Innovare Academic Sciences: E-Journals
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QUANTITATIVE ASSESSMENT OF SKIN STIFFNESS AND THICKNESS USING HIGH-FREQUENCY ULTRASOUND AND SHEAR WAVE ELASTOGRAPHY IN THE MANAGEMENT OF SCLERODERMA: A PROSPECTIVE COMPARATIVE STUDY
No full textObjective: The objective of this study is to analyze skin stiffness and thickness quantitatively in patients with systemic sclerosis using high-frequency ultrasound (HFUS) and shear wave elastography (SWE), and to compare those results with healthy controls. This study aims to examine the diagnostic utility, examine the performance between both modalities and determine their correlation with modified Rodnan skin score (mRSS), and establish their clinical utility in the early diagnosis and monitoring of disease severity in scleroderma.
Methods: In this observational study, skin stiffness and thickness were assessed in SSc patients and matched healthy controls using HFUS and SWE. Quantitative measurements were taken at standard anatomical sites. Receiver operating characteristic (ROC) curve analysis evaluated the diagnostic accuracy of each modality, while correlation with the modified Rodnan skin score (mRSS) was analyzed to determine clinical relevance.
Results: Both skin thickness and stiffness were significantly elevated in SSc patients compared to controls (p<0.001). SWE exhibited superior diagnostic accuracy (AUC 0.881) compared to HFUS (AUC 0.795), with sensitivities of 90% and 82%, respectively. Strong positive correlations were observed between imaging parameters and mRSS (r = 0.758 for SWE stiffness; r = 0.642 for HFUS thickness).
Conclusion: HFUS and SWE constitute effective, complementary tools for quantitative evaluation of skin involvement in systemic sclerosis. Their combined use improves diagnostic precision and correlates well with clinical skin scores, supporting integration into routine clinical assessment and trials. Further multicenter validation and protocol standardization are warranted
A COMPARATIVE EVALUATION OF PARACETAMOL, IBUPROFEN, AND COMBINATION THERAPY IN THE MANAGEMENT OF ACUTE MUSCULOSKELETAL PAIN: A PROSPECTIVE, OBSERVATIONAL STUDY
No full textObjective: Acute musculoskeletal pain (AMP) is a common clinical condition that significantly impairs functional ability and quality of life. Paracetamol and ibuprofen are widely used analgesics, while combination therapy is believed to offer enhanced pain relief. This study aimed to compare the efficacy and safety of paracetamol, ibuprofen, and their combination in the management of acute musculoskeletal pain. To evaluate and compare analgesic efficacy and tolerability among paracetamol, ibuprofen, and combination therapy using the Numeric Rating Scale (NRS).
Methods: A prospective, objective, comparative study was conducted on 90 adult patients with acute musculoskeletal pain. Patients were randomly allocated into three groups (n=30 each): Group A (Paracetamol 1000 mg), Group B (Ibuprofen 400 mg), and Group C (Paracetamol 1000 mg+Ibuprofen 400 mg). Pain intensity was assessed using the NRS at baseline, 2 h, 4 h, and 6 h after administration. Adverse effects were recorded. Data were analyzed using ANOVA and chi-square tests.
Results: mean pain reduction at 6 h was highest in the combination group (5.8±1.2) compared to ibuprofen (4.6±1.5) and paracetamol (3.9±1.4), p<0.01. The onset of analgesia was faster with the combination therapy (within 1 hour). Adverse effects were mildand comparable across groups.
Conclusion: Combination therapy of paracetamol and ibuprofen provided superior pain relief with a faster onset and acceptable safety profile. It may be recommended for short-term management of acute musculoskeletal pain
PATIENT-LEVEL MISCONCEPTIONS AS DETERMINANTS OF ORAL HYPOGLYCEMIC AGENT USE: A CROSS-SECTIONAL ANALYSIS
No full textObjective: To examine patient-level misconceptions related to oral hypoglycemic agent use and their association with treatment patterns using a cross-sectional analysis of outpatient data.
Methods: This cross-sectional study used an outpatient drug utilization survey involving adults with type 2 diabetes mellitus receiving OHAs, either alone or in combination with insulin. Patient-level misconceptions were inferred from reported medication-related behaviors that deviated from evidence-based diabetes management principles. Descriptive analyses were performed to assess the prevalence of identified misconception domains and their distribution across treatment patterns.
Results: Among 59 patients included in the analysis, treatment permanence misconceptions were observed in 27.1% of participants, while safety-related misconceptions were identified in 18.6%. Treatment permanence misconceptions were more common among patients receiving oral hypoglycemic agents alone compared with those receiving combined OHA–insulin therapy. Safety-related misconceptions were present in both treatment groups, but were more frequent among patients on OHA monotherapy.
