Formulation and In Vitro Evaluation of pH-Sensitive Oil-Entrapped Buoyant Beads of Clarithromycin

Purpose: To develop pH-sensitive controlled release formulation of clarithromycin in oil-entrapped calcium pectinate microgel bead.Methods: Pectin-based oil-entrapped microgel beads were prepared by ionic gelation technique. The gel beads were formed instantly after adding the liquid formulation mixture dropwise into calcium chloride solution. The beads were optimized by coating with ethylcellulose solution and then evaluated for their diameter, floating lag time, encapsulation efficiency and drug release.Results: Particle size, encapsulation efficiency and buoyancy were significantly affected by the concentration of the polymer and calcium chloride .The formulation exhibited sustained release profile and was best fitted to the Peppas model with n < 0.45. Ethylcellulose-coated formulation batch, C16, was the most suitable controlled formulation with drug release of 65 ± 2.61 % in 8 h.Conclusion: An ethylcellulose-coated formulation with potential for sustained delivery of clarithromycin in the acidic region of the gastrointestinal tract was successfully developed.Keywords: Clarithromycin; Calcium pectinate bead; Gastric residence time; pH-sensitive; Ethyl cellulose; Oil-entrappedTropical Journal of Pharmaceutical Research December 2010; 9 (6): 533-53

Neonatal Sepsis: past, present and future; a review article

Sepsis is the most common cause of neonatal mortality. As per NationalNeonatal Perinatal Database (NNPD) 2002-2003, the incidence of neonatal sepsis in India was 30 per 1000 live birth. It is 3% among intramural babies and 39.7% among extramural admissions. The early manifestations of neonatal sepsis are vague and ill-defined. Novel approaches in the diagnosis of neonatal sepsis include heart rate analysis on ECG or colorimetric analysis of skin color. Although blood culture is the gold standard for the diagnosis of sepsis, culture reports would be available only after 48-72 hours. In this era of multidrug resistance, it is mandatory to avoid unnecessary use of antibiotics to treat noninfected infants. Thus, rapid diagnostic test(s) that differentiate infected from non-infected infants, particularly in the early newborn period, that include Interleukien-6 (IL-6), neutrophil CD64 index, procalcitonin and nucleated RBC count, have the potential to make a significant impact on neonatal care. The aim of this review is to specify the diagnostic criteria, treatment guidelines and a summary of the newer diagnostic tests of sepsis.KEY WORDS: Sepsis; Intramural; Extramural; Multidrug resistanc

Study of Ventilator Associated Pneumonia in Neonatal Intensive Care Unit: characteristics, risk factors and outcome

Ventilator Associated Pneumonia (VAP), the nosocomial pneumonia developing in mechanically ventilated patients after 48 hours of mechanical ventilation, is the second most common nosocomial infection.Therefore, there is a vital need to study the etiology and risk factors associated with VAP in neonates. Neonates admitted to neonatal intensive care unit (NICU), over a period of 1 year and who required mechanical ventilation for more than 48 hours were enrolled consecutively into the study. Diagnosis of VAP was made by the guidelines given by National Nosocomial infection Surveillance System (NNIS, 1996). Semi-quantitative assay of endotracheal aspirate was used for microbiological diagnoses of VAP. 105CFU/ml was taken as the cut off between evidence of pathological infection and colonization. The risk factors such as birth weight, prematurity (gestational age < 37 weeks), duration of mechanical ventilation, number of reintubations, length of hospital stay, primary diagnosis of neonate, postnatal age and small for gestational age (SGA) were studied for the development of VAP. Risk factors found significant on bivariate analysis were subjected to multiple regression analysis to determine the most important predictors of VAP. The study group comprised of 98 neonates out of which, 30 neonates developed VAP (30.6%). VAP rates were 37.2 per 1000 days of mechanical ventilation. Most common bacterial isolated from endotracheal aspirate of VAP patients was Klebsiella spp (32.8%), E.coli (23.2%) and Acinetobacter (17.8%) being the other two common organisms. Very low birth weight

ASSESSMENT OF MICROALBUMINURIA IN ESSENTIAL HYPERTENSIVES AND ITS RESPONSE TO ANGIOTENSIN-CONVERTING ENZYME INHIBITOR THERAPY

