Showing papers in "Journal of Pharmacy and Bioallied Sciences in 2020"
TL;DR: Different methods used in the preparation and screening of medicinal plants in the authors' daily research can be grouped and discussed according to the intended biological testing to guide young researchers and make them more focused.
Abstract: Preparation of medicinal plants for experimental purposes is an initial step and key in achieving quality research outcome. It involves extraction and determination of quality and quantity of bioactive constituents before proceeding with the intended biological testing. The primary objective of this study was to evaluate various methods used in the preparation and screening of medicinal plants in our daily research. Although the extracts, bioactive fractions, or compounds obtained from medicinal plants are used for different purposes, the techniques involved in producing them are generally the same irrespective of the intended biological testing. The major stages included in acquiring quality bioactive molecule are the selection of an appropriate solvent, extraction methods, phytochemical screening procedures, fractionation methods, and identification techniques. The nitty-gritty of these methods and the exact road map followed solely depends on the research design. Solvents commonly used in extraction of medicinal plants are polar solvent (e.g., water, alcohols), intermediate polar (e.g., acetone, dichloromethane), and nonpolar (e.g., n-hexane, ether, chloroform). In general, extraction procedures include maceration, digestion, decoction, infusion, percolation, Soxhlet extraction, superficial extraction, ultrasound-assisted, and microwave-assisted extractions. Fractionation and purification of phytochemical substances are achieved through application of various chromatographic techniques such as paper chromatography, thin-layer chromatography, gas chromatography, and high-performance liquid chromatography. Finally, compounds obtained are characterized using diverse identification techniques such as mass spectroscopy, infrared spectroscopy, ultraviolet spectroscopy, and nuclear magnetic resonance spectroscopy. Subsequently, different methods described above can be grouped and discussed according to the intended biological testing to guide young researchers and make them more focused.
311 citations
TL;DR: Developed and validated HPTLC method provides an approach to estimate RA content as a common marker of investigated herbs and can facilitate the differentiation of investigated species using the chromatographic fingerprints of their phenolic compounds.
Abstract: Aim: Representatives of Nepetoideae Burnett subfamily are promising species of the Lamiaceae Martinov family because of accumulating such valuable groups of secondary metabolites as terpenoids and polyphenols. A high-performance thin layer chromatography (HPTLC) fingerprint method for the qualitative determination of phenolic compounds and for the quantification of rosmarinic acid (RA) content in methanol extracts of five species of this subfamily was developed for the first time. Materials and Methods: Dried aerial parts of Dracocephalum moldavica L., Ocimum americanum L., Lophanthus anisatus (Nutt.) Benth., Monarda fistulosa L., and Satureja hortensis L. collected in flowering period were macerated with methanol. The HPTLC analysis was conducted using the CAMAG analytical system (Muttenz, Switzerland). The comparative analysis of RA contents was performed by HPTLC densitometric detection at λ = 366nm. Results: Identification of polyphenols in the investigated herbs was performed by comparison of a color and Rf of the chromatographic zones with six reference standards: rutin, apigenin, luteolin, caffeic acid, chlorogenic acid, and RA. HPTLC method was also validated for the quantification of RA in the extracts of investigated herbs. RA contents decreased in such a sequence: D. moldavica (24.83 ± 0.78mg/g) > M. fistulosa (20.32 ± 0.64mg/g) > O. americanum (19.59 ± 0.61mg/g) > S. hortensis (18.77 ± 0.52mg/g) > L. anisatus (12.61 ± 0.43mg/g). Conclusion: Obtained data can facilitate the differentiation of investigated species using the chromatographic fingerprints of their phenolic compounds. Developed and validated HPTLC method provides an approach to estimate RA content as a common marker of investigated herbs.
20 citations
TL;DR: The neem gel showed significant decrease in dental plaque, gingival inflammation, and microbial counts, which was comparable to CHX gel proving to be a good herbal alternative.
Abstract: Background: The etiological relationship between the plaque and the gingival inflammation has been long established. The long-term use of chemical antiplaque agents may lead to side effects such as teeth staining and alteration of taste. Therefore, natural plant extracts with potential antibacterial and anti-inflammatory activity have been explored, which are equally effective and safe for long-term use. Objective: The aim of this study was to compare and evaluate effect of neem gel and chlorhexidine (CHX) gel on dental plaque, gingivitis, and bacterial count of Streptococcus mutans and Lactobacilli among 20–30-year-old school teachers in a city of western Maharashtra, over 90 days’ usage. Materials and Methods: A double-blind, parallel armed, controlled, randomized clinical study was conducted among 60 school teachers of 20–30 years’ age group for 90 days. The two study groups were as follows: Group A––2.5% neem gel (n = 30) and Group B––0.2% CHX gel (n = 30). The plaque scores were recorded by Plaque Index (Loe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967;38:610-6) and gingival scores by Gingival Index (Loe H, Silness J. Periodontal disease in pregnancy. Acta Odontol Scand 1963;21:533-51). Streptococcus mutans and Lactobacilli species count by conventional culture method was carried out at baseline, 30th day and 90thday. Considering P value 0.05) on intergroup comparison. Conclusion: The neem gel showed significant decrease in dental plaque, gingival inflammation, and microbial counts, which was comparable to CHX gel proving to be a good herbal alternative. No side effects were reported for use of neem gel over considered period of time.
16 citations
TL;DR: The microbial culture and sensitivity of the isolates from urine samples should be carried out as a routine before starting the antimicrobial therapy, but gram-negative bacteria were highly resistant to ampicillin and Gram-positive bacteria showed highly resistance to cefoxitin.
