Left ventricular dysfunction by strain echocardiography in thalassemia patients: a pilot study

Background: To evaluate the myocardial function and its correlation with serum ferritin and the number of transfusions in beta-thalassemia major patients by using standard echocardiography and left ventricular strain imaging.Methods: This was a cross-sectional exploration study comprised of 56 beta-thalassemia patients conducted at a tertiary-care center in India between September 2016 and August 2017. Patients with age less than 18 years, diagnosed with thalassemia major, recipients of >20 units of blood transfusions, and normal Left Ventricular (LV) function by 2D-echocardiography were included in the study. Severity of iron overload was determined by using serum ferritin levels and LV strain imaging parameters were evaluated by using strain values of 17 LV segments.Results: A total of 56 beta-thalassemia patients were included in the study. Of these, 29(51.8%) patients were boys and 27(48.2%) patients were girls with a mean age of 7.8±1.84 years. Average serum ferritin level was found to be 4089.83 ng/dl. Strain values of the basal lateral wall of the left ventricle were significantly abnormal in patients who received more (>80) transfusions compared with those who received lesser transfusions (p=0.025 and p=0.045), respectively. Patients with serum ferritin >6000 ng/ml had impaired strain (p=0.03).Conclusions: Conventional echocardiographic parameters and Left Ventricular Ejection Fraction (LVEF) do not provide adequate information about LV dysfunction. Systolic strain index imaging of the LV indicated the presence of early LV systolic dysfunction in patients who received a greater number of blood transfusions and patients with higher serum ferritin levels

FORMULATION AND EVALUATION OF TASTE MASKED ORAL SUSPENSION OF CHLOROQUINE PHOSPHATE

The purpose of this research was to mask the intensely bitter taste of Chloroquine phosphate using ion exchange resin and to formulate oral suspension of the taste masked drug. Batch method was used for formation of drug resin complex. Various ion exchange resins such as Doshion P 544 S and Kyron T- 114 were tried to obtained taste masked drug resin complex (DRC). Optimization of drug loading was carried out. With Doshion P 544 S, the drug-resin proportion of 1:4 achieved equilibrium in 5 hours. 96% w/w of drug loading was possible by this method. Complex formation was confirmed by DSC and IR studies. Oral taste masked suspension was prepared using xanthum gum at various concentrations 0.1%, 0.2% and 0.4% respectively. CPR 1 and CPR 2 batches showed satisfactory assay result that is it fulfills the official requirements. But physical properties of suspension were not satisfactory. CPR 1 was not easily redispersible and with CPR 2 caking was observed with sedimentation volume of 0.4, hence these batches were rejected. CPR 3 was found to be optimized batch as it showed complied assay results were found to be easily redispersible even after 7 days with no cake formation and sedimentation volume of 0.98. and was evaluated for various parameters such as Colour, pH, Viscosity etc. Thus, successful taste masking and formulation of suspension with taste masked drug especially for pediatric, geriatric, and non cooperative patients