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Papers by Sanjeev Rambharose

Nano Express, Jan 9, 2024

Prehospital Emergency Care, Sep 14, 2023

PLOS ONE, Jan 21, 2022

Background Informed consent is an essential prerequisite for enrolling patients into a study. Obt... more Background Informed consent is an essential prerequisite for enrolling patients into a study. Obtaining informed consent in an emergency is complex and often impossible. Delayed consent has been suggested for emergency care research. This study aims to determine the acceptability of prehospital emergency care research with delayed consent in the Western Cape community of South Africa. Methods This study was an online survey of a stratified, representative sample of community members in the Western Cape province of South Africa. We calculated a powered sample size to be 385, and a stratified sampling method was employed. The survey was based on similar studies and piloted. Data were analysed descriptively. Results A total of 807 surveys were returned. Most respondents felt that enrolment into prehospital research would be acceptable if it offered direct benefit to them (n = 455; 68%) or if their condition was life-threatening and the research would identify improved treatment for future patients with a similar condition (n = 474; 70%). Similar results were appreciable when asked about the participation of their family member (n = 445; 66%) or their child (n = 422; 62%) regarding direct prospects of benefit. Overwhelmingly, respondents indicated that they would prefer to be informed of their own (n = 590; 85%), their family member's (n = 593; 84%) or their child's (n = 587; 86%) participation in a study immediately or as soon as possible. Only 35% (n = 283) agreed to retention data of deceased patients without the next of kin's consent. Conclusion We report majority agreement of respondents for emergency care research with delayed consent if the interventions offered direct benefit to the research participant, if the participant's condition was life-threatening and the work held the prospect of benefit for future

Colloids and Surfaces B: Biointerfaces, Jun 1, 2017

New Journal of Chemistry, 2018

Anesthesiology, Dec 17, 2021

Chemistry and Physics of Lipids, Aug 1, 2018

Buccal delivery of antiretroviral (ARV) drugs may overcome disadvantages such as low bioavailabil... more Buccal delivery of antiretroviral (ARV) drugs may overcome disadvantages such as low bioavailability due to extensive first pass effects and gastrointestinal degradation associated with the oral route. However, the small mucosal surface area and low membrane permeability are challenges to buccal drug permeation. Identification of new permeation enhancers as well as new permeation enhancing strategies have been shown to overcome these limitations, thereby delivering adequate amounts of drug through the buccal mucosa. Polymeric excipients with previously reported mucoadhesive and controlled release properties could also possess additional buccal permeation enhancing effects and may therefore serve as multifunctional excipients in a buccal drug delivery system. Therefore the aims of this study were: 1) to identify and compare the buccal permeability potential of tenofovir (TNF) and didanosine (ddI). 2) to identify the buccal permeation effects of potential multifunctional excipients ie. carboxymethylcellulose (CMC), sodium alginate (SA), polyacrylic acid (PAA) and polyethylene glycol (PEG) for TNF and ddI, and 3) to identify the buccal permeation potential of saquinavir (SQV) and assess the effect of high-energy ball milling on its permeability. All in vitro permeation studies across porcine buccal mucosa were performed using vertical Franz diffusion cells with TNF, ddI and SQV being quantified using UV spectrophotometry at 262 nm, 250 nm and 239 nm respectively. The histomorphological evaluations were undertaken by light microscopy (LM) and Transmission Electron Microscopy (TEM). Ball milling of SQV samples for 1, 3, 15 and 30 hours was performed in a high-energy planetary mill. The integrity of the buccal mucosa was assessed by transepithelial electrical resistance (TEER) measurements using a Millicell ERS meter connected to a pair of chopstick electrodes.

African Journal of Emergency Medicine

JAC-Antimicrobial Resistance

Background Antimicrobial resistance is a public health problem of global concern and there is a h... more Background Antimicrobial resistance is a public health problem of global concern and there is a high turnover of antibiotics developing resistance when compared with new drugs being developed. Therefore, there is a need to develop multifunctional systems that protect and potentiate the current drug on the market. Herein, we present novel dual pH/enzyme-responsive capsules for ciprofloxacin free base (CFB) delivery against MRSA and P. aeruginosa. Methods Nano capsules preparation was carried out using the interfacial deposition method and was characterized for their physicochemical properties, as well as binding activities to HAase, and in vitro antibacterial properties. The preliminary biocompatibility was also evaluated via MTT assay. Results The cytotoxicity results revealed the viability of the MCF-7 celines to be above 75% after exposure to the prepared capsules, therefore indicating its biosafety. Capsules had hydrodynamic diameter (DH), polydispersity index (PDI) and a surface...