Abstract: Context: Clinicians face one of the most common bacterial infections in developing countries that is urinary tract infection (UTI). Current knowledge on antimicrobial susceptibility pattern is essential for selecting appropriate therapy. Aims: In this study, we investigated the various bacteria causing UTI and determined the sensitivity and resistance of antibiotics pattern against most prevalent uropathogens isolated from patients at tertiary hospital, Al-Baha, Saudi Arabia. Settings and Design: This was a retrospective study of urine culture conducted in King Fahad Hospital at Al-Baha in Saudi Arabia. Materials and Methods: Laboratory reports and patient medical files of both inpatient and outpatient were collected between June 2017 and May 2018, targeting both male and female of age above 18 years of age, who had been treated for UTI. Results: A total of 349 patients’ urine report was studied to identify the uropathogens. Escherichia coli was the main etiologic agent in community and hospital-acquired infections. The majority of the bacteria was isolated from female (60%), whereas the remaining (40%) was from male. The most common isolates were E. coli, Klebsiella pneumoniae, Enterococcus faecalis, E. coli Extended spectrum beta-lactamases, Pseudomonas, and K. pneumoniae ESBL (these represented 37.82%, 19.20%, 10.89%, 10.32%, 6.59%, and 3.72%, of isolate, respectively). UTI due to E. coli was at a higher rate during summer than during winter. This study showed that ciprofloxacin (20.29%) and cefuroxime (16.14%) are most prescribed medications, followed by ceftriaxone (12.96%) and then tazocin (8.80%). Imipenem, meropenem, amikacin, vancomycin, tigecycline, linezolid, and colistin were highly sensitive for most types of bacteria, but gram-negative bacteria were highly resistant to ampicillin. Gram-positive bacteria showed highly resistance to cefoxitin. Conclusion: The microbial culture and sensitivity of the isolates from urine samples should be carried out as a routine before starting the antimicrobial therapy. Current knowledge of the antibiotic sensitivity/resistance patterns of uropathogens at a particular geographical region is a guiding factor for choosing an appropriate empirical antimicrobial treatment rather than following universal guidelines.
14 citations
TL;DR: It is concluded that PPAR-γ agonism serves as one of the mechanisms in sinapic acid-mediated renoprotection and provides dose-dependent and significant nephroprotection against cisplatin-mediated nephrotoxicity in rats.
Abstract: Aim: The aim of this study was to investigate the involvement of peroxisome proliferator-activated receptor gamma (PPAR-γ) in renal protection offered by sinapic acid in cisplatin-induced nephrotoxicity in male rats. Materials and Methods: Nephrotoxicity was induced by single dose of cisplatin (5 mg/kg, intraperitoneal [i.p.]) in rats. Cisplatin-induced nephrotoxicity was assessed by measuring serum creatinine, creatinine clearance, urea, uric acid, potassium, magnesium levels, fractional excretion of sodium, and microproteinuria in rats. Superoxide anion generation, thiobarbituric acid reactive substances, myeloperoxidase activity, and reduced glutathione levels were measured to assess oxidative stress in renal tissues. Hematoxylin and eosin stain showed renal histological changes. Results: The significant changes in serum and urinary parameters, elevated oxidative stress, and renal histological changes established the induction of nephrotoxicity. Sinapic acid treatment (20 and 40 mg/kg, orally [p.o.]) provides dose-dependent and significant (P < 0.05) nephroprotection against cisplatin-mediated nephrotoxicity in rats. Nephroprotective effect of sinapic acid was abolished by PPAR-γ inhibitor, bisphenol A diglycidyl ether (30 mg/kg, i.p.) in rats. Conclusion: It is concluded that PPAR-γ agonism serves as one of the mechanisms in sinapic acid-mediated renoprotection.
14 citations
TL;DR: The aim of this review is to discuss about the various aspects of regenerative endodontics, current clinical protocols, and the future of pulp regeneration techniques.
Abstract: Preserving the natural dentition in its normal form and function is one of the major goals of endodontic treatment. Re-establishing the lost vitality and development of root maturation in immature permanent teeth with pulp necrosis/apical periodontitis is quiet challenging clinically. The very basis of regenerative endodontics relies on the concept of tissue engineering using stem cells, biomimetic scaffold, and bioactive growth factors to regenerate the pulp tissue damaged by microbial infection, injury, or developmental defects. In clinical endodontics, this approach is referred to as a "paradigm shift." Even though repair instead of true regeneration is achieved with current protocols, it is hoped that further research in the area of stem-cell-based tissue engineering will allow for true regeneration and improved treatment outcomes. The aim of this review is to discuss about the various aspects of regenerative endodontics, current clinical protocols, and the future of pulp regeneration techniques.
14 citations
TL;DR: The main objective of this study was to explore literature on dental materials used for implants, contrast them with titanium dental implants, with the aim to improve osseointegration and mechanical quality using Ti–Ga–Si dental implant.
Abstract: Titanium and its alloys are mainly used in manufacturing dental implants. The fact that titanium implants are immunologically very effective, new methods are being experimented to achieve utmost success rate as a biomaterial. One fundamental indicator for clinical achievement of implant is the decision of composition decided for the implant with the objective to improve osseointegration. The main objective of this study was to explore literature on dental materials used for implants, contrast them with titanium dental implants, with the aim to improve osseointegration and mechanical quality using Ti-Ga-Si dental implant.
14 citations
TL;DR: Chlorhexidine plays a key role in the dentistry and is used to treat or prevent periodontal disease, and has earned its eponym of the gold standard.
Abstract: Chlorhexidine is a cationic bisbiguanide with broad antibacterial activity, and wide spectrum of activity encompassing gram-positive and gram-negative bacteria, yeasts, dermatophytes and some lipophilic viruses. Its antibacterial action is due to the disruption of the bacterial cell membrane by the chlorhexidine molecules, increasing the permeability and resulting in cell lysis. Thus, chlorhexidine plays a key role in the dentistry and is used to treat or prevent periodontal disease, and has earned its eponym of the gold standard. This article reviews in detail about the mechanism of action, indications, forms and various studies related to chlorhexidine.
