The gelling properties of Dillenia indica mucilage in benzyl benzoate emulgel formulations

Abstract The objective of the study was to evaluate the gelling properties of Dillenia indica mucilage in benzyl benzoate emulgel formulation. Mucilage was extracted from the fruits of Dillenia indica using established methods and characterized by rheology and swelling. Emulsion (F1) was prepared using the continental emulsification method. Gelling agents (2 %w /v) were prepared by dispersing in distilled water with constant stirring at a moderate speed using a magnetic stirrer. F1 was added to the gel (0-75 %w /w) to obtain emulgel formulations and evaluated using viscosity, globule size, pH, release profiles and kinetic modeling. Data were expressed as mean ± SD, and similarity factor (f2) was used to compare all formulations. Formulation viscosity was significantly higher with carbopol than with Dillenia; globule sizes increased with concentration of gelling agents, and pH reduced as the concentration of Dillenia increased. All formulations showed controlled release properties with t80 ranging between 114 and 660 min. The release was governed by Korsmeyer-Peppas model. Formulation F5 prepared with 50 % Dillenia showed highest similarity to F4 prepared with 75 %w /w carbopol. Dillenia indica demonstrated acceptable gelling properties comparable with that of carbopol and could be improved for use in emulgel formulations.

Análisis crítico de un artículo: La suspensión de inhibidores de la bomba de protones induciría síntomas de reflujo / Critically appraised article

Background & Aims: Rebound acid hypersecretion (RAHS) has been demonstrated after 8 weeks of treatment with a proton-pump inhibitor (PPI). IfRAHS induces acid-related symptoms, this might lead to PPI dependency and thus have important implications. Methods: A randomized, double-blind, placebo-controlled trial with 120 healthy volunteers was conducted. Participants were randomized to 12 weeks of placebo or 8 weeks of esomeprazole 40 mg/d followed by 4 weeks with placebo. The Gastrointestinal Symptom Rating Scale (GSRS) was filled out weekly. A score of >2 on 1 of the questions regarding heartburn, acid regurgitation, or dyspepsia was defined as a clinically relevant acid-related symptom. Results: There were no significant differences between groups in GSRS scores at baseline. GSRS scores for acid-related symptoms were significantly higher in the PPIgroup at week 10 (1.4 ± 1.4 vs 1.2 ± 0.9; P = .023), week 11 (1.4 ± 1.4 vs 1.2 ± 0.9; P = .009), and week 12 (1.3 ± 1.2 vs 1.0 ± 0.3; P = .001). Forty-four percent (26/59) of those randomized to PPI reported >1 relevant, acid-related symptom in weeks 9-12 compared with 15% (9/59; P < .001) in the placebo group. The proportion reporting dyspepsia, heartburn, or acid regurgitation in the PPIgroup was 13 of 59 (22%) at week 10,13 of59 (22%) at week 11, and 12 of 58 (21%) at week 12. Corresponding figures in the placebo group were 7% at week 10 (P = .034), 5% at week 11 (P = .013), and 2% at week 12 (P = .001). Conclusions: PPI therapy for 8 weeks induces acid-related symptoms in healthy volunteers after withdrawal. This study indicates unrecognized aspects of PPI withdrawal and supports the hypothesis that RAHS has clinical implications.

A pilot study on the effect of telmisartan & ramipril on 24 h blood pressure profile & dipping pattern in type 1 diabetes patients with nephropathy.

Background & objectives: Angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) have been used to normalize the blood pressure and the dipping pattern in patients with type 1 diabetes mellitus (T1DM) and nephropathy. However, there are no data on the effect of the dual blockade on the dipping pattern in these subjects. We therefore, carried out this study to evaluate the effect of administrating an ACEI followed by ARB in the optimum doses in T1DM patients with nephropathy on 24 h blood pressure (BP) profile and nocturnal dipping pattern. Methods: An open label interventional pilot study was done during a one year period involving 30 consecutive patients who were treated with telmisartan 80 mg (0800-1000 h) for eight weeks followed by addition of ramipril 10 mg (1200-1400 h) for the next eight weeks. Ambulatory BP, dipping pattern and albumin excretion rate were studied after each phase. Twenty patients were hypertensive and 10 patients had macro- and 20 patients had microalbuminuria. Results: Telmisartan produced a fall in the clinic BP by 4/1.3 mm Hg (P<0.05 and P<0.362, respectively), 2/1.9 mm Hg in the mean 24 h BP, 1.4/1.1 mm Hg in the day BP and 3.7/3 mm Hg in the trough BP. Addition of ramipril to telmisartan produced a further reduction of 6.3/5.9 mm Hg in the clinic BP (P<0.001 for both), 4.3/4.2 mm Hg in the mean 24 h BP (P<0.01 and P<0.0001, respectively), 5.8/3.9 mm Hg in the day BP (P<0.01 for both), 4.2/2.5 mm Hg in the trough BP, with a reduction of clinic SBP and DBP of 10.3/7.2 mm Hg from the baseline. Telmisartan restored normal systolic dipping pattern in 33.3 per cent of the nondippers (P<0.01) but addition of ramipril was not complimentary. Hyperkalamia (>5.5 mmol/l) was observed only in 2 patients towards the end of the study. Interpretation & conclusions: The dual blockade with telmisartan and ramipril had complimentary effect on lowering of the BP, however, similar beneficial effect on the nocturnal dipping was not observed. Further studies with large number of subjects with longer duration of follow-up are required to validate these observations.

