Aloe barbadensis Miller peptide/polypeptide fraction alleviates inflammation through inhibition of proinflammatory cytokines and mediators in vitro and in rats with Freund’s adjuvant-induced hind paw edema

Objective:To evaluate the anti-inflammatory potential of peptide/polypeptide fraction of Aloe vera through in vitro and in vivo studies.Methods:The peptide/polypeptide fraction from Aloe vera was obtained through trichloroacetic acid precipitation.The anti-inflammatory property of the peptide/polypeptide fraction was tested by protein denaturation,membrane stabilization assays.The effect of the fraction on RAW 264.7 cell viability was examined by MTT assays.The nitric oxide level was determined through Griess reagent.TNF-αand IL-6 levels were estimated using ELISA kits.In vivo studies were carried out in male Wistar rats through injection of Freund’s adjuvant in the hind paw.Paw edema was measured through the Vernier scale and levels of alanine aminotransferase,aspartate transaminase,TNF-α,IL-6,and secretory phospholipase A2 were estimated through their respective kits after fourteen days of treatment.Graph Pad Prism6 was used for analyzing the results.Results:The peptide/polypeptide extract inhibited protein denaturation with an IC50 value of(218.9±15.6)μg/m L and stabilized the membrane of red blood cells with an IC50 value of(275.9±19.1)μg/m L.The extract showed no changes in cell morphology or cytotoxicity up to the concentration of 20μg/mL in MTT assays.The peptide/polypeptide fraction markedly reduced the levels of proinflammatory markers and mediators in both in vitro and in vivo studies.Conclusions:The results indicate that the peptide/polypeptide fraction of Aloe vera has antiinflammatory property through inhibition of inflammatory markers and mediators responsible for NF-κB and mitogen-activated protein kinase pathways.

Task sharing: situation analysis about capacity and resources for management of diabetic retinopathy in Pakistan

AIM: To assess the capacity and resources of eye care facilities, using the WHO Health Systems Framework, to manage diabetic retinopathy(DR) through task sharing.METHODS: Using purposive sampling, four participants(administrators) from four selected hospitals in two provinces in Pakistan were recruited for this cross-sectional study. A survey, to assess the capacity and resources of the selected eye care facilities for the feasibility to adopt task sharing in management of DR to prevent vision loss, was emailed to participants who were asked to complete. Responses to open-ended questions were entered into a Microsoft Excel spread sheet and inductive approach was applied for analysis.RESULTS: All the surveyed eye care facilities offer eye care services for people with diabetes and DR. All surveyed eye care facilities have a shortage in the number of human resources across all cadres. Optometrists and mid-level eye care workers did not have active roles in DR screening and management in all four hospitals. All the hospitals surveyed did not have a computerized record management system for patients who visit ophthalmologists for eye examinations. Equipment for detection and management of DR were short in number and main users were ophthalmologists. There was no policy for population-based screening program for detection of DR in any of the surveyed hospitals.CONCLUSION: A system-based approach to manage DR is needed. The capacity of eye care facilities and the potential to improve access of people with diabetes to eyecare services can be enhanced through implementation of task sharing.

Roles of the eye care workforce for task sharing in management of diabetic retinopathy in Cambodia

AIM： To identify the current roles of eye and health care workers in eye care delivery and investigate their potential roles in screening and detection for management of diabetic retinopathy（DR） through task sharing.METHODS： Purposive sampling of 24 participants including health administrators, members from non-government organizations and all available eye care workers in Takeo province were recruited. This cross sectional mixed method study comprised a survey and in-depth interviews. Data were collected from medical records at Caritas Takeo Eye Hospital（CTEH） and Kiri Vong District Referral Hospital Vision Centre, and a survey and interviews with participants were done to explore the potential roles for task sharing in DR management. Qualitative data were transcribed into a text program and then entered into N-Vivo（version 10） software for data management and analysis. RESULTS： From 2009 to 2012, a total of 105 178 patients were examined and 14 030 eye surgeries were performed in CTEH by three ophthalmologists supported by ophthalmic nurses in operating and eye examination for patients. Between January 2011 and September 2012, 151 patients（72 males） with retinal pathology including 125（83%） with DR visited CTEH. In addition 170 patients with diabetes were referred to CTEH for eye examinations from Mo Po Tsyo screening programs for people with diabetes. Factors favouring task sharing included high demand for eye care services and scarcity of ophthalmologists.CONCLUSION： Task sharing and team work for eye care services is functional. Participants favor the potential role of ophthalmic nurses in screening for DR through task sharing.

Alginate based encapsulation of polyphenols ofPiper betelleaves:Development,stability,bio-accessibility and biological activities

Plant polyphenols have recently gained attention in nutraceutical and pharmaceutical industries due to their various therapeutic potentials.However,the polyphenols are prone to oxidation,unstable towards heat,light,pH and their unpleasant taste also limits their application.The usage of encapsulated polyphenols can alleviate these drawbacks and hence,efficient encapsulation methods have been developed.The present study focused on the synthesis of microspheres of Piper betle polyphenols by extrusion method using alginate and assesses the impact of alginate encapsulation on stability,bioavailability and therapeutic properties.Microspheres of Piper betle were studied for their stability,yield,size,characterized by using SEM for surface morphology and FTIR and evaluated for their bioavailability using in vitro simulated gastrointestinal digestion and therapeutic properties for a period of 24 months.The results showed that encapsulation was successful using extrusion technique and the stability was improved as it protected the polyphenols and antioxidant from degradation for a period of 24 months.In addition,bioavailability was also increased in small intestine and the antioxidant and antidiabetic properties were better retained after encapsulation.Overall,this study showed that encapsulation of polyphenols of Piper betle leaves with alginate improved stability and can be a promising technique for food supplementation/nutraceutical with natural antioxidants.