Formulation and Evaluation of Solid Lipid Nanoparticle (SLN) Based Topical Gel of Etoricoxib.

The objective of present investigation was to prepare & evaluate solid lipid nanoparticle (SLN) based topical gel of non- steroidal anti-inflammatory drug (NSAID) etoricoxib for the treatment of arthritis which would attenuate the gastrointestinal related toxicities associated with oral administration. SLN were formulated by melt emulsification and solidification at low temperature method using stearic acid & tween 80. All the formulation were subjected to particle size, particle size distribution, zeta potential, scanning electron microscopy, crystallinity study by DSC and in-vitro release studies. It has been observed that, the high lipid concentration containing formulation have higher entrapment as compare to other two formulation. The SLN- dispersion shows 70.766% entrapment & zeta potential of the formulation were -25.6 which indicates the stability of formulation. The In Vitro drug release rate of gel was evaluated using Modified franz diffusion cell containing dialysis membrane with phosphate buffer pH 7.4 as the receptor medium. The in-vitro release was carried out in comparison with a carbopol gel & hydroxypropylmethylcellulose (HPMC) gel. The permeability parameters steady-state flux (Jss) was significantly increased in SLN-F3C (carbopol) formulation as compared with SLN-F3HPMC (hydroxypropyl methylcellulose) formulation. It was concluded that the Etoricoxib loaded SLN based gel formulation containing carbopol was suitable for topical application and shows much better result of anti-inflammatory activity.

Hydrophilic Matrix Based Oral Controlled Release Tablets of Melt Sonocrystallized Simvastatin.

The major drawback of Simvastatin to formulate a dosage form is its poor aqueous solubility. In this study a solvent and carrier less technique called Melt sonocrystallization was utilized to form tiny crystals of Simvastatin with enhanced solubility in distilled water and Phosphate buffer pH 7.4, with an insignificant (p > 0.05) change in partition behaviour. The Melt sonocrystallized Simvastatin (MSCSIM) was characterized by FT-IR, DSC and SEM. The flow property was characterized and compared with pure Simvastatin. The MSCSIM was incorporated in directly compressed matrix tablets formed with varying proportion of HPMC K100 LV and starch. The formed tablets were evaluated for pharmacotechnical parameters along with drug release study. After melt sonocrystallization the chemical integrity of drug was unchanged and showed a sound flow property. The pharmacotechnical features of the tablets were noted to be within pharmacopoeial limit. The formulation F5 displayed a comparatively more controlled release of drug (96.45%) over 12 hours. The major release mechanism was found to be anomalous diffusion, with n value of 0.58 from the Korsmeyer-Peppas model, suggesting the drug release driven by swelling of matrix and diffusion. This technique may prove to be beneficial for poorly water soluble drugs and the melt sonocrystallized drugs can lend themselves for developing controlled release formulations.

Pediatric obstructive sleep apnea.

For over 100 years obstructive sleep apnea has been recognized as a clinical entity in adults and more recently in children. A comprehensive review of the literature of pediatric obstructive sleep apnea was conducted using a PubMed search for original research articles. Bibliographies of these articles were reviewed for additional relevant articles not identified by the initial PubMed search. This article reviews the epidemiology, pathogenesis and risk factors, clinical features, diagnostic evaluation and treatment of obstructive sleep apnea in children. All physicians who provide care for children should be aware of the unique features of obstructive sleep apnea in children and the appropriate management.

Complementary and alternative medicine in developmental disabilities.

Developmental disabilities (DD) are defined as a diverse group of severe chronic conditions due to mental and/or physical impairments. Individuals with developmental disabilities have difficulty with major life activities including language, mobility, and learning. Developmental disabilities can begin anytime during development--from prenatal up to 22 years of age, and the disability usually lasts throughout a person's lifetime. Autism spectrum disorders, cerebral palsy, mental retardation, and attention deficit hyperactivity disorder are common conditions falling within the definition of developmental disabilities. Complementary and alternative medicine (CAM) is becoming increasingly utilized in the general population for treatment of everything from the common cold to complex and chronic medical conditions. This article reviews the prevalence of different types of CAM used for various developmental disabilities.

Therapeutic interventions in cerebral palsy.

Various therapeutic interventions have been used in the management of children with cerebral palsy. Traditional physiotherapy and occupational therapy are widely used interventions and have been shown to be of benefit in the treatment of cerebral palsy. Evidence in support of the effectiveness of the neurodevelopmental treatment is equivocal at best. There is evidence to support the use and effectiveness of neuromuscular electrical stimulation in children with cerebral palsy. The effectiveness of many other interventions used in the treatment of cerebral palsy has not been clearly established based on well-controlled trials. These include: sensory integration, body-weight support treadmill training, conductive education, constraint-induced therapy, hyperbaric oxygen therapy, and the Vojta method. This article provides an overview of salient aspects of popular interventions used in the management of children with cerebral palsy.

Pharmacologic interventions for reducing spasticity in cerebral palsy.

Motor function abnormalities are a key feature of cerebral palsy. Spasticity is one of the main motor abnormalities seen in children with cerebral palsy. Spasticity is a velocity dependent increased resistance to movement. While in some children, spasticity may adversely impact the motor abilities, in others, it may help maintain posture and ability to ambulate. Thus, treatment to reduce spasticity requires careful consideration of various factors. Non-pharmacologic interventions used to reduce spasticity include physiotherapy, occupational therapy, use of adaptive equipment, various orthopedic surgical procedures and neurosurgical procedures. Pharmacologic interventions used for reducing spasticity in children with cerebral palsy reviewed in this article include oral administration of baclofen, diazepam, dantrolene and tizanidine, intrathecal baclofen, and local injections of botulinum toxin, phenol, and alcohol.

Management of pelvic inflammatory disease in adolescents.

Pelvic inflammatory disease (PID) is highly prevalent among sexually active adolescent females. The major organisms are N gonorrhoeae and C trachomatis. Diagnosis is based on historical information and clinical findings. Early diagnosis and treatment effectively reduce the incidence of complications associated with PID. Highly effective treatment regimens are available and main antimicrobials used include quinolones, cephalosporins, metronidazole, doxycycline, and azithromycin. Delay or inadequate treatment is associated with long term sequelae including tubal infertility and chronic pelvic pain. Prevention efforts should be directed towards routine screening and treatment for sexually transmissible infections, public education and provision of resources for treatment and follow-up.

Angioimmunoblastic lymphadenopathy with dysproteinemia: thoracic involvement.

Angioimmunoblastic lymphadenopathy (AILD) is a rare condition, which is difficult to diagnose as it mimics tuberculosis or lymphoma both clinically and radiologically. A case of AILD with pulmonary involvement that was initially mistaken for tuberculosis on fine needle aspiration cytology and put on antituberculous treatment for three months, is presented here. The case was subsequently diagnosed to lymph node biopsy as one of AILD.