Application of biodegradable collagen matrix (Ologen™) implants in Dacryocystorhinostomy surgeries, a randomized clinical study

Abstract Background To introduce and evaluate the application of Ologen implants in external Dacryocystorhinostomy (DCR) Surgeries. Methods Prospective comparative randomized study was carried out on 60 patients coming to ophthalmology department, Menoufia University Hospitals. Patients included were suffering from primary acquired nasolacrimal duct obstruction with positive regurge test. Patients were randomly enrolled into two groups using alternating choice technique. Group A included 30 patients who had DCR surgery to treat the obstruction with Silicone tubes. Group B included 30 patients had a Dacryocystorhinostomy with Silicone tubes and Ologen implants. Results Success rates as regard to relief of symptomatic epiphora were 86.7% in group A and 96.7% in group B and time of dye clearance test was 4.5 ± 0.6 min in group A and 3.9 ± 0.4 min in group B with p value 0.353 &0.001 consecutively. Apart from immediate mild post operative hemorrhage that was encountered in 2 cases in group B and 1 case in group A, there were no significant complications in both groups. Conclusion The current study shows that application of Ologen implants in external DCR surgeries may improve symptomatic epiphora without exposing the patients to more intra-operative or post-operative complications. To the best of our knowledge, the current study is the first one to use Ologen implants in external DCR surgeries. However, the follow-up period was relatively short and the sample size is relatively small and further work is required to verify the effect of Ologen in external DCR surgeries. Trial registration Current Controlled Trials PACTR201711002809215, and the date of registration is 29 November 2017. The trial is Retrospectively registered

Phytol/Phytanic acid and insulin resistance: potential role of phytanic acid proven by docking simulation and modulation of biochemical alterations.

Since activation of PPARγ is the main target for the antidiabetic effect of TZDs, especially when it heterodimerizes with RXR, we aimed to test the potential antidiabetic effect of phytol (250 mg/kg), the natural precursor of phytanic acid, a RXR ligand and/or pioglitazone (5 mg/kg) to diabetic insulin-resistant rats. Regarding the molecular docking simulation on PPARγ, phytanic acid, rather than phytol, showed a binding mode that mimics the crystal orientation of rosiglitazone and pioglitazone, forming H bonds with the same amino acids (S289, H 323, H 449 and Y 473), and the least energy level, which emphasizes their importance for PPARγ molecular recognition, activation, hence antidiabetic activity. In addition, docking on the RXRα/PPARγ heterodimer, revealed that phytanic acid has higher binding affinity and lesser energy score on RXRα, compared to the original ligand, retinoic acid. Phytanic acid binds by 3H bonds and shares retinoic acid in arginine (R 316). These results were further supported biochemically, where oral phytol and/or pioglitazone (5 mg/kg) improved significantly glucose homeostasis, lipid panel, raised serum adiponectin level and lowered TNF-α, reaching in most cases the effect of the 10 mg/kg pioglitazone. The study concluded that the insulin sensitizing/anti-diabetic effect of phytol is mediated by partly from activation of nuclear receptors and heterodimerization of RXR with PPARγ by phytanic acid

Effect of diabetes (DV) and different oral drug regimens on the serum lipid profile.

<p>Effect of diabetes (DV) and different oral drug regimens, viz., phytol (DP_h, 250 mg/kg); pioglitazone (DP₅, 5 mg/kg); pioglitazone (DP₁₀, 10 mg/kg); phytol and pioglitazone (DP_hP₅); on serum levels of triglycerides, total cholesterol, LDL-C, HDL-C, ALT and TC/HDL ratio (mean of 7 animals ± S.D). As compared with non-diabetic [ND] (*) and diabetic [DV] (#) groups using one way ANOVA followed by Tukey post hoc test, <i>P</i><0.05. (^Ο) Significant interaction when P_h and P₅ were combined using Factorial Design.</p