The use of platelet-rich plasma in treatment of olfactory dysfunction: A pilot study.

BackgroundOlfactory dysfunction is a prevalent problem with a significant impact on quality of life and increased mortality. Limited effective therapies exist. Platelet-rich plasma (PRP) is an autologous biologic product with anti-inflammatory and neuroprotective effects. This novel pilot study evaluated the role of PRP on olfactory neuroregeneration in patients with hyposmia.MethodsSeven patients who had olfactory loss greater than 6 months in duration, no evidence of sinonasal inflammatory disease, and no improvement with olfactory training and budesonide topical rinses were enrolled in this preliminary study. Patients received a single intranasal injection of PRP into the mucosa of the olfactory cleft. The Sniffin' Sticks olfactory test consisting of threshold, discrimination, and identification measurements (TDI) was administered at the beginning of the study and at 1 and 3 months.ResultsAll patients reported a subjective improvement of their smell shortly after injection but then stabilized. At 3-month post-treatment, two patients with functional anosmia (TDI < 16) did not improve significantly. Five patients with hyposmia (TDI > 16 but <30) showed an improvement with 60% achieving normosmia (TDI > 30) at 3-month follow-up. On average, patients with baseline TDI > 16 improved by 5.85 points with the most significant improvement in the threshold subcomponent. There were no adverse outcomes from intranasal PRP injections.ConclusionPRP appears safe for use in the treatment of olfactory loss, and preliminary data suggest possible efficacy, especially for those with moderate yet persistent loss. Further studies will help determine optimal frequency and duration of use.Level of evidence 2

In the Treatment of Patients With Knee Joint Osteoarthritis, Are Platelet Rich Plasma Injections More Effective Than Hyaluronic Acid Injections?

Objective: The objective of this selective EBM review is to determine whether or not In the treatment of patients with knee joint osteoarthritis, are Platelet Rich Plasma injections more effective than Hyaluronic acid injections? Study Design: Review of one randomized double-blind trial, one randomized cohort study, and one randomized control trial published in the English language in the year 2012. Data Sources: All studies were published in peer-reviewed journals found via the use of PubMed. Outcome(s) Measured: Patients were divided into two groups: those who received platelet rich plasma injections (PRP) and those who received hyaluronic injections (HA). Efficacy of PRP injections was compared to the efficacy of HA injections. Outcomes were measured at baseline and various monthly intervals post treatment using WOMAC scores. In addition, outcomes were measured by giving the 11 point pain intensity Numeric Rating scale (NRS), IKDC, and KOOS scores. Results: In two studies, results of PRP injections versus HA injections reached statistical significance and proved to be an effective form of treatment in patients with knee osteoarthritis (p \u3c 0.01). In the third study, however, there was no statistical significance indicated in the use of PRP injections as compared to HA injections. More research studies are necessary to understand the full effect of PRP injections in the treatment of knee osteoarthritis. Conclusion: Overall, PRP injections alone cannot be the first line of treatment used for knee osteoarthritis. However, PRP injections are a safe and viable option for patients who do not benefit from other treatments like HA injections. They also tend to have a better effect on patients with lower-grade knee osteoarthritis

Is Brimonidine Tartrate Gel .5% Effective in Reducing Facial Erythema of Rosacea?

OBJECTIVE: The objective of this selective Evidence Based Medicine (EBM) review is to determine whether or not “Is Brimonidine Tartrate gel 0.5% effective in reducing facial erythema of Rosacea?” STUDY DESIGN: Review of two randomized controlled trials (RCT), and one 1-year longitudinal open-label study. DATA SOURCES: All studies were published in peer-reviewed journals found via the use of PubMed or Medline. OUTCOMES MEASURED: Patients were divided into two groups: those who received the Brimonidine Tartrate gel and those who received the vehicle (placebo) gel. Efficacy of Brimonidine tartrate gel was compared to the efficacy of the vehicle gel. Outcomes were measured at baseline and at various intervals post treatment using Clinician’s Erythema Assessment (CEA) and Patient’s Self-Assessment (PSA) scales. Both scales were designed as tools for evaluation of erythema. In the 1-year open label study, inflammatory lesion counts and telangiectasia were also evaluated to determine the long-term efficacy of the drug. Additionally, in this study, the subjects were asked to complete a questionnaire regarding the impact of rosacea on their social life at various points during the study. RESULTS: In both RCT, (Fowler – 2011 and Fowler – 2013) results of Brimonidine tartrate gel versus Vehicle gel reached statistical significance and proved to be an effective form of treatment in patients with facial erythema of Rosacea (p \u3c 0.001 and p CONCLUSION: Both RCT and one-year open label studies included in this review indicate that Brimonidine Tartrate gel 0.5% is an effective treatment for facial erythema of Rosacea in regards to quality of life and self-confidence due to the appearance