11 citations
TL;DR: The focus of this review was to provide clear and direct information about the currently available topical therapeutic agents in clinical practice used to cure and/or reduce the incidence of ulcerative symptoms of OM, excluding the associated pain and other coexisting complications such as bacterial and fungal infections.
Abstract: Oral mucositis (OM) is an extremely serious and challenging complication of chemoradiotherapy, which may limit the efficacy of cancer treatment. Complications related to OM include potential nutrition impairment, high economic burden, and negative impacts on patients' quality of life. Current therapeutic options with local traditional pharmaceutical formulations are largely focused on controlling symptoms, and only few agents are available for treatment. Several local supportive and palliative agents are used for the prevention of OM; however, a standard treatment for the disease has not been confirmed yet. The efficacy of treatment could be improved through the introduction of new medical agents with updated dosage forms that can enhance and optimize local drug delivery and create greater therapeutic effects with fewer side effects. The focus of this review was to provide clear and direct information about the currently available topical therapeutic agents in clinical practice used to cure and/or reduce the incidence of ulcerative symptoms of OM, excluding the associated pain and other coexisting complications such as bacterial and fungal infections. The review also provides recent evidences regarding agents that could be used as promising novel therapies in updated local delivering systems. This will support further encouraging options and approaches for the management of OM and will improve compliance that could be translated in better disease control and survival.
11 citations
TL;DR: A significant decrease in both unstimulated and stimulated salivary flow rate with the severity of progression of chronic periodontitis is identified.
Abstract: Background: Chronic periodontitis (CP) is an infectious disease, primarily affecting the attachment apparatus of the dentition, and is categorized into mild, moderate, and severe periodontitis on the basis of its severity. It is a well-established and proven fact that an adequate level of saliva is essential for maintaining the integrity of oral tissues including the periodontium. Although various factors, such as stimulation, circadian rhythm, diet, age, and drugs, can affect the salivary flow rate, many recent studies have provided evidence that it can be altered by pathological inflammatory conditions such as periodontal diseases. Therefore, this study has been undertaken to assess the unstimulated and stimulated salivary flow rate in the different clinical stages of chronic periodontitis. Materials and Methods: This study comprised 60 study participants, who were divided into four groups depending on clinical attachment level (CAL). In all, both unstimulated and stimulated saliva were collected, and the flow rate was expressed in milliliter per minute. Results: Statistical analysis was accomplished with Statistical Package for the Social Sciences (SPSS) software. One-way analysis of variance (ANOVA) was used to analyze differences in salivary flow rate among the groups. Statistical significance was set at P < 0.05. The amount of unstimulated saliva in healthy subjects, in mild, moderate, and severe periodontitis was 0.766, 0.400, 0.270, and 0.146 mL/min, respectively. Likewise, the amount of stimulated saliva in healthy subjects, in mild, moderate, and severe periodontitis was 1.017, 0.494, 0.347, and 0.236 mL/min, respectively. Conclusion: The study identified a significant decrease in both unstimulated and stimulated salivary flow rate with the severity of progression of chronic periodontitis.
10 citations
TL;DR: The study proposes reproducible and cost-effective rat models for both T1DM- and T2DM-induced diabetic nephropathy characterized by stable metabolic features and typical renal lesions.
Abstract: Background: Diabetes mellitus and its complications, such as nephropathy, represent a global burden. Recent research focuses on developing drugs that specifically target the pathogenesis of diabetic nephropathy rather than merely treating hyperglycemia. Rodent models of animal disease are integral in drug discovery and represent an obligatory regulatory requirement. Aim: The aim of this study was to develop and standardize rat models of type 1 and type 2 diabetic nephropathy, resembling characteristics of human clinical condition. Materials and Methods: Rats were administered streptozotocin (STZ) 50 mg/kg intraperitoneally (i.p.), and STZ 50 mg/kg i.p. + nicotinamide (NA) 110 mg/kg i.p., for induction of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), respectively. Metabolic parameters (body weight, feed and water intake, blood glucose, serum insulin, oral glucose tolerance test, intraperitoneal insulin tolerance test, and indices of insulin sensitivity) were evaluated to characterize the symptoms of T1DM and T2DM. Renal damage was confirmed by the estimation of renal function biomarkers, kidney antioxidant status, kidney hypertrophy index, and histopathology. Results: STZ and STZ + NA administration increased blood glucose levels significantly. Metabolic parameters indicated that administration of STZ resulted in clinical features of human T1DM, whereas STZ + NA rats resembled human T2DM. STZ- and STZ + NA-treated rats developed diabetic nephropathy in 4 weeks, indicated by altered levels of renal function markers, increased kidney hypertrophy index, increased renal oxidative stress, and altered tissue architecture. The study proposes reproducible and cost-effective rat models for both T1DM- and T2DM-induced diabetic nephropathy characterized by stable metabolic features and typical renal lesions.
TL;DR: Of the dentists, 90% agree that teledentistry would be the major advancement in the future; however, there needs to be a specific module of operation and promotion of the module in future.
