Effect of Gender on the Outcome of Acute Coronary Syndrome in Type 2 Diabetes Mellitus

OBJECTIVES To determine the frequency of acute coronary syndrome presentations among diabetic patients and in-hospital outcomes based on gender variance. METHODOLOGY This observational cross-sectional study was conducted at the cardiology department of the Pakistan Institute of Medical Sciences, Islamabad. 106 consecutive diabetic patients with acute coronary syndrome were enrolled. Patients were assessed for in-hospital outcomes like congestive heart failure, recurrent angina, and mortality. The outcomes were evaluated based on gender. The Chi-Square test was used for significant differences keeping the P value < 0.05.  RESULTSThe mean age of the patients was 57.75±8.16 years. Males were 57 (53.8%), and females were 49 (46.2%). Congestive heart failure, re-angina, and mortality were significant in both genders yielding a P value of <0.05. CONCLUSION Diabetes is an important predictor of acute coronary syndrome. The complications related to congestive heart failure and mortality are more prevalent in males than females

Response of a maize composite to selfed progeny recurrent selection for earliness and yield traits

Population improvement through recurrent selection is a traditional breeding method that has been used in maize for over 60 years. Objectives of the research were to: a) evaluate effect of selfed progeny recurrent selection on earliness and yield traits, b) compare responses of cycle-1 (S1-line) and cycle-2 (S2-line) populations, and c) determine better strategy for improvement of maize source population «PSEV3». The experiments were carried out in partially balanced lattice square design with two replications. In cycle-1 and cycle-2 populations, the differ- ences were highly significant for all studied traits. Selfing in both cycles of selection, resulted increase in days to tasseling while reduction in population means for yield traits. In selected progenies, an increase was seen in mean values of yield traits; however, not in days to tasseling and grain moisture in both cycles of selection. Moderate to high heritability values were observed for almost all the traits in both cycles. Selection differential values were positive and high for grain yield, ear height, prolificacy, ear length, and 100-grain weight in cycle-1 and cycle-2. However, negative values of selection differential were seen for days to tasseling and grain moisture in cycle-1 and 2 populations. The expected responses for days to tasseling and grain moisture were negative in first and second selection cycles. Comparatively, larger and positive responses were noted in cycle-2 than cycle-1 for grain yield and its components. Selfed progeny recurrent selection method was found more effective in improving the maize source population «PSEV3” for earliness and yield traits

Hemolytic and cellular toxicology of a sulfanilamide-based nonionic surfactant: a niosomal carrier for hydrophobic drugs

Biocompatible surfactants are of diverse pharmaceutical interest due to their ability to self-assemble into nano-particulate systems which can be used for single-step drug loading, based upon the hydrophobic hydrophobic interaction between a hydrophobic drug and the lipophilic part of a surfactant molecule. However, surfactants are associated with cytotoxicity and hemolysis due to their amphiphilic interaction with cellular membranes. This study reports a novel membrane-compatible surfactant, synthesized from sulfanilamide and its self-micellization into niosomes. The surfactant was synthesized in a single step reaction via the introduction of an alkyl chain in the sulfanilamide moiety by conjugation with deconyl chloride. The synthesized surfactant (S-SDC) was characterized by H-1 and C-13 NMR, mass spectrometry and single crystal XRD. The S-SDC niosomes were explored for drug delivery with clarithromycin as a model drug. The biocompatibility of the surfactant was investigated through hemolysis and cytotoxicity. The surfactant presented a very low critical micellar concentration (CMC) of 0.04 mM and entrapped 65% of the drug which was released in a sustained manner, over 12 h, at acidic and physiological pH. The vesicles were spherical in shape with 234 +/- 3.61 nm mean diameter and a narrow size distribution. Niosomes were hemocompatible and nontoxic to cellular membrane. The results suggested the sulfanilamide based surfactant can be applied as a novel and cell membrane compatible niosomal drug delivery vehicle

Development of Cephradine-Loaded Gelatin/Polyvinyl Alcohol Electrospun Nanofibers for Effective Diabetic Wound Healing: In-Vitro and In-Vivo Assessments

