Development and Evaluation of Vaginal Suppository Containing Althaea officinalis L. Polysaccharide Extract

Abstract Intrauterine adhesions cause several gynecological problems. Althaea officinalis L. roots known as marshmallows contain polysaccharides (M.P.) which possess anti-inflammatory and anti-ulcerogenic activities also can form a bio-adhesive layer on damaged epithelial membranes prompting healing processes. Vaginal formulations of herbal origin are commonly applied to relieve cervico-uterine inflammation. Herein, we aim to develop and evaluate vaginal suppositories containing polysaccharides isolated from the A. officinalis root. Six formulations (four P.E.G.-based and two lipid-based suppositories containing 25% and 50% M.P.) met standard requirements, which were then subjected to qualitative and quantitative evaluation. All suppositories exhibited acceptable weights, hardness, content uniformity, melting point, and disintegration time, which fall within the acceptable recommended limits. Higher concentrations of M.P. in PEG-bases moderately increased the hardness (p<0.05). PEG-formulations showed content uniformity>90% of the average content while it was 75-83% for suppocire formulations. All formulations disintegrated in<30minutes. In-vitro release test revealed that M.P. release from 25%-MP formulations was higher than that of 50%-M.P. suppositories. Overall, results revealed the feasibility of preparing P.E.G.-or lipid-based suppositories containing M.P., which met the B.P. quality requirement

Recurrent Eosinophilic Pneumonia Associated with Mesalazine Suppository in a Patient with Ulcerative Colitis / 대한소화기학회지

Mesalazine suppositories are widely used to treat ulcerative colitis and have a guaranteed safety profile, but although rare, they can cause pulmonary toxicity. A 35-year-old woman with ulcerative colitis was diagnosed to have acute eosinophilic pneumonia after 29 days of oral mesalazine use and improved after mesalazine and corticosteroid were withdrawn. Reintroduction of mesalazine suppositories resulted in acute eosinophilic pneumonia recurrence after 28 days. Mesalazine re-administration (even via a different route) in patients with a history of mesalazine-induced eosinophilic pneumonia should be undertaken cautiously, because eosinophilic pneumonia may recurrence.

Use of progesterone supplement therapy for prevention of preterm birth: review of literatures

Preterm birth (PTB) is one of the most common complications during pregnancy and it primarily accounts for neonatal mortality and numerous morbidities including long-term sequelae including cerebral palsy and developmental disability. The most effective treatment of PTB is prediction and prevention of its risks. Risk factors of PTB include history of PTB, short cervical length (CL), multiple pregnancies, ethnicity, smoking, uterine anomaly and history of curettage or cervical conization. Among these risk factors, history of PTB, and short CL are the most important predictive factors. Progesterone supplement therapy is one of the few proven effective methods to prevent PTB in women with history of spontaneous PTB and in women with short CL. There are 2 types of progesterone therapy currently used for prevention of PTB: weekly intramuscular injection of 17-alpha hydroxyprogesterone caproate and daily administration of natural micronized progesterone vaginal gel, vaginal suppository, or oral capsule. However, the efficacy of progesterone therapy to prevent PTB may vary depending on the administration route, form, dose of progesterone and indications for the treatment. This review aims to summarize the efficacy and safety of progesterone supplement therapy on prevention of PTB according to different indication, type, route, and dose of progesterone, based on the results of recent randomized trials and meta-analysis.

Eficacia y seguridad de supositorios de mesalazina en pacientes adultos con proctitis o proctosigmoiditis ulcerativa para las fases agudas y del mantenimiento de la remision / Efficacy and safety of mesalazine suppositories in adult patients with proctitis or ulcerative proctosigmoiditis for acute phases and maintenance of remission

