Nano-formulation of herbo-mineral alternative medicine from linga chenduram and evaluation of antiviral efficacy.

Traditional medicine is becoming a primary source of health care in many countries in recent years. The current study proposes a new dimension of understanding a traditional origin treatment, using herbo-mineral preparations in nanoform. The herbo-mineral preparation, Linga chenduram [HMLC], was prepared according to the ancient palm script protocol dates back to 1000 years. In search of alternative therapy for the coronavirus, an attempt was made to determine this ethnic medicine formulation's therapeutic potential for viral hepatitis infection. The Hepatitis C virus [HCV] has several genomic similarities with SARS-CoV-2 viruses. The herbo-mineral formulation (HMLC) were analyzed using UV-vis, EDAX, FTIR, XRD, SEM, and TEM studies. SEM images confirmed the ' presence of nanoparticles with agglomerated conditions having an average grain size of 18 to 25 nm. EDAX studies showed the presence of metallic components in oxide or sulfide form in HMLC. The HCV inhibitory effects of HMLC indicated a good response. The cytotoxicity of this preparation against the Huh-7 human hepatoma cell line was significant. The HMLC showed a strong inhibitory effect on HCV replication in a dose-dependent manner. The genomic component of HCV is similar to COVID -19 virus. The Hepatitis C virus (HCV) NS3/4A protease has a striking three-dimensional structural similarity to the SARS-CoV2 Mpro protease, particularly in the arrangement of key active site residues. So HMLC can be tried to treat coronavirus infection. At higher concentrations, HMLC exhibited over 100-fold inhibition. In the MTT assay, HMLC did not show any apparent cytotoxic effect on cell viability at the concentrations 1-100 µg. Histological studies indicated that the liver and kidney did not experience any toxicity by 7 and 15 consecutive days of administration of HMLC on experimental Wistar rats. Hence, the HMLC can be tried as a therapy for COVID -19 infections using the preparations strictly according to ethnopharmacological protocol and optimum doses.

Probiotic lactobacilli: Can be a remediating supplement for pandemic COVID-19. A review.

In recent years increased attention is focussed on microorganisms inhabiting the digestive system that provides prophylactic and therapeutic benefits to the host. After Metchnikoff exposed the secret behind Bulgarian peasants' extended longevity, a graze to incorporate the responsible microbes in functional food emerged. Then interest towards microbe-rich food went to the vegetative phase for some time, but now a renaissance to engage these wonder microbes in the healthcare sector is increasing. With a new definition, probiotics, these good microbes have been widely applied in different types of products, either as pharmaceuticals, nutritional supplements, or foods. Probiotics, a significant source in functional dairy products, claims diverse roles such as improving intestinal tract health, enhancing the immune system, synthesizing and enhancing the bioavailability of nutrients, reducing symptoms of lactose intolerance, decreasing the prevalence of allergy in susceptible individuals, and reducing the risk of certain cancers. In the recent COVID-19 issue, searches are going fast to use probiotics as vaccine carriers, dysbiosis balancer, and immunity booster. The high expectation from probiotics expanded the development of bioengineered probiotics as new-generation probiotics. From the animal model and in vitro studies, the probiotic intervention is extrapolated to innate and adaptive immunity inducer against SARS viral infections. The possibility of using it as prophylactic and therapeutic agents in COVID-19 is explored. However, its significant activity against corona virus-induced respiratory syndromes is questioned by a few researchers also. The emerging citations on the research approach and meta-analysis of probiotic intervention against the re-emerging pandemic viral attack on the respiratory and gastrointestinal domains need to be analyzed in this context. As it is essential to understand the reality of recent experimental outcomes in the probiotic approach towards SARS-CoV-2 prevention, management, and control, the recent publications were focused on this review.

Evaluation of Quality and Readability of Health Information Websites Identified through India's Major Search Engines.

Background. The available health information on websites should be reliable and accurate in order to make informed decisions by community. This study was done to assess the quality and readability of health information websites on World Wide Web in India. Methods. This cross-sectional study was carried out in June 2014. The key words "Health" and "Information" were used on search engines "Google" and "Yahoo." Out of 50 websites (25 from each search engines), after exclusion, 32 websites were evaluated. LIDA tool was used to assess the quality whereas the readability was assessed using Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and SMOG. Results. Forty percent of websites (n = 13) were sponsored by government. Health On the Net Code of Conduct (HONcode) certification was present on 50% (n = 16) of websites. The mean LIDA score (74.31) was average. Only 3 websites scored high on LIDA score. Only five had readability scores at recommended sixth-grade level. Conclusion. Most health information websites had average quality especially in terms of usability and reliability and were written at high readability levels. Efforts are needed to develop the health information websites which can help general population in informed decision making.