Conclusion: Patient-level misconceptions regarding oral hypoglycemic agent use are common and vary according to treatment exposure. Addressing these misconceptions through patient-centered education and consistent counselling may be essential for promoting rational and sustained use of oral hypoglycemic agents in routine diabetes care
GREEN SYNTHESIS OF CHITOSAN-MEDIATED SILVER NANOCOMPOSITE USING PIPER BETEL STEM EXTRACT: EVALUATING ANTIBACTERIAL AND ANTICANCER ACTIVITY
No full textObjective: The integration of herb-based nanomedicine has gained significant attention, aiming to improve therapeutic outcomes while minimizing drug toxicity. Piper betel is a medicinal herb widely used in traditional therapy due to its potent anticancer, antimicrobial, antioxidant, and anti-inflammatory properties.
Methods: P. betel stem extract is used to synthesize chitosan-mediated silver nanocomposite (AgNC). Characterization was done using UV-visible spectrophotometry, Fourier transform infrared (FTIR), X-ray diffraction, dynamic light scattering with Zeta potential, and FESEM with energy dispersive X-ray. Its antibacterial activity was evaluated in Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli, as well as antioxidant diphenyl-2-picrylhydrazyl and anti-inflammatory assays (egg albumin and bovine serum albumin) were performed. Further, its anticancer activity was evaluated in A549 and Henrietta Lacks (HeLa) cell lines.
Results: AgNC exhibited a sharp surface plasmon resonance peak at 450 nm. FTIR analysis revealed various peaks. Scanning electron microscopy analysis revealed a soft-fibrous sheet-like morphology. In antibacterial activity, a significant zone of inhibition was observed against P. aeruginosa and E. coli (16 mm). In addition, AgNC exhibited inhibition of free radicals and protein denaturation. In anticancer activity, it showed greater activity against A549 (66.7±5.9 μg/mL) than HeLa (85.7±7.8 μg/mL), and reduced cell migration within 48 h at 80 μg/mL in A549 cell lines.
Conclusion: These findings highlight AgNCs as the most promising candidates for biomedical applications, particularly for antibacterial and anticancer therapy. However, further investigations are required to elucidate the precise molecular mechanisms of therapeutic efficacies and modifications to enhance their anticancer activity
EVALUATION OF WOUND HEALING AND ANTI-INFLAMMATORY PROPERTY OF 5,3’DIHYDROXYFLAVONE AND GENE EXPRESSION OF JAK AND COX-2 IN LIPOPOLYSACCHARIDE-INDUCED RAW264.7 CELL LINE
No full textObjectives: The study aims to evaluate the wound healing potential and anti-inflammatory properties of 5,3’-dihydroxyflavone (DHF) and investigate its regulatory effects on the expression of Janus kinase (JAK) and cyclooxygenase-2 (COX-2) genes in lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophage cell line.
Methods: Cytotoxicity was evaluated using the MTT assay. RAW 264.7 cells were treated with DHF (1–100 μg/mL) for 24 h. Absorbance was measured at 490 nm and 630 nm. Wound healing was assessed through a scratch assay. LPS-induced and DHF-treated groups (12.5, 25, 50 μg/mL) were analyzed for scratch closure at 0 and 24 h. Nitric oxide (NO) production was quantified using the Griess assay. Nitrite levels were measured at 520–550 nm. Gene expression of COX-2 and JAK1 was analyzed using quantitative polymerase chain reaction (qPCR), with β-actin as a reference gene. Relative expression was determined by the 2−ΔΔCt method.
Results: The MTT assay confirmed DHF’s non-cytotoxicity, showing ≥90% viability at 1–100 μg/mL (p>0.05). The scratch assay showed enhanced wound closure. At 50 μg/mL, DHF achieved ~75% closure, compared to 45% in the LPS group. NO estimation revealed a dose-dependent reduction. At 50 μg/mL, DHF significantly lowered NO levels (p<0.01). qPCR analysis demonstrated downregulation of COX-2 (45%) and JAK1 (50%) at 50 μg/mL (p<0.001). These findings confirm DHF’s anti-inflammatory and wound-healing potential.