INTRODUCCIÓN: Antecedentes: El presente dictamen presenta la evaluación de tecnología de la eficacia y seguridad de los supositorios de mesalazina para su uso en pacientes adultos con proctitis o proctosigmoiditis ulcerativa para las fases aguda y del mantenimiento de la remisión. Aspectos Generales: La colitis ulcerativa (CU) es la condición inflamatoria crónica más común de las enfermedades gastrointestinales. Frecuentemente se desarrolla entre los 15 y 25 años y 55 y 65 años, aunque no excluye la población fuera de estos rangos de edad. Esta enfermedad genera inflamación a nivel de la mucosa del colon, siendo variable la extensión de la inflamación y pudiendo llegar a afectar también el área del recto. Se caracteriza por fases de relapso y remisión. Tecnología Sanitaria de Interés: Mesalazina (Canasa®/Mesacron®/Pentasa®/Salofalk®/Asacol®) es un medicamento anti-inflamatorio de acción tópica compuesto químicamente por el ácido 5 aminosalicílico o 5-ASA. Tiene dos vías de administración, oral y rectal, siendo los supositorios rectales, la forma de presentación de interés de esta evaluación de tecnología. METODOLOGÍA: Estratégia de Búsqueda: Se realizó una estrategia de búsqueda sistemática de la evidencia científica con respecto a la eficacia y seguridad de supositorios de mesalazina para pacientes con proctitis o proctosigmoiditis ulcerativa en fases aguda y del mantenimiento de la remisión. Para la búsqueda primaria se revisó la información disponible por entes reguladoras y normativas como la Administración de Drogas y Alimentos (FDA), y la Dirección General de Medicamentos y Drogas (DIGEMID). Posteriormente, se buscaron guías de práctica clínica a través de los metabuscadores: Translating Research into Practice (TRIPDATABASE), The National Guideline of Clearinghouse (NGC), y Health Systems Evidence (HSE). Seguidamente, se realizó una búsqueda dentro de la información generada por grupos internacionales que realizan revisiones sistemáticas, evaluaciónes de tecnologías sanitarias y guías de práctica clínica, tales comoHealth Technology Assesment (HTA), la Biblioteca de Cochrane, el Instituto Nacional de la Salud y Excelencia en Cuidado (NICE), la Agencia Canadiense de Drogas y Tecnologías en Salud (CADTH), y el Consorcio Escocés de Medicinas (SMC). Adicionalmente se revisaron las bases National Library of Medicine (Pubmed-Medline), LILACS, EMBASE, OVID, y complementando la búsqueda con la página de ensayos clínicos www.clinicaltrials.gov, para identificar estudios primarios en elaboración o que no hayan sido publicados aún. RESULTADOS: Tras la búsqueda se encontró evidencia que sustenta la eficacia y seguridad de supositorios de mesalazina en pacientes adultos con proctitis o proctosigmoiditis ulcerativa para las fases aguda y del mantenimiento de la remisión.RESULTADOS: Tras la búsqueda se encontró evidencia que sustenta la eficacia y seguridad de supositorios de mesalazina en pacientes adultos con proctitis o proctosigmoiditis ulcerativa para las fases aguda y del mantenimiento de la remisión. Sinopsis de la Evidencia: Se encontró evidencia acerca de la eficacia y seguridad de supositorios de mesalazina en pacientes adultos con proctitis o proctosigmoiditis ulcerativa para las fases aguda y del mantenimiento de la remisión. CONCLUSIONES: La presente evaluación de tecnología evalúa la evidencia disponible a Febrero del 2016 para el uso de supositorios de mesalazina para pacientes adultos con proctitis o proctosigmoiditis para las fases agudas y del mantenimiento de la remisión. - Se ha encontrado evidencia que sustenta la eficacia y seguridad de supositorios de mesalazina, la cual está basada en dos guías de práctica clínica y dos revisiones sistemáticas de buena calidad metodológica. Cabe resaltar que esta eficacia ha sido demostrada únicamente para la población de pacientes con proctitis o proctosigmoiditis ulcerativa, mas no en otras áreas del colon en fases aguda. Sin embargo, para la fase del mantenimiento de la remisión no se ha encontrado evidencia directa que evalúe el potencial beneficio de supositorios de mesalazina. , El Instituto de Evaluación de Tecnologías en Salud e Investigación ­ IETSI, aprueba el uso de supositorios de mesalazina en pacientes adultos con proctitis o proctosigmoiditis ulcerativa para el tratamiento de fases aguda y del mantenimiento de la remisión. El presente Dictamen Preliminar tiene una vigencia de dos años a partir de la fecha de publicación.

Perfil de progesterona em novilhas com diferente atividade luteal e tratadas com implantes vaginais / Serum progesterone in heifers with different luteal activity treated with vaginal devices

O dispositivo de liberação de progesterona (DLP) é muito importante em protocolos de Inseminação Artificial em Tempo Fixo (IATF). Representa cerca de 43% dos custos e é objeto de estudos sobre a eficiência da sua reutilização. No entanto, perfis de liberação de progesterona (P4) em animais com diferentes concentrações endógenas desse esteroide não são claramente descritos. Este estudo teve como objetivo avaliar a concentração sérica de P4 em fêmeas com diferentes situações de atividade luteal, tratadas com DLP novo (1g de P4) por 8 dias. Trinta novilhas mestiças cíclicas foram divididas em três grupos: em G1 e G2, o DLP foi inserido (D0) sete dias após a ovulação induzida. Adicionalmente, 0,15mg de D-cloprostenol foi administrado três dias depois para promover a luteólise em G2. Para G3, o corpo lúteo foi lisado antes da inserção do DLP para que a P4 exógena fosse a única fonte desse hormônio. O sangue foi coletado no D0, D3, D5 e D8, e a P4 avaliada por RIA. Médias de P4 foram comparadas entre os grupos em cada dia e dentro do grupo, entre os dias, utilizando o teste Tukey. Antes da inserção do implante (D0), os níveis de P4 foram, nos grupos, semelhantes em G1 e G2, e superiores a G3 (5,3±3,1a e 5,3±1,4avs 0,6±0.3bng/mL, respectivamente-P<0,05). No D3, ocorreu o mesmo perfil (5,7±2,6a e 5,4±2,0a e 3,6±0.8bng/mL, respectivamente para G1 e G2 vs G3, P<0,05). Trinta e seis horas (D5) após a PGF, a P4 no G2 caiu para níveis semelhantes aos do grupo G3 e ambos diferiram (P<0,05) de G1 (3,3±1,6b vs 2,4±0,9b e 2,1±0.7bng/mL). Essa diferença se manteve (P<0,05) em D8 (3,1±1,3a, 1,8±0,8b e 1,6±0.6b ng/mL). O aumento da P4 após a inserção (D3 - D0) foi maior (P<0,05) em G3 que em G1 e G2 (2,8±0,9a vs 0,4±1,8b e 0,2±1.4bng/mL). Os animais com maior P4 endógena levam a menor liberação de P4 exógena a partir do DLP. Portanto, os níveis remanescentes de P4 no DLP após o uso dependem da concentração endógena de P4 do animal e possíveis alterações durante a permanência.(AU)

