Gallic acid: a polyphenolic compound potentiates the therapeutic efficacy of cisplatin in human breast cancer cells

Gallic acid (GA) is a natural polyhydroxyphenolic compound with antioxidant, antimutagenic, anti-inflammatory, and antineoplastic activities. Cisplatin (CPT) is a platinum-based chemotherapeutic drug, and it is the treatment of choice for breast, ovarian, testicular, head, and neck cancers. However, the use of anticancer drugs has undesirable effects on patients due to associated toxicities. Thus, it is necessary to search for alternatives that reduce unintended side effects and enhance anticancer potential. The use of natural compounds with the conventional chemotherapeutic drug is a new aspect of cancer therapy. In the present study, we evaluated the ability of GA in the modulation of anticancer effects of CPT in human breast adenocarcinoma cells (MCF-7) by performing MTT, apoptosis, clonogenic cell survival, and micronucleus assays. GA and CPT showed significant cytotoxic activities in MCF-7 cells in a dose-dependent manner. In combination therapy (GA 2.5, 5.0, and 10 μg/mL + CPT10 μg/mL), GA synergistically reduced the MCF-7 cell viability in contrast to the individual therapies. Cancer cells death by GA is through the induction of apoptosis as observed in the acridine orange and ethidium bromide dual staining method. The frequency of micronuclei (MN) was decreased significantly (P < 0.001) in combinational therapy, possibly reducing the risk of chemotherapy-induced MN. Moreover, GA in mono or combinational therapy did not induce any cytotoxic effects in normal breast epithelial cells (MCF-10A). GA did not show any significant difference in colony inhibition compared to CPT. This outcome shows its differential effects in normal and cancerous cells. Hence, the combination GA with chemotherapeutic drugs could represent a promising alternative therapy in cancer treatment with minimal side effects.

Agreement of a Novel Artificial Intelligence Software With Optical Coherence Tomography and Manual Grading of the Optic Disc in Glaucoma

PRCIS

The offline artificial intelligence (AI) on a smartphone-based fundus camera shows good agreement and correlation with the vertical cup-to-disc ratio (vCDR) from the spectral-domain optical coherence tomography (SD-OCT) and manual grading by experts.

PURPOSE

The purpose of this study is to assess the agreement of vCDR measured by a new AI software from optic disc images obtained using a validated smartphone-based imaging device, with SD-OCT vCDR measurements, and manual grading by experts on a stereoscopic fundus camera.

METHODS

In a prospective, cross-sectional study, participants above 18 years (Glaucoma and normal) underwent a dilated fundus evaluation, followed by optic disc imaging including a 42-degree monoscopic disc-centered image (Remidio NM-FOP-10), a 30-degree stereoscopic disc-centered image (Kowa nonmyd WX-3D desktop fundus camera), and disc analysis (Cirrus SD-OCT). Remidio FOP images were analyzed for vCDR using the new AI software, and Kowa stereoscopic images were manually graded by 3 fellowship-trained glaucoma specialists.

RESULTS

We included 473 eyes of 244 participants. The vCDR values from the new AI software showed strong agreement with SD-OCT measurements [95% limits of agreement (LoA)=-0.13 to 0.16]. The agreement with SD-OCT was marginally better in eyes with higher vCDR (95% LoA=-0.15 to 0.12 for vCDR>0.8). Interclass correlation coefficient was 0.90 (95% CI, 0.88-0.91). The vCDR values from AI software showed a good correlation with the manual segmentation by experts (interclass correlation coefficient=0.89, 95% CI, 0.87-0.91) on stereoscopic images (95% LoA=-0.18 to 0.11) with agreement better for eyes with vCDR>0.8 (LoA=-0.12 to 0.08).

CONCLUSIONS

The new AI software vCDR measurements had an excellent agreement and correlation with the SD-OCT and manual grading. The ability of the Medios AI to work offline, without requiring cloud-based inferencing, is an added advantage.

Recent developments in biorefining of macroalgae metabolites and their industrial applications - A circular economy approach

The macroalgal industry is expanding, and the quest for novel ingredients to improve and develop innovative products is crucial. Consumers are increasingly looking for natural-derived ingredients in cosmetic products that have been proven to be effective and safe. Macroalgae-derived compounds have growing popularity in skincare products as they are natural, abundant, biocompatible, and renewable. Due to their high biomass yields, rapid growth rates, and cultivation process, they are gaining widespread recognition as potentially sustainable resources better suited for biorefinery processes. This review demonstrates macroalgae metabolites and their industrial applications in moisturizers, anti-aging, skin whitening, hair, and oral care products. These chemicals can be obtained in combination with energy products to increase the value of macroalgae from an industrial perspective with a zero-waste approach by linking multiple refineries. The key challenges, bottlenecks, and future perspectives in the operation and outlook of macroalgal biorefineries were also discussed.