Journal of Drug Delivery Science and Technology

Anesthesiology, 2021

More than 1,000,000 units of lyophilized plasma have been used in France, Germany, and South Afri... more More than 1,000,000 units of lyophilized plasma have been used in France, Germany, and South Africa. Recently, numerous other countries have adopted lyophilized plasma for patients with severe bleeding in prehospital and austere settings.

Chronic wound infections caused by antibioticresistant bacteria have become a global health conce... more Chronic wound infections caused by antibioticresistant bacteria have become a global health concern. This is attributed to the biofilm-forming ability of bacteria on wound surfaces, thus enabling their persistent growth. In most cases, it leads to morbidity and in severe cases mortality. Current conventional approaches used in the treatment of biofilm wounds are proving to be ineffective due to limitations such as the inability to penetrate the biofilm matrix; hence, biofilm-related wounds remain a challenge. Therefore, there is a need for more efficient alternate therapeutic interventions. Hydrogen peroxide (HP) is a known antibacterial/antibiofilm agent; however, prolonged delivery has been challenging due to its short half-life. In this study, we developed a hydrogel for the codelivery of HP and antimicrobial peptides (Ps) against bacteria, biofilms, and wound infection associated with biofilms. The hydrogel was prepared via the Michael addition technique, and the physiochemical properties were characterized. The safety, in vitro, and in vivo antibacterial/antibiofilm activity of the hydrogel was also investigated. Results showed that the hydrogel is biosafe. A greater antibacterial effect was observed with HP-loaded hydrogels (CS-HP; hydrogel loaded with HP and CS-HP-P; hydrogel loaded with HP and peptide) when compared to HP as seen in an approximately twofold and threefold decrease in minimum inhibitory concentration values against methicillinresistant Staphylococcus aureus (MRSA) bacteria, respectively. Similarly, both the HP-releasing hydrogels showed enhanced antibiofilm activity in the in vivo study in mice models as seen in greater wound closure and enhanced wound healing in histomorphological analysis. Interestingly, the results revealed a synergistic antibacterial/antibiofilm effect between HP and P in both in vitro and in vivo studies. The successfully prepared HP-releasing hydrogels showed the potential to combat bacterial biofilmrelated infections and enhance wound healing in mice models. These results suggest that the HP-releasing hydrogels may be a superior platform for eliminating bacterial biofilms without using antibiotics in the treatment of chronic MRSA wound infections, thus improving the quality of human health.

New Journal of Chemistry, 2018

Mono-oleate derivative (MOAPE) enhancing in vitro transdermal permeation of tenofovir.

Journal of Drug Delivery Science and Technology, 2019

Abstract The present study is aimed at the employment of novel fatty acid derived lipids for the ... more Abstract The present study is aimed at the employment of novel fatty acid derived lipids for the preparation of pH-responsive nanostructured lipid carriers (NLCs) for vancomycin (VCM) intravenous delivery against resistant and sensitive Staphylococcus aureus bacteria. Two branched lipids [stearic ‏acid derived solid lipid and oleic acid derived liquid lipid‏] were synthesized, characterized and used to fabricate NLCs by hot homogenization technique. Particle size, ‏polydispersity index, zeta potential and encapsulation efficiency were 225.2 ± 9.1 nm, 0.258 ± 0.02, −9.2 ± 2.7 mV and 88.7 ± 13.12%, respectively. An understanding of drug encapsulation efficiencies and formation of the NLCs were supported by in silico studies. In vitro antibacterial activity revealed ‏that‏ VCM loaded-NLCs had higher activity against methicillin-susceptible and resistant Staphylococcus aureus than the bare VCM. Cell viability study showed that NLCs had 2.5-fold better killing percentage than the bare drug at similar concentrations. Furthermore, the in vivo efficacy of VCM loaded-NLCs was assessed in a mouse model of MRSA skin infection. MRSA CFU load of the skin treated with NLCs was 37-fold lower than bare VCM (p

International Journal of Pharmaceutics, 2018

PLoS ONE, 2022

Background Informed consent is an essential prerequisite for enrolling patients into a study. Obt... more Background Informed consent is an essential prerequisite for enrolling patients into a study. Obtaining informed consent in an emergency is complex and often impossible. Delayed consent has been suggested for emergency care research. This study aims to determine the acceptability of prehospital emergency care research with delayed consent in the Western Cape community of South Africa. Methods This study was an online survey of a stratified, representative sample of community members in the Western Cape province of South Africa. We calculated a powered sample size to be 385, and a stratified sampling method was employed. The survey was based on similar studies and piloted. Data were analysed descriptively. Results A total of 807 surveys were returned. Most respondents felt that enrolment into prehospital research would be acceptable if it offered direct benefit to them (n = 455; 68%) or if their condition was life-threatening and the research would identify improved treatment for fut...

