Statistical design and optimization of nano-transfersomes based chitosan gel for transdermal delivery of cefepime.

OBJECTIVES: This research aimed to overcome challenges posed by cefepime excessive elimination rate and poor patient compliance by developing transdermal delivery system using nano-transfersomes based chitosan gel. METHODS: Rotary evaporation-sonication method and the Box-Behnken model were used to prepare cefepime loaded nano-transfersomes (CPE-NTFs). The physiochemical characterization of CPE-NTFs were analyzed including DLS, deformability index, DSC and antimicrobial study. Optimized CPE-NTFs loaded into chitosan gel and appropriately characterized. In vitro release, ex vivo and in vivo studies were performed. RESULTS: The CPE-NTFs were physically stable with particle size 222.6 ± 1.8 nm, polydispersity index 0.163 ± 0.02, zeta potential -20.8 ± 0.1 mv, entrapment efficiency 81.4 ± 1.1% and deformability index 71 ± 0.2. DSC analysis confirmed successful drug loading and thermal stability. FTIR analysis showed no chemical interaction among the excipients of CPE-NTFs gel. The antibacterial activity demonstrated a remarkable reduction in the minimum inhibitory concentration of cefepime when incorporated into nano-transfersomes. CPE-NTFs based chitosan gel (CPE-NTFs gel) showed significant physicochemical properties. In vitro release studies exhibited sustained release behavior over 24 h, and ex vivo studies indicated enhanced permeation and retention compared to conventional cefepime gel. In vivo skin irritation studies confirmed CPE-NTFs gel was nonirritating and biocompatible for transdermal delivery. CONCLUSION: This research showed nano-transfersomes based chitosan gel is a promising approach for cefepime transdermal delivery and provides sustained release of cefepime.

A comparative analysis of three distinct fractional derivatives for a second grade fluid with heat generation and chemical reaction.

This article provides a comparison among the generalized Second Grade fluid flow described by three recently proposed fractional derivatives i.e. Atangana Baleanu fractional derivative in Caputo sense (ABC), Caputo Fabrizio (CF) and Constant Proportional-Caputo hybrid (CPC) fractional derivative. The heat mass transfer is observed during the flow past a vertical porous plate that is accelerated exponentially under the effects of the Magneto hydro dynamics. The effects of the heat generation and exponential heating in the temperature boundary layer and chemical reaction at the concentration boundary layer are also analyzed in this article. The flow model is described by three partial differential equations and the set of non-dimensional PDE's is transformed into ODE's by utilization of the integral transform technique (Laplace transform). For the better understanding of the rheological properties of the Second Grade fluid we used the CF, ABC and CPC operators to describe the memory effects. The analytical exact solution of the problem is obtained in the form of G-functions and Mittag Leffler functions. For the physical significance of flow parameters, different parameters are graphed. From this analysis it is concluded that the CPC is the most suitable operator to describe the memory effects.

Time fractional Yang-Abdel-Cattani derivative in generalized MHD Casson fluid flow with heat source and chemical reaction.

This present research article investigates the exact analytical solution for the mathematical model of the generalized Casson fluid flow by using the new fractional operator with Rabotnov exponential kernel i.e. Yang-Abdel-Cattani operator. The impacts of heat source, magnetic hydrodynamics and chemical reactions on the flow of fractional Casson fluid through a vertical flat plate are studied in this article. For the sake of a better interpretation of the rheological behavior of Casson fluid we have used the new operator of fractional order with exponential kernel of Rabotnov known as Yang-Abdel-Cattani operator of fractional derivative. By making use of the technique of Laplace transform we have find the exact analytical solution of the problem in the Mittag-Leffler's form, for all the three governing equations i.e. Velocity, energy and concentration equation. It has been noticed from the literature that it is challenging to obtain analytical results from fractional fluid model derived by the various fractional operators. This article helps to address this issue by providing analytical solutions for fractionalized fluid models. To analyze the physical importance of different fluid parameters such as Schmidt number, Prandtl number, MHD and alpha on the heat, mass and momentum class are presented through graphs. The concentration of the fluid decreases with Schmidth number and temperature of the fluid decreases with the increasing Prandtl number. The velocity of the fluid decreases with increasing MHD effects and increases with increasing Alpha. The Yang-Abdel-Cattani operator of fractional order can describe the memory effects more suitably than the other fractional operators.

