Vaccines delivered to the mucosal tissues can mimic natural infections and protect the first site of infection. Thus, oral delivery is becoming the most preferred mode of vaccination. Vesicular carrier systems (liposomes & niosomes) are one of the potential candidates for vaccine delivery by the oral route. However, oral vaccines have to overcome several barriers such as the extremely low pH of the stomach (instability in gastrointestinal (GIT) environment), the presence of proteolytic enzymes and bile salts as well as low permeability in the intestine makes it less applicable to be used for oral immunization. This necessitates larger and more frequent doses of antigens for vaccination. Modified drug delivery systems such as a lipid vesicle containing bile salts (bilosome), which prevents antigen degradation and enhances mucosal penetration are now under investigation of oral delivery of vaccines. This paper is briefly focused on new generation bilosomes, mechanism of working, stability aspects, and in-vivo efficacy. Based on the studies, it was observed that bilosomes exhibits best systems for oral immunization. Further to this, surface engineered bilosomes are more effective that bilosomes as such in various animal models and there is need of clinical trials to study the safety and efficacy of bilosmes. Similarly, more research to be done on scaling up factors for bilosmal systems to hit the commercial market. 

Background: Diabetic foot Ulcer is one of most significant and devastating complications of Diabetes. To study risk factors for multi-drug resistant organisms in Diabetic foot ulcer; impact of Glycemic control on wound healing using Chi square test, student’s t test logistic regression analysis. Methods: In 100 patients hospitalized, microbiological specimens taken on admission. Potential risk factors for MDRO-positive specimens were examined using univariate analyses, logistic regression for MDRO presence and wound healing time. Prospective follow-up data from patients used to evaluate the influence of MDRO infection& glycemic control on time to healing. Results: MDRO were isolated in 75 of 100 patients. Poor glycemic control, previous hospitalization, history of amputation, history of antibiotic use, ulcer size, necrotic ulcer, recurrent ulcers, higher grade of ulcer and polymicrobial culture were associated with MDRO infected foot ulcers (p <0.1). MDRO has no impact on wound healing. Logistic regression analysis indicated higher Grade of ulcer, poor glycemic control significantly delayed wound healing. Conclusions: The prevalence of MDRO is alarmingly high. Higher grade ulcers & recurrent ulcers are more prone to acquire MDROs. Positive MDRO status is not associated with wound healing. Higher grade of ulcer & poor glycemic control delays healing of foot ulcer. Background: Diabetic foot Ulcer is one of most significant and devastating complications of Diabetes. To study risk factors for multi-drug resistant organisms in Diabetic foot ulcer; impact of Glycemic control on wound healing using Chi square test, student’s t test logistic regression analysis. Methods: In 100 patients hospitalized, microbiological specimens taken on admission. Potential risk factors for MDRO-positive specimens were examined using univariate analyses, logistic regression for MDRO presence and wound healing time. Prospective follow-up data from patients used to evaluate the influence of MDRO infection& glycemic control on time to healing. Results: MDRO were isolated in 75 of 100 patients. Poor glycemic control, previous hospitalization, history of amputation, history of antibiotic use, ulcer size, necrotic ulcer, recurrent ulcers, higher grade of ulcer and polymicrobial culture were associated with MDRO infected foot ulcers (p <0.1). MDRO has no impact on wound healing. Logistic regression analysis indicated higher Grade of ulcer, poor glycemic control significantly delayed wound healing. Conclusions: The prevalence of MDRO is alarmingly high. Higher grade ulcers & recurrent ulcers are more prone to acquire MDROs. Positive MDRO status is not associated with wound healing. Higher grade of ulcer & poor glycemic control delays healing of foot ulcer.

