Effectiveness of Different Concentrations of Chlorhexidine and Metronidazole Gels in the Management of Gingivitis: A Randomized Clinical Trial

Background: Management of gingivitis is commonly done by the removal of etiological agents by Periodontist. However, use of topical applications of antibiotic combinations has been shown to improve the treatment outcome. Various drugs alone or in combination have been used. So this study was conducted to determine the effect of different concentrations of combination drugs on gingivitis.Material & Methods:100 patients of gingivitis were divided into two groups of 50 each – Group-A and Group-B. After scaling and root planing, Group-A patients were made to apply Metronidazole 1% and Chlorhexidine 0.25% for period of 12 weeks while as Group-B patients applied Metronidazole 1.5% and Chlorhexidine 0.50% for 12 weeks. Baseline scores of gingival index and bleeding index were recorded followed by readings at 4 and 12 weeks.Results:Results showed that there was a significant improvement in gingivitis and bleeding on probing at 4 and 12 weeks after local application of Metronidazole and Chlorhexidine gel in both the groups. However there were no statistically significant differences between two groups.Conclusions:Topical application of Metronidazole and Chlorhexidine gel as an adjunct to scaling and root planing is an effective treatment modality for the management of gingivitis and the concentrations of the combination do not have any significant effect on the treatment.

Pain management & opioid dose reduction with topical sevoflurane instillations in intractable venous ulcers: a case report

Abstract Vascular ulcers (VU) constitute a major cause of pain and disability, and significantly compromise quality of life. VU have a natural tendency to become chronic and in many cases exhibit anunsatisfactoryresponse to many of the standard therapeutic options.The case of a 73 year-old Caucasian female with severe pain and poorly-controlled pain (Visual Analogic Scale-VAS- of 8-9) due to three lower leg long-standing VUs is reported and discussed herein. The patient was treated with topical instillations of undiluted sevoflurane as per institutional off-label protocol (starting doses of 1mL/cm2 twice a day, and up-titrated according to response to a maximum of 7 mL twice daily). The VAS score dropped to 0-1 shortly after initiation of therapy and remained stable throughout treatment up until the closure of the observations. Subsequently, opioid therapy was gradually tapered down and ultimately abandoned.Sevoflurane application resulted on adequate and sustained pain management of refractory VU, with no significant side effects. On account of its beneficial effectivity and safety profiles, topical sevoflurane emerges as an add-on alternative for the long-term management of VU, and potentially other painful conditions.

Preparation and characterization of naftifine-loaded poly(vinyl alcohol)/sodium alginate electrospun nanofibers

In this study, naftifine (a topical antifungal drug) loaded poly(vinyl) alcohol (PVA)/sodium alginate (SA) nanofibrous mats were prepared using the single-needle electrospinning technique. The produced nanofibers were crosslinked with glutaraldehyde (GTA) vapor. The morphology and diameter of the electrospun nanofibers were studied by scanning electron microscopy (SEM). SEM images showed the smoothness of the nanofibers and indicated that the fiber diameter increased with crosslinking and drug loading. Atomic force microscopy (AFM) images confirmed the uniform production of the scaffolds, and elemental mapping via energy dispersive X-ray spectroscopy (EDS) showed the uniform distribution of the drug within the nanofibers. An attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy study demonstrated that naftifine has sufficient secondary interactions with the polymer blend. The crosslinking treatment decreased the burst drug release effectively and the release mechanism followed Korsmeyer-Peppas Super Case-II transport. Overall, these findings suggest the potential use of naftifine-loaded PVA/SA nanofibers as a topical antifungal drug delivery system.

