Journal of Drug Delivery and Therapeutics

Toxic Epidermal Necrolysis: A Case Report to Oral Acyclovir

SathyaNarayana Reddy B — 2024-04-15

SJS/TEN is a rare, potentially life threatening, immune-complex-mediated cutaneous adverse drug reaction. Almost one-third of cases are idiopathic. This syndrome is associated with drug treatment as well as infectious agents, neoplasia, and connective tissue diseases. Here we report a 36-year-old male presenting with toxic epidermal necrolysis after 2 days of oral acyclovir.

Keywords: Toxic epidermal necrolysis; Stevens-Johnson Syndrome; acyclovir

Topical Minocycline Induced Bluish Black Hyperpigmentation in Acne Vulgaris Patient: The First Case Report of Topical Application

S N Sujaya — 2024-04-15

Minocycline induced hyperpigmentation is an aesthetically unsetting adverse drug event. Oral minocycline inducing hyperpigmentation is common course, keeping in line with this topical minocycline 4% was formulated. A moderately built woman diagnosed with acne was prescribed with topical minocycline 4% Gel and after 15 days of application she noticed dark patches on applied areas which progressed into macules. On examination, it was found that the topical minocycline has induced Type I (Bluish Black) Hyperpigmentation. To the best of clinician’s knowledge, the drug was withdrawn and observed over a period of month. Post-withdrawal for 30-days the skin started to regain its original tone. Regardless of the fact that the topical formulation has been designed to reduce the drug contact with the systemic circulation and to decrease the side-effects, will the formulation succeed in providing the effective and safe therapy in acne patients?

Keywords: Topical Minocycline 4%, Hyperpigmentation, Type I, Bluish Black Pigmentation, Acne Vulgaris

A Rare Presentation - Case Report on Tubercular Cold Abscess

Sagnika Bhattacharjee — 2024-04-15

Tuberculosis is a chronic granulomatous infection that is quite common and a threat to many developing countries. However, extrapulmonary cases involving tubercular skin and soft tissue abscess formation are rare, accounting for 1 or 2% of cases of Mycobacterium TB infections with skin and soft tissue involvement. The typical extrapulmonary tuberculosis symptoms and indications are nonspecific, making diagnosis difficult and time-consuming. We present a case of right arm tubercular cold abscess in a child related to mycobacterium tuberculosis, which was diagnosed by Ziehl- Neelson stain FNAC (Fine needle Aspiration cytology) and Mantoux test (18mm) induration. Due to its rare manifestation, it often gets misdiagnosed or overlooked. A proper diagnosis will ensure a proper treatment plan. Our case further depicts the collaborative effort of healthcare professionals. The patient came back complaining about the increased swelling in his right arm.

Keywords: Tubercular Cold Abscess, Ziehl- Neelson, Fine needle Aspiration cytology, Mantoux test, Mycobacterium Tuberculosis

The Effect of Honey on Bacteria Isolated from Urinary Tract Infections among Patients Attending Ruhengeri Referral Hospital

Ishimwe Alain Prudence — 2024-04-15

Background: Urinary tract infections (UTIs) occur when bacteria enter the urethra from the skin or rectum and infect the bladder, causing symptoms. UTIs are becoming increasingly multidrug-resistant, with some drugs no longer effective in treatment. According to the National Center for Biotechnology Information (NCBI), honey has been shown to have high osmotic pressure and high acidity that prevent the multiplication of bacteria. This study aimed to evaluate the effect of honey on bacteria isolated from urine samples collected from patients with UTI’s attending Ruhengeri Referral Hospital.

Methodology: Urine samples were collected in sterile containers at Ruhengeri Referral Hospital and transported to the microbiology laboratory at the Ruhengeri Institute of Higher Education (INES Ruhengeri). Two types of honey, raw and processed were used as antimicrobial agents on bacteria isolated from UTIs. Various methods were used to isolate and identify bacterial isolates, including culture on solid medium, gram staining, and biochemical tests.

Results: The most commonly isolated bacterium was S. aureus (33.3%) which is in the second group of bacteria susceptible to honey, followed by P. aeruginosa (13.8%) and CoNS (13.8%). E. coli, K. pneumonia, and Streptococcus spp. each accounted for 11.2%. The former and the latter were the most susceptible bacteria to natural honey honey (mIZ = 36 ±2.83; ±4.24 mm, respectively), while E. aerogenes was the least isolated bacterium at 5.5% and the least susceptible to honey.

Conclusion: Honey was showed to exhibit an antimicrobial effect against all bacteria isolated from the UTI, suggesting natural honey as a remedy in controlling urinary tract bacterial infection. Further studies are needed to evaluate its capacity compared to classical antibiotics currently used to treat bacteria in UTIs. The practical way to use honey to get targeted area is also an interested point that need to be investigated.

Keywords: Urinary tract infection; honey; bacteria.