Recent developments in ß-cell differentiation of pluripotent stem cells induced by small and large molecules.

Human pluripotent stem cells, including human embryonic stem cells (hESCs) and human induced pluripotent stem cells (hiPSCs), hold promise as novel therapeutic tools for diabetes treatment because of their self-renewal capacity and ability to differentiate into beta (ß)-cells. Small and large molecules play important roles in each stage of ß-cell differentiation from both hESCs and hiPSCs. The small and large molecules that are described in this review have significantly advanced efforts to cure diabetic disease. Lately, effective protocols have been implemented to induce hESCs and human mesenchymal stem cells (hMSCs) to differentiate into functional ß-cells. Several small molecules, proteins, and growth factors promote pancreatic differentiation from hESCs and hMSCs. These small molecules (e.g., cyclopamine, wortmannin, retinoic acid, and sodium butyrate) and large molecules (e.g. activin A, betacellulin, bone morphogentic protein (BMP4), epidermal growth factor (EGF), fibroblast growth factor (FGF), keratinocyte growth factor (KGF), hepatocyte growth factor (HGF), noggin, transforming growth factor (TGF-α), and WNT3A) are thought to contribute from the initial stages of definitive endoderm formation to the final stages of maturation of functional endocrine cells. We discuss the importance of such small and large molecules in uniquely optimized protocols of ß-cell differentiation from stem cells. A global understanding of various small and large molecules and their functions will help to establish an efficient protocol for ß-cell differentiation.

In vitro antioxidant evaluation and total phenolics of methanolic leaf extracts of Nyctanthes arbor-tristis L.

AIM: To investigate the in vitro antioxidant activity and total phenolic content of the methanolic leaf extract of Nyctanthes arbor-tristis L. (NA). METHODS: The sample was tested using five in vitro antioxidant methods (1, 1-diphenyl-2-picryl hydrazine radical scavenging activity (DPPH), hydroxyl radical-scavenging activity (-OH), nitric oxide scavenging activity (NO), superoxide radical-scavenging activity, and total antioxidant activity) to evaluate the in vitro antioxidant potential of NA and the total phenolic content (Folin-Ciocalteu method). The extract showed good free radical scavenging property which was calculated as an IC50 value. RESULTS: IC50 (Half maximal inhibitory concentration) of the methanolic extract was found to be 57.93 µg·mL(-1) for DPPH, 98.61 µg·mL(-1) for -OH, 91.74 µg·mL(-1) for NO, and 196.07 µg·mL(-1) for superoxide radical scavenging activity. Total antioxidant capacity of the extract was found to be (1198 ± 24.05) mg ascorbic acid for the methanolic extract. Free radical scavenging activity observed in the extracts of NA showed a concentration-dependent reaction. The in vitro scavenging tested for free radicals was reported to be due to high phenolic content in the leaf extract. The leaf extract of NA showed the highest total phenolic content with a value of 78.48 ± 4.2 equivalent mg TAE/g (tannic acid equivalent). CONCLUSIONS: N. arbor-tristis leaf extract exhibited potent free radical scavenging activity. The finding suggests that N. arbor-tristis leaves could be a potential source of natural antioxidant.

Periodontal status and its risk factors among young adults of the Sebha city (Libya).

BACKGROUND: The occurrence of periodontal diseases in humans has been a global problem. Certain risk factors affect the initiation, progression, and severity of periodontitis. The present study has been designed to assess the periodontal status in relation to risk factors such as age, gender, oral hygiene practices, and smoking among the young adults of the Sebha city in Libya. MATERIALS AND METHODS: A cross-sectional study was carried out among 1,255 subjects aged between 18 years and 34 years. 1,006 (80.15%) subjects were females and 249 (19.84%) subjects were males. Data was generated by conducting interview and clinical examination. The periodontal status was assessed by using Community Periodontal Index of Community Periodontal Index of Treatment Needs. The Chi-square test and analysis of variance were used for statistical analysis at 5% level of significance. RESULTS: A total of 89.08% reported the use of toothbrush and toothpaste for cleaning and 10.91% used other aids, such as finger and Siwak. Of the 1,255 subjects, 3.98% were current smokers (all males). Only 4.7% had healthy periodontium (CPI code 1), while majority of 44.30% were detected with calculus (CPI code 2). Nearly 40.63% had shallow pockets (CPI code 3), 6.29% had bleeding (CPI code 1), and 4.06% had deep pockets (CPI code 4). The overall mean CPI score was 2.33 (0.84). Age and gender showed a statistically significant difference with the CPI codes. CONCLUSION: The result of this study provides baseline information for planning a preventive program. With preventive procedures being implemented at this young age, there is a possibility that the prevalence of periodontal disease will be lesser during adulthood.

Descriptive analysis of toothbrushing used as an aid for primary prevention: a population-based study in Sebha, Libya.

This study aimed to assess toothbrushing behavior and descriptively analyze the effect of age and gender. Two thousand and six people from the city of Sebha, Libya, aged 1 to 64 years (mean age 26.9 ± 11.6 years, 1,463 females and 543 males) constituted the study sample. Data was collected using a self-administered questionnaire. Overall, 85.3% were using a toothbrush and toothpaste as a cleaning aid, whereas 6.3% never brushed their teeth. Only 36.1% brushed twice daily. Age and gender were significantly associated with use of a toothbrush and frequency of toothbrushing. This data serves as a baseline to implement a "preventive self-care instruction program."

Periodontal Status and Risk Factors among Adults of Sebha City (Libya).

The present study was aimed at assessing the periodontal status and risk factors like age, gender, tooth brushing habit, and smoking among the adult population of Sebha city, Libya. 452 adults, aged 35-54 years, comprised the study sample. 266 (58.84%) were females and 186 (41.15%) were males. Data was collected by interview and clinical examination using CPI of CPITN index. Chi-square test and ANOVA were used for statistical analysis at 5% level of significance. Results indicate that 76.32% used toothbrush and paste; 8.84% were current smokers and were all males. Majority, 52.65% were, detected with shallow pockets followed by 30.08% with calculus, 12.17% had deep pockets, 3.31% had bleeding, and only 1.33% were healthy. Age, gender, current smoking status and frequency of tooth brushing showed statistically significant difference with CPI codes. Health professionals can utilize this data to identify individuals at risk and to target population level interventions.

Is axial length a risk factor for idiopathic macular hole formation?

Current theories for macular hole formation implicate antero-posterior and tractional forces at the vitreofoveal interface. It is thought that localized perifoveal defects enlarge from centrifugal forces acting about the axis of ocular rotation. If this is true, eyes with longer axial lengths should have an increased incidence of macular holes. The aim of this study was to determine if axial length is a risk factor for macular hole development. The study group comprised 40 patients with refractive errors from hyperopia to myopia with stage 3 and 4 idiopathic macular holes. Controls matched for age, gender and spherical equivalent (SE) were used for statistical comparison. Axial length (AL) was analyzed using SPSS 13.0 statistical software and compared using Student's t test. P < 0.05 was considered significant. SE ranged from -8.88 to +3.63 dioptres in the macular hole group and -8.50 to +3.63 in controls. In the macular hole group, mean AL ± standard deviation was 23.62 ± 1.20 mm (21.81-27.51); in controls, 23.09 ± 1.16 mm (21.31-26.58). Univariate analysis showed that higher AL is associated with macular hole formation. The mean difference in AL was 0.531 mm (95 % confidence interval -0.1596 to -0.9024). Two-tailed t test: P < 0.006. This study showed that increasing ocular AL is significantly associated with macular holes. Dynamic forces at the macula would be greater in these eyes suggesting this may play a causative role in macular hole formation.

QTc interval prolongation by fexofenadine in healthy human volunteers and its correlation with plasma levels of fexofenadine: A demonstration of anticlockwise hysteresis.