Heat transfer analysis of generalized second-grade fluid with exponential heating and thermal heat flux.

The aim of present work is to apply the Caputo-Fabrizio fractional derivative in the constitutive equations of heat transfer. Natural convection flow of an unsteady second grade fluid over a vertical plate with exponential heating is discussed. The generalized Fourier law is substituted in temperature profile. A portion of the dimensionless factors are utilized to make the governing equations into dimensionless structures. The solutions for temperature and velocity profiles of Caputo-Fabrizio model are acquired through the Laplace transform method. These solutions are greatly affected through the variation of different dimensionless variables like Prandtl number, Grashof number, and second-grade fluid parameter. Finally, the influence of embedded parameters is shown by plotting graphs through Mathcad. From the graphical results it is concluded that, the temperature of the fluid decreases with the increasing values of the Prandtl number and Second grade fluid parameter and increases with the passage of time. The velocity of the fluid increases with increasing values of the Grashof number, second grade parameter and time while decreases with increasing values of fractional parameter and Prandtl number.

Heat transfer of generalized second grade fluid with MHD, radiation and exponential heating using Caputo-Fabrizio fractional derivatives approach.

The aim of the present work is to apply the Caputo-Fabrizio fractional derivative to the heat transformation of unsteady incompressible second grade fluid. The effects of magneto hydro dynamic and radiation are analyzed. In governing equation of heat transfer nonlinear radiative heat is examined. Exponential heating phenomena is considered at boundary. Firstly, the dimensional governing equations with the initial & boundary conditions are converted into non-dimensional form. Exact analytical solutions are obtained for dimensionless fractional governing equations which consist of momentum and energy equations by using Laplace transform method. Special cases are investigated of the obtained solutions and it is noticed that some well-known results are achieved published in literature from these special cases. At the end, for graphical illustration the influences of different physical parameters like radiation, Prandtl, fractional parameter, Grashof numbers and Magneto hydro dynamic are checked graphically.

To Compare Efficacy Between Cryotherapy And Mitomycin Microneedling For The Treatment Of Plantar Warts.

BACKGROUND: Cryotherapy is a common destructive treatment modality for treating plantar warts that results in blistering and scarring. Mitomycin an antitumor drug with antiviral property is a safe, better and a promising option for treating plantar warts. Objective was to compare efficacy of cryotherapy and mitomycin microneedling in the management of plantar warts. It was a randomized controlled trial conducted at the Skin Department CMH Abbottabad from 1st May to 31st December 2021. METHODS: The study included 60 patients with plantar warts. Each group with 30 patients. Random tables were used to determine the distribution of patients within each group. Group A received mitomycin microneedling (1u/ml) repeated every 3 weeks. Group B was prescribed liquid nitrogen cryotherapy. The freeze-thaw cycle was 20 secs and repeated every 2 weeks. Both groups were treated for 4 months duration. For analysis of data, SPSS version 21.0 was used. Efficacy was compared by the application of Chi-square test between the two groups. p<0.05 was considered statistically significant. RESULTS: Mitomycin microneedling completely cured 76.7% of patients, while cryotherapy was effective for only 56.7%. Complete remission was observed after two to three sessions of mitomycin microneedling while average of 4 sessions of cryotherapy were required for complete remission. In general, microneedling with mitomycin had better tolerance, pain being the commonest adverse effect. CONCLUSIONS: Plantar warts can be effectively treated with mitomycin microneedling. Treatment of plantar warts with this method is more effective, requires fewer sessions, and may take less time to complete.

