Carbon quantum dots (CQDs) are a new type of nano-carbons that are currently favored over semiconductor quantum dots (QDs) because of their solubility, low toxicity, eco-friendliness, and cheap and facile synthesis giving desired optical characteristics. Moreover, their physiochemical properties can be controlled by their synthetic route. CQDs can emit fluorescence in the range from the UV to the near-infrared (NIR) region, making them suitable for biomedical applications. Fluorescence in these nano-carbon atoms can be tuned by varying the excitation wavelength. As of now, CQDs have been used in various applications such as in bioimaging, biosensing, electrochemical biosensing, drug delivery, gene delivery, photodynamic therapy in the treatment of cancers, pharmaceutical formulations, and treating inflammation. This article highlights the current progress and advancement of CQDs with focus on their synthetic routes, chemical and optical properties, and biomedical applications along with new perceptions in this interesting and promising field.
Background Introduction of Bare Metal Stents (BMS) was itself a revolutionary step in the history of the medical industry; however, Drug Eluting Stents (DES) maintained its superiority over BMS in every aspect from restenosis rate to late lumen loss. The reason behind the magnanimous position of the DES in the stent market is the degree of improvement with which it evolves. New and better stents come into the market every year, surpassing their predecessors by many folds. Literature review This review paper discusses the journey of DES with supporting clinical trials in detail. In the first generation, there were stainless-steel stents with thicker coatings. Although they had superior results compared to BMS, there was still room for improvement. Afterward came the second-generation stents, which had superior metal platforms with thinner struts and thin coatings. The drugs were also changed from Paclitaxel and Sirolimus to Zotrolimus and Everolimus. These stents performed best; however, there was an issue of permanent coating, which remained intact over the stent surface after complete drug elution and started to cause issues in longer-term studies. Hence, an improved version of DES was introduced to these permanent coatings called the third generation of drug eluting stents, which initially utilized biodegradable polymer and ultimately moved towards polymer free drug coatings. This generation has introduced a unique amalgam of technologies to achieve its polymer free coatings; however, researchers have numerous prospects of growth in this field. This review paper highlights the major coups of stent technology evolution from BMS to DES, from thick polymeric coatings to thin coatings and from durable polymers to polymer free DES. Conclusion In conclusion, though the medical industry promptly accepted BMS as the best treatment option for cardiovascular diseases; however, DES has provided even better results than BMS. In DES, the first and second generation has ruled the technology for many years and are still on the shelves. Still, the issues aroused due to durable polymer shifted the attention towards biodegradable drug eluting stents, the third generation growing rapidly. But the scientific community has not restricted themselves and is investigating bioresorbable stents that completely eliminate the polymer intervention in drug eluting stent technology.
Diabetes is the 4th most common disease affecting the world’s population. It is accompanied by many complications that deteriorate the quality of life. Painful diabetic neuropathy (PDN) is one of the debilitating consequences of diabetes that effects one-third of diabetic patients. Unfortunately, there is no internationally recommended drug that directly hinders the pathological mechanisms that result in painful diabetic neuropathy. Clinical studies have shown that anticonvulsant and antidepressant therapies have proven fruitful in management of pain associated with PDN. Currently, the FDA approved medications for painful diabetic neuropathies include duloxetine, pregabalin, tapentadol extended release, and capsaicin (for foot PDN only). The FDA has also approved the use of spinal cord stimulation system for the treatment of diabetic neuropathy pain. The drugs recommended by other regulatory bodies include gabapentin, amitriptyline, dextromethorphan, tramadol, venlafaxine, sodium valproate, and 5 % lidocaine patch. These drugs are only partially effective and have adverse effects associated with their use. Treating painful symptoms in diabetic patient can be frustrating not only for the patients but also for health care workers, so additional clinical trials for novel and conventional treatments are required to devise more effective treatment for PDN with minimal side effects. This review gives an insight on the pathways involved in the pathogenesis of PDN and the potential pharmacotherapeutic agents. This will be followed by an overview on the FDA-approved drugs for PDN and commercially available topical analgesic and their effects on painful diabetic neuropathies.
Background: Painful Diabetic Neuropathy (PDN) is a devastating condition affecting one in three people with diabetes. Introduction: Keeping in mind the unceasingly escalating prevalence of diabetes mellitus worldwide, the number of PDN patients is also expected to rise with a reduced quality of life in patients and staggering increase in healthcare cost. Despite relentless efforts and continuous research, the commercially available medication for relieving diabetic neuropathy pain are only partially effective with substantial side effects. This is, in part, due to our partial awareness of the underlying complexities causing PDN. The pathogenesis of PDN remains elusive because of the difficulty in obtaining damaged nerve samples and the absence of non-invasive methods to investigate the pathogenesis at different stages of disease progression. The purpose of this review is to describe the pathogenesis, the clinical manifestations and treatment options for PDN. Methods: The keywords relevant to the scope of this paper were put in electronic databases (PubMed and Google Scholar) to fetch the relevant data. The data were then analyzed and compiled. Results: A simplified overview of PDN for researchers new to the field has been provided in an attempt to clarify common confusions. The changes in skin structure and functions in response to diabetes, diabetic neuropathy and painful diabetic neuropathy are also discussed. The unavailability of efficacious pain reliever for PDN stresses on the need for identifying the microenvironmental factors that are altered in PDN and manipulate them to tailor targeted theranostics. Conclusion: In the end, we propose to consider the altered skin structure, function and microenvironmental factors in diabetic population for devising smart, targeted, stimuli-responsive treatment options to attain maximum pain relief with minimum side effects.
Drug eluting stents (DES) can efficiently reduce the atherosclerosis and restenosis issues of coronary artery as compared to bare metal stents due to the presence of pharmaceutically active agent on their surface. Nevertheless, the arising safety concerns of DES such as delayed healing and late in stent restenosis and thrombus, has stirred the research efforts to improve the outcomes of the DES. In this connection, attention is being shifted from the use of synthetic drug to natural drug for DES. In the present work, natural compound loaded polymeric films were synthesized and their antioxidant and anticoagulation capabilities were assessed through in vitro testing. The potential of the drug loaded polymeric films to curb the production of free radicals was evaluated by carrying out antioxidant activity using 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. The in vitro platelet adhesion was investigated through static platelet adhesion test while effect of synthesized films on intrinsic coagulation pathway was investigated through activated partially thromboplastin time (APTT). Moreover, to further evaluate the blood compatibility of the developed drug loaded films, in vitro hemolytic and anti-thrombolytic assays were carried out. The obtained results indicated that, incorporating herbal compounds such as ginger, magnolol and curcumin, in polymeric matrix (PVA) has significantly improved the blood compatibility of the polymeric films. Hence, it can be concluded that the synthesized drug loaded polymeric films have the potential capability to be used as a potential coating material for coating biomedical implants with good anticoagulation and antioxidant property to cater the cardiovascular issues such as atherosclerosis, restenosis and thrombus formation.
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