The Unique Carboxymethyl Fenugreek Gum Gel Loaded Itraconazole Self-Emulsifying Nanovesicles for Topical Onychomycosis Treatment

The novel itraconazole (ITZ) nail penetration enhancing self-emulsifying nanovesicles (ITZ-nPEVs) loaded in carboxymethyl fenugreek gum (CMFG) gel circumvent the systemic onychomycosis treatment. The ITZ-nPEVs were prepared by the thin film hydration technique, and the particle size (PS), zeta potential (ZP), drug content (DC), entrapment efficiency (% EE), deformity index (DI), viscosity, morphology, and physical stability of the ITZ-nPEVs were measured. In terms of nail hydration, transungual drug absorption, and antifungal efficacy against Candida albicans, the chosen ITZ-nPEVs, nPEV-loaded CMFG (CMFG-ITZ-nPEVs) gel, and the commercialized Itrostred gel were compared. The ITZ-nPEVs showed spherical structure with high DC, % EE, low PS and PDI and positive ZP of ITZ ranging from 95.36 to 93.89 mg/5 mL and 95.36–96.94%, 196.55–252.5 nm, 0.092–0.49, and +11.1 to +22.5 mV, respectively. Compared to the Itrostred gel, the novel ITZ-nPEVs exhibited hydration enhancement factor for 24 h (HE24) of 1.53 and 1.39 drug uptake enhancement factor into nail clippings. Moreover, zone of inhibitions for ITZ-nPEVs (27.0 ± 0.25 mm) and CMFG-ITZ-nPEVs (33.2 ± 0.09 mm) against Candida albicans were significantly greater than that of Itrostred gel (22.9 ± 0.44 mm). For clinical investigation on onychomycotic patients, a nail penetration enhancer containing ITZ-nPEV-loaded CMFG gel presents a highly promising approach.

Therapeutic Practice Preference in Dentistry: Antibiotics, Analgesics and Antiseptics

Objective: Present study was aimed to find out the commonest medicines used in dentistry as preferred by dental practitioners in Nepal. Materials and Methods: Seventy pre-structured questionnaires were distributed to the dental practitioners. Questionnaire was designed to evaluate the use of the antimicrobial, analgesic and antiseptic agents. A total of three open ended questions were included in each questionnaire to know the preference of dental practitioners for different medicines used in dentistry. Yates corrected Chi square test was used wherever applicable and level of significance was set at 5%. Results: Amoxicillin (89.4%, P<0.05), metronidazole (57.8%), amoxicillin with clavulanic acid (21%) and doxycycline (26.2%) were the most frequently preferred antibiotics of first, second, third and fourth choice respectively. Similarly, among analgesics, ibuprofen (52.6%), diclofenac (31.5%), paracetamol (47.3%) and nimesulide (24.5%) had the highest predilection for first, second, third and fourth choice respectively among the dental practitioners. Chlorhexidine (77.2%, P<0.05)) was the most selected antiseptic for the first choice followed by listerine for the second (31.5%) and third (43.8%) choice. Conclusion: First choice antibiotic, analgesic and antiseptic are amoxicillin, ibuprofen and chlorhexidine respectively among the majority of dental practitioners. Asian Journal of Medical Science, Volume-4 (2013), Pages 17-23 DOI: http://dx.doi.org/10.3126/ajms.v4i4.8062