Journal of Ethnopharmacology

Nano Express, Jan 9, 2024

Prehospital Emergency Care, Sep 14, 2023

PLOS ONE, Jan 21, 2022

Background Informed consent is an essential prerequisite for enrolling patients into a study. Obt... more Background Informed consent is an essential prerequisite for enrolling patients into a study. Obtaining informed consent in an emergency is complex and often impossible. Delayed consent has been suggested for emergency care research. This study aims to determine the acceptability of prehospital emergency care research with delayed consent in the Western Cape community of South Africa. Methods This study was an online survey of a stratified, representative sample of community members in the Western Cape province of South Africa. We calculated a powered sample size to be 385, and a stratified sampling method was employed. The survey was based on similar studies and piloted. Data were analysed descriptively. Results A total of 807 surveys were returned. Most respondents felt that enrolment into prehospital research would be acceptable if it offered direct benefit to them (n = 455; 68%) or if their condition was life-threatening and the research would identify improved treatment for future patients with a similar condition (n = 474; 70%). Similar results were appreciable when asked about the participation of their family member (n = 445; 66%) or their child (n = 422; 62%) regarding direct prospects of benefit. Overwhelmingly, respondents indicated that they would prefer to be informed of their own (n = 590; 85%), their family member's (n = 593; 84%) or their child's (n = 587; 86%) participation in a study immediately or as soon as possible. Only 35% (n = 283) agreed to retention data of deceased patients without the next of kin's consent. Conclusion We report majority agreement of respondents for emergency care research with delayed consent if the interventions offered direct benefit to the research participant, if the participant's condition was life-threatening and the work held the prospect of benefit for future

Colloids and Surfaces B: Biointerfaces, Jun 1, 2017

New Journal of Chemistry, 2018

Anesthesiology, Dec 17, 2021

Chemistry and Physics of Lipids, Aug 1, 2018

Buccal delivery of antiretroviral (ARV) drugs may overcome disadvantages such as low bioavailabil... more Buccal delivery of antiretroviral (ARV) drugs may overcome disadvantages such as low bioavailability due to extensive first pass effects and gastrointestinal degradation associated with the oral route. However, the small mucosal surface area and low membrane permeability are challenges to buccal drug permeation. Identification of new permeation enhancers as well as new permeation enhancing strategies have been shown to overcome these limitations, thereby delivering adequate amounts of drug through the buccal mucosa. Polymeric excipients with previously reported mucoadhesive and controlled release properties could also possess additional buccal permeation enhancing effects and may therefore serve as multifunctional excipients in a buccal drug delivery system. Therefore the aims of this study were: 1) to identify and compare the buccal permeability potential of tenofovir (TNF) and didanosine (ddI). 2) to identify the buccal permeation effects of potential multifunctional excipients ie. carboxymethylcellulose (CMC), sodium alginate (SA), polyacrylic acid (PAA) and polyethylene glycol (PEG) for TNF and ddI, and 3) to identify the buccal permeation potential of saquinavir (SQV) and assess the effect of high-energy ball milling on its permeability. All in vitro permeation studies across porcine buccal mucosa were performed using vertical Franz diffusion cells with TNF, ddI and SQV being quantified using UV spectrophotometry at 262 nm, 250 nm and 239 nm respectively. The histomorphological evaluations were undertaken by light microscopy (LM) and Transmission Electron Microscopy (TEM). Ball milling of SQV samples for 1, 3, 15 and 30 hours was performed in a high-energy planetary mill. The integrity of the buccal mucosa was assessed by transepithelial electrical resistance (TEER) measurements using a Millicell ERS meter connected to a pair of chopstick electrodes.

African Journal of Emergency Medicine

JAC-Antimicrobial Resistance

Background Antimicrobial resistance is a public health problem of global concern and there is a h... more Background Antimicrobial resistance is a public health problem of global concern and there is a high turnover of antibiotics developing resistance when compared with new drugs being developed. Therefore, there is a need to develop multifunctional systems that protect and potentiate the current drug on the market. Herein, we present novel dual pH/enzyme-responsive capsules for ciprofloxacin free base (CFB) delivery against MRSA and P. aeruginosa. Methods Nano capsules preparation was carried out using the interfacial deposition method and was characterized for their physicochemical properties, as well as binding activities to HAase, and in vitro antibacterial properties. The preliminary biocompatibility was also evaluated via MTT assay. Results The cytotoxicity results revealed the viability of the MCF-7 celines to be above 75% after exposure to the prepared capsules, therefore indicating its biosafety. Capsules had hydrodynamic diameter (DH), polydispersity index (PDI) and a surface...