Histopathological changes in the placentas of pregnant women with Gestational Diabetes Mellitus

Süleyman Cemil Oğlak — 2024-04-15

Objectives: Placental damage might be the primary underlying cause of the high rates of fetal adverse outcomes in cases with gestational diabetes mellitus (GDM). Histopathological changes were considered to be associated with GDM in the literature. However, there are also studies showing no changes in the placenta in some gestational diabetic women. The pathophysiology of these placental alterations remains elusive. Therefore, this study aimed to examine the histopathological changes in the placentas of patients with GDM and compare them with the placentas of the healthy control group.

Material and methods: This experimental non-randomized case-control study was conducted with 40 GDM patients and 40 healthy pregnant women at Dicle University Faculty of Medicine between March 2023 and December 2023. Placental tissues obtained following cesarean delivery were subjected to routine tissue processing. Placental samples were stained with hematoxylin-eosin and examined histopathologically using a light microscope.

Results: When histopathological findings were compared between the GDM and control groups, villous degeneration, congestion in blood vessels, fibrinoid accumulation, inflammation and intervillous hemorrhage were higher in the GDM group than in the control group (p<0.001).

Conclusion: The intricate relationship between GDM and placental pathology underscores the profound impact of metabolic changes on placental structure and function throughout pregnancy. Understanding these pathological changes is crucial for elucidating the progression of GDM and its implications for maternal and fetal health, highlighting the importance of comprehensive placental analysis in managing pregnancies complicated by GDM.

Keywords: Gestational diabetes, hematoxylin-eosin staining, histopathological examination

Fulvic acid transdermal patch: Its properties, optimization and release

Maria Alex Konnova — 2024-04-15

There is a high demand for the design of fulvic acids (FA) transdermal patches being natural biologically active substances with a wide action. The difficulties in FA transdermal patches creating are due to the peculiarities of FA obtaining with high purity and solubility, the existence of many several polymorphic forms, as well as the problems of their insertion into dosage forms. In this work, we modified the FA isolation as water-soluble polymorph. This operation allowed us to reduce the impurities in the product, to optimize the formulation of the emulsion-based transdermal patches, to provide a quantitative assessment of FA release. Data of IR, ¹³C NMR, AAS, ICP-AES-spectra, direct and reverse titration of carboxyl groups and phenolic hydroxyls, potentiometry, molecular weight determination by cryoscopy (M.m=740 g/mol), fluorescent analysis, solubility (3.3 mL of water per gram) confirmed the receipt of the desired polymorph. Optimization of the transdermal patches formulations by Response Surface Methodology and release evaluation and kinetics mathematical modeling using a Franz cell showed the preferences of Pluronic Kolliphor p237 as a transcutant. The obtained water-soluble FA can be used as a potential component of transdermal patches with controlled release parameters.

Keywords: fulvic acid, transdermal patches, pluronics, release

Application of Sigma Metrics for Evaluating Analytical Performance of HbA1C Testing on D10- HbA1C Analyzer

Bibek Pun Magar — 2024-04-15

In this study, analyzed HbA1C over a period of 6 months. Six Sigma improves the quality of process outputs by analyzing and eliminating the source of defects and reducing variability in manufacturing and business practices. In terms of clinical laboratory, the identification of test with low Sigma values (< 3σ) indicate that actions should be taken to improve analytic quality or the laboratory should use alternate methods and reagents. Our study showed methodologies for HbA1C is of world class performance achieving Sigma value ˃6, to maintain and improve this frequency of QC should be run as rule as per the westguard QC rule. Sigma metrics helps to assess analytical methodologies and augment laboratory performance. It acts as a guide for planning quality control strategy. It can be a self -assessment tool regarding the functioning of clinical laboratory. Using Six Sigma techniques, able to identify problem areas as well as recurring issues that affect the overall quality expectation of laboratory result.

Keywords: HbA1C, Six Sigma, Six Sigma values

Electrocardiographic Abnormalities in Adult Homozygous Sickle Cell Disease Patients in Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-Eastern Nigeria

Chukwunonso Ikechukwu Emegoakor — 2024-04-15

Background; Sickle cell anaemia is the most common monogenic hematologic disorder in Nigeria. Cardiovascular pathology, resulting in electrocardiographic abnormalities are a common finding in adult sickle cell patients.

Objective; This study investigated the pattern of electrocardiographic (ECG) abnormalities in steady state adult sickle cell anaemia (HbSS) patients and compared the findings with that of age and sex matched Haemoglobin AA(HbAA) controls.

Methodology; Fifty steady state adult HbSS participants were recruited from the haematology clinic at Nnamdi Azikiwe University Teaching Hospital while fifty age and sex matched HbAA controls were recruited from the hospital community. Participants underwent resting 12 lead ECG using a Schiller CARDIOVIT AT-1 ECG machine. Data was analyzed using Statistical Package for Social Sciences version 21.

