Influence of different formulation variables on the performance of transdermal drug delivery system containing tizanidine hydrochloride: in vitro and ex vivo evaluations

The present study was aimed at preparation of transdermal patches of tizanidine HCl, evaluation of the effect of polymers on in vitro release pattern of the drug, and the effect of permeation enhancers on the penetration of the drug through the rabbit skin. Various proportions of hydrophilic (HPMC) and hydrophobic (Eudragit L-100) polymers were used with PEG 400 as film-forming agent, and Span 20 or DMSO as permeation enhancer. The formulations were assessed for physicochemical characteristics and in vitro drug release studies using USP paddle over disc method in phosphate buffered saline (pH 7.4) at 32.0±1°C. On the basis of in vitro studies and physicochemical evaluations, S03-A and S04-A were selected at Eudragit : HPMC ratios of 8 : 2 and 7 : 3, respectively, for further ex vivo analysis. The effects of different concentrations of Span 20 and DMSO were evaluated on excised rabbit skin using Franz diffusion cell. Cumulative drug permeation, flux, permeability coefficient, target flux, and enhancement ratio were calculated and compared with the control formulations. Kinetic models and Tukey's multiple comparison test were applied to evaluate the drug release patterns. Formulation SB03-PE containing Eudragit L-100:HPMC (7:3) with Span 20 (15% w/w) produced the highest enhancement in drug permeation, and followed zero order kinetic model with super case-II drug release mechanism.

Psychiatric co-morbidity in chronic pain disorder

To determine the psychiatric co-morbidity in patients with chronic pain disorder in hospital setting. Cross sectional descriptive study. This study was conducted at Combined Military Hospital [CMH] Okara from June 2011 to May 2012. A purposive sample of 400 patients [males=117; females=283] gathered from pain clinic and other outpatient departments of the hospital and were interviewed in detail and Present State Examination was carried out. Demographic variables were scored using descriptive statistics and results were analyzed using correlation methods. It was revealed that psychiatric illness in overall sample prevailed among 266 participants [67%]. Among which 164 participants [62%] were diagnosed with depression, 67 patients [25.2%] of chronic pain were diagnosed with anxiety disorders, 28 patients [11%] with adjustment disorder and 1.5% and 1.1% diagnosed with drug dependence and somatization disorder, respectively. Psychiatric co-morbidity especially the incidence of depression, anxiety and adjustment disorders were high amongst patients suffering from chronic pain disorder

Mefloquine - neuropsychiatric side effects profile

Mefloquine is a drug widely used for prophylaxis and treatment of malaria. The current study was aimed at finding out the common neuropsychiatric side effects in Pakistani troops serving abroad on United Nations peace keeping mission in malaria endemic areas and to prescribe alternative therapy in individuals more susceptible to these side effects. In a case control study 76 subjects taking mefloquine on weekly basis and reporting sick to the hospital were assessed for neuropsychiatric symptoms and compared with another 50 subjects not on this drug. This study was conducted at Pak-Field Hospital at Siera leone during 2003 to 2004. Sleep disturbances were found in 52.63%, while 60.52% had depressive and other mood related disorders. Anxiety was present in 35.52% whereas 6.57% subjects had psychotic symptoms. Other neurological symptoms like headache and tremors were common. General fatigue was seen in 61.84% of cases. Visual disturbances, delirium and seizure were not significant in our study. Mefloquine therapy in malaria is frequently associated with serious toxic and neurological side effects. An alternative regimen for prophylaxis and treatment is recommended in subjects who have history of mood disorders, paranoia, anxiety and convulsions

Psychiatric aspects of primary infertility in females

This study is designed to investigate the prevalence and pattern of psychiatric morbidity in females with primary infertility and to identify risk factors for psychiatric morbidity. One hundred females having primary infertility, who visited various outpatient departments at MH Rawalpindi and CMH Kharian, have been screened using General Health Questionnaire [GHQ 12] for the possible psychiatric morbidity. Another hundred females with one live issue have been taken as control and screened for psychiatric morbidity. They were ultimately evaluated by two psychiatrists on clinical psychiatric interview and final diagnosis made on ICD 10 diagnostic criteria. In 100 infertile women, psychiatric morbidity was detected in 76% of the cases, while 32% psychiatric morbidity were found in the control. Amongst those having the psychiatric illness, depression was the most common illness 46.03%. Other common diagnosed categories were somatization disorder 20.63%, conversion disorder 15.87% and generalized anxiety disorder 9.52%. obsessive compulsive disorder [OCD] was found in 4.76%, whereas panic disorder and phobic disorder were found in 1.58%. A positive correlation between depression and the duration of infertility was found. Anxiety and related disorders were found in earlier age group whereas depression was found in later age group. A significant proportion of women suffering from primary infertility have psychiatric morbidity. Early detection of these symptoms by screening instruments like General Health Questionnaire [GHQ 12] can enhance the early detection of psychiatric morbidity, formulate psychiatric interventions and possible reduction in morbidity and cost of the treatment. Efforts should be made to increase the awareness among the general population and to impart training in community health care workers to address the psychiatric issues in females who are treated for infertility