Abstract: Aim: To bridge the gap between urban and rural population, a vast number of researches are being carried out. Teledentistry is one of the technological advances in dentistry. It is defined by Cook in 1997 as “the practice of using video-conferencing technologies to diagnose and provide advice about treatment over a distance.” This study aimed to assess the knowledge, attitude, and practice of teledentistry among general dentists in and around Coimbatore district, Tamil Nadu, India. Materials and Methods: A self-administered closed-ended questionnaire was designed. The questions were divided into three sections based on knowledge, attitude, and practice. Data collected from the questionnaire were entered in Microsoft Excel. Level of significance (P < 0.05) was set at 95% confidence interval and P < 0.01 at 99% confidence interval was maintained, and the data were statistically analyzed. Results: The majority of the dentists had less knowledge about teledentistry. About 73% of the dentists believe that teledentistry can provide access of specialists to the rural population. Conclusion: Of the dentists, 90% agree that teledentistry would be the major advancement in the future; however, there needs to be a specific module of operation and promotion of the module in future.
TL;DR: Patients with the duration of T2DM less than or equal to 5 years surprisingly were susceptible to have low MA, while low MA was not affected by polytherapy.
Abstract: Background: Type 2 diabetes mellitus (T2DM) is a chronic disease where most of the patients usually need polytherapy. This could affect their medication adherence (MA). However, other complex factors may also associate with MA, which are important to identify. Aim: The purpose of this study was to evaluate the MA of patients with T2DM who received polytherapy and to identify other factors that can affect the MA. Materials and Methods: This was a cross-sectional study conducted in seven community health centers in Jakarta with HbA1C representing their MA level. Poor controlled blood glucose with Hemoglobin A1C (HbA1C) of ≥7% is indicated to have low MA. All characteristics were collected to identify factors that are potentially associated with low MA. The univariate analysis tests were used to analyze factors that potentially associate with low MA. Multiple logistic regression analysis was performed in the factors to find their relationship with low MA. Results: The study obtained 143 patients with a female dominance (67.8%) and mean ± standard deviation (SD) age of 59.53 ± 9.251 years. Approximately 75.5% of the patients had low MA (HbA1C ≥ 7). Univariate analysis found that duration of T2DM significantly (P = 0.047) related to MA, where patients with T2DM of less than or equal to 5 years tended to have low MA. Logistic regression showed that patients with T2DM less than or equal to 5 years (P = 0.015, odds ratio = 1.206, 95% confidence interval = 1.216–8.014) were associated with low MA. Conclusion: Patients with the duration of T2DM less than or equal to 5 years surprisingly were susceptible to have low MA. Low MA was not affected by polytherapy.
TL;DR: The application of proposed markers, on a pulpectomized tissue derived from human teeth, may be helpful to determine the regenerative potential and the usefulness in regenerative medicine and tissue engineering.
Abstract: Objectives: The dental pulp contains undifferentiated mesenchymal cells, blood vessels and so on, which are responsible for routine functions of a tooth. The determination of stemness and regenerative properties using biomarkers and further application in routine practice may unravel its potential. Materials and Methods: Inclusion criteria—original research articles published in English, from 2000 to 2019, were collected both manually and by electronic search from databases of Cochrane, Medline, Embase, and PubMed. Exclusion criteria—articles other than English and review manuscripts were omitted. The shortlisted articles were reviewed for specific biomarkers, to assess the regenerative potential, stemness, and lineage of dental pulp stem cells. Results: Of 512 articles, 64 were selected and reviewed to determine the mesenchymal, neurogenic, vasculogenic, hematopoietic, and stem cell potential. On the basis of the search analysis, a panel of markers was proposed. Conclusion: The application of proposed markers, on a pulpectomized tissue derived from human teeth, may be helpful to determine the regenerative potential and the usefulness in regenerative medicine and tissue engineering.
TL;DR: It is suggested that andrographolide can be successfully formulated into an acceptable nanoemulsion-based hydrogel which shows acceptable pH, viscosity, and physical appearance.
Abstract: Introduction: Andrographolide is a compound that shows various pharmacological activities, which can be applied topically or orally. Nanoemulsion can improve drug solubility and stability, but has limitations for topical application. Incorporation of nanoemulsion into hydrogel can increase the viscosity of the system which can prolong the drug residence time. The aim of this study was to develop andrographolide nanoemulsion-based hydrogel for topical application. Method: Andrographolide nanoemulsion was prepared using Capryol 90 as the oil, Kolliphor RH 40 as the surfactant, and propylene glycol as the cosurfactant. Droplet size and polydispersity index of the nanoemulsions were evaluated using particle size analyzer. D-optimal mixture design was employed to generate the total number of runs (formulation), and obtain the optimum formulation. Fourteen formulations of nanoemulsion-based hydrogel were prepared by incorporating nanoemulsion into the hydrogel base (1:1). Carbopol was employed as the gelling agent, whereas other excipients including propylene glycol, oleic acid, triethanolamine, methylparaben, and propylparaben were also added to produce hydrogel base. Nanoemulsion-based hydrogel was evaluated for its pH, viscosity, and physical appearance (after 8 weeks of storage). Results: The result revealed that nanoemulsion-based hydrogel containing 34.65% of carbopol, 1.35% of triethanolamine, and 9% of propylene glycol was selected as an optimum formulation which shows acceptable pH, viscosity, and physical appearance. This optimum nanoemulsion-based hydrogel has pH of 6.50 ± 0.02, and 2492.33 ± 36.91 cP of viscosity with milky white color, and smooth homogeneous texture. Conclusion: This study suggested that andrographolide can be successfully formulated into an acceptable nanoemulsion-based hydrogel.
TL;DR: The digital photography can be used as one of the reliable methods for shade selection in a clinical setup by using chi-square test, which shows highly significant value.
