BIODEGRADABLE LIPOSOMES FOR ACYCLOVIR-GOLD NANOPARTICLES AS AN EFFICIENT CARRIERFOR ENHANCED TOPICAL DELIVERY

Objective: Gold nanoparticles and nanoliposomes are effective new technology in delivering the bioactive agents and enhancing their performance by increasing the bioavailability. The goal of the present study was the formulation of liposome for the use as a carrier for nanogold conjugated with acyclovir (ACV), an antiviral drug, to enhance ACV delivery.Methods: The gold nanoparticles were used as a capping agent for ACV and sodium citrate was used as reducing agent for the gold. Transmission electron microscopy was used for characterization and to study the morphological and structural properties of drug-metallic nanostructures. Nanoliposomes were formulated using different molar ratios of a positive charge inducer (stearyl amine) or a negative charge inducer (diacetyl phosphate), lecithin, cholesterol and Span 60.Results: Gold nanoparticles with a particle size of 10–20 nm were formed. This small size of the formed particles has a clear effect in reducing the gold nanoparticles toxicity and enhancing the cellular uptake. The amount of sodium citrate used in this preparation influences the size of the gold nanoparticle. The present study employed 1% trisodium citrate that contains a carboxylic group and this carboxylic group works as a reducing and capping agent to synthesize ACV-gold nanoparticles conjugate. Liposomal formula F6 had the highest entrapment efficiency approaching 42%, the low particle size of 160 nm, and zeta potential of 43.5 mV.Conclusion: It is evident from the study that the liposomes can be used as a carrier of ACV conjugated with gold nanoparticles. This new strategy could be used successfully in the treatment of viral infection

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Molecular characterization of Newcastle disease virus (genotype VII) from broiler chickens in Egypt

Newcastle disease (ND) outbreaks have been occurred in the Egyptian poultry causing high mortalities with severe economic losses. Samples were collected from 3 to 4 weeks-old broiler chickens suffering from high mortalities respiratory and/or nervous signs, located at Beni-Suef, Minia, Fayoum, Ismailia and Menofia governorates and Postmortem examination showed hemorrhages at both proventricular glands and cecal tonsils. The samples were subjected to virus isolation trials by inoculation of the processed samples in the allantoic sac of 9-day-old specific pathogen free eggs (SPF). Hemagglutinating activity was tested by hemagglutination test and the isolated viruses were molecularly characterized by RT-PCR targeting the partial F-gene of NDV. Partial F gene sequence analysis showed that the isolated NDV strains belong to genotype VII with the characteristic amino acid sequences of the F0 protein proteolytic cleavage site motifs (112RRQKRF117) for the velogenic NDV strains. No significant differences in both nucleotide and amino acid sequences were observed among different examined strains. The vNDV isolates in this study were identical to each other and they were similar to strains isolated from Egypt during 2012–2014 with minor genetic variation. This study indicated that though intensive ND vaccination programs using LaSota like strains, the vNDV strains of genotype VII are still circulating in the field causing significant economic losses. The genetic variation between the used vaccine strains and the circulating NDV viruses may explain the inability of the currently used vaccines to protect chicken against vNDV genotype VII. Further studies are needed to screen the protection of the currently used vaccines against recently isolated vNDV strains