Efficacy of pentamidine-loaded chitosan nanoparticles as a novel drug delivery system for Leishmania tropica

@#The present study compares the in vitro effects of nanoparticles loaded pentamidine drug and conventional pentamidine on Leishmania tropica. Herein, pentamidine-loaded chitosan nanoparticles (PTN-CNPs) have been synthesized through an ionic gelation method with sodium tripolyphosphate (TPP). Next, the physical characteristics of PTN-CNPs were determined through the surface texture, zeta potential, in vitro drug release, drug loading content (DLC), and encapsulation efficacy (EE) and compared its efficacy with free pentamidine (PTN) drug against promastigotes and axenic amastigotes forms of L. tropica in vitro. The PTN-CNPs displayed a spherical shape having a size of 88 nm, an almost negative surface charge (-3.09 mV), EE for PTN entrapment of 86%, and in vitro drug release of 92% after 36 h. In vitro antileishmanial activity of PTN-CNPs and free PTN was performed against Leishmania tropica KWH23 promastigote and axenic amastigote using 3-(4, 5- dimethylthiazol-2-yl)-2, 5-diphenyletetrazolium bromide (MTT) assay. It was observed that the effect of PTN-CNPs and free PTN on both forms of the parasite was dose and time dependent. Free PTN presented low efficacy even at higher dose (40 µg/ml) with 25.6 ± 1.3 and 26.5 ±1.4 mean viability rate of the promastigotes and axenic amastigotes, respectively after 72 hrs incubation. While PTN-CNPs showed strong antileishmanial effects on both forms of parasite with 16 ± 0.4 and 19 ± 0.7 mean viability rate at the same higher concentration (40 µg/ml) after 72 hrs incubation. Half maximal inhibitory concentration (IC50) values of PTN-CNPs toward promastigotes and amastigotes were obtained as 0.1375 µg/ml and 0.1910 µg/ml, respectively. In conclusion, PTN-CNPs effectively inhibited both forms of the L. tropica; however, its effect was more salient on promastigotes. This data indicates that the PTN-CNPs act as a target drug delivery system. However, further research is needed to support its efficacy in animal and human CL.

Terminal ileum schistosomiasis with perianal fistula mimicking Crohn's disease

Schistosomiasis is a parasitic disease related to water contact in the agricultural fields, affecting millions of people in developing countries in tropical and subtropical parts of Africa, Asia, and South America. We report a case of a 27-year-old male, with intestinal schistosomiasis associated with perianal fistula mimicking Crohn's disease, where the terminal ileum showed a cobblestone appearance, and histopathological biopsy showed schistosoma granuloma

Precutaneous radiofrequency neurolysis for trigeminal neuralgia

In this retrospective study efficiency of selective percutaneous radiofrequency neurolysis in the gasserian ganglion was evaluated in 200 patients with a mean follow-up of seven years by the senior author and co-workers at the Department of Neurosurgery at St. George's Hospital Beirut. Mean age of patients was 60 years with a predominant number of patients having essential neuralgia [184 patients]. Excellent relief was obtained in 92 patients with another 36 patients achieving pain relief after a second intervention. Sixty-nine patients had recurrence not amenable to repeat intervention. And another 3 patients had bad penetration of foramen ovale. Thirty-two patients required reintervention with glycerol and fibrin glue. Complications included sensory loss of cornea in 6 cases, anaesthesia dolorosa in 8 cases, coagulation of motor root of the fifth nerve in 2 cases, intense pain of the ear [paralysis of tensor tympani] in 4 cases and damage to oculomotor nerve in one case. The authors propose that radiofrequency rhizotomy may be a safe and effective procedure in the neurosurgical armamentarium for the treatment of patients having trigeminal neuralgia