Abstract: Aim: The main purpose of the study was to learn the possible shade differences between human eye and the digital method with spectrophotometric methods. Materials and Methods: Fifty dental students of age groups 18–25 with maxillary right central incisor after undergoing oral prophylaxis were included in this study. Before undergoing shade selection, standardization protocol was followed. The shade of the right maxillary central incisor was determined by using the following methods: visual, spectrophotometer, and digital photography. The shades obtained by both spectrophotometer and visual methods are compared and similarly L*, a*, and b* values obtained by both spectrophotometer and digital methods are compared. Finally these comparisons are subjected to statistical analysis. Results: Z and P values of digital and spectrophotometric methods were found to be statistically significant. Tooth shade selected between spectrophotometric and visual method was analyzed by using chi-square test, which shows highly significant value. Conclusion: It was concluded that the digital photography can be used as one of the reliable methods for shade selection in a clinical setup.
TL;DR: The results suggest that the pretreatment method and primers used were effective in improving the bonding of resin cements to zirconia ceramic and the bonding properties of the veneering resin to the PEEK surface.
Abstract: Aim: The aim of the study was to compare the shear bond strength of composite resin bonded to polyether ether ketone (PEEK) and zirconia, and also to evaluate the effect of thermocycling on the shear bond strength. Materials and Methods: A total of 22 zirconia (Group 1) and 22 PEEK (Group 2) specimens (disks of 10 mm in diameter and 10 mm in thickness) were machine milled using computer-aided design (CAD)/computer-aided manufacturing (CAM) from commercially available zirconia and PEEK. These specimens were air abraded with 110-μm aluminum oxide. Following which these two groups were subdivided into four groups, that is, Group 1A: 11 zirconia specimens before thermocycling, Group 1B: 11 zirconia specimens after thermocycling, Group 2A: 11 PEEK specimens before thermocycling, and Group 2B: 11 PEEK specimens after thermocycling. These four groups of specimens were embedded in an acrylic block, and bonding agent was applied over the upper surfaces of the disks of each of these specimens. Composite resin was then cured, and then Group 1B and group 2B were thermocycled under a standard temperature. The bond strength of the specimen was tested using universal testing machine. Result: The result showed that there was no significant difference in shear bond strength between the groups, although higher shear bond strength was observed in the PEEK group. Conclusion: Shear bond strength of PEEK is similar to zirconia. The results suggest that the pretreatment method and primers used were effective in improving the bonding of resin cements to zirconia ceramic and the bonding properties of the veneering resin to the PEEK surface.
TL;DR: CGM has significant potential in the management of not only patients withtype 1 diabetes mellitus but also patients with type 2 diabetes mell Titus in spite of the few limitations that are being improvised in the upcoming years.
Abstract: Objective: The aim of this systematic review was to evaluate the clinical implications of continuous glucose monitoring (CGM) among patients with diabetes mellitus using variables that include glycated hemoglobin (HbA1c), estimated A1c, glucose variability, and users’ perspectives. Materials and Methods: This study analyzed 17 articles that were identified and studied according to the research question criteria. PRISMA guidelines were used for identification and screening of the literature. The required data were searched using Medscape, PubMed, PROSPERO, Wiley Library, Scopus, Clinical Trial Registry, and Trip. Results: The articles reviewed were on the use of CGM in type 1 and type 2 diabetes mellitus, which showed significant improvement in the levels of HbA1c as compared to non-CGM. The application of CGM on acute sudden onset type of adverse drug reactions (i.e., hypoglycemia) is better than fasting blood sugar or self-monitoring of blood glucose or capillary blood glucose (random blood glucose monitoring). CGM is beneficial for use in patients with type 2 diabetes mellitus including elderly patients as it gives information regarding glucose variability as well as HbA1c levels. The health-care providers require full spectrum of patients’ CGM data to design a better therapeutic plan. However, the patients experienced inconvenience on wearing the device on the body for longer periods. The findings also stated the fact that more education and training is required for the patients to interpret their own glycemic data using CGM and modify their lifestyle accordingly. Use of CGM along with HbA1c has also been used to achieve better glycemic results and it allows the health care professional to guide patients in terms of their glucose level; whether they are hypoglycemic or hyperglycemic, however its use has some controversies that minimize its application. Conclusion: The study concluded that CGM has significant potential in the management of not only patients with type 1 diabetes mellitus but also patients with type 2 diabetes mellitus in spite of the few limitations that are being improvised in the upcoming years. However, limited literature of CGM among patients with type 2 diabetes mellitus and pregnant women reduces the practice scope.
TL;DR: The findings highlighted the need of an interprofessional partnership between the pharmacy professional bodies with Malaysian dental associations to develop, and evaluate evidence-based resources, guidelines, the scope of oral health in pharmacy curricula and services to deliver improved oral health care within Malaysian communities.
Abstract: Introduction: Pharmacists have been well recognized as an active and have a more integrated role in the preventive services within the National Health Services. This study assessed the community pharmacists’ attitudes, beliefs, and practices toward oral health in the Malaysian setting. Materials and Methods: A cross-sectional survey-based study was used to conduct this project. An anonymous self-administered questionnaire was developed and distributed among community pharmacists within Kuala Lumpur and Selangor states areas, Malaysia. The data collection was carried out from the beginning of November to the end of December 2018. Results: Of the 255 pharmacists, 206 agreed to participate in the study, yielding a response rate of 80.8%. Overall, approximately half of the pharmacists provided two to five oral health consultations per week and two to five over the counter (OTC) oral health products recommendations per week. The main services provided by community pharmacists in were the provision of OTC treatments (93.7%), referral of consumers to dental or medical practitioners when appropriate (82.5%), and identify signs and symptoms of oral health problems in patients (77.2%). In addition, more than 80% of the pharmacists viewed positively and supported integrating oral health promotion and preventive measures into their practices. The most commonly reported barriers to extending the roles of pharmacists in oral health care include lack of knowledge or training in this field, lack of training resources, and lack of oral health educational promotion materials. Conclusion: The study shows that community pharmacists had been providing a certain level of oral health services and play an important role in oral health. The findings highlighted the need of an interprofessional partnership between the pharmacy professional bodies with Malaysian dental associations to develop, and evaluate evidence-based resources, guidelines, the scope of oral health in pharmacy curricula and services to deliver improved oral health care within Malaysian communities.
