The Potential Contribution of Nanoparticles in the Treatment of Inflammatory Diseases

The scope of this chapter is to review the significant effect that nanomedicine has had in the treatment of inflammatory diseases. Nanotechnology has been widely studied in the last decade and proved to be an encouraging strategy in the healthcare system and the medical field. This novel technology provides a vast number of nanomaterials and tools that could actually diagnose and treat different inflammatory disorders and conditions. An enormous amount of in vivo and in vitro research was conducted by many groups to validate the positive contribution that nanoparticles have in regard to the treatment of inflammation and its associated illnesses. This contribution is due to the fact that nanoparticles could be modulated to pass through metabolic barriers and specifically targeted to deliver drugs to the required sites without affecting healthy cells and tissues. This makes them a promising therapeutical choice for the treatment of inflammatory diseases in the future

BIOAVAILABILITY STUDY OF ONDANSETRON GEL IN RABBITS AND HUMAN VOLUNTEERS APPLING UPLC AS ANALYTICAL TOOL AND EVALUATION OF THE ANTIEMETIC EFFECT OF ONDANSETRON GEL IN CISPLATIN-INDUCED EMESIS IN RATS

Objective: This study was undertaken to determine the bioavailability of ondansetron gel in experimental animals and humans applying UPLC as an analytical tool and evaluation of the antiemetic effect of ondansetron gel in cisplatin-induced emesis in rats. Methods: Ondansetron gel (F13: sodium alginate 7% w/w) was used, marketed I. V. ondansetron (Zofran) ® was chosen as reference. The bioavailability study in rabbits was selected as a parallel design using nine healthy rabbits divided into three groups whereas, bioavailability study in humans was an open-label, wherein 6 healthy subjects administered ondansetron gel. The potential effect of ondansetron gel was evaluated for the prevention of different phases of emesis motivated by exposure to antineoplastic drugs (cisplatin) by determination of body weight loss, water and food intake applying kaolin-pica model in rats using seventy-two rats divided into six groups. Results: Ondansetron gel (0.5%) showed detectable plasma concentration 22.833±2.17 ng/m1 after ¼ h and 419.55±2.17 ng/ml after 1-h post-treatment in rabbits and human respectively and concentration was maintained above-reported minimum effective concentration for more than 2.5 h for rabbits and 7 h for humans compared to 1.75 h after I. V. administration. The ondansetron gel significantly reduces all phases of cisplatin-induced emesis and a decrease in body weight, water, and food consumption was significantly attenuated. Conclusion: Based on the high efficacy of gel on emesis induced by cisplatin, and its high bioavailability, transdermal ondansetron gel could be a promising convenient system to prevent nausea and vomiting following administration of antineoplastic drugs

EVALUATION OF PERFORMANCE OF DAMASCUS GOAT AND ITS CROSSES WITH EGYPTIAN BALADI AND BARKI

A total of 3108 records on conception rate (CR) and 2123 on litter size (LS) were used in this study. CR data represented 1600 Damascus (D) does, 201 Barki (BR) does, 229 Baladi (BL) does and 1070 crossbred does between D and each of BR and BL, while LS represented  1070 D does, 128 BR does, 145 BL does and 775 crossbred does.  These records were used to study the effect of crossing and other fixed effects and to estimate heritability of these two traits in the Damascus goats. Statistical models included varying combination of the fixed effects of station, genotypes within station, year of mating, month of mating, and parity and the random effect of animal nested within station, genotype, year of mating   and month of mating. Variance and covariance components for Damascus data were estimated through the Gibbs Sampling technique using a model that included the fixed effects of station, year and month of mating and parity, and the random effects of doe additive genetics and permanent environmental. CR mean in different analyses ranged from 0.39 to 0.63. Damascus, with a range of CR of 0.48 to 0.63, surpassed both local breeds (ranging from 0.33 to 0.58) and was close to the crossbreds that ranged between 0.34 and 0.68.  LS mean ranged from 1.26 to 1.50 in different analyses. Baladi scored the highest in LS (1.49). Damascus ranged from 1.15 to 1.24 in different locations. LS ranged from 1.37 to 1.67 for crossbreds. For both traits there was no clear evidence of the merit of Damascus goats or their crosses over the Barki and Baladi goats. More data taken under sound herd management are needed to clarify the utility of the Damascus and its crosses. Heritability estimates+SE for CR and LT in Damascus goats were 0.03 ± 0.003 and 0.04 ± 0.003, respectively