BACKGROUND: Bacterial vaginosis is an infection in the vaginal region caused due to shift in microflora. Untreated vaginosis can often lead to severe complications such as pelvic inflammatory disease, cervicitis, salpingitis, endometritis, infertility, ectopic pregnancy and preterm delivery This study therefore, aimed to determine clinico-epidemiology and management practices of Bacterial vaginosis. METHODS AND METHODOLOGY: For 117 women attending OP of OBGY, samples were collected and subjected for pH test, whiff’s test. Smear was prepared and subjected for gram’s staining for clue cell determination and nugent scoring. They were treated according to the guidelines and counselled for personal hygiene. The patients are asked for follow up after 4 weeks to evaluate therapeutic outcomes. RESULTS: Out of 117 women tested for BV, 24 were positive. It shows the prevalence of 20.5%. Amongst them 21% were found to be asymptomatic. Prevalence of BV in non-pregnant women was 25.4% and none of the pregnant women were tested positive. Prevalence rate was high (28%) between the age group of 30-39 years. Vaginal discharge is common in both positive and negative patients. Clue cells test and gram staining was found to be more appropriate for diagnosis of BV. Treatment with metronidazole and clindamycin have shown positive outcome. CONCLUSION: The prevalence of Bacterial vaginosis was found to be low in our study. BV was found to be prevalent even in asymptomatic. Since method of identification was simple, cost effective and less time consuming all patients with vaginal discharge can be screened for early identification of disease and prevention of its complications. 

COVID-19 pandemic has been devasting the world with increased number of patients day by day. Obesity which is itself a pandemic proving as key factor which increases the mortality in COVID-19 patients. Lockdown has changed lifestyle and eating habit of people which ultimately worsen the obesity problems . Person with obesity problem has large storage of adipose tissues .Obesity invites many metabolic disorders like diabetes’s and hypertensions. It has been observed to worsens the COVID-19 situation irrespective of the age and genders. In this article a systematic review on expected mechanism of increased severity of COVID-19 infection due to obesity and its various consequences has been compiled. ACE – 2 enzyme which is playing crucial role in the entry of corona virus into the host cell. Consequences like metabolic disorder, chronic inflammation and oro-naso-sensory perceptions .Renin angiotensin system playing important role and acting as bridge between COVID-19 and obesity relevance. Overall considering the effect of obesity on the COVID-19 , it may worsen the case and also increases the chances of the death , By this it may be concluded that obesity and COVID-19 has direct relations  

Systemic Lupus Erythematosus (SLE) is an autoimmune, chronic multisystem inflammatory condition that occurs when the body's tissues are attacked by its own immune system. This has a broad clinical appearance, and is primarily hard to diagnose across the emergency departments (EDs). Most of the SLE-stricken patients continue to experience “secondary heart disease” during their primary illness. Most patients experiences severe fatigue, joint pain, swelling, headache, butterfly rashes and other symptoms which depends on the area affected. A 29 year old female patient presented to emergency department with complaints of generalized tiredness, several on and off seizure episodes, numbness of upper and lower limbs and blackish discoloration of big toe. Examination revealed patient was ill, tired, febrile with fever 100.5?F,tachycardia and oxygen saturation 96%. The patient was diagnosed with probable SLE. The patient was treated with Hydrocortisone, hydroxychloroquine, antiepileptics, prednisone and antibiotics and noticed symptomatic improvement. Multisystemic and acute life-threatening conditions may be suspected for autoimmune diseases, predominantly SLE. The treatment shall be planned separately taking into account the use of “best-suited medication” for addressing the affected organ system. Lack of an explicit biological marker, the heterogeneity of the disease and the absence of a specific outcome measurement for improvement makes this procedure more difficult. 

Coronaviruses (CoV) are a large family of viruses that can lead to diseases ranging from the common cold to more severe illness such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).[3] Novel coronavirus (nCoV) is a found to be a new strain of virus which is not previously isolated in humans. These diseases presume to zoonotic, meaning they are transmitted between animals and people.[1]. Studies states, civet cats, which is easily seen in tropical as well as temperate regions could be the vector for SARS-CoV which would have eventually lead to the transmission to humans and MERS-CoV would have transmitted from dromedary camels to humans. Majority of the people who are infected with Covid-19 shows many clinical manifestations which include respiratory symptoms, fever, and cough, shortness of breath and breathing difficulties. [5] Pneumonia, severe acute respiratory syndrome, kidney failure can be seen in patients who are severely ill and even can lead to death of an individual. As the virus undergoes constant mutation, it is practically impossible to find an optimum treatment regimen in a short span of time. [7] Therefore optimal measures are adopted by WHO to reduce person-to-person transmission of COVID-19, to control the current outbreak. Active precaution and efforts must be taken to protect or reduce transmission in susceptible populations which includes children, health care providers, and elderly people. This review, intents to have a general outlook about the present pandemic disease by gathering information on genetic composition of SARS CoV, signs and symptoms, transmission, pathogenesis and treatment modalities.[10]. 

