Salivary PCR detection of Helicobacter pylori DNA in Egyptian patients with dyspepsia

Several methods are available for detecting Helicobacter pylori infection: [1] invasive methods based on gastric biopsies, [2] non invasive methods like Urea Breath Test [UBT], serology and stool antigen tests. Importance of salivary PCR in detection of H. pylori is still questionable. To evaluate the role of salivary PCR technique in detecting H. pylori gastric affection in Egyptian patients with dyspepsia and in differentiating between functional dyspepsia and acid-ulcer syndrome. This study included 60 patients with dyspepsia classified into three groups: [Group 1] patients with gastric H. pylori and ulcers or erosions [n = 20], [Group 2] patients with gastric H. pylori and no ulcers or erosions and had functional dyspepsia [n = 20], [Group 3] patients without H. pylori and had functional dyspepsia [n = 20]. All underwent upper gastrointestinal endoscopy with biopsies, rapid urease test and salivary samples for H. pylori PCR. Significant difference between the three groups regarding salivary PCR values. No significant difference between Group 1 and Group 2 but both had significant difference with Group 3, significant difference between gastric H. pylori positive patients [n = 40] and negative ones [n = 20]. Salivary PCR test had sensitivity of 85%, specificity of 70% in diagnosing H. pylori. PCR value of 534000 Iu/ml had best sensitivity [75%] and specificity [100%] for diagnosing H. pylori, highly significant positive correlation between H. pylori gastric affection and salivary PCR values. No significant difference between patients with acid ulcer syndrome [n = 20] and those with functional dyspepsia [n = 40] as regard salivary PCR mean values. Salivary PCR test showed sensitivity of 100%, specificity of 50% in differentiating between patients with acid ulcer syndrome and those with functional dyspepsia. PCR value of 440000 Iu/ml had best sensitivity [100%] and specificity [55%] in differentiating acid ulcer syndrome from functional dyspepsia with non significant. H. pylori salivary PCR may be of value in diagnosing H. pylori gastric affection and is strongly correlated with it but it is of limited value in differentiating between acid ulcer syndrome and functional dyspepsia

Rapid and selective assay of clozapine in human plasma using high performance liquid chromatography and ultraviolet detection

Arapid high performance liquid chromatographic method has been developed for the determination of clozapine in human plasma. A simple extraction step with acetonitrile was done. The analysis was performed on a C[18] [3.9 x 150 rnm] reversed phase analytical column with the wavelength fixed at 280 nm. The mobile phase consisted of methanol-water-triethylamine, 70:30:0.05 [v:v:v], flowing at a rate of 0.6 ml/minute, using celecoxib as an internal standard. Calibration curves were linear in the range of 10-300 ng/ml and the lower detection limit was 5 ng/ml. The intra-assay and inter-assay precision as well as recovery and reproducibility values were satisfactory. The developed method was used to compare between two commercially available products of clozapine in 24 healthy volunteers

Surgical aspects of acute scrotum in children [a prospective study]

Acute painful swelling of scrotum is common surgical emergency and it requires hospital admission. Although most etiologies of acute scrotal swelling are not emergent, some atypical presentations of testicular torsion, delayed recognition of the condition and its confusion with other causes of acute scrotum can delay diagnosis and may lead to testicular necrosis and orchidectomy . Colored Doppler scanning can play important role in differentiation in these doubtful cases. To review clinical presentations, diagnosis, and management of common causes of acute scrotum in children in Sohag and highlight role of colored Doppler scanning in the management. Sixity child diagnosed as acute scrotum were admitted at surgery department of Sohag University Hospital from April 2000 to April 2005. The age ranged from two years to 12 years. Cases of obstructed inguinal hernia and testicular tumour are excluded from the study. Patients are classified into four main groups: epididymoorchitis [1], torsion of testicular appendage [2], torsion of testis [3], and idiopathic scrotal oedema [4]. A comparative study was done between four groups as regard to mean age, history of trauma, duration of symptoms, affected site of pathology and local signs. These data were analyzed using Chi square test and statistical significant results were recorded. Also, recording degree of accuracy and percentage of successful rate of colored Doppler scanning in the diagnosis. Group [1] was 26 cases [43.3%], group [2] was 21 cases [35%], group [3] was 8 cases [13.3%] and group [4] was 5 cases [8.3%]. Mean age was 8.4 in group 1, 10.6 in group 2, 5.6 in group 3 and 6 years in group 4. History of trauma was 11.5% in group 1, 50% in group 2, 87.5% in group 3 and 20% in group 4. The lesion was bilateral in 15% of group 1, 34% of group 2, 12.5% of group 3 and in all cases of group 4. 39 patients were diagnosed by history and clinical examination confirmed by scrotal ultrasound. 21 patients were diagnosed by colored Doppler scanning. [10 cases were epididymoorchitis, 7 cases were torsion of testicular appendix and 4 cases were torsion of the spermatic cord] with successful rate 85% and Specificity test 97%. 31 patients [51.7%] were subjected to conservative medical treatment, Exploration was done in 29 patients [48.3%], orchiopexy was done in 26 patients and orchidectomy was done in 3 patients. Testicular salvage rate was 89.5%. History and clinical examination are considered enough data for diagnosis and management of cases of acute scrotum in children. An absent Cremasteric reflex was the most sensitive physical finding for diagnosing torsion of the testes. Scrotal ultrasound could confirm the diagnosis in patients with scrotal oedema and early epididymoorchitis. In small number of patients, when physical findings are equivocal, or the ultrasound findings are inconclusive, colored Doppler scanning is mandatory

