Box-Behnken Design: Optimization of Proanthocyanidin-Loaded Transferosomes as an Effective Therapeutic Approach for Osteoarthritis.

Transferosomes are one of the vesicular carriers that have received extensive research and attention recently because of their capacity to get beyond the barriers posed by the stratum corneum to penetration. The intent of the current study is to optimize and evaluate proanthocyanidin (PAC) containing transferosomal transdermal gels. PAC-containing transferosomes were prepared using the film hydration method and then loaded into a 4% methylcellulose gel. A 23 Box-Behnken design was used to optimize the PAC-loaded transferosomal gel, where the effects of phospholipid 90 G (X1), Tween 80 (X2), and sonication time (X3) were evaluated. The formulation factors, such as the drug entrapment efficiency percentage (PEE) and in vitro drug release, were characterized. A PEE of 78.29 ± 1.43% and a drug release in vitro at 6 h of 24.2 ± 1.25% were obtained. The optimized transferosomal-loaded proanthocyanidin (OTP) formulation penetrated the porcine skin at an excellent rate (0.123 ± 0.0067 mg/cm2/h). Stability tests were conducted for OTP to predict the effects of various temperature conditions on the physical appearance, drug content, and PEE for periods of 15, 30, and 45 days. Finally, this transferosomal system for transdermal PAC delivery may be a suitable alternative to the conventional treatment for osteoarthritis.

Physiological biomarkers of chronic stress: A systematic review.

OBJECTIVE: The basic objective of this systematic review was to identify potential biomarkers for chronic stress. METHODS: A systematic review of studies linking biomarkers in people with chronic stress was conducted using PRISMA guidelines. The last 40 years' studies were included in the systematic review with no age restrictions; animal studies were excluded from the study. Electronic databases including PubMed, Embase, and Google Scholar were searched for the study purpose. The studies were searched using the combinations of search terms that comprised chronic stress together with the keywords hypothalamic-pituitary-adrenal axis (HPA axis), autonomic nervous system (ANS), immune system, metabolic biomarkers, cortisol, hair cortisol, salivary cortisol, urinary cortisol, epinephrine, norepinephrine, adrenocorticotropic hormone (ACTH), brain-derived neurotropic factor (BDNF), metabolic biomarkers, antioxidants, glucose, hemoglobin, C-reactive protein (CRP), cytokines, pro-inflammatory cytokines, anti-inflammatory cytokines, and tumor necrosis factor (TNF). RESULTS: A total of 37 studies out of 671 studies met the eligibility criteria and were included in this review. Potential diagnostic biomarkers of chronic stress included cortisol, ACTH, BDNF, catecholamines, glucose, HbA1c, triglycerides, cholesterol, prolactin, oxytocin, dehydroepiandrosterone sulfate (DHEA-S), CRP, and interleukin - 6 and 8. While the others including antioxidants and natural killer (NK) cells require further validation. Taken together, addition, these stress biomarkers have critical prognostic capacities for stress-associated diseases and therapeutic guidance. CONCLUSION: This systematic review provides an update to the literature by highlighting the role of physiological biomarkers in chronic stress and describing their prognostic and therapeutic values.

Vertical distribution and contamination assessment of heavy metals in sediment cores of ship breaking area of Bangladesh.

Vertical heavy metal profiling reflects the history of the deposition of metals and helps to understand the characteristics of accumulation in various layers of the sediment. Nevertheless, no previous studies in Bangladesh had focused on the vertical distribution of heavy metals in core sediments. In this study, vertical distribution, contamination level and potential ecological risks of six heavy metals (Zn, Cu, Pb, Cr, Ni, Mn) from the core sediment of ship breaking were assessed and compared with the non-ship breaking area of Bangladesh. The concentration (µg/g) of heavy metals in the 0-10 cm (surface), 10-20 cm (middle) and 20-30 cm (bottom) of sediment cores was as follows, respectively: Zn (35.54-100.68, 37.27-258.02, 42.78-66.45); Cu (16.38-75.25, 30.64-92.02, 34.99-52.98); Pb (4.84-132.08, BDL-204.48, BDL-23.51); Cr (14.57-42.13, 25.31-42.71, 15.26-36.34); Ni (4.02-42.23, 4.94-43.70, 4.40-43.13); Mn (198.74-764.16, 257.77-980.50, 255.62-856.44). The heavy metal content of core sediment from the shipbreaking region was substantially higher than that of non-shipbreaking area. Except for Ni, heavy metal content was highest in the middle layer, followed by the upper and lower layers of the sediment core. Contamination exponents such as enrichment factor, contamination factor and geo-accumulation index (Igeo) revealed contamination by Zn, Cu and Pb while potential ecological risk factor ([Formula: see text]) and risk index suggested low ecological risk by studied heavy metals except for Pb. Correlation matrix, cluster analysis and principal component analysis indicated that all studied heavy metals could have similar anthropogenic origins.

Quality of Life in Children Treated for Craniopharyngiomas.

Craniopharyngiomas are common but complex paediatric brain lesions that present interesting management challenges. Quality of life is an important consideration while choosing management options. In this review, we have discussed the existing literature on various aspects of quality of life in patients treated for craniopharyngioma, assessed by variety of measurement tools.

