MATERIALS AND METHODS: The produced nanoparticles were characterized using UV-visible spectroscopy. The Bovine Serum Assay (BSA) and Egg Albumin (EA) assays were used to assess the anti-inflammatory effects. The protein denaturation of AgNPs was calculated and compared to a standard to determine the anti-inflammatory activity of green synthesized AgNPs. Using varying concentrations of OGmediated AgNPs in Mueller Hinton Agar (MHA), the antimicrobial effects of OG have been investigated against E. coli, S. aureus, and Pseudomonas sp. Additionally, by measuring optical density, the time-kill curve analysis for E. Coli and S. Aureus has been examined from one hour for up to five hours.
RESULTS: The green synthesized AgNPs were developed successfully using a plant Ocimum gratissimum. The synthesized AgNPs exhibited a maximum absorption peak at 440 nm and SEM analysis revealed that the synthesized AgNPs were spherical and oval. The result findings of the anti-inflammatory activity reveal that AgNPs have great potential when compared to the standard. At the concentration of 50 μg/mL, AgNPs exhibit 76% in BSA assay and 74% in EA assay, where the standard shows 80% inhibition. The antimicrobial activity showed a zone of inhibition around 19mm for E. coli and a 20mm zone of inhibition for S. aureus and Pseudomonas sp., which shows the efficacy of AgNPs. The time-kill assay shows that the optical density of E. coli and S. aureus was reduced to 0.1 after 5 hours of incubation, which shows the potential of green synthesized AgNPs.
CONCLUSION: OG-mediated AgNPs have both antiinflammatory and antimicrobial effects. Anti-inflammatory effects are better when compared to standard drugs. Antimicrobial effects are better for Gram-negative bacteria.
METHODS: Retrospective analysis of medical records of patients in the COVID-19 wards of three tertiary care hospitals to assess antibiotic use during the sixth COVID-19 wave.
RESULTS: A total of 284 patients were included, most were male (66.9%), aged 30-50 years (50.7%) with diabetes mellitus the most common comorbidity. The most common symptoms at presentation were cough (47.9%) and arthralgia-myalgia (41.5%). Around 3% were asymptomatic, 34.9% had mild, 30.3% moderate, and 23.6% had severe disease, with 8.1% critical. Chest X-ray abnormalities were seen in 43.3% of patients and 37% had elevated white cell counts, with 35.2% having elevated C-reactive protein levels. Around 91% COVID-19 patients were prescribed antibiotics during their hospital stay, with only a few with proven bacterial co-infections or secondary bacterial infections. Most antibiotics were from the 'Watch' category (90.8%) followed by the 'Reserve' category (4.8%), similar to previous COVID-19 waves.
CONCLUSION: There continued to be excessive antibiotics use among hospitalized COVID-19 patients in Pakistan. Urgent measures are needed to address inappropriate prescribing including greater prescribing of Access antibiotics where pertinent.
PURPOSE: The purpose of this network meta-analysis was to assess the comparative efficacy of interventions used for the treatment of DS.
MATERIAL AND METHODS: A search was conducted for trials published in Medline, Scopus, PubMed, and Cochrane Central Register of Controlled Trials from inception until February 2022 (PROSPERO Reg no: CRD42021271366). Network meta-analysis was performed on data from randomized controlled trials that assessed the comparative efficacy of any form of intervention for the treatment of DS in denture wearers. Agents were ranked according to their effectiveness in the treatment of DS based on outcomes using surface under the cumulative ranking (SUCRA).
RESULTS: A total of 25 articles were included in the quantitative analysis. Topical antifungal agents (risk ratio [RR]=4.37[95% confidence interval [CI]: 2.15,8.90), topical antimicrobial agents used along with systemic antifungal agents (RR=4.25[95% CI: 1.79,10.33]), systemic antifungal agents (RR=4.25[95% CI: 1.79,10.10]), photodynamic therapy (RR=4.25[95% CI: 1.75,8.98]), and topical plant products (RR=3.40[95% CI: 1.59,7.26]) were found to effectively improve DS. Microwave disinfection concurrently administered with topical antifungal agents (RR=7.38(95% CI: 2.75,19.81), microwave disinfection 7.38[95% CI: 2.75,19.81]), topical antifungal agents (RR=4.88[95% CI: 1.92,12.42]), topical plant products (RR=4.49[95% CI: 1.70,11.82]), systemic antifungal agents together with topical antimicrobial agents (RR=3.85[95% CI: 1.33,11.10]), topical antimicrobial agents (RR=3.39[95% CI: 1.17,9.81]), systemic antifungal agents (RR=3.37[95% CI: 1.21,9.34]), and photodynamic therapy or photochemotherapy (PDT) (RR=2.93[95% CI: 1.01,8.47]) were found to effectively resolve mycological DS. Topical antifungals ranked highest in the SUCRA ranking for clinical improvement, whereas microwave disinfection concurrently administered with topical antifungal agents ranked highest for mycological resolution. None of the agents demonstrated significant side effects except for topical antimicrobial agents which demonstrated altered taste and staining of oral structures.
CONCLUSIONS: Available evidence suggests that topical antifungals, microwave, and systemic antifungals are effective in the treatment of DS, but confidence in these findings is low because of the limited number of studies and a high risk of bias. Additional clinical trials are needed on photodynamic therapy, topical plant products, and topical antimicrobials.