RP-HPLC Method Development and Validation for Simultaneous Estimation of Duloxetin and Methylcobalamine in Combined Dosage Form

A simple, precise, accurate, simultaneous stability indicating RP-HPLC method for the estimation of DLU (Duloxetin) and MCB (Methylcobalamine) in combined dosage form was developed using Intersil-C18 (4.6 x 250mm, 5m) in an Isocratic mode with mobile phase comprising of Phosphate buffer (pH 4.5) The flow rate was 1 mL/ min and effluent was monitored at 255.0 nm. The retention times were found to be 5.32 min for DLU and 3.59 min for MCB. The assay exhibited a linear dynamic range of 20- 120 g/mL for DLU and 10- 60 g/mL for MCB. The calibration curves were linear (r 2 = 0.999 for DLU and r 2 = 0.999 for MCB) over the entire linear range. Mean % recovery was found to be 99.68 % for DLU and 100.3 % for MCB with % RSD was NMT 2 for both estimations which fully agrees with system suitability which is in good agreement with labeled amount of formulation. The % RSD for Intra- Day and Inter-Day Precision was NMT than 2 for both the drugs. The developed method was validated as per ICH guidelines

Are interventions to increase the uptake of screening for cardiovascular disease risk factors effective? A systematic review and meta-analysis

Abstract Background Cardiovascular disease (CVD) is the leading cause of death globally. However, many individuals are unaware of their CVD risk factors. The objective of this systematic review is to determine the effectiveness of existing intervention strategies to increase uptake of CVD risk factors screening. Methods A systematic search was conducted through Pubmed, CINAHL, EMBASE and Cochrane Central Register of Controlled Trials. Additional articles were located through cross-checking of the references list and bibliography citations of the included studies and previous review papers. We included intervention studies with controlled or baseline comparison groups that were conducted in primary care practices or the community, targeted at adult populations (randomized controlled trials, non-randomized trials with controlled groups and pre- and post-intervention studies). The interventions were targeted either at individuals, communities, health care professionals or the health-care system. The main outcome of interest was the relative risk (RR) of screening uptake rates due to the intervention. Results We included 21 studies in the meta-analysis. The risk of bias for randomization was low to medium in the randomized controlled trials, except for one, and high in the non-randomized trials. Two analyses were performed; optimistic (using the highest effect sizes) and pessimistic (using the lowest effect sizes). Overall, interventions were shown to increase the uptake of screening for CVD risk factors (RR 1.443; 95% CI 1.264 to 1.648 for pessimistic analysis and RR 1.680; 95% CI 1.420 to 1.988 for optimistic analysis). Effective interventions that increased screening participation included: use of physician reminders (RR ranged between 1.392; 95% CI 1.192 to 1.625, and 1.471; 95% CI 1.304 to 1.660), use of dedicated personnel (RR ranged between 1.510; 95% CI 1.014 to 2.247, and 2.536; 95% CI 1.297 to 4.960) and provision of financial incentives for screening (RR 1.462; 95% CI 1.068 to 2.000). Meta-regression analysis showed that the effect of CVD risk factors screening uptake was not associated with study design, types of population nor types of interventions. Conclusions Interventions using physician reminders, using dedicated personnel to deliver screening, and provision of financial incentives were found to be effective in increasing CVD risk factors screening uptake

Development and validation of new analytical method for the estimation of fluoxetine in bulk and dosage form by UV spectrophotometry

A simple, rapid and precise method is developed for the quantitative determination of Fluoxetine in combined pharmaceutical-dosage forms. The method was based on UV Spectrophotometric determination of Fluoxetine drug using Beer-Lamberts Law. It involves absorbance measurement at 224 nm (λmax of Fluoxetine) in water. For UV Spectrophotometric method, linearity was obtained in concentration range of 5-30 mcg/ml with regression 0.999 for Fluoxetine respectively. Recovery was in the range of 98 -102%; the value of standard deviation and %R.S.D was found to be < 2 shows high precision of the method.

EVALUATION OF ANTI-OXIDANT AND HEPATOPROTECTIVE ACTIVITY OF COUROUPITA GUIANENSIS LEAVES

Abstract: The present study was conducted to evaluate the hepatoprotective activity of ethanolic leaf extract of Couroupita guianensis against CCL 4 induced liver damage in rats. Anti-oxidant activity was evaluated by DPPH (2, 2-diphenyl-1-picrylhydrazyl) and hydrogen peroxide scavenging. Ascorbic acid was used as the standard antioxidants for comparison. Healthy male Wistar albino rats of either sex (150-200g) were used for the in-vivo investigations. Liver damage was induced by administration of 30% CCl 4 suspended in olive oil (1ml/kg body weight). Activities of liver marker enzymes, serum glutamate oxaloacetate transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), asparate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin (TB) and total protein (TP) at doses of 150mg/kg and 300 mg/kg showed a significant hepatoprotective effect in comparison with the standard (silymarin). The present study demonstrates that the extract of Couroupita guianensis has hepatoprotective effect against CCl 4 induced hepatotoxicity

Are interventions to increase the uptake of screening for cardiovascular disease risk factors effective? a systematic review and meta-analysis

