ABSTRACT
Fear of hospitals [operations, diagnosis and injections] where the children are separated from their parents, prior to anesthesia, is very common, where ketamine hydrochloride [KH] was widely used as a preanaesthetic medication by intravenous and intramuscular injection. So, this study is an attempt to produce another alternative method as preanesthesia. This study is designed to formulate and evaluate the efficacy and safety of oral transmucosal ketamine as premedication in children in a dose of 100 mg. Ketamine is chosen to be formulated in different traditional formulations for transmucosal administration including [lozenges, powders, chewable tablets and granules] in which KH concentration is 2% [100 mg / 5g of each dose]. The released studies from different oral transmucosal formulations were carried out in-vitro over a period of twenty one minutes at a thermostatically controlled water bath operating at 37°C +/- 0.5 and 50 r.p.m, by using dissolution tester. The results showed that chewable tablets > powder > granules > lozenges. Because lozenges are more preferable than other oral transmucosal dosage forms in children, different formulations of lozenges were prepared using different sugar bases, different binders and shapes of lozenges which gave the following results: Regarding the type of sugar bases; Glucose + sucrose combined base > glucose base > mannitol base > fructose base > maltose base > sucrose base. Regarding the type of binders; the release of ketamine from lozenges using gelatin as a binder was higher than using gum tragacanth as a binder. Regarding the shape of lozenges; the flat shape of ketamine lozenges gave more and rapid release than oval shape.
ABSTRACT
Ascorbic acid is present in the market as solutions, effervescent tablets, chewable tablets, lozenges and injection for systemic action to treat vitamin C deficiency and promote wounds healing. A large number of cosmetic creams and lotions are available in the market containing the derivatives of ascorbic acid. This investigation is an attempt for the preparation of vitamin C, for topical actions, to promote wound healing in traditional formulations such as ointment, cream and gel. In vitro release studies of the prepared formulation were done by using cellophane membrane in a diffusion cell [dissolution apparatus] operating at 37.5 C° and 50 rpm, the receptor media employed through this investigation was phosphate buffer pH 6, the amount of drug released were determined spectrophotometrically at ?-max 265 nm and at specified periods of time. The results obtained are as the following: Gel > Cream > Ointment, then anin-vivo studies were done on alive rabbit skin by using the best formulation [Gel] of different constituents. After 10 days, the following results have been obtained: Sodium fusidate plus vitamin C gel with healing of 100% > Vitamin C gel alone with healing area of 96 % > Sodium fusidate alone with healing area of 87% > control group gel with healing area of 20% .
ABSTRACT
Objective: renal artery stenosis [RAS] occurs in 0.4-12% of cases after kidney transplantation [KT]. The objective of this study is to report the incidence of RAS after KT in our experience, the presenting symptoms, and the modality of diagnosis, the types of treatment, and the outcomes
Methods: between October 1985 and December 2003, 501 KTs from living related donors [LRD] were performed at Al-Mouassat University Hospital, Damascus, Syria. Renal artery stenosis was diagnosed in six patients. All cases of RAS in this series were studied whether they were diagnosed by color Doppler, MRI, or arteriogram
Results: six cases of RAS out of 501 KTs has been diagnosed [1.2%]. The age of the patients at the time of diagnosis ranged between 27 and 60 years [mean 36.8]. There were 4 males and two females. The delay between the time of KT and diagnosis of RAS was from 2.5 to 24 months [mean 13.5]. The diagnosis was suspected clinically based on arterial hypertension and elevated blood creatinine in all cases, by color Doppler ultrasound in five cases, and by MRI in two cases. It was confirmed by selective arteriogram in 6 cases. Conservative treatment was applied to all patients. Transluminal angioplasty without stenting was performed in three cases. It was successful in two cases and complicated by renal artery rupture with subsequent kidney transplant resection in 1 case. Successful surgical treatment was applied in three patients. The follow-up ranged between two to 61 months [mean: 20.6]. All cases except one have a normal blood arterial pressure and normal blood creatinine level at discharge and on follow-up
Conclusion: RAS after KT should be suspected clinically in case of arterial hypertension resistant to medical treatment associated with elevated blood creatinine level. The color Doppler ultrasound is a very effective mean for diagnosis. Transluminal angioplasty is the treatment of choice and should be performed by experienced interventional radiologists. Surgical treatment in experienced hands has very good results