Synergy Publishers Journal System
Not a member yet
557 research outputs found
Sort by
Exploiting the Power of Stereochemistry in Drugs: An Overview of Racemic and Enantiopure Drugs
No full textAbstract: Stereochemistry is one of the essential dimensions in pharmacology as it dictates how enantiomers interact with biological systems. Chirality is very important in drug design. Enantiomers of the same chiral drug can have different pharmacodynamic and/or pharmacokinetic properties. In this context, replacing some existing racemates with single isomers has resulted in improved safety and/or efficacy profile of various racemates. Single enantiomer drug use can potentially lead to simpler and more selective pharmacologic profiles, improved therapeutic indices, simpler pharmacokinetics due to different rates of metabolism of the different enantiomers, decreased drug interactions, and drug companies are increasingly using chiral switching as a marketing strategy. Additionally, due to different pharmacological activity, enantiomers of chiral drugs can differ in toxicity. However, unpredicted toxicity has been reported in some chiral switching cases which has resulted the withdrawal of the enantiomer from the market or a halt in its development. In view of above, before switching to single enantiomer drugs, prescribers should look for evidence from well-conducted clinical trials to prove that the chiral switch is cost-effective and improves the outcomes for patients rather than patents. The U.S. Food and Drug Administration (FDA) have allowed single enantiomers of generic drugs to be patented and marketed under different name. FDA regulations require that all chiral bioactive drug molecules must be isolated and tested for the efficacy and safety, and have to be as pure as possible containing a single pure enantiomer
Factors Influencing Proper Plantar Ulcer Care of Leprosy Patients: Experience from Mon-Ywa Township of Disabilities Survey Project, Myanmar
No full textA cross-sectional study design was applied to explore types and ways of proper plantar ulcer care and factors influencing it. This study was conducted during 2008 in Mon-ywa Township because it is one of the ‘9 selected townships of the Disabilities survey project’. The study involved 19 patients affected by leprosy (PAL) with foot grade 2 disability, but without plantar ulcer at the time of study, 6 community members who had PAL in their immediate family and 6 community members who had PAL among their surroundings. They participated voluntarily in the study. The information was gathered by in-depth interview. Stigma attached to disability-related leprosy was still observed among the study respondents. They knew that ulcer could weaken their life and their surroundings. They were also aware of that one would gain benefit if one would free from ulcer. Personal outlook, a close attachment of their families and responsibility for the family, community’s reactions and the provision from the health service were the key factors to push and pull the PAL to perform plantar ulcer care. Consequently, as to regain the normal life in a society, despite a number of difficulties, PAL tried their best to look after the plantar ulcer along with the help from their families and relatives. As they were aware of the value of ulcer-free condition. for the future, they had positive view on plantar ulcer care not only for them but also for their families
Successful Treatment to Dermatitis Papillaris Capilliti (Kaposi) with Kampo (Japanese Traditional Herbal Medicine) Formulations
No full textWe report a case of dermatitis papillaris capilliti (DPC) that was successfully treated with Kampo (Japanese traditional herbal medicine) formulations (Keigai-rengyo-to and Keishi-bukuryo-gan). A 38-year-old man presented with longstanding-therapy resistant papillomatous lesions on the occipital area and nape for 15 years. Diagnosis was made as DPC. He had also cystic acne. Histopathological findings revealed follicular hyperkeratosis in the infundibulum and fibrosis in the dermis. After Kampo formulations (Keigai-rengyo-to and Keishi-bukuryo-gan) were administered, inflamed and granulomatous lesions subsided remarkably. The successful treatment with these herbal formulations shows Kampo therapy can acts as an alternative treatment for DPC
New Disposable Transanal Endoscopic Surgery Platform: Longer Channel, Longer Reach
No full textAbstract: Background: Transanal endoscopic surgical (TES) resection using rigid transanal platforms (TEM, TEO) is associated with improved outcomes compared to traditional transanal excision (TAE) of rectal lesions. An alternative technique using a disposable single incision surgery platform was developed in 2009, transanal minimally invasive surgery (TAMIS), resulting in a surge in interest and access to transanal access platforms to perform TES. However, compared to rigid transanal access platforms, the disposable platforms do not facilitate internal rectal retraction and have limited proximal reach. A new long channel disposable transanal access platform has been developed (15 cm in length, 4 cm in width) thereby facilitating endoluminal surgical access to the upper rectum and rectosigmoid colon. Methods: This is a retrospective case series report. Patient demographics and peri-operative outcome variables were recorded. The Gelpoint Path Long Channel was utilized in three patients with proximal rectal lesions that were not accessible using a standard disposable transanal access platform.Results: Three patients underwent TES excision of rectal adenomas using a long channel, disposable, transanal access platform. All patients were female, aged 51 – 53, BMI 23-32 kg/m2. The tumor size ranged from 2.4 – 8.5 cm, 15-100% circumference, and proximal location from the dentate line ranged from 9 – 11 cm. Final pathology revealed adenoma with negative margins in all three cases. The hospital length of stay ranged from 1 – 3 days and there were no perioperative complications. None of the patients have developed a local recurrence during the follow up period ranging from 5 – 11 months.Conclusions: The new long channel, disposable, transanal access platform facilitates transanal endoluminal surgical removal of lesions in the mid to upper rectum that may be difficult to reach using the standard disposable transanal access devices. We have successfully achieved 100% margin negative rate using this new device in this small series of patients with proximal rectal adenomas
The Anesthesiologist’s Impact on Bleeding Control During Liver Surgery
No full textLiver surgery is often associated with increased likelihood of massive bleeding. The blood loss is one of major intraoperative issue the surgical team must deal with. Bleeding is usually present in cirrhotic patients but can be faced even in the patients with normal liver function undergoing liver surgery. Correction of preoperative abnormal coagulation’s tests, strong interaction between the surgeon and the anesthesiologist, and finally the anesthesia technique, may successfully reduce the bleeding intensity and blood transfusions requirements. This review will be focused only in the anesthesiologist’s role in minimizing the blood loss during major liver surgery
Participant Feedback in the Evaluation of Novel Stroke Rehabilitation Technologies
No full textPurpose: Stroke participant perspectives are used to evaluate a novel rehabilitation system employing electrical stimulation (ES) technology combined with robotic assistance and virtual reality. The broader implications of such feedback for future technological development are discussed.Method: While supported by a robot, ES was applied to the triceps and anterior deltoid muscles of 5 chronic stroke participants with upper limb impairment to assist them in completing functional, virtual reality tracking tasks. Advanced ES controllers adjusted the amount of ES applied on each attempt to improve accuracy and maximise voluntary effort. The system was evaluated in terms of participants’ perspectives, expressed during a semi-structured interview, and clinical outcome measures.Results: The rehabilitation system was well accepted by participants and viewed positively, despite mixed opinions regarding effectiveness. Feedback demonstrated an alignment in participants’ perceptions of reduced impairment and clinical outcomes, in which a significant (p < 0.001) mean change of 9.3 in Fugl-Meyer scores was observed. Participant feedback also provided insight into individual differences observed in clinical outcomes. From our findings six key issues regarding effectiveness, muscles trained, system flexibility and portability, possible discomfort and the value of participant perspectives emerged that may be relevant for researchers developing new rehabilitation technologies.Conclusion: Participant feedback via a semi-structured interview provided important insight into the usability and effectiveness of using this system as a platform for upper limb stroke rehabilitation
Novel Dynamic Interpolation Strategy for Upper-Limb Rehabilitation Robot
No full textFocusing on providing stable and smooth robot-assisted exercises, this paper proposes a novel dynamic interpolation strategy to improve the robot movement performances. During the robot-assisted exercise, the designed control system dynamically employs appropriate interpolation method according to the physical state of the training impaired limb (PSTIL). The remarkable feature of this strategy is that it can make full use of the characteristics of different interpolation methods, which contributes to achieve better performances. Moreover, position-based impedance control is adopted to achieve the interaction compliance between the impaired limb of patient and robot end-effector. The results of experiments on 4-DOF upper-limb rehabilitation robot demonstrate the effectiveness and potentiality of the proposed method for achieving more stable and smoother robot-assisted exercises
Effect of Robot-Assisted Treadmill Training on Motor Functions Depending on Severity of Impairment in Patients with Bilateral Spastic Cerebral Palsy
No full textObjective: To assess impact of RATT (robot-assisted treadmill training) on motor function in patients with cerebral palsy depending on the severity of motor impairment.Design: Uncontrolled prospective pilot study with pre-post treatment outcome comparison according to severity of motor impairment. Setting: Outpatient Rehabilitation Centre.Participants: Fifty-one patients aged 4 - 27 years with bilateral spastic cerebral palsy.Interventions: Patients were divided into two groups according to severity of motor impairment determined by the Gross Motor Function Classification Scale (GMFCS). All 51 participants underwent 20 RATT sessions over a 5-6 week period in an outpatient approach using the Lokomat® driven gait orthosis (DGO).Outcome Measures: Dimension A(lying, rolling), B(sitting), C(crawling, kneeling), D (standing) and E(walking, running, jumping) within the Gross Motor Function Measure (GMFM-88), 6-minute walking test, 10-meter walk test, Functional Ambulation Categories (FAC).Results: Patients demonstrated statistically significant improvements in all GMFM-88 dimensions. Improvements in GMFM A, B and C were significantly larger in the more severely affected cohort (GMFCS III, IV) compared to the mildly affected cohort (GMFCS I, II). In contrast, GMFM D and E improvements were greater in the mildly affected cohort, but not statistically significant. Mean (SD) maximum gait speed of 0.75 (0.48) to 0.89 (0.52) m/s; mean (SD) 6 Min WT of 154 (103.21) to 191.21 (114.55) m; as well as the mean (SD) FAC of 1.44 (1.22) to 1.89 (1.33) showed a statistically significant level of improvement (p= .000).Conclusion: RATT is a promising treatment option in ambulatory and non-ambulatory patients with cerebral palsy. The severity of motor impairment affects the amount of improvement that can be achieved
Dual Inhibitors of COX-2 and Soluble Epoxide Hydrolase (sEH)
No full textA series of novel Dual Inhibitors of COX-2 and sEH containing an N-urea substituted pyrazole as a lead for sEH inhibition have been synthesized and screened as novel analogues to reduce blood pressure elevation by acting as sEH inhibitors. The synthesized compounds having varying degrees of selectivity towards the sEH enzymes. Particularly compounds 6g and 6i emerged as the most potent sEH inhibitor displaying IC50 values of 0.114 ± 0.014 µM and 0.120 ± 0.03 µM for in-vitro sEH inhibition and the selectivity for COX-2 enzyme pave the way for discovery of novel Dual Inhibitors