Common issues in diabetes

Diabetes mellitus (DM) is a chronic medical condition that can attack many people regardless age and gender, and which is defined as that condition where there is too much glucose in the bloodstream. DM occurs when body cannot use insulin very well or the pancreas is unable to produce enough insulin to process ingested sugars. This study revealed that the vast majority of patients registered with the outpatient clinic at Hospital Tengku Ampuan Afzan (HTAA) have uncontrolled diabetes; the risk factors for uncontrolled diabetes include being female and over 40 years old, which indicates that this was most prevalent among those with type 2 diabetes. Based on the findings of the current study, the majority of caregivers have a high awareness of diabetic foot care. More than half of the caregivers claim that they have received information about diabetic foot care. In terms of sociodemographic data factors, the study indicated that age, race, religion, education level, and monthly family income are independent variables that are not related to the level of awareness among caregivers about diabetic foot care.This study showed that public in Kuantan, Pahang Darul Makmur, has a low level of knowledge about maggot therapy treatment in diabetic foot ulcers (DFU) healing and that a high number of people thus tend to reject maggot therapy treatment. Based on the outcomes, the majority of DM type 2 respondents were identified as having high self-efficacy beliefs, suggesting they had confidence in caring for their own feet. In terms of actual foot-care behaviours, both in the past week and in general, the majority of respondents displayed good practice. However, there was no significant association shown between foot-care self-efficacy beliefs and actual foot-care behaviour in the past week or in general.Finally, the findings of this study suggest that the prevalence of gestational diabetes mellitus (GDM) at the Maternal and Child Health Clinic Indera Mahkota was higher than in other similar studies. It also demonstrated that higher maternal age, higher body mass index (BMI) and a history of GDM were factors associated with increased risk of developing gestational DM

DEVELOPMENT AND VALIDATION OF UV-VIS SPECTROSCOPIC METHOD OF ASSAY OF CARBAMAZEPINE IN MICROPARTICLES

Objective: This study aimed to develop a new, rapid, robust, effective, inexpensive, and accurate UV-Vis method for the quantification analysis of carbamazepine (CBZ) in the carbamazepine-loaded microparticles.Methods: CBZ was encapsulated in ethyl cellulose microparticles by a solvent evaporation method using polyvinyl alcohol (PVA) as a stabilizer. Methanol was used to dissolve CBZ followed by dilution with distilled water as diluent. CBZ drug, excipients, and microparticles were subjected to specificity, solution stability, linearity, precision and accuracy to confirm and ensure the validity of this method.Results: The results showed no interference from the excipients in the selected wavelength 286 nm. It was exhibited linearity in the range 2-12 μg/ml with R2 = 0.9992. CBZ solution was stable during 24 h. Accuracy and precision were within the accepted limits (100±2%). All results were in accordance to the ICH-Q2 guideline.Conclusion: As a conclusion, CBZ could be quantified from loaded EC microparticles using UV-Vis spectrophotometer at 286 nm. Therefore, this method can be used for the quantification analysis of CBZ in CBZ-loaded microparticles can be utilized also as an alternative method to calculate CBZ in different dosage forms.Â

The nephrotoxicity of concurrent use of enalapril and gentamicin in rats

Objective: The present study was aimed to assess the concurrent administration of Enalapril (ENAL) and Gentamicin (GM) in the kidney of rats. Methods: Sixty male Sprague Dawley rats were divided into 4 main groups (n=15) according to the administered dose. Each main group was further subdivided into three subgroups according to the day of sacrificing (n=5). Group (C) was administered daily with normal saline as control, Group (E) was treated with oral ENAL, Group (G) was treated with 75 mg/kg GM, and Group (EG) was treated with GM and ENAL. The handling of the experiment persisted daily for 15 days, and the investigational examination carried out on days 5, 10, and 15. Results: The result showed that GM nephrotoxicity augmented with the period of the experimental study, there was rising in the levels of serum creatinine and blood urea nitrogen on the 10th day and persisted in rising significantly during the period on the 15th day of the experiment. Administration of ENAL showed no significant alteration from those of controls. While the concurrent administration of ENAL and GM showed that ENAL gradually increased GM nephrotoxicity, these physiological retrogressions were accompanied with intensive renal histopathological deteriorations. Conclusion: The present study has revealed that the concurrent administration of ENAL enormously aggravated the functional and histological nephrotoxicity of GM in rats

Carbamazepine gel formulation as a sustained release epilepsy medication for pediatric use