Liposomal encapsulation of the tuberculocidal drug, pyrazinamide, for increasing safety and potency

Mycobacterium tuberculosis infects approximately one-third of the world's population and causes about three-million deaths each year. Pyrazinamide is a key drug in the short- course chemotherapy of pulmonary tuberculosis and is included in several drug regimens recommended by the IUAT and WHO. Liposomes are taken up avidly by macrophages and are targetted naturally to the reticuloendothelial system. These facts propelled our interest in formulating pyrazinamide in liposomal form and studying various aspects on this formulation preceeding future work on treatment of Mycobacterium tuberculosis. Pyrazinamide liposomes were formulated using L-alpha-lecithin and also L-alpha- dipalmitoyl phosphatidyl choline [DPPC], as the major phospholipids. Encapsulation efficiencies of the prepared liposomes were estimated by spectrophotometric measurement of free pyrazinamide at 268.4 nm. Charged liposomes effected higher pyrazinamide entrapment compared to neutral liposomes, with the exception of 7:2 neutral pyrazinamide liposomes which exhibited the highest trapping efficacy. Pyrazinamide liposomes were characterized by transmission electron microscopy and differential scanning calorimetry [DSC]. The DSC-thermograms obtained revealed interaction between DPPC and the other phospholipids included in the preparations indicating liposome formation. In-vitro release kinetics study was conducted to anticipate the liposomes' behavior under the hydrodynamic stress in-vivo. The drug release pattern was biphasic and followed first order kinetics. The negative liposomes exhibited higher drug release compared to the neutral liposomes. The formulation 7:2 neutral pyrazinamide liposomes showed maximum drug retention. Lung disposition of pyrazinamide liposomes was conducted in an experiment employing 7:2 neutral pyrazinamide liposomes and free pyrazinamide. The results indicated that liposomal pyrazinamide was detected, in mice lungs, in higher amounts lasting for a period of 14-days compared to free pyrazinamide. These studies are a predictor for further studies involving the efficacy of pyrazinamide liposomes for treatment of Mycobacterium tuberculosis

Mechanism of the Spinal antinociceptive action of indomethacin using microdialysis technique in freely moving mice

Although it is well known that the anti-inflammatory action of NSAIDs is mediated through cyclooxygenase [COX] enzyme inhibition there is debate about the mechanism of their antinociceptive action. The involvement of the arachidonic acid in the synthesis of endocannabinoids raises a question about the role of cannabinoid receptors in the antinociceptive effect of NSAIDs. The aim of this study is to investigate the relation of the cannabinoid receptors to the antinociceptive action of indomethacin. The antinociceptive effect of indomethacin [9 micro M] was tested after CB 1 receptor blockade in normal freely moving mice using the formalin test and microdialysis technique. It was further tested in CB 1 -/- knockout mice using intrathecal indomethacin [30 nmol] to confirm the participation of CB 1 receptors in the antinociceptive action of indomethacin. The experiment was repeated with supplementation of exogenous PGE 2 both through the microdialysis probe [5.681 micro M] and intrathecaly [283.6 fmol] to confirm that spinal PGE2 production is not related to the antinociceptive action of indomethacin. CB 1 receptor blockade significantly reduced the antinociceptive effect of indomethacin in the formalin test. Additionally, indomethacin was effective in CB 1+/+ but not in CB 1 -/- knockout mice which confirms the role of cannabinoid receptors in the antinociceptive action of indomethacin. However, CB 1 receptor blockade showed insignificant effect on indomethacin-induced inhibition of spinal PGE 2 production. In addition, exogenous supplementation of PGE 2 did not reverse the antinociceptive effect of indomethacin in the formalin test. These findings dissociate the antinociceptive action of indomethacin from its inhibitory effect on spinal PGE 2 production. In the cannabinoid receptors [CB 1] may be involved in the antinociceptive action of indomethacin but not in its inhibitory effect on spinal PGE 2 production. It is possible that inhibition of COX enzyme by indomethacin shifts the accumulated arachidonic acid to produce endocannabinoid with subsequent activation of CB 1 receptors which mediates the antinociceptive effect

