A B S T R A C TRheumatoid arthritis (RA) is the most common complex multifactorial joint related autoimmune inflammatory disease with unknown etiology accomplished with increased cardiovascular risks. RA is characterized by the clinical findings of synovial inflammation, autoantibody production, and cartilage/bone destruction, cardiovascular, pulmonary and skeletal disorders. Pro-inflammatory cytokines such as IL-1, IL-6, IL-8, and IL-10 were responsible for the induction of inflammation in RA patients. Drawbacks such as poor efficacy, higher doses, frequent administration, low responsiveness, and higher cost and serious side effects were associated with the conventional dosage forms for RA treatment. Nanomedicines were recently gaining more interest towards the treatment of RA, and researchers were also focusing towards the development of various anti-inflammatory drug loaded nanoformulations with an aid to both actively/passively targeting the inflamed site to afford an effective treatment regimen for RA. Alterations in the surface area and nanoscale size of the nanoformulations elicit beneficial physical and chemical properties for better pharmacological activities. These drug loaded nanoformulations may enhances the solubility of poorly water soluble drugs, improves the bioavailability, affords targetability and may improve the therapeutic activity. In this regimen, the present review focus towards the novel nanoparticulate formulations (nanoparticles, nanoemulsions, solid lipid nanoparticles, nanomicelles, and nanocapsules) utilized for the treatment of RA. The recent advancements such as siRNA, peptide and targeted based nanoparticulate systems for RA treatment were also discussed. Special emphasis was provided regarding the pathophysiology, prevalence and symptoms towards the development of RA.
Background: There is an increased demand for newer safer drugs for the treatment of peptic ulcer disease as its incidence is increasing gradually in view of changing lifestyle and stress. The objective of this study was to evaluate the anti-ulcer activity of ethanol extract of seeds of Vitis vinifera. Methods: The ethanol extract of Vitis vinifera was investigated for its anti-ulcer activity in rats against Aspirin plus Pylorus ligation induced gastric ulcer. The antiulcer activity was assessed by determining and comparing gastric volume, pH, free and total acidity; ulcer number and its inhibition, ulcer severity and ulcer index. Results: A significant antiulcer activity was observed. Pylorus ligation model showed significant (p<0.01) reduction in gastric volume, free acidity and ulcer index as compared to control. Conclusions: This present study indicates that Vitis vinifera seed extract have potential anti-ulcer activity in the model tested.
Background: Antibiotics are the most commonly used and misused of all drugs. Patterns of antibiotic resistance widely follows local patterns of antibiotic prescribing and usage. Periodic data collection and analysis of antibiotic prescriptions at regional level are essential to understand and combat antibiotic resistance. Objective of the study was to study the prescribing pattern of antibiotics in outpatient department of Otorhinolaryngology in a tertiary care teaching hospital. Methods: A prospective observational study of prescribing pattern of antibiotics was conducted in the department of Otorhinolaryngology. Data of antibiotic utilization in outpatient department was collected through duplicate copies of the prescriptions. The data obtained was analyzed and the conclusions were drawn using descriptive analysis.Results: A total of 606 prescriptions were collected and analyzed during the study. Average number of antibiotics prescribed per prescription was 1.24 most of the antibiotics were prescribed for a duration of 1 to 5 days. Commonly prescribed antibiotic class was penicillin (48.1%) followed by quinolone (18.3%). Most of the antibiotics were prescribed by their brand names (98.8%).Conclusions: The present study highlights the wide use of extended spectrum antibiotics, along with brand names for prescribing. Interventions for prescribing of generic drugs from the essential drug list needs to be encouraged among physicians.
