The aim of this study was to investigate the antioxidant activity of Caesalpinia sappan aqueous extract (CE) and its potential on synthesis of silver nanoparticles (AgNPs). The antioxidant activity of CE was investigated using ferric reducing antioxidant power (FRAP) assay and two radical scavenging methods using 2,20-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS) and 1,1-diphenyl-2-picrylhydrazyl (DPPH) as free radicals. Silver nitrate (AgNO3) was used as precursor for the synthesis of AgNPs. Effects of AgNO3 concentration, reaction temperature, and duration of reaction were investigated. The obtained AgNPs was characterized using UV-Vis and photon correlation spectrophotometers. The antimicrobial activity of AgNPs was studied by means of diffusion method. The results from FRAP demonstrated that CE had high reducing property of 78.7 ± 2.4 mM Fe2+/mg. The trolox equivalent antioxidant capacity of CE determined by ABTS was 64.8 ± 4.2 µM/mg. The concentration of CE that can inhibit 50% of DPPH radicals (IC50) was 51.2 ± 3.2 µM. These results indicated that CE possesses strong antioxidant and reducing activities. The present study also showed that CE can act as reducing agent to produce AgNPs. The concentration of AgNO3, reaction temperature, and reaction time play an important role on the particles size and zeta potential of the obtained AgNPs. The antimicrobial activity of the AgNPs against Escherichia coli, Candida albicans, and Streptococcus mutants was stronger than against Staphylococcus aureus.
In the present study, three different rice varieties; Jasmine (JM), Niaw Koko-6 (NKK), and Saohai (SH) were determined for reducing power using ferric reducing antioxidant power (FRAP) assay. SH showed the highest reducing property followed by JM and NKK, respectively. All modified rice samples were used to fabricate silver nanoparticles (AgNPs) by reducing silver nitrate (AgNO3) to metallic Ag. The obtained AgNPs from JM, NKK, and SH namely JM-AgNPs, NKK-AgNPs, and SH-AgNPs, respectively, showed maximum absorption at 410, 408, and 409 nm, respectively, which confirmed the spectra of AgNPs. Reaction parameters such as AgNO3 and modified rice concentration as well as the reaction period were investigated. It was found that increasing of these parameters gave better AgNPs until the concentration of modified rice and AgNO3 reached to 0.3% and 10 mM, respectively and the reaction period reached to 60 min, the most suitable AgNPs were obtained. Among the three rice varieties, SH showed the most potential for synthesis of AgNPs. SH-AgNPs showed the smallest size of 80.4 ± 2.8 nm and the highest zeta potential of – 45.9 ± 1.4 mV. The AgNPs obtained from all three rice varieties showed effective against Escherichia coli than Staphylococcus aureus and SH-AgNPs showed significantly higher antibacterial activity than JM- AgNPs and NKK-AgNPs.
In the present study, the modified white rice of Jasmine (JM) and Saohai (SH) were used to prepare the rice gels. Carbamide peroxide (CP) containing rice gels (CP rice gels) of JM (CP-JM) and SH (CP-SH) were prepared. The rice gels and CP rice gels show homogenous texture. Rice variety influences the characteristics and properties of the rice gels. Amylose content of JM was lower than SH. Rheological behavior of JM and CP-JM was pseudoplastic without thixotropy whereas that of SH and CP-SH was pseudoplastic with thixotropy. CP-SH showed higher adhesive property and viscosity than CP-JM whereas CP-JM showed faster in vitro drug release than CP-SH. For ex vivo efficacy evaluation, 55 normal human teeth were subjected to the CP rice gels. Samples were applied on tooth surface according to the dental bleaching techniques. For at-home bleaching technique, the CP rice gels with 10% and 20% CP were used with bleaching time of 8h and 4h, respectively. For in-office bleaching technique, the CP rice gels with 35% CP was used with bleaching time of 1 h. The developed CP rice gels showed significantly higher efficacy than the positive and negative controls. For at-home bleaching technique, CP-SH was the most effective gels whereas for in-office bleaching technique, CP-JM was the most effective gels.
The Japanese government actively urges pharmacists to support efforts to reduce surplus medicines. However, these activities currently serve only to dispose of surplus medicines; no measures are being taken to fundamentally prevent the accumulation of surplus medicines from the outset. A deep understanding of patients' views about storing medicines at home and how they might be accumulating surplus medicines would contribute to the prevention of surplus accumulation. This study aimed to characterize the process by which elderly chronic disease patients in Japan accumulate surplus medicines. Semi-structured interviews were conducted with 18 elderly patients, and the interview data were analyzed using a modified grounded theory approach (M-GTA) to present the process by which surplus medicines were accumulated at patients' homes. The results suggest that elderly patients with chronic diseases often wish to avoid unnecessary medications because of anxiety about medicines, and that these patients seek to maximize medicine suppression. In this context, patients use their own judgment to decide whether to use medicines as needed. Additionally, when patients accumulate surplus medicines, they hesitate to throw them away because they feel that to do so is mottainai (wasteful), or because they accumulate surplus medicines as emergency household medicines. These findings reveal when and how surplus medicine accumulation occurs and the points at which pharmacists can easily intervene to promote a close relationship with patients.
Gnotobiotic animals are useful for investigation of the effects of specific lactic acid bacteria on individual animals. Here we report that lactic acid bacteria colonize and proliferate in the intestinal tract of germ-free silkworms. When silkworms hatching from formalin-treated eggs were reared to fifth-instar larvae with an artificial diet containing antibiotics, bacteria and fungi were not observed in their intestines. An antibiotic-free diet supplemented with viable lactic acid bacteria, such as Enterococcus faecalis 0831-07, Lactococcus lactis 11/19-B1, or Leuconostoc carnosum #7-2, was fed to the germ-free silkworms for 1 day. After feeding the larvae on a diet without lactic acid bacteria for 5 days, each type of lactic acid bacterium was found in the intestine. Moreover, an increase in the number of Enterococcus faecalis 0831-07 was observed in the intestine 2-5 days after ingestion. These findings suggest that we successfully established a method to construct a gnotobiotic silkworm model.