TL;DR: Nonadherence to medications is a substantial problem among the elderly in the UAE and the study findings confirm the need for further research to examine the perspectives of at-risk population with a focus on knowledge, beliefs, and attitudes on medication nonadherence.
Abstract: Introduction: Drug adherence is a major factor in determining health outcomes of geriatric patients and is a growing concern for health-care systems as the geriatric population shows a steep rise due to improved health-care services in the UAE. Aim: We aimed to evaluate the adherence and beliefs of geriatric patients in the UAE toward their medicines and to explore the factors affecting them. Methods: A cross-sectional study was performed including 163 geriatric patients. Surveys, direct observations, and interviews were used for primary data collection. Demographic data were computed using descriptive statistics method. The Statistical Package for the Social Sciences (SPSS) program, Version 19.0, SPSS Inc., Chicago, IL, USA, was used to analyze and code the raw data, whereas chi-squared test was used to analyze the responses. Secondary data were also collected. Results: The results indicated that patient factors and medication factors are the main risk factors for medication nonadherence among geriatric patients in the UAE. The study found that drug regimen (91.4%, N = 149), forgetfulness (87.1%, N = 142), time constraints (67.5%, N = 110), and cost (55.2%, N = 90) were the main key factors affecting medication adherence. Also, poor communication (12.9%), the lack of trust (16.6%), confidence (20.2%), and patient involvement (43.6%) were shown to influence adherence behaviors to medication. The main habits, attitudes, and beliefs that were found to affect patient’s adherence were follow-ups (73%), inadequate knowledge of medicine (60.1%), the lack of perceived benefits (18.4%), and limited knowledge on health conditions (19.6%). The study showed 161 patients among the total 163 participants forget taking their medications and others cease from taking their medications. To conclude, nonadherence to medications is a substantial problem among the elderly in the UAE. Conclusion: The study findings confirm the need for further research to examine the perspectives of at-risk population with a focus on knowledge, beliefs, and attitudes on medication nonadherence.
TL;DR: This study is a useful example for the independent investigations using thermal and spectroscopic analysis to confirm potential hidden variations between generic and branded products that could not be obtained by the bioequivalence studies.
Abstract: Background and Purpose: There has been a long-standing belief that generic drugs are of lower value in comparison to their branded name counterparts. They are in particular under scrutiny due to their low market price. Even though the reduction in costs is largely based on skipping expensive preclinical studies and clinical trials for generic drugs, the purity and quality of the raw materials in the production of generic drugs is debatable. Thus, the objective of the study was to analyze and assess the quality comparability of generic furosemide 40 mg (FSD) tablets to branded product available in the market. Materials and Methods: Quality control tests, in vitro drug release assessments, and thermal analysis investigations for both analog products of FSD were performed. Various physical parameters related to the tablet quality, such as hardness, weight variation, and friability tests, were examined. In vitro drug release behavior evaluations were conducted according to United States Pharmacopeia (USP) specifications and guidelines, whereas thermal analysis was carried out using thermal gravimetric analysis (TGA), and tablets were further evaluated by Fourier transform infrared (FTIR) spectroscopy. Results: The results indicated a significant variation between the two products in terms of hardness, weight variation, and friability. This could be correlated to variation appeared in thermal and spectroscopic spectra between the two products using TGA and FTIR. Drug release of FSD was slightly different between both products following incubation in different pH media (1.2, 3.0, and 6.5; 120 min), however, this was in accordance with USP dissolution requirements as < 80% of drug release was obtained within the first 30 min from each product. Conclusion: This study is a useful example for the independent investigations using thermal and spectroscopic analysis to confirm potential hidden variations between generic and branded products that could not be obtained by the bioequivalence studies.
TL;DR: The prevalence of LBW infants was considerably less in mothers with a healthy periodontium and increased with progressive periodontal disease, whereas literacy of mothers showed statistical significant association with periodontic disease, andperiodontal status and hemoglobin levels of the mothers also showed a significant association.
Abstract: Background: There is emerging interest and increasing amount of evidence that support the interrelationship between periodontitis and systemic conditions. Epidemiological and microbiological–immunological studies have lent credence to the concept that periodontal disease may be a separate risk factor for cardiovascular disease, cerebrovascular disease, and respiratory disease, as well as preterm delivery of low-birth-weight infants. Aim: The aim of this study was to evaluate the influence of periodontal infection as a possible risk factor for preterm low birth weight (LBW) based on age, literacy, and hemoglobin level of mother. Materials and Methods: The observational study was conducted on 200 subjects, which were selected from the free labor ward, District Hospital, Saifai, Etawah, UP, India. Periodontal examinations were performed using the World Health Organization criteria. The periodontal status of the mother was recorded using Community Periodontal Index. Results: For this study, chi-square test was performed to know the effect of variables and to find out the statistical significance of the study. Age of mother shows statistical insignificant association with periodontal disease, whereas literacy of mothers showed statistical significant association with periodontal disease, and periodontal status and hemoglobin levels of the mothers also showed a significant association. Conclusion: The prevalence of LBW infants was considerably less in mothers with a healthy periodontium and increased with progressive periodontal disease.
TL;DR: The docking molecular study identified the possible potential compounds from Zingiberaceae plants that might be used for anti-HIV-1 treatment by possessing lower docking energy than native ligand of amprenavir, raltegravir, and nevirapine.