A Study to Evaluate Intrathecal 1% Chloroprocaine and 0.5% Levobupivacaine in Perianal Surgeries: A Prospective Randomized Study

Background:

With increasing focus on outpatient care, there has been an increased demand for short-acting spinal anesthetics, facilitating early recovery and mobilization of the patient.

Aims:

The aim of the study was to compare 1% chloroprocaine, characterized by short latency and short duration with 0.5% levobupivacaine, which has shown to preserve motor function at low concentrations, with recovery from motor block as the primary objective and recovery from sensory block and hemodynamic stability as secondary objectives.

Settings and Design:

A prospective study to evaluate newer isobaric chloroprocaine and levobupivacaine intrathecally in a cohort of patients using randomization and double blinding.

Materials and Methods:

Sixty American Society of Anesthesiologist physical status Classes I and II patients undergoing perianal surgeries were randomly divided into Group C (n = 30) receiving intrathecal 1% chloroprocaine 3 mL and Group L (n = 30) receiving 0.5% levobupivacaine 1.5 mL. Patients were assessed for sensory and motor block characteristics, hemodynamic changes, period of analgesia, time for ambulation, and urination.

Statistical Analysis:

Qualitative data were analyzed using Chi-square test and quantitative data using Independent t-test.

Results:

There was no significant difference in highest sensory level, onset of motor block, maximum Bromage scale achieved, and hemodynamic changes between the two groups. There was a significant difference in mean Time for Maximum Bromage scale, Time for Sensory regression (Lumbar-L₁), Duration of Motor Block (Group C 50.7 ± 5.7 min and Group L 181 ± 27.8 min), Time for rescue Analgesia, Time for 1^st void, and Time for ambulation (Group C 88.3 ± 9.1 min and Group L₂ 06.7 ± 27.2 min) between chloroprocaine and levobupivacaine group. The above duration was shorter in chloroprocaine group than in levobupivacaine group.

Conclusion:

Thus, chloroprocaine provides good surgical anesthesia and early motor recovery than levobupivacaine and is well suited for day care surgeries.

Gallic acid: A promising genoprotective and hepatoprotective bioactive compound against cyclophosphamide induced toxicity in mice

Cyclophosphamide (CP) is a potent chemotherapeutic agent and is also known to interact with specific biological molecules and produce numerous side effects such as genotoxicity, neurotoxicity, reproductive toxicity and nephrotoxicity. CP induces genotoxicity by generating oxygen/nitrogen derived free radicals during chemotherapy and causes DNA damage. Hence, to overcome such side effects of chemotherapeutic agents antioxidants are recommended. Gallic acid (GA) a phenolic compound is commonly exists in variety of fruits and in many plants. In the present study, genoprotecive effects of GA against CP induced genotoxicity in Swiss albino mice were evaluated by using comet assay, bone marrow, and peripheral micronucleus (MN) assays. CP produced oxidative stress induced hepatic damage was assessed by estimating the activity of liver superoxide dismutase (SOD), reduced glutathione content (GSH), and also by examining the histological alterations induced by CP in hepatic tissue of mice. It was noticed that, GA pretreatment significantly reduced the frequency of MN and DNA strand breaks induced by CP. GA also protected the hepatic tissue against CP induced reactive oxygen species (ROS) mediated damage and was evident by increased levels of liver SOD and GSH. GA ameliorated the histological changes induced by CP in hepatic tissue. These findings suggest that, GA is a versatile antioxidant with promising protection against CP induced genotoxicity and hepatic damage in Swiss albino mice.

Distribution of Ocular Perfusion Pressure in Hypertensive Patients

Aim: To describe the distribution of ocular perfusion pressure hypertensive patients. Design: Cross-sectional observation study. Materials and Methods: Hospital-based, case control cross-sectional study conducted on 100 patients. Systolic and diastolic blood pressure (SBP and DBP) was measured with a Mercury Sphygmomanometer. Mean ocular perfusion pressure (MOPP) = ⅔ (mean arterial pressure − IOP), where mean arterial pressure (MAP) = DBP + ⅓ (SBP − DBP), systolic perfusion pressure (SPP) = SBP – IOP and diastolic perfusion pressure (DPP) = DBP − IOP was calculated. Results: High values of diastolic BP (>90 mmHg) and low values of OPP (<40 mmHg) were associated to an increased risk of confirmed POAG. Conclusion: There is a close relationship between OPP and confirmed glaucoma in hypertensive patients.

