The Expanding Role of Dapagliflozin Beyond the Glucose-lowering Effect

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have varied metabolic effects beyond increasing glycosuria. This consensus review examines the role of dapagliflozin in health promotion, particularly its benefits in patients with and without type 2 diabetes mellitus (T2DM) and in cardiorenal rehabilitation post-coronavirus disease 2019 (COVID-19). Consensus recommendations were developed by subject experts in Endocrinology and Diabetology based on the online meeting held on 27 June 2020 to review the available evidence related to the role of SGLT2 inhibitors, with a focus on cardiovascular and renal metabolic therapy. Evidence suggests that dapagliflozin has a direct role in improving clinical outcomes in patients with chronic kidney disease (CKD) or heart failure (HF). These benefits of dapagliflozin were independent of reduction in blood pressure, glycemic control and weight, and also extend to patients without diabetes. The use of dapagliflozin in metabolic syndrome was endorsed by the majority of the experts; however, this would be off-label. It was opined that the role of dapagliflozin would currently be limited to treating T2DM with a focus on preventing HF or kidney disease progression. The need for conducting multidisciplinary academic meetings to have a balanced approach regarding the use of dapagliflozin among nondiabetic patients and the need for detailed evaluation of the role of SGLT2 inhibitors in vasculometabolic and cardiorenal rehabilitation post-COVID was also suggested.

Epidemiology of Body Dysmorphic Disorder Among Adolescents In Imphal West District, Manipur

Background: Body Dysmorphic Disorder (BDD) is a psychiatric disorder characterized by preoccupa-tion with a perceived flaw(s) in one’s appearance, leads sufferers to engage in repetitive behaviours to try to hide or fix the flaw(s) causing significant distress and interference. BDD is an unrecognized and undiagnosed problem among adolescents. Therefore, conducting a study in the Imphal West will identify the adolescents at risk. The objective of the study is to determine the prevalence of BDD among higher secondary students in Imphal West, Manipur. Methodology: This study was conducted among higher secondary students during Aug 2019 -Feb 2020. Sampling was done by stratified two stage cluster design and self-administered validated Body Image Disturbance Questionnaire was used. Data were summarized using descriptive statistics. Chi-square test was used for comparing proportions. Results: Out of the total 1207 students, 52% were female. Almost 92.2% of the students were concerned about some aspect of their appearance. About 2.6% met the DSM-V criteria for BDD. Females were sig-nificantly dissatisfied with their skin (71.3%), nose (59.3%), hair (34.7%), whereas men with their mus-cle build (54.8%) and eyes (40.3%). Conclusions: The study revealed BDD was prevalent but many individuals were unaware about the condition and its treatment.

A community-based study on electrocardiographic abnormalities of adult population from South India - Findings from a cross sectional survey

Background: There are no data on electrocardiographic (ECG) findings from general population of Indian subcontinent. We analyzed ECG abnormalities of in adults as part of a community survey of prevalence of coronary artery disease and risk factors from South India. Methods and results: In this cross-sectional study of men and women between the ages 20 to 79 years, ECGs recorded digitally were analyzed using the Minnesota code. Electrocardiograms were analyzed for abnormalities in 4630 participants (women 59.6%). The overall prevalence of ECG abnormalities (39.9%) was higher in men (47.24% vs. 34.9% p <0.0001). QRS axis deviation, first degree AV block, fascicular blocks, incomplete right bundle branch block, sinus bradycardia and ST elevation in the anterior chest leads were markedly higher in men. Sinus tachycardia and low voltage QRS occurred more often in women. The overall prevalence of atrial fibrillation was 0.32% which was markedly lower than the western data. Brugada and early repolarisation patterns occurred in 1.06% and 1.56% respectively, equal in both age groups, but markedly higher in men. Brugada pattern occurred more often than in the west, but much less than the Far East population. Early repolarisation pattern was similar to rest of Asian population, but significantly less than the Caucasian population Conclusion: In this community-based study, prevalence of major electrocardiographic abnormalities was high. Overall, men had significantly higher ECG abnormalities

