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Hydroxyapatite (HA) is similar to natural bone regarding composition, and its structure favors in biomedical applications. Continuous research and progress on HA nanomaterials (HA-NMs) have explored novel fabrication approaches coupled with functionalization and characterization methods. These nanomaterials have a significant role in many biomedical areas like sustained drug and gene delivery, bio-imaging, magnetic resonance, cell separation, and hyperthermia treatment due to their promising biocompatibility. This review highlighted the HA-NMs chemical composition, recent progress in synthesis methods, characterization and surface modification methods, ion-doping, and role in biomedical applications. HA-NMs have a substantial role as drug delivery vehicles, coating material, bone implant, coating, ceramic, and composite materials. Here, we try to summarize an overview of HA-NMs with the provision of future directions.

The ongoing escalation of drug-resistant bacteria creates the leading challenges for human health. Current predictions show that deaths due to bacterial illness will be more in comparison to cancer in 2050. Irrational use of antibiotics, prolonged regimen and using as a prophylactic treatment for various infections are leading cause of microbial resistance. It is an emerging approach to introduce evolving nanomaterials (NMs) as a base of antibacterial therapy to overcome the bacterial resistance pattern. NMs can implement several bactericidal ways and turn into a challenge for bacteria to survive and develop resistance against NMs. All the pathways depend on the surface chemistry, shape, core material and size of NMs. Because of these reasons, NMs based stuff shows a critical role in advancing the treatment efficiency by interacting with the cellular system of bacteria and functioned as an antibiotic substitute. We divided this review into two sections. The first part highlights the development of microbial resistance to antibiotics and their mechanisms. The second section details the NMs mechanisms to combat antibiotic resistance. In short, we try to summarize the advances in NMs role to deal with microbial resistance and giving solution as antibiotics substitute.

The global health of humans is seriously affected by the dramatic increases in the resistance patterns of antimicrobials against virulent bacteria. From the statements released by the Centers for Disease Control and Prevention about the world entering a post-antibiotic era, and forecasts about human mortality due to bacterial infection being increased compared to cancer, the current body of literature indicates that emerging tools such as nanoparticles can be used against lethal infections caused by bacteria. Furthermore, a different concept of nanomaterial-based methods can cope with the hindrance faced by common antimicrobials, such as resistance to antibiotics. The current review focuses on different approaches to inhibiting bacterial infection using nanoparticles and aiding in the fabrication of antimicrobial nanotherapeutics by emphasizing the functionality of nanomaterial surface design and fabrication for antimicrobial cargo.

Objective: To assess growth hormone (GH) stimulation test efficacy in short stature workup for establishing GH deficiency. Study Design: Cross-sectional survey. Place and Duration of Study: Diagnostic Endocrine Section, Department of Chemical Pathology & Endocrinology, Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan, from Aug 2020 to Jan 2021. Methodology: The study was conducted on 129 individuals aged 2-16 years. History, axiological data and biochemical parameters were assessed to establish GH deficiency for short stature workup. Results: Out of 129 individuals, 76(59%) boys and 53(41%) girls reported GH stimulation tests. 81(62.3%) children were in <3rd percentile, 29(22.3%) in <5th percentile, 9(6.9%) in <10th percentile and 5(3.8%) in <25th percentile. Among the group with bone age difference >2 years, 34(82.9%) fell in <3rd percentile. GH Stimulation test post-Levo Dopa was performed in 102(78.46%) patients. 49(37.4%) patients responded inadequately to the GH stimulation test. The adequate response to the GH Stimulation test improved as the percentile declined from the 50th to the 3rd percentile. Conclusion: GH stimulation test results can only partially rely upon though their importance remains in combination with other short-stature workup parameters for ruling out growth hormone deficiency. 

In the present condition of COVID-19, the demand for antimicrobial products such as face masks and surgical gowns has increased. Because of this increasing demand, there is a need to conduct a study on the development of antimicrobial material. Therefore, this study was conducted on the development of Aloe Vera and Polyvinyl Alcohol (AV/PVA) electrospun nanofibers. Four different fibers were developed by varying the concentrations of Aloe vera (0.5%, 1.5%, 2.5%, and 3%) while maintaining the concentration of PVA constant. The developed samples were subjected to different characterization techniques such as SEM, FTIR, XRD, TGA, and ICP studies. After that, the antimicrobial activity of the developed Aloe Vera/PVA electrospun nanofibers was checked against Gram-positive (Staphylococcus aureus) bacteria and Gram-negative (Escherichia coli) bacteria. The developed nanofibers had high profile antibacterial activity against both bacteria, but showed excellent results against S. aureus bacteria as compared with E. coli. These nanofibers have potential applications in the development of surgical gowns, gloves, etc.

Liver cirrhosis is a complication usually due to the consequence of persistent chronic liver disease. It is associated with different mechanisms, including hypoalbuminemia, impaired amino acid turnover, and micronutrient deficiencies. Consequently, cirrhotic patients can develop progressive complications like ascites, hepatic encephalopathy, and hepatocellular carcinoma. The liver is a vital organ that regulates the different metabolic pathways and transportation of trace elements. Zn is an indispensable micronutrient trace element involved in its crucial functions in cellular metabolic activity. Zn mediates its action by binding to a wide range of proteins; therefore, it imparts numerous biological effects, including cellular division, differentiation, and growth. It is also involved in critical processes for the biosynthesis of structural proteins and regulation of transcription factors and acts as a co-factor for the various enzymatic processes. As the liver is a significant regulator of Zn metabolism, its abnormalities lead to Zn deficiency, which has consequences on cellular, endocrine, immune, sensory, and skin dysfunctions. Conversely, Zn deficiency may modify the functions of hepatocytes and immune responses (acute phase protein production) in inflammatory liver diseases. This review has concisely stated the evolving indication of the critical role of Zn in biological processes and complications associated with liver cirrhosis pathogenesis due to Zn deficiency.

