Ethosomes as Vesicles for Effective Transdermal Delivery: From Bench to Clinical Implementation.

BACKGROUND: Drug delivery across the deeper layers of skin to make it systemically available is a considerable challenge in the development of a carrier. Numerous efforts have been put forward to find ways to overcome the formidable barrier of stratum corneum. Various lipid based vesicles viz liposomes, transfersomes, and invasomes have gained prominent deliberations across the globe. More recently, ethosomes have been investigated for their potential for transdermal delivery of several drugs. OBJECTIVE: In the present review an attempt has been made to illustrate preclinical and clinical studies depicting enhanced safety and efficacy of drugs delivered via ethosomes. Further, patents on transdermal delivery have been highlighted specifying the effectiveness of ethosomes in the transport of therapeutic actives. METHODS: Through the search engine "Scopus" literature on therapeutic categories such as antimicrobials, anti-inflammatory, and drugs acting on CNS has been collected. RESULTS: Preclinical and clinical studies that have been carried out by various researchers affirm the potentiality of ethosomes for delivering wide variety of drugs belonging to different therapeutic categories. In vitro and in vivo permeability analyses delineated the enhancement of permeability. Consequently, enhanced transdermal flux was reported and in vivo confocal laser scanning microscopy depicted the quantity as well as depth of penetrability via ethosomes. CONCLUSION: From various research reports, it can be concluded that ethosomes are the competent and efficient vesicles to provide better drug transport via transdermal route.

Cognitive function in subclinical hypothyroidism in elderly.

AIM: To study the association of cognitive function with subclinical hypothyroidism in elderly. MATERIALS AND METHODS: It's a cross-sectional, case-control study of 103 patients (≥65 years) who met the criteria for subclinical hypothyroidism. Similarly 103 age, sex and education-matched healthy controls were taken. Serum TSH, free T3 and free T4 were measured. Cognitive functions were assessed by using Folstein Mini Mental Examination (MMSE) and clock drawing test. RESULTS: Out of the 103 diagnosed subclinical hypothyroidism cases, cognitive impairment (by MMSE) was found in 33 (30.9%) while it was present in only 15 (14.54%) out of 103 controls (P = 0.003), cognitive impairment (by CDT) was present in 32 patients (31.06%) out of 103 cases while it was present in 26 patients (25.24%) out of 103 controls (P > 0.05, insignificant). Mean TSH of subclinical hypothyroidism with cognitive impairment was 7.67 ± 1.22 mIU/liter and without cognitive impairment was 6.47 ± 0.98 mIU/liter (P value = 0.0001, significant). CONCLUSIONS: Prevalence of cognitive impairment was significantly higher in subclinical hypothyroidism as compared to controls. Presence of cognitive impairment correlated with the level of TSH; as TSH increased cognitive function declined.

Association of metabolic syndrome with schizophrenia.

BACKGROUND: Metabolic syndrome (MetS) is associated with mental illnesses. It is a major predictor of mortality and morbidity in patients of such mental illnesses. This study was undertaken to study the association of MetS and schizophrenia. OBJECTIVES: To study the association of MetS in patients of schizophrenia. MATERIALS AND METHODS: Adult schizophrenic patients diagnosed as per Diagnostic and Statistical Manual -IV Third R evisioncriteria visiting the psychiatric Out Patient Day during the study period were evaluated for prevalence of MetS as per the criteria of the international diabetes federation. Fifty patients of schizophrenia with age-and sex-matched 50 controls were enrolled for the study. RESULTS: MetS was found to be 28% in patient group and 12% in control group (P < 0.05). Fourteen patients were found to have MetS out of 38 patients who were on antipsychotics for >6 months. All the 14 patients having MetS were taking second-generation antipsychotics (SGAs) (P < 0.05). CONCLUSION: The study showed a higher prevalence of MetS in schizophrenia than in general population. MetS was present only in patients taking SGAs and prevalence of MetS had a positive correlation with duration of treatment. The study points toward urgent need for consultation - liaisoning between Diabetologist and Psychiatrists.

Association of depression and its relation with complications in newly diagnosed type 2 diabetes.

INTRODUCTION: The prevalence of major depressive disorders is higher among persons with diabetes compared to the general population. These associations may be related to the increased risk of depressive symptoms in individuals with diabetes, increased risk of type 2 diabetes (T2DM) in individuals with depressive symptoms, or both. OBJECTIVES: To study the association of depression with diabetes and its complications in newly diagnosed type 2 diabetes in eastern UP. MATERIAL AND METHODS: Sixty cases and an equal number of age- and sex-matched controls were assessed for depression, diabetes complications, and a demography profile. RESULTS: Depression was found in 26 (43.34%) cases, while it was present in only eight (13.33%) controls (P = 0.002). Depression correlated with the level of hyperglycemia at presentation, as measured by fasting and postprandial blood glucose (FBG and PPBG) values. The presence of diabetic nephropathy was significantly associated with depression, while the prevalence of other complications of diabetes (retinopathy and dyslipidemia), although higher among those with depression, was not statistically significant. The level of HbA1c was 8.56 ± 1.66 in the depressed versus 8.04 ± 1.88 in the non-depressed diabetics (P = 0.26). CONCLUSIONS: The association of depression with diabetes and its complications in newly diagnosed type 2 diabetics was highlighted in our subpopulation and emphasized the need for integrated health services. The prevalence of depression was higher among them compared to controls. The chances of becoming depressed increased as the diabetes complications worsened.