ABSTRACTObjective: Objective is to study the prevalence of microalbuminuria among patients suffering from essential hypertension and also to evaluate theresponse of microalbuminuria to angiotensin-converting enzyme (ACE) inhibitors therapy.Methods: The study conducted at Santosh Medical College and Hospital, Ghaziabad, on 300 patients with essential hypertension. After attainingbaseline parameters in all patients, those newly diagnosed essential hypertensives with microalbuminuria not on any treatment were started on anACE inhibitor (ramipril), for 8 weeks, after which all parameters were reassessed and comparison and statistical analysis were done to establish theprevalence of microalbuminuria and its response to therapy.Results: In our study, mean microalbuminuria excretion was 101.79 mcg/mg creatinine at the beginning of the study and 80.20 mcg/mg creatinineafter 8 weeks of ACE inhibitor therapy, with 21.2% fall rate.Conclusion: Microalbuminuria is an independent risk factor for the development or worsening of hypertensive nephropathy and endothelialdysfunction, thereby increasing the risk of micro- and macro-vascular complications.Keywords: Microalbuminuria, Essential hypertension, Angiotensin-converting enzyme inhibitor therapy

BIOMARKERS IN SERUM, URIC ACID AS A RISK FACTOR FOR TYPE 2 DIABETES ASSOCIATED WITH HYPERTENSION

ABSTRACTObjectives: Uric acid (UA) is the end product of purine metabolism in humans. UA is the final oxidation product of purine catabolism and has beenimplicated in diabetes mellitus (DM) as well as in hyperlipidemias. Hyperuricemia can cause serious health problems including renal insufficiency.Hyperuricemia is associated with many diseases including hypertension (HTN), DM, hypertriglyceridemia, and obesity. The aim was to determine theserum UA (SUA) level in Patients of Type 2 DM with HTN.Methods: Out of 100 samples, 50 were found as cases of Type 2 diabetic with HTN, and the 50 control samples were without Type 2 diabetic HTN.Results: SUA, glycosylated hemoglobin, and low-density lipoprotein of male and female cases of Type 2 DM with HTN compared to control were(p&lt;0.05) highly significant and also serum triglycerides and total cholesterol of both sex groups of Type 2 DM with HTN compared to control werefound to be (p&lt;0.05) highly significance.Conclusion: It is concluded from our present study that level of SUA &gt;7.0 mg/dl were significantly seen in cases of diabetes with HTN. SUA ≤5.0 mg/dlwas significantly seen in subjects without diabetes with HTN. Our data showed hyperuricemia and glycated hemoglobin as significant risk factors inthe progression of DM, atherosclerosis, myocardial infarction, renal disorder, hypertriglyceridemia, and obesity. Further large sample size studies areneeded to be done in the direction with more focused mechanistic approaches to fortify the fact. Very little is known about the relationship betweenUA, DM, and HTN in India.Keywords: Diabetes mellitus, Hypertension, Uric acid, Glycosylated hemoglobin, Lipid profil

Theoretical study of Oldroyd-b visco-elastic fluid flow through curved pipes with slip effects in polymer flow processing

The characteristics of the flow field of both viscous and viscoelastic fluids passing through a curved pipe with a Navier slip boundary condition have been investigated analytically in the present study. The Oldroyd-B constitutive equation is employed to simulate realistic transport of dilute polymeric solutions in curved channels. In order to linearize the momentum and constitutive equations, a perturbation method is used in which the ratio of radius of cross section to the radius of channel curvature is employed as the perturbation parameter. The intensity of secondary and main flows is mainly affected by the hoop stress and it is demonstrated in the present study that both the Weissenberg number (the ratio of elastic force to viscous force) and slip coefficient play major roles in determining the strengths of both flows. It is also shown that as a result of an increment in slip coefficient, the position of maximum velocity markedly migrates away from the pipe center towards the outer side of curvature. Furthermore, results corresponding to Navier slip scenarios exhibit non-uniform distributions in both the main and lateral components of velocity near the wall which can notably vary from the inner side of curvature to the outer side. The present solution is also important in polymeric flow processing systems because of experimental evidence indicating that the no-slip condition can fail for these flows, which is of relevance to chemical engineers

Metabolic Regulation in Progression to Autoimmune Diabetes

Recent evidence from serum metabolomics indicates that specific metabolic disturbances precede β-cell autoimmunity in humans and can be used to identify those children who subsequently progress to type 1 diabetes. The mechanisms behind these disturbances are unknown. Here we show the specificity of the pre-autoimmune metabolic changes, as indicated by their conservation in a murine model of type 1 diabetes. We performed a study in non-obese prediabetic (NOD) mice which recapitulated the design of the human study and derived the metabolic states from longitudinal lipidomics data. We show that female NOD mice who later progress to autoimmune diabetes exhibit the same lipidomic pattern as prediabetic children. These metabolic changes are accompanied by enhanced glucose-stimulated insulin secretion, normoglycemia, upregulation of insulinotropic amino acids in islets, elevated plasma leptin and adiponectin, and diminished gut microbial diversity of the Clostridium leptum group. Together, the findings indicate that autoimmune diabetes is preceded by a state of increased metabolic demands on the islets resulting in elevated insulin secretion and suggest alternative metabolic related pathways as therapeutic targets to prevent diabetes