Therapeutic Implications of Dietary Polyphenols-Loaded Nanoemulsions in Cancer Therapy

Cancer is one of the major causes of death worldwide, even the second foremost cause related to non-communicable diseases. Cancer cells typically possess several cellular and biological processes including, persistence, propagation, differentiation, cellular death, and expression of cellular-type specific functions. The molecular picture of carcinogenesis and progression is unwinding, and it appears to be a tangled combination of processes occurring within and between cancer cells and their surrounding tissue matrix. Polyphenols are plant secondary metabolites abundant in fruits, vegetables, cereals, and other natural plant sources. Natural polyphenols have implicated potential anticancer activity by various mechanisms involved in their antitumor action, including modulation of signaling pathways majorly related to cellular proliferation, differentiation, relocation, angiogenesis, metastatic processes, and cell death. The applications of polyphenols have been limited due to the hydrophobic nature and lower oral bioavailability that could be possibly overcome through encapsulating them into nanocarrier-mediated delivery systems, leading to improved anticancer activity. Nanoemulsions (NEs) possess diverse feasible properties, including greater surface area, modifiable surficial charge, higher half-life, site-specific targeting, and formulation imaging capability necessary to create a practical therapeutic impact, and have drawn increased attention in cancer therapy research. This review has summarized and discussed the basic concepts, classification, delivery approaches, and anticancer mechanism of various polyphenols and polyphenols-encapsulated nanoemulsions with improved cancer therapy.

The Design, Development, and Implementation of a Web-Enabled Informatics Platform to Enhance the Well-being of Individuals Aged 18-24 Years: Protocol for an Experimental Study

BACKGROUND

Well-being is multidimensional, complex, and dynamic in nature. It is an amalgam of physical and mental health, essential for disease prevention and the promotion of a healthy life.

OBJECTIVE

This study aims to explore the features that impact the well-being of individuals between 18 and 24 years of age in an Indian setting. It further aims to design, develop, and evaluate the usefulness and effectiveness of a web-based informatics platform or stand-alone intervention to enhance the well-being of individuals aged 18-24 years in an Indian setting.

METHODS

This study follows a mixed method approach to identify factors influencing the well-being of individuals in the age group of 18-24 years in an Indian setting. The college-going students in this age group from the states of Uttarakhand (urban settings of Dehradun) and Uttar Pradesh (urban settings of Meerut) will be enrolled. They will be randomly allocated to the control and intervention groups. The participants in the intervention group will have access to the web-based well-being platform.

RESULTS

This study will examine the factors that influence the well-being of individuals aged 18-24 years. It will also facilitate the design and development of the web-based platform or stand-alone intervention, which will enhance the well-being of individuals in the age group of 18-24 years in an Indian setting. Furthermore, the results of this study will help generate a well-being index for individuals to plan tailored interventions. The 60 in-depth interviews have been conducted as of September 30, 2022.

CONCLUSIONS

The study will help understand the factors that influence the well-being of individuals. The findings of this study will help in the design and development of the web-based platform or stand-alone intervention to enhance the well-being of individuals in the age group of 18-24 years in an Indian setting.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/38632.

A Promising Approach of Dermal Targeting of Antipsoriatic Drugs via Engineered Nanocarriers Drug Delivery Systems for Tackling Psoriasis

Psoriasis is a complex autoimmune skin condition with a significant genetic component. It causes skin inflammation and is characterized by flaky, silvery reddish spots that can worsen with age. This condition results from an impaired immunological response of T-cells and affects 2-5% of the global population. The severity of the illness determines the choice of treatment. Topical treatments are commonly used to treat psoriasis, but they can have several adverse effects. Biological therapy is another option for treating specific types of psoriasis. Recently, new nanoformulations have revolutionized psoriasis treatment. Various nanocarriers, such as liposomes, nanostructured lipid nanoparticles, niosomes, and nanoemulsions, have been developed and improved for drug delivery. The use of nanocarriers enhances patient compliance, precise drug delivery, and drug safety. This review aims to suggest new nanocarrier-based drug delivery systems for treating psoriasis. It discusses the importance of nanocarriers and compares them to traditional treatments. Anti-psoriatic drugs have also been investigated for cutaneous delivery using nanocarriers. The review also covers various factors that influence dermal targeting. By highlighting several relevant aspects of psoriasis treatment, the review emphasizes the current potential of nanotechnology. Using nanocarriers as a drug delivery technique may be a promising alternative treatment for psoriasis.

Curcumin-loaded hydrotropic solid dispersion topical gel development and evaluation: A greener approach towards transdermal delivery of drugs

Aims and background:

Curcumin's poor water solubility still presents a challenge. Because of Curcumin's instability in solubilizing solvents, using a non-sustainable solvent and dissolved oxygen in the Solution might be the problem. Thus, considering all facts, looking for a promising alternative solvent medium is in need. Indeed, a solution of hydrotropic agent has been assessed recently. Hydrotropic agents are the best replacements for organic solvents. These are eco-friendly, safe, and non-toxic agents. Hence, the presented research focuses on improving the solubility of Curcumin through a hydrotropic solid dispersion approach. Amazingly, Curcumin showed a significant solubility enhancement in sodium salicylate hydrotropic Solution. Sodium salicylate hydrotrope ensured the stability of Curcumin in Solution, maintained homogeneity, and exhibited antioxidant properties. Hydrotropy combined with the solid dispersion technique is a simple and effective way to improve the bioavailability of Curcumin. Hydrotropic solid dispersion loaded curcumin topical gel was developed to achieve transdermal delivery of Curcumin. Solid dispersion was prepared by solvent evaporation method and evaluated for in-vitro performance. In-vitro drug dissolution, drug content, FTIR, and XRD were carried out for the prepared HSD.

Objective:

The selected HSD (1:4) was loaded into a topical gel by dispersion method, and in-vitro parameters like drug content, Spreadability, pH, rate of drug dissolution, and drug content were performed.

Methods:

The solubility study has substantially enhanced the solubility of Curcumin in a 2M sodium salicylate hydrotropic solution. Sodium salicylate was compatible with formulating the solid dispersion. Hydrotropic solid dispersion was successfully prepared in 1:4 ratios. XRD results have shown the amorphous nature of Curcumin in the presence of sodium benzoate. The dissolution studies have shown improved release compared to pure Curcumin and PM (1:4). The prepared HSD was then incorporated into a gel by dispersion method using carbopol 934 and hydroxypropyl methylcellulose as a gelling agent. The Cur-HSD gel was homogeneous and transparent in appearance.

Result:

The gel showed excellent Spreadability and drug content of 94.2 with 90.21% of percent drug release for 120 min and showed improved release in the presence of hydrotrope for improved topical delivery of Curcumin.

Conclusion:

Thus, to enhance the topical delivery of poorly soluble phytoconstituents, hydrotropes are suggested as a greener approach and to be applied for other poorly soluble phytoconstituents.

Relationship between Insulin Resistances with Autonomic Functions in Patients with Type 2 Diabetes in South Indian Population

Cardiovascular disease (CVD) and type 2 diabetes mellitus (T2D) are major health concerns In India. Insulin resistance (IR) itself is a risk factor for CVD. Though it is associated to sympathetic activity this relation may get altered in presence of obesity. Therefore, in the present study we measured the link of IR, with their body mass index (BMI) and the corresponding degree of alteration in various autonomic function tests in T2D patients. It was an observational study conducted in a tertiary care hospital for a period of six months. Eighty-five T2D patients visiting medicine OPD were recruited out of which 17 were normal, 31 were overweight and 31 were obese as per WHO criteria of obesity. Their glucose, insulin, insulin resistance was analyzed in fasting blood samples. Conventional autonomic function tests such as isometric hand-grip test and deep breathing test was digitally recorded. Heart rate variability was recorded as LF: HF ratio. The Rate-pressure product (RPP), the marker of myocardial work stress was calculated from systolic blood pressure and basal heart rate. E: I ratio was calculated from RR interval from ECG tracing. Insulin resistance was positively associated with increased basal heart rate. It was linked to increase LF: HF ratio even after controlling for BMI. Regression analysis showed insulin resistance to be an independent factor for sympathovagal imbalance in T2D patients. The severity of insulin resistance independently predicts degree of deterioration in sympathovagal imbalance as measured in LF: HF ratio in our study which is independent of their degree of obesity.

Consumption of Salt in Patients Suffering from Heart Failure

Heart failure is the deadliest medical emergency condition and considered as a global health priority. In order to prevent heart failure disease and death caused by heart failure, the healthcare professionals spreading the awareness among the public. Till now, effective curing of heart failure is still not possible but if patients treated well then it can improve quality of life and survival. Many healthcare professionals recommend taking sodium (in the form of salt) by the heart failure patients. But the consumption of sodium in heart failure patients is still a debatable topic among the healthcare professionals. How much quantity of salt patients’ needs to take is still a question. Excessive salt consumption can cause hypertension and left ventricular hypertrophy and less salt consumption is illogically linked with the poorer heart failure results. This overview discussed about the merits as well as demerits related to the consumption of salt in patients suffering from heart failure.

