Deprescription: a global need to rationalize drug prescribing

Appropriate prescribing and deprescription of unwanted medicines are a global concern. Polypharmacy is common in old age due to multiple comorbidities. This poses many risks that can be prevented by deprescription as a measure of planned reduction in number of medicines no longer needed. For articles to be included in this narrative review, a non-systematic search of deprescription and related term was conducted at PubMed and Google Scholar database. Articles detailing deprescription in general were included whereas those about deprescription in a particular disease or of particular drug groups were excluded. The review discusses about related terms, process of deprescription, when it is to be planned, which patients need deprescription, tools available for appropriate prescription, importance of patient oriented deprescription, actual steps involved in deprescription, present scenario, future scope of trials and formulation of guidelines for deprescription, and finally current state of deprescription in India and actions needed.

SILK FIBROIN IN EFFECTIVE WOUND DRESSING: AN OVERVIEW.

Silk materials have been shown to promote wound healing since the 1990s. Both fibroin and sericin have been found to be an effective substrate for the proliferation of adherent animal cells and can be used as a substitute for collagen. Because of their excellent physical and biological properties, silk fibroin and sericin were widely investigated for their use in biomedical applications including wound healing materials. Medical wound dressing is a commonly-used treatment for skin defects. Silk fibroin (SF) is a natural protein derived from Bombyxmori cocoons, and shows potential in tissue repair applications due to its excellent biomedical properties. Numerous silk fibroin wound dressings have been developed in the lab, however, lack of large animal studies and clinical trials have hindered their wide use in the clinic. In recent era, the growing field of tissue engineering has introduced remarkable wound dressings based on natural polymers. The unique properties of SF, such as its biocompatibility, biodegradability, high water and oxygen uptake, low immunogenicity, and robust mechanical properties, make it an exceptional choice for wound healing. Despite the successful use of SF in wound dressings, it is not yet approved as an artificial skin. Recently, biomimetic wound dressings were introduced as potential replacements for treating skin injuries. Although there are some clinically available skin replacements, the range of wound types and locations necessitates a broader range of options for the clinic. Natural polymeric-based dressings are of central interest in this area due to their outstanding biocompatibility, biodegradability, low toxicity, and non-allergenic nature. Among them, silk fibroin has exceptional characteristics as a wound dressing. SF-based dressings can also be used as carriers for delivering drugs, growth factors, and bioactive agents to the wound area, while providing appropriate support for complete healing. This dressing is expected to promote good health and wellbeing of masses at an affordable cost. Therefore this is in alignment to UN sustainable development goal (SDG) and can be very effective for smart Kashi initiatives

Synthetic and structural investigation of ZnO nano-rods, hydrothermally grown over Au coated optical fiber for evanescent field-based detection of aqueous ammonia

We present the fabrication of modified clad optical fiber coated with ZnO nanorod over Au thin film to be served as ammonia gas sensor. The deposited material ZnO synthesized by hydrothermal process and modified clad fiber is coated by Autoclave technique. The as-synthesized materials are characterized by XRD, XPS, FTIR, Raman spectra and its hexagonal nanorods morphology was checked by FESEM. The ZnO coated over Au thin film fiber is found to be a good candidate towards ammonia sensing. The developed sesnor exihibted sensitivity (%) ~ 0.638 of ammonia gas at room temperature

Co-Crystallization Techniques for Improving Nutraceutical Absorption and Bioavailability

Nutraceuticals is an umbrella term for therapeutic leads derived from plants, animals and/or microbial species. Being synthesized in nature’s own laboratory a nutraceuticals have structural and functional features for interacting with an array of physiological targets. However, because of this very structural complexity and diversified nature, nutraceuticals often suffer from diminished gastrointestinal (GI) absorption and limited systemic bioavailability. Thus, in-spite of having an obvious edge over synthetic molecules, pharmaceutical applicability of nutraceuticals play second fiddle in the present pharmaceutical prospective. In this regard, co-crystallization of nutraceuticals have evolved as an attractive prospect. Co-crystallization causes stoichiometric non-covalent binding between nutraceutical API (active pharmaceutical ingredient) and a pharmaceutically acceptable co-former creating a single-phase crystalline material. Nutraceutical co-crystals thus created possess excellent absorption and bioavailability attributes. The principal aim of the current chapter is to highlight co-crystallization as the means of nutraceutical ascendancy over toxic synthetic drugs currently dominating the pharmaceutical market. In the current chapter the authors provide a detail exposition on the methods and application of co-crystallization in context of nutraceutical absorption and bioavailability. Herein, we discuss in detail about the constituents, characteristics, mechanism of action and protocol for preparation of nutraceutical co-crystals with relevant references from current and past studies

Chemistry of enediynyl azides: activation through a novel pathway

The spontaneous activation of a nonaromatic enediynyl azide under ambient conditions has been demonstrated. The aromatic enediyne followed the expected cycloaddition with the alkene in the neighbouring arm to form a stable bridged bicyclic enediyne

Reforms to Increase Teacher Effectiveness in Developing Countries: Systematic Review, September 2016

RLOsRLOsProvides high-quality evidence on reforms/interventions in education systems aimed at improving teacher effectiveness, at scale. This executive summary provides an overview of that key evidence to answer three review questions: RQ1. What is the evidence on the impacts of reforms/interventions of education systems, at scale, to increase teacher effectiveness on: the quality of teaching and on learning outcomes in low- and middle-income countries? RQ2. What is the evidence on the relationship between educational reforms/interventions for improving teacher effectiveness, at scale, and the quality of teaching and learning outcomes in low- and middle-income countries? RQ3. Where reforms/interventions to education systems to increase teacher effectiveness, at scale, have occurred, what is the evidence on how technical, financial and political barriers have been overcome?ESRC-DFI

