The purpose of this research was the fabrication, statistical optimization, and in vitro characterization of insulin-loaded poly(hydroxybutyrate-co-hydroxyvalerate) (PHBV) nanoparticles (INS-PHBV-NPs). Nanopar-ticles were successfully developed by double emulsification solvent evaporation method. The NPs were characterized for particle size, entrapment efficiency (EE%), and polydispersity index (PDI). The NPs also were characterized by scanning electron microscopy (SEM), Fourier transformed infrared spectroscopy (FTIR), X-ray diffraction (XRD), differential scanning calorimetry (DSC), and circular dichroism (CD). The optimum conditions were found to be 1.6% polyvinyl alcohol (PVA), 0.9% of PHBV, and 15 mg/ml of insulin with the aid of the Box-Behnken experimental design results. The optimized NPs showed spherical shape with particle size of 250.21 ± 11.37 nm, PDI of 0.12 ± 0.01, and with EE% of 90.12 ± 2.10%. In vitro drug release pattern followed Korsmeyer-Peppas model and exhibited an initial burst release of 19% with extended drug release of 63.2% from optimized NPs within 27 d. In conclusion, these results suggest that INS-PHBV-NPs could be a promising candidate for designing an injectable sustained release formulation for insulin.
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Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis (WG), is a multisystem autoimmune disease of unknown etiology often misdiagnosed as pneumonia. The hallmark features include necrotizing granulomatous inflammation and pauci-immune vasculitis in small and medium-size blood vessels. We described a 15-year-old female with a history of six months of acne-like facial and peri-auricular lesions. She had received the conventional treatment for acne (antibiotics + topical corticosteroid) with no response. She also had a history of chronic coughs which always diagnosed and treated as sinusitis. In addition, she had a history of frequent dysuria which always diagnosed and treated as urinary tract infection. Given the history, with suspicion of a multi-systemic disease such as vasculitis; we performed some diagnostic laboratory and radiologic tests in order to rule out the possible etiologies. The results showed positive for cytoplasmic anti-neutrophil cytoplasmic antibody (C-ANCA). The urine analysis suggested the involvement of kidney micro-vasculature. In addition, two nodular lesions with cystic pattern were observed in lungs CT scan. However, the skin and nasal biopsies revealed no evidence of chronic necrotizing vasculitis or granulomatous lesion. Nonetheless, treatment was initiated with a strong suspicion of GPA. Following the treatment, the patient's symptoms completely disappeared, and the diagnosis of GPA was confirmed.
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