Current surgical treatment of Parkinson's disease

There has been a renaissance in the surgical management of Parkinson's disease. This has been due to long-term effects of levodopa and a better understanding of the basal ganglia and its circuitry. Ablative surgery and neurostimulation are the only realistic surgical options at present. Although surgical treatments, such as ablation and stimulation are effective, they are not useful for stopping the progression or restoring the system. Neural transplantation helps restore the system by using a number of techniques. Targets mostly used are in the thalamus, globus pallidus and subthalamic nucleus. A number of factors must be considered including patient's age, disability and his wishes. Globus pallidus stimulation might be preferable for patients who suffer from dyskinesia as a major source of disability. Pallidotomy might be appropriate in cases where frequent stimulator adjustments are impractical. Subthalamic nucleus stimulation is more suitable for patients with significant off periods and in younger patients in whom it may be desirable to maintain intact circuitry. Fetal neural transplantation, stem cell transplantation, xenotransplantation, adrenal medullary transplantation and transplantation of genetically engineered cells are at various stages of development and research. Ethical issues surrounding these process are likely to arouse strong emotions and have to be carefully considered

Current surgical treatment of Parkinson's disease

There has been a renaissance in the surgical management of Parkinson's disease. This has been due to long-term effects of levodopa and a better understanding of the basal ganglia and its circuitry. Ablative surgery and neurostimulation are the only realistic surgical options at present. Although surgical treatments, such as ablation and stimulation are effective, they are not useful for stopping the progression or restoring the system. Neural transplantation helps restore the system by using a number of techniques. Targets mostly used are in the thalamus, globus pallidus and subthalamic nucleus. A number of factors must be considered including patient's age, disability and his wishes. Globus pallidus stimulation might be preferable for patients who suffer from dyskinesia as a major source of disability. Pallidotomy might be appropriate in cases where frequent stimulator adjustments are impractical. Subthalamic nucleus stimulation is more suitable for patients with significant off periods and in younger patients in whom it may be desirable to maintain intact circuitry. Fetal neural transplantation, stem cell transplantation, xenotransplantation, adrenal medullary transplantation and transplantation of genetically engineered cells are at various stages of development and research. Ethical issues surrounding these process are likely to arouse strong emotions and have to be carefully considered

Upper gastrointestinal endoscopy findings at Riyadh Armed Forces Hospital

To analyze the results of upper gastrointestinal endoscopic findings performed at Riyadh Armed Forces Hospital over a period of 15 years in 18,829 patients who were entered in the computer at the endoscopy unit. A retrospective study based on data of 18,829 patients who underwent upper gastrointestinal endoscopy. The data was entered into a computer with special codes for symptoms and endoscopic findings. Eighteen thousand eight hundred and twenty nine upper gastrointestinal endoscopy results were analyzed. Oesophagitis was found in 16.45%, Hiatus Hernia in 10%, Oesophageal varices in 7%, Oesophageal Cancer in 1.14%, Gastritis in 22%, Gastric erosions in 13.6%, Benign gastric ulcer in 3.29%, Gastric malignancy in 1.22%, Duodenal Ulcer in 14%, Duodenal erosions in 3.7% and Duodenitis in 12.7%. Only in 5.15% endoscopic findings were normal. In our analysis only 5.15% had normal upper gastrointestinal endoscopy findings while majority of patients had abnormal findings

Review of physico-chemical properties of endodontic sealers

History of Dental diseases and treatment is as old as history of mankind. Dentists are continously making efforts for the preservation of teeth and their supporting structures. Endodontics is one of the disciplines of dentistry aiming at it. Endodontics aims at removal of pain and infection by extirpation, proper obturation and maintenance of seal play a vital role in any root canal therapy. It is therefore imperative to understand the various materiais employed in root canal obturation. Studies have also been carried out to check the sealing properties of gutta-percha or silver points used without sealer. All the researchers agree that the use of a sealer is essential for effective canal obturation. Cement has been used as sealers satisfactorily for many years because of its goon handling and sealing properties and spatulated material prevent the seating ability of points at correct level during insertion. To fullfill all the ideal properties, many sealers are available to-day. Review on the properties of currently available sealers is a need to chose for the ideal sealer material for successful endodontic therapy. The researchers and clinicians are still searching for the material which fulfil all the requirements of a good endodontic sealers