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  1. Evaluation of polycaprolactone matrices for the intravaginal delivery of metronidazole in the treatment of bacterial vaginosis
    Pathak M, Turner M, Palmer C, Coombes AG
    J Biomater Appl, 2014 Sep;29(3):354-63.
    PMID: 24682036 DOI: 10.1177/0885328214528256
    Microporous, poly (ɛ-caprolactone) (PCL) matrices loaded with the antibacterial, metronidazole were produced by rapidly cooling suspensions of drug powder in PCL solutions in acetone. Drug incorporation in the matrices increased from 2.0% to 10.6% w/w on raising the drug loading of the PCL solution from 5% to 20% w/w measured with respect to the PCL content. Drug loading efficiencies of 40-53% were obtained. Rapid 'burst release' of 35-55% of the metronidazole content was recorded over 24 h when matrices were immersed in simulated vaginal fluid (SVF), due to the presence of large amounts of drug on matrix surface as revealed by Raman microscopy. Gradual release of around 80% of the drug content occurred over the following 12 days. Metronidazole released from PCL matrices in SVF retained antimicrobial activity against Gardnerella vaginalis in vitro at levels up to 97% compared to the free drug. Basic modelling predicted that the concentrations of metronidazole released into vaginal fluid in vivo from a PCL matrix in the form of an intravaginal ring would exceed the minimum inhibitory concentration of metronidazole against G. vaginalis. These findings recommend further investigation of PCL matrices as intravaginal devices for controlled delivery of metronidazole in the treatment and prevention of bacterial vaginosis.
    Matched MeSH terms: Vaginosis, Bacterial/drug therapy*
  2. Graphene and graphene oxide as a docking station for modern drug delivery system
    Muthoosamy K, Bai RG, Manickam S
    Curr Drug Deliv, 2014;11(6):701-18.
    PMID: 24909150
    Motivated by the success and exhaustive research on carbon nanotubes (CNTs) based drug delivery, graphene, a two-dimensional; honey-comb crystal lattice has emerged as the rising star in recent years. Graphene is a flat monolayer of carbon atoms that holds many promising properties such as unparalleled thermal conductivity, remarkable electronic properties, and most intriguingly higher planar surface and superlative mechanical strength, which are attractive in biotechnological applications. Delivery of anti-cancer drugs using graphene and its derivatives has sparked major interest in this emerging field. The anti-cancer therapies often pose a limitation of insolubility, administration problems and cell penetration ability. In addition, systemic toxicity caused by lack of selective targeting towards cancer cells and inefficient distribution limits its clinical applications. Graphene nanocomposite is a promising tool to address these drawbacks. This review will focus on various synthesis and functionalization of graphene and graphene oxide for providing better solubility and targeted drug delivery at cancer cells. A more advanced and 'smart' graphene hybrid nanostructures that have several functionalities such as stimulus-response mediated delivery, imaging at release sites as well as transfection into cancer cells are also presented. A brief description on the challenges and perspectives for future research in this field is also discussed.
    Matched MeSH terms: Neoplasms/drug therapy*
  3. Hydnocarpus: an ethnopharmacological, phytochemical and pharmacological review
    Sahoo MR, Dhanabal SP, Jadhav AN, Reddy V, Muguli G, Babu UV, et al.
    J Ethnopharmacol, 2014 May 28;154(1):17-25.
    PMID: 24732111 DOI: 10.1016/j.jep.2014.03.029
    The genus Hydnocarpus (Flacourtiaceae) includes forty species that are spread across the globe. In the Indian System of Medicine, Hydnocarpus pentandrus (Buch.-Ham.) Oken. is primarily used for treating leprosy and other skin disorders. It is known as "Chaulmoogra" and is also used to treat other indications including constipation, inflammation, blood disorders, and worm infestations. Various species of Hydnocarpus are also used in traditional medicine in China, Thailand, Malaysia, and Myanmar for several skin disorders. To assess the therapeutic potential of species from the Hydnocarpus genus and to determine future avenues for research.
    Matched MeSH terms: Leprosy/drug therapy
  4. Evaluation of medicinal interventions for the management of oral submucous fibrosis: a systematic review of the literature
    Awan KH, Patil S, Habib SR, Pejcic A, Zain RB
    J Contemp Dent Pract, 2014 Nov 1;15(6):812-7.