The progesterone (P4) device is a very important step in the ovulation control in Timed Artificial Insemination (TAI) protocols. It represents about 43% of the hormone costs, thus it has been the subject of several studies on efficiency of the reused device as an alternative to reduce TAI costs. However, to our knowledge, profiles for P4 release in animals with different endogenous concentrations of P4 are not clearly described. This study aimed to evaluate serum concentration of P4 in females with different ovarian conditions - related to luteal activity - and treated with a new intravaginal device (1g of P4) for 8 days. Thirty normally cyclic crossbred heifers were divided into three groups: for G1 and G2, P4 device was inserted (D0) seven days after ovulation (7 day old CL). Additional PGF (0.15 mg of D-cloprostenol) was given three days later to promote luteolysis in the G2 group. For G3, CL was killed before P4 insertion and the exogenous progesterone was the only source of this hormone. Blood samples were collected on D0, D3, D5 and D8 and P4 concentration was measured by radioimmunoassay (RIA). Means for P4 concentration were compared among groups in each day and within the group among days using the Tukey test. Before P4 device insertion (D0), P4 levels were higher (P<0.05) in G1 and G2 when compared to G3 (5.3±3.1 and 5.3±1.4 vs. 0.6±0.3ng/mL, respectively). Three days later (D3), the same pattern was observed (5.7±2.6 and 5.4±2.0 and 3.6±0.8ng/mL, respectively for G1 and G2 vs. G3, P<0.05). Thirty-six hours (D5) after PGF injection (G2), P4 in G2 dropped to levels similar to the G3 group and both differed (P<0.05) from G1 (3.3±1.6 vs. 2.4±0.9 and 2.1±0.7ng/mL, G1 vs. G2 and G3, respectively). There were no differences (P>0.05) among groups on D8 (3.1±1.3, 1.8±0.8 and 1.6±0.6ng/mL, respectively, for G1, G2 and G3). Progesterone increase after P4 insertion (D3 - D0) was higher (P<0.05) in G3 compared to G1 and G2 (2.8±0.9 vs. 0.4±1.8 and 0.2±1.4ng/mL, respectively). The interpretation was that animals with higher endogenous P4 promote less release of the exogenous P4 from the device. Therefore, the remaining P4 levels from used progesterone devices depend on the physiological condition of the animal at the time of insertion and possible changes during the treatment.(AU)

Mesalazina enema e supositório para tratamento da Doença de Crohn / Mesalazine enema and suppository for treatment of Crohn's Disease