Fungal infections of skin are most common dermatological problems in this world. It has been investigated that worldwide 40 million people suffer from various kinds of fungal infections. During the past several years, there has been an increasing incidence of fungal infections due to a growth in immunocompromised population such as organ transplant recipients, cancer and HIV/AIDS patients. There are numerous antifungal agents used clinically to treat fungal infections, i.e., echinocandins, griseofulvin, azoles, allylamines, and flucytosine. The treatment with modern drugs has not been without its complications, particularly the drug resistances. Since ancient times, plants have been an exemplary source of medicine. Phytochemistry of different plant species has shown that the phytochemicals could be a superior wellspring of medication when contrasted with artificially created drugs. Regular drugs from a plant source are as yet utilized as remedial specialists, particularly for treating bacterial, contagious, viral, protozoal, helminthic diseases. This review focuses on the use of phytoconstituents to treat fungal infections caused by various pathogens. Hence, it will be beneficial for the drug industries and for research activities. Review also focuses on work done with some herbal antifungals and novel approaches which will be future prospective for new drug discoveries in providing better antifungal therapy. 

Transdermal Drug Delivery System (TDDS) are topically administered medicaments that deliver drugs for systemic effects at predetermined and controlled rate. Polymer matrix, drug permeation enhances are the main components of TDDS. TDDS are of many types varying from single layer drug in adhesive to the multi-layer drug in adhesive and other are reservoir and matrix systems. TDDS is a recent technology which promises great future it has potential to limit the use of needles for administering wide variety of drugs. Transdermal patches are helpful to deliver specific dose of the drug. The main objective of TDDS is to deliver drugs into systemic circulation through skin with minimal inter and intra patient variations. Several important advantages of transdermal drug delivery are limitation of hepatic first pass metabolism, enhancement of therapeutic efficiency and maintenance of steady plasma level of the drug. This review on TDDS highlights various recent advancement, fabrication methods and improved efficacy of transdermal drug delivery system. 

AIM: To compare the Neurocognitive effects of typical and atypical antipsychotics among schizophrenic patients. PURPOSE: Schizophrenia is a mental disorder that is characterized by hallucinations, delusions and other cognitive difficulties; it can often be a lifelong struggle. Although it can be treated very effectively, acute aggravations often occur. Antipsychotic drug therapies are fairly effective for decreasing the rate of relapses and neurocognitive difficulties in patients with schizophrenia. This study aimed to compare the typical and atypical antipsychotics used to treat patients with schizophrenia in terms of neurocognitive effects and Quality of life. METHODS: A cross-sectional comparative study is proposed to be conducted in 6 months. All the patients were administered the Morisky Medication Adherence Scale, to evaluate cognitive function by the Mini-Mental State Examination (MMSE). Short Form 36, and the Schedule for Assessing the Neurocognition (Attention, Memory, and Intelligence). SETTING: The study was conducted in the government general hospital, Guntur; an 1170 bedded tertiary care teaching hospital. PARTICIPANTS: The study included 75patients who were taking typical antipsychotics and 75 patients taking atypical antipsychotics for the treatment of schizophrenia. RESULTS: The medication adherence was similar in both groups of patients and perceived scores of the patients treated with atypical antipsychotics were significantly higher than those of the patients treated with typical antipsychotics in terms of neurocognition and quality of life. CONCLUSIONS: Neurocognitive dysfunction is a core feature of schizophrenia and is related to the functional outcome of the illness. In our study, it reveals that atypical antipsychotics therapy was associated with more favourable results of neurocognition and quality of life compared with typical antipsychotics. So Finally, Our study concluded that Patients of Schizophrenia who are taking atypical antipsychotics showed positive results than typical antipsychotics in terms of Neurocognition and Overall patients Quality of Life.