Traditional healers working with primary care and mental health for early intervention in psychosis in young persons: protocol for the feasibility cluster randomised controlled trial.

OBJECTIVES: In low/middle-income countries (LMICs), more than half of patients with first-episode psychosis initially seek treatment from traditional and religious healers as their first care. This contributes to an excessively long duration of untreated psychosis (DUP). There is a need for culturally appropriate interventions to involve traditional and spiritual healers to work collaboratively with primary care practitioners and psychiatrists through task-shifting for early detection, referral and treatment of first episode of psychosis. METHODS: To prevent the consequences of long DUP in adolescents in LMICs, we aim to develop and pilot test a culturally appropriate and context-bespoke intervention. Traditional HEalers working with primary care and mental Health for early interventiOn in Psychosis in young pErsons (THE HOPE) will be developed using ethnographic and qualitative methods with traditional healers and caregivers. We will conduct a randomised controlled cluster feasibility trial with a nested qualitative study to assess study recruitment and acceptability of the intervention. Ninety-three union councils in district Peshawar, Pakistan will be randomised and allocated using a 1:1 ratio to either intervention arm (THE HOPE) or enhanced treatment as usual and stratified by urban/rural setting. Data on feasibility outcomes will be collected at baseline and follow-up. Patients, carers, clinicians and policymakers will be interviewed to ascertain their views about the intervention. The decision to proceed to the phase III trial will be based on prespecified stop-go criteria. ETHICS AND DISSEMINATION: Ethical approval has been obtained from Keele University Ethical Review Panel (ref: MH210177), Khyber Medical University Ethical Review Board (ref: DIR/KMU-EB/IG/001005) and National Bioethics Committee Pakistan (ref no. 4-87/NBC-840/22/621). The results of THE HOPE feasibility trial will be reported in peer-reviewed journals and academic conferences and disseminated to local stakeholders and policymakers. TRIAL REGISTRATION NUMBER: ISRCTN75347421.

Antioxidant, antibacterial, and catalytic performance of biosynthesized silver nanoparticles of Rhus javanica, Rumex hastatus, and Callistemon viminalis.

Rhus javanica (Anacardiaceae) containing abundant glucopyranosidal constituents, is traditionally used to treat gastric and duodenal ulcer, dysentery, and diarrhea. Rumex hastatus (Polygonaceae) widely distributed in Pakistan, has traditional importance in treating wound healing, jaundice, rheumatism, and skin diseases. Callistemon viminalis (Myrtaceae), a rich source of essential oils, saponins, triterpenoids, phloroglucinols, and flavonoids is used in industries, perfumes, nutrition, and cosmetics. Taking the importance of the subject plants, this study is designed to synthesize silver nanoparticles via aqueous extracts of R. javanica (RJAgNPs), R. hastatus (RHAgNPs), and C. viminalis (CVAgNPs). Synthesis, surface, and sizes of silver nanoparticles (AgNPs) were confirmed using spectroscopic techniques including ultraviolet-visible (UV-Vis), Fourier transform-infrared (FT-IR), and scanning electron microscopy (SEM). AgNPs were produced in ratios 1:15, 1:16, and 1:9 and inferred via appearance of a sharp surface plasmon resonance (SPR) absorption peak (400-435 nm), which represented well-defined, stable, and spherical AgNPs. From SEM analysis, the sizes of RJAgNPs, RHAgNPs, and CVAgNPs were found to be 67 nm, 61 nm, and 55 nm, respectively. The synthesized AgNPs exhibited potential free radical scavenging, antibacterial, and catalytic properties in degradation of dyes including Congo red, methylene blue, methyl orange, rhodamine B, ortho and para-nitrophenols, and several food colours. Hence, the subject AgNPs in the current study might display promising role in drug development and remediation of environmental/industrial effluents.

Characterization of natural gums via elemental and chemometric analyses, synthesis of silver nanoparticles, and biological and catalytic applications.

