Potensi Rebusan Kulit Buah Manggis Alami (Garcinia mangostana Linn) untuk Meningkatkan Aktivitas Mikrobisida Sel Neutrofil terhadap Streptococcus mutans (The Potency of Mangosteen Peel Infution (Garcinia mangostana L.) to Increase Neutrophil Microbicidal

Neutrophils were part of leucocyte cells which dominate in blood circulation. When the microorganism entered the body, neutrophils kill it immediately. The steps that were migration, ingestion, swallowing, and microbicidal activity or intercellular killing. The contents of mangosteen peel is presumed to help neutrophils beat bacteria. Samples numbered 28 consist of 7 treatment groups, namely K 1 (negative control), K II (positive control), K III 100% MPI (Mangosteen Peel Infution), K IV 75% MPI, K V 50% MPI, K VI 25% MPI, and K VII 100% MPIwithout neutrophils. Isolated neutrophils exposed to MPI appropriate treatments groups above and then incubated for 3 hours. Subsequently exposed to S. mutans and incubated again for 3 hours. After that, the sample werecultured in BHI-A media and incubated for 1x24 hours. Furthermore, bacterial colonies were counted with a colony counter method. The result showed a significant difference between MPI treatment groups with control groups. The conclusion of this research is thenatural mangosteen peel infution hasthe potential to increase microbicidal activity of neutrophils and can act as an antibacterial.   Keywords: mangosteen (Garcinia mangostana L.),microbicidal,neutrophils, S. mutans

Bioequivalence Study of Deferiprone In Healthy Pakistani Volunteers

The study was conducted to evaluate the bioequivalence of deferiprone 500 mg with innovator drug in Pakistani men. Twenty four healthy volunteers were enrolled in this study. Each volunteer take two tablets of generic and innovator deferiprone with two-week washout period. Blood samples were collected at predetermined time intervals. Plasma deferiprone levels were analyzed using validated HPLC method. Pharmacokinetic parameters computed non-compartmentally after logarithmic transformation of data. The mean relative bioavailability was 104 %. The mean Cmax , AUC0–t , AUC0–∞ for generic drug were 14.41, 40.49, and 42.84 μg.h/mL and for innovator were 12.68, 38.63, and 40.75 μg.h/mL, respectively. Mean ratio (generic/innovator) of AUC0–t at 90 % CI was 0.9737-1.1150 and for Cmax was 0.99876- 1.2425. Hence, the mean ratio of 90 % confidence interval of AUC0–t and Cmax lie within the acceptable limit of (0.80-1.25) for bioequivalence. Therefore, it was concluded that Ferinil and Ferriprox was proved to be bioequivalent in healthy Pakistani men.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Bioequivalence Study of Deferiprone In Healthy Pakistani Volunteers

The study was conducted to evaluate the bioequivalence of deferiprone 500 mg with innovator drug in Pakistani men. Twenty four healthy volunteers were enrolled in this study. Each volunteer take two tablets of generic and innovator deferiprone with two-week washout period. Blood samples were collected at predetermined time intervals. Plasma deferiprone levels were analyzed using validated HPLC method. Pharmacokinetic parameters computed non-compartmentally after logarithmic transformation of data. The mean relative bioavailability was 104 %. The mean Cmax , AUC0–t , AUC0–∞ for generic drug were 14.41, 40.49, and 42.84 μg.h/mL and for innovator were 12.68, 38.63, and 40.75 μg.h/mL, respectively. Mean ratio (generic/innovator) of AUC0–t at 90 % CI was 0.9737-1.1150 and for Cmax was 0.99876- 1.2425. Hence, the mean ratio of 90 % confidence interval of AUC0–t and Cmax lie within the acceptable limit of (0.80-1.25) for bioequivalence. Therefore, it was concluded that Ferinil and Ferriprox was proved to be bioequivalent in healthy Pakistani men.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Altered Coagulation Pattern in Different Histological Grades of Squamous Cell Carcinoma

