Development and Evaluation of PEG-Gelatin-Based Microparticles to Enhance the Oral Delivery of Insulin.

BACKGROUND: Diabetes mellitus is a global disease identified by hyperglycemia due to defects in insulin secretion, insulin action, or both. OBJECTIVE: The main objective of this research was to evaluate the ability of gelatinized Poly(ethylene glycol) (PEG) microparticles to be used as carriers for oral insulin delivery via double emulsion preparation. METHODS: Five different batches of the formulation consisting of gelatin:PEG were prepared as follows: 0:1 (W1), 1:0 (W2), 1:1 (W3), 1:3 (W4), and 3:1 (W5). The prepared microparticles (from insulin-loaded batches) had particle sizes ranging from 19.5 ± 0.32-23.9 ± 0.22 µm and encapsulation and loading capacities ranging from 78.8 ± 0.24-88.9 ± 0.95 and 22.2 ± 0.96-29.7 ± 0.86%, respectively. The minimum and maximum in vitro release rates were 8.0 and 66.0%, respectively, for batches W1 and W2 at 8 h. RESULTS: Insulin-loaded MPs induced a significant decrease in glucose levels, with a reduction from 100 to 33.35% in batch W5 at 9 h compared to that of subcutaneous insulin (100 to 22.63%). A liver function study showed that the formulation caused no obvious toxicity to the experimental rats. CONCLUSION: Gelatinized PEG-based microparticles as insulin delivery systems may open a new window into the development of oral insulin for diabetic treatment.

Prevalence of Spontaneous Bacterial Peritonitis (SBP) in Hepatitis B (HBV), and Hepatitis C (HCV) Liver Cirrhosis: A Systematic Review and Meta-Analysis.

Background and Aim: Spontaneous bacterial peritonitis (SBP) is a common infection in liver cirrhosis. This systematic review and meta-analysis provide detailed information on the prevalence of SBP among hepatitis B virus (HBV) and hepatitis C virus (HCV)-related liver cirrhosis globally. Methods: A systematic search for articles describing the prevalence of SBP in HBV and HCV-related cirrhosis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Our search returned ten (10) eligible articles involving 1713 viral cirrhosis cases representing eight (8) countries. A meta-analysis was performed on our eligible studies using the random effect model. A protocol was registered with PROSPERO (CRD42022321790). Results: The pooled prevalence of SBP in HBV-associated cirrhosis had the highest estimate [8.0% (95% CI, 2.7−21.0%; I2 = 96.13%; p < 0.001)], followed by SBP in HCV-associated liver cirrhosis [4.0% (95% CI, 1.3%−11.5%; I2 = 88.99%; p < 0.001)]. China (61.8%, CI: 57.1−66.3%), the USA (50.0%, CI: 34.6−65.4%), and Holland (31.1%, CI: 21.6−42.5%) had the highest estimate for SBP in HBV associated liver cirrhosis, SBP in HCV associated liver cirrhosis and SBP in HBV + HCV associated liver cirrhosis respectively. There was a significant difference in the prevalence of SBP in viral hepatitis-associated liver cirrhosis with the year of sampling and method of SBP detection at P < 0.001. There was an increase in SBP incidence at the beginning of 2016 across the liver cirrhosis in this study. Conclusion: The findings of this review revealed a rise in the incidence of SBP in viral hepatitis over the last decade. The latter indicates a possible future rise in the global prevalence of SBP among HBV and HCV-related liver cirrhosis.

Evidence of hepatitis B infection and co-infection with enteric fever among febrile patients in a primary health facility in Kogi State, Nigeria.

Hepatitis B and enteric fever remain infectious diseases of major health concern and the etiologic agents share overlapping regions of high endemicity worldwide. This study determined the seroprevalence of hepatitis B and enteric fever among febrile patients in Ejule metropolis, North-central Nigeria. In a cross-sectional study, blood samples obtained from 200 consenting patients were screened for hepatitis B and enteric fever with standard diagnostics ABON hepatitis B surface antigen (HBsAg) and Widal agglutination tests, respectively. A structured questionnaire was used to collect socio-demographic and risk factor information. Of the 200 sera tested, 20 (10%) had HBV alone, 35 (17.5%) enteric fever while 6 (3%) had both HBV/enteric fever. Males recorded more HBV (12% vs 6.7%), enteric fever (20% vs 13.3%), and co-infection (3.2% vs 2.7%) than their counterpart females. Ages 18-30 years were more predisposed to single and dual infections compared to older categories. Although sex, ages as well as the participants' occupation were not significantly linked to both infections (p > .05). The prevalence of enteric fever differed significantly with being married (p = .01). The illiterate had a higher prevalence of HBV, enteric fever, and dual infection (16.7%, 25%, and 8.3%) compared to higher educational levels. The study confirms the endemicity of hepatitis B and enteric fever in the area. Their concurrent rate highlights the need for clinicians to always consider the laboratory diagnosis of both diseases among febrile patients in endemic regions for proper management in events of co-morbidity. The high prevalence of both infections in connection with illiteracy shows the need to further intensify education of masses on the predisposing risk factors.

Hepatitis B and syphilis prevalence and risk factors of transmission among febrile patients in a primary health facility in Kogi State, Nigeria.

Hepatitis B and syphilis remained a global disease with a worrisome prevalence in Nigeria. This study was to determine their prevalence and factors associated with HBV and syphilis infection in febrile patients in Ejule metropolis, Nigeria. In a cross-sectional study, sera obtained from the patients were screened for HBsAg (HBV) and syphilis using commercial immunoassay kits. Data on patients' demographic, social, and behavioral indicators were collected using structured questionnaires. Of the 200 participants, 15 (7.5%) were HBsAg-positive, 3(1.5%) had syphilis, while 2(1.0%) had both HBV and syphilis infections. Ages 31-40 had a higher prevalence of single- and co-infection. Comparable rates of single and concurrent infection were observed in both sexes (P > .05), despite higher participating rates in females. Being single significantly influenced HBV/syphilis co-infection (p = .02), while no statistical difference in prevalence rates was observed with patients' level of education and occupational status. Intravenous drug use (p = .02), history of surgeries (p = .001), and blood transfusion (p = .01) were significantly associated with HBV infection. Also, a significant rate of syphilis was observed in an association with the history of surgeries (p = .001) and blood transfusion (p = .008). Findings from our study show an intermediate level of hepatitis B endemicity in the study area. The low rate of syphilis and co-infection with HBV shows that further strengthening of the current public health measures, including awareness of potential risk factors, could be beneficial in reducing the burden of both HBV and syphilis infection. The low frequency of individuals vaccinated against HBV suggests a need for improved vaccination services.