Prediction of protein-protein interaction networks and druggable genes associated with parkinson’s disease-Supplementary data

Parkinson’s disease (PD) affects about 2-3% of the global population over 65 years of age and hence, it is the second most common neurodegenerative disorder in the world. This study explored the key genes and miRNA involved in PD. Microarray dataset (accession number GSE19587) comprising of two regions of medulla: dorsal motor nucleus of vagus (DMNV) and inferior olivary nucleus (ION) was downloaded from Gene Expression Omnibus (GEO) database. A total of 697 DEGs from ION (605 up-regulated genes and 92 down-regulated genes) and 663 DEGs from DMNV (638 up-regulated genes and 25 down-regulated genes) were screened. These DEGs were found to be enriched in 46 (DMNV) and 24 (ION) pathways common in DAVID and Comparative Toxicogenomics Database. In PPI network analysis, IGF1 and CD44 were identified as hub genes in DMNV whereas for ION, the hub genes identified were CSF2 and CD44. In TF-miRNA-target gene networks, an aggregate of 11 transcription factors and 46 miRNA were observed to influence the target genes. In drug-gene interaction studies, CYP3A5 and ESR1 had higher connective degrees and hence, they might be novel druggable targets for Parkinson’s disease.

Prediction of protein-protein interaction networks and druggable genes associated with parkinson’s disease

Parkinson’s disease (PD) affects about 2-3% of the global population over 65 years of age and hence, it is the second most common neurodegenerative disorder in the world. This study explored the key genes and miRNA involved in PD. Microarray dataset (accession number GSE19587) comprising of two regions of medulla: dorsal motor nucleus of vagus (DMNV) and inferior olivary nucleus (ION) was downloaded from Gene Expression Omnibus (GEO) database. A total of 697 DEGs from ION (605 up-regulated genes and 92 down-regulated genes) and 663 DEGs from DMNV (638 up-regulated genes and 25 down-regulated genes) were screened. These DEGs were found to be enriched in 46 (DMNV) and 24 (ION) pathways common in DAVID and Comparative Toxicogenomics Database. In PPI network analysis, IGF1 and CD44 were identified as hub genes in DMNV whereas for ION, the hub genes identified were CSF2 and CD44. In TF-miRNA-target gene networks, an aggregate of 11 transcription factors and 46 miRNA were observed to influence the target genes. In drug-gene interaction studies, CYP3A5 and ESR1 had higher connective degrees and hence, they might be novel druggable targets for Parkinson’s disease.

Video modelling technique used to manage the behaviour of uncooperative children in a dental set up / Técnica de modelagem em vídeo usada no manejo de comportamento de crianças não cooperativas no consultório odontológico

Objective: To investigate if video modelling is an effective technique in behaviour modelling of a child in a dental set up. Material and Methods: Fifty children aged 4-6 years indicated for pulpectomy were enrolled in this study. They were selected based on their behaviour using Frankl behaviour rating scale. Children with Frankl behaviour rating 1 and 2 were selected for this study. The video of a child who was cooperative while undergoing pulpectomy was shown to these children. The behaviour was assessed using Frankl behaviour rating scale after the video was shown to the children included in the study. Results: There was a statistically significant difference in the behaviour rating score of the children before after the video of the cooperative child was shown to them. Conclusion: It was observed that video modelling is an effective technique in managing the behaviour of an uncooperative child in a dental set up. (AU)

Objetivo: Investigar se a modelagem em vídeo é uma técnica eficaz no manejo do comportamento de crianças no consultório odontológico. Material e Métodos: Cinquenta crianças, de 4 a 6 anos, indicadas para pulpectomia foram incluídas neste estudo. Elas foram selecionadas com base em seu comportamento utilizando a Escala de Classificação de Comportamento de Frankl. Crianças com classificação de comportamento Frankl 1 e 2 foram selecionadas para este estudo. O vídeo de uma criança que cooperou durante o procedimento de pulpectomia foi mostrado a essas crianças. Posteriormente, o comportamento das mesmas foi avaliado usando a Escala de Classificação de Comportamento de Frankl. Resultados: Houve uma diferença estatisticamente significativa na pontuação da classificação do comportamento das crianças antes e depois do vídeo da criança cooperativa ter sido mostrado a elas. Conclusão: Observou-se que a modelagem em vídeo é uma técnica eficaz no manejo do comportamento de uma criança não cooperativa em um ambiente odontológico (AU)

