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A facile one step green synthesis of silver (AgNP), gold (AuNP) and platinum (PtNP) nanoparticles has been attempted using the rind extract of the fruit of Garcinia mangostana L. The rind of the fruit is enriched with wide varieties of natural resources which could be conveniently exploited as alternative for synthesis of nanoparticles eliminating the need for hazardous chemical methods. The formation of gold nanoparticles occurred at room temperature within a few seconds while the formation of silver and platinum nanoparticles was obtained after heating the solution for 20 min at 80 °C. Parameters such as contact time, temperature and pH were optimized to obtain the precise nanoparticles. The green synthesized nanoparticles were characterized using several state-of-the-art techniques like UV–Vis spectroscopic, FT-IR, HR-SEM and HR-TEM, XRD analyses and zeta potential measurements. Attempt has also been made to evaluate the antibacterial activity of the metal nanoparticles before and after combining with commercially used antibiotics as well as free antibiotics against human pathogenic bacteria. The bare silver nanoparticles (AgNP) showed relatively higher antibacterial activity than AuNP and PtNP and this activity was found to be more pronounced against gram negative bacteria than gram positive ones. Interestingly, all the three metal nanoparticles combined with antibiotics showed enhanced antibacterial activity against the pathogenic bacteria which suggested synergism between the nanoparticles and antibiotics. The high point of the present investigation has been that the Bacillus sp. which is highly resistant to streptomycin becomes highly susceptible to the same antibiotic when combined with gold nanoparticles. This particular observation opens up windows for the treatment of antibiotic resistant bacteria after combining with different nanoparticles under clinical set up.

Background Exclusive enteral nutrition (EEN) is an established induction treatment for active Crohn’s disease (CD) with a proposed mechanism of action involving the gut microbiome. We have previously shown that CD-TREAT diet, a food-based diet with similar dietary profile to EEN, improves rat ileitis and replicates the effect of EEN on the gut microbiome of healthy volunteers and animal models. Here, we test the efficacy of CD-TREAT diet to induce clinical remission in active CD. Methods This is an open-label study in children (wPCDAI≥12.5) and adults (HBI≥5) with active CD. Primary outcome was clinical response (wPCDAI fall≥17.5; HBI fall≥3) or clinical remission (wPCDAI< 12.5; HBI Results 25 children, [age, 14.4 (12.5,15.7) years] and 32 adults, [age, 32.6 (24.2,43.9) years] were treated. 7 (12%) failed treatment and n=10 (18%) dropped out during the first 2 weeks of treatment due to palatability issues. In patients who completed 8 weeks of CD-TREAT course (n=40), 85% and 78% achieved clinical response and remission, respectively. CD-TREAT diet improved QoL in children [IMPACT-III score, baseline: 136 (122,143) vs 8weeks: 148 (133,153), p50% FC reduction. Median FC levels decreased significantly? in the group of patients (n=22) who had undetectable GIP at 4 or 8 weeks [mg/kg FC, baseline: 1190 (361,1129); 8weeks: 534 (92,1230), p Conclusion CD-TREAT diet improved disease activity indices and QoL in the majority of patients who completed treatment and decreased FC in those who were most likely to be compliant. Future RCT should aim to compare CD-TREAT with other induction treatments and improve meal variety and palatability to improve compliance and reduce drop-out rates.

A 26 year old near-term pregnant patient with severe mitral stenosis and pulmonary edema presented to us with labor pain. After starting her on oxygen, diuretics, we provided labor analgesia with a combination of low-dose epidural local anesthetics with fentanyl. The conduct of the delivery was uneventful. We recommend the use of labor analgesia to attenuate the response of pregnancy and labor on the cardiovascular system, especially in parturients with valvular disease like mitral stenosis. We also state that a multidisciplinary approach is necessary in handling such sick parturients.

Laser ablation-sector field-inductively coupled plasma mass spectrometry has been used for in situ determination of silver concentration in treated human teeth. Silver nitrate has long been used to trace the presence of micro sized gaps between the walls of dental restorations and teeth, and more recently, to trace the presence of nanometer sized voids within resin-bonded restorations. This study examines the diffusion of silver nitrate into submicron voids beneath resin-bonded composite restorations. The silver treated-teeth were analyzed for 43Ca, 107Ag, and 109Ag isotopes. Elemental data were obtained by ablation with Nd:YAG laser operating in the UV region 266 nm and 213 nm by New Wave-Merchantek and isotopic analysis with a sector field ICP MS by Finnigan MAT. A 50 ppm glass standard (NIST-612) was also analyzed for the same isotopes. Quantification was performed by assuming a uniform nominal calcium concentration value of 27 g per 100 g of dry dentin across the root and using the 43Ca signal for internal calibration. The precision (RSD%) of measurements for 43Ca for the NIST-612 glass standard was found to be within 1.8% to 2.5% and for the tooth samples within 2.8% to 7.1%. The precision of analysis for 107Ag for the NIST-612 glass standard was between 2.6% and 4.4%. The analysis revealed a significant penetration of resin-bonded dentin by silver, ranging from ∼35000 ppm at the very bottom of the resin-infiltrated demineralized dentin to only 10 s of ppm in the areas within the underlying mineralized dentin. The analysis revealed that a significant amount of silver penetrated through resin-dentin bonds, and that the amount of silver increased with increased acid-etching time. The results from this study suggest that current adhesive resin system do not create perfect bonds and that laser ablation sector field ICPMS can be used to quantify the amount of nanoleakage of bonded restorations.