Development and optimization of Clitoria teratea synthesized silver nanoparticles and its application to nanogel systems for wound healing

OBJECTIVE

The present research deals with sequential optimization strategy based on Central Composite Design to optimize the process variables for efficient production of Clitoria teratea (CLT) synthesized silver nanoparticles (AgNPs) using biological synthesis.

METHODS

Two substantial factors influencing the dependent variables viz UV-visible absorbance, particle size, zeta potential and polydispersity index (PDI) were identified as NaOH concentration, RH concentration, temperature as independent variables. In-vitro and ex-vivo studies of prepared CLT-AgNPs gel and marketed gel were carried out using dialysis membrane and egg membrane, respectively. In addition, antimicrobial study was also performed on the bacterial strains.

RESULTS

The particles size (114 nm), PDI (0.45), and zeta potential (-29.5 mV) of optimized formulation were found, respectively. In-vitro profile of AgNPs from prepared CLT-AgNPs gel was noted (95.6%) in 8 h. It was found that the prepared CLT-AgNPs gel stimulates fibroblast and agranulocytosis development resulting better and timely wound healing.

CONCLUSIONS

The prepared CLT-AgNPs gel can be as a potential substitute in the management and treatment of acute and chronic wounds.

Conjugates of amphotericin B to resolve challenges associated with its delivery

INTRODUCTION

Amphotericin B (AmB), a promising antifungal and antileishmanial drug, acts on the membrane of microorganisms. The clinical use of AmB is limited due to issues associated with its delivery including poor solubility and bioavailability, instability in acidic media, poor intestinal permeability, dose and aggregation state dependent toxicity, parenteral administration, and requirement of cold chain for transport and storage, etc.

AREAS COVERED

Scientists have formulated and explored various covalent conjugates of AmB to reduce its toxicity with increase in solubility, oral bioavailability, and payload or loading of AmB by using various polymers, lipids, carbon-based nanocarriers, metallic nanoparticles, and vesicular carriers, etc. In this article, we have reviewed various conjugates of AmB with polymers and nanomaterials explored for its delivery to give a deep insight regarding further exploration in future.

EXPERT OPINION

Covalent conjugates of AmB have been investigated by scientists, and preliminary in vitro and animal investigations have given successful results, which are required to be validated further with systematic investigation on safety and therapeutic efficacy in animals followed by clinical trials.

Stepping into small shoes: Gaining user perspective on appropriate administration devices for paediatric medication in India

A cross sectional pan-India study about use of administration devices for paediatric oral and inhalation medicines was conducted with a diverse pool of participants of various age groups. Via 634 respondents from more than 15 states in India, this study has identified the administration devices commonly used by parents/caregivers for children 0 to 18 years and by children over 10 years. It has provided insights on device ease of use, challenges faced and recommendations to facilitate the correct use of administration devices for paediatric oral and inhalation medicines. Ethics approval (DPSRU-BREC/2020/A/008)) was obtained from the Biomedical Research Ethics Committee of Delhi Pharmaceutical Sciences and Research University. The survey was completed by parents only (n = 514) and jointly by both parents and children (n = 120). The mean age of the child was 7.2 ± 4.96 years. 72% of the respondents reported that an oral medicine had been taken recently, 6.3% reported that an inhaled medicine had been taken and the remaining 21.9% reported that both an oral and inhaled medicine had been taken. The use of measuring cup was most prevalent followed by household spoons. The mean of the score for ease of use was found to be highest 4.6 ± 0.50 for oral syringe and lowest (3.8 ± 0.76) for measuring cups. The majority of them found the oral device easy to use. Difficulties were reported mostly for measuring cups and household spoons and were related to a lack of user instructions and measuring difficulties. The respondents who found the device easy to use had mostly received clear instructions from healthcare professionals. Compared to oral devices, there were very limited responses for inhalation devices (n = 175/634). Nebulisers with facemasks were most frequently used followed by manually actuated Metered dose inhalers with and without spacer. The mean of the ease-of-use score for dry powder inhalers was found to be highest (4.2 ± 0.37) followed by mist inhalers (4.0 ± 0) and manually actuated pressurised metered dose inhalers (4.0 ± 0.71). The nebulisers with facemask were reported to be difficult to use by most of the respondents despite receiving clear instructions from healthcare professionals. The study findings add evidence to the understudied area of user experiences and perspectives on administration devices for oral and inhalation medicines in India. It highlights a need for initiatives to improve the usability, availability, and affordability of administration devices for children in India. Awareness on the importance of proper use of devices needs to be raised and sustained about the existence of affordable administration devices.