Stump appendicitis single centre experience: a retrospective study

Background: Appendicectomy is the most common surgical procedure done for acute appendicitis worldwide. However, one among 50000 appendicectomy patients may present with recurrent abdominal pain, requiring hospitalization as stump appendicitis and may need completion appendicectomy. There are a few reports addressing management of stump appendicitis in the literature. Here we present our experience of laparoscopic completion appendicectomy over ten-year duration.Methods: A retrospective evaluation of records of appendicectomy from January 2008 to December 2018. All patients who had stump appendicitis as diagnosis and those who underwent completion appendicectomy were included. There were no exclusions. Details pertaining to presentation, duration of symptoms, records of previous surgery, perioperative and postoperative data was recorded, including follow-up of at least six months.Results: All 15 patients were managed by laparoscopic completion appendicectomy. Patients age range from 12 to 58 years, 12 were males and 3 female, duration of symptoms was from two to ten days, previous appendicectomy was done 4 to 84 months before, nine were diagnosed by ultrasonography of abdomen and six by CT scan, stump size ranged from 1 to 3.6 cm, mean operating time was 86.4 mins (range, 60-120 minutes). Duration of hospital stay was 3 to 5 days. There were no perioperative morbidity or mortality.Conclusions: Laparoscopic approach of completion appendicectomy is safe for management of stump appendicitis.

It is not asthma! An arcane case of ‘Scimitar’ syndrome: A case report

@#‘Scimitar’ syndrome in adulthood is usually asymptomatic. Significant structural abnormalities symptoms usually manifest early during infancy or young childhood with features of congestive heart failure from significant shunting of the anomalous pulmonary venous drainage. Diagnosis of ‘Scimitar’ Syndrome in adults is rare and usually an incidental finding on chest radiograph. Here, we report a case of an adult who presented with symptoms in her 40’s. This syndrome has never been reported nor discussed in Malaysia. This is the first case report of ‘Scimitar’ Syndrome in Malaysian literature. The diagnostic dilemma, medical management, and multi-disciplinary management by cardiology, physiotherapy and pulmonary rehabilitation teams are discussed.

Assessing the quality of root canal filling and instrumentation time using kedo-s files, reciprocating files and k-files / Avaliando a qualidade de obturação e tempo instrumentação usando limas kedo-s, limas reciprocantes e limas k manuais

Objective: Pulpectomy is the conservative treatment approach that retains and preserves the primary tooth in the dental arch in its normal function and non-pathologic state until its exfoliation. Over the years, pulpectomy has been performed using various instrumentation techniques. The aim of this study was to compare the quality of root filing and instrumentation time using Kedo-S files, Reciprocating files and K-files in primary teeth. Material And Methods: A randomized clinical trial was performed on 45 primary molars equally distributed for instrumentation with Kedo-S files, reciprocating files and K-Files. Immediate post-operative digital radiographs were taken to evaluate the quality of root filing and root canal instrumentation time was also recorded. Results: Mean instrumentation time with Kedo-S was 75.6 seconds, reciprocating file was 190.6 seconds and K-file was 95.4 seconds. Highest optimal fill was obtained with Kedo-S file group, highest overfill was obtained with Kedo-S group and highest under fill was obtained with reciprocating file group. Conclusion: Kedo-S rotary system provides better quality of root canal filling in minimum instrumentation time. (AU)