Results; The prevalence of ECG abnormalities amongst the adult sickle cell participants and controls was 70% and 10% respectively. ECG abnormalities were more common amongst male sickle cell participants and left ventricle hypertrophy was the most frequent ECG abnormality detected.

Conclusion; There is a high prevalence of ECG abnormalities amongst adult sickle cell anaemia patients. Regular Electrocardiography is recommended for early detection of these abnormalities for early treatment and improved quality of life.

Keywords: Electrocardiographic Abnormalities, Sickle Cell Disease Patients, Nnamdi Azikiwe University, Haemoglobin AA

Effects of Extraction Methods on the Physicochemical Properties and Biological Activities of heteroglycans from Hibiscus sabdariffa calyx

Judith Emery Kanemoto Ngomoyogoli — 2024-04-15

The hot-water extraction method has been employed to enhance the diffusion rate of heteroglycans, thereby augmenting the extraction efficiency. This study investigates the antioxidant activities and immunological properties of water-soluble polysaccharides derived from the Hibiscus sabdariffa calyx (HWPF and LWPF). These polysaccharides were isolated through two distinct extraction methods involving hot water followed by ethanol precipitation. The physicochemical characterization was conducted through a series of experiments encompassing monosaccharide composition, ultraviolet-visible spectrum analysis, and Fourier-transform infrared (FT-IR) spectroscopy. The evaluation of antioxidative properties employed various techniques, including DPPH and ABTS radical scavenging activities, Ferric Reducing Antioxidant Power, ferrous chelating power, total reducing power, and protection against DNA damage. The assessment of anti-inflammatory potential involved the inhibition of hemolytic activity induced by a hypotonic solution and heat. Furthermore, the impact of the polysaccharides on the production of pro-inflammatory cytokines was analyzed through Luminex assay and RTPCR assay in PBMCs and LPS-stimulated RAW 264.7 cells, respectively. The findings revealed that heteroglycans (LWPF and HWPF) exhibit a content of Ara-Man-Rha-GluA-GalA (41.2:17.2:15.7:9.2:8.8) and Ara-Glu-Rha-Xyl-GluA-Man (31.5:23.8:12.16:10.4:7:6) with molecular weights of approximately 4.5 KDa and 41.3 KDa, respectively. HWPF demonstrated robust metal chelating and scavenging activities. Additionally, each fraction exhibited substantial protection of DNA against damage induced by H2O2. LWPF was observed to significantly down-regulate the expression of pro-inflammatory cytokines IL-6 and COX-2 at both transcriptional and translational levels, along with inhibiting NO production. In summary, these results indicate that the choice of extraction methods influences both the structure and biological activities of heteroglycans, providing valuable insights into the structure-activity relationship.

Keywords: Hibiscus sabdariffa, heteroglycans, hot water extraction, physicochemical properties, Antioxidant activity, Pro-inflammatory cytokines.

Effects of the COVID-19 pandemic on the consumption of antiretrovirals and HIV/AIDS prevention indicators at the Treichville University Hospital (Ivory Coast)

Gbongue Eric Tia — 2024-04-15

Objective: To understand the impact of Covid-19 on the prevention and consumption of antiretroviral drugs at Treichville University Hospital.

Methods: This was a retrospective cross-sectional study with a descriptive, multicenter aim, carried out in six screening and treatment departments for HIV patients at the Treichville University Hospital. Monthly order reports from January 2019 to December 2021 from six services were used to collect data on screening and antiretroviral treatment. After a univariate analysis, an Anova made it possible to carry out a comparison of several variables between the study periods.

Results: In total, a decrease of 40 to 55% (p>0.05) in the consumption of antiretrovirals was recorded compared to 2019. The antiretrovirals affected more specifically were tenofovir 300mg, lamivudine 150 mg, abacavir / adult lamivudine, lopiritonavir and the tenofovir / adult lamivudine combination (p<0.05). Therapeutic protocols and prevention data varied between 2019 and 2021 with a drop in the prescription of dolutegravir to the profile of efavirenz and a drop of 17.5% of individuals screened in 2020.

Conclusion: The Covid-19 health crisis has led to a drop in the frequency of HIV testing and a non-significant effect on the consumption of antiretrovirals essential for the management of the disease.

Keywords: Covid-19; Antiretrovirals; Prevention; HIV

Formulation Development of Medicated Chewing Gum by Direct Compression utilizing the SeDeM Diagram Expert System

Preeti Gajendra Karade — 2024-04-15

The main objective of this study was to prepare and characterize the MCG of Ondan HCl which helps to improve the effectivity of the drug and to investigate the applicability of the SeDeM system for the formulation of MCG. The Ondan HCl was formulated into directly compressed MCG utilizing the SeDeM Diagram Expert System. The MCG was optimized using 3² factorial design. Performance evaluation was carried out by evaluating different parameters. Statistical analysis showed that micromeritic properties were improved after inclusion of appropriate excipient in optimum amount. In-vitro drug release study showed 90.01% drug release whereas ex vivo buccal permeation study exhibited significant drug permeation within 15 min indicating its potential for increasing bioavailability. It was concluded that various characteristics of powder material at pre formulation level can be successfully predicted by SeDeM diagram expert system. The developed medicated chewing gum is more effective than mouth dissolving and conventional tablet formulation.