Functional role of aspartic proteinase cathepsin D in insect metamorphosis

BACKGROUND: Metamorphosis is a complex, highly conserved and strictly regulated development process that involves the programmed cell death of obsolete larval organs. Here we show a novel functional role for the aspartic proteinase cathepsin D during insect metamorphosis. RESULTS: Cathepsin D of the silkworm Bombyx mori (BmCatD) was ecdysone-induced, differentially and spatially expressed in the larval fat body of the final instar and in the larval gut of pupal stage, and its expression led to programmed cell death. Furthermore, BmCatD was highly induced in the fat body of baculovirus-infected B. mori larvae, suggesting that this gene is involved in the induction of metamorphosis of host insects infected with baculovirus. RNA interference (RNAi)-mediated BmCatD knock-down inhibited programmed cell death of the larval fat body, resulting in the arrest of larval-pupal transformation. BmCatD RNAi also inhibited the programmed cell death of larval gut during pupal stage. CONCLUSION: Based on these results, we concluded that BmCatD is critically involved in the programmed cell death of the larval fat body and larval gut in silkworm metamorphosis

COMPARATIVE EFFICACY OF SYNTHETIC AND BOTANICAL INSECTICIDES AGAINST SUCKING INSECT PEST AND THEIR NATURAL ENEMIES ON COTTON CROP

The Synthetic and botanical insecticides are relatively safer for environment and beneficial insects. The study was conducted in Rahim Yar Khan during the cotton cropping season 2014 to evaluate the comparative efficacy of two Synthetic insecticides i.e. Nitenpyram (Jasper 10% SL) and Pyriproxyfen (Bruce 10.8% EC) and two botanical extracts of Calotropic procera and Azadirachta indica, against sucking insect pest complex of cotton and their natural enemies. Upon reaching economic thresholds, the recommended field doses of all the insecticides were applied on cotton cultivar MNH-886. Data against sucking pests and their natural enemies was recorded 24 hours prior to insecticidal application and then 24, 48, 72 and 96 hours after insecticidal application. Results revealed that Nitenpyram was much toxic against sucking pests followed by Pyriproxyfen as compared to two botanical extracts. On the other hand, the synthetic insecticides did not prove safer for natural enemies as compared to botanical extracts. It was concluded that as an Integrated Pest Management (IPM) strategy, botanical extracts can be used at low infestation levels so that ecosystem service of biological control may be sustained

Effectiveness of elephantorhiza elephantina as traditional plant used as the alternative for controlling coccidia infections in goats.

Elephantorrhiza elephantina Bruch Skeels is used by farmers in the Eastern Cape Province of South Africa to control Gastro-intestinal parasites in goats. The objective of the study was to determine the effects of E. elephantina on coccidia oocysts and determine the effectiveness of the dose levels on goats. Thirty six goats (18 males and 18 females) between ages of 8-12 months were used; randomly assigned to six treatments (A-F).  Treatments A and B received Prodose orange® at 2ml/10kg and distilled water at 0.5 ml/kg per goat respectively, whereas treatments C (12.5mg/ml), D (25mg/ml), E (50mg/ml) and F (75mg/ml) received aqueous extract of E. elephantina at different concentrations dosed at 2ml/10kg.  Faecal samples were collected on first month, second month and third month for faecal egg counts (FEC) and body-weights recorded to assess weight changes. Animals receiving the extract had weight increases of between 3 to 4 kg by end of experiment, but those drenched with Prodose orange ® gained by less than 2 kg. Findings are indicative that E. elephantina possess some anti-coccidian properties against coccidia oocysts in goats. Keywords: Elephantorrhiza elephantina; faecal egg counts; coccidia oocysts, Ethno-veterinary medicine

Glucose enhancement of human memory: A comprehensive research review of the glucose memory facilitation effect

The brain relies upon glucose as its primary fuel. In recent years, a rich literature has developed from both human and animal studies indicating that increases in circulating blood glucose can facilitate cognitive functioning. This phenomenon has been termed the ‘glucose memory facilitation effect’. The purpose of this review is to discuss a number of salient studies which have investigated the influence of glucose ingestion on neurocognitive performance in individuals with (a) compromised neurocognitive capacity, as well as (b) normally functioning individuals (with a focus on research conducted with human participants). The proposed neurocognitive mechanisms purported to underlie the modulatory effect of glucose on neurocognitive performance will also be considered. Many theories have focussed upon the hippocampus, given that this brain region is heavily implicated in learning and memory. Further, it will be suggested that glucose is a possible mechanism underlying the phenomenon that enhanced memory performance is typically observed for emotionally laden stimuli

Diethylcarbamazine activity against Brugia malayi microfilariae is dependent on inducible nitric-oxide synthase and the cyclooxygenase pathway