A DOENÇA: A doença de Crohn (DC) é uma doença inflamatória intestinal de origem não conhecida e caracterizada pelo acometimento focal, assimétrico e transmural de qualquer porção do tubo digestivo, da boca ao ânus. Apresenta-se sob três formas principais: inflamatória, fistulosa e fibroestenosante.Os segmentos do tubo digestivo mais acometidos são íleo, cólon e região perianal. A DC não é curável clínica ou cirurgicamente e sua história natural é marcada por agudizações e remissões. TRATAMENTO: O tratamento da DC é definido segundo a localização da doença, o grau de atividade e as complicações. As opções são individualizadas de acordo com a gravidade, a resposta sintomática e a tolerância ao tratamento. O tratamento medicamentoso envolve o uso de anti-inflamatórios esteroidais e não esteroidais, antibióticos, imunomoduladores, e anticorpos monoclonais anti-fator de necrose tumoral (anti-TNF). Os primeiros incluem corticosteroides e aminossalicilatos (sulfassalazina e mesalazina). JUSTIFICATIVA DA EXCLUSÃO: Aminossalicilatos e antibióticos não têm ação uniforme ao longo do trato gastrointestinal, enquanto corticosteroides, imunomoduladores e terapias anti-TNF parecem ter uma ação mais constante em todos os segmentos gastrointestinais. Os aminossalicilatos não atingem concentração terapêutica no esôfago e no estômago, pois são formulados de maneira a serem liberados em segmentos mais distais no trato digestivo. Pacientes com doença ileal devem ser tratados com corticosteroide (qualquer representante e via de acordo com a situação clínica), uma vez que a mesalazina, o aminossalicilato que atinge níveis terapêuticos nesta região, tem efeito muito modesto quando comparado ao placebo. Desta forma, aminossalicilatos são indicados apenas no tratamento de doença colônica e ileocolônica. DELIBERAÇÃO FINAL: A CONITEC, na presença dos membros, na reunião do plenário do dia 02/07/2015 deliberou por unanimidade recomendar a exclusão da mesalazina nas apresentações enema e supositório para o tratamento da doença de Crohn conforme Protocolo Clinico e Diretrizes Terapêuticas estabelecidos pelo Ministério da Saúde. Foi assinado o Registro de Deliberação nº 129/2015. DECISÃO: PORTARIA Nº 36, de 24 de julho de 2015 - Torna pública a decisão de excluir a mesalazina nas apresentações enema e supositório para o tratamento da doença de Crohn no âmbito do Sistema Único de Saúde - SUS.

Randomized, single-blinded comparison of efficacy, safety and tolerability of metronidazole 750mg - miconazole 200mg vaginal suppository vs. metronidazole 500mg - nystatin 100, 000 IU vaginal suppository in the treatment of bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis, and mixed vaginal infections / Philippine Journal of Obstetrics and Gynecology

OBJECTIVE: This randomized, single-blind, two-arm controlled study compared the efficacy, safety, and tolerability of an intravaginal suppository preparation containing metronidazole 750mg + miconazole 200mg (Neopenotran Forte) with another vaginal preparation containing metronidazole 500 mg + nystatin 10000 IU (Flagystatin) in the treatment of bacterial vaginosis (BV), candidal and trichomonial vulvovaginitis (CVV, TV), mixed vaginitis and in the prevention of secondary candidal vulvovaginitis. MATERIALS AND METHODS: Women ages 18-45 years with chief complaints of abnormal vaginal discharge or vaginal/vulvar itching were examined and microbiologic confirmation of BV, VVC, TV or mixed infection was made. They were then randomly assigned to receive either treatment once daily (nightly) for 7 days. A total of 261 subjects had evaluable clinical and microbiological findings at the end of the study. Test of cure by Amsel criteria and Nugent score were performed twice after treatment. RESULTS: The overall test revealed that microbiological cure rate is significantly different between the two treatment groups. CONCLUSION: The odds of being cured microbiologically is 2.35 times more in the metronidazole 750mg + miconazole nitrate 200mg group compared to the metronidazole 500 mg + nystatin 10000 IU group. However, no significant difference in the clinical cure between the two groups was found. Both drugs are safe and convenient to use.

Study on effect of pH on rectum permeability of active ingredients in Reduning suppositories in vitro / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the effect of different pH on rectum permeability of chlorogenic acid and geniposide.</p><p><b>METHOD</b>Four kinds of Reduning suppositories of different pH were separated and put into the rectum to study the suppositories in vitro and the content of chlorogenic acid and geniposide samples was determined by HPLC to calculate the permeation in 24 hours.</p><p><b>RESULT</b>With increase of pH within 2.5-7.4, the steady state flux of chlorogenic acid was increased, but the steady state flux of geniposidesamples was steady.</p><p><b>CONCLUSION</b>Adjusted the pH can increase the rectum permeability of active ingredients in Reduning auppositories.</p>

Local Management of Constipation: Enemas, Suppositories / 대한내과학회지

The treatment for constipation should be individualized and dependent on the cause, coexisting morbidities, and patient's cognitive status. Although most cases of constipation respond to conservative treatment, including dietary and life-style changes, or mild laxatives, some patients still complain of consistent symptoms and need an assessment of defecatory dysfunction. There is insufficient evidence to support the use of enemas in chronic constipation, although many clinicians and patients find them useful and effective for the treatment of fecal impaction when used with other modalities. In addition, suppositories can be considered as an initial trial for the treatment of defecatory dysfunction, since they help to initiate or facilitate rectal evacuation. The routine use of enemas is typically discouraged, especially sodium phosphate enemas, although tap-water enemas seem safe for more regular use. Soapsuds enemas are not recommended due to possible rectal mucosal damage.

