Patient Adherence to Immunosuppressive Therapy in Treatment of Chronic Inflammatory Eye Disease.

TITLE: Patient Adherence to Immunosuppressive Therapy for Chronic Inflammatory Eye Disease. PURPOSE: To investigate adherence rates to immunosuppressive therapy (IMT) for treatment of noninfectious inflammatory eye disease (IED), adherence and disease control, and factors associated with nonadherence. METHOD: Retrospective review of medical charts from 2015 to 2020 was conducted on patients with IED at 6 months, 1 and 2 years after initiation of IMT. RESULTS: Of 183 patients, adherence rates at 6 months and 1 year were 70% and 58% by 2 years. Eighty-two percent, 78%, and 65% of patients with disease quiescence were adherent at 6 months, 1 and 2 years, respectively. Adherent patients have 1.86 (95% CI 1.09, 3.20) times greater likelihood for disease control compared to nonadherent. Primary reason for nonadherence was patient self-discontinuation. No specific factors were associated with nonadherence. CONCLUSION: Patients on IMT for IED had steady adherence rates up to 1 year, with decreased adherence at 2 years. Adherence to IMT significantly correlates with disease quiescence.

Investigating the effect of processing parameters on pharmaceutical tablet disintegration using a real-time particle imaging approach.

Tablet disintegration is a fundamental parameter that is tested in vitro before a product is released to the market, to give confidence that the tablet will break up in vivo and that active drug will be available for absorption. Variations in tablet properties cause variation in disintegration behaviour. While the standardised pharmacopeial disintegration test can show differences in the speed of disintegration of different tablets, it does not give any mechanistic information about the underlying cause of the difference. With quantifiable disintegration data, and consequently an improved understanding into tablet disintegration, a more knowledge-based approach could be applied to the research and development of future tablet formulations. The aim of the present research was to introduce an alternative method which will enable a better understanding of tablet disintegration using a particle imaging approach. A purpose-built flow cell was employed capable of online observation of tablet disintegration, which can provide information about the changing tablet dimensions and the particles released with time. This additional information can improve the understanding of how different materials and process parameters affect tablet disintegration. Standard USP analysis was also carried out to evaluate and determine whether the flow cell method can suitably differentiate the disintegration behaviour of tablets produced using different processing parameters. Placebo tablets were produced with varying ratios of insoluble and soluble filler (mannitol and MCC, respectively) so that the effect of variation in the formulation can be investigated. To determine the effect of the stress applied during granulation and tableting on tablet disintegration behaviour, analysis was carried out on tablets produced using granular material compressed at 20 or 50bar, where a tableting load of either 15 or 25kN was used. By doing this the tablet disintegration was examined in terms of the tablet porosity by monitoring the tablet area and particle release. It was found that when 20 and 50bar roller compaction pressure was used the USP analysis showed almost identical disintegration times for the consequent tablets. With the flow cell method a greater tablet swelling was observed for the lower pressure followed by steady tablet erosion. Additionally, more particles were released during disintegration due to the smaller granule size distribution within the tablet. When a higher tableting pressure was applied the tablet exhibited a delay in the time taken to reach the maximum swelling area, and slower tablet erosion and particle release were also observed, largely due to the tablet being much denser causing slower water uptake. This was in agreement with the USP analysis data. Overall it was confirmed by using both the standard USP analysis and flow cell method that the tablet porosity affects the tablet disintegration, whereby a more porous tablet disintegrates more slowly. But a more in-depth understanding was obtained using the flow cell method as it was determined that tablets will swell to varying degrees and release particles at different rates depending on the roller compaction and tableting pressure used.

Nucleation, growth and characterization of semiorganic nonlinear optical crystal sodium acetate doped L-tyrosine.

Sodium acetate doped L-tyrosine single crystal with dimensions 47×15×8 mm(3) was grown by slow evaporation solution growth technique. Nucleation kinetics of the growth of the material was studied to optimize the growth conditions. The grown doped crystal was then characterized using single crystal XRD, UV-vis-NIR, FTIR, NMR, SEM-EDAX and NLO studies. XRD study reveals that the grown crystal belongs to monoclinic system with space group P21. Lattice parameters of the grown crystals are found to be a=5.096 Å, b=8.966 Å, c=11.088 Å, α=ß=90° and γ=92.035°. The transparent range of the grown crystal was measured as 260-1100 nm with 260 nm as lower cut off wavelength using UV-vis-NIR absorption spectrum and the optical band gap was evaluated as 3.24 eV from the Tauc's plot. The various functional groups were identified using FTIR spectral analysis. The thermal behavior of the title compound has been analyzed using TGA/DTA and DSC thermal curves. From the thermal study, the material is found to possess thermal stability up to 158°C. The microstructure of the grown crystal and the presence of various elements in the crystal were analyzed using SEM and EDAX techniques. NMR spectral analysis confirms the molecular structure of the grown compound. The nonlinear optical property was tested using Kurtz Perry powder technique and SHG efficiency was measured nearly same as that of KDP.