Old Wine in new Bottles: Silver Sulfadiazine Nanotherapeutics for Burn Wound Management.

According to the World Health Organization (WHO), ∼180,000 casualties are recorded every year due to burns, majorly from low- and middle-income countries that require medical attention. For the last 5 decades, silver sulfadiazine (SSD) 1% cream has been the most widely used topical antimicrobial agent for managing burn wound infections. Although SSD is considered the gold standard therapy in burn wound management, however in the last 10 years, several studies have reported the negative impact of SSD on the wound healing process. The therapeutic potential of SSD is restricted by its poor solubility, and antimicrobial action appears only after the dissociation of SSD into silver ions (Ag+) and sulfadiazine (SD). Pharmaceutical researchers and industries are looking for alternative strategies to overcome the challenges and limitations of the available SSD formulation due to rising costs, extensive time commitment, and the high risk of failure associated with the de novo development of new antimicrobial drugs. Recent advances in drug delivery systems nanotechnology-based strategies have had a colossal impact on them, particularly in burn wound management. Nanoparticulate systems and nanotools could be considered as potential drug delivery approaches for burn management. This contemporary review provides an abridgment of the literature on advanced SSD nanotherapeutics and their importance in managing burns.

e-antigen-negative chronic hepatitis B in Bangladesh.

BACKGROUND: Bangladesh is a densely populated country where about 10 million people are chronically infected with hepatitis B virus (HBV). The aim of the present study was to evaluate the biochemical, virological and histological characteristics of HBeAg-negative chronic hepatitis B (CHB). METHODS: Patients were included in this study if they were chronically infected with HBV with detectable DNA. The patients who were co-infected with human immunodeficiency virus, hepatitis delta virus or hepatitis C virus, and previously subjected to antiviral treatment, and those with hepatocellular carcinoma were excluded. The study was conducted during the period of January 2001 to December 2007. During this period 2617 patients with CHB were studied. HBeAg-positive cases were included to compare the characteristics. Among them, 237 cases underwent liver biopsy. RESULTS: 2296 patients (87.7%) were male, with a mean age of 28.9+/-13.7 years. 2375 patients (90.8%) had CHB, and 242 (9.2%) were cirrhotic. HBV DNA levels were 7.6+/-1.5 copies/ml, ALT was 111.3+/-212.5 U/L, and AST was 91.5+/-148.9 U/L. The number of HBeAg-negative CHB cases was 1039 (39.7%). HBeAg-negative patients with a lower DNA load were older, and they had more fibrotic changes in the liver than HBeAg-positive patients. The two groups did not differ in necroinflammatory activity, but the former had lower ALT and AST values. Cirrhosis was more common in e-antigen-negative patients. CONCLUSIONS: e-antigen-negative CHB patients are older and have more hepatic fibrosis patients than HBeAg-positive patients, although they have similar necroinflammatory activity.

Dubin-Johnson syndrome with systemic lupus erythematosus: a case report.

BACKGROUND: Dubin-Johnson syndrome (DJS) is a rare clinical entity. We describe a case of DJS complicated by systemic lupus erythematosus (SLE). METHODS: A case of congenital hyperbilirubinemia with SLE was evaluated systematically including review of history, physical examination for the stigmata of chronic liver disease, and other investigations. RESULT: Liver biopsy revealed a black liver with preserved architecture suggestive of DJS. CONCLUSIONS: SLE may develop in DJS. The relationship between DJS and SLE in this case is most likely a chance occurrence.