Comparison of placebo and intrauterine lidocaine with/or without rectal diclofenac sodium suppositories used in office endometrial biopsy

To compare the effects of intrauterine lidocaine, intrauterine lidocaine plus rectal diclofenac, and a placebo on analgesia and to determine the satisfaction of patients and surgeons in cases of endometrial biopsy. The double-blind, randomised, placebo-controlled study was conducted in the Department of Obstetrics and Gynaecology of the Ondokuz Mayis University, Samsun, Turkey, from April 2013 to January 2014, and comprised patients scheduled for in-office endometrial biopsy. They were divided into three groups: Group P, 5ml of 0.9% saline intrauterine; Group L, 5ml of 2% lidocaine intrauterine; and Group LD, 5ml of 2% lidocaine intrauterine +/- 10min before the procedure plus 50mg of rectal diclofenac sodium. Haemodynamic changes and visual analogue scale scores were recorded during the preoperative period, when the cervix was grasped with a tenaculum, immediately after intrauterine instillation, during uterine curettage and at postoperative 10 min. The patient and the surgeon were questioned about their satisfaction 15 min after the procedure. SPSS 21 was used for statistical analysis. The 90 patients in the study were divided into three equal groups of 30[33.33%] each. There were no statistically significant inter-group differences in age, bodyweight, parity, number of postmenopausal patients, haemodynamic parameters and American Society of Anesthesiologists scores [p>0.05 in all categories]. In Group P, the visual analogue scale score estimated when the cervix was grasped with the tenaculum was lower when compared with Group L and Group LD [p=0.029 and p=0.007, respectively]. At other measurement time points, the scores did not differ between the groups. The groups did not differ with respect to patient and surgeon satisfaction and complication rates [p>0.05]. Intrauterine lidocaine or intrauterine lidocaine plus rectal diclofenac application had no effect on visual analogue scale scores, patient satisfaction and vasovagal reaction

Estabilidad de supositorios de naproxeno para uso infantil y adulto / Stability of Naproxen suppositories for children and adults

INTRODUCCIÓN: el naproxeno en supositorios para uso infantil y adulto constituye una de las líneas de investigación en desarrollo de la Empresa Roberto Escudero Díaz. Los estudios de estabilidad son una parte indispensable para el registro de una nueva formulación. OBJETIVO: determinar la estabilidad de los supositorios de naproxeno para uso infantil y adulto, teniendo en cuenta la estabilidad física y química del analito en las nuevas formulaciones. MÉTODOS: se realizó el estudio de estabilidad para formulaciones en fase de desarrollo de supositorios de naproxeno para uso infantil y adulto, teniendo en cuenta la metodología propuesta por el Centro para el Control Estatal de la Calidad de los Medicamentos (CECMED). Se emplearon para cada dosis evaluada, supositorios de tres lotes pilotos envasados en tiras de aluminio termosellables. Se almacenaron los supositorios a temperatura de refrigeración (2-8 °C) y ambiente (30 ± 2 °C) durante un año, y se les realizaron muestreos a los 0, 1, 3, 6 y 12 meses de elaborados. Para el análisis de la estabilidad química, se consideraron los resultados del contenido de naproxeno obtenidos por volumetría de neutralización y por cromatografía líquida de alta resolución, así como la determinación de los posibles productos de degradación por cromatografía en capa delgada. RESULTADOS: se demostró la adecuada estabilidad física de los supositorios de ambas dosis, independientemente de la temperatura de almacenamiento durante 12 meses, ya que se mantuvieron inalteradas las características organolépticas y el peso. Aunque el tiempo de liquefacción disminuyó durante el almacenamiento, siempre fue inferior al límite establecido. Con el método por cromatografía líquida de alta resolución, se detectaron pequeños cambios en la concentración de analito, por lo que este método fue superior para el seguimiento de la estabilidad química que la volumetría de neutralización. No se detectaron productos de degradación en los supositorios por ninguna de las técnicas cromatográficas utilizadas. CONCLUSIONES: los supositorios fueron estables desde el punto de vista físico y químico a temperatura de refrigeración (2-8 °C) y ambiente (30 ± 2 °C) durante 12 meses(AU)

INTRODUCTION: Naproxen suppository for children and adults is one of the developing research lines of Roberto Escudero Diaz drug production enterprise. The stability studies are indispensable for the registration of a new formulation. OBJECTIVE: to determine the stability of Naproxen suppositories for children and adults, taking the physical and chemical stability of the analyte into account in the new formulations. METHODS: pursuant to the methodology of the Center for the State Quality Control of Drugs (CECMED), the stability study for developing formulations was conducted in Naproxen suppositories for children and adults. These products packaged in heat-seal aluminum blister packs from three pilot batches were used for each evaluated dose. They were stored at 2 to 8 °C refrigeration and at air temperature of 30 ± 2 °C during one year, and sampled at 0, 1, 3, 6 and 12 months after preparation. For the analysis of the chemical stability, the Naproxen content determined by the neutralizing volumetry and high performance liquid chromatography tests and the possible degradation products identified in the thin layer chromatography test were taken into account. RESULTS: this study proved the adequate physical stability of suppositories at both doses regardless of the storage temperatures during 12 months because their organoleptic characteristics and weight remained unchanged. Although the liquefaction time decreased under the storage conditions, it was lower than the set limit. The high performance liquid chromatography detected slight changes in the analyte concentration, so this method was better for the chemical stability analysis than the neutralization volumetry method. The chromatographic techniques did not detect any degradation product in the suppositories. CONCLUSIONS: the suppositories were physically and chemically stable at a refrigerating temperature of 2 to 8 °C and at air temperature of 30 ± 2 °C during 12 months(AU)