    PMID: 25825114
    Oral submucous fibrosis is a chronic, progressive scarring disease associated with both significant morbidity including pain and limited mouth opening and an increased risk for malignancy. This systematic review evaluated the different medicinal (i.e. nonsurgical) interventions available for the management of oral submucous fibrosis. An automated literature searches of online databases from January 1960 to December 2013 were performed and only studies with high level of evidence based on the guidelines of the Oxford Centre for evidence-based medicine were selected. Thirteen studies (3 randomized controlled trials and 10 clinical trials/controlled clinical trials) were included and drugs like steroids, hyaluronidase, human placenta extracts, chymotrypsin and collagenase, pentoxifylline, nylidrin hydrochloride, iron and multivitamin supplements including lycopene were used. There is a clear lack of evidence on the available drug treatment for oral submucous fibrosis and further high quality randomized controlled trials are needed to evaluate the different therapeutic agents.
    Matched MeSH terms: Oral Submucous Fibrosis/drug therapy*
  5. Effectiveness of pharmacist-led medication review in chronic pain management: systematic review and meta-analysis
    Hadi MA, Alldred DP, Briggs M, Munyombwe T, Closs SJ
    Clin J Pain, 2014 Nov;30(11):1006-14.
    PMID: 24480911 DOI: 10.1097/AJP.0000000000000063
    OBJECTIVE: To evaluate the effectiveness of pharmacist-led medication review in chronic pain management.

    MATERIALS AND METHODS: Six electronic databases (Medline, Embase, PsycInfo, CINHAL, CENTRAL, International Pharmaceutical Abstracts) reference lists of retrieved articles and relevant websites were searched for randomized controlled trials published in the English language involving adults with chronic pain. Studies were included if one of the intervention arms had received pharmacist-led medication review independently or as part of a multidisciplinary intervention. Risk of bias was assessed for all the included studies.

    RESULTS: The search strategy yielded 583 unique articles including 5 randomized controlled trials. Compared with control, meta-analysis showed that participants in the intervention group had: a 0.8-point reduction in pain intensity on a 0 to 10 numerical rating scale at 3 months [95% confidence interval (CI), -1.28 to -0.36] and a 0.7-point reduction (95% CI, -1.19 to -0.20) at 6 months; a 4.84 point (95% CI, -7.38 to -2.29) and -3.82 point (95% CI, -6.49 to -1.14) improvement in physical functioning on a 0- to 68-point function subscale of Western Ontario and McMaster Universities Osteoarthritis Index at 3 and 6 months, respectively; and a significant improvement in patient satisfaction equivalent to a "small to moderate effect."

    DISCUSSION: Pharmacist-led medication review reduces pain intensity and improves physical functioning and patient satisfaction. However, the clinical significance of these findings remain uncertain due to small effect size and nature of reported data within clinical trials that limits recommendation of wider clinical role of pharmacist in chronic pain management.

    Matched MeSH terms: Chronic Pain/drug therapy*
  6. Fulltext Effects of Tamarindus indica fruit pulp extract on abundance of HepG2 cell lysate proteins and their possible consequential impact on metabolism and inflammation
    Chong UR, Abdul-Rahman PS, Abdul-Aziz A, Hashim OH, Mat-Junit S
    Biomed Res Int, 2013;2013:459017.
    PMID: 24455694 DOI: 10.1155/2013/459017
    The fruit pulp extract of Tamarindus indica has been reported for its antioxidant and hypolipidemic properties. In this study, the methanol extract of T. indica fruit pulp was investigated for its effects on the abundance of HepG2 cell lysate proteins. Cell lysate was extracted from HepG2 cells grown in the absence and presence of the methanol extract of T. indica fruit pulp. Approximately 2500 spots were resolved using two-dimensional gel electrophoresis and the abundance of 20 cellular proteins was found to be significantly reduced. Among the proteins of reduced abundance, fourteen, including six proteins involved in metabolism (including ethanolamine phosphate cytidylyltransferase), four mitochondrial proteins (including prohibitin and respiratory chain proteins), and four proteins involved in translation and splicing, were positively identified by mass spectrometry and database search. The identified HepG2 altered abundance proteins, when taken together and analyzed by Ingenuity Pathways Analysis (IPA) software, are suggestive of the effects of T. indica fruit pulp extract on metabolism and inflammation, which are modulated by LXR/RXR. In conclusion, the methanol fruit pulp extract of T. indica was shown to cause reduced abundance of HepG2 mitochondrial, metabolic, and regulatory proteins involved in oxidative phosphorylation, protein synthesis, and cellular metabolism.