Nanotheranostics for Diagnosis and Treatment of Breast Cancer

Abstract:

Recently, breast cancer has reached the highest incident rate amongst all the reported cancers, and one of its variants, known as triple-negative breast cancer (TNBC), is deadlier compared to the other types of breast cancer due to a lack of feasible diagnostic techniques. Advancements in nanotechnology have paved the way to formulate several nanocarriers with the ability to deliver anticancer drugs effectively and selectively to cancer cells with minimum side effects to non-cancerous cells. Nanotheranostics is a novel approach that can be used in the diagnosis of disease along with therapeutic effects. Currently, various imaging agents, such as organic dyes, radioactive agents, upconversion nanoparticles, various contrasting agents, quantum dots, etc., are being explored for the imaging of internal organs or to examine drug distribution. Furthermore, ligand-targeted nanocarriers, which have the potential to target cancer sites, are being used as advanced agents for cancer theranostic applications, including the identification of various metastatic sites of the cancerous tumor. This review article discusses the need for theranostic application in breast cancer with various imaging techniques, the latest nanotheranostic carriers in breast cancer, and related safety and toxicity issues, as well as highlights the importance of nanotheranostics in breast cancer, which could be helpful in deciphering questions related to nanotheranostic systems.

Patient satisfaction with access, affordability and quality of diabetes care at Mohalla Clinics in Delhi, India

Introduction

Mohalla Clinics have been set up to provide curative care for minor ailments free of cost within walking distance in the urban slums, thus making primary care more accessible and affordable. Studies evaluating patient satisfaction with treatment of chronic conditions, such as diabetes, in these clinics are lacking.

Methods

A survey of 400 type 2 diabetes patients was conducted, split equally between Mohalla clinics (MC) and Private clinics (PC) in Delhi. Responses were analyzed using STATA17, applying appropriate statistical tests for the data type (Chi-square test, Mann-Whitney U test, Wilcoxon signed rank test, or two-sample t test).

Results

Satisfaction level was high in both groups with no significant difference between mean satisfaction scores of MC patients and PC patients (Mean 3.79 vs. 3.85 respectively, p = 0.4). However, MC patients reported a significant improvement in their satisfaction score after switching to MC (Mean 3.79 vs. 3.3 for the previous facility, p < 0.05). Physician interaction with the patients was the most important factor in influencing the satisfaction score. Proximity to the clinic was the second most important factor for MC patients but was not as important for PC patients. Surprisingly, treatment success was considered an important factor for satisfaction level by < 10% MC and < 20% PC patients only, pointing to the need for patient education across both the groups. None of the MC patients mentioned free treatment as a contributory factor to high satisfaction, perhaps because most shifted from a government setup to MC. PC patients had more frequent follow-up visits and blood glucose monitoring, and longer consultation duration compared to MC patients, which were offset by access factors, thus not causing much difference to the satisfaction score between the two groups.

Conclusion

Mohalla clinics are making diabetes treatment accessible and affordable for the marginalized population of Delhi, despite not being designed or fully equipped to care for chronic diseases such as diabetes that require multi-specialty care to monitor and manage multiple co-morbidities and long-term complications. Positive perception of physician interaction and convenient location of the clinics are the two major contributors to the high satisfaction patients expressed with diabetes care at these clinics.