Formulation and evaluation of controlled release ibuprofen granules and coprecipitates

Ibuprofen controlled release granules were prepared by either pan coating or solid dispersion technique. In the first case, ibuprofen core granules were coated with different ratios of certain polymers; namely, ethyl cellulose, Eudragit RS 100 and 1:1 mixture of both polymers. The process of pan coating was continued until the weight of the granules has increased by 20, 30 and 40% for each type of polymers. In the second case, coprecipitates of ibuprofen were prepared by solvent evaporation technique using the same polymers in ratios 3:1, 2:1 and 1:1. The adhered drug and microencapsulated drug were determined and the coated granules were evaluated for angle of repose, flow rate, bulk density, Hausner factor, compressibility and drug content and dissolution. The coprecipitate was evaluated for drug content and dissolution. Both coated granules and coprecipitate were evaluated for ulcerogenic activity using albino rats

Preparation and pharmacokinetic evaluation of carbamazepine controlled release solid dispersion granules

Solvent evaporation technique was applied to prepare granules of carbamazepine coprecipitates using Eudragit RLPM, Eudragit RS 100, Cellulose acetate phthalate and Ethyl cellulose in 1: 1 and 1:2 drug: polymer w/w. In vitro release of carbamazepine from its coprecipitates with the previously mentioned polymers as well as the commercially available tablets [Tegretol CR200 tablets, Ciba] was carried out in gradient pH media [1.2, 2.5, 4.5, 7, 7.4] for 7 hours. The data were kinetically treated. Pharmacokinetic studies of the selected formula made with ethyl cellulose [1:1] and Tegretol CR 200 mg tablets [Ciba], as a reference standard, as well as carbamazepine powder were done using albino rabbits. Carbamazepine plasma level was determined using HPLC. The in vitro and in vivo data revealed that the suggested formula and the innovator's product exhibit% dissolution, tmax, Cpmax, AUC and /delta[1/2] as follows, 58.4%, 8 hr, 24.15 +/- 5.5/-microg/ml, 277.24hr microg/ml, 5.6hr and 64.22%, 8hr, 28.93 +/- 315.14 microg/ml, 313.6 hr, microg/ml, 5.2 hr respectively. It is worthy to note that the suggested formula showed a more prolonged duration of action

Bio-pharmaceutical evaluation of tenoxicam suppositories

With the object of reducing hepatic first-pass elimination of tenoxicam, the drug was formulated in suppository form using different suppository bases. The bases used include Witepsols, Suppocires, Novatas in addition to PEGs an cacao butter. The effect of different additives, surfactants and gels, on drug suppository formulation in Witepsol H15 was also investigated. Suppositories containing tenoxicam solid dispersions were also evaluated, using PEG 4000 and 6000, PVP K25, the hydrotropes sodium benzoate and sodium salicylate, urea, lactose, sorbitol, mannitol, and the electrolytes sodium chloride, magnesium carbonate and aluminum hydroxide. The suppositories prepared were evaluated for in vitro drug release, when fresh and on storage. Selected formulae were also evaluated through tenoxicam relative bioavailability and its anti-inflammatory activity compared to indomethacin as reference drug