    Matched MeSH terms: Inflammation/drug therapy
  7. Fulltext In vitro and in vivo antimalarial evaluations of myrtle extract, a plant traditionally used for treatment of parasitic disorders
    Naghibi F, Esmaeili S, Abdullah NR, Nateghpour M, Taghvai M, Kamkar S, et al.
    Biomed Res Int, 2013;2013:316185.
    PMID: 24455686 DOI: 10.1155/2013/316185
    Based on the collected ethnobotanical data from the Traditional Medicine and Materia Medica Research Center (TMRC), Iran, Myrtus communis L. (myrtle) was selected for the assessment of in vitro and in vivo antimalarial and cytotoxic activities. Methanolic extract of myrtle was prepared from the aerial parts and assessed for antiplasmodial activity, using the parasite lactate dehydrogenase (pLDH) assay against chloroquine-resistant (K1) and chloroquine-sensitive (3D7) strains of Plasmodium falciparum. The 4-day suppressive test was employed to determine the parasitemia suppression of the myrtle extract against P. berghei in vivo. The IC50 values of myrtle extract were 35.44 µg/ml against K1 and 0.87 µg/ml against 3D7. Myrtle extract showed a significant suppression of parasitaemia (84.8 ± 1.1% at 10 mg/kg/day) in mice infected with P. berghei after 4 days of treatment. Cytotoxic activity was carried out against mammalian cell lines using methyl thiazol tetrazolium (MTT) assay. No cytotoxic effect on mammalian cell lines up to 100 µg/mL was shown. The results support the traditional use of myrtle in malaria. Phytochemical investigation and understanding the mechanism of action would be in our upcoming project.
    Matched MeSH terms: Malaria/drug therapy*
  8. Novel agents in the treatment of osteoporosis
    Shuid AN, Ima Nirwana S, Das S
    Curr Drug Targets, 2013 Dec;14(14):1631.
    PMID: 24383964
    Matched MeSH terms: Osteoporosis/drug therapy*
  9. In vivo anti-hyperglycemic activity of saliva extract from the tropical leech Hirudinaria manillensis
    Mohammed AA, Mohammad GA, Mohamed A, Mohamed A, Ahmed M
    Chin J Nat Med, 2013 Sep;11(5):488-93.
    PMID: 24359772 DOI: 10.1016/S1875-5364(13)60089-8
    The anticoagulant effect of leech saliva was traditionally employed in the treatment of diabetes mellitus complications such as peripheral vascular complications. This study was carried out to examine the effect of leech saliva extract (LSE) on blood glucose levels in alloxan-induced diabetic rats. First, LSE was collected from leeches which were fed on a phagostimulatory solution. Second, total protein concentration was estimated using the Bradford assay. Third, diabetic rats were injected subcutaneously (sc) with LSE at doses of 500 and 1 000 μg·kg(-1) body weight (bw). Other diabetic rats were injected sc with insulin at doses of 10 and 20 U·kg(-1) bw. Another group was injected simultaneously with LSE (250 μg·kg(-1) bw) and insulin (10 U·kg(-1) bw). Fasting blood glucose (FBG) concentrations were monitored during a study period of eight hours at regular intervals. Findings showed that both doses of LSE resulted in a significant and gradual decrease in FBG starting from 10%-18% downfall after two hours of injection reaching the maximal reduction activity of 58% after eight hours. Remarkably, LSE was sufficient to bring the rats to a near norm-glycemic state. The high dose of insulin induced a severe hypoglycemic condition after 2-4 h of injection. The lower dose was able to decline FBG for 2-6 h in rats which became diabetic again after 8 h. On the other hand, the concurrent injection of low doses of LSE and insulin produced a hypoglycemic effect with all rats showing normal FBG levels. Taken together, these findings indicated that the subcutaneous injection of LSE of the medicinal Malaysian leech was able to provide better glycemic control compared with insulin. Moreover, the synergism between LSE and insulin suggests that LSE could be utilized as an adjuvant medication in order to reduce insulin dosage or to achieve better control of blood glucose.
