PREPARATION AND EVALUATION OF NILVADIPNE LIQUISOLID COMPACTS

The purpose of the present study is to develop a novel liquid solid technique which enhances the dissolution rate of water insoluble or poorly water soluble drugs of Nilvadipine, which belong to class II of BCS. Generally the liquisolid technique is based upon the admixture of drug loaded with non volatile solutions (or) liquid drug incorporated with required carrier and coating materials in order to obtain a dry, non adherent, free flowing and compressible powder. Various non volatile solvents used were Propylene glycol, Poly ethylene glycol. The solubility of drug in the non volatile solvents plays an important role in this formulation Avicel PH 102 and aerosil were used as carrier and coating materials. Super disintegrants were used to increase the dissolution rate.Evaluation tests such as Disintegration time, Friability, Hardness and in-vitro dissolution studies were conducted. Amongst all the formulations F14 was considered to be the best in which Propylene glycol is used and the drug release was found to be 97% in 10 min

PREPARATION AND EVALUATION OF ETHYLCELLULOSE MICROSPHERES PREPARED BY SOLVENT EVAPORATION TECHNIQUE

Losartan is high specific angiotensin 2 type receptor antagonist with antihypertensive activity was formulated as microspheres by using Ethyl cellulose as carrier. These Ethyl cellulose microspheres were prepared by the solvent evaporation method. The prepared microspheres were subjected to various evaluation and in vitro release studies. Highest percentage of loading was obtained by increasing the amount of Losartan with respect to polymer. The particle sizes of the prepared microspheres were determined by optical microscopy and SEM analysis. The prepared microspheres had good spherical geometry with smooth surface as evidence by SEM. The in vitro release studies showed that Losartan microspheres of 1:5 ratios showed better sustained effect over a period of 12 hours

FORMULATION AND EVALUATION OF GASTRO RETENTIVE EFFERVESCENT FLOATING MATRIX TABLETS OF CEPHALEXIN

The present research work was an attempt to formulate and evaluate gastro retentive buoyant drug delivery system containing cephalexin in the form of tablets prepared by direct compression method by using the hydrophilic polymers such as HPMC K4M, HPMC K100M, Xanthan gum, Guar gum, Karaya gum, Sodium cmc and hydrophobic polymers ( Ethyl cellulose) . Both grades of HPMC were used individually in different ratios and remaining polymers were used in combination with both HPMC polymers. Sodium bicarbonate & citric acid, MCC were also used. The prepared tablets were evaluated for their Pre & Post compression parameters such as weight variation, thickness, hardness, friability, drug content, swelling index, in vitro buoyancy , in vitro drug release studies. All formulations followed first order kinetics, showed good correlation in higuchi kinetics indicating drug release was predominantly diffusion controlled. When data was fitted to peppas slope values suggest that release followed non fickian diffusion. KEY WORDS: Cephalexin, HPMC K15M, HPMC K100M, Xanthan gum

5 Years Mortality of Severe Traumatic Brain Injury during the Establishment of Closed System Neurocritical Care Unit in a Resource Constrained Developing Country

Background & Objectives: Severe traumatic brain injury is one of the leading causes of mortality and morbidity.Efficient management of severe traumatic brain injury demands a specialty driven focused intensive care. We developed our model of closed ICU driven by Neurosurgical Neurointensivist and the corollary to thiscommitment is a TBI patient centered Neurocritical care with the capacity and capability to deal with most of the neurological illnesses.Materials & Methods: A prospective study was conducted to find out the impact of the establishment of closed system of neurocritical care on 5 year mortality of severe TBI. Total 1288 patients met the inclusion criteria, which were enrolled. Tabulation was done for gender, age range, Glasgow outcome scale and mortality.Results: It was observed that mortality reduced from 47% to 35% over a span of five years. The most common age range was 30-40 years, which is the most productive group of any population. Bed sore incidence is always on rise in any ICU. After the implementation of SOPs based management and increase in nursing staff theincidence of bedsore also showed a detrimental pattern from 35 % to 19%.Conclusion: Neurocritical care unit is proven to be an integral part of any neurosurgical unit and this closed system of NCC unit provide best SOP based care with significant reduction in mortality of patients with STBI

Finite Element Analysis of the Dynamics of Power-Law Fluid around an Obstacle in a Channel

Control of uid forces is an emerging area of research with numerous engineering applications. ­e uneven wake behind an obstacle causes undesirable structural oscillations, which can lead to fatigue or structural failure. Controlling the wake phenomena could directly bene t a wide range of engineering applications, including skyscrapers, naval risers, bridges, columns, and a few sections of airplanes. ­is study is concerned with the time dependent simulations in a channel in presence of an obstacle aiming to compute uid forces. ­e underlying mathematical model is based on nonstationary Navier–Stokes equations coupled with the constitutive relations of power law uids. Because the representative equations are complex, an e ective computing strategy based on the nite element approach is used. To achieve higher accuracy, a hybrid computational grid at a very ne level is used. ­e P2 − P1 elements based on the shape functions of the second and rst-order polynomials were used to approximate the solution. ­e discrete nonlinear system arising from this discretization is linearized by Newton’s method and then solved through a direct linear solver PARADISO. ­e code validation study is also performed for Newtonian uids as a special case, and then the study is extended to compute drag and lift forces for other cases of viscosity as described by the power law index. When looking at the phase plot, it can be seen that for the Newtonian case n 1, there is only one closed orbit after the steady state is reached, whereas for n 0.5, there are multiple periodic orbits. Moreover, the e ects of shear rate on the drag-lift phase plot are also discussed.Scopu

Hepatoprotective Effects of Silybum marianum

Oxidative stress, lipid peroxidation, and transaminase reactions are some of the mechanisms that can lead to liver dysfunction. A time-dependent study was designed to evaluate the ability of silymarin (SLN) and glycyrrhizin (GLN) in different dosage regimens to lessen oxidative stress in the rats with hepatic injury caused by the hepatotoxin carbon tetrachloride. Wistar male albino rats (n = 60) were randomly assigned to six groups. Group A served as a positive control while groups B, C, D, E, and F received a dose of CCl4 (50% solution of CCl4 in liquid paraffin, 2 mL/kg, intraperitoneally) twice a week to induce hepatic injury. Additionally, the animals received SLN and GLN in different doses for a period of six weeks. CCl4 was found to induce hepatic injury by significantly increasing serum alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and thiobarbituric acid reactive substances while decreasing total protein and the activities of reduced glutathione, superoxide dismutase, and catalase. Treatment with various doses of SLN and GLN significantly reduced ALT, AST, ALP, and TBARS levels and increased GSH, SOD, and CAT levels. Our findings indicated that SLN and GLN have hepatoprotective effects against oxidative stress of the liver

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Measuring routine childhood vaccination coverage in 204 countries and territories, 1980-2019 : a systematic analysis for the Global Burden of Disease Study 2020, Release 1

Background Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dosespecific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in countryreported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings By 2019, global coverage of third-dose DTP (DTP3; 81.6% [95% uncertainty interval 80.4-82 .7]) more than doubled from levels estimated in 1980 (39.9% [37.5-42.1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38.5% [35.4-41.3] in 1980 to 83.6% [82.3-84.8] in 2019). Third- dose polio vaccine (Pol3) coverage also increased, from 42.6% (41.4-44.1) in 1980 to 79.8% (78.4-81.1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56.8 million (52.6-60. 9) to 14.5 million (13.4-15.9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. Interpretation After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019

Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries