Antimicrobial usage and its quantification for neonatal sepsis at a tertiary care hospital neonatal intensive care unit

Background: Antimicrobial therapy for neonatal sepsis is challenging as its judicious use can save neonates while its inappropriate use can lead to rapid emergence of resistant strains. Quantification of consumption of antimicrobial agents (AMA) has not been undertaken in Indian neonatal intensive care units (NICU) setting. This prospective observational study evaluated the antimicrobial prescribing pattern and quantified its consumption in clinically suspected neonatal sepsis (NS) cases.Methods: Clinically suspected NS cases admitted over study period of 18 months in a tertiary care level III NICU were enrolled. Data of antimicrobials prescribed, its consumption, culture sensitivity profile of organisms isolated were collected.Consumption was quantified by computing the days of therapy (DOT) per 1000 patient-days (PD).Results: 150 clinically suspected NS cases were enrolled; 37.33% were culture positive. The most common AMA prescribed were netilmicin (94.67%), piperacillin-tazobactam (88.67%). Only 0.67% cases received reserve antimicrobials like colistin, vancomycin and linezolid. 58% received 2 AMA, 39.33% received ≥3 agents. Total antimicrobial consumption was 614.86 DOT/1000 PD and 21.68 DOT/ neonate. Statistically significant difference in total AMA consumption amongst culture positive versus negative cases (p <0.001) was observed but difference was not significant in EOS versus LOS (p=0.95).Conclusion: Usage of antimicrobials for neonatal sepsis was guided by sensitivity pattern of local prevalent flora and clinical response. Usage of reserve antimicrobials were restricted. However, consumption of AB was higher compared to developed countries and we intend to use the study outcome data for antibiotic stewardship program to reduce antibiotic consumption and modify prescribing trends at the study setting

Potential and future scope of nanoemulgel formulation for topical delivery of lipophilic drugs

The aim of this review is to evaluate and report the current potential and future scope of nanoemulgel formulation for becoming an effective delivery system for poorly water soluble drugs. In this review, we have summarized and discussed the outcome of different studies on permeability, pharmacokinetic, pharmacodynamic and safety profile of the drugs delivered topically through nanoemulgel. Rationality of use along with the major challenges to overcome for nanoemulgel formulation has been discussed. The Nanoemulgel drug delivery system is a formulation related intervention to improve the systemic delivery and therapeutic profile of lipophilic drugs. Nanoemulgel is an amalgamated formulation of two different systems in which nanoemulsion containing drug is incorporated into a gel base. The fusion of the two systems makes this formulation advantageous in several ways. Lipophilic drugs can be easily incorporated and the skin permeability of the incorporated drugs can be enhanced in several folds due to the finely distributed droplets of nanoemulsion phase. As a result, the pharmacokinetic and pharmacodynamic profiles of the lipophilic drugs are improved significantly. An increasing trend in nanoemulgel use in recent years has been noticed because of the better acceptability of the preparation to the patients due to their, noninvasive drug delivery, avoidance of gastrointestinal side effects, easier applicability and good therapeutic and safety profile. Despite of having few limitations, nanoemulgel formulation can be considered as a potential and promising candidates for topical delivery of lipophilic drugs in the future

An Accretion Model for Anomalous X-Ray Pulsars

We present a model for the anomalous X-ray pulsars (AXPs) in which the emission is powered by accretion from a fossil disk, established from matter falling back onto the neutron star following its birth. The time-dependent accretion drives the neutron star towards a ``tracking'' solution in which the rotation period of the star increases slowly, in tandem with the declining accretion rate. For appropriate choices of disk mass, neutron star magnetic field strength and initial spin period, we demonstrate that a rapidly rotating neutron star can be spun down to periods characteristic of AXPs on timescales comparable to the estimated ages of these sources. In other cases, accretion onto the neutron star switches off after a short time, and the star becomes an ordinary radio pulsar. Thus, in our picture, radio pulsars and AXPs are drawn from the same underlying population, in contrast to models involving neutron stars with ultrastrong magnetic fields, which require a new population of stars with very different properties.Comment: 15 pages and 3 Postscript figure

Stability-indicating RP-HPLC method for simultaneous quantitation of tramadol and aceclofenac in presence of their major degradation products: Method development and validation

Primary objective of this study was to develop a stability indicating reverse phase high performance liquid chromatography method for simultaneous quantitation of tramadol and aceclofenac in presence of their degradation products. The drugs were subjected to various International Conference on Harmonization recommended stress conditions, such as acid hydrolysis, alkaline hydrolysis, peroxide oxidation, thermolysis and photolysis. The major degradation products got well resoluted from the analytes in HPLC analysis with a mobile phase composed of a mixture of 0.01 M ammonium acetate buffer (pH 6.5) and acetonitrile (65:35, v/v) through a Phenomenex Gemini C18 (250 mm x 4.6 mm, 5 µm particle size) column. The method was linear over a range of 15-60 µg/ ml for tramadol and 40-160 µg/ ml for aceclofenac concentration. The analytes were detected at a wavelength of 270 nm. The method was validated and found to be specific, accurate, precise, stable and robust for its intended use. The method can be recommended for its future use in routine quality control, accelerated and real time stability analysis of the formulations containing tramadol and aceclofenac combination

The Spin Period, Luminosity and Age Distributions of Anomalous X-Ray Pulsars

We consider the accretion model for anomalous X-ray pulsars proposed recently by Chatterjee, Hernquist and Narayan, in which the emission is powered by accretion from a fossil disk formed by the fallback of material from a supernova explosion. We demonstrate that this model is able to account for the spin period, luminosity and age distributions of the observed population of AXPs for reasonable and broad distributions of the free parameters of the model, namely, the surface magnetic field of the neutron star, the mass of its accretion disk and its initial spin period. In particular, this model is able statistically to account for the puzzlingly narrow observed spin distribution of the AXPs. We show also that if the establishment of fallback accretion disks around isolated neutron stars is a universal phenomenon, then a fairly large minority ($\sim 20$) of these objects become X-ray bright AXPs or X-ray faint systems spinning down by propeller action, while the rest become radio pulsars.Comment: 11 pages, 2 figures; accepted for publication in Ap

Incorporation of carbopol to palm olein based analgesic cream: effect on formulation characteristics

The purpose of the investigation was to incorporate carbopol gel with palm olein based emulsion and to investigate the effect of such incorporation on formulation characteristics. A palm olein based emulsion was formulated followed by addition of carbopol 940 to it. The critical parameters of incorporating carbopol in bench scale level were checked. The developed palm olein-carbopol based analgesic cream was analyzed for pH, zeta potential, viscosity, rheological property and forced centrifugation.Incorporation of 0.3% of carbopol gel (1% w/w) helps to maintain the viscosity and stability. pH and zeta potential of palm olein-carbopol combined cream was within range of 6.90 to 7.20 and -23.1 to -74.9, respectively. Combination of palm olein based emulsion and carbopol would be a suitable option for topical cream formulation. The pH of carbopol gel and method of mixing with the palm olein based emulsion had crucial effects on phase separation of the product

Pharmacokinetic and pharmacodynamic features of nanoemulsion following oral, intravenous, topical and nasal route

Abstract: Background: Most of the active pharmaceutical ingredients discovered recently in pharmaceutical field exhibits poor aqueous solubility that pose major problem in their oral administration. The oral administration of these drugs gets further complicated due to their short bioavailability, inconsistent absorption and inter/intra subject variability. Methods: Pharmaceutical emulsion holds a significant place as a primary choice of oral drug delivery system for lipophilic drugs used in pediatric and geriatric patients. Pharmacokinetic studies on nanoemulsion mediated drugs delivery approach indicates practical feasibility in regards to their clinical translation and commercialization. Results: This review article is to provide an updated understanding on pharmacokinetic and pharmacodynamic features of nanoemulsion delivered via oral, intravenous, topical and nasal route. Conclusion: The article is of huge interest to formulation scientists working on range of lipophilic drug molecules intended to be administered through oral, intravenous, topical and nasal routes for vivid medical benefits. Keywords: Hydrophobicity, oral delivery, pharmacokinetics, pharmacodynamics, routes of administration

Physicochemical, microbiological and antioxidant property of traditionally prepared Misti Dahi sold in West Bengal

75 Misti dahi samples from different districts of West Bengal were collected randomly and analysed for physico-chemical, microbiological quality and antioxidant activity. Significant variations in the composition of the dahi samples were observed.  The average fat, protein, lactose, ash, total solid, pH and titratable acidity content of dahi samples were found to be 3.94±0.55%,3.7±0.032 %,4.39±0.035 %, 0.66± 0.012%,12.82±0.087 %,3.48±0.045 and 1.16±0.00 % lactic acid respectively. Hydroxy methyl furfural (HMF) value, Peroxide value (PV) and Tyrosine value (TV) of the market dahi samples were found to be 1.03±0.04604μmole/L, 0.344±0.009milli eq. /kg of fat and 0.276±0.008 mg of tyrosine/ml respectively and varied significantly. Baudouin test which is an indicator of adulteration of dahi with Vanaspati showed positive results for 48% of the samples. Average coliform and Yeast &amp; Mould count were found to be 4.37±0.21 log cfu/g and 3.54±0.11 log cfu/g respectively. Antioxidant activity was measured by ABTS and DPPH method. All Misti dahi samples showed good antioxidant activity and varied significantly (p&lt;0.05)

A comparative study of vital capacity of Indian and Nepalese young female

Vital capacity is an important index in pulmonary function. At present, it is difficult to achieve accuracy in clinical diagnosis because of lack of unified standard of the normal reference value in younger women&apos;s vital capacity in Nepal. So, the present study was carried out to evaluate vital capacity of healthy Nepalese young females and compare their values with healthy Indian counterparts to know whether Indian prediction equations for vital capacity can be used for Nepalese population or not. Ninety six (42 were Indians and 54 were Nepalese) young, non-smoker, female students of 18 to 20 years of age were recruited for this study. The mean vital capacity of Nepalese and Indian girls were 2650.31 ± 464.34 and 2629.21 ± 449.97 ml respectively. As no significant difference was found in the mean vital capacity of Nepalese and Indian female students, prediction equation made for Indian females may be used for Nepalese subjects. Therefore, an attempt has been made to formulate a regression equation from the combined Indian and Nepalese subjects. A stepwise, multiple, linear, regression equation was performed for this purpose. The regression equation based on height for the combined Indian and Nepalese adult females is calculated as: Vital capacity (ml) = 26.2 × Height (cm) -1467.21