Objetivo: A pulpectomia é o tratamento conservador que retém e preserva o dente decíduo na arcada dentária em sua função normal e estado não patológico até sua esfoliação. Ao longo dos anos, a pulpectomia foi realizada usando várias técnicas de instrumentação. O objetivo deste estudo foi comparar a qualidade da obturação do canal radicular e do tempo de instrumentação usando limas Kedo-S, limas reciprocantes e limas K em dentes decíduos. Material e Métodos: Foi realizado um ensaio clínico randomizado em 45 molares decíduos distribuídos igualmente para instrumentação com limas Kedo-S, limas reciprocantes e limas K. Radiografias digitais pós-operatórias imediatas foram realizadas para avaliar a qualidade da obturação e também foi registrado o tempo de instrumentação do canal radicular. Resultados: O tempo médio de instrumentação com Kedo-S foi de 75,6 segundos, com limas reciprocantes foi de 190,6 segundos e com limas K foi de 95,4 segundos. O maior índice de obturação ideal foi obtido com o grupo de limas Kedo-S, o maior índice de sobreobturação foi obtido com o grupo Kedo-S e o maior índice de infraobturação foi obtido com o grupo de limas reciprocantes. Conclusão: O sistema rotatório Kedo-S fornece melhor qualidade de obturação do canal radicular em tempo mínimo de instrumentação.(AU)

Quantification of rasagiline mesylate by stability indicating RP-HPLC method: Development and validation

A novel reversed phase-high-performance liquid chromatography (HPLC) method for the estimation of rasagilinemesylate (RM), a potent anti-Parkinson drug in Active Pharmaceutical Ingredient (API), and tablet dosage form wasdeveloped and validated in the present research. HPLC instrument (Shimadzu) comprises ultraviolet detector andphenomenex 100 C18 (250 × 4.6 mm, 5 µm) column was utilized in the study. A mixture of acetonitrile and waterin the ration of 50:50, adjusted to pH 3.0 ± 0.05 with ortho-phosphoric acid was used as the mobile phase. Thechromatographic conditions; flow rate 0.8 ml/minute, run time 6.0 minutes, injection volume 50 µl, and detectionwavelength 268 nm were maintained during the study at room temperature. To ensure performance of novel methoddeveloped, it was validated according to International conference on harmonization guidelines. The developed methodwas subjected to the forced degradation studies to find out the stability indicating nature of the method by quantifyingthe RM in presence of its degradation products and the peaks which were responsible for the degraded products werenot interfered with the API principle peak. The proposed stability indicating newly developed and validated methodcan be adopted for the quantification of RM in bulk and pharmaceutical formulations.

Knowledge and socio-demographic profile of Anganwadi workers in Mangalagiri rural Integrated Child Development Services project, Guntur

Background: Integrated Child Development Services (ICDS) today represents one of the world’s largest programmes for early childhood development. The Anganwadi workers and Anganwadi Helpers are the grass root level functionaries responsible for delivery of services.Methods: A field based cross sectional observational study was conducted in Mangalagiri rural ICDS project to assess the knowledge levels and the socio-demographic profile of the Anganwadi workers, all the Anganwadi workers who are working in Mangalagiri rural ICDS project area have been included in the study.Results: Out of 212 AWWs, majority of AWWs were from the age group of between 30-49 years; 123 (58%) AWWs have education qualification from 6th class to 10th class standard and 135 (63.7%) workers had an experience of more than 10 years. About 142 (67%) AWWs had a good knowledge assessment score. They had best knowledge about immunization (96.7%), referral services (93.4%), growth monitoring (82.5%), health check-ups (75.1%) and nutrition and health education (70%). AWWs complained problems like infrastructure related, excessive work overload and record maintenance.Conclusions: The majority of the AWWs are in the age group of 30 to 49 years. More than half of them belong to lower middle socio-economic class. Maximum number of workers has experience of 10 years or more. All the AWWs in our study had 50% and above knowledge about Anganwadi services. Best knowledge is seen regarding immunization followed by referral services. Least knowledge is seen regarding supplementary nutrition. Major problems reported were excess work and record maintenance.