Dihydroartemesinin and Curcumin Based Self-Microemulsifying Drug Delivery System for Antimalarial Activity

Malaria is a significant global problem which still persists despite the development of various effective antimalarial drugs. It is challenging to treat this disease due to the parasite's complex life cycle and high recrudensce of antimalarial drugs. A new self-micro emulsifying drug delivery system has been developed to improve the solubility of dihydroartemisinin and curcumin. The prepared formulation contained Dihydroartemesinin, curcumin, Groundnut Oil, Cremephor RH, and Tween 80. Self-micro emulsification time, zeta potential, droplet size, polydispersity index, transmission electron microscopy, drug release, and in-vivo studies were performed for characterization. The globule size was found to be 25.59±0.40 nm and the zeta potential was-5.75±0.18 mV. The globules prepared were spherical in shape. The in-vitro dissolution performance of formulation of dihydroartemisinin and curcumin self emulsifying drug delivery system showed significantly (p<0.05, Origin Pro 8.5) higher release as compared to the pure drugs. The results of the study suggested that the prepared self emulsifying drug delivery system combination of Dihydroartemesinin and curcumin has a better potential to cure parasitemia as compared to the individual drug.

Therapeutic potential of policosanol in the concurrent management of dyslipidemia and non-alcoholic fatty liver disease

Background

High-fat diet (HFD) possesses a major cause of cardiovascular disease, and hepatosteatosis. Unfortunately, long-term use of statins has a theoretical possibility of worsening of hepatic histology in the patients with non-alcoholic fatty liver disease (NAFLD). The objective of the study was to explore hepatoprotective potential of policosanol as an alternative to statins in experimental NAFLD. For the same, young male Wistar rats were fed with HFD for 8 weeks to induce NAFLD. 48 adult Wistar rats were distributed into six investigational groups: normal control, HFD control, and four treatment groups, receiving policosanol (50 and 100 mg/kg/day), atorvastatin (30 mg/kg/day), and silymarin (100 mg/kg/day) for 8 weeks along with HFD.

Result

HFD consumption caused profound hepatotoxicity evident by hepatic oxidative stress, increased Serum glutamic oxaloacetic transaminase (SGOT), Serum glutamic pyruvic transaminase (SGPT), Alkaline phosphatase (ALP), and bilirubin content. Treatment with policosanol (100 mg/kg) markedly reduced the elevated SGOT, SGPT, and ALP levels in HFD-fed rats. Moreover, policosanol significantly reduced hepatic oxidative stress manifest by reduced malondialdehyde (MDA) and increased glutathione (GSH) level. The treatment with policosanol (100 mg/kg) was found to be more active in attenuating the HFD-induced hepatotoxicity as compared to policosanol (50 mg/kg) and atorvastatin (30 mg/kg). Moreover, we observed that the hepatoprotective potential of policosanol was comparable to the silymarin.

Conclusions

The results of the study clearly indicated that the policosanol could be considered an intriguing approach for the treatment of NAFLD.

Development and validation by statistical treatment of stability indicating RP-HPLC method for quantification of Orlistat in Orlistat-loaded solid dispersion

Background

Most of the analytical methods reported for the estimation of Orlistat were complex, expensive, and deficient in reproducibility with no or very less informative regarding various statistical methods and equations used for the validation purpose. This study provides a fast, accurate, descriptive, and precise isocratic reversed phase high-performance liquid chromatographic (HPLC) method using Waters Spherisorb 5 μm Octadecyl-silica-2 (250 × 4.6 mm) column, for the estimation of Orlistat in bulk drug and pharmaceutical formulations with minimized drug extraction steps. The drug was detected in an analytical column with mobile phase comprising a mixture of methanol, acetonitrile, and 2% phosphoric acid in the ratio of 85:14:1 v/v/v at flow rate of 1 ml/min with elution monitoring at 215.0 nm.

Results

The retention time for Orlistat was found to be 5.9 min with sharp and proper peak. The linearity was covered over the concentration range of 1.00–10.00 μg/ml (r2 = 0.9997) with a limit of detection and limit of quantitation 0.06 and 0.2 μg/ml, respectively. The developed analytical technique was found to be validated for all the parameters within the acceptance criteria of ICH guidelines. The mean ± standard deviation (SD) recoveries of Orlistat were 99.87 ± 0.45.

Conclusion

The optimized method was well precise, accurate, sensitive, stability indicating, and tested with all statistical parameters. Thus, the method can be conveniently used in quality control and routine analysis of Orlistat containing solid dispersions and other formulations. The main advantage of the developed method was its high specificity for the estimation of Orlistat in presence of various degradation products resulting from stress conditions and formulation excipients.

