Preparation, Characterization and In-vitro Evaluation of Microcapsules for Controlled Release of Diltiazem Hydrochloride by Ionotropic Gelation Technique.

The problems of frequent administration and variable low bioavailability after oral administration of conventional dosage forms of diltiazem can be attenuated by designing it in the form of microcapsules which would facilitate intimate contact with the absorption surface and thereby improve and enhance the bioavailability. Diltiazem-loaded microcapsules were successfully prepared by ionotropic gelation technique employing Sodium carboxy methylcellulose, Xanthan gum as rate controlling polymers and Aluminium chloride as cross linking agent. Microcapsules obtained were discrete, spherical, free flowing and showed a maximum encapsulation efficiency of 91.20 ± 0.08%. Particle size of the microcapsules was found to be in the range of 1009 – 1311 μm. Interaction studies performed using FTIR spectroscopy revealed that there were no drug and polymer interactions. The drug remained dispersed in the polymer matrix in amorphous state, which was confirmed by X-ray diffraction analysis. The in vitro drug release follows matrix-diffusion controlled release and the release mechanism was non-Fickian type controlled by swelling and relaxation of polymer. There was no significant change in drug content and cumulative drug release of drug-loaded microcapsules stored at different storage condition after 90 days. From the study, it was concluded that diltiazem loaded microcapsules could be successfully prepared by ionotropic gelation technique with high entrapment efficiency and prolonged release characteristics.

Design and Characterization of Oral Dispersible Tablets of Enalapril Maleate Using a Co-Processed Excipient.

In the present work, oral dispersible tablets of Enalapril maleate were prepared using three different superdisintegrants and a co-processed superdisintegrant consisting of crospovidone and sodium starch glycolate in the ratio 1:1. Oral dispersible tablets of Enalapril maleate were prepared by employing direct compression technique using the above superdisintegrants, and evaluated for precompression as well as post-compression parameters, such as determination of weight variation, thickness, hardness, friability, wetting time, disintegration time, drug content, water absorption ratio, in vitro dispersion time, and in vitro drug release study. Formulation F-VII. F-VIII and F-IX were subjected to stability Studies as per ICH guidelines at temperatures and humidity of 25±5ºC/60±5%RH; 30±5ºC/65±5%RH and 40±5ºC/75±5%RH. Tablets didn’t reveal any appreciable changes in respect to hardness, disintegration time, drug content and dissolution profiles. From the results, it could be concluded that the formulation(F-VII) made with coprocessed super disintegrant (1:1) at a concentration of 5% w/w revealing a disintegrating time of 13.2 sec, and 97.84 % cumulative drug release emerged as the best formulation.

Prospective Randomized Open Labeled Study Comparing Prophylactic Efficacy of Parenteral Single Dose Cefuroxime vs Ampicillin-Sulbactam in Patients undergoing elective cholecystectomy.

The present study was carried to compare the prophylactic efficacy of parenteral single dose Cefuroxime (C) in comparison to parenteral single dose Ampicillin-Sulbactam (A+S) in patients undergoing elective cholecystectomy. Two hundred patients were randomly allocated to single dose parenterally (intra-venous) of either of the regimen before the induction of anaesthesia. Two groups were compared on the basis of American Society of Anesthesiologists (ASA) score, rate of development of wound infection, duration of surgery and hospital stay. Patients were followed up for 30 days and inspected for the development of wound infection. Frequency of bile infection and the sensitivity of the organisms to study drugs and the corelation between bile infection and risk of wound infection were also recorded. Peri-operative prophylactic antimicrobials seem to play a significant role. Both A+S and C when given prophylactically play a significant role in prevention of surgical site infections. However, A+S seems to be more effective than C in doing so in case of high risk groups. Risk of wound infection significantly increases with co existing morbidity. Bile infection does not significantly increase the risk of surgical site infection. Duration of surgery does not significantly increase the risk of wound infection. A+S and C were equally effective in preventing surgical site infections undergoing elective cholecystectomy, but A+S favored better than C in prevention of surgical site infections in high risk patients.

Prevalence and mode of spread of hepatitis B and C in rural Sindh, Pakistan.

The aim of this study was to determine the prevalence and identify risk factors associated with the spread of hepatitis B and C in the rural areas of the upper Sindh Province, Pakistan. Included in this cross-sectional survey were 873 subjects belonging to 174 families residing in Jarwar, a small town of upper Sindh. A study using a systematic random sampling method was undertaken. One questionnaire per household was filled out and blood samples collected for hepatitis B surface antigen (HBsAg), hepatitis B core antibody total (HBcAb), and hepatitis C antibody (anti-HCV). HBsAg was reactive in 44 (5%), HBcAb in 494 (56.6%) and anti-HCV in 294 (33.7%). In the case control study, independent risk factors for exposure to hepatitis B were male sex, age greater than 16 years, absence of vaccination, previous history of jaundice, and family history of liver disease (adjusted odds ratios 1.4, 2.1, 1.7, 1.8 and 1.8, respectively). Independent risk factors for hepatitis C were age greater than 16 years, previous dental procedures, history of liver disease, lack of vaccination, and 10 or more injections in a year (adjusted odds ratios 3.7, 2.1, 2.4, 1.8 and 2.9, respectively). There was indication of intrafamilial and household clustering: for hepatitis C, parent to child p = 0.001, sibling-to-sibling p = 0.046; for hepatitis B, spouse-to-spouse p = 0.052 and parent to child p = 0.001. In conclusion, there is high exposure to hepatitis B and C in upper Sindh. There is a need to educate people about hepatitis B vaccination and iatrogenic factors responsible for transmission. The study suggests the possibility of intrafamilial spread of these viruses.

Prevalence and Covariates of Electrocardiographic Left Ventricular Hypertrophy in Diabetic Patients in Tanzania : Cardiovascular Topics

Background : Left ventricular hypertrophy (LVH) has been demonstrated to be a powerful predictor of cardiovascular (CV) morbidity and mortality in diabetic as well as hypertensive patients. However; less is known about the prevalence of electrocardiographic LVH (ECG-LVH) and its relation to other CV risk factors in diabetic patients in sub-Saharan Africa. Therefore; the aim was to assess the prevalence of ECG-LVH in diabetic patients in Dar es Salaam; Tanzania; and its relation to other cardiovascular risk factors. Methods: Two hundred and thirty-seven consecutive patients attending the Muhimbili diabetic clinic were studied. ECGlvH was diagnosed by Sokolow-Lyon voltage and Cornell voltage-duration product criteria. Q waves; ST-segment deviation; T-wave abnormalities and intraventricular conduction defects were classified by the Minnesota codes. Blood pressure (BP); serum creatinine; cholesterol and triglyceride levels; and HbA1c and urinary albumin and creatinine concentrations were determined. Results: The prevalence of LVH in patients was 16by either ECG criteria; 12.2by Sokolow-Lyon and 5.1by Cornell product criteria. Patients with LVH had significantly higher systolic and mean BP and pulse pressure; and a higher prevalence of ST-segment abnormalities; T-wave inversion and albuminuria than those without LVH (all p 0.05). in multivariate logistic regression analysis; systolic BP was the only independent predictor of ECG-LVH. The prevalence of ECG-LVH increased by 15per 10 mmHg higher systolic BP [OR 1.151 (95CI 1.00921.314); p 0.05]. Clustering of cardiovascular risk factors differed significantly between type 1 and type 2 diabetes patients. On average; type 1 patients had 0.8 and type 2 had 2.2 additional CV risk factors. Conclusion: ECG-LVH was present in 16of diabetic patients in Tanzania. Systolic BP was the most important predictor of ECG-LVH. Clustering of CV risks was significantly higher in type 2 than in type 1 diabetics; demonstrating the need for systematic multiple risk-factor assessment in these patients

Cancer registration in Basrah 2005: preliminary results.

Cancer is a disease which shows significant variation with time and across geographical entities. In Basrah, Iraq, despite the widespread impression that cancer is increasing, researchers are not yet able to draw clear boundaries as to the extent of cancer and its determinants. In this paper, we make a start in that direction; the aim was to measure as accurately as possible the incidence of cancer (all types) in Basrah, to assess age specific incidence rates and to map the cases across different areas of the governorate. For this purpose we compiled data on every accessible case of cancer. The cancer registry in Basrah was used as the prime source of data on newly diagnosed cancer cases, supported by three other sources: the Cancer Registration Section at the Department of Pathology and Forensic Medicine, College of Medicine, University of Basrah; the Oncology Centre at Al-Sadr Teaching Hospital; and the Oncology Ward in Basrah Maternity and Child Hospital. Other minor sources were also utilized. Information on cases from these sources was subjected to meticulous verification regarding repetition, place of residence and other potential errors. The overall incidence rate was 74.3/100,000 population with a higher rate for females (80.5/100,000) than for males (68.1/100,000). The results indicate clear increase in registered cancer cases with increasing age. The lowest incidence rate was among females aged 5-14 years (10.5/100,000) and the highest was among males aged 65 years and above (660.2/100,000). The results show no major variation in the annual incidence rates of cancer in different areas of Basrah governorate. This finding may suggest a common exposure to cancer risk factors. To reach sound conclusions about extent and determinants of cancer in Basrah, immense multi-spectrum efforts are now needed.