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   Table of Contents - Current issue
Coverpage
January-March 2017
Volume 8 | Issue 1
Page Nos. 1-42

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EDITORIAL  

Microneedles-mediated drug and vaccine delivery p. 1
Upendra Nagaich
DOI:10.4103/2231-4040.197330  
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ORIGINAL ARTICLES Top

A study of the formation of magnetically active solid dispersions of phenacetin using atomic and magnetic force microscopy p. 2
Liana Stanislavovna Usmanova, Marat Akhmedovich Ziganshin, Valery Vilenovich Gorbatchuk, Sufia Askhatovna Ziganshina, Dmitry Anatolevich Bizyaev, Anastas Akhmetovich Bukharaev, Timur Anvarovich Mukhametzyanov, Alexander Vladimirovich Gerasimov
DOI:10.4103/2231-4040.197331  
A lot of pharmaceutical substances have a poor solubility that limits their absorption and distribution to the targeted sites to elicit the desired action without causing untoward effects on healthy cells or tissues. For such drugs, new modes of delivery have to be developed for efficient and effective delivery of the drug to the target site. Formation of magnetically active solid dispersion of such drugs could be a useful approach to addressing this problem because they combine targeted delivery and good solubility. In this work, the distribution of superparamagnetic nanoparticles in the solid dispersion of polyethylene glycol with average molecular weight 950-1050 g/mol and phenacetin was studied using atomic force and magnetic force microscopy. The distribution of nanoparticles was found to be uniform in studied composites. Magnetically active solid dispersions may find application in the production of the capsulated drug delivery systems with enhanced solubility parameters.
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Polygonum multiflorum root extract as a potential candidate for treatment of early graying hair p. 8
Nguyen Dinh Thang, Pham Ngoc Diep, Pham Thi Huong Lien, Le Thi Lien
DOI:10.4103/2231-4040.197332  
Despite Polygonum multiflorum (PM) has been experiencely used as a drug to treat early graying hair phenomenon in Asian countries for a long time, there is limited study examined the real biological effects of PM on hair graying in vitro and in vivo. In this study, we investigated the effects of PM root extract (PM-RE) on melanin synthesis in human melanoma SKMEL-28 cells and embryos/larvae of wild-type strain AB zebrafish. We also preliminary revealed the molecular mechanism of early hair graying phenomenon in both in vitro and in vivo models. Our results showed that PM-RE significantly induced melanin synthesis in melanin-producing SKMEL-28 melanoma cells and also in zebrafish embryos/larvae at 4-day postfertilization through activation of MC1R/MITF/tyrosinase-signaling pathway. We also investigated the differences in genotype between graying hair follicle and black hair follicle of young peoples and found that early hair graying phenomenon may be related to downregulation of MC1R/MITF/tyrosinase pathway. Taken together, we suggested that PM-RE at safe doses could be used as a potential agent for the treatment of early hair graying and other loss pigmentation-related diseases.
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Anticoagulation control among patients with nonvalvular atrial fibrillation: A single tertiary cardiac center experience p. 14
Shaban Mohammed, Amer H. S. Aljundi, Mohamed Kasem, Mohammed Alhashemi, Ayman El-Menyar
DOI:10.4103/2231-4040.197370  
There is a limited knowledge about the predictors of anticoagulation control in patients with nonvalvular atrial fibrillation (NVAF). Furthermore, few reports addressed the role of time in therapeutic range (TTR) that could reflect the safety and efficacy of anticoagulation therapy. We aimed to assess factors that affect the quality of anticoagulation therapy utilizing TTR in patients with NVAF. A retrospective observational study was conducted for patients with NVAF who were maintained on warfarin >6 months at a tertiary cardiac care hospital. Patients were categorized according to the TTR status (≥65% vs. <65%). A total of 241 eligible patients were identified. A high-quality anticoagulation based on TTR values ≥65% was found in 157 (65.1%) patients; the remaining (34.9%) patients represented the low-quality anticoagulation group (TTR <65%). Demographics and clinical characteristics were comparable in the two TTR groups. Both groups were comparable in terms of warfarin dose and medications use. When compared to patients with high-quality anticoagulation, patients in the low-quality anticoagulation group were more likely to seek outpatient warfarin clinic visits more frequently (22.3 ± 5.5 vs. 18 ± 4.4, P = 0.001) and to have higher rate of polypharmacy (57.1% vs. 42%, P = 0.03). Of note, patients in both groups had similar major bleeding events (P = 0.41). After adjusting for age and sex, polypharmacy use was a predictor of poor coagulation control (odds ratio = 1.89, 95% confidence interval: 1.03-3.33; P = 0.03). In NVAF patients, TTR is generally high in our cohort. Patients with polypharmacy and frequent clinic visits have lower TTR. High-quality oral anticoagulation could be achieved through optimizing TTR without a significant risk of major bleeding.
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Antidiabetic and anticancer activities of Mangifera indica cv. Okrong leaves p. 19
Aunyachulee Ganogpichayagrai, Chanida Palanuvej, Nijsiri Ruangrungsi
DOI:10.4103/2231-4040.197371  
Diabetes and cancer are a major global public health problem. Plant-derived agents with undesirable side-effects were required. This study aimed to evaluate antidiabetic and anticancer activities of the ethanolic leaf extract of Mangifera indica cv. Okrong and its active phytochemical compound, mangiferin. Antidiabetic activities against yeast α-glucosidase and rat intestinal α-glucosidase were determined using 1 mM of p-nitrophenyl-α-D-glucopyranoside as substrate. Inhibitory activity against porcine pancreatic α-amylase was performed using 1 mM of 2-chloro-4 nitrophenol-α-D-maltotroside-3 as substrate. Nitrophenol product was spectrophotometrically measured at 405 nm. Anticancer activity was evaluated against five human cancer cell lines compared to two human normal cell lines using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Mango leaf extract and mangiferin exhibited dose-dependent inhibition against yeast α-glucosidase with the IC 50 of 0.0503 and 0.5813 mg/ml, respectively, against rat α-glucosidase with the IC 50 of 1.4528 and 0.4333 mg/ml, respectively, compared to acarbose with the IC 50 of 11.9285 and 0.4493 mg/ml, respectively. For anticancer activity, mango leaf extract, at ≥200 μg/ml showed cytotoxic potential against all tested cancer cell lines. In conclusion, mango leaf possessed antidiabetic and anticancer potential in vitro.
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Cost-effectiveness of glaucoma management with monotherapy medications in Egypt p. 25
Amal Abd-Elaal El-Khamery, Amir Ibrahim Mohamed, Hassan Eisa Hassan Swify, Alaa Ibrahim Mohamed
DOI:10.4103/2231-4040.197384  
Glaucoma is a serious chronic ophthalmic disease since it causes irreversible visual disability if untreated can lead to blindness. Treatment options include medications (classified into five major classes of drugs which are muscarinic cholinergic agonists, alpha-2 adrenergic agonists, beta-1 adrenergic antagonists, prostaglandins [PGs], and carbonic anhydrase inhibitors); use of laser therapy or conventional surgery. Pharmacoeconomic analysis helps in choosing among this variety of treatments. There is a great need for such analysis in Egypt since undergoing of it in different countries or societies may produce different results. This work aimed to compare cost-effectiveness of bimatoprost 0.03% once daily versus brimonidine 0.2% twice daily and timolol 0.5% twice daily as monotherapy treatment in Egyptian patients with open-angle glaucoma or ocular hypertension. Clinical data revealed that all treatments decreased intraocular pressure (IOP) significantly but bimatoprost 0.03% showed the highest efficacy (27.7% decrease in IOP from baseline), while timolol 0.5% reduced IOP by 22.5% then brimonidine 0.2% which decreased IOP by 20.8%. From the cost-effectiveness view, it would be preferable to initiate treatment with timolol in case of absence of any contraindications. PG analog can be used as add-on therapy in low responder patients or as alternative treatment in case of presence of contraindication to use of beta blockers.
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Effectiveness and safety of topical tacrolimus in treatment of vitiligo p. 29
Ghasem Rahmatpour Rokni, Massoud Golpour, Alimorad Heidari Gorji, Alireza Khalilian, Hamta Ghasemi
DOI:10.4103/2231-4040.197388  
Vitiligo is one of the most primitive well-known dermatoid disorders with different suggested therapies. Therefore, this study investigated the efficiency and safety of topical tacrolimus in treatment of patients with vitiligo. This study was a clinical randomized designed study pre- post-test method, has been conducted on thirty cases with vitiligo who have referred to polyclinic and dermatology clinic. Participant's evaluated and demographic information recorded in designed checklist. In the next stage, the disease activity scored by vitiligo index disease activity system. Photography and depigmentation percent has recorded before treatment and further in 4 th , 8 th , 12 th , 16 th , 20 th , and 24 th weeks. Finally, gathered data compared through SPSS-20 software. The final sample comprised 30 persons including: 12 men (40%) and 18 women (60%). The average of patient's age in this study was 26/13 ΁ 18/20 (2-76-year-old). Eleven persons was ≤15 years old and rest was older than 15. Sixty-six lesions have funded in patients that maximum has accrued on face and neck (37/87%) and trunk (21/21%). In addition, minimum of lesions is related to genitalia (9/09%). In the in 4 th , 8 th , 12 th , 16 th weeks, improvement in face and neck had increased significantly, into the past weeks. In the 20 th and 24 th weeks, the improvement has increased although it was not significant enhancement. Also about trunk, in the 4 th week the improvement does not have significant increasing in compare to the past week. In the eighth, 12 th , 16 th , 20 th , and 24 th weeks the improvement has been increased significantly in compare to the past weeks. Although in the case of limbs and genitalia, the improvement was lower. There was no significant difference between male and females and age. Although the improvement was, slow in older persons. Study results, has presented applying topical tacrolimus in vitiligo, particularly in face and neck, could be effective and does not seen any specified adverse effects during consumption of tacrolimus, it could be effective in decreasing effects in use of corticosteroid.
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Effect of vestibular stimulation on auditory and visual reaction time in relation to stress p. 34
Archana Rajagopalan, Sai Sailesh Kumar, Joseph Kurien Mukkadan
DOI:10.4103/2231-4040.197390  
The present study was undertaken to provide scientific evidence and for beneficial effects of vestibular stimulation for the management of stress-induced changes in auditory and visual reaction time (RT). A total of 240 healthy college students of the age group of 18-24 of either gender were a part of this research after obtaining written consent from them. RT for right and left response was measured for two auditory stimuli (low and high pitch) and visual stimuli (red and green) were recorded. A significant decrease in the visual RT for green light and red light was observed and stress-induced changes was effectively prevented followed by vestibular stimulation. Auditory RT for high pitch right and left response was significantly decreased and stress-induced changes was effectively prevented followed by vestibular stimulation. Vestibular stimulation is effective in boosting auditory and visual RT and preventing stress-induced changes in RT in males and females. We recommend incorporation of vestibular stimulation by swinging in our lifestyle for improving cognitive functions.
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SHORT COMMUNICATION Top

Innate antioxidant activity of some traditional formulations p. 39
Gunpreet Kaur, Vikas Gupta, Parveen Bansal
DOI:10.4103/2231-4040.197393  
Herbal medicine is the oldest form of healthcare known to humanity. Recently, much attention is being directed toward the use of antioxidants. There are some very commonly used Ayurvedic preparations that might have inbuilt antioxidant activity, and their therapeutic potential can be partially attributable to its antioxidant activity. Hence, it was proposed to find out antioxidant activity of such common formulations. Estimation of innate antioxidant activity of some commonly used traditional formulations. In this study, five formulations were evaluated for antioxidant activity in comparison to gallic acid (standard) using the in vitro reducing power method and superoxide radical scavenging activity by dimethyl sulfoxide method followed by calculation of scavenging activity and inhibitory concentration 50% (IC 50 ). The result shows that Ayurvedic drug extracts possess good reducing power and antioxidant activity. Laxmivilas Ras shows higher reducing power ranging from 117 ± 0.021 to 0.176 ± 0.012 as compared to other extracts. The drug extracts were also found to be an efficient scavenger of superoxide radical. The IC 50 values for Laxmivilas Ras, Agnitundi Vati, Ajmodadi Churna, Tribhuvankirti Rasa, gallic acid (standard) and Sitopladi Churna, were found to be 50.07, 98.41, 105.13, 116.39, 176.80, and 200.17, respectively. From this study, it can be concluded that the above Ayurvedic formulations possess antioxidant property. However, work could be initiated on the isolation and identification of these antioxidant components.
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