Traumatized periosteum: Its histology, viability, and clinical significance

The periosteum covers the surface of long bone except at the joints. During fracture fixation, we found the periosteum is ragged and damaged. Our objective is to determine the microscopic picture of traumatized periosteum in terms of the degree of damage, cell type, stromal tissue, and vascularity. Periosteum of 1cm*1cm is harvested at 1cm, 3cm, and 5cm proximal and distal to fracture site following fracture of a long bone in 20 humans. Ragged and damaged periosteum mainly consists of an outer fibrous layer with many hemorrhagic tissue and neovascularization. Osteoprogenitor cells were seen only in 12 out of 97 samples, mostly harvested 5 cm from the fracture site. The innermost layer of the periosteum remains attached to the bone surface after separating the fibrous layer following a fracture. The use of a periosteal elevator on the bone surface further damages the inner layer of the periosteum. Using a scalpel to separate the periosteum or merely pulling it away from the bone surface will decrease damage to the inner cambium layer. Fracture reduction can be achieved by indirect means at least 5 cm away from the fracture site.

Potential role of nicotinamide analogues against SARS-COV-2 target proteins

Background and objective

Coronavirus 2019 (COVID-19) is caused by ‘severe acute respiratory syndrome coronavirus 2′ (SARS-CoV-2), first reported in Wuhan, China in December 2019, which eventually became a global disaster. Various key mediators have been reported in the pathogenesis of COVID-19. However, no effective pharmacological intervention has been available to combat COVID-19 complications. The present study screens nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) as potential inhibitors of this present generation coronavirus infection using an in-silico approach.

Materials and methods

The SARS-CoV-2 proteins (nucleocapsid, proteases, post-fusion core, phosphatase, endoriboruclease) and ACE-2 protein were selected. The 2D structure of nicotinamide ribonucleoside and nicotinamide ribonucleotide was drawn using ChemDraw 14.0 and saved in .cdx format. The results were analyzed using two parameters: full fitness energy and binding free energy (ΔG).

Results

The full fitness energy and estimated ΔG values from docking of NM, and NMN with selected SARS-CoV-2 target proteins, ADMET prediction and Target prediction indicate the interaction of NR and NMN in the treatment of COVID-19.

Conclusions

Based on full fitness energy and estimated ΔG values from docking studies of NM and NAM with selected SARS-CoV-2 target proteins, ADME prediction, target prediction and toxicity prediction, we expect a possible therapeutic efficacy of NR in the treatment of COVID-19.

Insightful Investigative Account on Hydrotropic Solubilization Practice Utilized for Solubility Management of Poorly Dissolvable Drugs

Background:

Executing the centralization of medication in the foundational flow for approaching their pharmacological has necessitated studying a vital parameter, i.e. solubility reaction. The poor water dissolvability has an impact on medication adequacy and, consequently, owned poor drugs bioavailability.

Aim:

The aim of this study is to attain the convergence of medication in an introductory course, a significant parameter, i.e. solvency, has been executed for the pharmacological reactions. On account of revolution and advancement, there is a diversity of new medications, and their subordinates are approachable. Over 40% of lipophilic medication up-and-comers neglect to achieve because of poor bioavailability even though these medications have potential pharmacodynamics activities. Due to high market requirements, lipophilic medication has accomplished the relevant pharmacological activity. Consequently, most strategies are streamlined to improve fluid solvency to upgrade proficiency and lessen the reactions for specific medications.

Objectives:

The process of hydrotropic solubilization has persisted a novel and promising methodology to improve the solvency of drugs with poor water solvency by ascending the dissolvability to many folds with the involvement of hydrotropes, i.e. Niacinamide, Urea, sodium benzoate, sodium citrate, and so on. The potentiality of hydrotropic solubilization counts on the balance among hydrophobic and hydrophilic parts of hydrotropes. Hence, advancement in hydrotropic updated visualized in novel drug delivery systems and their mechanism of compatibilities and biocompatibilities. Novelty is also reprinted in its usefulness as an extraction agent for bio-active compounds to increase the rate of heterogeneous reactions and in a green synthesis for a substrate.

Conclusion:

This review focuses on practice utilized for solubility management of drugs with poor solvency, its unmet needs, utilizing the artificial machine learning in the prediction of hydrotropeenhanced solubilization of drugs, practical applicability in drug delivery, interpreted kinetic involved, and various associated mechanisms.

Synergistic effect of Ocimum Sanctum and Andrographis Paniculata against Diabetic Complications

The present study explored the effect of Ocimum sanctum, Andrographis paniculata and their combination for the management of experimental diabetic vascular complications. Diabetes associated dyslipidemia and free radical generation have been connected to the pathogenesis of diabetes-induced vascular complications.  Ocimum sanctum, Andrographis paniculata, possess hypolipidemic and antioxidant property, thus we evaluated their vaso-protective potential. Hydroalcoholic extract of Ocimum sanctum (200 mg/kg p.o) and hydroalcoholic extract of Andrographis paniculata (400 mg/kg p.o) were noted to possess vascular protective potential in experimental chronic diabetes. Experimental diabetes mellitus was induced by Streptozotocin (55 mg/kg i.p., once) to Wistar rats. The induction of diabetes and its associated vascular complications were assessed biochemically. Diabetes-associated dyslipidemia and tissue oxidative stress were also assessed. Treatment of combination of Ocimum sanctum + Andrographis paniculata (300mg/kg p.o) was noted to be more efficient against the diabetes-induced vascular endothelial dysfunction and renal impairment as compared to either treatment with Ocimum sanctum (400mg/kg p.o) or Andrographis paniculata (200mg/kg p.o) or Lisinopril (1 mg/kg/day p.o.) (a reference agent). To conclude, diabetes associate oxidative stress and dyslipidemia are majorly accountable for the induction of vascular and renal impairment. The combination of Ocimum sanctum + Andrographis paniculata (300mg/kg p.o) shown the synergistic effect and may have prevented the progression of diabetes-induced vascular endothelial dysfunction and nephropathy by preventing the alteration lipid profile, restoring the serum nitrate/nitrite concentration, and decreasing the renal oxidative stress.

Effect of selected group of asana when used as an adjunct in management of cervical spondylosis of mild to moderate severity: An observational study

BACKGROUND

"Cervical spondylosis" (CS) is a collective term used for non-specific neck pain post 30 age group. Management of CS is mainly non-surgical, particularly in mild to moderate severity that includes the oral anti-inflammatory drugs, exercises, manipulation, mobilization, or combination of these.

OBJECTIVE

The objective of the study is to assess the possible benefit of a selected group of asana in a group of patients over a short time frame and assess their functional outcome.

MATERIALS AND METHODS

An observational study of cohort of patients having mild to moderate CS, who visited the AYUSH department between May 2016 and November 2016 were included. "Selected group of Asana (SGOA)" was practiced for 30 min supervised and then home-based for a period of 8 weeks with usual standard treatment. Patients followed up fortnightly, and their degree of severity & disability assessed.

RESULTS

Thirty patients with 19 males and 11 females having ages mean ± SD 45.61 ± 8.3 and 44.18 ± 9.78 having NDI score of mean ± SD 17.83 ± 4.749 at baseline (0 weeks) were included. Patients showed an improvement in NDI score to finally 7.40 ± 3.180, p-value = 0.0001. This improvement was also noted at various time intervals (p-value = 0.0001 each time), as seen in the post hoc analysis.

CONCLUSION

Yogic practices "Specific Group of Asana" done for eight weeks on a home-based program could be useful in reducing pain and disability in people suffering from CS of mild to a moderate degree. However, more extensive, comparative, and multi-centric trials are required for establishing this as a treatment modality.

Current updates in transdermal therapeutic systems and their role in neurological disorders

The transdermal therapeutic system presents an important role in the treatment of neuropathic pain. Transdermal drug delivery is considered an ideal therapeutic approach for the management of chronic neurological disorders in the elderly population, It is a simple to use, non-invasive and painless drug delivery system, which provides sustained therapeutic plasma levels of drug for an extended period. Moreover, it bypasses the first-pass metabolism of the active agent, improves bioavailability and reduces undesired adverse effects, which in turn improves patient compliance. Several transdermal delivery systems are currently under investigation for the treatment of Parkinson's syndrome, Alzheimer's disorders, and Neurological pain. Drug delivery via the transdermal route is proposed as an alternative remedy to overcome the drawbacks associated with the conventional dosage forms for chronic neurological disorders. The management of Alzheimer's disease via transdermal drug administration exhibits the greatest therapeutic improvements in the treatment of cognition and global functioning among neuropathic patients. Technological breakthroughs in transdermal drug administration such as microreservior system, microneedles, metered-dose transdermal spray (MDTS), needle-free injections, ultrasound-based transdermal therapeutic systems have been successfully used to treat neurological disorders. For example microneedle (MN) is a highly efficient and versatile device due to its distinctive properties. Ultrasounds have been very popular for the delivery of bioactive agents across the skin barrier. This review focuses on the recent advances of various technologies employed in the transdermal therapeutic systems and its applications towards neurological disorders for achieving patient therapeutic outcomes.

Effect of metformin on thyroid function tests in patients with subclinical hypothyroidism: an open-label randomised controlled trial

PURPOSE

Though most of the observational studies have shown that metformin can reduce serum thyroid stimulating hormone (TSH) level in patients of hypothyroidism with diabetes or polycystic ovarian disease, randomised controlled trials are sparse. The primary objective of this study was to evaluate the effect of metformin on thyroid function tests (TSH, free T4, and free T3) in patients with subclinical hypothyroidism (SCH).

METHODOLOGY

In this open label, parallel arm, randomised controlled trial, 60 patients of SCH (TSH 5.5-10 mIU/L) were randomised to either metformin group (1500 mg/day) or control group.

RESULT

A total of 46 patients (23 in each group) completed the study and no significant difference in serum TSH, free T4 or free T3 was found in between the 2 groups. Neither there was any significant change in serum TSH, free T4 or free T3 (pre and post 6 months) within the individual groups. However, the rate of normalisation of serum TSH in patients with negative thyroid antibody was significantly higher than patients with positive thyroid antibody (71.4% vs. 18.8%; P = 0.026) in metformin group in post hoc analysis. Fasting plasma glucose, serum high-density lipoprotein and indices of insulin sensitivity significantly improved in metformin group. Four patients (17%) had mild gastrointestinal adverse effects in the metformin group.

CONCLUSION

We did not find any significant change in thyroid function test in patients with SCH with metformin therapy.

Effect of cabergoline monotherapy in Cushing's disease: an individual participant data meta-analysis

CONTEXT

The primary treatment of choice for Cushing's disease (CD) is the removal of the pituitary adenoma by transsphenoidal surgery (TSS). The surgical failure is seen in up to 75% of cases depending on the experience of the surgeon in different studies. Medical therapy is one of the options for the treatment of recurrent or persistent CD.

METHODOLOGY

The primary outcome of this meta-analysis was to find the proportion of patients achieving normalisation of 24-h urinary free cortisol (remission of CD) following cabergoline monotherapy. Literature search was conducted in January 2018 in PubMed/MEDLINE database from its date of inception to 31st December 2017. The search strategy used was "[(cushing) OR Cushing's] AND cabergoline". Individual participant data were extracted from the included studies and risk of bias was analysed by review checklist proposed by MOOSE.

RESULTS

The individual participant data of 124 patients from six observational studies were included in this meta-analysis. 92 patients (74.2%) had past pituitary surgery. The proportion of patients achieving remission of Cushing’s disease (CD) with cabergoline monotherapy was 34% (95% confidence interval 0.26–0.43; P = 0.001) [corrected]. The previous surgery [odds ratio (OR) 28.4], duration of cabergoline monotherapy (OR 1.31) and maximum cabergoline dose (OR 0.19) were predictors for remission of CD. Mild and severe side effects were reported in 37.3% and 5.6% of patients, respectively, during cabergoline monotherapy.

CONCLUSIONS

This meta-analysis shows that cabergoline monotherapy is a reasonable alternative for subjects with persistent or recurrent CD after TSS. It can also be used in CD patients either as a bridge therapy while waiting for surgery or in those unwilling for surgery or have contraindication to it.

Therapeutic evaluation of "Ayush Tulsi Jiwan Plus" oil for chronic musculoskeletal pain relief

Background:

Chronic pain of musculoskeletal origin is a very common symptom and has major effect on the physical, mental, and economic aspects of the patients. There is always a crave among physicians and patients for effective analgesic, curable preparation that can be locally applied.

Aim:

The aim of this study is to assess the efficacy and safety of “Ayush Tulsi Jiwan Plus” oil in chronic pain management of musculoskeletal origin.

Materials and Methods:

Fifty patients of chronic musculoskeletal pain of unknown origin of mild to moderate condition were advised to apply “Ayush Tulsi Jiwan Plus” oil locally twice daily for 6 weeks and examined weekly. After completion of the treatment, the efficacy of the therapy was assessed on the basis of the subjective criteria such as perception of pain, tenderness, swelling, and joint mobility.

Results:

In this study, mean baseline score versus last visit score of pain (2.84 ± 0.68 vs. 1.33 ± 0.76), tenderness (1.64 ± 0.74 vs. 0.36 ± 0.56), and swelling (0.64 ± 0.85 vs. 0.38 ± 0.66) was significantly decreased, and also clinical improvement was seen in the study participants along with no evidence of adverse drug reactions.