Keywords: Ondansetron HCl; Medicated chewing gum; direct compression; SeDeM diagram expert system.

Assessment of Parents Knowledge, Attitude and Practice about Child Vaccination in Selected Rural Areas of Kalaburagi District, India

S Sandeep — 2024-04-15

Objective: Immunization has evolved as one of the most successful public health interventions, reducing the incidence of infectious diseases and improving quality of life. This study was conducted to analyze the level of knowledge, attitude and experience of childhood vaccination among local participants from selected rural areas of Kalaburagi District, which can be related to the immunization status of their children.

Method: The Prospective, Cross-Sectional study was conducted at selected villages of rural areas in Kalaburagi district. Parents were enrolled into the study by considering the study criteria. Demographic details and other relevant data were collected at pre-test and post-test

Results: A total of 631 parents from 10 selected rural areas were enrolled in the study out of which 611 parents completed the study and 20 parents did not complete the study. It was evident that 470(76.92%) children’s immunization was completed according to schedule, 73(11.95%) children’s immunization was not complete according to schedule and 68(11.13%) parents did not know whether child immunization was complete according to schedule or not. The pre and post-test KAP score was assessed using SPSS software and Chi- Square test was carried out to analyze the Statistical significance. The study was statistically significant at p-value of <0.01.

Conclusion: The study concluded that better awareness of childhood immunization among parents led to increased immunization experience in their children. Health workers must be trained at the grass root level and through them the importance of childhood vaccination must spread to all rural areas.

Keywords: Immunization, Knowledge, Attitude, Practice

UV Spectrophotometric Method Development and Validation of Butorphanol Tartrate in Bulk Drug and Pharmaceutical Formulation

Sonu Ahirwar — 2024-04-15

The present research work discusses the development and validation of a UV spectrophotometric method for butorphanol tartrate. Simple, accurate and cost efficient spectrophotometric method has been developed for the estimation of butorphanol tartrate in tablet dosage form. The optimum conditions for the analysis of the drug were established. The maximum wavelength (λ max) was found to be 278nm. The percentage recovery of butorphanol tartrate was in the 100.016±0.68. Beers law was obeyed in the concentration range of 2-12μg/ml. Calibration curves shows a linear relationship between the absorbance and concentration. The line equation y = 0.0674x - 0.0057 with r2 of 0.9998was obtained. Validation was performed according to ICH guidelines for linearity, accuracy, precision, LOD and LOQ. The sample solution was stable up to 36 hours. The proposed method may be suitable for the analysis of butorphanol tartrate in tablet formulation for quality control purposes.

Keywords: Butorphanol tartrate, Validation, Precision, Accuracy, LOQ, LOD, ICH guidelines.

Immunohistochemical Analysis of Sperm Aquaporin-3 Expression in Men with Varicocele

Senem Çetin Duran — 2024-04-15

Objective: The primary objective of this study is to detect potential alterations in sperm cells in cases of varicocele using immunohistochemical methods.

Materials and Methods: In this study, semen samples obtained with consent from infertile males aged between 25-40 years were analyzed for the presence of varicocele and other determined factors, and were divided into two groups: a normozoospermic control group and a group diagnosed with varicocele. Direct swim-up techniques were utilized to separate spermatozoa with high motility. Immunohistochemical staining methods were employed to visualize protein expression, and the results were photographed at high magnification for documentation.

Results: This research was conducted on sperm samples collected from males diagnosed with varicocele and from a healthy control group. The findings suggest that the presence of aquaporin-3 protein is associated with low or negative expression in sperm cells in the presence of varicocele. Immunohistochemical analyses have revealed a reduced or absent expression of aquaporin 3 in patients with varicocele compared to healthy individuals.

Conclusion: The results of this study clearly demonstrate the adverse effects of varicocele on the structural and functional integrity of spermatozoa. Given that aquaporin-3 protein is critical for the motility of spermatozoa, the reduced expression or absence of this protein sheds light on the molecular mechanisms of male infertility.

Keywords: Sperm DNA fragmentation, immunohistochemistry, Varicocele, protein expression, male infertility, aquaporin-3.