Background: The incidence of squamous cell carcinoma has doubled in the last three decades associated with a high rate of morbidity and mortality. The incidence of bleeding and/or thrombosis in advanced stage cancer necessitates a need for research in blood coagulation abnormalities in malignancy. The objective of the present study was to determine the alteration in coagulation pattern among patients diagnosed with squamous cell carcinoma (SCC). Material and Methods: This cross-sectional study was conducted in Pathology department of Isra University Hospital, Hyderabad over a period of 06 months. A total of 126 samples were selected through non-probability convenient sampling. Both male and female patients of all age groups having SCC of skin, gastrointestinal and genital tract were included. The coagulation profile was analyzed by Sysmax CA 50 and Nycocard reader II. Data was entered into SPSS version 22.0 and results were analyzed. Results: The mean age of the patients with SCC in the present study was 55.5 ± 12 years with more male patients (n=81; 64.3%) as compared to females (n=45; 35.7%). Oral SCC was found to be the most common site of squamous cell carcinoma (43.7%). Majority of the patients had well differentiated SCC (42.1%) followed by moderately differentiated (40.5%) and poorly differentiated SCC (17.4%). The comparison of severity of SCC with coagulation profile revealed that PT (P=0.01), APTT (P=0.001), D-dimers (P=0.01 and TT (P=0.01) were significantly increased, whereas fibrinogen was significantly decreased (P=0.001). Conclusions: The histological differentiation of SCC (from well differentiated to poorly differentiated tumors) showed a highly significant association with different coagulation profile parameters like PT, APTT, BT, CT, D-dimer, TT, and fibrinogen levels

Bioequivalence Study of Deferiprone In Healthy Pakistani Volunteers

The study was conducted to evaluate the bioequivalence of deferiprone 500 mg with innovator drug in Pakistani men. Twenty four healthy volunteers were enrolled in this study. Each volunteer take two tablets of generic and innovator deferiprone with two-week washout period. Blood samples were collected at predetermined time intervals. Plasma deferiprone levels were analyzed using validated HPLC method. Pharmacokinetic parameters computed non-compartmentally after logarithmic transformation of data. The mean relative bioavailability was 104 %. The mean Cmax , AUC0–t , AUC0–∞ for generic drug were 14.41, 40.49, and 42.84 μg.h/mL and for innovator were 12.68, 38.63, and 40.75 μg.h/mL, respectively. Mean ratio (generic/innovator) of AUC0–t at 90 % CI was 0.9737-1.1150 and for Cmax was 0.99876- 1.2425. Hence, the mean ratio of 90 % confidence interval of AUC0–t and Cmax lie within the acceptable limit of (0.80-1.25) for bioequivalence. Therefore, it was concluded that Ferinil and Ferriprox was proved to be bioequivalent in healthy Pakistani men.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

To investigate, how peer feedback contributes to enhance grade 5 science teacher’s formative assessment practices in a private school in Hunza

Peer-feedback is considered to be the central process in the formative assessment that provides a platform, which helps both, the giver and the receiver, to progress and improves, instead of arguing about the past performances. It also encourages a collaborative dialogue between the observer and the participant, where two-way feedback takes place. This study investigates how peer-feedback contributes to enhance grade 5 science teacher’s FA practices based on a study in a private school in Hunza, Gilgit-Baltistan. The design of the study employed an action research under a qualitative approach over eight weeks. The data collection tools were; semi-structured interviews, classroom observations, document analysis, and reflective journals. The data was collected in three main phases: reconnaissance phase, action phase, and post-action phase. Particular attention was paid to ensure that the participant-teacher understood that observation and feedback was a developmental mechanism rather than an evaluative process. The overall analysis and findings in the reconnaissance stage indicated that the teacher’s knowledge of peer-feedback in the selected school was very limited and unclear. Furthermore, the data revealed that there is no feedback mechanism to support student’s learning. Since the school had introduced a virtual teaching-learning process due to COVID-19, the teacher’s focus remained to complete the lesson in the given time. However, the data gathered during the action stage showed that the friendly environment enabled the participant-teacher to examine supportive and collaborative discussion and revisit her earlier notion about peer-feedback and FA practices. For instance, the encouragement and support provided to her gave her an opportunity for self-reflection and enhanced her confidence level. As a result, she expressed her desire to share the pedagogical and subject matter challenges openly. The study found that the nature of peer-feedback during COVID-19 has great potential to enhance the competencies of teachers. Therefore, it is essential to use the ‘teachers observing teachers’ strategies effectively by the school administrators that enable a culture to cultivate a noncompetitive exchange of ideas and promote a certain level of trust. Thus, this research provides evidence of participant-teacher’s learning about peer-feedback and FA that resulted in the collaboration with the peer-researcher. This study reveals that school culture could enhance teachers’ practices within their workplace, but it needs extra effort and training. The analysis also informed that the teachers in the selected school are hardworking and competent, but they need proper guidance, support, and peer-feedback, which should be included in the school policy and made part of their daily practices. Therefore, the school needs to revisit the teaching approaches to improve the teaching-learning process. For that purpose, special (CPD) training should be arranged for teachers after intervals, which could help them to work collaboratively and improve the teaching-learning process