Folic acid tagged nanoceria as a novel therapeutic agent in ovarian cancer

BACKGROUND: Nanomedicine is a very promising field and nanomedical drugs have recently been used as therapeutic agents against cancer. In a previous study, we showed that Nanoceria (NCe), nanoparticles of cerium oxide, significantly inhibited production of reactive oxygen species, cell migration and invasion of ovarian cancer cells in vitro, without affecting cell proliferation and significantly reduced tumor growth in an ovarian cancer xenograft nude model. Increased expression of folate receptor-α, an isoform of membrane-bound folate receptors, has been described in ovarian cancer. To enable NCe to specifically target ovarian cancer cells, we conjugated nanoceria to folic acid (NCe-FA). Our aim was to investigate the pre-clinical efficacy of NCe-FA alone and in combination with Cisplatin. METHODS: Ovarian cancer cell lines were treated with NCe or NCe-FA. Cell viability was assessed by MTT and colony forming units. In vivo studies were carried in A2780 generated mouse xenografts treated with 0.1 mg/Kg NCe, 0.1 mg/Kg; NCe-FA and cisplatinum, 4 mg/Kg by intra-peritoneal injections. Tumor weights and burden scores were determined. Immunohistochemistry and toxicity assays were used to evaluate treatment effects. RESULTS: We show that folic acid conjugation of NCe increased the cellular NCe internalization and inhibited cell proliferation. Mice treated with NCe-FA had a lower tumor burden compared to NCe, without any vital organ toxicity. Combination of NCe-FA with cisplatinum decreased the tumor burden more significantly. Moreover, NCe-FA was also effective in reducing proliferation and angiogenesis in the xenograft mouse model. CONCLUSION: Thus, specific targeting of ovarian cancer cells by NCe-FA holds great potential as an effective therapeutic alone or in combination with standard chemotherapy

Detection of Ammonia Gas Molecules in Aqueous Medium by Using Nanostructured Ag-Doped ZnO Thin Layer Deposited on Modified Clad Optical Fiber

The synthesis of Ag-doped ZnO nanorod employing hydrothermal process over modified cladd optical fiber is reported. The developed material is characterized using X-ray diffraction (XRD), Fourier transformed infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), field emission scanning electron microscopy (FESEM), and Brunauer-Emmett-Teller (BET)analysis to evaluate the morphology and the nature of nanorod formed. The initial performance of the coated modified clad optical fiber toward detection of ammonia gas in aqueous solution is also presented. The sensing performance revealed that the developed material possess improved sensitivity toward ammonia gas at room temperature compared to Ag doped nanowires containing optical fiber sensor

Development of SSR markers and construction of a linkage map in jute

Jute is an important natural fibre crop, which is only second to cotton in its importance at the global level. It is mostly grown in Indian subcontinent and has been recently used for the development of genomics resources. We recently initiated a programme to develop simple sequence repeat markers and reported a set of 2469 SSR that were developed using four SSR-enriched libraries (Mir et al. 2009). In this communication, we report an additional set of 607 novel SSR in 393 SSR containing sequences. However, primers could be designed for only 417 potentially useful SSR. Polymorphism survey was carried out for 374 primer pairs using two parental genotypes (JRO 524 and PPO4) of a mapping population developed for fibre fineness; only 66 SSR were polymorphic. Owing to a low level of polymorphism between the parental genotypes and a high degree of segregation distortion in recombinant inbred lines, genotypic data of only 53 polymorphic SSR on the mapping population consisting of 120 RIL could be used for the construction of a linkage map; 36 SSR loci were mapped on six linkage groups that covered a total genetic distance of 784.3 cM. Hopefully, this map will be enriched with more SSR loci in future and will prove useful for identification of quantitative trait loci/genes for molecular breeding involving improvement of fibre fineness and other related traits in jute

Bryostatin Modulates Latent HIV-1 Infection via PKC and AMPK Signaling but Inhibits Acute Infection in a Receptor Independent Manner

HIV's ability to establish long-lived latent infection is mainly due to transcriptional silencing in resting memory T lymphocytes and other non dividing cells including monocytes. Despite an undetectable viral load in patients treated with potent antiretrovirals, current therapy is unable to purge the virus from these latent reservoirs. In order to broaden the inhibitory range and effectiveness of current antiretrovirals, the potential of bryostatin was investigated as an HIV inhibitor and latent activator. Bryostatin revealed antiviral activity against R5- and X4-tropic viruses in receptor independent and partly via transient decrease in CD4/CXCR4 expression. Further, bryostatin at low nanomolar concentrations robustly reactivated latent viral infection in monocytic and lymphocytic cells via activation of Protein Kinase C (PKC) -α and -δ, because PKC inhibitors rottlerin and GF109203X abrogated the bryostatin effect. Bryostatin specifically modulated novel PKC (nPKC) involving stress induced AMP Kinase (AMPK) inasmuch as an inhibitor of AMPK, compound C partially ablated the viral reactivation effect. Above all, bryostatin was non-toxic in vitro and was unable to provoke T-cell activation. The dual role of bryostatin on HIV life cycle may be a beneficial adjunct to the treatment of HIV especially by purging latent virus from different cellular reservoirs such as brain and lymphoid organs