A suppository-base-matrix tablet for time-dependent colon-specific delivery system

Our research has focused on the main design features and release performances of time-dependent colon-specific (TDCS) delivery tablets, which relies on the relative constancy that is observed in the small intestinal transit time of dosage forms. But inflammatory bowel disease（IBD）can affect the transit time, and usually results in watery stool. Compared to the TDCS and wax-matrix TDCS tablet, a promising time-dependent colon-specific delivery system was investigated. In our study, a suppository-base-matrix coated tablet was evaluated. Water soluble suppository-base helps the expansion of tablet, facilitates uniform film dissolution and achives high osmotic pressure. Combining the expansion of carboxymethyl starch sodium (CMS-Na) and the moisture absorption of NaCl, the coated TDCS tablet obtained a burst and targeted drug delivery system. A very good correlation between in vitro drug release and in vivo outcome was observed. This TDCS coated tablet provides a promising strategy to control drug release to the desired lower gastrointestinal region.

Nossa pesquisa focou-se nas principais características de planejamento e de desempenho de liberação cólon-específica tempo-dependente (TDCS) de comprimidos, que leva em conta a constância relativa observada no tempo de trânsito intestinal das formas de dosagem. A doença inflamatória do intestino (IBD) pode afetar o tempo de trânsito e, geralmente, resulta em fezes aquosas. Comparando ao TDCS e a comprimidos TDCS com matriz-cerosa, investigou-se sistema promissor de liberação cólon-específica tempo-dependente. Em nosso estudo, avaliou-se comprimido revestido com matriz base de supositório. A base de supositório solúvel em água auxilia a expansão do comprimido, facilita a dissolução uniforme do filme e atinge alta pressão osmótica. Associando a expansão do carboximetil amido sódico (CMS-Na) à absorção de umidade do NaCl, o comprimido revestido TDCS originou sistema de liberação direcionado e de erupção. Observou-se correlação muito boa entre a liberação in vitro e a in vivo do fármaco. Este comprimido revestido TDCS representa estratégia promissora para o controle da liberação do fármaco na região gastrintestinal mais baixa.

In vitro release of ketoprofen suppositories using the USP basket and the flow-through cell dissolution methods

In order to study the release characteristics of ketoprofen suppositories under the hydrodynamic environment generated by USP Apparatus 1 and 4, the dissolution profiles of the Mexican reference product [100 mg] were determined. Phosphate buffer pH 8 and 1% sodium lauryl sulfate [SLS] aqueous solutions were proved as dissolution mediums. Baskets were rotated at 100 rpm with USP Apparatus 1 and different flow rates from 16-32 mL/min with USP Apparatus 4 were used. Drug samples were taken and quantified during 60 min by UV analysis at 260 nm. Mean dissolution time [MDT] and dissolution efficiency [DE] were calculated by model-independent methods. Data were also fitted to several kinetic models. Poor dissolution was found in both dissolution mediums when USP basket method was used [< 10% dissolved] while better results were obtained with USP Apparatus 4 when 1% SLS at 24 mL/min was used [43.6% dissolved, MDT of 25.5 min and DE of 25.0%]. Kinetics showed a great variability when the USP Apparatus 1 was used, and Gompertz fitted well for data of 1% SLS at 24 mL/min [R2 adjusted > 0.99]. The results suggest the need to establish an adequate dissolution method to evaluate the release kinetics of ketoprofen from suppositories.

[Comparison the analgesic effect of naproxen suppositories with intra wound injection of markain after inguinal hernia surgery]

Anti-inflammatory drugs are used for reducing the pain after surgery especially in minor surgery and local anesthesia drugs, especially Markain, is also employed. Regarding performing little studies about the comparison of these two kinds of drugs, this study was done for comparison two methods. This double-blind randomized clinical trial study was done on 198 patients with inguinal hernia. Patients were divided into case group [intra wound Markain] and control group [the suppository of naproxen]. Surgery was done with standard method [Liechtenstein] and the severity of pain was assessed by the visual analogue scale [VAS] in one, six and 24 hours after surgery. Data were analyzed by SPSS- ver16 software. Mean age in case group were 52.6 +/- 5.7 years and in control group were 53.7 +/- 4.9 years. Mean pain intensity in the first and 6[th] hours in case group were 6.3 and 4.6 and in control group were 3.9 and 2.9, respectively [P<0.001]. The pain immediately and 24 hours after surgery were similar in both groups and there was no significant difference between the two groups. Need to opioid analgesics was further reduced in the naproxen group one and six hours after surgery. Although both methods were effective in reducing postoperative pain and less expensive, but naproxen suppositories was more effective pain reliever for optimal pain control, especially in the first and six hours after surgery and is more effective in reducing pain intensity than Markain. Naproxen also reduces the need to deal with housing has been opioid analgesics