PROTECTIVE EFFECT OF MORINGA OLEIFERA SEED EXTRACT ON CISPLATIN INDUCED NEPHROTOXICITY IN RATS

Objective: The main objective of this study is to investigate the antioxidant and nephroprotective efficacy of moringa oleifera seed extract (MOSE) against cisplatin which induced acute renal injury. Methods: Forty male Wister rats were equally segregated into 4 groups (10 rats per group): group I (0.5 ml of sterile saline orally), group II (200 mg MOSE/kg b. wt orally for 10 consecutive days), group III (7.5 mg cisplatin/kg b. wt/intraperitonially as a single dose on the 5th day of the experiment) and group IV (200 mg moringa oleifera seed extract (MOSE)/kg orally for 10 d followed by 7.5 mg cisplatin/kg body weight/intraperitonially once as a single dose on the 5th day of the experiment. Serum biochemical analysis of renal biomarkers (urea, uric acid, and creatinine), oxidative stress markers (malondialdehyde [MDA]), a crucial antioxidant enzyme (catalase) and the expression of renal activity interleukin (IL)-6, (IL)-10 and Tumer necrotic factor (TNF-α) mRNA were determined. Histopathological examination of renal tissue was done. Results: Cisplatin induced renal damage, increased renal biomarkers (urea, creatinine and uric acid)(375.87±1.65, 5.238±0.25, 4.47±0.25). Tissue concentrations of malondialdehyde, IL-6 and TNF-α.(387.56±0.97, 2.188±0.20, 3.06±0.27)compared to control group(140.58±1.25,0.938±0.017, 1.24±0.17), (163.99±1.34, 1.008±0.05, 0.982±0.026) Moreover, cisplatin induced significantly down-regulation of anti-inflammatory (IL-10) and catalase (0.780±0.47, 1.62±0.06) compared to control one (1.010±0.02, 3.12±0.11),. The histopathological examination showed renal tissue damage and degeneration of tubules in the cortical portion in cisplatin group. However, interestingly concurrent adminsteration of the MOSE with cisplatin can alleviated the renal damage, oxidative stress and renal toxicity caused by cisplatin. Conclusion: These results suggest that the antioxidant and the anti-inflammatory effects of MOSE alleviate the cisplatin-induced nephrotoxicity

Retrospective Radiographic Survey of Unconventional Ectopic Impacted Teeth in Al-Madinah Al-Munawwarah, Saudi Arabia

OBJECTIVES: Ectopic unconventional impacted teeth are rare. These teeth erupt in an unusual direction with limited unconventional access and have increased surgical risks. AIM: This study aimed to investigate and assess the prevalence and distribution of rare ectopic impacted teeth at the Taibah University Dental College and Hospital (TUDCH), Al-Madinah Al-Munawwarah, Saudi Arabia. METHODS: The study designed through a retrospective radiographic cross-sectional survey involving the review and examination of 9000 archived digital orthopantomograms of patients who visited the (TUDCH) in the period from January 2014 to December 2019 and to analyze any associated factors. RESULTS: There were 63 ectopically impacted teeth, with an incidence of 0.7%. The age of the patients ranged from 18 to 68 years, with a mean of 32.4 ± 13 years. Regarding patient nationality, 68.3% were Saudis. The most common ectopically impacted teeth were the extra impacted premolars, with an incidence of 0.2%, followed by the inverted molars, impacted first or second molars, and buccoversion or lingoversion third molars, with incidences of 0.16%, 0.13%, and 0.12%, respectively. The mandible was affected with ectopic impaction more than the maxilla, with an incidence of 55.6%. There was no difference between the right and left sides. Impacted teeth in the sinus were the least common. CONCLUSION: The prevalence of ectopic impacted teeth was 0.7% among the surveyed patients at TUDCH, Al-Madinah Al-Munawwarah, Saudi Arabia. Hence, the oral surgeon must have readiness for such a challenging, increasing situation

H5N1 Clade 2.2 Polymorphism Tracing Identifies Influenza Recombination and Potential Vaccine Targets

Highly pathogenic Influenza A H5N1 was first identified in Guangdong Province in 1996, followed by human cases in Hong Kong in 1997 1. The number of confirmed human cases now exceeds 300 and the associated Case Fatality Rate exceeds 60% 2. The genetic diversity of the serotype continues to increase. Four distinct clades or sub-clades have been linked to human cases 3.4. The gradual genetic changes identified in the sub-clades have been attributed to copy errors by viral encoded polymerases that lack an editing function, thereby resulting in antigenic drift 5. We traced polymorphism acquisition in Clade 2.2 sequences. We report here the concurrent acquisition of the same polymorphism by multiple, genetically distinct, Clade 2.2 sub-clades in Egypt, Russia and Ghana. These changes are not easily explained by the current theory of “random mutation” through copy error, and are more easily explained by recombination with a common source. This conclusion is supported by additional polymorphisms shared by Clade 2.2 isolates in Egypt, Nigeria and Germany including aggregation of regional polymorphisms from each of these areas into a single Nigerian human hemagglutinin gene

Role of calcium and magnesium on dramatic physiological and anatomical responses in tomato plants

Minerals are the fundamental source of nutrients for plant functions such as photosynthesis, ATP currency, cellular respiration, metabolic activities, defense mechanisms, and tolerance to biotic and abiotic stressors. Minerals are the most significant component of plant nutrition and applying these minerals supplements can increase fruit output. The study’s main aim was to make agricultural farming easier by foliar applying newly created nutrients like Lebosol-calcium and Magnesium. The four treatments: To (Control), T1 (Lebosol-Mg-Plus, 3 ml/L), T2 (Lebosol-Ca-Forte, 3 ml/L), and T3 (Lebosol-Mg-Plus and Lebosol-Ca-Forte, 3 ml/L) was applied as foliar spray to the seedlings of tomato. It was found that T3 substantially enhanced tomato’s morphological features and yield. The treatment T3 significantly increased total soluble protein, chlorophyll content, and antioxidant enzyme activity. Furthermore, the foliar application of T3 considerably improved phenolic and ascorbic acid contents. The general anatomical features of the leaf, stem, and roots of tomato were qualitatively affected by the treatments. Application of Lebosol-Ca provided the highest total thickness of lamina, number of vessel elements, total phloem area, chlorenchyma layer, total area of vessel elements, xylem ratio, and increased palisade layer thickness, vessel diameter. Furthermore, T3 treatment showed a diverse impact on the internal structure of tomato organs, with palisade and spongy parenchyma growing to maximum values and vessel diameters expanding. T3 had also posed remarkable alterations in morpho-physiological, biochemical, and anatomical aspects in tested plants

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication