ASSESSMENT OF DRUG UTILIZATION AMONG PEDIATRIC PATIENTS IN PRIVATE CLINIC AND PUBLIC HOSPITAL OF BANGLADESH

Objective: Aim of the study was to assess drug utilization among pediatric patients in both private practice and hospital settings in Rajshahi city, Bangladesh. Methods: This observational study was conducted during a period of two months (March to April) in 2017. Prescriptions were randomly collected from patients and recorded in a predesigned questionnaire form. The data analysis was carried out by using a statistical software package GraphPad Prism. Results: The study involved a total of 185 patients, of which 62.70% were male and 37.30% were female. The patient’s age ranges from 1 mo-12 y and highest number of patients visited physicians belong to group 1 mo-1 y (47.57%). Most commonly occurring disease conditions were pneumonia (24%), the leading cause of hospitalizations among the children's age group of 1 mo-1 y. The results indicated that physician’s handwriting was not clear and legible in 50 (27.03%) prescriptions. A total of 468 drugs were prescribed with an average of 2.53 per prescription. However, none of the drugs were prescribed by generic name. The most commonly prescribed drugs were antibiotics 173 (93.5%). About 78% patients were exposed to antibiotics, of which single antibiotic was prescribed in 116 (62.70%) and two antibiotics in 23 (12.43%) prescriptions. Among the drugs, NSAIDS 65 (35.14%), anti-histamine 57 (30.81%), anti-asthmatic 49 (26.49%) drugs were assigned in prescriptions followed by vitamin and minerals 51 (27.57%). Steroids 57 (30.81%) and hypnotics 26 (14.05%) were also accounted in many prescriptions. Interestingly, antibiotics were indiscriminately prescribed in private practices without any bacteriological examinations, whereas in hospital settings, most of the treatment was initiated after culture and sensitivity tests. Conclusion: Children were highly exposed to antibiotics, steroids and hypnotics in both private practice and hospital settings.  So Medical practitioners should be aware of current guidelines for prescriptions of antibiotics and drugs in child

PATTERNS OF PRESCRIPTION AND ANTIBIOTIC USE AMONG OUTPATIENTS IN A TERTIARY CARE TEACHING HOSPITAL OF BANGLADESH

Objective: Irrational drug use increased the risk of adverse drug reactions (ADRs), the emergence of drug resistance and a leading cause of morbidity and mortality worldwide. The study was designed to analyse prescription patterns and antibiotic use among outpatients in a tertiary care teaching hospital in Bangladesh.Methods: This prospective survey was conducted among the out-patients in a district hospital. The prescribed drugs were classified according to Anatomical and Therapeutic Chemical (ATC) classification system. Patient characteristics and drug data were recorded. The prescription pattern was analysed using general drug use indicators according to world health organisation (WHO).Results: A total of 405 prescriptions were analyzed of which 54% of child and 46% of adult prescriptions. The age and body weight of the patients were not mentioned in 30% of child and 62% of adult prescriptions and none of the prescriptions included sex of the patients. Physician's handwriting was not clear and legible in 31% prescriptions. A total 1362 drugs were used in this study with an average 3.36 drugs per prescription. However, none of the drugs was prescribed in generic name. Children were highly exposed to antibiotics (66%) than to adults (44%) of which cephalosporin's (30%) and macrolides (14%) were commonly used. Interestingly, non-steroidal anti-inflammatory drugs (NSAIDs) were also highly accounted in children (53%) than to adults (36%).Conclusion: Our results suggested that the prescription information was incomplete and physicians did not follow the standard guideline for drug treatment resulting in polypharmacy and indiscriminate use of antimicrobials irrespective to the age of patients

Cefuroxime Axetil loaded dispersed formulation for enhanced drug release and antibacterial activity

Aim: Aqueous solubility of drugs is a determining factor for bioavailability in systemic circulation and confronts in the unbeaten formulation of therapeutic agents. Cefuroxime axetil (CA) is a broad-spectrum β-lactamase cephalosporin that pertains to class II drugs under Biopharmaceutical Classification System (BCS) with poor aqueous solubility and high absorption permeability after oral administration. The objective of this current work was to achieve the enhanced solubility in water and subsequent antibacterial activity of CA loaded coarse dispersion (CCD) formulations. Materials and Methods: CCDs were prepared by anti-solvent precipitation method by blending CA with a carrier, Microcrystalline cellulose (MCC) at different ratios. In-vitro dissolution test using paddle method and antibacterial study against Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922) were carried out for both pure CA and CCDs for performance comparison. Results: Among the formulations, CCD-3 exhibited maximized dissolution rate by 1.67-fold higher than that of pure CA with the drug-carrier (CA: MCC) ratio of 1:3. Antibacterial activity of CCD-3 against S. aureus and E. coli was also found by 1.75-fold and 5.25-fold higher relative zone of inhibition (RZOI), respectively than that of pure drug. Conclusion: As an optimized formulation, CCD-3 is a promising to be a fruitful substitute to conventional dosage forms of CA for the modified dissolution rate and antibacterial potency. However, before its recommendation as a novel formulation validation study to point its pharmacokinetics, competence with in-vivo antibacterial property and safety is needed

Antibiotic resistant microencapsulated probiotics synergistically preserved orange juice

BACKGROUND: In contemporary medicine, the utilization of various dosage forms of probiotics is increasing both for the treatment of human and animal diseases in Bangladesh. A number of imported pharmaceutical probiotic preparations are available in the local markets at present without justification the scientific information of viability. This study was, therefore, designed to explore the viability of commercial probiotics as well as recommend the consumers for the better products in term of viability. Since probiotics preserved foods have expanded in acceptance, popularity and compliance, the goal of this research was also to investigate the combination effects of lactic acid bacteria (LAB) on development of functional foods like orange juice (OJ). METHODS: Here, we screened five commercially available pharmaceutical probiotic products for rejuvenation and identification of LAB and associated resistance against different classes of antibiotics. Finally, the isolated LAB were microencapsulated and compared with free form of bacteria for biopreservation of OJ. RESULTS: We observed an inconsistency between the feasible live LAB counts and the declaration of the manufacturing companies. The recovered viable bacteria of pharmaceutical probiotic preparations ranged between (6.2 -7.3) × 1010 at 37 °C and (5.33-7.1) × 1010 at 25 °C, the claimed (9-10) × 1010 colony forming unit (CFU)/g. The encapsulated Lactobacillus acidophilus (LAB 1), L. bulgaricus (LAB 2), Lactococcus lactis (LAB 3) and Bifidobacterium bifidum (LAB 4) in OJ was resistant to drop out their viability as quickly as the free-form probiotic bacteria and >106 CFU/mL were still appeared after 6 wks of storage. Unencapsulated probiotics was found to have a significant reduction in viability in OJ at both 37 °C and 4 °C temperatures. However, the microencapsulation process significantly reduced the loss of viability of four probiotic bacteria as well as the control of acidification of OJ at 4 °C. CONCLUSIONS: The loss of potency and spoiled food associated with pathogenic microbial growth are serious problems in tropical countries including Bangladesh. The biopreserved OJ will become an important functional food due to its expansion of shelf-time, market reputation, profits and innate tastes. This report has an indication that the combination of these four LAB may become good candidate for the development of an OJ with functional characteristics

Preparation and characterization of naproxen solid dispersion using different hydrophilic carriers and in-vivo evaluation of its analgesic activity in mice

Background: Solid dispersion (SD) has been used conventionally as a successful technique for improving the dissolution profile and bioavailability of poorly water-soluble drugs. The aim of this study was to progress the dissolution rate and bioavailability of naproxen (BCS class II) by SD technique. Materials &amp; methods: In this study, hydrophilic carriers are used for preparing solid dispersion of naproxen by evaporation method. The prepared optimized SDNs were evaluated by in-vitro drug dissolution test, differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), powder X-ray diffraction (PXRD), and scanning electron microscopy (SEM). The in-vivo analgesic effects tests of the optimized SDNs (SDN-2 and SDN-5) were performed by tail immersion method and writhing method. Results: All the prepared SDNs exhibited a significant increase in the dissolution of naproxen compared to that of the pure drug. Among them, SDN-2 (the dispersion with sodium starch glycolate at 1:2 ratio of naproxen and sodium starch glycolate) and SDN-5 (using the combination of PEG-8000 and sodium starch glycolate with naproxen at 1:1:1 ratio) showed faster dissolution rate as compared to other solid dispersions (SDNs) and pure naproxen. SDN-2 showed 5.4 times better dissolution rate and SDN-5 depicted 6.5-fold increment of dissolution rate compared to pure naproxen drug. DSC, PXRD and SEM microscopy showed that the drugs crystallinity was decreased during the preparation process. FTIR study revealed that naproxen was stable in polymeric dispersions and there was no interaction among the drug and polymers. In writhing method, the percentage inhibition of the number of writhes showed significantly greater (p < 0.01), (p < 0.0001) analgesic activity for the higher dose treatment groups SDN-2(H), and SDN-5(H), respectively, when contrasted to the pure drug naproxen. For tail immersion test, there is increase in latency time at 90 min which is significantly greater (P < 0.01), (P < 0.05), (P < 0.01) for treatment groups SDN-2(H), SDN-5(L), and SDN-5(H), respectively that ultimately authenticates that the optimized SDNs (SDN-2, SDN-5) showed better analgesic activity in mice in comparison with the pure drug. Conclusion: It can be concluded that dissolution of the naproxen could be improved by the making solid dispersion using sodium starch glycolate and/or combination of sodium starch glycolate and PEG 8000 due to the complete transformation of drug into amorphous form with the entire loss of crystallinity, as evidenced by DSC, PXRD, and SEM and also consequences the enhanced analgesic activity in mice