Evaluation of fixed dose combination (FDC) of telmisartan+ramipril usage in patients with micro-albuminuria and persistent hypertension: A TRIUMPH study.

Micro-albuminuria is a marker for declining kidney function and predicts increasing cardiovascular risk especially in diabetic hypertensives. Angiotensin receptor blockers and angiotensin-converting enzyme inhibitors may slow the progression of proteinuric kidney disease and thus would be valuable in these high risk patients. The present study was undertaken to assess the efficacy and tolerability of a fixed dose combination (FDC) of telmisartan and ramipril in adult Indian patients with sustained stage 2 hypertension, comorbidities and micro-albuminuria. A total 382 patients were enrolled in this multicentric, prospective open, non-comparative phase IV postmarketing surveillance study by 40 physicians in India and treated with FDC of telmisartan 40 mg+ ramipril 5 mg once daily for 12 weeks. A total 370 patients completed the study but 12 patients were lost to follow-up and considered as drop-outs. There was a significant (p<0.05) reduction in the systolic blood pressure (SBP) from 170.89 at baseline to 132. 77 mm Hg at week 12 and diastolic blood pressure (DBP) from 104.47 to 83.30 mm Hg at the end of 12 weeks therapy as well as urine albumin levels from 186.25 mg/24-hour to 62.42 mg/24-hour (66.49%) at the end of 12 weeks. Overall assessment of treatment was rated as good to excellent in 87.3% and fair in 11.4% patients. The most common adverse event reported was cough (5.2%). Results of the present study indicate that the FDC of telmisartan+ramipril brings about significant reductions in the systolic and diastolic blood pressure as well as urine albumin excretion.

Avaliação da reutilização de implantes auriculares contendo norgestomet associados ao valerato ou ao benzoato de estradiol em vacas nelore inseminadas em tempo fixo / Evaluation of norgestomet auricular implants reused associated to valerate or to estradiol benzoate in fixed time artifical insemination in Nelore cows

Em fêmeas bovinas a utilização da técnica de inseminação artificial em tempo fixo (IATF) é possibilitada pelo emprego de fármacos que tem como objetivos sincronizar a emergência das ondas foliculares, os estros e a ovulação. Em rebanhos comerciais, o custo de tais fármacos deve estabelecer uma vantajosa relação com os benefícios. O presente estudo, objetivou comparar as taxas de prenhez em vacas Nelore (Bos taurus indicus) inseminadas em tempo fixo, tratadas com implantes auriculares contendo 3mg de norgestomet (Crestar®), novos (IN) ou utilizados uma vez (IR; reutilizados), associados a administração de norgestomet (NG) e valerato de estradiol (VE) ou progesterona (P4) e benzoato de estradiol (BE). Vacas Nelore PO (n=241), amamentando, com o bezerro ao pé, receberam um dos quatro tratamentos: Crestar® novo durante 10 dias associado a administração de 3mg de NG e 5mg de VE (grupo IN/NG+VE; n=61); Crestar® novo inserido durante 8 dias associado a 50mg de P4 e 2mg de E (grupo IN/P4+BE; n=61); Crestar® reutilizado inserido durante 10 dias associado a administração de 3mg de NG e 5mg de VE (grupo IR/NG+VE; n=58) ou Crestar® reutilizado inserido durante 8 dias associado a e 50mg de P4 e 2mg de BE (grupo IR/ P4+BE; n=61). No dia da remoção dos implantes os animais receberam 7,5mg de Luprostiol e 24 horas após a remoção 1mg de BE. A IATF foi realizada 54 a 56 horas após a retirada dos implantes. Após a IATF, as vacas tiveram os estros observados durante um período de 49 dias e em estro foram reinseminadas 12 horas após a observação. O diagnóstico de gestação foi realizado por ultra-sonografia 35 dias após a IATF e após o final da estação de monta. Foram avaliadas as taxas de prenhez na IATF (TP IATF) e no final da estação de monta (TP EM). Não houve interação entre as características dos implantes (novos e reutilizados) e os tratamentos administrados no dia da inserção do implante (NG+VE e P4+BE). A utilização do CIDR® novo ou reutilizado não teve...

