Knowledge, Attitude, and Practice Regarding Foot Care among Diabetic Patients: A Scoping Review

Context: Diabetic foot is considered one of the most preventable complications among patients with diabetes mellitus. This problem is correlated with premature death and severe morbidity because of major long-term complications which affect patients' feet.Aim: This review aims to identify the extent of current evidence regarding the level of knowledge, attitude, and practice of diabetic patients about foot care. Methods: Studies published in the period from 2013 to 2020 were evaluated. International electronic databases such as Ovid MEDLINE, PubMed, Embase Classic, EMBASE (Ovid), The Web of Science (Thomson Reuters), The Cochrane Library (Wiley), and CINAHL and (EBSCO) were explored to find articles written in English-language using relevant keywords. All quantitative studies that focused on the knowledge, attitude, and practice regarding diabetic foot care among diabetic patients have been searched. Results: There are two main themes generated from this scoping review and seven subthemes. In this scoping review, 845 articles were searched. After checking for duplicates, 815 papers were left to evaluate titles and abstracts. This evaluation left 52 articles for reading of full texts. Of these, 21 papers did not meet the aim. Thirty-one studies were included in the present review.Conclusion: Patients' knowledge, practices, and attitude toward foot care were not considered satisfactory in most study settings included in this review. Several factors affect patients' knowledge, attitude, and practices, including gender, income, age of patients, marital status, and educational level. Specific health education programs should be targeted toward patients with diabetes mellitus to enhance and improve their knowledge and practices regarding protecting them from future harmful complications as diabetic foot

Towards an approach for weaving Open Digital Rights Language into Role-Based Access Control

Establishing an adequate and flexible access control over assets in an organization is one of the main pillars of a successful information and technology security-strategy. To ensure efficient use of these assets in terms of availability, safety, and confidentiality, organizations roll out different strategies and adopt different techniques. These strategies and techniques could be based on roles to set access controls (Role-Based Access Control). Despite its popularity, there is an increasing interest in addressing RBAC\u27s limitations with focus on how to enforce an adequate level of access control over the available resources and how to define a flexible control over these resources so that accessibility and authenticity are achieved at the right time and right place. This paper addresses some of these limitations by adopting the Open Digital Rights Language (ODRL) to express who can do what, where, when, and how. ODRL is a policy language that offers flexible control over digital content. By weaving ODRL into RBAC, this paper illustrates how to specify what users are allowed, not allowed, and must be allowed to do through a set of constrained rules specialized into permissions, prohibitions, and duties

Preparation and characterization of nano liposomes of Orthosiphon stamineus ethanolic extract in soybean phospholipids

BACKGROUND: O. stamineus is a medicinal herb with remarkable pharmacological properties. However, poor solubility of the active principles limits its medicinal value. This study sought to prepare nano liposomes of OS ethanolic extract in unpurified soybean phospholipids in order to improve its solubility and permeability. OS liposomes were prepared by the conventional film method, and were characterized for solubility, entrapment efficiency, Fourier transform infrared spectroscopy (FTIR), transmission electron microscopy (TEM), particle size and zeta potential, release, absorption in everted rat intestinal sacs, and DPPH scavenging effect. RESULTS: OS liposomes showed substantial enhancement of extract’s solubility from 956 ± 34 to 3979 ± 139 μg/ml, with entrapment efficiency of 66.2 ± 0.9%. FTIR study indicates interaction between soybean phospholipids and OS extract. TEM and dynamic light scattering showed presence of round anionic nano liposomes with particle size and zeta potential of 152.5 ± 1.1 nm and −49.8 ± 1.0 mV, respectively. A study using the fluorescent probe pyrene showed the critical micellar concentration is 9.2 ± 2.9 μg/ml. Release studies showed 94 ± 0.1% release in non-formulated extract and 62.4 ± 0.1% in OS liposomes. Released extract from OS liposomes showed improvement in DPPH scavenging effect, IC50 = 23.5 ± 1.1 μg/ml compared to 32.4 ± 0.5 μg/ml in non-formulated extract. OS liposomes were stable at pH 5.5 and 7.4, but showed reversible agglomeration at pH 1.6. Absorption in everted rat intestinal sacs showed substantial improvement in permeability of 3′-hydroxy-5, 6, 7, 4″-tetramethoxyflavone, sinensetin, eupatorin, and 3 other unknown compounds. CONCLUSIONS: Enhanced solubility, absorption and antioxidant effect may improve the overall pharmacological effects and medicinal value of OS ethanolic extract