Accelerated aqueous solubility and antibacterial activity of cefuroxime axetil using microcrystalline cellulose as carrier

This investigation was undertaken to enhance the solubility and consequent antibacterial activity of cefuroxime axetil (CA), a β-lactamase-stable broad spectrum second generation cephalosporin through solid dispersion (SD) technique. For this purpose, CA loaded SDs (CSDs) were prepared by solvent evaporation method using different concentrations of microcrystalline cellulose (MCC) as carrier. The CSDs were characterized by in-vitro dissolution study, thermal analysis (DSC), crystallinity (PXRD), interactions (FTIR) and morphology (SEM). Among the formulations, CSD-2 showed the highest dissolution rate which was 2.59-fold higher than pure CA with a drug-carrier (CA: MCC) ratio of 1:3. Enhanced dissolution rate was attributed to conversion of drug from crystalline to amorphous state during preparation of SDs, which was validated by DSC, PXRD, FTIR and SEM analyses. Antibacterial activity of CSD-2 against Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922) showed 1.94- and 6.75-fold higher relative zone of inhibition (RZOI), respectively than pure CA. CSD-2 has been found to be the most effective optimized formulation in terms of both enhanced dissolution rate and antibacterial activity. Thus, it can be an effective alternative to conventional dosage forms of CA. However, further investigations are needed to validate its pharmacokinetic properties, in-vivo antibacterial efficacy and safety before recommending as a novel formulation

Development of Indomethacin Sustained Release Microcapsules using Ethyl Cellulose and Hydroxy Propyl Methyl

ABSTRACT: Indomethacin (IM) sustained release microcapsules were successfully prepared using ethyl cellulose (EC) and hydroxy propyl methyl cellulose phthalate (HPMCP) by o/w emulsification-solvent evaporation technique. The prepared microcapsules were evaluated for size, shape, drug content and in vitro drug release. The microcapsules show sustained release curves at pH 7.2 phosphate buffer for up to 6 h. The data obtained from the dissolution profiles were compared in the light of different kinetics models and the regression coefficients were compared. The in vitro dissolution study confirmed the Higuchi-order release pattern. Particle size and release data analysis from five consecutive batches prepared in the laboratory indicated suitable reproducibility of the solvent evaporation process. The release rate increased exponentially with the addition of HPMCP in EC. IM release rate was observed highest with the highest concentration of HPMCP (3:7 ratio of EC:HPMCP), used in the present studies. On the other hand, IM release rate was lowest when EC and HPMCP combination was used at the ratio of 10:0. When percent of HPMCP was increased, the particle size of microcapsules was decreased

Genetic Diversity of SARS-CoV2 and Environmental Settings: Possible Association with Neurological Disorders

International audienceThe new coronavirus (CoV), called novel coronavirus disease 2019 (COVID-19), belongs to the Coronaviridae family which wasoriginated from the sea market in Wuhan city in China, at the end of the year 2019. COVID-19 and severe acute respiratorysyndrome (SARS) are belonging to the same family (Coronaviridae). The current outbreak of COVID-19 creates public concernand threats all over the world and now it spreads out to more than 250 countries and territories. The researchers and scientists fromall over the world are trying to find out the therapeutic strategies to abate the morbidity and mortality rate of the COVID-19 pandemic. The replication, spreading, and severity of SARS-CoV2 depend on environmental settings. Noteworthy, meteorological parameters are considered as crucial factors that affect respiratory infectious disorders, although the controversial effectof the meteorological parameter is exposed against COVID-19. Besides, COVID-19 accelerates the pathogenesis of the neurological disorders. However, the pathogenic mechanisms between COVID-19 and neurological disorders are still unclear. Hence,this review is focused on the genomics and ecology of SARS-CoV2 and elucidated the effects of climatic factors on theprogression of COVID-19. This review also critically finds out the vulnerability between COVID-19 and neurological disordersbased on the latest research data

COVID-19 Outbreak: Pathogenesis, Current Therapies, and Potentials for Future Management

International audienceAt the end of 2019, a novel coronavirus (CoV) was found at the seafood market of Hubei province in Wuhan, China, and this virus was officially named coronavirus diseases 2019 (COVID-19) by World Health Organization (WHO). COVID-19 is mainly characterized by severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) and creates public health concerns as well as significant threats to the economy around the world. Unfortunately, the pathogenesis of COVID-19 is unclear and there is no effective treatment of this newly life-threatening and devastating virus. Therefore, it is crucial to search for alternative methods that alleviate or inhibit the spread of COVID-19. In this review, we try to find out the etiology, epidemiology, symptoms as well as transmissions of this novel virus. We also summarize therapeutic interventions and suggest antiviral treatments, immune-enhancing candidates, general supplements, and CoV specific treatments that control replication and reproduction of SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV)