An observational study on acceptability, palatability, and safety of Ayurveda immunity booster kit for the prevention of COVID-19 in frontline workers in Jaipur, India.

Background: National Institute of Ayurveda, Jaipur, India, had distributed Ayurveda immunity booster kit (AIBK) (prepared at own pharmacy and comprising Chyawanprasha - 300 g, Vyadhi Kshamatva Kwatha - 300 g, and Vyadhi Kshamatva capsule - 30 g) for 15 days among the health-care workers, sanitation workers, and security and police staff engaged in the containment zones for prevention of COVID-19. Aim: The aim of present study was to explore the medication that may be effective in prevention of the COVID -19. Hence, this study was done to assess the compliance of these medicines and their effects in the prevention of COVID-19. Methods: One thousand seven hundred and fourteen frontline workers were provided with the AIBK for 15 days from April 24, 2020, to June 27, 2020. Data of frontline workers who had participated in AIBK and completed the treatment regimen with 2 weeks of follow-up after treatment with complete available data for safety, palatability, efficacy, and compliance were included in the study. Any adverse event needing hospitalization or medication, drug compliance and palatability, and appearance of the symptoms of COVID-19 or testing positive for COVID-19 were the outcome measures. Results: Out of 1714 participants, 1003 participants were found to be eligible for this analysis. The median age of these participants was 39 years (range, 19-70), and males accounted for 90.1% (904 of 1003). A total of 7.5% of participants (75 of 1003) reported having adverse events after taking the study treatment. None of the participants reported any serious adverse effects after the administration of the AIBK. The acceptability of the AIBK was as high as 97.4%. None of the participants reported positive for COVID-19 results or COVID-19 symptoms up to 2 weeks of follow-up after completion of the study treatment. Conclusion: The acceptability of AIBK is good and indicates its role in the prevention of COVID-19-like illness, hence further randomized control trials or cohort studies can be done to assess the mechanism of action and efficacy of AIBK as the preventive strategy in COVID-19.

An Interdisciplinary Approach in Rehabilitation of an Adult Mutilated Dentition with Multiple Missing Permanent Teeth--A Case Report.

Adult orthodontics has been an area of increasing focus in recent times. Comprehensive treatment of adults is more challenging due to a myriad of problems that coexist in an adult that makes treatment planning more challenging. A large number of individuals seek dental care because of aesthetic reasons, that is, the desire to look more attractive by improving their smiles. The role an attractive smile plays on a person's self-image and confidence cannot be overemphasized. Evaluating and treating patients for the purpose of smile design often involves a multi-discipline approach. Achieving an ideal smile may require orthodontics, orthognathic surgery, periodontal therapy, including soft tissue repositioning and bone re-contouring, cosmetic dentistry, and plastic surgery. This aesthetic approach to patient care produces the best dental and dental-facial beauty. This paper describes a case report in which an orthodontist, an endodontist, and a prosthodontist worked as a team to improve the patients smile and confidence.

Energetics of association in poly(lactic acid)-based hydrogels with crystalline and nanoparticle-polymer junctions.

We report the energetics of association in polymeric gels with two types of junction points: crystalline hydrophobic junctions and polymer-nanoparticle junctions. Time-temperature superposition (TTS) of small-amplitude oscillatory rheological measurements was used to probe crystalline poly(L-lactide) (PLLA)-based gels with and without added laponite nanoparticles. For associative polymer gels, the activation energy derived from the TTS shift factors is generally accepted as the associative strength or energy needed to break a junction point. Our systems were found to obey TTS over a wide temperature range of 15-70 °C. For systems with no added nanoparticles, two distinct behaviors were seen, with a transition occurring at a temperature close to the glass transition temperature of PLLA, T(g). Above T(g), the activation energy was similar to the PLLA crystallization enthalpy, suggesting that the activation energy is related to the energy needed to pull a PLLA chain out of the crystalline domain. Below T(g), the activation energy is expected to be the energy required to increase mobility of the polymer chains and soften the glassy regions of the PLLA core. Similar behavior was seen in the nanocomposite gels with added laponite; however, the added clay appears to reduce the average value of the activation enthalpy. This confirms our SAXS results and suggests that laponite particles are participating in the network structure.