Bridging Tradition and Modern Pharmacology of Bergenia ciliata (Haw.) Sternb: A Review

Upakar Rai — 2024-04-15

Bergenia ciliata, a perennial rhizomatous herb holds a special place in the traditional herbal healthcare system due to its diverse therapeutic uses and potentials. Validation of its efficacy with scientific investigation is a prerequisite of any prospective herbal resource. The plant is a rich source of various bioactive chemical compounds. The present review is an attempt to consolidates comprehensive information sourced from 100 different literatures, exploring the plant's distribution, phytochemistry, traditional medicinal uses, and pharmacological activities specially focusing on some prevalent diseases of present day. The herb’s antimicrobial, anticancer, antiulcer and antidiabetic properties signify its potential in modern pharmacology. The review underscores B. ciliata's relevance in drug development and nutraceutical formulations, bridging age-old wisdom with contemporary healthcare solutions. Further exploration into its bioactive compounds and clinical applications promises innovative avenues in therapeutic intervention.

Keywords: Bergenia ciliata, perennial rhizomatous herb, traditional herbal healthcare, age-old wisdom

Strategies for Managing Anemia in Chronic Kidney Disease

Blessy Biju — 2024-04-15

Anemia is a common complication in chronic kidney disease (CKD) and is associated with decreased quality of life, deteriorating kidney function, increased illness, higher mortality rates, and elevated healthcare costs. Management of CKD-related anemia aims to enhance renal function (when feasible) and bolster red blood cell production. Anemia in chronic kidney disease (CKD) stems from a variety of factors, including reduced erythropoietin (EPO) production, inadequate iron availability or functionality, and inflammation leading to heightened levels of hepcidin, among other causes. Typical treatment for CKD-related anemia involves administering oral or intravenous iron supplements in conjunction with erythropoiesis-stimulating agents (ESAs). Over the past decade, erythropoiesis-stimulating agents (ESAs) have proven effective in boosting hemoglobin (Hb) levels for many patients. However, concerns about their safety, particularly regarding increased cardiovascular risk—especially at high doses and in hyporesponsive patients—have emerged. As a result, there's been a shift towards adopting more cautious Hb targets. Iron deficiency is widespread among CKD patients, particularly in those not undergoing dialysis. While iron supplementation has traditionally been used to support anemia management, there's growing recognition of the potential benefits of intravenous iron therapy, especially in the context of heart failure. HIF prolyl hydroxylase inhibitors are promising new drugs being clinically evaluated as alternatives to ESAs for anemia treatment in CKD patients. Initial data suggest they effectively boost endogenous erythropoietin production with potential benefits like lower peak concentrations, efficacy in inflamed patients, and improved iron utilization. However, further research is needed to confirm their safety and efficacy in the long term use.

Keywords: anemia, chronic kidney disease, erythropoiesis-stimulating agents, iron, HIF-prolyl-hydroxylase inhibitors

Pharmacovigilance: A Necessary Tool for Drug Safety Monitoring Globally

Asra Mansuri — 2024-04-15

Pharmacovigilance, which is like a parasol to define the procedures for monitoring and analysing adverse drug reactions (ADRs), is a crucial part of efficient clinical practise, public health initiatives, and drug control systems. The volume of data processed has increased as a result of the rise in reported adverse drug reactions (ADRs), and understanding pharmacovigilance requires a high degree of skill in order to quickly identify medication hazards and defend the product against an unwarranted removal. An impartial method of evaluation would strengthen the present global network of pharmacovigilance centres, which is managed by the Uppsala Monitoring Centre. This would take into account contentious and significant medication safety problems that might have a negative impact on public health across international borders. Pharmacovigilance has recently focused mostly on identifying previously unrecognised or poorly understood adverse medication occurrences. Pharmacovigilance is a crucial and essential component of clinical research, and it is now expanding in many nations. However, with the turn of the millennium, pharmacovigilance confronts enormous hurdles in aspect of improving safety and monitoring of medications. Today, several pharmacovigilance centres are engaged for drug safety monitoring in this global arena. In this overview, we'll talk about medication safety, the function of international pharmacovigilance centres, the advantages and drawbacks of pharmacovigilance, and how it may be used in the future by the healthcare industry.

Keywords: Drug safety, Adverse drug reaction, Drug Monitoring, Erice declaration, pharmacovigilance

Concept of Cosmetology and its Historical Background in Unani Perspective

Faisel Manzoor — 2024-04-15

Unani physicians have paid great attention to the use of cosmetics since very ancient times. Around 4000 BC first archaeological evidence of cosmetics usage was found in ancient Egypt. The use of perfumes, oils, burning of aromatic incense, copper eye shadows, lamp black for eyes and dying of hairs red were in practice by ancient Egyptians. Unani literature is very rich in cosmeceutical formulations taking care of appearance and dealing with cosmetic diseases in humans. In Unani classical text like Kitab-ul-Mansoori, Al-Hawi-fil-Tib, Kamil-us-Sana, Al-Qanoon-fit-Tib, Zakheera-e-Khwarzam Shahi, the details of cosmetics are mentioned under the headings of Tazeeniyaat. This systematic review can be concluded that various cosmetics and cosmeceuticals prevailing in contemporary era may have been introduced or inspired by these physicians. There are several single drugs or compound formulations described in Unani classical text. Unani cosmetics can be a very good choice owing to their range, low cost and safety and can also be incorporated as an adjuvant in several contemporary preparation. There are several Unani cosmeceuticals are described in unani classical text like Solid Cosmeceutical (Ghaza, Ghaliya, Kajal), Semi-solid Cosmeceutical (Tila, Zimad, Ubtan) and Liquid cosmeceutical (Ghusool, Pashoya).