Formulation and evaluation of tenoxicam capsules

With the aim of preparing tenoxicam capsules, different additives commonly used in capsule formulation were used for the preparation of tenoxicam capsules. Twenty-four different capsule formulae were prepared and were subjected to an in vitro dissolution study using the USP dissolution tester. The anti-inflammatory activity was determined using the rat paw edema technique taking indomethacin as a standard for comparison. The study revealed that there was a significant difference between indomethacin and tenoxicam from its capsule formulations indicating the superior anti-inflammatory activity of tenoxicam. The bioavailability of tenoxicam was determined using an HPLC assay, where the pharmacokinetic parameters were determined using rabbits plasma. A good correlation was found between the percentage inhibition in edema activity and the peak plasma concentration as a measure of drug absorption where the correlation coefficient was found to be 0.928

Bioavailability of salbutamol sulphate from different suppository formulations

Adult suppositories each containing 10 mg of salbutamol sulfate were prepared using different bases, namely, Witepsol H15, Witepsol H5 Witepsol W35, Witepsol E75, Suppocire NA 10, Suppocire AM, Novata type D and cacao butter. In addition, suppositories containing mixture of Witepsol H15 and different gels viz. methyl cellulose [MC], pluronic F127 [PL], carpobol 934 [CP], hydroxypropylmethylcellulose [HPMC] were prepared. The in vitro release of the drug from the different prepared formulae was done in Sorensen's phosphate buffer of pH 7.4 at 37 +/- 0.5C using dialysis method. The physical parameters viz. hardness and melting time of all the prepared formulae were also determined. The bioavailability studies of the chosen formulae were carried out on six healthy male rabbits, blood samples were analyzed using HPLC method and different pharmacokinetic parameters were determined. Results showed that the amount of salbutamol sulfate released was higher from the base cacao butter than from the emulsifying bases. Of the tested emlsifying bases, Witepsol H15 afforded the maximum amount of drug released while Witepsol H5 afforded the minimum amount. Analysis of the data by linear regression indicated that the release of salbutamol sulfate from different suppository bases followed a diffusion controlled mechanism. The incorporation of different gels with Witepsol H15 resulted in increasing the amount of salbutamol sulfate released. Among the tested gels, pluronic F127 incorporated with Witepsol H15 afforded the maximum amount of drug released while carbopol 934 slightly decreased the amount of drug released compared with the plain Witepsol H15. The release of salbutamol sulfate from the tested bases was found to correlate well with the melting time of the suppositories but not with the hardness. In vivo studies showed that salbutamol sulfate is well absorbed following rectal administration of different suppository formulae. The percentage relative bioavailability for the two tested suppository formulae was higher than that of the used control tablet. A correlation was found to exist between the in vitro release and the in vivo rectal absorption

Development and application of a spectrophotometric method for the quantitation of metoclopramide in urine

A simple, reliable rapid and specific spectrophotometric assay has been developed for the quantitation of metoclopramide in urine. After extraction of the drug with ethyl acetate from alkalinized samples, the organic extract was evaporated to dryness, reconstituted with ethanol and assayed spectrophotometrically at 273 nm. The average recoveries of metoclopramide from spiked human urine [5-30 meg/ml] samples were 96.5%, and their respective CV was 3.2. Regression analysis for the calibration plots for urine standards obtained on three different days for the drug concentration between 5.30 meg/ml for urine indicated excellent linearity [r >0.99] and reproducibility [f=1.3, p >0.01]. The method was applied to monitor urinary excretion data in human volunteers and to determine the bioavailability of metoclopramide from different commercial products. The calculated pharmacokinetic parameters of the drug using this method were found to be in accordance with that obtained by application of other complicated methods. The percentage relative bioavailability of metoclopramide from different products was found to range from 91.2 to 99.9%

Interaction of chlorpheniram maleate with carrageenan

The interaction of carrageenan [Aubygum x 23] with chlorpheniramine maleate in aqueous medium was studied. The effect of drug conception, polymer [Aubygum x 23] concentration, electrolytes and pH on the extent of such interaction was investigated. It was found that the percentage of drug interacted with the polymer increases with increasing polymer or drug concentration. On the other hand, the presence of electrolytes decreased the interaction between the drug and the polymer. Such decrease in the interaction was found to depend on the concentration of electrolyte added and its valency. The interaction was found to be pH dependent and the optimum pH was found to be 7. The m.p. and solubility of the interaction of product were found to differ from the m.p. and solubility of the original compounds [chlorpheniramine maleate and Aubygum x 23]. IR analysis showed that there is a very powerful interaction induced via hydrogen bonding and large polarity of the produced mixture