Formulation And Optimization Of Terbinafine Hcl Solid Lipid Nanoparticles For Topical Antifungal Activity

Objective: Solid lipid nanoparticles (SLNs) are at the forefront of the rapidly developing field of nanotechnology with several potential applications in drug delivery and research. The aim of this study was to develop and characterize SLNs formulae of Terbinafine HCl (TFH) for topical drug delivery applications. Methods: SLNs were prepared using the solvent injection technique. Glyceryl Monostearate (GMS) served as the lipid base. Three stabilizers; Tween 80, Cremophor RH40, and Poloxamer 188, were used. The effect of stabilizer type and concentration, as well as the lipid concentration, were studied, factorial design of 32*21was applied. The prepared SLNs were characterized regarding their particle size, zeta potential, polydispersity index (PDI), entrapment efficiency percent (EE %), and physicochemical stability. The selected formulae were subjected to further investigations such as morphological studies, in vitro release studies, and Infrared (IR) spectroscopy. They were compared with the marketed cream Lamifen® in term of their antifungal activity against Candida albicans. Results: Lipid concentration, together with the type and concentration of stabilizer, appeared to be the main cornerstones which affect the formation of SLNs. Smaller particle size was observed when increasing the stabilizer concentration and decreasing the lipid concentration. Higher EE% was observed when increasing both the stabilizer and the lipid concentrations. Formulae (F6, F12 andF19) were selected as the most suitable SLNs with optimum particle size of 480.2±18.89, 458.6±12.45 and 246.7±10.5 nm, respectively as well as the highest EE% of 87.13±0.19, 93.69±0.7 and 95.06±0.25, respectively. In vitro microbiological screening of their antifungal activity showed significantly larger zones of inhibition of diameters 25.9±0.25, 25±0.35 and 24.67±0.36 mm, respectively in comparison with the marketed Lamifen® cream which showed a zone of 11.2±0.44 mm diameter. Conclusion: Applying SLNs containing TFH as topical antifungal preparations may be considered as a very promising option as they show good physicochemical characterization with high antifungal activity, which delineates them as a promising dosage form for topical antifungal treatment.

Microsponge: An Innovative Strategy For Drug Delivery System

Microsponge technology has been introduced in topical drug products to facilitatethe controlled release of active drug into the skin in order to reduce systemic exposure andminimize local cutaneous reactions to active drugs. Microsponge consists of macroporousbeads, typically 10-25µ in diameter, loaded with active agent. When applied to the skin, themicrosponge releases its active ingredients on a time mode and also in response to otherstimuli. Microsponge drug delivery technology holds a great promise for reaching the goal ofcontrolled and site-specific drug delivery and hence, has attracted wide attention ofresearchers. This article presents a broad review of Microsponges delivery system discussingthe principles and preparation methods. Appropriate analytical techniques for characterizationof Microsponges like Particle size and its distribution, surface morphology, porosity, densityare covered. These microsponges are used in the sunscreens, creams, ointments, over-thecounter skin care preparations, which are meant for topical application. Microsponge drugdelivery can provide increased efficacy for topically active agents with enhanced safety,extended product stability and improved aesthetic properties in an efficient and novel manner.They are mostly used for topical use and have recently been used for oral administration

Tratamientos farmacológicos en pacientes con síndrome de boca urente: revisión sistemática / Pharmacologic treatment of burning mouth syndrome: a systematic review

El objetivo fue determinar mediante una revisión sistemática, cuáles tratamientos farmacológicos para el Síndrome de Boca Urente (SBU) logran una reducción de síntomas, según Escala Visual Análoga (EVA). Se realizó una búsqueda bibliográfica en la bases de datos PubMed y SciELO, Trip Database, Scopus Database, EBSCO host y LILACS entre el 2005 y 2015. De 72 artículos, se seleccionaron un total de 11. Los tratamientos sistémicos usados fueron, Hipericum perforatum, Catuama, Clonazepam, Ácido alfa lipoico y Lafutidina. Entre los tratamientos tópicos, Aceite de oliva virgen enriquecido con licopeno, Lisozima lactoperoxidasa, Clonazepam y Capsaicina. Los fármacos que obtuvieron mejores resultados para el tratamiento del SBU fueron Lafutidina, Catuama, Clonazepam tópico y sistémico, y en menor grado Capsaicina.