Keywords: Unani Medicine, Cosmetics, Cosmeceuticals, Tazeeniyaat

Anticonvulsants in Hepatic Encephalopathy

Sona Jose — 2024-04-15

Hepatic encephalopathy (HE) is a complex neurological syndrome that arises as a complication of liver dysfunction. The primary focus in HE management has traditionally been on ammonia detoxification, but recent research has paved light on the potential role of anticonvulsant medications in improving the cognitive impairment and preventing seizures associated with HE. This review mainly aims to provide a comprehensive analysis of the use of anticonvulsants in hepatic encephalopathy, by taking a looking at their mechanisms of action, efficacy, and safety profiles.

Keywords: Hepatic encephalopathy, Anticonvulsants, Cognitive impairment

Advancements In Pharmacotherapy for Hyperlipidemia: A Comprehensive Review of Recent Drug Innovations and Clinical Outcomes

Hrithik Dey — 2024-04-15

Hyperlipidemia, characterized by elevated blood lipid levels, significantly contributes to cardiovascular diseases (CVDs), the leading cause of global mortality per the World Health Organization (WHO). Studies reveal a 20-30% increase in coronary heart disease risk for every 1 mmol/L rise in LDL-C levels. While statins are widely used, novel pharmacotherapeutic approaches are necessary for effective hyperlipidemia management and CVD risk reduction. Recent clinical trials demonstrate the efficacy of innovative drugs like proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in lowering LDL-C levels and reducing adverse cardiovascular events. These findings highlight the potential of new therapies to enhance existing treatments for hyperlipidemia. Additionally, safety evaluations of emerging lipid-lowering agents address concerns about adverse effects and long-term risks. Despite progress, challenges persist in refining treatment strategies and ensuring equitable access to advanced therapies, especially for marginalized populations. Incorporating innovative pharmacotherapies into current approaches offers personalized and efficient hyperlipidemia management. Continued research and interdisciplinary collaborations are vital for advancing our understanding of lipid metabolism and translating scientific discoveries into improved patient outcomes and cardiovascular health. Ongoing innovation and investment in tailored hyperlipidemia therapies are crucial for better outcomes in individuals at risk of CVDs.

Keywords: hyperlipidemia, pcsk9 inhibitors, bempedoic acid, evinacumab, inclisiran mipomersen, volanesorsen

Superporous Hydrogel: A Novel Approach for Safe Gastroretentive Drug Delivery System

Darshana Pawar — 2024-04-15

Superporous hydrogel are developed initially as novel drug delivery system to retain dosage form in upper gastrointestinal tract, and absorbs drug in gastric medium. The generation-based classification of superporous hydrogel is covered in this review. The hydrophilic polymer networks formed by the molecular entanglements which absorb water up to thousands of times to their dry weight. These systems swells quickly and resist in an extremely acidic condition in stomach. This hydrogel is instantly swell through capillary force which is driven by absorption of water through an open porous structure. This system provides better solubility and bioavailability by targeting the specific site of absorption. The conventional superporous hydrogels have the poor mechanical strength which is overcome by developing the second superporous hydrogel generation composites and the third-generation superporous hydrogel hybrids. This article has mainly focused on the classification, techniques, drug loading, research papers, characterizations and applications of superporous hydrogel.

Keywords: Gastric retention, Cross-linking, Superporous hydrogel, Swelling rate, Elastic property, Hydrophilic polymer networks.

Understanding Vitiligo: Causes, Diagnosis, Promising Advances in Treatment and Management and the Impact on Mental Health

Tadikonda Rama Rao — 2024-04-15

Vitiligo is a chronic skin disorder characterized by the loss of pigmentation, resulting in white patches on the skin. The condition arises from the destruction of melanocytes, the cells responsible for producing melanin, the pigment that gives colour to the skin, hair, and eyes. Although the exact etiology of vitiligo remains elusive, it is believed to involve a complex interplay of genetic, autoimmune, and environmental factors.

This overview provides the key aspects of vitiligo, including its epidemiology, pathogenesis, clinical manifestations, and current treatment approaches. The prevalence of vitiligo varies globally, affecting individuals of all ethnic backgrounds and age groups.