The current work aimed to formulate a novel chitosan-based finasteride nanosystem (FNS-NS) for skin delivery to optimize the drug availability in skin for a longer time and enhance ex vivo performance of finasteride against androgenic alopecia. Both undecorated and chitosan decorated FNS-NSs were synthesized by a high energy emulsification technique. All the prepared nanosystems were further subjected to physicochemical characterizations like pH, viscosity, encapsulation efficiency, surface morphology and in vitro drug release behavior. The influence of the nanosystem on the drug permeation and retention in rat skin was examined using Franz diffusion cell apparatus. The droplet size of developed nanosystems ranged from 41 to 864 nm with a low polydispersity index. The zeta potential of the nanosystems was between -10 mV and +56 mV. This chitosan decorated nanosystem exhibited controlled drug release, ie about 78-97% in 24 h. Among all the nanosystems, our chitosan decorated formulation (F5) had low drug permeation (16.35 µg/cm ) and higher drug retention (10.81 µg/cm ). The abovementioned results demonstrate satisfactory in vitro drug release, skin retention profiles and ex vivo performance with chitosan decorated FNS-NS (F5). This optimized formulation could increase drug availability in skin and could become a promising carrier for topical delivery to treat androgenic alopecia.

The incorporation of nanoparticles (NPs) into textile fabrics can transform ordinary products to endow the new functional characteristics owing to their interesting surface characteristics. The surface functionalization of NPs can play a key role in controlling the colloidal stability followed by interactions between substrate and NPs leading to enhanced functional characteristics. Here, the synthesis of ZnO NPs was carried out through hydrothermal method. The surface of NPs was modified using silanol and tertiary amine-based coupling agents. The functionalized NPs were characterized using zeta potential, size distribution, XRD, EDX, and FTIR. The size of prepared NPs was observed as 34 nm. The disperse stability of functionalized NPs was studied by varying the concentration of coupling agent and assessed through the ultraviolet protection factor (UPF) and antibacterial activity of the fabrics treated with functionalized NPs. The functionalized NPs exhibited stable dispersion with higher zeta potential and have a smaller size. A significant improvement in the UPF value and antibacterial activity of treated cotton fabrics was observed.

Amongst the pre-analytical, analytical, and post-analytical phase of laboratory testing, pre-analytical phase is the most error-prone. Knowledge gaps in understanding of pre-analytical factors are identified in the clinical years amongst undergraduate students due to lack of formal teaching modules on the pre-analytical phase. This study was conducted to seek experts' consensus in Clinical Chemistry on learning objectives and contents using the Delphi technique with an aim to develop an asynchronous virtual classroom for teaching pre-analytical factors of laboratory testing. A mixed method study was conducted at the Aga Khan University. A questionnaire comprising of 16 learning objectives and their associated triggers was developed on Google Docs for developing the case vignettes. A four-point Likert Scale, which included strongly agree, agree, disagree and strongly disagree, was utilized for the learning objectives. An open-ended question was included for experts to suggest new items for inclusion. A cut off of at least 75% agreement was set to establish consensus on each item. A total of 17 Chemical Pathology faculty from 13 institutions across Pakistan were invited to participate in the first round of Delphi. Similar method of response was used in round two to establish consensus on the newly identified items suggested by the faculty in round 1. Later, the agreed-upon objectives and triggers were used to develop interactive scenarios over Moodle to concurrently test and teach medical students in a nonchalant manner. A total of 17 responses were received in Round 1 of the Delphi process (response rate = 100%), while 12 responses were received in Round 2 (response rate = 71%). In round 1, all 16 learning objectives reached the required consensus (≥ 75%) with no additional learning objectives suggested by the experts. Out of 75 triggers in round 1, 61 (81.3%) reached the consensus to be included while 39 were additionally suggested. In 2nd round, 17 out of 39 newly suggested triggers met the desired consensus. 14 triggers did not reach the consensus after two rounds, and were therefore eliminated. The virtual classroom developed using the agreed-upon learning objectives and triggers consisted of 20 items with a total score of 31 marks. The questions included multiple choice questions, fill in the blanks, drag and drop sequences and read-and-answer comprehensions. Specific learning points were included after each item and graphs and pictures were included for a vibrant experience. We developed an effective and interactive virtual session with expert consensus on the pre-analytical phase of laboratory testing for undergraduate medical students which can be used for medical technologist, graduate students and fellows in Chemical Pathology.

Nanomedicine has been under investigation for several years to improve the efficiency of chemotherapeutics, having minimal pharmacological effects clinically. Ineffective tumor penetration is mediated by tumor environments, including limited vascular system, rising cancer cells, higher interstitial pressure, and extra-cellular matrix, among other things. Thus far, numerous methods to increase nanomedicine access to tumors have been described, including the manipulation of tumor micro-environments and the improvement of nanomedicine characteristics; however, such outdated approaches still have shortcomings. Multi-functional convertible nanocarriers have recently been developed as an innovative nanomedicine generation with excellent tumor infiltration abilities, such as tumor-penetrating peptide-mediated transcellular transport. The developments and limitations of nanomedicines, as well as expectations for better outcomes of tumor penetration, are discussed in this review.