Quercetin loaded silver nanoparticles in hydrogel matrices for diabetic wound healing

Quercetin (QCT) is an effective antioxidant, antifibrotic and wound healing agent. Silver nanoparticles (AgNPs) are an effective antimicrobial, antifungal and wound healing agent and considered as gold standard for wound treatment especially diabetic and burn wounds. The present study aimed to investigate QCT loaded AgNPs in hydrogel matrices (QCT-AgNPs hydrogel) as synergistic treatment paradigms for diabetic wound. Quality by Design approach was employed for the optimization of hydrogel preparation using carbopol-934 andaloevera.The developed QCT-AgNPs hydrogel was characterized for hydrodynamic diameter, %entrapment efficiency (%EE), surface morphology, texture analysis,in-vitrodrug release, skin irritation study,ex-vivopermeation study (confocal study), and antimicrobial efficacy. The optimized formulation showed hydrodynamic diameter of ∼44.1 nm with smooth spherical surface morphology and ∼92.09% of QCT was entrapped in QCT-AgNPs hydrogel matrices. The antimicrobial study revealed superior therapeutic efficacy of QCT-AgNPs hydrogel in comparison to marketed (MRKT) gel onS. aureusandE. coli. Moreover,in-vivoresults demonstrated that QCT-AgNPs hydrogel significantly (p < 0.001) reduced the wound gap and increased % re-epithelialization compared with diabetic control after 18 d of post treatment in excisional diabetic wound model. In conclusion, this study opens up an avenue for the treatment of diabetic wound.

Intranasal solid lipid nanoparticles for management of pain: A full factorial design approach, characterization & Gamma Scintigraphy

Pain is a noxious stimulus caused due to tissue damage and varies from mild to severe. Nalbuphine (NLB) is an approved, inexpensive, non-controlled, opioid agonist/antagonist analgesic used worldwide in various clinical settings for pain management. The current study aims to formulate NLB loaded solid lipid nanoparticles (SLNs) using solvent injection technology. The morphological and chemical structure of the developed SLNs were characterized using Field Emission Scanning Electron Microscopy (FESEM), Transmission Electron Microscopy (TEM) and Fourier Transformation Infrared Spectroscopy (FTIR). The results revealed from the point prediction confirmation in design expert software was the formulation of NLB-SLNs with an average particle size of (170.07 ± 25.1 nm), encapsulation efficiency (93.6 ± 1.5%) & loading capacity of 26.67%. The in-vitro permeation of developed NLB-SLNs was observed to be 94.18% at 8 h when compared with NLB solution whose maximum permeation was seen within 3 h of application. Efficacy of the formulation was also evaluated using eddy's hot plate method, where the onset of action started within 10 min of administration, and the maximum effect was observed at 1 h. The NLB-SLNs was screened for cytotoxicity in human embryonic kidney cells (HEK-293), and the dosage was considered safe when administered intranasally in animal since no detectable effect to the brain was observed. Biodistribution and gamma scintigraphy study of NLB-SLNs showed the prepared formulation reaching the target site, i.e. brain and was retained. Conclusively, the prepared NLB-SLNs formulation was safe and effective in producing an analgesic effect in vivo.

Floquet spin states in OLEDs

Electron and hole spins in organic light-emitting diodes constitute prototypical two-level systems for the exploration of the ultrastrong-drive regime of light-matter interactions. Floquet solutions to the time-dependent Hamiltonian of pairs of electron and hole spins reveal that, under non-perturbative resonant drive, when spin-Rabi frequencies become comparable to the Larmor frequencies, hybrid light-matter states emerge that enable dipole-forbidden multi-quantum transitions at integer and fractional g-factors. To probe these phenomena experimentally, we develop an electrically detected magnetic-resonance experiment supporting oscillating driving fields comparable in amplitude to the static field defining the Zeeman splitting; and an organic semiconductor characterized by minimal local hyperfine fields allowing the non-perturbative light-matter interactions to be resolved. The experimental confirmation of the predicted Floquet states under strong-drive conditions demonstrates the presence of hybrid light-matter spin excitations at room temperature. These dressed states are insensitive to power broadening, display Bloch-Siegert-like shifts, and are suggestive of long spin coherence times, implying potential applicability for quantum sensing.

Submental nalbuphine exhibits improved efficacy in ameliorating acute pain in prehospital emergent conditions; a comparative study with conventional intramuscular using gamma scintigraphy

BACKGROUND

Nalbuphine (NLB) is a kappa-agonist and mu-partial antagonist, widely used for opioid withdrawal de-addiction, opioid-induced pruritis and as emergent analgesia.