The autoimmune hypothesis proposes that the immune system mistakenly targets and attacks melanocytes, leading to their destruction. Triggering factors, such as oxidative stress, viral infections, and neural factors, may contribute to the initiation and progression of vitiligo.

Clinically, vitiligo can significantly impact the quality of life for affected individuals, both psychologically and socially. The distribution and extent of involvement vary, and the condition can affect any part of the body.

Various treatment modalities are available for vitiligo, ranging from topical corticosteroids and calcineurin inhibitors to phototherapy and surgical interventions. While these approaches may help to re-pigment the skin to some extent, there is no definitive cure, and the outcomes can be unpredictable. Ongoing research is focused on understanding the molecular mechanisms underlying vitiligo and developing targeted therapies to address the root causes of the disease.

Keywords: Vitiligo, Autoimmune, Melanocytes, Pigmentation, Corticosteroids, Quality of life.

Management of Amenorrhoea (Ihtibas-al-Tamth) in Unani System of Medicine: A Review

Ayesha Raza — 2024-04-15

Menstrual patterns can be an indicator of overall health and self-perception of well-being. Amenorrhoea is the absence of menses in women of reproductive agewhich may be primary or secondary. Primary amenorrhoea refers to the absence of menarche at the age of 16 and secondary amenorrhoea is the cessation of menses for at least 6 months in already cycling women. Secondary amenorrhoea is more common than primary amenorrhea. Ihtibas al-Tamth (amenorrhoea) is defined in the Unani system of medicine as the absence of monthly bleeding for more than 2 months or a decrease in the quantity of menstrual blood. The etiologies of amenorrhoea may be considered categorically as outflow tract abnormalities, primary ovarian insufficiency, hypothalamic or pituitary disorders, other endocrine gland disorders, sequelae of chronic disease, physiologic, or induced. The causes of Ihtibas al-Tamth are related to Quwwat Dafia al-Badan, Madda and Johar Khun-i-Hayd, or Ala Makhraj -i-Hayd. Su’-i-Mizaj Barid, Yabis, Harr or Harr wa Yabis, Su’-i-Mizaj Maddi or Sada can lead to Du’f al-Quwwat-i-Dafia. Abnormality in quality and quantity of Madda in Su’-i-Mizaj Maddi can also lead to ihtibas al-tamth. Amenorrhoea is not a diagnosis but a symptom indicating anatomical, genetic and neuroendocrine abnormalities. It can be determined by two different groups of causes: (a) anatomical defects of the genital organs; (b) endocrine dysfunctions. Both congenital and acquired anomalies in the structure of the uterus and vagina could produce amenorrhoea; nevertheless, in most patients, amenorrhoea is related to an ovarian malfunction. Symptoms usually associated with amenorrhoea are headache, nausea, back ache and lower abdominal pain, tiredness, and some respiratory problems. Main principle of treatment includes Tawleed-i-Dam, Tanqiya-i-Akhlat Ghaleeza, Talteef-i-Khilt, Tafteeh-i-Uruq Raham and Tahzeel if obesity is the cause. Surgical intervention if hymen is imperforated. Some regimenal therapies are also beneficial in amenorrhoea, such as Fasd-i-Safin, Hammam-i-Murattib and Hijama-i-Nariya on calf area. Some Unani drugs, which are beneficial in amenorrhoea, are Habb-i-Mudir, Safoof-i-Baboona, Kushta Faulad, and Safoof Muhazzil. In the present scenario, it is utmost important to educate the patients to live a healthy and hygienic life and to avoid those factors which cause amenorrhoea.

Withania somnifera: A potential rejuvenator of medicinal system for healthcare

Vibhuti Sharma — 2024-04-15

Medicinal herbs have been used since the time of the Vedas. The plants have therapeutic qualities in every part. Secondary metabolites of extensive variety are present in medicinal plants and are utilised in the production of medications as well as in the treatment of many different ailments. Withania somnifera is a medicinal plant, have various properties. 'Ashwagandha' is the popular name of Withania somnifera. It is offered as churna, a finely sieved powder that can be combined with ghee, water or honey. It has memory-enhancing, anti-oxidant, anti-stress, anti-venom, anti-inflammatory and anti-tumor effects. It is employed to treat a variety of clinical problems. In addition to being used as a suppressant in HIV/AIDS patients, Withania somnifera is used to treat ulcers, emaciation, colds, coughs, diabetes, conjunctivitis, insomnia, senile dementia, epilepsy, leprosy, Parkinson's disease, nervous disorders, rheumatism, arthritis, intestinal infections, bronchitis and asthma. The review article concentrates on the Withania somnifera plant's different pharmacological qualities.