Antifungal activity of silver nanoparticles from Aspergillus niger.

In recent years, silver nanoparticles have gained attention because of their high surface area to volume ratio that makes them more advantageous than their bulky counterparts. Apart of chemical and physical methods of silver nanoparticles (AgNPs) production, green synthesis is being exploited by the researchers. Aspergillus niger are among some fungi being used in fabrication of silver nanoparticles and their antifungal activities are being studied. We have experimented using A. niger Gin for extracellular silver nanoparticle synthesis. Characterization of AgNPs was done by UV-Visible spectroscopy and SEM-EDS.

Non O1, non O139 Vibrio cholerae bacteraemia in an infant; case report and literature review.

Non 01, Non O139 Vibrio cholerae bacteraemia is a rare but potentially fatal occurrence. There have been very few incidents of this infection from around the world. The treatment regimen of antibiotics also varies in literature. We present a case of bacteraemia caused by Non O1, Non O139 Vibrio cholerae along with associated risk factors, disease manifestations, laboratory diagnosis and treatment regimen. This serves to add additional information regarding symptoms and signs of this infection along with management of patient. Knowledge regarding this topic shall be highly useful to professionals if further cases are detected. In the discussion section, a review of literature of previous cases is also presented.

30-Day Readmission Rate and its Causes in General Surgical Patients.

OBJECTIVE: To find out the 30-day readmission rate for different surgical procedures and determine the causes for readmissions. STUDY DESIGN: An audit report. PLACE AND DURATION OF STUDY: Department of Surgery, The Aga Khan University Hospital, Karachi, in the calendar year 2014. METHODOLOGY: Records were retrospectively reviewed for 30-day readmission rate and their cause in general surgical patients who underwent a general surgical procedure at The Aga Khan University Hospital, Karachi, in the year 2014. RESULTS: Out of 217 (6.4%) readmissions in 3,387 patients, more than 50% unplanned readmissions were avoidable. The highest readmission rate was after placement of feeding tubes (28.5%). CONCLUSION: More than half of the readmissions could have been prevented by proper patient/attendant education, good communication and provision of nursing services to these patients beyond the hospital.

Association of Vitamin D with outcome after intra cytoplasmic sperm injection.

OBJECTIVE: To observe effects of vitamin D levels on pregnancy outcome after intra cytoplasmic sperm injection (ICSI). METHOD: It was a cross-sectional study conducted in Australian Concept Infertility Medical Center from July 2011 to August 2014. Estimation of 25-hydroxy cholecalciferol (25-OHD) of consented females (252) was done before treatment protocol for ICSI. Results of ß hCG performed 14 days after embryo transfer categorized groups; Pregnant with ß hCG more than 25 IU/mL and rest included in non-pregnant group. Both groups were compared by independent sample t-test and Pearson's Chi Square test. Binary Logistic Regression Analysis was used to estimate odds ratio of pregnancy outcome with its predictors including Vitamin D. RESULTS: The mean value of 25-OHD, number of oocytes, fertilized oocytes and endometrial thickness was significantly higher in pregnant women. A significant positive association of 25-OHD with clinical pregnancy and thickness of endometrium was observed. After adjustment with female age and BMI, positive association of vitamin D with endometrial thickness was observed. CONCLUSION: Deficiency of 25-OHD in females hinders the accomplishment of optimal endometrial thickness required for implantation of embryo after ICSI. The improvement in vitamin D status can thus improve success results in assisted reproductive clinics.

Fertilization rate and its determinants in intracytoplasmic sperm injection.

OBJECTIVE: To identify predictors of fertilization rate in patients of unexplained infertility after intracytoplasmic sperm injection (ICSI). METHODS: Retrospective analysis of females (282) enrolled in quasi experimental design for ICSI at "Islamabad Clinic Serving Infertile Couples" was carried out from July 2013 till June 2014. Females with unexplained infertility were included, whereas well defined male and female causes of infertility were excluded. Fertilization rate (FR) was calculated as percentage transformation of micro injected oocytes into two pronuclei. Categorical variable of FR defined on the basis of 50% FR grouped females; Group I with FR ≤50% and Group II with FR >50%. The groups were compared in terms of demographic variables, base line hormones and oocyte parameters. Univariate logistic regression was executed to obtain odds ratio with 95% confidence interval to quantify the association of predictors like age, duration of infertility, oocytes parameters, hormones; Estradiol, progesterone, follicle stimulating hormone (FSH), luteinizing hormone, prolactin and cytokines interleukin-Iß (IL-Iß) with the FR. RESULTS: In our study out of 282 females, 19 (6.73%) were in group I and 263 (93.26%) comprised of Group II. Females with high FR(group II) had low Progesterone and FSH (p=0.04, p=0.02) respectively. Mature oocytes (OR: 0.35; 95% CI 1 - 2.56) and IL-Iß in follicular phase (OR: 1.04; 95% CI: 0.000- 1.20) were significant positive predictors of FR while peak progesterone and FSH had significant negative effect on it. CONCLUSION: Fertilization of oocytes in females of unexplained infertility depended on maturity of oocytes and optimal amounts of ILI- ß released by developing follicles in the follicular phase of stimulation cycles of ICSI.