Diabetic wound infections caused by conventional antibiotic-resistant Staphylococcus aureus strains are fast emerging, leading to life-threatening situations (e.g., high costs, morbidity, and mortality) associated with delayed healing and chronic inflammation. Electrospinning is one of the most widely used techniques for the fabrication of nanofibers (NFs), induced by a high voltage applied to a drug-loaded polymer solution. Particular attention is given to electrospun NFs for pharmaceutical applications (e.g., original drug delivery systems) and tissue regeneration (e.g., as tissue scaffolds). However, there is a paucity of reports related to their application in diabetic wound infections. Therefore, we prepared eco-friendly, biodegradable, low-immunogenic, and biocompatible gelatin (GEL)/polyvinyl alcohol (PVA) electrospun NFs (BNFs), in which we loaded the broad-spectrum antibiotic cephradine (Ceph). The resulting drug-loaded NFs (LNFs) were characterized physically using ultraviolet-visible (UV-Vis) spectrophotometry (for drug loading capacity (LC), drug encapsulation efficiency (EE), and drug release kinetics determination), thermogravimetric analysis (TGA) (for thermostability evaluation), scanning electron microscopy (SEM) (for surface morphology analysis), and Fourier-transform infrared spectroscopy (FTIR) (for functional group identification). LNFs were further characterized biologically by in-vitro assessment of their potency against S. aureus clinical strains (N = 16) using the Kirby–Bauer test and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, by ex-vivo assessment to evaluate their cytotoxicity against primary human epidermal keratinocytes using MTT assay, and by in-vivo assessment to estimate their diabetic chronic wound-healing efficiency using NcZ10 diabetic/obese mice (N = 18). Thin and uniform NFs with a smooth surface and standard size (<400 nm) were observed by SEM at the optimized 5:5 (GEL:PVA) volumetric ratio. FTIR analyses confirmed the drug loading into BNFs. Compared to free Ceph, LNFs were significantly more thermostable and exhibited sustained/controlled Ceph release. LNFs also exerted a significantly stronger antibacterial activity both in-vitro and in-vivo. LNFs were significantly safer and more efficient for bacterial clearance-induced faster chronic wound healing. LNF-based therapy could be employed as a valuable dressing material to heal S. aureus-induced chronic wounds in diabetic subjects

Development and Characterizations of Pullulan and Maltodextrin-Based Oral Fast-Dissolving Films Employing a Box–Behnken Experimental Design

Migraine is a neurological disorder characterized by severe headaches, visual aversions, auditory, and olfactory disorders, accompanied by nausea and vomiting. Zolmitriptan (ZMT®) is a potent 5HT1B/1D serotonin receptor agonist frequently used for the treatment of migraine. It has erratic absorption from the gastrointestinal tract (GIT), but its oral bioavailability is low (40–45%) due to the hepatic metabolism. This makes it an ideal candidate for oral fast dissolving formulations. Hence, the current study was undertaken to design and develop oral fast-dissolving films (OFDFs) containing ZMT for migraine treatment. The OFDFs were formulated by the solvent casting method (SCM) using Pullulan (PU) and maltodextrin (MDX) as film-forming agents and propylene glycol (PG) as a plasticizer. The strategy was designed using Box–Behnken experimental design considering the proportion of PU:MDX and percentage of PG as independent variables. The effectiveness of the OFDF’s was measured based on the following responses: drug release at five min, disintegration time (D-time), and tensile strength (TS). The influence of formulation factors, including percent elongation (%E), thickness, water content, moisture absorption, and folding endurance on ZMT-OFDFs, were also studied. The results showed a successful fabrication of stable ZMT-OFDFs, with surface uniformity and amorphous shape of ZMT in fabricated films. The optimized formulation showed a remarkable rapid dissolution, over 90% within the first 5 min, a fast D-time of 18 s, and excellent mechanical characteristics. Improved maximum plasma concentration (C max) and area under the curve (AUC 0–t) in animals (rats) treated with ZMT-OFDFs compared to those treated with an intra-gastric (i-g) suspension of ZMT were also observed. Copolymer OFDFs with ZMT is an exciting proposition with great potential for the treatment of migraine headache. This study offers a promising strategy for developing ZMT-OFDFs using SCM. ZMT-OFDFs showed remarkable rapid dissolution and fast D-time, which might endeavor ZMT-OFDFs as an auspicious alternative approach to improve patient compliance and shorten the onset time of ZMT in migraine treatment

Rizatriptan-loaded oral fast dissolving films: design and characterizations

Rizatriptan (RZT) is an efficient anti-migraine drug which belongs to the class of selective 5 HT (1B/1D) serotonin receptor agonists. Nevertheless, RZT elicits several adverse effects and RZT nasal sprays have a limited half-life, requiring repeated doses that could cause patient noncompliance or harm to the nasopharynx and cilia. The current research aimed to develop orally disintegrating films (ODFs) of RZT employing maltodextrin (MTX) and pullulan (PUL) as film-forming polymers, as well as propylene glycol (PG) as a plasticizer. The ODFs were prepared by solvent casting method (SCM). The technique was optimized using Box-Behnken design (BBD), contemplating the ratios of PUL: MTX and different levels of PG (%) as factor variables. The influence of these factors was systematically analyzed on the selected dependent variables, including film thickness, disintegration time (D-time), folding endurance (FE), tensile strength (TS), percent elongation (%E), moisture content (%), and water uptake (%). In addition, the surface morphology, solid state analysis, drug content uniformity (%), drug release (%), and pH of the RZT-ODFs were also studied. The results demonstrated a satisfactory stable RZT-ODFs formulation that exhibited surface homogeneity and amorphous RZT in films with no discernible interactions between the model drug and polymeric materials. The optimized film showed a rapid D-time of 16 s and remarkable mechanical features. The in vitro dissolution kinetics showed that 100% RZT was released from optimized film compared to 61% RZT released from conventional RZT formulation in the initial 5 min. An animal pharmacokinetic (PK) investigation revealed that RZT-ODFs had a shorter time to achieve peak plasma concentration (Tmax), a higher maximum plasma concentration (Cmax), and area under the curve (AUC0-t) than traditional oral mini capsules. These findings proposed a progressive approach for developing anti-migraine drugs that could be useful in reducing the complications of dysphagia in geriatric and pediatric sufferers. </p