The use of fixed -time artificial insemination (IATF) in cows is possible by the use of drugs that aim at the synchronization of the folicular wave pool, the estrus and ovulation. In trading cattle the costs of these drugs must stablish a profitable relation with the benefits. The present study meant to compare the pregnancy rates in Nelore (Bos taurus indicus) cows inseminated at fixed-time, treated with new (IN) or once used (IR; reused) auricular releasing devices with 3mg of norgestomet (Crestar®), associated with the administration of norgestomet (NG) and estradiol valerate (VE) or progesterone (P4 and estradiol benzoate (BE). Pure breed Nelore cows (n=241), on lactation with calf received one of the four treatments: new Crestar® during 10 days administrated with 3mg of NG and 5 mg of VE (group lN/NG+VE; n=61); new Crestar® inserted during 8 days with 50mg of P4 and 2mg of BE (group lN/P4 +BE; n=61); reused Crestar® inserted during 10 days in association with 3 mg of norgestomet and 5 mg of VE (group IR/NG+ VE; n=58) or reused Crestar® inserted during 8 days in association with 50mg of P 4 and 2mg of BE (group lR/P4+BE; n=61). On the day the releasing devices were removed the animals received 7,5mg of Luprostiol and after 24 hours 1mg of BE. A fixed-time artificial insemination was done 54 to 56 hours after the removal of the releasing devices. Cows detected in estrus after the insemination at fixed-time were observed during a period of 49 days and reinseminated. The pregnancy diagnosis was done by ultrassonography 35 days after the IATF and after the end of the breeding season. The pregnancy rates of IATF (TPIATF) and at the end of the breeding season (TP EM) were estimated. There was no interaction between the characteristics of the (new or reused) releasing devices and the treatment given at the day the releasing devices were inserted (NG+ VE e P4 + BE). The use of new or used CIDR® had no effect on TP IATF (48,3%vs 48,7%) and on TP EM (85)...

Assessment of efficacy, safety and tolerability of fixed dose combination of telmisartan 40mg and hydrochlorothiazide 12.5mg in adult Indian patients with mild to moderate hypertension.

The objective of the study was to assess the efficacy, safety and tolerability of a fixed dose combination of telmisartan 40 mg and hydrochlorothiazide 12.5 mg in adult Indian patients with mild to moderate hypertension. A prospective, multicentric, open-label, non-comparative, phase IV study was conducted. A total of 353 patients of either sex, between 18- 65 years of age with supine blood pressure (BP) levels of systolic BP (SBP) of 140-200 mmHg and diastolic BP (DBP) of 95-114 mmHg were included. After a placebo run-in period of 2 weeks, each patient received a fixed dose combination of telmisartan/hydrochlorothiazide (40mg/12.5mg) once daily, for 8 weeks. Supine BP was assessed at the end of every 2 weeks. Tolerability and safety were assessed by physical examination, laboratory parameters and evaluation of adverse events. A total of 339 patients completed the study with 14 drop-out cases because of loss to follow-up. There was a significant fall (p<0.05) in both the SBP and DBP starting from the second week as compared to the baseline. Mean SBP had a significant reduction of 23.55 mmHg (15.0%) and 27.79 mmHg (18%) at the end of 6th and 8th week respectively, compared to baseline values. Mean DBP had also had a significant reduction of 12.51 mmHg (12.6%) and 15.17 mmHg (15.3%) at the end of 6th and 8th week respectively, compared to baseline values. This combination was well tolerated with only 3.9% of the total cases reporting mild adverse events like fatigue, dizziness, nausea, diarrhoea etc. The laboratory values were within normal limits. Fixed dose combination of telmisartan/hydrochlorothiazide (40 mg/12.5 mg) once daily has a significant therapeutic effect and a good tolerability profile in adult Indian patients with mild to moderate hypertension.