Journal of Drug Delivery Science and Technology

Anesthesiology, 2021

More than 1,000,000 units of lyophilized plasma have been used in France, Germany, and South Afri... more More than 1,000,000 units of lyophilized plasma have been used in France, Germany, and South Africa. Recently, numerous other countries have adopted lyophilized plasma for patients with severe bleeding in prehospital and austere settings.

Chronic wound infections caused by antibioticresistant bacteria have become a global health conce... more Chronic wound infections caused by antibioticresistant bacteria have become a global health concern. This is attributed to the biofilm-forming ability of bacteria on wound surfaces, thus enabling their persistent growth. In most cases, it leads to morbidity and in severe cases mortality. Current conventional approaches used in the treatment of biofilm wounds are proving to be ineffective due to limitations such as the inability to penetrate the biofilm matrix; hence, biofilm-related wounds remain a challenge. Therefore, there is a need for more efficient alternate therapeutic interventions. Hydrogen peroxide (HP) is a known antibacterial/antibiofilm agent; however, prolonged delivery has been challenging due to its short half-life. In this study, we developed a hydrogel for the codelivery of HP and antimicrobial peptides (Ps) against bacteria, biofilms, and wound infection associated with biofilms. The hydrogel was prepared via the Michael addition technique, and the physiochemical properties were characterized. The safety, in vitro, and in vivo antibacterial/antibiofilm activity of the hydrogel was also investigated. Results showed that the hydrogel is biosafe. A greater antibacterial effect was observed with HP-loaded hydrogels (CS-HP; hydrogel loaded with HP and CS-HP-P; hydrogel loaded with HP and peptide) when compared to HP as seen in an approximately twofold and threefold decrease in minimum inhibitory concentration values against methicillinresistant Staphylococcus aureus (MRSA) bacteria, respectively. Similarly, both the HP-releasing hydrogels showed enhanced antibiofilm activity in the in vivo study in mice models as seen in greater wound closure and enhanced wound healing in histomorphological analysis. Interestingly, the results revealed a synergistic antibacterial/antibiofilm effect between HP and P in both in vitro and in vivo studies. The successfully prepared HP-releasing hydrogels showed the potential to combat bacterial biofilmrelated infections and enhance wound healing in mice models. These results suggest that the HP-releasing hydrogels may be a superior platform for eliminating bacterial biofilms without using antibiotics in the treatment of chronic MRSA wound infections, thus improving the quality of human health.

New Journal of Chemistry, 2018

Mono-oleate derivative (MOAPE) enhancing in vitro transdermal permeation of tenofovir.

Journal of Drug Delivery Science and Technology, 2019

Abstract The present study is aimed at the employment of novel fatty acid derived lipids for the ... more Abstract The present study is aimed at the employment of novel fatty acid derived lipids for the preparation of pH-responsive nanostructured lipid carriers (NLCs) for vancomycin (VCM) intravenous delivery against resistant and sensitive Staphylococcus aureus bacteria. Two branched lipids [stearic ‏acid derived solid lipid and oleic acid derived liquid lipid‏] were synthesized, characterized and used to fabricate NLCs by hot homogenization technique. Particle size, ‏polydispersity index, zeta potential and encapsulation efficiency were 225.2 ± 9.1 nm, 0.258 ± 0.02, −9.2 ± 2.7 mV and 88.7 ± 13.12%, respectively. An understanding of drug encapsulation efficiencies and formation of the NLCs were supported by in silico studies. In vitro antibacterial activity revealed ‏that‏ VCM loaded-NLCs had higher activity against methicillin-susceptible and resistant Staphylococcus aureus than the bare VCM. Cell viability study showed that NLCs had 2.5-fold better killing percentage than the bare drug at similar concentrations. Furthermore, the in vivo efficacy of VCM loaded-NLCs was assessed in a mouse model of MRSA skin infection. MRSA CFU load of the skin treated with NLCs was 37-fold lower than bare VCM (p

International Journal of Pharmaceutics, 2018

PLoS ONE, 2022

Background Informed consent is an essential prerequisite for enrolling patients into a study. Obt... more Background Informed consent is an essential prerequisite for enrolling patients into a study. Obtaining informed consent in an emergency is complex and often impossible. Delayed consent has been suggested for emergency care research. This study aims to determine the acceptability of prehospital emergency care research with delayed consent in the Western Cape community of South Africa. Methods This study was an online survey of a stratified, representative sample of community members in the Western Cape province of South Africa. We calculated a powered sample size to be 385, and a stratified sampling method was employed. The survey was based on similar studies and piloted. Data were analysed descriptively. Results A total of 807 surveys were returned. Most respondents felt that enrolment into prehospital research would be acceptable if it offered direct benefit to them (n = 455; 68%) or if their condition was life-threatening and the research would identify improved treatment for fut...

Journal of Ethnopharmacology