Abstract: Introduction: Human immunodeficiency virus type-1 (HIV-1) that causes acquired immunodeficiency syndrome (AIDS) has become a worldwide health problem today. There are approximately 30 anti-HIV-1 drugs that have been used in the treatment of AIDS. However, effective anti HIV-1 agents with less side affect and high inhibition potency are still in demand. Objective: The objective of this study was to identify the potential compounds from Zingiberaceae plants that might be active as anti-HIV-1 by molecular docking. Materials and Methods: Molecular docking simulation was performed by using AutoDock 4.2 on Linux operation system. Docking protocol was validated by using root mean square deviation (RMSD) value using redocking and cross-docking methods. The reported metabolites from Zingiberaceae plants were docked on HIV-1 protease, integrase, and reverse transcriptase protein enzymes. Results: The docking result showed that the genera of Zingiber, Etlingera, Alpinia, Hedychium, and Boesenbergia have potential metabolites that inhibit HIV protease, integrase, and reverse transcriptase enzymes by possessing lower docking energy than native ligand of amprenavir, raltegravir, and nevirapine. Among the metabolites, noralpindenoside B and alpindenoside A from Alpinia densespicata inhibited protease enzymes with the lowest docking energy of -18.02 and -17.90 kcal/mol, respectively. Meanwhile, panduratin E from Boesenbergia pandurata Roxb. and 5α,8α-epidioxyergosta-6,22-dien-3β-ol from Etlingera elatior showed the lowest docking energy on integrase protein with docking energy of -11.97 and -11.41 kcal/mol, respectively. Pahangensin A from Alpinia pahangensis Ridley showed the lowest docking energy on reverse transcriptase enzyme with docking energy of -13.76 kcal/mol. Conclusion: The docking molecular study has identified the possible potential compounds from Zingiberaceae plants that might be used for anti-HIV-1 treatment. So, this study suggested further isolation and purification of the predicted compounds.
TL;DR: The results showed statistically noteworthy association between the toothbrushing regularity, number of dental appointments, history of oral trauma, smoking, and subdomains of OHIP-14 (P < 0.05).
Abstract: Background: Kids and teenagers are more prone to oral diseases. Poor oral health has a significant impact on oral well-being–associated quality of life. Thus, we performed an investigation to examine the outcome of oral health status on the quality of life of children and adolescents in Indian population, by using the Oral Health Impact Profile-14 (OHIP-14). Materials and Methods: A total of 100 children, ranging between 1 and 19 years of age who attended Indian hospitals from November 2016 to October 2019, were included in the study. The DMFT Index (Decayed, Missing, and Filled Teeth) and OHIP-14 were used as data collection tools. Association of the total OHIP-14 score and seven subscales associated with it was evaluated using Spearman’s correlations. Results: The results showed statistically noteworthy association between the toothbrushing regularity, number of dental appointments, history of oral trauma, smoking, and subdomains of OHIP-14 (P < 0.05)Conclusion: Dental and oral health of an individual has a great impact on their quality of life.
TL;DR: The miswak raw extract containing film that can act against P. gingivalis and HSV-1 can be used to treat chronic periodontitis by placing it in periodontal pockets by forming a film of size 0.5 mm × 0.4 mm.
Abstract: Introduction: Miswak is a tooth brushing stick that contains many ingredients that are beneficial for maintenance of oral hygiene. The aim of this study is to formulating a film containing miswak extract for treatment of chronic periodontitis. Materials and Methods: Here we tested the miswak raw extract invitro against Porphyromonas gingivalis and Herpes simplex virus-1 (HSV-1). The film was prepared using solvent casting method. Disintegration test was conducted to find the stability of the film. Results: Cytotoxicity of miswak was also tested. Minimum inhibitory concentration against P. gingivalis was 62.5 µg/mL. Therapuetic index against HSV-1 was 11.3 µg/mL. Cytotoxicity against 50% Vero cells was present at 210 µg/mL. Based on this invitro study 100 µg/mL dose was calculated to be incorporated in a film of size 0.5 mm × 0.4 mm. This film is made of polymers HPMC K 100 and Eudragit L 100. Disintegration test of the film showed that they remained stable for around 5 days. Conclusion: In the present study we formulated the miswak raw extract containing film that can act against P. gingivalis and HSV-1. So it can be used to treat chronic periodontitis by placing it in periodontal pockets.
TL;DR: The gel from an extract of red onion showed significant antifungal activity against T. rubrum, which means these gels can be used as a natural antIFungal in the healing of tinea pedis caused by Trichophyton rubrum.
Abstract: Introduction: Tinea pedis is a dermatophyte infection of human feet, especially between the fingers and soles of the feet. Tinea pedis is caused by a fungal infection of Trichophyton rubrum. Red onion is one of the spices that has been widely known by the community and used as a traditional medicine in the prevention of fungus. The objective of this research was to determine the antifungal activity of gel produced from an extract of red onion on T. rubrum. Materials and Methods: The gel was formulated with various concentration of red onion, FI with a concentration of extract (5%), F2 (7.5%). and F3 (12.5%). Each formula tested the physical characteristics and antifungal activity toward T. rubrum. The antifungal activity was determined by the agar well-diffusion method using Saboround Dextrose Agar plates. Furthermore, the antifungal activities were assessed by the presence or absence of inhibition zones after the plates were incubated at 28oC for 7 days. Results: F3 has the greatest inhibitory power than F1 and F2 (P 0.05). Discussion: All gel understudy at various concentrations of red onion was formulated in gel-exhibited antifungal activity. Antifungal activity of red onion occurred because it contained allicin. Therefore, the researchers can use these gels as a natural antifungal in the healing of tinea pedis caused by T. rubrum. Conclusion: The gel from an extract of red onion showed significant antifungal activity against T. rubrum.