Nanoparticle-reinforced associative network hydrogels.

ABA triblock copolymers in solvents selective for the midblock are known to form associative micellar gels. We have modified the structure and rheology of ABA triblock copolymer gels comprising poly(lactide)-poly(ethylene oxide)-poly(lactide) (PLA-PEO-PLA) through addition of a clay nanoparticle, laponite. Addition of laponite particles resulted in additional junction points in the gel via adsorption of the PEO corona chains onto the clay surfaces. Rheological measurements showed that this strategy led to a significant enhancement of the gel elastic modulus with small amounts of nanoparticles. Further characterization using small-angle X-ray scattering and dynamic light scattering confirmed that nanoparticles increase the intermicellar attraction and result in aggregation of PLA-PEO-PLA micelles.

Micro- to nanoscale structure of biocompatible PLA-PEO-PLA hydrogels.

We observe large-scale structures in hydrogels of poly(l-lactide)-poly(ethylene oxide)-poly(l-lactide) (PLLA-PEO-PLLA) ranging in size from a few hundred nanometers to several micrometers. These structures are apparent through both ultra-small angle scattering (USAS) techniques and confocal microscopy. The hydrogels showed power law scattering in the USAS regime, which is indicative of scattering from fractal structures. The fractal dimension of the scattering from hydrogels revealed that the gels have large size aggregates with a mass fractal structure over the nanometer-to-micrometer length scales. The aggregates also seem to become more "dense" with an increase in the molecular weight of crystalline PLLA domains. Visualization through confocal microscopy confirms that the gels have a microstructure of interspersed micrometer-sized polymer inhomogeneities with water channels running between them. The presence of micrometer-sized water channels in the hydrogels has very important implications for biomedical applications.

Novel drug release profiles from micellar solutions of PLA-PEO-PLA triblock copolymers.

We have achieved nearly zero order sustained release behavior for periods up to 10-20 days for two hydrophobic drugs, sulindac and tetracaine, from 5wt.% micellar solutions of poly(lactide)-poly(ethylene oxide)-poly(lactide) (PLA-PEO-PLA) triblock copolymer. The effect of PLA block length and crystallinity on the drug release profiles was studied. A series of polymers with constant PEO molecular weight of 8900Da and PLA molecular weight varying in the range of 4100-6500Da were examined. Drug release was found to be much faster for polymers with crystalline PLA blocks as compared to those with amorphous PLA blocks. The drug release rate also depends significantly on the length of the PLA block. Sustained release of sulindac was observed up to 20 days, and for tetracaine up to 10 days. By comparison, release of these drugs without polymeric carriers occurs over 4-6h. This result, along with a proposed mechanism for drug release, suggests that polymer-drug interactions significantly impact release profiles, causing slow and sustained release of the drug.

New properties from PLA-PEO-PLA hydrogels.

Polymeric materials are important in many medical applications. Regenerative medicine offers the potential to repair or replace damaged tissue and polymers are an essential component of many tissue engineering approaches. Hydrogels have many advantageous properties but, generally, lack robust mechanical properties. At the same time, mounting evidence points to the importance of the matrix modulus when constructing devices. In this context, triblock copolymers made from poly(-lactide)-poly(ethylene glycol)-poly(-lactide) have been prepared and formulated into hydrogels. Investigations into their mechanical properties found the elastic modulus to be greater than 10 kPa which is at least one order of magnitude stiffer than previously reported from macromolecules composed of similar monomers. Part of the reason is the presence of crystalline lactide domains. Creating hydrogels with tailored modulus across the kPa range will likely have important ramifications in regenerative medicine.