The aim of this study was to determine through a systematic review, which is the best drug treatment for burning mouth syndrome (SBU), measured on a Visual Analogue Scale. A scientific literature search was conducted in PubMed and SciELO, Trip Database, Database Scopus, EBSCO host and LILACS data between 2005 and 2015. Of a total of 72 articles, 11 were included for analysis. Systemic treatments were Lycopene-enriched virgin olive oil, Hypericum perforatum, Catuama, Clonazepam, Alpha lipoic acid; topical treatments were Lysozyme lactoperoxidase, Clonazepam, Capsaicin and Lafutidine. The best results obtained were with Lafutidine, Catuama, topical and systemic Clonazepam, and to a lesser degree Capsaicin.

Topical administration of traditional Chinese medicine and the methods for the promotion of drug penetration / 中国药科大学学报

@#Monomer component extracted from the herb is the main effective component of traditional Chinese medicine(TCM). Topical administrations of monomer component of TCM has attracted more and more attention due to the convenience of administration and the concentration enrichment in lesion. The main task for the studies of topical drug delivery system is to design the methods which can promote the penetration of the drugs. Currently, the main methods used to improve the penetration of monomer component of TCM includes the synthesis of different dosage forms and the application of physical and chemical techniques to facilitate the penetration of the drugs. This review summarizes the progress in different indications and mechanisms of diverse monomer components of TCM, different dosage forms, and physicochemical techniques used to facilitate drug penetration.

Development of short peptides for enhancing transdermal drug delivery / 中国药学杂志

OBJECTIVE: To summarize the application of some short peptides which have transdermal enhancing activity in recent ten years. METHODS: By sorting, analyzing and summarizing domestic and foreign literatures, the types and characteristics of short peptides, the modes of enhancing transdermal drug delivery, enhancing mechanisms, the existing problems and direction of future de-vejopment were reviewed. RESULTS AND CONCLUSION: Penetrating peptides can help drugs penetrate stratum corneum into viable derma or systemic circulation effectively. Compared to conventional physical and chemical methods, short peptides, as novel biological enhancers, have advantages such as good biocompatibility and low toxicity. Meanwhile, short peptides have transdermal enhancing activity for biomacromolecules like insulin, which bring hope for developing novel administration route of biomacromolecule drugs.

A new proposal for a clinical-oriented subclassifi-cation of baboon syndrome and a review of baboon syndrome.

Objective: To review baboon syndrome (BS). Data Sources: Date sources were obtained from PubMed and Google Scholar: Photographs of baboon syndrome were obtained from our patient. Study Selections: PubMed and Google Scholar were searched up to June 30, 2010. The search terms were “baboon syndrome”, “SDRIFE” and “thimerosal allergy”. Reverse references from relevant articles and Google Scholar were also used. As BS is a classical disease and cases of offending agents were relatively old, some references were more than five years old. In order to gather as many cases of offending agents as possible, more than 50 references were collected. Results and Conclusion: We divided BS into as 4 groups; classical baboon syndrome, topical drug-induced baboon syndrome, systemic drug-induced baboon syndrome and symmetrical drug-related intertriginous and flexural exanthema (SDRIFE). The pathomechanism of BS is still unknown. A delayed type of hypersensitivity reaction, a recall phenomenon, pharmacologic interaction with immune-receptors and anatomical factors may be involved in the causation of BS.

Iontophoretic drug delivery: History and applications.

The goal of delivery system is to get optimal therapeutic management. But, it still remains a challenge in the field of pharmaceuticals for delivery of ionic species and some non ionic. Several transdermal approaches have been used and recently there has been a great attention in using iontophoretic technique for the transdermal drug delivery of medications, both ionic and non ionic. This technique of facilitated movement of ions across a membrane under the influence of an externally applied electric potential difference is one of the most promising physical skin penetrations enhancing method. The payback of using iontophoretic technique includes improved systemic bioavailability ensuing from bypassing the first metabolism. Variables due to oral administration, such as pH, the presence of food or enzymes and transit times can all be eliminated. This article is an overview of the history of iontophoresis, mechanism, principles and factors influencing iontophoresis and its application for various dermatological conditions.