ABSTRACT
BACKGROUND: Rheumatoid arthritis is indeed a constant, progressive autoimmune disease that acts on the synovial membrane, distinguished by joint pain, swelling, and tenderness. Sulfasala- zine belongs to BCS Class IV having low solubility and low permeability. To overcome the issue and provide a localized effect Cubosomes were chosen for the transdermal drug delivery system. OBJECTIVE: The primary objective of this investigation was to pass on sulfasalazine-loaded cubo- somes over the skin to treat rheumatoid arthritis. On the way to overcome this issue of oral sulfasala- zine and provide localized effect, Cubosomes were chosen for the transdermal drug delivery system. METHODS: Sulfasalazine-loaded cubosomes were prepared by the top-down method using GMO and Poloxamer 407. Different concentrations of lipid and surfactant were used in the formulation using 32 full factorial designs. The prepared formulations were assessed for p.s, z,p, %EE, FTIR, SEM, in- vitro release, ex-vivo permeation, and deposition studies with pH 7.4 phosphate buffer saline. RESULTS: The particle size varies between 65 nm to 129 nm, while the negative zeta potential ranged from - 18.8 mV to -24.8 mV. The entrapment efficiency was between 87% and 95%. The formulations' in-vitro drug release was carried out for 12 hours. The optimized formulation showed a controlled release of sul- fasalazine and better ex-vivo permeation and deposition properties than sulfasalazine suspension. CONCLUSION: Overall study findings support the possibility of applying transdermal sulfasalazine- loaded cubosomes to alleviate rheumatoid arthritis.
ABSTRACT
BACKGROUND: There is a dearth of studies which are related to consultation-liaison psychiatry in India. The psychiatric referral rates in India are very low, considering the higher rates of psychiatric morbidity in patients who attend various departments of a hospital. Studying the pattern of psychiatric referrals may pave the way for interventions to improve the current scenario. METHODS: The study population comprised of all the patients who were referred for psychiatric consultation from other departments (both in-patient and out-patient) of the hospital over a period of two years. Data which was related to socio-demographic profile, source of referral, reason for referral and the psychiatric diagnosis were recorded and analyzed by using descriptive statistical methods. RESULTS: A total of 520 patients were referred for psychiatric consultation, with a referral rate of 0.42%. A majority of the psychiatric referrals (59%) were from the department of medicine and the most common reason for referral was medically unexplained somatic complaints (23.1%), followed closely by anxiety (21%) and abnormal behaviour (13.1%). The most commonly diagnosed psychiatric disorders were neurotic, stress related and somatoform disorders (41.7%) followed by mood disorders (12.9%) and substance use disorders (12.7%). CONCLUSION: There is a need to encourage multi-disciplinary interaction in the management of patients who attend general hospitals, so as to better identify the psychiatric morbidity. Further studies should focus on interventions that can improve referral rates through early recognition of the common psychiatric conditions, with particular emphasis on sensitizing the general physicians, who are the most common source of psychiatric referrals.
ABSTRACT
Death due to strangulation is generally considered homicidal unless proved otherwise. Here a case of accidental strangulation by a faulty machine is presented and discussed where the deceased was strangled by a heated rubber belt of a rice mill machine. The ligature mark was an assortment of abrasion and dermo-epidermal burns. The term "thermal ligature strangulation" is proposed for such an occurrence.