Mupirocin is a topical antibiotic that has been used extensively for treating methicillin resistant Staphylococcus aureus (MRSA) associated infections. However, the prevalence of resistance to mupirocin is being increasingly found due to its irrational and widespread use. Retapamulin: a pleuromutilin antibacterial agent is an effective topical antibiotic against these resistant strains. This study was carried out to determine the rates of resistance to mupirocin in MRSA isolates in our patient population, and to estimate the association of such resistance and resistance to other classes of antimicrobial agents in order to consider the effect of the use of mupirocin on the selection of antimicrobial resistant strains. This prospective study was conducted in the Department of Microbiology at VIMS & RC, Bengaluru. 200 Staphylococcus aureus isolates were recovered from various clinical specimens from out patients and in patients admitted into various wards and intensive care units. Isolation and identification of isolates S. aureus isolated from clinical specimens were identified according to the standard laboratory operating procedures. Antimicrobial sensitivity was determined by the Vitek 2 K automated system. All tests and quality assurance procedures were performed and interpreted according to the standards set by the Clinical and Laboratory Standards Institute (CLSI). For fusidic acid and retapamulin The European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria was used. For the macrolide-lincosamide streptogramin B (MLSB) phenotype (inducible clindamycin resistance encoded by the plasmid-borne gene, erm) was determined by the disc approximation test, clindamycin was reported to be resistant. Mupirocin resistance testing was done by disc diffusion with disc concentration of 5μg and 200μg. Among the 200 Staphylococcus aureus isolates 108 (54%) were MRSA, highest percentage of MRSA strains were from blood isolates (62%), followed by aspirated fluids and pus (59 % and 56 % respectively). Of the 108 MRSA strains, 26 (24%) were mupirocin resistant Staphylococcus aureus (MupRSA). Mupirocin resistance was not detected in methicillin sensitive Staphylococcus aureus (MSSA) isolates. High-level mupirocin resistance was observed in 11% and low-level resistance in 13% of the 108 isolates. Higher prevalence of high level mupirocin resistance was from blood isolates followed by pus (45% and 36.3% respectively), low level mupirocin resistance was maximum seen in the isolates from respiratory secretions (46%). MupRSA was more frequently isolated from ICUs and surgical wards. The mupirocin resistant MRSA strains exhibited resistance to other class of antibiotics also: ampicillin (90%), ciprofloxacin (88%), erythromycin (86%), co trimoxazole (73%). However fusidic acid, vancomycin and linezolid showed sensitivity of 99%, 96% and 96% respectively. All the strains were sensitive to retapamulin. Increase in mupirocin resistance among MRSA isolates is a matter of concern. Antimicrobial stewardship programmes are i...
Objectives:To evaluate the antiulcer activity of ethanolic extract of seeds of (grape) Vitis vinifera in Wistar albino rats. Methods:The ethanolic extract of V. vinifera was investigated for its antiulcer activity in Wistar albino rats against hydrochloric acid -ethanolinduced ulcer model. The antiulcer activity was assessed by determining and comparing the gastric volume, pH, free, and total acidity; ulcer number and its inhibition, ulcer severity, and ulcer index.Results: A significant antiulcer activity was observed. The grape seed 100 mg/kg group showed significant (p<0.05) reduction in ulcer number as compared to the control. The grape seed 200 mg/kg showed significant (p<0.05) reduction in ulcer number, free acidity, and gastric lesion as compared to the control. Conclusion:This study indicates that V. vinifera seed extract has potential antiulcer activity in the model tested.
Background: Urinary tract infection is defined as bacteriuria along with urinary symptoms. It is one of the most common bacterial infections in humans and a major cause of morbidity. UTI has become difficult to treat because of appearance of pathogens with increasing resistance to antimicrobial agents. The objective of this study was to determine the bacteriological profile of pathogens responsible for urinary tract infection and to assess the antibiotic sensitivity pattern of the causative uropathogens.Methods: This cross-sectional study was performed at the hospital of Sree Mookambika Institute of Medical Sciences, Kulasekharam during January 1, 2016 to December 12, 2016. Institutional ethical committee clearance was obtained. We surveyed 628 patients, who had clinical manifestations of UTI. Urine specimens were cultured for isolation of the microbial agents of UTI. The isolated bacteria were identified using biochemical tests. Data was entered in Microsoft Excel Version 2016.Statistical analysis was done using SPSS TRIAL VERSION 21C.Results: The commonest organism isolated overall was extended spectrum beta lactamase positive E. coli (35.5%) followed by extended spectrum beta lactamase negative E. coli and Enterococcus. Females (68.63%) were mostly affected than males in our study. The people in the age group of 41-60 years are found to be more (48.46%) affected than the people of other age groups. The most sensitive oral antibiotic to almost all organisms in our study is Nitrofurantoin followed by Cotrimoxazole and Norfloxacin and among parenteral antibiotics, Amikacin stands first followed by Piperacillin-Tazobactam and Gentamicin. Apart from the above antibiotics, Klebsiellapnemoniae also shows good response to Cefotaxime (96.15%) and Cefipime (96.15%) and Aztreonam (92.3%).Conclusions: From our study, it is observed that the most common causative organism for Urinary tract infection is found to be extended spectrum beta lactamase positive E. coli followed by Extended Spectrum Beta Lactamase negative E. coli and Enterococcus. The current status of sensitivity of common organism rests mainly on Nitrofurantoin (oral) and Amikacin, Piperacillin-Tazobactam (parenteral).
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