A study on prevalence of chronic kidney disease and its risk factors among adults in selected slums of Chennai

Background: Chronic kidney disease (CKD) is a silent epidemic. The true prevalence of CKD with in a population are very difficult to estimate, since early to moderate CKD were usually asymptomatic. ESRD in the consequence of CKD is one of the most expensive diseases to treat.Only way is to prevent it and Hence this was conducted to estimate the prevalence of CKD and its associated risk factors among adults in selected slums of Chennai.Methods: This is a cross sectional study done from May 2013 to June 2014 in selected slums of Chennai. The study population includes adult males and females. Multi stage sampling method used. Sample size covered was 400. A semi structured questionnaire used as tool. Based on the serum creatinine eGFR calculated using modified MDRD study equation and CKD prevalence was identified. The data was entered in MS excel and analyzed using SPSS version 21.Results: Total of 400 participants involved. Females were predominant in the study. Among them, 67 (16.8%) were diagnosed as CKD patients and Stage 1, 4.0% had stage 2, 3.6% had stage 3, 1.3% had stage 4 and 0.5% had stage 5 at the time of diagnosis.Conclusions: This study revealed prevalence of CKD among slum population was 16.8%. This study showed that old age, uncontrolled hypertension, uneducated, Diabetes with poor control, overuse of analgesics, H/o smoking, obesity, alcoholism, passive smoking, family H/o CKD and proteinuria were significant risk factor for CKD among study subjects. Slum population with risk factors should be regularly screened for CKD.

Larvicidal activity of essential oil from Vitex negundo and Vitex trifolia on dengue vector mosquito Aedes aegypti

Abstract INTRODUCTION: The ability of Vitex trifolia and Vitex negundo essential oils to kill Aedes aegypti and Culex quinquefasciatus larvae was evaluated. METHODS: The larvae were treated with their respective essential oils at 50-125 ppm concentration. RESULTS: LC50 and LC90 for V. trifolia against Ae. aegypti and C. quinquefasciatus, and those for V. negundo against Ae. aegypti were 57.7+0.4, 77.9+0.9 ppm and 55.17+3.14, 78.28+2.23 ppm, and 50.86+0.9, 73.12+1.3 ppm, respectively. Eucalyptol and caryophyllene were the major components in Vitex trifolia and Vitex negundo essential oil, respectively. CONCLUSIONS: This study revealed potential larvicidal properties of essential oil from V. trifolia.

Comparative Evaluation of The Efficacy Of Rotary file system (Kedo-S) Vs Hand K-Files In Root Canal Preparation Of Primary Teeth Using Cone Beam Computed Tomography (CBCT) - An In Vitro Study / Avaliação Comparativa da Eficácia dos Sistemas de Limas Rotatórias (Kedo-S) Versus Limas manuais (Kerr) no Preparo do Canais Radiculares de Dentes decíduos Utilizando Tomografia Computadorizada de Feixe Cônico (TCFC) - Um Estudo In Vitro

Objective: To evaluate the efficacy of rotary Kedo-S and hand K-files in shaping ability in primary canines using cone beam computed tomography. Material and Methods: Thirty extracted primary maxillary and mandibular canines were selected. Using cone beam computed tomography the teeth were scanned before instrumentation. In Group I, the teeth were prepared using stainless steel K file up to the size of 40. In the Group II teeth, U1 size Kedo-S rotary file was used in crown down technique. The instrumented teeth were scanned again with cone beam computed tomography and the images were compared. Results: The canal taper was more conical for rotary Kedo-S files as compared to K-files, which was statistically significant. Conclusion: Canal preparation with Rotary files resulted in more conical canals when compared to manual instrumentation in primary teeth that contributes to more uniform obturation. (AU)

Objetivo: Avaliar a eficácia da instrumentação rotatória com limas Kedo-S e instrumentação manual com limas Kerr na modelagem de caninos decíduos utilizando tomografia computadorizada de feixe cônico (TCFC). Material e Métodos: Foram selecionados 30 caninos decíduos superiores e inferiores extraídos. Usando a TCFC, os dentes foram escaneados previamente a instrumentação. No Grupo I, os dentes foram confeccionados com limas de aço inoxidável até o tamanho 40. Nos dentes do Grupo II, utilizou-se a lima rotatória Kedo-S tamanho U1 na técnica coroaápice. Os dentes instrumentados foram novamente escaneados por TCFC e as imagens foram comparadas. Resultados: A conicidade do canal foi maior no grupo com instrumentação rotatória em comparação com a instrumentação manual, com diferença estatística significante entre eles. Conclusão: O preparo do canal com o Rotary resulta em canais mais cônicos em comparação com a instrumentação manual em dentes decíduos, o que contribui para uma obturação mais uniforme.(AU)

Antimicrobial and Antioxidant Potential of Selected Seaweeds from Kodinar, Southern Coast of Saurashtra, Gujarat, India.