    Matched MeSH terms: Diabetes Mellitus, Experimental/drug therapy*
  10. An exploration of compulsory licensing as an effective policy tool for antiretroviral drugs in India
    Jain D, Darrow JJ
    Health Matrix Clevel, 2013;23(2):425-57.
    PMID: 24341078
    Access to affordable drugs for the treatment of HIV/AIDS and other diseases is increasingly challenging in many developing countries such as Brazil, South Africa, and India. These challenges are in part the result of strengthened patent laws mandated by the 1994 Trade-Related Aspects of Intellectual Property Rights (TRIPS) treaty. However, there are underutilized instruments within TRIPS that governments can use to limit the adverse effects of patent protection and thereby ensure a supply of affordable generic drugs to their people. One such instrument is compulsory licensing, which allows generic manufacturers to produce pharmaceutical products that are currently subject to patent protection. Compulsory licensing has been used by a number of countries in the last few years, including the United States, Canada, Indonesia, Malaysia, Brazil, and Thailand, and is particularly significant for countries such as India, where large numbers of people are infected with HIV. This Article explores the feasibility of compulsory licensing as a tool to facilitate access to essential medicines within the current patent regime in India, drawing on the experiences of other countries.
    Matched MeSH terms: HIV Infections/drug therapy
  11. Papase as a treatment option for the overgranulating wound
    Mustafah NM, Chung TY
    J Wound Care, 2014 Feb;23(2 Suppl):S10-2.
    PMID: 24526167
    Overgranulation (also commonly known as hypergranulation) is a common problem in chronic wound management. We describe a case involving a 57-year-old lady with a chronic diabetic foot ulcer, complicated with overgranulation for the past year. She was administered with various treatments, including hydrocortisone 1% cream and hydrofiber, which proved ineffective and further delayed the healing process of her ulcer. We then decided to use crushed Papase tablets applied to her ulcer after a normal saline dressing and prior to an application of secondary dressing. The patient was instructed clearly on the dressing technique to be performed daily at home and was monitored weekly in a foot care clinic. The overgranulation resolved within 5 weeks and the patient continues recieving care to promote epithelialisation.
    Matched MeSH terms: Diabetic Foot/drug therapy
  12. Fulltext Phytoagents for cancer management: regulation of nucleic acid oxidation, ROS, and related mechanisms
    Lee WL, Huang JY, Shyur LF
    Oxid Med Cell Longev, 2013;2013:925804.
    PMID: 24454991 DOI: 10.1155/2013/925804
    Accumulation of oxidized nucleic acids causes genomic instability leading to senescence, apoptosis, and tumorigenesis. Phytoagents are known to reduce the risk of cancer development; whether such effects are through regulating the extent of nucleic acid oxidation remains unclear. Here, we outlined the role of reactive oxygen species in nucleic acid oxidation as a driving force in cancer progression. The consequential relationship between genome instability and cancer progression highlights the importance of modulation of cellular redox level in cancer management. Current epidemiological and experimental evidence demonstrate the effects and modes of action of phytoagents in nucleic acid oxidation and provide rationales for the use of phytoagents as chemopreventive or therapeutic agents. Vitamins and various phytoagents antagonize carcinogen-triggered oxidative stress by scavenging free radicals and/or activating endogenous defence systems such as Nrf2-regulated antioxidant genes or pathways. Moreover, metal ion chelation by phytoagents helps to attenuate oxidative DNA damage caused by transition metal ions. Besides, the prooxidant effects of some phytoagents pose selective cytotoxicity on cancer cells and shed light on a new strategy of cancer therapy. The "double-edged sword" role of phytoagents as redox regulators in nucleic acid oxidation and their possible roles in cancer prevention or therapy are discussed in this review.
    Matched MeSH terms: Neoplasms/drug therapy*
  13. Recurrence of a nasopharyngeal carcinoma manifesting as a cerebellopontine angle mass
    Kong MH, Jeevanan J, Jegan T
    Ear Nose Throat J, 2013 Dec;92(12):E11-3.
