Preparation and characterization of a hydroxypropyl methylcellulose based wafer for simultaneous delivery of phenytoin and insulin as wound dressing material.

In this study, a novel wafer based on Hydroxypropyl methylcellulose (HPMC) was prepared as a wound dressing for the simultaneous delivery of phenytoin (PT) and insulin; evaluation of the cutaneous wound repair property was performed too. Due to its low water solubility, PT was encapsulated in polymeric micelles (PM) by the film hydration method at different polymer/drug ratios and characterized in terms of particle size (PS), polydispersity index (PdI), zeta potential (ZP), drug loading (DL) %, entrapment efficiency (EE) %, and drug release. Then, the optimized PT loaded PM (PT-PM) was embedded in the wafers prepared from the HPMC polymer, alone or in combination with Carbopol 940 (CB) and xanthan gum (XG). This wafer also contained a fixed amount of insulin (PT-PM-Insulin-wafer). The obtained wafers were evaluated in terms of morphology, water uptake ability, porosity, bioadhesion and hardness features. Finally, the efficacy of the PT-PM-Insulin-wafer was assessed in full-thickness excision wound models. The optimized PT-PM showed the PS of 84.05 ± 1.80 nm, PdI of 0.28 ± 0.22, ZP of -3.38 ± 0.26 mV, DL of 15.63 ± 0.01%, EE of 92.66 ± 0.08%, and the release efficiency of 59.95 ± 0.03%. The results obtained from the XRD studies of PT-PM also demonstrated the transition of the crystalline nature of the PT to the amorphous form, while FTIR studies showed some intermolecular interaction of PT and the Soluplus® copolymer chain. It was also found that the incorporation of XG into HPMC wafers influenced the microstructure, thus increasing the porosity, water uptake ability and bioadhesion. Compared with other groups, the PT-PM-Insulin-wafer group showed the enhancement of wound closure through increasing collagen deposition and re-epithelialization. The present study, therefore, revealed that the PT-PM-Insulin-wafer group might have very promising applications for wound healing.

Antibacterial Effects of Erbium Chromium Laser along with/without Silver Nanoparticles in Root Canals Infected by Enterococcus faecalis.

This study investigates the antibacterial effects of erbium chromium laser at 2780 nm, silver nanoparticles, and erbium chromium along with silver nanoparticles on Enterococcus faecalis in comparison with sodium hypochlorite. In the present study, 90 extracted human single-rooted teeth were selected and standardized to a length of 15 mm. The canals were prepared by V-taper Gold rotary files and then incubated with E. faecalis for 21 days. The samples were divided into four experimental groups including hypochlorite sodium, silver nanoparticle, erbium chromium laser, and erbium chromium laser along with silver nanoparticle groups. Results showed that there was a significant reduction in colony count for all groups after interventions. Moreover, there was a significant reduction in the colony count for sodium hypochlorite group in comparison with another groups, and this group showed the highest reduction of colony count. There was a significant difference between silver nanoparticles and erbium chromium laser groups in colony count. According to the results, the silver nanoparticles offered strong antibacterial effects on E. faecalis and therefore can decrease bacterial colonies, while the use of the laser, despite the reduction of the bacterial colony, could not be sufficiently used for disinfection of root canal system.

Effect of in ovo feeding of amino acids and dextrose solutions on hatchability, body weight, intestinal development and liver glycogen reserves in newborn chicks.

Early development of the digestive tract is crucial for achieving maximal growth and development of chickens. This study examined the effects of in ovo (IO) feeding of 0.70 mL of dextrose (10.00% and 20.00%) or amino acids solutions into the yolk sac at day 14 of incubation on small intestine histomorphometry and histomorphology, intestinal development, hatchability, body weight, and liver glycogen reserves in newborn chicks. Results showed body weight in amino acid fed hatchlings was higher than control and dextrose groups non-significantly, but hatchability was lower in amino acid group than others. Also, diameter of glycogen vacuoles in all IO treatment groups was more than control. Administration of exogenous dextrose and amino acids solutions into the yolk sac enhanced intestinal development by increasing the size and surface area of the villi and changed villi shape as well. It seems that dextrose or amino acids solutions could improve the intestinal villi development, while they did not affect finger-like villi in jejunum.

Flucloxacillin and fusidic acid-associated neutropenia in a patient with periaortic abscess: rare side effects of commonly used antibiotics.

The use of long-term antibiotics for deep-seated infections is very common, and is associated with many clinically significant side effects. In this report we describe the history of a 48-year-old man who attended West Suffolk Hospital with nausea and vomiting, and was subsequently found to have a deep-seated infection following his repeat aortic valve replacement. He completed a 7-week course of intravenous flucloxacillin and oral fusidic acid, however, prior to finishing this course a random blood test revealed a neutrophil count of zero. He was re-admitted to hospital with fever, and was treated accordingly as per the trust's neutropenic sepsis protocol with the addition of growth colony stimulating factor (GCSF). His neutrophil count recovered after 3 days and has remained within the normal range ever since.

The frequency of Helicobacter pylori in dental plaque is possibly underestimated.

OBJECTIVE: The commonest bacteria, causing infection across the world is Helicobacter pylori, which colonizes the human stomach. This bacteria has also been detected in some extra-gastric ecological niches such as the oral cavity and water. However, the results of H. pylori detection in extra-gastric ecological niche are controversial. The improvement of the sensitivity and the specificity of the detection methods appear to be some of the main bottleneck issues in providing compelling evidence. The aim of this study was to detect the presence of this organism in dental plaque samples using an analytically sensitive and specific Polymerase Chain Reaction (PCR) as well as a new nucleic acid detection method termed the Loop-mediated Isothermal Amplification (LAMP). DESIGN: In a descriptive cross-sectional study 45 participants enrolled and dental plaque samples were collected from at least two teeth surfaces (one anterior and one posterior tooth) using a sterile periodontal curette. The DNA content was extracted from the samples and the presence of H. pylori was determined by PCR and LAMP reactions. RESULTS: The frequency of detection of H. pylori in the dental plaque samples were 44% (20/45), 66.67% (30/45) and 77.78% (35/45) using PCR, LAMP and positivity for both tests, respectively. CONCLUSION: The high frequency of H. pylori was detected in the dental plaque samples of the participants, which concurs with the high prevalence of this bacteria in the population. This is one of the highest reported rates around the world. The results reveal that dental plaque can be one of the main causes of re-infection and also be the cause of oral-oral transmission.

Citalopram-induced hyponatraemia and parkinsonism: potentially fatal side-effects not to be missed.

The use of selective serotonin reuptake inhibitors (SSRIs), such as citalopram, is on the rise and, as such, clinicians must be vigilant of rare side-effects associated with this group of medications. We report the case of a 65-year-old man who presented to West Suffolk Hospital with a fall, confusion and movement abnormalities, and was found to have a serum sodium of 105 on admission. He was managed with hypertonic saline, dopamine agonists and intensive physiotherapy. Despite initially deteriorating neurologically, he made a remarkable recovery, and was discharged home at his pre-admission baseline. The learning points from this report are as follows: (1) regular monitoring of electrolytes on starting an SSRI (and similarly selective noradrenaline reuptake inhibitors-SNRIs) in SSRI/SNRIs naïve patients, (2) awareness of possible citalopram-induced parkinsonism and the potential benefits of dopamine agonists as one management strategy and (3) vigilant fluid/electrolyte monitoring in patients with profound hyponatraemia.