Compound ciprofloxacin suppository combined with ningbitai and yunnan baiyao for histological prostatitis with PSA elevation / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the efficacy of compound ciprofloxacin suppository (CCS) combined with Ningbitai (NBT) and Yunnan Baiyao (YB) capsules in the treatment of histological prostatitis with elevated levels of PSA.</p><p><b>METHODS</b>This study included 150 cases of type IIIA histological prostatitis, with PSA levels ranging from 4 to 50 microg/L. After 1 month's treatment with oral Levofloxacin tablets at 0.5 g qd, the PSA levels remained high in 86 patients. Prostate cancer was excluded by transrectal ultrasound-guided prostatic biopsy, and histological prostatitis was confirmed in 65 patients, who were assigned to an experimental group (n=45) and a control group (n=20) to receive CCS combined with NBT and YB capsules and CCS with NBT only, respectively, both for 4 weeks. We determined the PSA levels, obtained NIH-CPSI scores before and after medication, and compared them between the two groups.</p><p><b>RESULTS</b>The two groups were well balanced in demographics and baseline characteristics. After treatment, both showed significant differences in the PSA level, PSA density (PSAD) and CPSI scores from the baseline (P<0.05), and there were also statistically significant differences between the two groups in the changes of the PSA level and CPSI scores after medication (P = 0.029 and 0.001).</p><p><b>CONCLUSION</b>Compound ciprofloxacin suppository combined with Ningbitai and Yunnan Baiyao capsules can significantly decrease the level of serum PSA and relieve related symptoms in III A histological prostatitis with PSA elevation, and Yunnan Baiyao capsules can significantly enhance the therapeutic effect.</p>

Desarrollo y validación de un método por cromatografía en capa delgada para los estudios de estabilidad del naproxeno / Development and validation of a thin-layer chromatography method for stability studies of naproxen

Se realizó la validación de un método analítico con vistas a su aplicación en los estudios de estabilidad de las futuras formulaciones de supositorios de naproxeno para uso infantil y adulto. Se determinaron los factores que más influyeron en la estabilidad del naproxeno; la mayor degradación ocurrió en el medio ácido, oxidante y por acción de la luz. Se determinó la posibilidad de formación de ésteres entre el grupo carboxilo libre presente en el naproxeno y el monoestearato de glicerilo presente en la base como una de las vías de degradación en la nueva formulación; se obuvieron resultados satisfactorios. Se desarrolló un método por cromatografía en capa delgada y se seleccionaron las mejores condiciones cromatográficas. Se emplearon placas de sílica gel GF254 y revelador ultravioleta a 254 nm. Se evaluaron 3 sistemas de disolventes entre los cuales el A, compuesto por: acético glacial:tetrahidrofurano:tolueno (3:9:90 v/v/v), permitió una adecuada resolución entre el analito y los posibles productos de degradación, con un límite de detección de 1 µg. La aplicación del método propuesto se limitó a la identificación de los posibles productos de degradación solo con fines cualitativos y no como prueba límite. El método fue suficientemente sensible y selectivo para aplicarlo con el objetivo para el cual fue diseñado, según los resultados obtenidos en la validación

The validation of an analytical method was carried out to be applied to the stability studies of the future formulations of naproxen suppositories for infant and adult use. The factors which mostly influenced in the naproxen stability were determined, the major degradation occurred in oxidizing acid medium and by action of light. The possible formation of esters between the free carboxyl group present in naproxen and the glyceryl monoestereate present in the base was identified as one of the degradation paths in the new formulation. The results were satisfactory. A thin-layer chromatography-based method was developed as well as the best chromatographic conditions were selected. GF254 silica gel plates and ultraviolet developer at 254 nm were employed. Three solvent systems were evaluated of which A made up of glacial acetic: tetrahydrofurane:toluene (3:9:90 v/v/v)allowed adequate resolution between the analyte and the possible degradation products, with detection limit of 1 µg. The use of the suggested method was restricted to the identification of possible degradation products just for qualitative purposes and not as final test. The method proved to be sensitive and selective enough to be applied for the stated objective, according to the validation results

Validación de métodos analíticos para los estudios de estabilidad del naproxeno en supositorios para uso infantil y adulto / Validation of analytical methods for the stability studies of naproxen suppositories for infant and adult use