The antimicrobial and antioxidant activity was evaluated for the marine seaweeds viz., Enteromorpha sp. Cystoseria indica, Sargassum swartzii, Gracilaria corticata, Caulerpa taxifolia and Caulerpa racemosa from Kodinar coast, Gujarat. Different solvents viz., methanol, ethanol, chloroform and diethyl ether were used for seaweed extraction to envisage the antibacterial activity against both Gram positive and Gram negative bacteria viz., Escherichia coli, Proteus sp., Pseudomonas aeruginosa, Klebsiella pneumoniae, and Staphylococcus aureus. Hydrogen peroxide scavenging assay and total antioxidant capacity were determined in ethanol extracted seaweeds. The maximum antibacterial activity was observed in the ethanol extract of all the seaweeds except C. racemosa. Among the seaweeds, the total antioxidant potential was found to be maximum in the ethanol extract of S. swartzii - 19.84±0.14 (19.8 mg of Ascorbic acid/g of seaweed extract) and the greatest H2O2 scavenging activity was shown by the ethanol extract of S. swartzii (81.63±0.39 % inhibition) compared to the control (ascorbic acid) 95.24±0.22. Hence, from the present study it is evident that the seaweeds collected from Kodinar coast harbors excellent inhibitory activity against various human pathogens and has significant antioxidant potential as well. In particular, the antimicrobial and antioxidant activity of S. swartzii was found to be excellent and can be pointed out as the best candidate among the other seaweeds tested.

Effect of carbon and nitrogen sources on in vitro flower and fruit formation and withanolides production in Withania somnifera (L.) Dunal.

We studied the influence of sucrose and nitrogen concentration on in vitro flowering and fruit setting in elongated shoots of Withania somnifera. BA (1.5 mg/l) and IAA (0.3 mg/l) on MS medium supplemented with 4% sucrose showed 67% of in vitro flower induction frequency, 9 flowers/shoot, 4 fruits/shoot and 11 seeds/fruit in elongated-shoots. Different concentrations of nitrogen sources (L-glutamine, adenine sulphate, ammonium nitrate, potassium nitrate and sodium nitrate 5-25 mg/l) were tested in combination with 4% sucrose and BA at 1.5 mg/l and IAA at 0.3 mg/l. Highest number of flowers (20 flowers/shoot; 2.2-fold) and fruits (16 fruits/shoot; 3.39-fold), fruit setting (12 seeds/fruit; 1.08-fold) at a higher frequency (88 %) were achieved on MS medium augmented with 15 mg/l adenine sulphate with same PGRs and sucrose concentration. The maximum production of withanolide A (0.68 mg/g DW) and withanolide B (0.77 mg/g DW) was recorded in in vitro fruits. Highest accumulation of withaferin A (2 mg/g DW) was quantified from in vitro flowers, whereas, it was low in in vitro fruits (0.49 mg/g DW withaferin A). However, withanone (0.23 mg/g DW) was found accumulated uniformly in both in vitro flowers and fruits compared to control.

Evaluation of effect of topical ozone therapy on salivary Candidal carriage in oral candidiasis.