This study aimed to develop a carbamazepine (CBZ) sustained release formulation suitable for pediatric use with a lower risk of precipitation. The CBZ was first prepared as sustained release microparticles, and then the microparticles were embedded in alginate beads, and finally, the beads were suspended in a gel vehicle. The microparticles were prepared by a solvent evaporation method utilizing ethyl cellulose as a sustained release polymer and were evaluated for particle size, encapsulation efficiency, and release profile. The beads were fabricated by the dropwise addition of sodium alginate in calcium chloride solution and characterized for size, shape, and release properties. The gel was prepared using iota carrageenan as the gelling agent and evaluated for appearance, syneresis, drug content uniformity, rheology, release profile, and stability. The microparticles exhibited a particle size of 135.01 ± 0.61 µm with a monodisperse distribution and an encapsulation efficiency of 83.89 ± 3.98%. The beads were monodispersed with an average size of 1.4 ± 0.05 mm and a sphericity factor of less than 0.05. The gel was prepared using a 1:1 ratio (gel vehicle to beads) and exhibited no syneresis, good homogeneity, and good shearthinning properties. The release profile from the beads and from the gel was not significantly affected, maintaining similarity to the tablet form. The gel properties were maintained for one month real time stability, but the accelerated stability showed reduced viscosity and pH with time. In conclusion, CBZ in a gel sustained release dosage form combines the advantages of the suspension form in terms of dosing flexibility, and the advantages of the tablet form in regards to the sustained release profile. This dosage form should be further investigated in vivo in animal models before being considered in clinical trials

Analgesic synergism of gabapentin and carbamazepine in rat model of diabetic neuropathic pain

Purpose: To evaluate synergy in the analgesic effects of a combination therapy of carbamazepine (CBZ) and gabapentin (GBP) in diabetic neuropathic pain. Methods: Neuropathic pain was produced in rats by a single intraperitoneal injection of streptozotocin (STZ) at 60 mg/kg. CBZ, GBP, and their combination were orally administered at varying doses (GBP 30 - 180 mg/kg; CBZ 20 - 40 mg/kg) comparable to their therapeutic doses in humans. Nociceptive responses in the diabetic rats were assessed using hot plate test. Results: Hot plate latency significantly increased with oral administration of GBP at a dose of 180 mg/kg when compared with control group (p < 0.05), while at a dose of 90 mg/kg, the increase was not significant. Oral administration of CBZ at doses of 20 and 40 mg/kg did not produce any significant impact on hot plate latency. However, a combination of GBP at 90 mg/kg and CBZ at 20 mg/kg produced significant increase in latency, compared with control group and other groups (p < 0.05), except the group that received 180 mg/kg GBP. The combination of low dose GBP 30 mg/kg and carbamazepine 30 mg/kg had no significant effect on latency (p > 0.05). Conclusion: The results obtained in this study provide useful information on the combination therapy of GBP and CBZ, which may be applied in the treatment of pain in diabetic neuropathy

A cross-sectional study on the quality of life of patients with peripheral diabetic neuropathy pain in Hospital Tegku Ampaun Afzan, Kuantan, Malaysia

Purpose: To evaluate the quality of life of patients with peripheral diabetic neuropathy pain (PDNP) in Hospital Tegku Ampaun Afzan (HTAA), Kuantan, Malaysia.Methods: Ninety (90) participants were selected from the Medical Outpatient Department (MOPD) clinic of HTAA. The study adopted a cross-sectional design, and the self-administered Douleur Neuropathy 4 (DN4) and Audit of Diabetes-Dependent Quality of Life (ADDQoL) questionnaires were used for data collection.Results: The negative impact of diabetes on QoL was clearly reflected in the fact that every domain had a negative mean value. Overall, 27.8 % of the participants reported that DM negatively affected their QoL and 37.8 % expressed the opinion that their QoL would have been higher if they were not diabetic. QoL correlated with marital status and age, with married participants and participants in the age range 50 - 59 years old showing QoL negatively affected (p &lt; 0.05) by DM with PDNP. Apart from diabetes type, all other characteristics significantly affected participants QoL as reflected by the various related domains (p &lt; 0.05).Conclusion: Based on the findings of this study, it seems that individuals with diabetes and PDNP have a low QoL, with regard to “freedom to eat”, “freedom to drink”, “physical health”, “family life”, and “living condition”.Keywords: Quality of life, Diabetes, Peripheral neuropathy pai

Microencapsulation of peppermint oil using an ionic gelation electrospray technique

INTRODUCTION: Alginate has become the material of choice for encapsulation by ionic gelation and widely used in engineering and biotechnological industries, due to its biocompatibility, low cost and being a non-toxic polymer. Peppermint oil have been used for many pharmaceutical formulations and currently used as pharmaceutical active ingredient for few specific diseases. OBJECTIVES: This study aims to encapsulate and characterize peppermint oil in alginate microbeads by electrospray technique. METHODS: In this study, sodium alginates, Lecithin, calcium chloride and peppermint oil were used consecutively as an encapsulating material, emulsifying or, stabilizing agent, gelling solution and, as an active pharmaceutical ingredient. The electrospray technique was employed to encapsulate the peppermint oil by preparing the microbeads. To characterize emulsion, emulsion stability, size distribution of emulsion oil droplets and zeta potential, microstructure and shape and size of beads was determined followed by centrifugation or accelerated technique, a light scattering instrument, and light microscope. Finally, the analytical method was validated followed by ICH_Q2 guideline and encapsulation efficiency was determined by using UV-vis spectrophotometric (600 nm) method. The method was validated for specificity, linearity, accuracy, precision, limit of detection, and limit of quantitation. RESULTS: For the analysis method, it was found that peppermint oil obeys linearity within the concentration range of 3 mg/ml - 25 mg/ml and coefficient correlation was found to be 0.9890. The proposed method was found to be specific while estimating commercial formulations without interference of excipients. The emulsion was found to be highly stable while the percentage of beads yield was about 88%. In addition, the distribution of particle size of the emulsion was almost in nano size. In the characterization of beads, the size and shape of the beads were in good spherical shape. CONCLUSION: The analytical method was found to be simple, sensitive, accurate, precise & the most important cost effective and can be used for quantifying peppermint oil in the beads. Furthermore, peppermint oil was successfully encapsulated in alginate microbeads

