabetes mellitus from 18 February 2020 to 18 August 2020 after obtaining ethical clearance from the Institutional Review Committee. Demographic and blood samples were analysed and recorded using validated and calibrated tools. A convenience sampling technique was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of 390 patients with type 2 diabetes mellitus, 343 (87.95%) (84.72-91.18, 95% Confidence Interval) had dyslipidemia. The most prevalent dyslipidemia was high low-density lipoprotein cholesterol at 85 (24.78%) followed by mixed dyslipidemia at 305 (88.92%). Conclusions: The prevalence of dyslipidemia among patients with type 2 diabetes mellitus was found to be higher than studies conducted in similar settings. We recommend regular testing of blood glucose and blood lipid levels for early detection of dyslipidemia and putting them under medical supervision to reduce the unwanted complications of cardiovascular diseases. Keywords: cardiovascular disease; dyslipidemia; prevalence; type 2 diabetes mellitus.

Enhancement of the anticancer effect of atorvastatin-loaded nanoemulsions by improving oral absorption via multivalent intestinal transporter-targeting lipids.

Atorvastatin (ATV) has attracted considerable attention as a potential therapeutic agent for cancer because it inhibits cancer cell proliferation by suppressing the mevalonate pathway. However, because of its low oral absorption, high doses of ATV are required for chemotherapeutic applications. In this study, we constructed ATV-loaded nanoemulsions (ATV-NEs) containing multivalent intestinal transporter-targeting lipids to improve the oral bioavailability of ATV. ATV-NEs were prepared via oil-in-water emulsification for transporter-targeted delivery, and contained the following anchors: an ionic complex of deoxycholic acid (DOCA) with the cationic lipid 1,2-dioleyl-3-trimethylammonium propane (DOTAP) (DOCA-DOTAP), a biotin-conjugated lipid (Biotinyl PE), and d-alpha-tocopherol polyethylene glycol succinate (TPGS) to allow bile acid- and multivitamin transporter-mediated permeation of ATV without P-glycoprotein (P-gp)-mediated efflux. The optimized formulation (ATV-NE#6) had 1,091% higher oral bioavailability than free ATV. Finally, treatment of 4T1 cell-bearing mice with oral ATV-NE#6 (equivalent to 40 mg/kg ATV) significantly suppressed tumor growth; the maximum tumor growth reduction was 2.44-fold that of the control group. The results thus suggest that ATV-NEs allow for effective oral chemotherapy by enhancing the oral bioavailability of ATV.

Impacts of Drug Interactions on Pharmacokinetics and the Brain Transporters: A Recent Review of Natural Compound-Drug Interactions in Brain Disorders.

Natural compounds such as herbal medicines and/or phyto-compounds from foods, have frequently been used to exert synergistic therapeutic effects with anti-brain disorder drugs, supplement the effects of nutrients, and boost the immune system. However, co-administration of natural compounds with the drugs can cause synergistic toxicity or impeditive drug interactions due to changes in pharmacokinetic properties (e.g., absorption, metabolism, and excretion) and various drug transporters, particularly brain transporters. In this review, natural compound-drug interactions (NDIs), which can occur during the treatment of brain disorders, are emphasized from the perspective of pharmacokinetics and cellular transport. In addition, the challenges emanating from NDIs and recent approaches are discussed.

The Role of Natural Compounds and their Nanocarriers in the Treatment of CNS Inflammation.

Neuroinflammation, which is involved in various inflammatory cascades in nervous tissues, can result in persistent and chronic apoptotic neuronal cell death and programmed cell death, triggering various degenerative disorders of the central nervous system (CNS). The neuroprotective effects of natural compounds against neuroinflammation are mainly mediated by their antioxidant, anti-inflammatory, and antiapoptotic properties that specifically promote or inhibit various molecular signal transduction pathways. However, natural compounds have several limitations, such as their pharmacokinetic properties and stability, which hinder their clinical development and use as medicines. This review discusses the molecular mechanisms of neuroinflammation and degenerative diseases of CNS. In addition, it emphasizes potential natural compounds and their promising nanocarriers for overcoming their limitations in the treatment of neuroinflammation. Moreover, recent promising CNS inflammation-targeted nanocarrier systems implementing lesion site-specific active targeting strategies for CNS inflammation are also discussed.

Recent progress in therapeutic drug delivery systems for treatment of traumatic CNS injuries.

Most therapeutics for the treatment of traumatic central nervous system injuries, such as traumatic brain injury and spinal cord injury, encounter various obstacles in reaching the target tissue and exerting pharmacological effects, including physiological barriers like the blood-brain barrier and blood-spinal cord barrier, instability rapid elimination from the injured tissue or cerebrospinal fluid and off-target toxicity. For central nervous system delivery, nano- and microdrug delivery systems are regarded as the most suitable and promising carriers. In this review, the pathophysiology and biomarkers of traumatic central nervous system injuries (traumatic brain injury and spinal cord injury) are introduced. Furthermore, various drug delivery systems, novel combinatorial therapies and advanced therapies for the treatment of traumatic brain injury and spinal cord injury are emphasized.

Prevalence of Thyroid Dysfunction Among Depression Patients in a Tertiary Care Centre.

INTRODUCTION: Patients with thyroid disorders are more prone to develop depressive symptoms and conversely depression may be accompanied by various subtle thyroid abnormalities. The aim of the study was to estimate the prevalence of thyroid dysfunction in depression. METHODS: This is a descriptive cross-sectional study conducted at Devdaha Medical College and Research Institute employing a simple random sampling technique during the period of August 2019-January 2020. The research was approved by the Ethical Committee of the Institutional Review Board of Devdaha Medical College and Research Institute. The protocol approval number is 009/019. Data analysis was done in Statistical Package for the Social Sciences (Version 23). Results were presented as frequencies and percentages where required. RESULTS: Among 263 patients with depression, 69 (26.2%) had abnormal thyroid status with most common being subclinical hypothyroidism 32 (12.2%), 13 (4.9%) overt hypothyroidism and 7 (2.7%) overt hyperthyroidism. CONCLUSIONS: The prevalence of thyroid dysfunction is high among patients with depression. We recommend to conduct routine thyroid function tests for all the patients with depression.

Correlates of Biochemical Markers of Bone turnover among Post-Menopausal Women.

INTRODUCTION: Bone turnover leading to osteoporosis and poor quality of life is common during post-menopausal period. Study of bone turnover markers that contribute to non-invasive assessment of bone-metabolic disorders holds an important area of research in low income country like Nepal. This study aimed to examine the correlates of bone turnover markers in post-menopausal women in tertiary level of health care center of Nepal. METHODS: A hospital-based cross-sectional study conducted during the period of November 2016 to December 2017 among 354 women. Blood samples for calcium, inorganic phosphorus, alkaline phosphatase and vitamin D were collected and analyzed using a validated and calibrated tools. Data were analyzed using Statistical Package for the Social Sciences software version 20. RESULTS: Mean±Standard deviation of age of post-menopausal women was significantly higher compared to pre-menopausal women (post-menopausal women, (57.98±8.08) vs. pre-menopausal, (31.35±5.83), (P<0.001). Selected biochemical markers of bone-turnover such as alkaline phosphatase levels were significantly higher with year since menopause (P<0.001), whereas serum calcium, and vitamin D were decreasing with year since menopause among post-menopausal women. In addition, calcium and vitamin D were significantly negatively correlated with year since menopause (P<0.01) while body mass index, inorganic phosphorus and alkaline phosphatase were significantly positively correlated with year since menopause (P<0.01). CONCLUSIONS: Our study revealed that body mass index, inorganic phosphorus and alkaline phosphatase positively correlated with year since menopause while calcium and vitamin D were negatively correlated suggesting for a medical supervision of hormonal changes and periodic dosing of calcium and vitamin D among post-menopausal women to reduce the problem of bone health.

Prevalence and Factors Associated with Microalbuminuria among Type 2 Diabetic Patients : A Hospital Based Study.

INTRODUCTION: Microalbuminuria is the earliest clinical evidence of diabetic nephropathy. However, prevalence and associated factors with microalbuminuria among type 2 diabetic patients has been understudied area of research in Nepalese context. This study aimed to determine the prevalence and factors associated with microalbuminuria among type 2 diabetic patients. METHODS: This study was a hospital-based cross-sectional study. Blood samples for serum creatinine, Hemoglobin A1C, Fasting blood sugar and urine sample for microalbumin and urine creatinine were collected and analyzed using validated and standardized tools from a total of 400 Type 2 diabetic patients in Devdaha Medical College and Teaching Hospital, Rupandehi, Nepal from August 2014 to September 2017. Microalbuminuria was defined as urinary albumin-to-creatinine ratio greater than 30 and less than300 µg /mg of creatinine Results: Of 400 type 2 diabetic patients, 186 (46.5%) had microalbuminuria. The mean values of FBS, HbA1C, serum creatinine, microalbumin, microalbumin/urine creatinine ratio were higher in microalbuminuria group. Microalbuminuria was significantly positively correlated with duration of diabetes, FBS, HbA1C, serum creatinine, microalbumin, microalbumin/ urine creatinine, systolic blood pressure and diastolic blood pressure (P< 0.01). CONCLUSIONS: Our study demonstrated that nearly half of the type 2 diabetic patients had microalbuminuria. Our results emphasize to increase to accessibility to microalbuminuria testing for all the type 2 diabetic patients and bring them under medical supervision to reduce the unwanted complications of diabetes mellitus.