Non-nucleoside reverse transcriptase inhibitors (NNRTIs) are the backbone of effective anti-retroviral therapy in the developing world. Efavirenz is the current NNRTI of choice due to reports of higher incidence of serious adverse events with nevirapine. Majority of patients with Human immunodeficiency virus (HIV) infection in India are still on nevirapine based therapy. The aim of the study was to evaluate the need of shifting these patients to efavirenz based therapy. A cross-sectional study was conducted on adult patients, who were on NNRTI based regimen for more than one year with good adherence. The patients were divided into efavirenz or nevirapine groups based on the treatments they were receiving at the time of study. The different arms were compared based on their clinical and laboratory profile, adverse events and immunological response. A total of 244 patients were recruited. A total of 125 patients were receiving nevirapine based regimen while 119 patients were receiving efavirenz based regimen. There was no significant difference in the frequency of hematological and biochemical derangements between the two groups. There was no difference in the median highest CD4 count achieved during therapy between the two groups. Clinically observed side effects were more common in the efavirenz group. These results suggest that there isn't enough evidence to shift patients tolerating long term nevirapine based therapy to efavirenz based therapy.
Iron overload is implicated in many disorders in the body such as heart failure, liver cirrhosis and fibrosis, gallbladder disorders, diabetes, arthritis, depression, infertility, and cancer. Even though synthetic chelating agents are available, they have several limitations such as poor oral bioavailability, short plasma half-life, high cost and numerous side effects. Therefore, the aim of this study is using agricultural residues as sources for alternative efficient, benign, and economic iron chelators of natural origin. Eighteen agricultural residues were screened for iron chelating activity using 2, 2'-bipyridyl assay. The results showed that the extract of Mangifera indica leaves had the highest iron chelation activity (69.7%), in comparison to ethylenediaminetetraacetic acid (EDTA) (70.3%) (standard iron chelator). The M. indica leaves extract was further investigated for its flavonoidcontent, phenolic content and antioxidant activity. The high concentration of phenolic (405.5µg/g expressed as gallic acid equivalent) and flavonoid (336.9 µg/g expressed as quercetin equivalent) phytochemicals in the extract, as well as its significant antioxidant capacity (96.95%) compared to ascorbic acid (91.90%) (standard antioxidant agent), suggested that the M. indica leaves could represent a good source for new iron chelating agents in iron overload disorders.
We described fecal retention during the defecation cycles of adults with functional constipation via ultrasonography (US) of the large intestine. US was performed continuously after the last defecation until the next defecation. We defined the fecal finding level on US as follows: weak fecal retention, a marginally high echo in the colonic lumen; or strong fecal retention, a strongly echoic colon lumen with showing a crescent-shaped acoustic shadow on transverse images and haustrations on longitudinal images. The findings confirmed weak fecal retention in the colon throughout the defecation cycle and a pattern of strong fecal retention in the descending and sigmoid colon and over the colon, including the transverse colon and ascending colon, in patients with functional constipation.
Esophageal variceal bleeding is a common lethal complication of cirrhosis. Endoscopic injection sclerotherapy (EIS) is one of the major endoscopic approaches for treating esophageal variceal bleeding. However, complications may occur after EIS, which mainly include retrosternal discomfort/pain, dysphagia, re-bleeding, esophageal ulcer, esophageal strictures, and esophageal perforation, etc. In this article, we reported a 36-year-old male who developed esophageal ulcer related bleeding after EIS. Currently, there is no consensus on the treatment strategy for esophageal ulcer-related bleeding after EIS. In the present case, the following treatment strategy may be effective for ulcer related bleeding. The first step is to inhibit gastric acid secretion and reduce portal pressure by intravenous infusion of esomeprazole and somatostatin, respectively. The second is local hemostasis by oral norepinephrine and lyophilizing thrombin powder. The third is to protect digestive tract mucosa by oral Kangfuxin Ye and aluminum phosphate.
Statins can cause a wide spectrum of muscular adverse effects ranging from asymptomatic elevation of Creatine Kinase (CK), myalgia and exercise intolerance to rhabdomyolysis. Most of these effects generally resolve on stopping the medication. However, statins can be associated with a unique autoimmune myopathy wherein symptoms persist or even progress after statin discontinuation and require immunosuppressive therapy. The case presented is a 60-year-old woman who was on statin treatment for a period of 2 years. She developed muscle weakness with a limb girdle distribution. She had persistent elevation of CK even after discontinuation of statin therapy. EMG done revealed irritable myopathy and muscle biopsy showed necrosis without inflammation. She subsequently tested positive for anti-3-hydroxy-3-methylglutaryl-coenzyme A (anti-HMG CoA) antibody which is found to be present in patients with statin-associated necrotizing autoimmune myopathy. Patient was started on steroid without much improvement in her symptoms. After a month of follow up, her upper extremity strength was back but lower extremity continued to be weak which prompted us to start her on Methotrexate and Azathioprine. Like our patient, there are rare subgroup of patients with an immune-mediated necrotizing myopathy that does not improve after discontinuation of the drug and requires aggressive treatment with immunosuppressive agents. Awareness and early recognition of this disease is very important in patients who continue to have CK elevation and weakness after discontinuation of statin therapy.