AIM: The study was designed to establish relationship between the plasma concentration and QTc interval prolonging effect of fexofenadine and demonstrate the phenomenon of anticlockwise hysteresis. MATERIALS AND METHODS: Six subjects were given fexofenadine 60 mg tablet orally under stable conditions, and their drug concentrations were measured at regular intervals. At predetermined time, their ECGs were recorded. Data were analyzed and plotted graphically. DESIGN AND SETTING: Randomized parallel design, single group study conducted at clinical research organization of Ahmadabad. RESULTS: In all subjects time taken for maximum plasma concentration of fexofenadine (T(max)) was around 3 h and the value of average maximum plasma concentration was 460.63 ng/mL, the effect of fexofenadine on the heart (measured as QTc interval prolongation) was maximum (E(max)) after 6 h and average QTc interval was 469.75 ms. Thus, the time to maximum concentration of fexofenadine did not match with the maximum effect on the heart as measured by QTc interval. CONCLUSION: The relationship between the drug concentration and drug effect on the heart are at two different time scales. It can be understood by two-compartment model of pharmacokinetics, and this retardation or lagging of an effect behind the concentration is known as hysteresis. The increase of QTc was not beyond 500 ms and not sustained, demonstrating overall cardiac safety of fexofenadine.

Epidemiological features of pneumonic plague outbreak in Himachal Pradesh, India.

Four people admitted to a tertiary care hospital during February 2002 had similar respiratory symptoms; they belonged to one family residing in a village in Himachal Pradesh, India. The clustering of these cases in space and time led to the suspicion that it could be a pneumonic plague outbreak. A standard case definition, and treatment and prophylaxis guidelines were prepared. Active surveillance identified 30 cases. The incubation period ranged from 3 to 7 days. Among the affected people, 53.3% were males, and 90% were >15 years of age. Fever with cough was the most common presenting feature (43.3%). The diagnosis of pneumonic plague was confirmed from blood cultures using conventional biochemical tests, phage susceptibility of the identified organisms, and F1 antigen ELISA and PCR for the pla gene. Five patients died giving a case-fatality ratio of 16.6%. The other cases recovered following treatment. Early identification of cases and prompt institution of control measures, particularly among close family members, relatives and health care contacts is essential for containing outbreaks. To prevent future outbreaks, known endemic foci should be identified and essential information should be gathered on the epizoology of plague.

Treatment seeking behavior for urinary incontinence among north Indian women.

BACKGROUND: Urinary incontinence is a common but neglected problem of women. AIMS: To ascertain the treatment seeking behavior of north Indian women having urinary incontinence (UI). SETTING: Two residential colonies of Chandigarh. DESIGN: Cross-sectional face-to-face interview based study. MATERIALS AND METHODS: This study was conducted by a trained nurse during April 2005-July 2005 among women aged 18 years and above. Women with UI were identified in a screening survey. They were interviewed individually regarding their treatment seeking behavior and socio-demographic data. STATISTICAL ANALYSIS USED: Percentage, mean, standard deviation, chi-square test. RESULTS: Of the 220 enlisted incontinent women 20% (44) women consulted some health agency. Only 8.6% (19) women had heard about pelvic floor muscle exercises. Seventy-two percent (158) cases had UI for more than one year. The most common reason quoted for not seeking treatment was, 'UI was considered as 'normal', 'did not take it seriously' and 'shyness.' Many (153;70%) women reported that UI affected their daily routine as well as social activities like shopping and visiting friends. CONCLUSION: Urinary incontinence seriously affected the quality of life of women. Still, consultation rate for UI was low in the north Indian women.

Sequential Descemet's membrane detachments and intraocular lens haze secondary to SF6 or C3F8.

PURPOSE: To report an unusual complication of treatment in the case of a Descemet's membrane detachment. METHODS: Observational case report. RESULTS: A 79-year-old woman presented for elective cataract surgery. Ocular risk factors identified preoperatively included moderately shallow anterior chambers bilaterally, previously treated with bilateral YAG peripheral iridotomies. After a clear corneal section during phacoemulsification, large Descemet's tears on introducing the micro finger and phaco probe were noticed. Conversion to an extracapsular technique was necessary because of poor view. Similar peroperative Descemet's detachments were noticed in the contralateral eye during phacoemulsification by a senior surgeon a year later. Postoperatively, the Descemet's detachments were managed by intracameral SF6 and later C3F8 gas. A few weeks later, a fine haze was noticed under the anterior surface of the intraocular lens (IOL). Corneal edema persisted and corneal decompensation ensued. Both eyes needed penetrating keratoplasties. The right eye needed an IOL exchange due to IOL haze. CONCLUSIONS: In this case the SF6 or C3F8 gas may have produced the unexpected effect of an anterior IOL haze. The mechanism of this phenomenon is unknown. To the knowledge of the authors, this effect has not been observed previously with SF6 or C3F8 gas. This haze was visually significant and required an IOL exchange. To the knowledge of the authors this is the first report of this nature. The authors advise caution when using intracameral SF6 or C3F8 gas for repair of Descemet's membrane detachment with this type of IOL.