BACKGROUND: Diethylcarbamazine (DEC) has been used for many years in the treatment of human lymphatic filariasis. Its mode of action is not well understood, but it is known to interact with the arachidonic acid pathway. Here we have investigated the contribution of the nitric oxide and cyclooxygenase (COX) pathways to the activity of DEC against B. malayi microfilariae in mice. METHODS: B. malayi microfilariae were injected intravenously into mice and parasitaemia was measured 24 hours later. DEC was then administered to BALB/c mice with and without pre-treatment with indomethacin or dexamethasone and the parasitaemia monitored. To investigate a role for inducible nitric oxide in DEC's activity, DEC and ivermectin were administered to microfilaraemic iNOS(-/- )mice and their background strain (129/SV). Western blot analysis was used to determine any effect of DEC on the production of COX and inducible nitric-oxide synthase (iNOS) proteins. RESULTS: DEC administered alone to BALB/c mice resulted in a rapid and profound reduction in circulating microfilariae within five minutes of treatment. Microfilarial levels began to recover after 24 hours and returned to near pre-treatment levels two weeks later, suggesting that the sequestration of microfilariae occurs independently of parasite killing. Pre-treatment of animals with dexamethasone or indomethacin reduced DEC's efficacy by almost 90% or 56%, respectively, supporting a role for the arachidonic acid and cyclooxygenase pathways in vivo. Furthermore, experiments showed that treatment with DEC results in a reduction in the amount of COX-1 protein in peritoneal exudate cells. Additionally, in iNOS(-/- )mice infected with B. malayi microfilariae, DEC showed no activity, whereas the efficacy of another antifilarial drug, ivermectin, was unaffected. CONCLUSION: These results confirm the important role of the arachidonic acid metabolic pathway in DEC's mechanism of action in vivo and show that in addition to its effects on the 5-lipoxygenase pathway, it targets the cyclooxygenase pathway and COX-1. Moreover, we show for the first time that inducible nitric oxide is essential for the rapid sequestration of microfilariae by DEC

Clinical trial of extended-dose chloroquine for treatment of resistant falciparum malaria among Afghan refugees in Pakistan

BACKGROUND: Falciparum malaria is a significant problem for Afghan refugees in Pakistan. Refugee treatment guidelines recommended standard three-day chloroquine treatment (25 mg/kg) for first episodes and extended five-day treatment (40 mg/kg) for recrudescent infections, based on the assumption that a five-day course would more likely achieve a cure. An in-vivo randomized controlled trial was conducted among refugees with uncomplicated falciparum malaria to determine whether five-day treatment (CQ40) was more effective than standard treatment (CQ25). METHODS: 142 falciparum patients were recruited into CQ25 or CQ40 treatment arms and followed up to 60 days with regular blood smears. The primary outcome was parasitological cure without recrudescence. Treatment failures were retreated with CQ40. PCR genotyping of 270 samples, from the same and nearby sites, was used to support interpretation of outcomes. RESULTS: 84% of CQ25 versus 51% of CQ40 patients experienced parasite recrudescence during follow-up (adjusted odds ratio 0.17, 95%CI 0.08-0.38). Cure rates were significantly improved with CQ40, particularly among adults. Fever clearance time, parasite clearance time, and proportions gametocytaemic post-treatment were similar between treatment groups. Second-line CQ40 treatment resulted in higher failure rates than first-line CQ40 treatment. CQ-resistance marker pfcrt 76T was found in all isolates analysed, while pfmdr1 86Y and 184Y were found in 18% and 37% of isolates respectively. CONCLUSIONS: CQ is not suitable for first-line falciparum treatment in Afghan refugee communities. The extended-dose CQ regimen can overcome 39% of resistant infections that would recrudesce under the standard regimen, but the high failure rate after directly observed treatment demonstrates its use is inappropriate

Effects of Individual and Group Therapies on Verb Production in Aphasia

Language interventions are frequently classified along a continuum (Paul & Cascella, 2007). At one end of the continuum are impairment-based approaches that aim to remediate a particular language skill. Successful treatments often utilize models of cognitive-linguistic processing and have been shown to improve language performance in individuals with aphasia (Thompson & Shapiro, 2005; Whitworth, Webster, & Howard, 2005, Wertz et al 1981). At the other end of the continuum is the participant-centered approach. These types of interventions place the client at the center of the intervention. Group treatment is a socially oriented intervention and an example of a participant-centered approach. Studies support the use of conversation group treatments to improve language performance in individuals with aphasia (Wertz et al., 1981, Elman & Bernstein-Ellis, 1999b). Considerable evidence exists in the literature to support both these types of interventions and both interventions seek to improve communication in the individual with aphasia (Martin, Thompson & Worrall, 2008). However, there have been no studies that compare the effects of these two approaches. This study compared the effect of these two approaches on remediation of verb production in aphasia. The goals were 1) to determine if performance on verbs trained in an impairment-based approach, a participant-centered approach, or an integrated context that used both approaches improved to a greater extent, and 2) to determine whether combining these training approaches led to improvements in related language functions and in verbal communication