Conclusion: This study demonstrates that DHF enhances wound healing in RAW 264.7 cells by downregulating JAK and COX-2 expression, highlighting its anti-inflammatory potential
DEVELOPMENT AND VALIDATION OF A QUESTIONNAIRE ASSESSING KNOWLEDGE, ATTITUDE, AND PRACTICE TOWARD ANTIBIOTIC USE AMONG PARENTS: Parental Antibiotic usage
No full textObjective: Antibiotics can only treat serious bacterial infections. However, public’s misconception, that antibiotics cure every disease including viral infections leads to misuse. Common practices such as irregular intake, self-medication, and obtaining antibiotics without prescription contribute to antimicrobial resistance, which is threatening global health. This study aims to develop and validate appropriate scales to measure parents’ knowledge, attitudes, and practices (KAPs) regarding antibiotic use.
Methods: A questionnaire on assessing KAP about antibiotic use was constructed and tested among the parents in Kedah, Malaysia. Reliability and test-retest stability were assessed using Cronbach’s alpha and the intraclass correlation coefficient. Factor analysis confirmed construct validity, with items expected to load strongly on single factors. Data were collected June–August 2024 from parents of children ≤12 years.
Results: Reliability testing showed a very high internal consistency and test-retest reliability (all scales score higher than 0.7 on Cronbach’s alpha). Exploratory analysis for attitudes revealed four factors, and for practices, two, with good variance accounted for (>70%). Items with loadings <0.4 were eliminated. Kaiser-Meyer-Olkin (KMO) measure > 0.6 and Bartlett’s test p<0.001 confirmed data adequacy. Of the 46 young, educated Chinese parents involved, knowledge and attitude scores were moderate according to Bloom’s criteria.
Conclusion: The final tool included 17 items of knowledge, 11 of attitude, and 9 of practice, which all showed validity and reliability. Participants had moderate knowledge, a neutral attitude, and practices. Further validation is recommended before wider use
IMPACT OF CENTRAL OBESITY ON COGNITIVE FUNCTIONS IN UNDERGRADUATE MEDICAL STUDENTS: A CROSS-SECTIONAL STUDY
No full textObjectives: Obesity, particularly central obesity, has been increasingly recognized as a risk factor for impaired cognitive function due to its association with metabolic and neuroinflammatory changes. Among medical students, whose academic and clinical performance relies heavily on executive function, such associations are of particular concern. To examine the relationship between central obesity, assessed by waist–hip ratio (WHR), and cognitive performance in undergraduate medical students using standardized cognitive function tests (CFTs).
Methods: A cross-sectional study was conducted among undergraduate medical students (n=112). Anthropometric indices, including body mass index (BMI), waist circumference (WC), and WHR, were measured. Cognitive function was assessed using standardized tests: Stroop Word (WR), Stroop Color–Word (CW), Stroop Effect, Trail Making Test A and B (TMT-A, TMT-B), and the Grid Concentration Test (GCT). Associations between obesity indices and CFT performance were analyzed using correlation and group comparisons.
Results: The prevalence of central adiposity (elevated WHR) was 39.28%, with a higher prevalence among females (40.48%). Students with higher WHR required significantly longer times to complete Stroop WR, CW, and Stroop Effect tasks (p<0.05), indicating impaired inhibitory control and reduced cognitive flexibility. Moderate positive correlations were observed between WHR and Stroop outcomes, particularly CW and Stroop Effect, while BMI and WC showed minimal associations. TMT-A, TMT-B, and GCT performances were not significantly related to any adiposity indices.
Conclusion: Central obesity, as measured by WHR, is associated with subtle but meaningful impairments in executive function, especially inhibitory control, among healthy individuals too. These findings underscore the value of WHR as a sensitive marker of obesity-related cognitive risk and highlight the need for early lifestyle interventions to safeguard cognitive health and academic performance in future healthcare professionals
LC-MS AS A VERSATILE TOOL FOR DRUG DISCOVERY, DEVELOPMENT, AND CLINICAL DIAGNOSTICS
No full textOne of the crucial elements in the analysis of biomolecules is liquid chromatography-mass spectrometry (LC-MS), affording unique sensitivity and specificity to a broad spectrum of applications in the discovery of new drugs, proteomics, and metabolomics. Modern biomolecular science has been reshaped by new techniques in LC-MS technology by enabling the potential to deconstruct increasingly complex systems in biological and life sciences research. A highlight of current trends, hot instruments, and advancements, along with modern approaches for improvements in separations and processing the data for advancement in this sector, will also be addressed herein. Combining high-resolution MS (HRMS) and ultra-high-performance liquid chromatography (UHPLC) marks one of the most meaningful changes since this combination produces the best results, both in terms of better resolution and as regards increasing sample throughput. Many of these previous limitations for biological macromolecule analysis are fast being mitigated because improved ionization technologies, particularly in electrospray ionization and matrix-assisted laser desorption/ionization, expand the breadth of possible LC-MS analyses. Recent improvements in multidimensional separation technology and stationary phase diversity increase chromatographic efficiencies, especially to study more intricate biological matrices. Together with strategies to overcome these limitations, this paper also discusses challenges such as matrix effects, sample preparation challenges, and data quality. Researchers can uncover novel information on biomolecular interactions, disease mechanisms, and therapeutic targets by integrating state-of-the-art LC-MS technologies with innovative computational approaches. As LC-MS continues to evolve, it holds immense potential to shape the future of precision medicine and biomolecular research
CYP2D6, HUMAN EPIDERMAL GROWTH FACTOR RECEPTOR 2, AND BEYOND: PHARMACOGENOMICS-GUIDED PERSONALIZATION IN BREAST CANCER MANAGEMENT
No full textBreast cancer is a serious worldwide health concern, and it is highly fatal, debilitating, and unpredictable because of tumor heterogeneity and an individual difference in the metabolism and toxicity of drugs. The development of pharmacogenomics has been a potent instrument in overcoming these issues by incorporating individual genetic data into the decision-making process of the therapeutic process. This is a review that summarizes existing evidence regarding the use of pharmacogenomics determinants to affect endocrine therapy, immunotherapy, and chemotherapy in breast cancer. Polymorphism in CYP2D6 plays a potentially significant role in tamoxifen activation and endoxifen concentrations in hormone receptor-positive disease, and variants in CYP19A1, ESR1, and ESR2 also play a role in the efficacy and toxicity of aromatase inhibitor. The FCGR3A and FCGR2A polymorphisms of PI3K/AKT pathways, as well as HER2 structural changes, can predict the responsiveness to trastuzumab in HER2-positive breast cancer and determine how to use the new agents like trastuzumab deruxtecan and margetuximab. In the case of triple-negative breast cancer, the biomarkers such as PD-L1 expression, immune-related gene signature, HLA variants, and polygenic risk scores narrow immune checkpoint inhibitors selection and determine vulnerability to immune-related adverse events. Also, germline mutations in DPYD, CYP2C8, ABCB1, UGT2B7, and anthracycline cardiotoxicity-related genes assist in the reduction in dose and toxicity of anthracycline. The increased use of pharmacogenomics testing, multigene panels, and next-generation sequencing in both clinical research and clinical practice highlight the growing importance of this technology in precision oncology. Together, the pharmacogenomics allow the use of more personalized therapy choice, reduce the adverse effects, and increase the overall outcome of treatment in breast cancer
DEVELOPMENT AND VALIDATION OF AN REVERSE PHASE-HIGH PERFORMANCE LIQUID CHROMATOGRAPHY METHOD FOR THE SIMULTANEOUS DETERMINATION OF OLANZAPINE AND FLUOXETINE HYDROCHLORIDE IN TABLET DOSAGE FORM
No full textObjectives: To develop and validate a novel reverse phase-high performance liquid chromatography (RP-HPLC) method for the simultaneous estimation of olanzapine and fluoxetine hydrochloride in a fixed-dose combination tablet formulation.
Methods: Chromatographic separation was carried out on a Waters Symmetry C18 column (250 mm × 4.6 mm, 5 μm) using a mobile phase of phosphate buffer (pH 3.0) and acetonitrile in the ratio of 55:45 (v/v), delivered at a flow rate of 1.0 mL/min. Detection was performed at 235 nm using a ultraviolet detector. The method was validated in accordance with ICH Q2(R1) guidelines.
Results: The method exhibited linearity over the concentration range of 2–12 μg/mL for olanzapine and 4–24 μg/mL for fluoxetine hydrochloride, with correlation coefficients (r2) of 0.999 for both drugs. Precision studies showed percentage relative standard deviation (%RSD) values below 1% for intra-day and inter-day measurements. Accuracy was confirmed by recovery studies, yielding average recoveries of 99.44% for olanzapine and 99.59% for fluoxetine hydrochloride. The method demonstrated robustness at lower flow rates, while sensitivity was observed at higher flow variations. Ruggedness studies showed %RSD values within acceptable limits. Assay of marketed tablets resulted in average assay values of 100.22% for olanzapine and 99.66% for fluoxetine hydrochloride.
Conclusion: The developed RP-HPLC method is simple, precise, accurate, and suitable for routine quality control analysis of olanzapine and fluoxetine hydrochloride in combined dosage forms