Background and Aim: Ozone is highly valued for various therapeutic applications such as antimicrobial, antihypoxic, analgesic, and immunostimulating for more than a century in the medical profession. Ozone therapy is now gaining a strong foothold in dentistry. Ozone has bactericidal, fungicidal, and virucidal properties. Oral candidiasis is one of the most common opportunistic fungal infections of the oral cavity. Hence, a study was conducted to evaluate and compare the ability of ozonated water and topical clotrimazole in reducing the Candidal species colony‑forming unit (CFU) count in oral candidiasis. Materials and Methods: The study included 40 candidiasis patients of either sex aged between 18 and 60 years attending the Department of Oral Medicine and Radiology. The patients were randomly assigned to either topical ozone therapy or topical clotrimazole groups. Salivary Candidal CFU counts were assessed during and after the treatments. Results and Conclusion: There was gradual but significant reduction in Candidal CFU count in both groups. At the end of the treatment, Candidal CFU count reduction in ozone group (60.5% reduction) was more than the clotrimazole group (32.3% reduction). 14 patients (70%) with candidiasis in ozone group were reduced to 6 (30%) whereas only 8 patients (40%) out of 13 (65%) in clotrimazole group, although intergroup comparison was not statistically significant. Ozone therapy was much more effective in reducing the patients with candidiasis to a state of carriers. These findings suggest that ozonated water might be useful to treat oral candidiasis.

In vitro assessment of Ag and TiO2 nanoparticles cytotoxicity.

Background: Silver (Ag) and titanium dioxide (TiO2) nanoparticles are the most eminent nanoproducts. Due to their antimicrobial and antifungal activity, they have been the well commercialized nanosubstances. The hazards associated with human exposure to Ag and TiO2 nanoparticles should be investigated, and hence both the nanoparticles were synthesized to facilitate the risk assessment process. Methods: Prior to the cytotoxic studies, Dynamic Light Scattering (DLS) and Transmission Electron Microscopy (TEM) were carried out to ensure the particle size. Glutathione (GSH), Nitric Oxide (NO) and superoxide dismutase (SOD) estimated by ELISA method. Results: In the present study, the cytotoxicity of Ag and TiO2 were investigated by using the glutathione (GSH), Nitric Oxide (NO) and superoxide dismutase (SOD) by incubating various concentration of silver (0.25 to 76 mg/mL) and titanium dioxide (0.25 to 2 mg/mL) nanoparticles in different incubation periods (24, 48 and 74 hours at 37°C) in plasma. Results observed that significant decrease (P <0.0001) in the concentration of GSH associated with increased concentration of NO (P <0.0001) and SOD (P <0.0001) after incubation with silver and titanium dioxide nanoparticles at 24hrs at 37°C, however at 48 hours and 74 hours there is not much change. Conclusion: The results indicate that silver and titanium dioxide nanoparticles exhibits, nanoparticles mediated cytotoxicity by induction of Reactive Oxygen Species (ROS).

Influence of anti-epileptic drugs on hematological and biochemical parameters in patients with epilepsy.

Background: Epilepsy is a chronic neurological condition which may require long-term treatment with antiepileptic drugs (AEDs). The challenge in AED management is to attain freedom from seizures, without side-effects and with good quality-of-life. However, AEDs are reported to induce potential adverse effects, which can remain unnoticed over long time. In this regard, earlier studies report inconsistent results in hematological and biochemical toxicity of AEDs. The objective of the present study was to evaluate the effects of AED monotherapy and polytherapy on hematological and biochemical parameters. Methods: This was a cross-sectional, observational study carried out among patients with epilepsy (PWE) receiving AEDs. The data on baseline demographic characteristics, treatment, adverse drug reactions, hematological, and biochemical investigations were collected. Statistical analysis was performed using the SPSS version 18 and descriptive statistics such as mean and median were used to summarize the data and inferential tests like Chi-square was used to compare categorical variables between groups. Results: There were 255 PWE in mean age range of 28.68±9.29 years, with 56.54% males. A total of 78.04% had focal, 18.04% had generalized seizures and remaining 3.92% were unclassified. Majority of (55.69%) PWE received polytherapy with AEDs. Females had significantly lower levels of hemoglobin (Hb) when compared with males (p=0.000), and patients on AED polytherapy showed significant difference in low Hb (p=0.006) and high alkaline phosphatase (ALP) levels (p=0.001). Conclusions: The results of this study showed significant alterations in the levels of Hb and ALP with the use of AED polytherapy in PWE. Routine hematological and biochemical investigations may be considered during AED treatment in those patients receiving AED polytherapy.