Tratamiento de escabiosis en el Hospital Militar de Arequipa, estudio comparativo de benzoato de bencilo, hexacloruro de benceno gama y permetrina en 130 pacientes

Hemos realizado el estudio comparativo con tratamiento de Permetrina al 5 por ciento, Hexacloruro Gama Benceno al 1 por ciento y Benzoato de Bencilo al 30 por ciento en 130 pacientes en el Hospital Militar Regional de Arequipa, realizando un estudio de ensayo clínico, prospectivo y longitudinal distribuido en 4 grupos: Grupo 1 - Permetrina con 33 pacientes. Grupo 2 - Hexacloruro de Benceno Gama con 34 pacientes. Grupo 3 - Benzoato de Bencilo con 33 pacientes. Grupo 4 - Blanco con 30 pacientes. Las lesiones y el prurito para Permetrina comienzan a desaparecer a las 24 horas con 27 pacientes haciendo un 81.81 por ciento y desapareciendo a los 7 dias con 32 pacientes haciendo un 96.97 por ciento. Para Hexacloruro Gama Benceno las lesiones y el prurito comenzaron a desaparecer a las 48 horas, con 20 pacientes, haciendo un 58.52 por ciento y desapareciendo a los 7 dias con 30 pacientes haciendo un 88.23 por ciento. Para Benzoato de Bencilo las lesiones y el prurito comenzaron a desaparecer a los 7 dias con 13 pacientes haciendo un 39.39 por ciento y desaparecieron a los 10 dias con 14 pacientes haciendo un 42.42 por ciento. para Permetrina se logró con la primera aplicación de tratamiento con un 96.97 por ciento de curación, necesitando una segunda aplicación de tratamiento en un 3.03 por ciento con lo que se logro el 100 por ciento de curación. Para H.G.B. se logró la remisión de la enfermedad con la primera aplicación del tratamiento en un 88.23 por ciento necesitando una segunda aplicación de tratamiento en un 11.77 por ciento con lo que se logró el 100 por ciento de curación. Para Benzoato de Bencilo con la primera serie de aplicación del tratamiento se logró en un 42.42 por ciento de remisión de lesiones y necesitó una segunda serie de aplicación de tratamiento en un 57.58 por ciento con lo que se logró el 100 por ciento de curación. Hallamos con el diagnóstico clínico 100 por ciento de escabiosis y utilizamos ademas el método de escarificación con hidroxido de sodio al 10 por ciento, se encontro 2 casos positivos (4 por ciento). Solo hubo 3 pacientes (6 por ciento) con complicaciones de eccematización. A un paciente se le excluyó por que no cumplió con el tratamiento; Ilustramos el trabajo con fotografías con los casos mas importantes.

Crusted scabies associated with systemic lupus erythematosus: response to benzyl benzoate therapy.

A 30-year-old Thai woman with systemic lupus erythematosus developed crusting, erythematous scaling plaques on the scalp and neck. Histologic section showed numerous mites in the stratum corneum. The diagnosis was further confirmed by identification of Sarcoptes scabiei in scraping and potassium hydroxide preparations made from the cutaneous lesions. After applications of 25 per cent benzyl benzoate for one month, there was complete resolution of the parasitic infestation.

Alteraciones en el coagulograma por el manejo de la encefalopatía hepática con benzoato de sodio / The effect of sodium benzoate on the coagulation test, in patients with hepatic encephalopathy

En un estudio longitudinal, comparativo al azar, se evaluó el efecto del benzoato de sodio (BS) sobre las pruebas de coagulación en un grupo de 10 sujetos con encefalopatía hepática severa, y se comparó con un grupo similar de 10 pacientes con encefalopatía hepática manejados con lactosa al 20 por ciento. En el grupo con BS, 8 sujetos fallecieron con agravamiento de la encefalopatía, 6 presentaron prolongación del tiempo parcial de tromboplastina (TTP) de 30" o más, no se registró modificación del tiempo de protrombina (TP). En el grupo que recibió lactosa hubo 3 defunciones (P=0.05), 1 sujeto presentó prolongación similar del TTP (P=0.025), 5 presentaron mejoría del mismo y tampoco hubo cambios del TP. Estos resultados sugieren que el BS prolonga el TTP y que la lactosa al 20 por ciento es una mejor opción que dicho fármaco en los pacientes con encefalopatía grave