Keywords: Withania somnifera, Ayurveda, Anti-oxidant, Anti-inflammatory, Anti-tumour

Devising of Lazūq (A Conventional Unani Dosage Form) with reference to Transdermal Patch; Then and Now: A Critical Review

, Amreen — 2024-04-15

Objective: The endeavor is made to criticize the classical indications, preparations and application of Lazūq even after passing many centuries since its inception. Background: According to classical Unani literature, Lazūq is primarily formulated for headache, migraine, toothache, cervical pain, dropping of uvula and different types of pain like sciatica, backache, myalgia and some orthopedic conditions. Its approach is still conventional that encompasses thick sticky stuff of drug/s which is pasted over a cloth or thick paper, consequently, maximum ratio of medicinal properties remains insignificant owed to stratum corneum (layer of skin that functions as a barrier). Devising and method of drug delivery in classical form of Lazūq makes it inconvenient to the patient, thus, it drops patient’s compliance and anticipated efficacy. In this day and age, Unani practitioners do not prescribe it very often because of its devising and limited indications documented in classical literature. Hence, it’s now becoming out of practice. Whereas, modern medicine is practicing its novel approach epitomized as Transdermal patch for several bodily conditions like Acute post-operative pain, Alzheimer disease, Angina pectoris, Anti-emetic patch, Atrial fibrillation, Attention deficit hyperactivity disorder, Dementia, Depression, Dysmenorrhea, Hypertension, Local dermal analgesia, Menopausal symptoms, Motion sickness, Osteoporosis, Overactive bladder, Parkinson’s disease, Post herpetic neuralgia pain, Smoking cessation, Tic disorder, Tourette syndrome and to prevent pregnancy. In transdermal patch, drug is used in micro/nano form with chemically produced permeation enhancers (CPEs) and other smart physio-chemical techniques that makes it very easy to apply, imparts maximum active pharmaceutical ingredients with controlled release of drug. Methodology: Ancient classical Unani formulations of Lazūq was appraised and then its course with respect to today’s newer formulations as transdermal patch was reviewed to look for its progress and application in novel dosage form with the advantage of innovations in pharmaceutical and allied sciences. Conclusion: Classical Unani formulations of Lazūq must be reviewed, transformed, evaluated, coped and applied as per the standard operating procedures (SOPs) of transdermal drug delivery system. Future Prospects: New formulations of Lazūq should be designed and appraised from the medicinal treasure of Unani system of medicine for different therapeutic conditions.

Platelet-Rich Plasma Therapy for Chronic Low Back Pain with Neuropathic Component in a Pain Medicine Clinic in Mexico: Retrospective Study

César Amescua-García — 2024-04-15

Introduction: Low back pain is a common problem affecting millions worldwide. Even after surgical treatment some patients do not improve; others suffer from persistent radiculopathy. We define Complex Chronic Low Back Pain (CCLBP) as any low back pain that has lasted for at least three months and has at least two triggering pain mechanisms. Objective: To describe our experience with platelet-rich plasma (PRP) therapy in managing CCLBP with a neuropathic component Methods: Quantitative, retrospective analysis from 57 medical records of patients treated with PRP for CCLBP. We used IBM-SPSS 21 to obtain descriptive statistics, Chi-square, Student T and Odds-Ratio. Results: The mean age of our sample was 59.8 (±14.4) years, with 6.51 (±8.7) years of pain and a follow-up of 9 (±12.2) months. 33.3% had lumbar surgery, 29.8% had lumbar trauma, 31.6% used a walking aid, 56.7% had MODIC changes on MRI, and 42% of them received intraosseous-PRP technic. 84.2% reported severe pain (VAS 8-10). The results showed that 96.5% of patients experienced some improvement after PRP treatment. Additionally, 10.5% experienced pain suppression. No significant differences in age, lumbar trauma, lumbar surgery, diseases, or the use of walking aids between patients who benefited from PRP treatment and those who did not. VAS after treatment shows significance (p<0.01) with 5.36±2.6 points. Subjects with less than five years of radicular pain had an improvement greater than 3 points on VAS (OR 7.38, IC95% 1.72-31.7). Conclusion: Autologous platelet-rich plasma injections for chronic low back pain with a neuropathic component are an effective alternative to address CCLBP’s current challenge. New studies with greater statistical power are necessary to make a statement of efficacy, but with the data obtained, it seems a promising option.

Keywords: Platelet-Rich Plasma, Low Back Pain, Radiculopathy, Intraosseous

Binge drinking and the risks to adolescent health

Luiz Antonio Del Ciampo — 2024-04-15

Adolescence is a phase characterized by physical, emotional and social changes that make adolescents more susceptible to risky practices and behaviors. One of these common practices is excessive alcohol consumption, known as “binge drinking”, which causes numerous acute and chronic health problems. This article presents some characteristics observed in adolescent development and the consequences of excessive alcohol consumption for physical and emotional health, and its repercussions on community life.

Keywords: Adolescence, Alcohol, Binge Drinking, Adolescent Health