Sequential Descemets membrane detachments and intraocular lens haze secondary to SF6 or C3F8.

PURPOSE: To report an unusual complication of treatment in the case of a Descemets membrane detachment. METHODS: Observational case report. RESULTS: A 79-year-old woman presented for elective cataract surgery. Ocular risk factors identified preoperatively included moderately shallow anterior chambers bilaterally, previously treated with bilateral YAG peripheral iridotomies. After a clear corneal section during phacoemulsification, large Descemets tears on introducing the micro finger and phaco probe were noticed. Conversion to an extracapsular technique was necessary because of poor view. Similar peroperative Descemets detachments were noticed in the contralateral eye during phacoemulsification by a senior surgeon a year later. Postoperatively, the Descemets detachments were managed by intracameral SF6 and later C3F8 gas. A few weeks later, a fine haze was noticed under the anterior surface of the intraocular lens (IOL). Corneal edema persisted and corneal decompensation ensued. Both eyes needed penetrating keratoplasties. The right eye needed an IOL exchange due to IOL haze. CONCLUSIONS: In this case the SF6 or C3F8 gas may have produced the unexpected effect of an anterior IOL haze. The mechanism of this phenomenon is unknown. To the knowledge of the authors, this effect has not been observed previously with SF6 or C3F8 gas. This haze was visually significant and required an IOL exchange. To the knowledge of the authors this is the first report of this nature. The authors advise caution when using intracameral SF6 or C3F8 gas for repair of Descemets membrane detachment with this type of IOL.

Ocular manifestations of congenital lamellar ichthyosis.

PURPOSE: To describe the ophthalmic manifestations in a series of children with congenital lamellar ichthyosis. These cases presented with varying types of eyelid abnormality associated with the systemic disease. The clinical features and ophthalmic management were studied. METHODS: The case histories of three children presenting to the oculoplastic clinic were reviewed. All were diagnosed with congenital lamellar ichthyosis and under the care of the Dermatology department. Family history and pedigree analysis was performed to determine mode of genetic inheritance. Ocular examination for visual acuity, eyelid and eyelash malposition, lid function and closure were carried out. Corneal examination including tests for exposure was also done. RESULTS: All three patients had eyelid position abnormalities from the systemic disease. There was no clinical evidence of conjunctival involvement. One patient required full thickness skin grafts to treat corneal exposure secondary to lower lid ectropion. One had mild lower lid ectropion but without corneal exposure. The third case had the unusual finding of inward turning of the anterior lamella of the upper eyelid with a marked lash ptosis and only mild ectropion of the lower lid. CONCLUSIONS: Congenital lamellar ichthyosis is a heterogeneous disorder with phenotypic variability. The most common eyelid abnormality is cicatricial ectropion of the upper and mainly lower eyelids. Most cases are managed conservatively although in severe cases secondary corneal exposure may require surgical correction. In this condition, to the best of our knowledge, the tendency for the eyelids to turn inwards has not previously been described.

Late onset vitreoretinal complications of regressed retinopathy of prematurity.

AIM: To report the clinical findings, management, and outcomes in eyes undergoing surgery for regressed retinopathy of prematurity (ROP) with vitreoretinal complications. METHOD: Retrospective review of 40 eyes of 32 patients with regressed ROP who presented between 1989 and 2001 at two UK referral centres. RESULTS: Of 29 eyes presenting with rhegmatogenous retinal detachment (RRD), 15 initially underwent a scleral buckling procedure and 14 initially underwent vitrectomy with or without additional buckling. Primary surgery was anatomically successful in 11/15 eyes that underwent a non-vitrectomy retinal detachment repair and 8/14 that required vitrectomy. The final reattachment rate after reoperation was 28/29 eyes. Median visual acuity improved from 6/60 to 6/36 following retinal detachment repair. A further 11 eyes of eight patients from this series underwent prophylactic surgery, laser, or cryotherapy for predisposing vitreoretinal pathology and/or retinal breaks, all of which were stabilised. CONCLUSIONS: In eyes with RRD and signs of regressed ROP successful reattachment of the retina can be achieved using either vitrectomy or external surgery with an associated overall improvement in visual acuity. A range of external and closed microsurgical approaches is required to effectively deal with the diverse manifestations of regressed ROP.