TL;DR: Dental pulp stem cells (DPSCs), which are isolated from dental pulp, have shown excellent neuroregenerative properties in various animal studies, and this review outlines the clinical perspective of DPSCs in neuro Regeneration.
Abstract: Neurological diseases and injuries affect the routine life of patients. Current medical and surgical treatment has not improved the quality of life to desired limits. Neural regeneration through stem cells may be ideal choice in current scenario. Dental pulp stem cells (DPSCs), which are isolated from dental pulp, have shown excellent neuroregenerative properties in various animal studies. This review outlines the clinical perspective of DPSCs in neuroregeneration.
TL;DR: Authors found that above drugs were effective in reducing pain, size of ulcer, erythema, and improving healing in patients with recurrent aphthous stomatitis.
Abstract: Aim: The aim of this study was to assess the efficacy of 5% topical amlexanox and 0.1% topical triamcinolone acetonide in recurrent aphthous stomatitis (RAS) management. Materials and Methods: Sixty adult patients of RAS of both genders were divided into two groups with each group having 30 patients. In group I, 0.1% topical triamcinolone acetonide was prescribed. In group II, 5% topical amlexanox was prescribed. Patients were recalled regularly and size of ulcer, erythema, and pain score was recorded on days 1, 3, and 5. Results: The mean ulcer size (mm) on day 1 in group I was 4.3 and in group II it was 4.1, on day 3 it was 3.5 in group I and in group II it was 3.6, on day 5 in group I it was 1.3 and in group II it was 1.7. The result was not statistically significant (P > 0.05). The mean pain score recorded on visual analog scale was in descending grade day by day on first, third, and fifth days. In group I, healing was seen in 29 (96.6%) patients and in 28 (93.3%) patients in group II. Partially healing was seen in 1 (3.3%) patient in each group, whereas in group II nonhealing was observed in 1 (3.3%) patient. The statistical significance was not achieved as P > 0.05. Conclusion: Authors found that above drugs were effective in reducing pain, size of ulcer, erythema, and improving healing in patients with recurrent aphthous stomatitis. There were better results with triamcinolone acetonide as comparison of amlexanox.
TL;DR: NaOCl 5% showed maximum antibacterial activity against 3-week biofilm on tooth substrate and the use of herbal alternatives might prove to be advantageous considering the several undesirable characteristics of NaOCl.
Abstract: Aim: The purpose of this study was to evaluate the antimicrobial efficacy of Tylophora indica, Curcumin longa, and Phyllanthus amarus on Enterococcus faecalis biofilms formed on the tooth substrate. Sodium hypochlorite was used as a positive control. DMSO (dimethyl sulfoxide), the vehicle for the herbal extracts, was used as the negative control. Materials and Methods: Extracted human teeth were biomechanically prepared, vertically sectioned, placed in the tissue culture wells exposing the root canal surface to E. faecalis to form a biofilm. At the end of the third week, all groups were treated for 15 min with the test solutions and the control. The results were analyzed both quantitatively and qualitatively. Results: Statistical analysis was performed by using one-way analysis of variance and compared by the Mann–Whitney test using the Statistical Package for the Social Sciences (SPSS) software, version 20.0. The qualitative assay with the 3-week biofilm on the canal portion showed complete inhibition of bacterial growth for NaOCl, whereas samples treated with herbal solutions showed significant reduction of bacterial growth compared to control group, which showed 139.9 × 109 CFU/mL among the experimental herbal solutions groups. P. amarus has shown maximum bacterial count followed by C. longa and T. indica. Conclusion: NaOCl 5% showed maximum antibacterial activity against 3-week biofilm on tooth substrate. T. indica, P. amarus, and C. longa showed statistically significant antibacterial activity against 3-week biofilm. The use of herbal alternatives might prove to be advantageous considering the several undesirable characteristics of NaOCl.
TL;DR: Community pharmacist’s knowledge about the uses of herbal medicines and its adverse drug reactions reporting can contribute in better therapeutic outcomes and patient safety and recall the empowerment of experienced pharmacists with training programs in this area for better clinical outcomes.
Abstract: Introduction: Community pharmacist’s knowledge about the uses of herbal medicines and its adverse drug reactions reporting can contribute in better therapeutic outcomes and patient safety. Objectives: To evaluate community pharmacists’ knowledge about the use of herbal medicines and its adverse drug reactions reporting in Kedah state, Malaysia. Methods: A cross-sectional, questionnaire-based study was conducted among 103 pharmacists from 74 different community pharmacies to assess their knowledge about the use of herbal medicines and its adverse drug reaction reporting by using a pre-validate knowledge questionnaire consisting of 12 questions related to it. The pharmacists’ responses were measured at a 3-point Likert scale (Poor=1, Moderate=2, and Good=3) and data was entered in SPSS version 22. The minimum and maximum possible scores for knowledge questionnaires were 12 and 36 respectively. Quantitative data was analyzed by using One Way ANOVA and Paired t-test whereas Chi-square and Fisher exact test were used for qualitative data analysis. A p-value of less than 0.05 was considered statistically significant for all the analyses. Results: About 92% of the pharmacist had good knowledge regarding the use of herbal medicines and its adverse drug reaction reporting with a mean knowledge score of 32.88±3.16. One-way ANOVA determined a significant difference of employment setting (p<0.043) and years of experience (<0.008) with mean knowledge scores of Pharmacists. Pharmacists’ knowledge was significantly associated with their years of experience with the Chi-square test. Conclusion: Pharmacists exhibit good knowledge regarding the use of herbal medicines and its adverse drug reaction reporting. However, with an increasing trend of herbal medicine use and its adverse drug reaction reporting it recalls the empowerment of experienced pharmacists with training programs in this area for better clinical outcomes.