En el presente trabajo se realizaron los estudios analíticos y de validación para su aplicación en los estudios de estabilidad de las futuras formulaciones de supositorios de naproxeno para uso infantil y adulto. Se determinaron los factores que más influyeron en la estabilidad del naproxeno; la mayor degradación ocurrió en el medio ácido, oxidante y por acción de la luz. Se evaluó un método por cromatografía líquida de alta resolución, el cual mostró adecuado desempeño para cuantificar naproxeno en supositorios y fue selectivo frente a los productos de degradación. Se obtuvo un límite de cuantificación de 3,480 µg, por lo que fue válido para la realización de dichos estudios. Adicionalmente, se evaluaron los parámetros especificidad para estabilidad, límites de detección y de cuantificación para el método por volumetría ácido-base semiacuosa directa validado anteriormente para control de calidad, lo cual mostró resultados satisfactorios. No obstante, los métodos volumétricos no se consideran indicadores de estabilidad, por lo que este método será utilizado conjuntamente con los métodos cromatográficos de elección para determinar productos de degradación: cromatografía de capa delgada y cromatografía líquida de alta resolución

Analytical and validating studies were performed in this paper, with a view to using them in the stability studies of the future formulations of naproxen suppositories for children and adults. The most influential factors in the naproxen stability were determined, that is, the major degradation occurred in acid medium, oxidative medium and by light action. One high-performance liquid chromatography-based method was evaluated, which proved to be adequate to quantify naproxen in suppositories and was selective against degradation products. The quantification limit was 3,480 µg, so it was valid for these studies. Additionally, the parameters specificity for stability, detection and quantification limits were evaluated for the direct semi-aqueous acid-base method, which was formerly validated for the quality control and showed satisfactory results. Nevertheless, the volumetric methods were not regarded as stability indicators; therefore, this method will be used along with the chromatographic methods of choice, that is, thin-layer chromatography and high-performance liquid chromatography, to determine the degradation products

Validación de métodos analíticos para el control de calidad de naproxeno supositorios / Validation of analytical methods for the quality control of Naproxen suppositories

En el presente trabajo se desarrollaron por primera vez, los métodos de análisis que serán utilizados para el control de calidad de las futuras formulaciones de supositorios de naproxeno, para uso infantil y adulto de producción nacional. Se propuso un método por espectrofotometría ultravioleta directa, el cual resultó específico, lineal, exacto y preciso para su aplicación en el control de calidad del naproxeno en supositorios, teniendo en cuenta la presencia de grupos cromóforos en su estructura. Se modificó el método por volumetría ácido-base semiacuosa directa reportado para control de calidad de la materia prima de naproxeno y se adaptó al control de calidad en los supositorios. A partir del proceso de validación realizado, se demostró la adecuada especificidad frente a los componentes de la formulación, así como su linealidad, exactitud y precisión en el rango de 1 a 3 mg/mL. Se compararon los resultados obtenidos por ambos métodos sin detectar diferencias estadísticamente significativas entre las réplicas analizadas por cada dosis, por lo que cualquiera de ellos pueden aplicarse al control de calidad de los supositorios

The analysis methods that will be used for the quality control of the future Cuban-made Naproxen suppositories for adults and children were developed for the first time in this paper. One method based on direct ultraviolet spectrophotometry was put forward, which proved to be specific, linear, accurate and precise for the quality control of Naproxen suppositories, taking into account the presence of chromophore groups in their structure. Likewise, the direct semi-aqueous acid-base volumetry method aimed at the quality control of the Naproxen raw material was changed and adapted to the quality control of suppositories. On the basis of the validation process, there was demonstrated the adequate specificity of this method with respect to the formulation components, as well as its linearity, accuracy and precision in 1-3 mg/ml range. The final results were compared and no significant statistical differences among the replicas per each dose were found in both methods; therefore, both may be used in the quality control of Naproxen suppositories

Effect of induction of meconium evacuation using per rectal laxatives on neonatal hyperbilirubinemia in term infants: A systematic review of randomized controlled trials.

Objective: To study the efficacy of early meconium evacuation using per rectal laxatives on the level of serum bilirubin and the need for phototherapy in healthy term infants. Materials and Methods: Systematic review of randomized controlled trials comparing per rectal laxatives versus no intervention was conducted using English language articles identified from the Cochrane Central Register of Controlled Trials, Medline, Ovid, and CINAHL databases and bibliographies of selected articles. Eligible studies were assessed for the risk of bias in conduct and reporting. Results: A total of three trials (n = 469) mostly with "unclear risk" were eligible for inclusion. Two trials used glycerin suppository whereas one used glycerin enema for meconium evacuation. Meta-analysis was not possible due to clinical heterogeneity in the choice of laxatives and frequency of intervention. In all the three studies, serum bilirubin levels at 48 h and the need for phototherapy was not significantly different between the two groups. Passage of first meconium and the transitional stools occurred significantly early in the intervention group compared to controls. Conclusion: Early evacuation of meconium using per rectal laxatives does not offer any significant clinical advantage for neonatal jaundice.