Conclusion:

The analysis of the overall effect of this “Ayush Tulsi Jiwan Plus” oil preparation was found efficacious and topically safe in chronic pain conditions. However, further study will be required with larger sample size and in heterogeneous population to elicit long-term effect of this polyherbal preparation.

Quality Evaluation of Functional Chicken Nuggets Incorporated with Ground Carrot and Mashed Sweet Potato

This study was envisaged to evaluate the effect of ground raw carrot (0%, 5%, 10% and 15%) and mashed sweet potato (0%, 5%, 10% and 15%) as functional ingredients on the quality of chicken meat nuggets. The products were evaluated for physicochemical quality, proximate composition, nutritive value, sensory quality as well as color and texture profile analyses. Additions of either raw carrot or mashed sweet potato represent an improvement in the nutritional value and have some beneficial effects due to the presence of dietary fibers and β-carotene. They were also found to be effective in sustaining the desired cooking yield and emulsion stability. Treated samples showed lower (p > 0.05) protein, fat and ash contents but higher (p < 0.05) moisture content than control. There were differences among the nugget samples with respect to sensory qualities, and control samples as well as samples with 10% added carrot/sweet potato had higher overall acceptability scores. Hunter color values (L*, a* and b* values) were higher (p < 0.05) for both the formulated products, while their textural parameters were nearly unchanged. In conclusion, carrot and sweet potato at 10% added level have greater potential as good source of dietary fibers and β-carotene and may find their way in meat industry.

Efficacy of soy protein isolate as a fat replacer on physico-chemical and sensory characteristics of low-fat paneer

The nutritional and textural properties of low fat paneer using soy protein isolate (SPI) as fat replacer was investigated. The physico-chemical and sensory characteristics of 4 types of paneer made of low-fat milk (3% milk fat (MF) and 10% solids-not-fat (SNF)) and SPI of 0 (T1), 0.1 (T2), 0.2 (T3) and 0.3% SPI (T4) were compared with high fat paneer (TC) made of high fat milk (6% MF and 9% SNF). CaCl2 (0.2%, w/v) was used as coagulant at 75 ± 1°C. Increased level of SPI in paneer increased yield, protein, ash, moisture content and decreased fat, moisture protein ratio, lactose and calorie contents. Titratable acidity and pH varied in narrow range. Instrumental firmness was higher (p ≤ 0.05) in T1-T4 than in TC. The gumminess, chewiness and firmness showed the same trend. Resilience and cohesiveness values showed no significant difference among the samples. Hunter colour L values showed a decreasing, and a and b values increasing trend with increasing levels of SPI. Sensory appearance and colour scores were lower (p ≤ 0.05) for T1-T4 than TC. More than 0.2% SPI imparted beany flavour to paneer.

Formulation of sustained-release dosage form of verapamil hydrochloride by solid dispersion technique using Eudragit RLPO or Kollidon SR

The release of verapamil hydrochloride from tablets with Eudragit RLPO or Kollidon SR with different drug-to-polymer ratios were investigated with a view to develop twice-daily sustained-release dosage form by solid dispersion (SD) technique. The SDs containing Eudragit RLPO or Kollidon SR at drug-polymer ratios of 1:1, 1:2, and 1:3 with verapamil hydrochloride were developed using solvent evaporation technique. The physical mixtures of drug and both polymers were prepared by using simple mixing technique at the same ratio as solid dispersion. The physicochemical properties of solid dispersion were evaluated by using Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), and differential scanning calorimetry (DSC). The study of DSC, XRD, and FTIR could not show significant interaction between verapamil HCl and Kollidon SR or Eudragit RLPO. The solid dispersions or physical mixtures were compressed to tablets. The tablets were prepared with solid dispersions containing Eudragit RLPO or Kollidon SR, with all the official requirements of tablet dosage forms fulfilled. Tablets prepared were evaluated for the release of verapamil hydrochloride over a period of 12 h in pH 6.8 phosphate buffer using US Pharmacopoeia type II dissolution apparatus. The in vitro drug release study revealed that the tablet containing Eudragit has extended the release rate for 12 h whereas the tablet containing Kollidon SR at the same concentration has extended the release rate up to 8 h. The in vitro release profile and the mathematical models indicate that release of verapamil hydrochloride can be effectively controlled from a tablet containing solid dispersions of Eudragit RLPO. The reduction of size fraction of the SD system from 200-250 to 75-125 microm had a great effect on the drug release.