Evaluation of cytotoxic activity of docetaxel loaded gold nanoparticles for lung cancer drug delivery

The effective use of the gold nanoparticle (AuNPs) conjugated drugs for targeted drug delivery applications is one of the most promising research areas in the field of cancer. Herein, we aimed to establish a nano drug conjugated with docetaxel as a possible therapy option. Gold nanoparticles were synthesized by chemical reduction method. This is followed by the conjugation with an anticancer drug, docetaxel (Dtx) by a non-covalent method and folic acid (FA) was conjugated by a covalent method. The physicochemical characteristics of the synthesized AuNPs, Dtx and FA were studied by various analytical techniques such as UV-vis spectroscopy (UV-vis), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), Raman spectroscopy, X-ray photoelectron spectroscopy (XPS), field emission scanning electron microscope (FE-SEM) high-resolution transmission electron microscope (HR-TEM) and energy dispersive X-ray spectroscopy (EDS). The surface morphology and microstructure of the synthesized AuNPs and gold conjugates (AuNPs-Dtx-FA) were examined by FESEM and HR-TEM. The average size of the spherical shaped AuNPs was observed in the range of 5-18 nm. XPS and EDS spectra were examined the oxidation state and chemical composition of the synthesized nanoparticles. The cytotoxicity of the synthesized AuNPs nano-conjugates was evaluated by in-vitro studies against lung cancer cell line (H520). The chemical reduction method followed here in the development of AuNPs is a simple and one-step process, which exhibits the excellent binding specificity, biocompatibility and feasible for the large scale up process of the AuNPs.

Genoprotective effects of gallic acid against cisplatin induced genotoxicity in bone marrow cells of mice

Chemotherapeutic drugs are used for the treatment of cancer. However, the use of these drugs is limited due to their side effects on normal cells. One of the measures to detect chemoprotection of plant extracts is to evaluate their anticlastogenic effects. In this study, we report the anticlastogenic effect of gallic acid (GA) against cisplatin (Csp), a chemotherapeutic drug, in Swiss albino mice. Three different doses of GA (100, 200 and 400 mg per kg bw) were administered orally to the experimental animals in 0.2 mL quantity for 5 days at 24 hour intervals. Cisplatin, the positive control agent (10 mg per kg bw), was administered intraperitoneally (i.p.) in 0.1 mL quantity. Overall, the results showed that the pretreatment of GA caused a remarkable decrease in Csp induced micronucleus frequency and DNA damage in bone marrow cells of mice. The results suggest that GA showed potent antigenotoxic effects against Csp induced damage in mice bone marrow cells.

Antigenotoxic effects of a polyherbal drug septilin against the genotoxicity of cyclophosphamide in mice

Septilin (Spt) is a polyherbal drug formulation from Himalaya Drug Company, consisting of extracts from different medicinal plants and minerals. In the traditional system of medicine, septilin is being used as immunomodulatory, antioxidant and anti-inflammatory agent. In the present study, the protective effects of septilin against the genotoxicity of cyclophosphamide (CP) a widely used alkylating anticancer drug was evaluated by using in vivo micronucleus (MN) and sperm shape abnormality assays in Swiss albino mice. CP administered intraperitoneally at a dose of 50 mg/kg b.w. was used as positive mutagen. Different doses of septilin viz., 125, 250 and 500 mg/kg b.w. was orally administered for 5 consecutive days. CP was administered intraperitoneally on 5th day. MN and sperm preparations were made after 24 h and 35 days respectively. CP induced significant MN in both bone marrow and peripheral blood cells and also a high frequency of abnormal sperms. In septilin supplemented animals, no significant induction of MN and abnormal sperms was recorded. In septilin supplemented groups, a dose dependent significant decrease in CP induced clastogenicity was observed. Thus the current in vivo study revealed the antigenotoxic effects of septilin against CP induced damage, in both somatic and germ cells of Swiss albino mice.

