Outcome of shaft fractures among children treated with elastic stable intramedullary nailing

Background: Long bone fractures are frequent occurrence among children and considered a frequent pediatric orthopedic injury requiring hospitalization. Authors aimed to retrospectively analyze the outcome of fixation of long bone fractures with elastic stable intramedullary nailing (ESIN) among children and adolescents.Methods: From 2010 to 2018, ESIN was performed on 128 children aged 2 to 17 years having single shaft fractures of long bones. The data related to associated injuries, postoperative complications, postoperative treatment, till bony union or removal of rods, mal-union, functional deficit, need for secondary surgical intervention and subjective complaints at follow-up originated from postoperative clinical and radiological consultations carried out regularly. The primary end points were time of complete radiological union or removal of rods.Results: The mean age at the time of accident was 9.5 years. There were 37 (28.9%) femoral fractures, 16 (12.5%) of the lower leg, 51 (39.8%) fractures of radius/ulna and 24 (18.8%) of the humerus. In 2 (2.3%) children, reoperation was necessary due to prominent ends of elastic rods and 6 (4.7%) had early removal of rods due to same reasons. End point of the study, removal of rods noted in 126 (82.8%), radiological evidence of union in 7 (5.5%) and 15 (11.7%) cases were lost at follow-up.Conclusions: ESIN fixation of diaphyseal fractures in children and adolescents is safe. ESIN was found to be minimally invasive method, noted to produce excellent functional as well as cosmetic outcomes.

Formulation and in vitro evaluation of mucoadhesive controlled release matrix tablets of flurbiprofen using response surface methodology

The objective of the current study was to formulate mucoadhesive controlled release matrix tablets of flurbiprofen and to optimize its drug release profile and bioadhesion using response surface methodology. Tablets were prepared via a direct compression technique and evaluated for in vitro dissolution parameters and bioadhesive strength. A central composite design for two factors at five levels each was employed for the study. Carbopol 934 and sodium carboxymethylcellulose were taken as independent variables. Fourier transform infrared (FTIR) spectroscopy studies were performed to observe the stability of the drug during direct compression and to check for a drug-polymer interaction. Various kinetic models were applied to evaluate drug release from the polymers. Contour and response surface plots were also drawn to portray the relationship between the independent and response variables. Mucoadhesive tablets of flurbiprofen exhibited non-Fickian drug release kinetics extending towards zero-order, with some formulations (F3, F8, and F9) reaching super case II transport, as the value of the release rate exponent (n) varied between 0.584 and 1.104. Polynomial mathematical models, generated for various response variables, were found to be statistically significant (P<0.05). The study also helped to find the drug's optimum formulation with excellent bioadhesive strength. Suitable combinations of two polymers provided adequate release profile, while carbopol 934 produced more bioadhesion.

O objetivo do presente estudo foi formular comprimidos mucoadesivos de flurbiprofeno, de liberação controlada, e otimizar o perfil da liberação do fármaco e a bioadesão, utilizando a metodologia de superfície de resposta. Prepararam-se os comprimidos via técnica de compressão direta, que foram avaliados in vitro quanto aos parâmetros de dissolução e da força bioadesiva. Planejamento com componente central para dois fatores em cinco níveis cada foi empregado para esse estudo. Carbopol 934 e carboximetilcelulose sódica foram tomados como variáveis independentes. Efetuaram-se estudos de espectroscopia por transformada de Fourier (FTIR) para observar a estabilidade do fármaco durante a compressão direta e para avaliar a interação a fármaco-polímero. Aplicaram-se vários métodos cinéticos para avaliar a liberação do fármaco dos polímeros. Gráficos de superfície de contorno e de resposta foram efetuados para retratar a relação entre as variáveis dependentes e a resposta. Os comprimidos mucoadesivos de flurbiprofeno apresentaram cinética de liberação não-fickiana, estendendo para ordem zero, para algumas formulações (F3, F8 e F9), alcançando transporte super caso II, à medida que o valor do expoente (n) de taxa de liberação variou entre 0,584 e 1,104. Modelos matemáticos polinomiais, gerados por diversas variáveis de resposta, foram estatisticamente, significativos (P<0,05). O estudo também auxiliou a encontrar a formulação ótima do fármaco, com excelente força de bioadesão. Combinações adequadas dos dois polímeros resultaram em perfis de liberação adequado, sendo que o Carbopol 934 produziu mais adesão.

In vitro-in vivo correlation study on nimesulide loaded hydroxypropylmethylcellulose microparticles / 药学学报

This study involves mathematical simulation model such as in vitro-in vivo correlation (IVIVC) development for various extended release formulations of nimesulide loaded hydroxypropylmethylcellulose (HPMC) microparticles (M1, M2 and M3 containing 1, 2, and 3 g HPMC, respectively and 1 g drug in each) having variable release characteristics. In vitro dissolution data of these formulations were correlated to their relevant in vivo absorption profiles followed by predictability worth analysis of these Level A IVIVC. Nimaran was used as control formulation to validate developed formulations and their respective models. The regression coefficients of IVIVC plots for M1, M2, M3 and Nimaran were 0.834 9, 0.831 2, 0.927 2 and 0.898 1, respectively. The internal prediction error for all formulations was within limits, i.e., < 10%. A good IVIVC was found for controlled release nimesulide loaded HPMC floating M3 microparticles. In other words, this mathematical simulation model is best fit for biowaiver studies which involves study parameters as those adopted for M3 because the value of its IVIVC regression coefficient is the closest to 1 as compared to M1 and M2.

Comparison of bioavailability and pharmacokinetics of diclofenac sodium and diclofenac potassium in normal and dehydrated rabbits / 药学学报

Two different salts of diclofenac, diclofenac sodium and dielofenae potassium, in tablet dosage form were tested for their bioavailability and disposition kinetics in a group of eighteen rabbits in normal and experimentally induced dehydrated conditions with a wash out period of 7 days between both stages of study. Biochemical and physiological parameters were also measured in both normal and dehydrated states. Diclofenac levels in plasma were determined using a validated reversed phase HPLC method. Primary kinetic parameters i.e. AUC0-∞, Cmax, Tmax and other disposition kinetics were obtained with non-compartmental procedure. Biochemical parameters i.e. packed cell volume, plasma glucose and total lipid concentration in dehydrated rabbits increased significantly. Plasma concentration of diclofenac sodium and diclofenac potassium decreased significantly in water deprived rabbits. In comparison, diclofenac potassium in normal and dehydrated state of the same group of rabbits showed a significantly increased plasma concentration when compared with diclofenac sodium.

Identification and selection of local probiotic bacteria for preparation of fermented milk and study their effects on lipid profile of rabbit serum

Two local isolates of Lactobacillus acidophilus [L-53] and Bifidobacterium [B3] was obtained from neonatal stool cultured on MRS media. These isolates was used in preparation of pro bio tic fermented milk products [ABT and ABY].The effect of the prepared probiotic products on rabbit serum lipid profile was studied through two experimental designs [Therapeutic: A, Prophylactic: B]. Consumption of ABT and ABY products showed clear reduction in the levels of total cholesterol [TC] and low density lipid [LDL] by 4 weeks of utilization which teas more reduced by 8 weeks of consumption [P<0.01] referring to the importance of consumption duration in reducing these levels compared to the control groups. Proportional mixing of probiotic bacteria with ordinary yogurt bacteria enhances their effect of the levels of TC and LDL. In contrast, the levels of high density lipid [HDL] and triglycerides [TG] showed no significant differences [P>0.05]. However, the consumption of these products reduces the ratio of LDL: HDL which has a significant value in reducing the risk of acquiring atheroschlerosis. The regular consumption of probiotic products [Exp.B] showed clear prophylactic effect in maintaining lower levels ofTC and LDL compared to the control group despite the utilization ofcholestrol enriched diet

Diabetes mellitus exploration of characteristics and evaluation of management

Objectives: [1] To explore the trends and characteristics of diabetes mellitus in our community in Mosul. [2] To evaluate the patients’ behavior as regards their disease and the current state of management

Design: A cross sectional descriptive study

Setting: The laboratory unit of AI Razi general hospital in Mosul, from the 1"of April, through the10 of May 2001

Participants: Two hundreds and tifteen diabetic patients randomly enrolled during their attendance to the laboratory to have tests for their diabetes

Intervention: Demographic, clinical, and management data were gathered using interview schedule. Data regarding body weight and height were affirmed as well, and body mass index calculated. Blood glucose was assessed by measuring glycated hemoglobin A1c[Hb A1c] level in a number of randomly selected patients

Main outcome measures: The main outcome measures were the demographic features [age, sex and education], types of the disease trends of eating, frequency of conducting periodical clinical and laboratory checkups in addition to the measurement of HbA1c levels

Results: The study uncovered the ratio of the main types, prevalence of the disease among the patients' relatives. body weights, incidence of co-morbidities [hypertension and symptomatic ischemic heart disease]and sex and age distribution. Most of these were nearly similar to the western results. illiteracy was marked among the inflicted. Dietary attitudes were markedly defective and bodily exercises were extensively ignored. Ambulatory self-monitoring and the periodical laboratory and clinical checkups were unsatisfactory. Patients who got an HbA1c level of [> 7] constituted 89% of the sample

Conclusions: The current state of diabetic management is in gross failure. An energetic collaboration is required to improve it urgently