Electro-hydrodynamic assisted synthesis of lecithin-stabilized peppermint oil-loaded alginate microbeads for intestinal drug delivery

Peppermint oil (PO) is the most prominent oil using in pharmaceutical formulations with its significant therapeutic value. In this sense, this oil is attracting considerable attention from the scientific community due to its traditional therapeutic claim, biological and pharmacological potential in recent research. An organic solventfree and environment-friendly electrohydrodynamic assisted (EHDA) technique was employed to prepared POloaded alginate microbeads. The current study deals with the development, optimization, in vitro characterization, in vivo gastrointestinal tract drug distribution and ex-vivo mucoadhesive properties, antioxidant, and antiinflammatory effects of PO-loaded alginate microbeads. The optimization results indicated the voltage and flow rate have a significant influence on microbeads size and sphericity factor and encapsulation efficiency. All these optimized microbeads showed a better drug release profile in simulated intestinal fluid (pH 6.8) at 2 h. However, a minor release was found in acidic media (pH 1.2) at 2 h. The optimized formulation showed excellent mucoadhesive properties in ex-vivo and good swelling characterization in intestine media. The microbeads were found to be well distributed in various parts of the intestine in in vivo study. PO-loaded alginate microbeads similarly showed potential antioxidant effects with drug release. The formulation exhibited possible improvement of irritable bowel syndrome (IBS) in MO-induced rats. It significantly suppressed proinflammatory cytokines, i.e., interleukin- IL-1β, and upregulated anti-inflammatory cytokine expression, i.e., IL-10. It would be a promising approach for targeted drug release after oral administration and could be considered an antiinflammatory therapeutic strategy for treating IBS

Effect of royal jelly on male infertility

Male infertility may occur due to different causes, therefore , different therapeutic approaches have been applied in order to improve the ability of men to get children . Semen analysis is used to determine the fertility potential in males, but the occurrence of pregnancy is the evidence of sperm ability for fertilization. Although male fertility is affected by food and nutrients, but little attention is paid for the use of Royal Jelly and no previous studies on the use of Royal Jelly in the treatment of male infertility. Eighty – three infertile men were treated with Royal Jelly, twenty – two with 100mg Royal Jelly, twenty –one with 50mg Royal Jelly, twenty with 25mg Royal Jelly and twenty with pure honey. Our study showed that, the treatments were safe and there were no side effects. After three months of treatment , the sperm active motility , testosterone level , Lutelizing hormones level , sluggishly motile sperm and intercourse / week increased significantly in infertile men treated with Royal Jelly , while sperm count and FSH level increased not significantly . On the basis of results, Royal Jelly is safe and effective in the treatment of male infertility

Electro-hydrodynamic assisted mucoadhesive-floating beads containing black seed oil: development and characterization in-vitro and ex-vivo

Background: Black seed oil (BSO) is attracting deep attention by scientific community due to its traditional therapeutic claim and pharmacological potential. Alginate widely used due to its biocompatibility, low cost and being a non-toxic polymer. Objective: The main objective of this study was to develop the BSO loaded mucoadhesive-floating beads with targeted size. Material and methods: BSO oil, alginate, lecithin and calcium chloride was used in this formulation. Electro-hydrodynamic assisted technique was employed to prepare BSO loaded alginate microsphere. The current study deals with the development, optimization, in-vitro characterization and ex-vivo mucoadhesive properties of BSO-loaded alginate beads. Results: The beads % of yield was determined. The optimized beads showed high drug encapsulation efficiency and suitable drug release pattern in simulated intestine media. The mean size and sphericity factor of the beads ranged from 0.75 ± 0.01 to 2.64 ± 0.01 mm and 0.05 ± 0.005 to 0.01 ± 0.00 mm respectively. It found to be dominant by Hixson-Crowell model (R2 = 0.983) with correlation coefficient close to unity over 2 h. The beads showed excellent floating behavior, insight of greater mucoadhesive properties and almost 100% swelling rate over 2 h in buffer media (pH 6.8). Conclusion: The technique for the preparation of beads containing BSO was found to be simple, reproducible, easily controllable, economical and consistent. Besides, the raw materials used for the formulation in this study such as sodium alginate, lecithin, calcium chloride and peppermint oil were cheap and easily available. This new approach to sustainable development goal is going to take a step forward, through a wider contribution to the pharmaceutical sector