Chronic tension-type headache as a risk factor of myofascial trigger points in upper trapezius muscle fibers in neck pain patients

Chronic tension type headache (CTTH) is one of the very common neurological conditions which have striking impact on daily functional activities. In tension type headaches the myofascial TrP\u27s are frequently examined .It is observed that myofascial pain syndrome is frequent determinant of chronic nonspecific neck pain

Development of Polymeric Nanoparticles of Garcinia mangostana Xanthones in Eudragit RL100/RS100 for Anti-Colon Cancer Drug Delivery

Xanthones are a group of oxygenated heterocyclic compounds with anticancer properties, but poor aqueous solubility and low oral bioavailability hinder their therapeutic application. This study sought to prepare a xanthones extract (81

Evaluation of in vitro cytotoxicity effect of Clinacanthus nutans (Brum. f.) Lindau standardized leaf extracts

Purpose: To standardize Clinacanthus nutans (CN) leaf extracts, evaluate their contents of orientin, vitexin and isovitexin using a reversed-phase high-performance liquid chromatography (RP-HPLC) method, and also to investigate in vitro cytotoxicity of CN. Methods: CN leaf powder was macerated in distilled water, methanol, methanol (50 %), ethanol, and ethanol (50 %) over a hot water bath at 50 - 55 °C for 24 h. The extracts were standardized for total phenolic, flavonoid, proteins and polysaccharides content by ultra-violet (UV) spectrophotometry. Moreover, RP-HPLC was used to determine the contents of orientin, vitexin and isovitexin in the extracts. The anti-proliferative effect of the extracts against human colorectal carcinoma cell line (HCT116) and human colon normal cell line (CCD-18Co) was assessed using 3-(4,5-dimethylthiazol-2-yl)- 2,5-diphenyl tetrazolium bromide (MTT) assay. The most active extract was fractionated using silica gel flash column chromatography to produce 20 fractions. All the fractions were subjected to the MTT test. Results: The extracts showed modest cytotoxicity against HCT-116 and non-cytotoxicity against CCD18Co cell lines. Of all the extracts tested, the methanol extract (CN-M) showed the highest activity of all the extracts and had the highest content of flavonoid and phenolic compounds. Twenty fractions were obtained from this extract. Fraction nos. F3, F4, F14 and F16 showed significant (p < 0.05) cytotoxicity against HCT-116, with F14 having the highest activity. Conclusion: Fraction F14 has the potential to be developed to anti-colon cancer agent. However, further studies including chemical profiling, mechanism of action and safety profile of this fraction are required

Flavonoids-Rich Orthosiphon stamineus Extract as New Candidate for Angiotensin I-Converting Enzyme Inhibition: A Molecular Docking Study

This study aims to evaluate the in vitro angiotensin-converting enzyme (ACE) inhibition activity of different extracts of Orthosiphon stamineus (OS) leaves and their main flavonoids, namely rosmarinic acid (RA), sinensetin (SIN), eupatorin (EUP) and 30-hydroxy-5,6,7,40-tetramethoxyflavone (TMF). Furthermore, to identify possible mechanisms of action based on structure–activity relationships and molecular docking. The in vitro ACE inhibition activity relied on determining hippuric acid (HA) formation from ACE-specific substrate (hippuryl-histidyl-leucine (HHL)) by the action of ACE enzyme. A High Performance Liquid Chromatography method combined with UV detection was developed and validated for measurement the concentration of produced HA. The chelation ability of OS extract and its reference compounds was evaluated by tetramethylmurexide reagent. Furthermore, molecular docking study was performed by LeadIT-FlexX: BioSolveIT’s LeadIT program. OS ethanolic extract (OS-E) exhibited highest inhibition and lowest IC50 value (45.77 � 1.17 �g/mL) against ACE compared to the other extracts. Among the tested reference compounds, EUP with IC50 15.35 � 4.49 �g/mL had highest inhibition against ACE and binding ability with Zn (II) (56.03% � 1.26%) compared to RA, TMF and SIN. Molecular docking studies also confirmed that flavonoids inhibit ACE via interaction with the zinc ion and this interaction is stabilized by other interactions with amino acids in the active site. In this study, we have demonstrated that changes in flavonoids active core affect their capacity to inhibit ACE. Moreover, we showed that ACE inhibition activity of flavonoids compounds is directly related to their ability to bind with zinc ion in the active site of ACE enzyme. It was also revealed that OS extract contained high amount of flavonoids other than RA, TMF, SIN and EUP. As such, application of OS extract is useful as inhibitors of ACE

Antiangiogenic properties of Koetjapic acid, a natural triterpene isolated from Sandoricum koetjaoe Merr

Background: Angiogenesis, the formation of new blood vessels, has become an important target in cancer therapy. Angiogenesis plays an important role in tumor growth and metastasis. Koetjapic acid (KA) is a seco-A-ring oleanene triterpene isolated from S. koetjape. The solvent extract of this plant species was shown previously to have strong antiangiogenic activity; however the active ingredient(s) that conferred the biological activity and the mode of action was not established. Given the high concentration of KA in S. koetjape, an attempt has been made in this study to investigate the antiangiogenic properties of KA.Results: Treatment with 10-50 μg/ml KA resulted in dose dependent inhibition of new blood vessels growth in ex vivo rat aortic ring assay. KA was found to be non-cytotoxic against HUVECs with IC40.97 ± 0.37 μg/ml. KA inhibited major angiogenesis process steps, endothelial cell migration and differentiation as well as VEGF expression.Conclusions: The non-cytotoxic compound, KA, may be a potent antiangiogenic agent; its activity may be attributed to inhibition of endothelial cells migration and differentiation as well VEGF suppression

Proapoptotic and antimetastatic properties of supercritical CO2 extract of Nigella sativa Linn. Against breast cancer cells

Nigella sativa, commonly referred as black cumin, is a popular spice that has been used since the ancient Egyptians. It has traditionally been used for treatment of various human ailments ranging from fever to intestinal disturbances to cancer. This study investigated the apoptotic, antimetastatic, and anticancer activities of supercritical carbon dioxide (SC-CO) extracts of the seeds of N. sativa Linn. against estrogen-dependent human breast cancer cells (MCF-7). Twelve extracts were prepared from N. sativa seeds using the SC-CO extraction method by varying pressure and temperature. Extracts were analyzed using FTIR and UV-Vis spectrometry. Cytotoxicity of the extracts was evaluated on various human cancer and normal cell lines. Of the 12 extracts, 1 extract (A3) that was prepared at 60 C and 2500 psi (∼17.24 MPa) showed selective antiproliferative activity against MCF-7 cells with an IC of 53.34±2.15 μg/mL. Induction of apoptosis was confirmed by evaluating caspases activities and observing the cells under a scanning electron microscope. In vitro antimetastatic properties of A3 were investigated by colony formation, cell migration, and cell invasion assays. The elevated levels of caspases in A3 treated MCF-7 cells suggest that A3 is proapoptotic. Further nuclear condensation and fragmentation studies confirmed that A3 induces cytotoxicity through the apoptosis pathway. A3 also demonstrated remarkable inhibition in migration and invasion assays of MCF-7 cells at subcytotoxic concentrations. Thus, this study highlights the therapeutic potentials of SC-CO extract of N. sativa in targeting breast cancer