Primary peritoneal carcinoma: regional cancer institute experience

Primary peritoneal serous carcinoma (PPSC) is a rare malignancy that arises primarily from peritoneal surface epithelium. However there are limited studies on these tumors even in world literature. To study the clinical, pathologic profile, outcome and prognostic features of PPSC. A 5 year retrospective study of PPSC diagnosed and treated at our centre was conducted. The pathological specimen of PPSC diagnosed from January 2008 to December 2012 were reviewed by gynaeconcopathologists. The diagnosis was based on GOG criteria, complemented with IHC. Majority of the patients underwent upfront de-bulking surgery. Postoperatively, six cycles of combination chemotherapy with paclitaxel (175 mg/m(2)) and carboplatin (AUC 6) was administered every 3 weekly. These patients were analysed for progression free survival (PFS), this was correlated with stage and surgical adequacy. The median age of presentation was 56 years. The total number of ovarian cancers treated during study period was 374. The 30 cases were clinically suspected to have primary peritoneal carcinoma (PPC) on pre- and intra-operatve gross findings, but further evaluation with histopathological examination, IHC and GOG criteria revealed only 10 cases were genuine PPSC. The remaing 20 cases; 13 were found to poorly differentiated ovarian carcinomas, six were primary fallopian tube carcinoma and one was appendicular carcinoma. The 10 (2.7 %) cases of the 374 were eligible for the PPSC analysis. The two (20 %) of the 10 cases had family history of breast and ovarian cancers, two (20 %) cases were diagnosed as abdominal tuberculosis (TB) prior referral to our centre. Radiological presentation includes gross ascites, with omental caking and normal adenexa. The eight (80 %) of 10 cases presented with stage IIIC and other two cases (20 %) with stage IV disease. The eight (80 %) of 10 cases underwent upfront surgery; six (75 %) of these eight cases had optimal cytoreduction, i.e. residual disease (RD) <1 cm or no visible disease (R0) and other two (25 %) suboptimal cytoreduction. The two (20 %) of 10 cases with stage IV disease received neoadjuvant chemotherapy (NACT) followed by interval cytoreduction. After debulking surgery the most useful IHC marker include CK7+, CK20-, CA125+, WT-1+, and GCDFP- . At median follow up of 24 months (range 3-60 months), the median progression free survival (PFS) was 22 months, while the estimated 5 year PFS was 18 %. Stage IV disease and suboptimal surgery had poor outcome. The PPSC presents with advanced stage disease and are observed to be misdiagnosed abdominal TB in tropical countries. The GOG criteria and IHC complement the diagnosis. These have poor outcome despite optimal care, highlighting need for larger studies on this disease.

Role of VEGF and VEGFR2 Receptor in Reversal of ALS-CSF Induced Degeneration of NSC-34 Motor Neuron Cell Line

Vascular endothelial growth factor (VEGF), the well-known angiogenic factor is both neurotrophic and neuroprotective. Altered VEGF signalling is implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS), a fatal degenerative disease of motor neurons. We have shown earlier that VEGF protects NSC-34 motor neuronal cell line, when exposed to cerebrospinal fluid (CSF) from sporadic ALS patients (ALS-CSF). Here, we have investigated the consequences of ALS-CSF and VEGF supplementation on the VEGFR2 receptor and endogenous VEGF expression. ALS-CSF caused significant down-regulation of VEGFR2 as well as the Calbindin-D28K levels, but not endogenous VEGF. Exogenous supplementation restored the depletion of VEGFR2 and Calbindin-D28K with a concomitant up-regulation of endogenous VEGF. The up-regulated caspase 3 in the ALS-CSF group was reinstated to basal levels along with a significant reduction in the number of TUNEL-positive cells. Electron photomicrographs of ALS-CSF-exposed cells divulged presence of cytoplasmic vacuoles alongside severe damage to organelles like mitochondria, endoplasmic reticulum, etc. Substantial recovery of most of the damaged organelles was noted in response to VEGF supplementation. While the enhancement in endogenous VEGF levels highlights the autocrine functions, the up-regulation of VEGFR2 receptor emphasizes the paracrine functions of VEGF in modulating its neuroprotective effect against ALS-CSF. The revival of cellular organellar structure, increased calbindin expression and enhanced survival in response to VEGF supplementation consolidates the opinion that VEGF indeed has a therapeutic potential in sporadic ALS.

Clinical effect of miswak as an adjunct to tooth brushing on gingivitis

Background:

The aim of the study was to clinically evaluate the effect of miswak as an adjunct to tooth brushing on plaque levels and gingival health in subjects diagnosed with mild to moderate chronic generalized marginal gingivitis in comparison with those of toothbrush users.

Materials and Methods:

The study comprised of 30 systemically healthy subjects, aged 18-35 years diagnosed with mild to moderate gingivitis. The study was designed as a randomized, single-blind, parallel-armed study. Subjects were randomly divided into three groups. Group A (toothbrush users), group B (toothbrush and miswak users), and group C (miswak users). Subjects were advised to use toothbrush, miswak, or both, three times daily depending on their respective allocations. Gingival index according to Loe and Silness, Plaque index, according to Turesky modified Quigley-Hein plaque index, and the digital photographs of the total labial surfaces of the teeth were taken for image analysis. Recording of data were done at baseline, 2^nd, 4^th, 6^th, and 8^th week time intervals. Obtained data were analyzed using repeated measure ANOVA and student t test (independent samples).

Results:

Group B showed statistically significant (P<0.0001) decrease in plaque score and gingival score compared to group A and group C, respectively, from 2^nd to 8^th week, whereas no statistical significant difference was found in plaque score, when group A was compared with group C (P>0.05) from 2^nd to 4^th week. Further at the 6^th and 8^th week, there was significant difference (P<0.05) in plaque score between group A and group C. The difference in gingival score was not significant (P<0.05), when group A was compared with group C on all the indicated time intervals.

Conclusion:

Results showed significant improvement in plaque score and gingival health when miswak was used as an adjunct to tooth brushing.