Lessons learned from COVID-19 pandemic: Vaccine platform is a key player.

The SARS-CoV-2 outbreak and emergence of COVID-19 resulted in the development of different vaccines based on various platforms to combat the disease. While the conventional platforms of inactivated/live attenuated, subunit proteins and virus-like particles (VLPs) have provided efficient and safe vaccines, novel platforms of viral vector- and nucleic acid-based vaccines opened up new horizons for vaccine development. The emergence of COVID-19 pandemic showed that the availability of platforms with high possibility of quick translation from bench to bedside is a prerequisite step in vaccine development in pandemics. Moreover, parallel development of different platforms as well as considering the shipping, storage condition, distribution infrastructure and route of administration are key players for successful and robust response. This review highlights the lessons learned from the current COVID-19 pandemic in terms of vaccine development to provide quick response to future outbreaks of infectious diseases and the importance of vaccine platform in its storage condition and shipping. Finally, the potential application of current COVID-19 vaccine platforms in the treatment of non-infectious diseases has been discussed.

The effect of nanocurcumin on the incidence of atrial fibrillation, and markers of inflammation and oxidative stress level after coronary artery bypass graft surgery: A randomized, double-blind, placebo-controlled clinical study.

Objective: Postoperative atrial fibrillation (POAF) is the most frequent dysrhythmias observed following coronary artery bypass graft (CABG) surgery. Several studies have shown the beneficial effects of curcumin on cardiovascular diseases; however, there is no clinical trial to examine its effect on POAF. This randomized, double-blind, placebo-controlled clinical study was designed to evaluate the prophylactic effects of a nano-formulation of curcumin (SinaCurcumin™) versus placebo on POAF and levels of biomarkers of inflammation and oxidative stress in patients undergoing CABG surgery. Materials and Methods: A total of 234 eligible patients were randomized to receive 240 mg curcumin nano-formulation or placebo three days prior to the surgery and on the first four postoperative days. The occurrence of POAF was monitored for at least 96 hr after the surgery. Also, C-reactive protein (hs-CRP), malondialdehyde (MDA) and glutathione (GSH) levels were assessed at baseline and the end of the study. Results: Analyses were done in the intention-to-treat population. No significant difference was observed in the occurrence of POAF between the treatment (9.5%) and placebo (11.5%) groups. Also, curcumin intervention did not alter serum concentration of the hs-CRP, MDA, or GSH in comparison with placebo. Conclusion: In conclusion, it seems that perioperative treatment with SinaCurcumin™ did not prevent POAF after CABG surgery.

Improving knowledge, attitudes, and practice of nurses in medication administration through enteral feeding tubes by clinical pharmacists: a case-control study.

PURPOSE: Administering drugs and food to patients with swallowing disabilities via enteral tubes requires special skills. This task is a nursing duty and vital to ensure that they do this safely. An integrated program training nurses by a clinical pharmacist is likely to result in improved quality of oral drug administration via enteral feeding tubes. This quantitative study was undertaken to determine the efficacy of a clinical pharmacist educational program for improving nurses' knowledge, attitudes, and practice (KAP) concerning administrating medication via feeding tubes. METHODS: This case-control study was performed to evaluate KAP of intensive-care nurses with regard to drug delivery through enteral feeding tubes before and after their training program. A questionnaire focusing on nurses' KAP was prepared by a clinical pharmacist and reviewed by 18 nurses for its reliability. Then, an educational program was designed for the case group. Two months later, nurses' KAP in the case and control groups were reevaluated. Nurses' practice regarding drug administration through feeding tube was observed three times. RESULTS: This study was carried out with 82 nurses working in six intensive-care units in two major training hospitals in Shiraz, Iran. The overall knowledge of nurses increased significantly after the training program in the case group, with adequate awareness regarding solid dosage-form crushing increasing from 14% to 63.2% (P˂0.001), tube flushing and drug dilution from 32.6% to 81.6% (P˂0.001), and knowledge about mixing crushed drugs through a feeding tube from 23.3% to 55.3% (P˂0.001). On the contrary, there was no change in the control group. After intervention, nurses' attitudes in the case group had changed significantly, and 50% of them consulted with pharmacists regarding drug administration. CONCLUSION: An in-service education program by clinical pharmacists can lead to substantial improvements in administration of drugs via enteral feeding tubes.

Double domain polyethylenimine-based nanoparticles for integrin receptor mediated delivery of plasmid DNA.

The objective of the present study is to conjugate L-thyroxine PEI derivative onto another PEI to compensate the amine content of the whole structure which has been utilized for the ligand conjugation. Since αvß3 integrin receptors are over-expressed on cancer cells and there is binding site for L-thyroxine on these receptors, PEI conjugation by L-thyroxine along with restoring the PEI amine content might be an efficient strategy for targeted delivery using polymeric nanoparticles. The results demonstrated the ability of the PEI conjugate in the formation of nanoparticles with the size of around 210 nm with higher buffering capacity. The conjugated PEI derivative increased the transfection efficiency in the cell lines over-expressing integrin by up to two folds higher than unmodified PEI, whereas in the cell lines lacking the integrin receptors there was no ligand conjugation-associated difference in gene transfer ability. The specificity of transfection demonstrated the delivery of plasmid DNA through integrin receptors. Also, the results of in vivo imaging of the polyplexes revealed that 99mTc-labeled PEI/plasmid DNA complexes accumulated in kidney and bladder 4 h post injection. Therefore, this PEI derivative could be considered as an efficient targeted delivery system for plasmid DNA.