Gums; composed of polysaccharides, carbohydrates, proteins, and minerals, are high molecular weight hydrophilic compounds with several biological applications. This study describes the nutritional and toxic elements content, chemical composition, synthesis of silver nanoparticles (G-AgNPs), and pharmacological and catalytic properties of Prunus armeniaca (apricot), Prunus domestica (plums), Prunus persica (peaches), Acacia modesta (phulai), Acacia arabica (kikar), and Salmalia malabarica (silk cotton tree) gums. The elemental contents were analyzed by inductively coupled plasma-optical emission spectroscopy (ICP-OES) and ICP-mass spectrometry (ICP-MS). NMR spectroscopy was used for the identification of class of compounds in the mixture, their functional groups were determined through FTIR techniques, and plasmon resonance and size of G-AgNPs through UV-Vis spectroscopic technique and transmission electron microscopy (TEM). From the results, nutritional elements were present at appreciable concentrations, whereas toxic elements showed content below the maximum permissible ranges. Using the elemental data, linear discriminant and principal component analyses classified the gums to 99.9% variability index. Furthermore, G-AgNPs exhibited significant antioxidant, antibacterial, and redox catalytic potential. Hence, the subject G-AgNPs could have promising nutritional, therapeutic and environmental remediation applications.

Pyrazinium thioacetate capped gold nanoparticles as Fe(III) sensor and Fe(III) marked anti-proliferating agent in human neuroblastoma cells.

Gold nanoparticles (AuNPs) stabilized by new cationic 1­(3­(acetylthio)propyl)pyrazin­1­ium ligand (PPTA) were synthesized. AuNPs stabilized by PPTA (PPTA-AuNPs) were found to be spherical and polydispersed with the average size of 60 nm. Human neuroblastoma (SHSY-5Y) cells permeability of PPTA-AuNPs was found to be a key feature to study the intracellular quenching of Fe(III) proliferative activity. In vitro MTT assay revealed non-cytotoxicity of PPTA and PPTA-AuNPs at 100 µM concentration, while treatment of 100 µM of Fe(III) with SHSY-5Y cells resulted into higher cells viability. Contrary, a mixture of 1:1 Fe(III) with PPTA-AuNPs showed no change in the viability of cells at same concentration which suggests the intracellular complexation and recognition of Fe(III) by PPTA-AuNPs. AFM morphological analysis of SHSY-5Y cells also supported the MTT assay results, and it is safe to conclude that PPTA-AuNPs can be used as Fe(III) probes in living cells. In addition, Fe(III) caused a significant decrease in the absorbance of surface plasmon resonance (SPR) band of PPTA-AuNPs in a wide range of concentration and pH, with limit of detection 4.3 µM. Moreover, the specific response of PPTA-AuNPs towards Fe(III) was unaffected by the interference of other metals and components of real samples of tap water.

Synthesis and characterisation of calix[4]arene based bis(triazole)-bis(hexahydroquinoline): Probing highly selective fluorescence quenching towards mercury (Hg2+) analyte.

In the present study, we are reporting the synthesis of a triazoles incorporated fluorescent hexahydroquinoline appended calix[4]arene 7 and its highly selective optical recognition ability towards Hg2+. The optical sensor 7 was synthesized via two different synthetic pathways and unambiguously characterized by mass spectrometry and NMR spectroscopy. The stoichiometric ratio between 7 and Hg2+ was determined as 1:1 based on Job's plot and ESI-MS analysis. The chemosensor 7 selectively recognized Hg2+ in the presence of competitive cations such as Cu2+, Cu1+, Co3+, Ni2+, Ag1+, Fe2+, Fe3+, Cr3+, Pb2+, Cd2+, Zn2+, Sn2+, Ti4+, Sb3+, In3+, Ba2+, Ca2+, and K1+. The limit of detection (LOD) was established as 0.5 µM on spectrofluorimetric analysis. According to world health organization (WHO) in guidelines for drinking-water quality, the mercury level in natural occurring ground and surface water is about ∼0.5 µM (µg/L). The supra molecule 7 with LOD (0.5 µM) could potentially serve effective receptors for Hg2+ cation. The probe 7 was applied effectively for detection of Hg2+ in real water samples (i.e. tap and deionized water), spiked with Hg2+ (10 µM) solution. Moreover, the compound 7 showed non-toxicity during cytotoxic assay against human B cells as they retain their morphology. The supramolecule 7 in living cells showed selectivity towards Hg2+ in cytotoxic assay with T lymphocytes, evident by morphological changes observed via AFM analysis.