Enhancement of dissolution rate of gliclazide using solid dispersions with polyethylene glycol 6000

The aim of the present study was to enhance the dissolution rate of gliclazide using its solid dispersions (SDs) with polyethylene glycol (PEG) 6000. The phase solubility behavior of gliclazide in presence of various concentrations of PEG 6000 in 0.1 N HCl was obtained at 37 degrees C. The solubility of gliclazide increased with increasing amount of PEG 6000 in water. Gibbs free energy (deltaG(o)(tr)) values were all negative, indicating the spontaneous nature of gliclazide solubilization and they decreased with increase in the PEG 6000 concentration, demonstrating that the reaction conditions became more favorable as the concentration of PEG 6000 increased. The SDs of gliclazide with PEG 6000 were prepared at 1:1, 1:2 and 1:5 (gliclazide/PEG 6000) ratio by melting-solvent method and solvent evaporation method. Evaluation of the properties of the SDs was performed by using dissolution, Fourier-transform infrared (FTIR) spectroscopy, differential scanning calorimetry (DSC) and X-ray diffraction (XRD) studies. The SDs of gliclazide with PEG 6000 exhibited enhanced dissolution rate of gliclazide, and the rate increased with increasing concentration of PEG 6000 in SDs. Mean dissolution time (MDT)of gliclazide decreased significantly after preparation of SDs and physical mixture with PEG 6000. The FTIR spectroscopic studies showed the stability of gliclazide and absence of well-defined gliclazide-PEG 6000 interaction. The DSC and XRD studies indicated the microcrystalline or amorphous state of gliclazide in SDs of gliclazide with PEG 6000.

Comparative study of propranolol hydrochloride release from matrix tablets with KollidonSR or hydroxy propyl methyl cellulose

The release of propranolol hydrochloride from matrix tablets with hydroxy propyl methyl cellulose (HPMC K15M) or KollidonSR at different concentrations was investigated with a view to developing twice daily sustained release dosage form. A hydrophilic matrix-based tablet using different concentrations of HPMC K15M or KollidonSR was developed using direct compression technique to contain 80 mg of propranolol hydrochloride. The resulting matrix tablets prepared with HPMC K15M or KollidonSR fulfilled all the official requirements of tablet dosage forms. Formulations were evaluated for the release of propranolol hydrochloride over a period of 12 h in pH 6.8 phosphate buffer using USP type II dissolution apparatus. Propranolol hydrochloride and pure KollidonSR or HPMC K15M compatibility interactions was investigated by using Fourier-transform infrared (FTIR) spectroscopy and differential scanning calorimetry (DSC). FTIR spectroscopic and DSC studies revealed that there was no well defined chemical interaction between propranolol hydrochloride with KollidonSR or HPMC K15M. Tablets were exposed to 40 degrees C/75% of RH in open disc for stability. The in vitro drug release study revealed that HPMC K15 at a concentration of 40% of the dosage form weight was able to control the release of propranolol hydrochloride for 12 h, exhibit non-Fickian diffusion with first-order release kinetics where as at 40% KollidonSR same dosage forms show zero-order release kinetics. In conclusion, the in vitro release profile and the mathematical models indicate that release of propranolol hydrochloride can be effectively controlled from a single tablet using HPMC K15M or KollidonSR matrix system.

A comparative study of controlled release matrix tablets of diclofenac sodium, ciprofloxacin hydrochloride, and theophylline

The need for controlled release formulations for diclofenac sodium, ciprofloxacin, and theophylline is well recognized. In our study, controlled release tablets of the three drugs were formulated by the matrix-embedding technique using ethyl cellulose as retardant. Tablets of all the drugs were of good physical quality with respect to appearance, drug content uniformity, hardness, weight variation, and friability. In vitro release rate studies showed that ethyl cellulose extended the release of the three drugs to 12 hr or more. Release patterns from formulations of the three drugs followed Higuchi's square root kinetics. At pH 6.8, the release rate was higher in all three drugs, probably due to increased solubility of the drugs and/or increased swelling of ethyl cellulose at the higher pH. The formulations were highly stable and possessed reproducible release kinetics across batches.

Painful extensor digitorum brevis manus muscle

Diagnosis was confirmed of 10 extensor digitorum brevis manus muscles in 7 patients. The muscle is located on the dorsum of the hand, just distal to the wrist. It is most prominent with the wrist flexed to 30 degrees and the fingers fully extended. We propose that pain in the extensor digitorum brevis manus muscle is due to compression of the muscle in the rigid fibro-osseous fourth dorsal compartment. Extensor retinacular release is the treatment of choice.