OBJECTIVE

The present study aimed to assess the safety and efficacy of NLB in pain sensitization, through a submental route so as to provide faster management in emergent situations.

MATERIALS & METHODS

In-vivo efficacy and safety studies of NLB-submental injection were assessed in Sprague-Dawley(SD) rats. For eddy's hot plate study, animals were allocated into three groups, the first group served as normal control; group II received NLB (through submental route at 1.2 mg/kg); group III received NLB (through intramuscular route at 1.2 mg/kg). Response latency (in terms of response latency) was measured at 10, 30 & 60 min in all the experimental groups. Safety studies were carried out according to OECD 423. In-vitro release study was conducted using a cellulose dialysis membrane (12,000 KDa). The biodistribution and release kinetics studies were carried out using gamma scintigraphy studies in New Zealand rabbits and humans respectively.

RESULTS

The response latency of NLB from the submental route was found to be 7.17 (SD 1.47) seconds and in the case of the intramuscular route it was calculated as 4.00 (SD 1.26) seconds at 10 min. The data depicts the better efficacy of submental injection in ameliorating pain than the intramuscular injection. Toxicity studies predict the safe profile through a submental route. The release kinetics in humans of submental NLB was 46% faster as compared to the intramuscular site of injection. The NLB injection through both routes was compared by non-invasive gamma scintigraphy technique and we found that submental injection has faster (within 10 min) onset of action & distributes rapidly.

CONCLUSION

The submental route of NLB is faster, more efficacious than the intramuscular route. Thus, we conclude that in the case of emergent scenarios (i.v or i.m. route is compromised), where immediate relief is necessary, the submental route is a preferred choice.

A comprehensive review on Citrus aurantifolia essential oil: its phytochemistry and pharmacological aspects

Citrus essential oil, commonly, known as lime oil, has been widely reported in traditional system of medicine. Industrially, oil is isolated by mainly by hydrodistillation from fruit and peel of Citrus aurantifolia, family, Rutaceae. Cultivation practice of citrus plants dates back for over 4000 years and are one of most valuable fruit crops in the world. In this review, we aim to summarise the phytochemical and biological properties of citrus oil. The literature was collected from various online resources such as e journals, books and magazines. The citrus essential oil is globally used in food industry to impart citric flavour and odour to cuisines. Llime juice and oil is known to possess multiple biological properties including anti-cancer, antimicrobial, antioxidant, antiulcer, anti-inflammatory, hypolipidemic, antityphoid and hepatoprotective properties. Due to potent antibacterial and antifungal properties, citrus oil is becoming important component of skin care products. The medicinal importance of plant is due to presence of various secondary metabolites, alkaloids, carotenoids, coumarins, essential oils, flavonoids, phenolic acids, and triterpenoids. The citrus oil is rich in aromatic compounds namely, monoterpenes and their derivatives, aldehydes, ketones, esters, alcohols such as limonene (58.4%), β-pinene (15.4%), γ-terpinene (8.5%), citral (4.4%) and others. The bitter taste and aroma of citrus fruit peels is attributed to limonoids. p-caryophyllene constitute 5.7% of all the sesquiterpenes. On the basis of the available information, we conclude that citrus oil possess huge potential to be developed into pharmaceutical products.

Luliconazole-Loaded Thermosensitive Hydrogel as Aqueous based Nail Lacquer for the Treatment of Onychomycosis

Background:

Onychomycosis is a nail fungal infection which accounts for 50% of the nail diseases and is characterized by disfigurement and discoloration of nails. The current therapy includes oral and topical formulations both of which come with their own drawbacks. This has left a room for developing patient- compliant novel strategies which can facilitate drug delivery deeper into the nails effectively.

Objective:

The main objective of the present work was to develop and evaluate in situ gelling thermosensitive hydrogel as an aqueous nail lacquer for the treatment of onychomycosis. The idea was to enhance permeation of Luliconazole into the nail while simultaneously solubilizing it in a hydrophilic formulation.