    PMID: 24366707
    As many as 31% of patients with nasopharyngeal carcinoma present with intracranial extension. Despite this high percentage, extension to the cerebellopontine angle is rare. The mechanism of tumor spread to the cerebellopontine angle is not completely understood. The most likely mechanism is direct extension to the skull base with involvement of the petrous apex and further extension posteriorly via the medial tentorial edge. We report the case of a 46-year-old woman with nasopharyngeal carcinoma who had been treated initially with chemoradiation and subsequently with stereotactic radiosurgery for residual tumor. One year later, she presented with an intracranial recurrence of the nasopharyngeal carcinoma in the cerebellopontine angle; the recurrence mimicked a benign tumor on magnetic resonance imaging. The tumor was ultimately diagnosed as an undifferentiated carcinoma of nasopharyngeal origin. She was treated with palliative chemotherapy.
    Matched MeSH terms: Cerebellar Neoplasms/drug therapy
  14. Fulltext Bilateral retinal vein occlusion and rubeosis irides: lessons to learn
    Md Noh UK, Ahem A, Mustapha M
    Acta Med Iran, 2013;51(9):657-60.
    PMID: 24338200
    Uncontrolled hypertension is well- known to give rise to systemic complications involving multiple central organs. Artherosclerosis leads to damage of the retinal vessels wall, contributing to venous stasis, thrombosis and finally, occlusion. Retinal vein occlusions compromise vision through development of ischaemic maculopathy, macular oedema, and rubeotic glaucoma. Laser photocoagulation remains the definitive treatment for ischaemic vein occlusion with secondary neovascularization. Timely treatment with anti- vascular endothelial growth factor prevents development of rubeotic glaucoma. We hereby report an unusual case of bilateral retinal vein occlusion complicated by rubeosis irides, which was successfully managed to improve vision and prevent rubeotic glaucoma.
    Matched MeSH terms: Neovascularization, Pathologic/drug therapy
  15. Beneficial effects of mangiferin isolated from Salacia chinensis on biochemical and hematological parameters in rats with streptozotocin-induced diabetes
    Sellamuthu PS, Arulselvan P, Fakurazi S, Kandasamy M
    Pak J Pharm Sci, 2014 Jan;27(1):161-7.
    PMID: 24374436
    Salacia chinensis L. is a traditional Southeast Asian herbal medicine and used in the treatment of diabetes. To investigate the antidiabetic properties of mangiferin from Salacia chinensis and its beneficial effect on toxicological and hematological parameters in streptozotocin induced diabetic rats. Mangiferin was orally treated with the dose of 40 mg/kg body weight/day for 30 days to diabetic rats. Biochemical (blood glucose, uric acid, urea and creatinine), toxicological (AST, ALT and ALP) and hematological parameters (red and white blood cells) and their functional indices were evaluated in diabetic treated groups with mangiferin and glibenclamide. Mangiferin treated diabetic rats significantly (p<0.05) lowered the level of blood glucose, in addition, altered the levels of biochemical parameters including urea, uric acid, and creatinine. Toxicological parameters including AST, ALT and ALP were also significantly reduced after treatment with mangiferin in diabetic rats. Similarly, the levels of red blood, white blood cells and their functional indices were significantly improved through the administration of mangiferin. Thus, our results indicate that mangiferin present in S. chinensis possesses antidiabetic properties and nontoxic nature against chemically induced diabetic rats. Further experimental investigations are warrant to make use of its relevant therapeutic effect to substantiate its ethno-medicinal usage.
    Matched MeSH terms: Diabetes Mellitus, Experimental/drug therapy*
  16. Irreversible blindness following intravenous streptokinase
    Peyman M, Subrayan V
    JAMA Ophthalmol, 2013 Oct;131(10):1368-9.
    PMID: 23929315 DOI: 10.1001/jamaophthalmol.2013.4489
    Matched MeSH terms: Myocardial Infarction/drug therapy
  17. Fulltext Statins in heart failure: do we need another trial?
    Bonsu KO, Kadirvelu A, Reidpath DD
    Vasc Health Risk Manag, 2013;9:303-19.