Time fractional analysis of channel flow of couple stress Casson fluid using Fick's and Fourier's Laws.

This study aim to examine the channel flow of a couple stress Casson fluid. The flow is generated due to the motion of the plate at [Formula: see text], while the plate at [Formula: see text] is at rest. This physical phenomenon is derived in terms of partial differential equations. The subjected governing PDE's are non-dimensionalized with the help of dimensionless variables. The dimensionless classical model is generalized by transforming it to the time fractional model using Fick's and Fourier's Laws. The general fractional model is solved by applying the Laplace and Fourier integral transformation. Furthermore, the parametric influence of various physical parameters like Casson parameter, couple stress parameter, Grashof number, Schmidt number and Prandtl number on velocity, temperature, and concentration distributions is shown graphically and discussed. The heat transfer rate, skin friction, and Sherwood number are calculated and presented in tabular form. It is worth noting that the increasing values of the couple stress parameter [Formula: see text] deaccelerate the velocity of Couple stress Casson fluid.

Caputo-Fabrizio fractional model of MHD second grade fluid with Newtonian heating and heat generation.

In this research article the heat transfer of generalized second grade fluid is investigated with heat generation. The fluid flow is analyzed under the effects of Magneto hydrodynamics over an infinite vertical flat plate. The Newtonian heating phenomenon has been adopted at the boundary. For this purpose the problem is divided into two compartments i.e. momentum equation and energy equations. Some specific dimensionless parameters are defined to convert the model equations into dimensionless system of equations. The solutions for dimensionless energy and momentum equations are obtained by using the Laplace transform technique. From obtained results by neglecting magneto hydrodynamic effects and heat source some special case are achieved which are already published in literature. The case for which the fractional parameter approaches to the classical order is also discussed and it has been observed that it is convergent. Finally, the influences of different physical parameters are sketched graphically. It has been observed that for increasing values of Prandtl number the velocity and temperature decreases, for increasing values of Grashof number the velocity of the fluid increases. Also it has been investigated that for increasing values of fractional parameter the velocity and temperature of the fluid increases.

Comparative Study Between Intralesional Injection Of Platelet Rich Plasma And Intra Lesional Triamcinolone For The Treatment Of Alopecia Areata.

BACKGROUND: Alopecia areata is an autoimmune disorder of patchy non scarring hair loss. Steroids, either Intralesional, e.g, triamcinolone or potent topical, e.g, clobetasol are the first line treatment. Platelet rich plasma is an autologous concentrated plasma with growth factors which enhances regeneration of hair follicles. It is simple and effective treatment with no major side effects. Objective was to compare the efficacy of intralesional injection of platelet rich plasma and triamcinolone in patients of alopecia areata. It was a randomized controlled trial (open-labelled), conducted at the Dermatology Department, Combined Military Hospital Abbottabad from 1st May to 31st December 2021. METHODS: Sixty clinically diagnosed patients of alopecia areata of the scalp were enrolled in the study. They were divided into two groups, A and B. Random numbers table was used to allocate 30 patients into each group. Group A patients were given an intralesional injection of triamcinolone while intralesional platelet rich plasma was given to Group B. Both treatments were repeated at one-month intervals for four months. In the study, Chi-square tests were used to compare effectiveness. It was considered significant when the p-value turned out to be <0.05.. RESULTS: There was significant difference in complete response rate between intralesional injection of steroid and intralesional injection of platelet rich plasma. Platelet rich plasma was less effective (p =0.05). Local corticosteroid injection was significantly more effective than platelet rich plasma (p<0.05). CONCLUSIONS: Intralesional injection of steroid is an effective and considerable treatment for alopecia areata. This study also proposes intralesional injection of platelet rich plasma as an alternative therapy for alopecia areata as it is not associated with serious local side effects.

Convection heat mass transfer and MHD flow over a vertical plate with chemical reaction, arbitrary shear stress and exponential heating.

The present research article is directed to study the heat and mass transference analysis of an incompressible Newtonian viscous fluid. The unsteady MHD natural convection flow over an infinite vertical plate with time dependent arbitrary shear stresses has been investigated. In heat and mass transfer analysis the chemical molecular diffusivity effects have been studied. Moreover, the infinite vertical plate is subjected to the phenomenon of exponential heating. For this study, we formulated the problem into three governing equations along with their corresponding initial and boundary conditions. The Laplace transform method has been used to gain the exact analytical solutions to the problem. Special cases of the obtained solutions are investigated. It is noticed that some well-known results from the published literature are achieved from these special cases. Finally, different physical parameters' responses are investigated graphically through Mathcad software.

Efficacy of learning through play plus intervention to reduce maternal depression in women with malnourished children: A randomized controlled trial from Pakistan✰.

BACKGROUND: The risk factors and adverse outcomes related to maternal depression and child malnutrition are a leading cause of morbidity and mortality in low and middle-income countries (LMIC) including Pakistan. Above 25% of women suffer from maternal depression. Up to 50% children are under-nourished which contributes to 35% of all under-5 deaths in the country. AIM: To determine the efficacy of Learning through Play Plus Thinking Healthy Program (LTP Plus) intervention to reduce maternal depression in mothers with undernourished children. METHODS: In this randomised controlled trial, all eligible mothers presenting to the paediatric departments were invited to participate in the study. Out of the total 256 mothers screened, 107 were included, 54 of those were randomly allocated to LTP Plus group and 53 to treatment as usual (TAU). Edinburgh Postnatal Depression Scale (EPDS) was used to screen for depression. Hamilton Depression Rating Scale (HDRS), Maternal Attachment Inventory (MAI), Social Support Scale (OSLO-3) and the Euro-QoL (EQ-5D) were used to measure the severity of depression, mother-child attachment, level of support and health related quality of life dimensions. Assessments were completed at baseline, end of intervention (3 months from baseline) and at 6 months from baseline. RESULTS: Mothers in the LTP Plus group significantly showed improvements in depression (p<0.001), social support (p = 0.02) and quality of life (p<0.001) at the end of the intervention (LTP Plus), as compared to the TAU group, which were sustained up to 6 months after baseline. CONCLUSION: The outcomes of LTP Plus intervention for mothers of malnourished children show promising results in reducing maternal depression and improving child outcomes. A full trial with longer-term outcomes and cost-effectiveness needs to be conducted.

Treatment of maternal depression in urban slums of Karachi, Pakistan: A randomized controlled trial (RCT) of an integrated maternal psychological and early child development intervention.

BACKGROUND: Maternal depression is a major public health problem. This may affect a mother's ability to provide adequate care for the child. The objective of this study was to evaluate the effectiveness of the Learning through Play Plus program (LTP Plus) - a parenting program integrated with Cognitive Behaviour Therapy (CBT). METHODS: A total of 247 women with symptoms of depression in Karachi, Pakistan were assigned randomly to either LTP Plus or routine care (Clinical Trials Identifier: NCT00835016). Symptoms of maternal depression were measured using the Edinburgh Postnatal Depression Scale (EPDS) at 3 and 6 months after baseline. RESULTS: At 3 months, there was a significant reduction in the EPDS scores in the intervention group compared to the routine group (adjusted mean difference [AMD] -3.65, 95% CI -6.14 to -1.15, p <0.004). This effect was sustained at 6 months (AMD -2.62, 95% CI -4.43 to -0.81, p<0.005). These women also reported less parental distress and disability. There was also a significant improvement in maternal knowledge about child development at 6 months. CONCLUSION: There was a significant reduction in depression among women who received the group parenting program LTP Plus. This intervention has the potential to be scaled up and integrated with mother and child health programs.