Methods:

The sample of Luliconazole was authenticated using modern analytical techniques. The hydrogel- nail lacquer was prepared using poloxamer Pluronic F127. The formulation was evaluated in terms of drying time, viscosity, non- volatile content, pH, transition temperature, etc. In vitro study was done to check the drug release while determining release kinetics. In vitro transungual permeation study was done to check drug permeation through porcine hoof membrane. Stability studies were conducted to ensure formulation stability.

Results:

The results confirmed a stable formulation with enhanced permeation through porcine hoof membrane.

Conclusion:

The results support the potential use of in situ gelling thermo-sensitive hydrogels as a novel transungual formulation in the treatment of onychomycosis with a slight improvement in water resistance.

Novel Drug Delivery Strategies for the Treatment of Onychomycosis

Onychomycosis accounts for 50% of all nail disease cases and is commonly caused by dermatophytes. It was primarily considered a cosmetic problem but has been garnering attention lately due to its persistent nature and difficult treatment with relapses. With prolonged treatment duration and high cost involved in treating onychomycosis, several attempts have been made in overcoming the rigid nail barrier. The conventional treatment of onychomy-cosis involves oral and topical therapy. The oral antifungal agents though quite effective, are hepato-toxic and cause drug-drug interactions. Topical therapy is more patient compliant being devoid of such adverse effects but it suffers from another setback of improper nail penetration. Amorolfine and ciclopirox nail lacquers are popular market products. Since decades, efforts have been made to enhance topical delivery for efficiently treating ony-chomycosis. Mechanical, physical and chemical methods have been em-ployed. Despite all the attempts made, the nail delivery issues are far from be-ing solved. Recently, the focus has shifted to novel drug delivery systems like nanoparticles, microemulsions, polymeric films and nail lacquers for en-hanced drug permeation and localized therapy. The research around the world is exploring their potential as effective treatment options. This review intends to further explore the novel delivery strategies to treat a persistent fungal in-fection like onychomycosis.

A Comparative Study of Chitosan Gel and Soframycin in the Management of Wounds

Wounds and related injuries remain a major cause of death and disability. Healing of wound is a complex, highly regulated process that includes cellular, molecular, biochemical, and physiological events that permit living organisms to repair accidental lesions. Therefore, dealing with wounds has always been a subject of concern to the world, and demand for products in wound management had increased to $9.3 trillion worldwide in the health care industry, affecting economic growth. The present work aimed to assess the wound healing effect of chitosan, and a comparative profile with soframycin is established in experimental animals. Enormous research reports, the wound healing properties of chitosan, but the protective mechanism implicated in wound healing activity of chitosan is unknown. In addition to this, we evaluated the anatomical, macroscopical, and histopathological alterations in wounds of experimental rats. Collagenase activity was performed to determine the granulation tissue formation and epithelialization of wounds treated with untainted chitosan. Wounds treated with glycerated chitosan gel, that is, GCG-3 (high degree of deacetylation), showed faster healing with highest percentage of contraction as compared with the soframycin-treated group. The healing of wounds was found to be 85% in GCG-3 on the sixth day of treatment, showing significant ( P < .001) improvement in epithelial tissue. The collagenase activity in GCG-3 was 192 unit/mg of protein. Wound reepithelialization was found to be to 94 ± 4% in case of the GCG-3-treated group and 87 ± 5% in the soframycin-treated group. Higher degree of deacetylation in the chitosan, GCG-3, warrants its use in the treatment and management of dermal wounds.

Diabetes mellitus treatment using herbal drugs

<p>Diabetes mellitus is becoming a common metabolic disorder which has serious threat to public health in the world. There are chemicals and biochemical agent that helps in controlling diabetes but there is no permanent remedy available which helps to get recovered completely from this disorder. By conducting large number of research work, numerous traditional medicines have been found for diabetes. Substances and extracts isolated from different natural resources especially plants have always been a rich arsenal for controlling and treating diabetes problem and complication arising due to it. So this review helps the reader to understand the importance of various types of herbal and polyherbal formulations present traditionally which can be used to treat diabetes mellitus. </p>