    PMID: 23807852 DOI: 10.2147/VHRM.S44499
    Statins lower serum cholesterol and are employed for primary and secondary prevention of cardiovascular events. Clinical evidence from observational studies, retrospective data, and post hoc analyses of data from large statin trials in various cardiovascular conditions, as well as small scale randomized trials, suggest survival and other outcome benefits for heart failure. Two recent large randomized controlled trials, however, appear to suggest statins do not have beneficial effects in heart failure. In addition to lowering cholesterol, statins are believed to have many pleotropic effects which could possibly influence the pathophysiology of heart failure. Following the two large trials, evidence from recent studies appears to support the use of statins in heart failure. This review discusses the role of statins in the pathophysiology of heart failure, current evidence for statin use in heart failure, and suggests directions for future research.
    Matched MeSH terms: Heart Failure/drug therapy*
  18. ATRA-induced cerebral sinus thrombosis
    Lee KR, Subrayan V, Win MM, Fadhilah Mohamad N, Patel D
    J Thromb Thrombolysis, 2014 Jul;38(1):87-9.
    PMID: 24046068 DOI: 10.1007/s11239-013-0988-7
    All-trans retinoic acid (ATRA) and Idarubicin are part of the AIDA protocol employed for the treatment of Acute promyelocytic leaukaemia (APML) and has been associated with marked improvement in the prognosis. However, it is known to worsen the haematological picture during the course of induction of therapy. Herein, we present a case of an APML patient who developed a rare documented incidence of cerebral sinus thrombosis, first noticed as an ophthalmology referral. This 22 year old lady, a known APML patient was then started on chemotherapy based on AIDA protocol but 17 days into the initiation of therapy, she began to complain of blurred vision on the right eye. Anterior segments were normal but both fundi showed papilloedema with peripapillary haemorrhages. A contrast MRI that was then ordered showed multiple filling defects in numerous venous sinuses. She was started on anticoagulant treatment and the findings resolved. Though a rare case of its side-effects, ATRA usage in APML has a multitude of presentations since its primary pathology lies in the inherent pro-coagulant potential.
    Matched MeSH terms: Leukemia, Promyelocytic, Acute/drug therapy*
  19. Fulltext Functional roles of fibroblast growth factor receptors (FGFRs) signaling in human cancers
    Tiong KH, Mah LY, Leong CO
    Apoptosis, 2013 Dec;18(12):1447-68.
    PMID: 23900974 DOI: 10.1007/s10495-013-0886-7
    The fibroblast growth factor receptors (FGFRs) regulate important biological processes including cell proliferation and differentiation during development and tissue repair. Over the past decades, numerous pathological conditions and developmental syndromes have emerged as a consequence of deregulation in the FGFRs signaling network. This review aims to provide an overview of FGFR family, their complex signaling pathways in tumorigenesis, and the current development and application of therapeutics targeting the FGFRs signaling for treatment of refractory human cancers.
    Matched MeSH terms: Neoplasms/drug therapy
  20. Fulltext Review on the demographic and social impact of methadone-medication therapy on Malaysian patients
    Manan MM, Ali SM, Khan MA, Jafarian S, Hameed MA
    Pak J Pharm Sci, 2013 Jul;26(4):841-6.
    PMID: 23811468
    This study is an observational cross-sectional study aimed to examine the possible demographic and social characteristics of patients enrolled at the Methadone Maintenance Therapy Adherence Clinic (MMTAC) in Malaysia. Medical records from year 2009 - 2011 were Reviewed. Demographic, social characteristics and laboratory examinations such as age, gender, race, clinic attendances and urine analysis were recorded. Subjects were selected by means of convenient sampling but based on the specified inclusion and exclusion criteria. Data were analyzed by either Chi-square test, Fisher's exact test Mann-Whitney U-test, with the limit of significance was set at p < 0.05. Demographically, this study found that the ratio of Malays, Chinese and Indian enrolled to the MMTAC program is similar to the distribution of races in Malaysia. Their starting age for drug use was between 14-35 years and the age to enrolment between 30-58 years. Socially, many are unemployed, lowly educated and married. Most are drug users with a high percentage of HCV accompanied with impaired liver function. Retention rate was 87% but illicit drug use was at 57.50%. However, percentage of employment increased significantly after therapy. The study managed to identify several demographical and social distributions of patients attending the MMTAC. Although attendance rate was high, many were on illicit drug use. Nevertheless, employment rate improved significantly.
    Study site: government methadone clinic in Klang, Selangor, Malaysia
    Matched MeSH terms: Substance-Related Disorders/drug therapy*
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