Journal of Pharmaceutical
Research and Integrated Medical Sciences

Background: Fruit peels are sources of phytoconstituents including polyphenols and flavonoids. Dragon fruit and kiwi fruit peel extracts were incorporated into an optimized herbal syrup to utilize their biological potential. Objective: The study evaluated the in vitro antioxidant and antibacterial activities of an optimized syrup containing ethanolic and aqueous peel extracts of dragon fruit and kiwi fruit. Methods: The optimized syrup contained a total peel-extract load of 5.0% w/v. Antioxidant activity was evaluated using the DPPH radical-scavenging assay at syrup concentrations of 10-50 mg/mL, with ascorbic acid at 20-100 µg/mL as standard. Antibacterial activity was evaluated by agar well diffusion against Staphylococcus aureus and Escherichia coli using ciprofloxacin (5 µg/mL) as positive standard. Results: DPPH scavenging increased from 22.56% at 10 mg/mL to 85.51% at 50 mg/mL. The calculated IC50 values were 25.18 mg/mL for the syrup and 37.92 µg/mL for ascorbic acid. The syrup produced zones of inhibition of 22.4 ± 0.5 mm against S. aureus and 18.6 ± 0.8 mm against E. coli. Net zones were 16.4 and 12.6 mm, and relative antibacterial efficacies were 73.87% and 61.46%, respectively. Conclusion: The optimized formulation demonstrated concentration-dependent DPPH radical-scavenging activity and antibacterial activity against both test organisms, with greater antibacterial activity against S. aureus.

Background: A high-flow arteriovenous connection between the internal carotid artery (ICA) and the cavernous sinus is known as a direct carotid-cavernous fistula (CCF). The most common cause of direct CCF is trauma, and the current standard of care is endovascular therapy. Visual impairment and severe epistaxis are rare but dangerous presentations that may require immediate, effective treatment. Case: About a month after a fall from a height that resulted in right-eye blindness, a 29-year-old man developed acute nasal bleeding after sneezing. A direct right CCF was confirmed by digital subtraction angiography (DSA), which showed a significant rent between the right cavernous ICA and cavernous sinus with no distal flow into the right anterior and middle cerebral arteries. Deconstructive right ICA parent artery blockage with coils was used to treat the fistula as there was no distal right ICA flow and collateral cerebral circulation. Complete right ICA occlusion, no residual CCF, and collateral supply to the right hemisphere via the anterior and posterior communication channels were all shown by follow-up angiography. Conclusion: In conclusion, this case demonstrates delayed post-traumatic direct CCF that mostly manifests as epistaxis and visual loss instead of the traditional ocular triad. When reconstructive preservation of the wounded ICA was not possible, angiographic evaluation of collateral circulation was essential to safely choosing parent artery closure.

Background: Herbal syrups provide a convenient oral dosage form for incorporation of plant-derived constituents, but suspended herbal extracts may present challenges related to viscosity, sedimentation and physical stability. Objective: The study aimed to develop and optimize a herbal syrup containing dragon fruit and kiwi fruit peel extracts using a Design of Experiments approach and to characterize the optimized formulation for physicochemical properties and accelerated stability. Methods: Ethanolic and aqueous peel extracts of dragon fruit and kiwi fruit were incorporated into a sucrose-based syrup containing sodium carboxymethyl cellulose (Na-CMC). A two-factor, five-level Central Composite Design consisting of 13 experimental runs was used. Na-CMC concentration (0.16-0.44%) and sucrose concentration (34.4-72.6%) were independent variables, while viscosity and sedimentation were dependent responses. Quadratic models were evaluated by analysis of variance and numerical optimization. Results: The viscosity model was significant (F=29.59, p=0.0001, R²=0.9548) and the sedimentation model was significant (F=14.64, p=0.0014, R²=0.9127). Numerical optimization identified 0.318971% Na-CMC and 66.6245% sucrose, with desirability 1.000. Predicted viscosity and sedimentation were 364.22 cP and 0.0976969%, respectively. Experimental validation gave 368.45 cP viscosity and 0.10% sedimentation. Conclusion: The CCD-based approach identified an optimized herbal syrup containing approximately 0.32% Na-CMC and 66.62% sucrose with acceptable viscosity and minimal sedimentation. The formulation was selected for accelerated stability assessment at 40±2°C/75±5% RH for six months.