Background: Cardiovascular disease (CVD) is the leading cause of death globally. However many individuals are unaware of their CVD risk factors. The objective of this systematic review is to determine the effectiveness of existing intervention strategies to increase uptake of CVD risk factors screening. Methods: A systematic search was conducted through Pubmed, CINAHL, EMBASE and Cochrane Central Register of Controlled Trials. Additional articles were located through cross-checking of the references list and bibliography citations of the included studies and previous review papers. We included intervention studies with controlled or baseline comparison groups that were conducted in primary care practices or the community, targeted at adult populations (randomized controlled trials, non-randomized trials with controlled groups and pre- and post-intervention studies). The interventions were targeted either at individuals, communities, health care professionals or the health-care system. The main outcome of interest was the relative risk (RR) of screening up take rates due to the intervention. Results: We included 21 studies in the meta-analysis. The risk of bias for randomization was low to medium in the randomized controlled trials, except for one, and high in the non-randomized trials. Two analyses were performed; optimistic (using the highest effect sizes) and pessimistic (using the lowest effect sizes). Overall, interventions were shown to increase the uptake of screening for CVD risk factors (RR 1.443; 95% CI 1.264 to 1.648 for pessimistic analysis and RR 1.680; 95% CI 1.420 to 1.988 for optimistic analysis). Effective interventions that increased screening participation included: use of physician reminders (RR ranged between 1.392; 95% CI 1.192 to 1.625, and 1.471; 95% CI 1.304 to 1.660), use of dedicated personnel (RR ranged between 1.510; 95% CI 1.014 to 2.247, and 2.536; 95% CI 1.297 to 4.960) and provision of financial incentives for screening (RR 1.462; 95% CI 1.068 to 2.000). Meta-regression analysis showed that the effect of CVD risk factors screening uptake was not associated with study design, types of population or types of interventions. Conclusions: Interventions using physician reminders, using dedicated personnel to deliver screening, and provision of financial incentives were found to be effective in increasing CVD risk factors screening uptake

Diffusion tensor imaging parameters in mild traumatic brain injury and its correlation with early neuropsychological impairment: a longitudinal study

We explored the prognostic value of diffusion tensor imaging (DTI) parameters of selected white matter (WM) tracts in predicting neuropsychological outcome, both at baseline and 6 months later, among well-characterized patients diagnosed with mild traumatic brain injury (mTBI). Sixty-one patients with mTBI (mean age=27.08; standard deviation [SD], 8.55) underwent scanning at an average of 10 h (SD, 4.26) post-trauma along with assessment of their neuropsychological performance at an average of 4.35 h (SD, 7.08) upon full Glasgow Coma Scale recovery. Results were then compared to 19 healthy control participants (mean age=29.05; SD, 5.84), both in the acute stage and 6 months post-trauma. DTI and neuropsychological measures between acute and chronic phases were compared, and significant differences emerged. Specifically, chronic-phase fractional anisotropy and radial diffusivity values showed significant group differences in the corona radiata, anterior limb of internal capsule, cingulum, superior longitudinal fasciculus, optic radiation, and genu of corpus callosum. Findings also demonstrated associations between DTI indices and neuropsychological outcome across two time points. Our results provide new evidence for the use of DTI as an imaging biomarker and indicator of WM damage occurring in the context of mTBI, and they underscore the dynamic nature of brain injury and possible biological basis of chronic neurocognitive alterations

Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial

Objective: To determine the effectiveness of an individually-tailored multifactorial intervention in reducing falls among at risk older adult fallers in a multi-ethnic, middle-income nation in South-East Asia. Design: Pragmatic, randomized-controlled trial. Setting: Emergency room, medical outpatient and primary care clinic in a teaching hospital in Kuala Lumpur, Malaysia. Participants: Individuals aged 65 years and above with two or more falls or one injurious fall in the past 12 months. Intervention: Individually-tailored interventions, included a modified Otago exercise programme, HOMEFAST home hazards modification, visual intervention, cardiovascular intervention, medication review and falls education, was compared against a control group involving conventional treatment. Primary and secondary outcome measures: The primary outcome was any fall recurrence at 12-month follow-up. Secondary outcomes were rate of fall and time to first fall. Results: Two hundred and sixty-eight participants (mean age 75.3 ±7.2 SD years, 67% women) were randomized to multifactorial intervention (n = 134) or convention treatment (n = 134). All participants in the intervention group received medication review and falls education, 92 (68%) were prescribed Otago exercises, 86 (64%) visual intervention, 64 (47%) home hazards modification and 51 (38%) cardiovascular intervention. Fall recurrence did not differ between intervention and control groups at 12-months [Risk Ratio, RR = 1.037 (95% CI 0.613–1.753)]. Rate of fall [RR = 1.155 (95% CI 0.846–1.576], time to first fall [Hazard Ratio, HR = 0.948 (95% CI 0.782–1.522)] and mortality rate [RR = 0.896 (95% CI 0.335–2.400)] did not differ between groups. Conclusion: Individually-tailored multifactorial intervention was ineffective as a strategy to reduce falls. Future research efforts are now required to develop culturally-appropriate and affordable methods of addressing this increasingly prominent public health issue in middle-income nations

Effect of Ashwagandha and Aloe vera pretreatment on intestinal transport of buspirone across rat intestine

The transport of buspirone across rat intestine (duodenum, jejunum, ileum and colon) was studied by using the non-everted sac method. Rats were pretreated with ashwagandha (Withania somnifera) and Aloe vera juice for 7 days. The rats were sacrificed by using anesthetic ether, the intestinal segments were isolated and used for the studies. The probe drug (buspirone) solution was placed in the isolated intestinal sac. Samples were collected at preset time points and replaced with fresh buffer. The drug content in the samples was estimated using high performance liquid chromatography method. Control experiments were also performed. The results reveal that there was a significant (p < 0.05) difference compared to control, in the transport of buspirone from the intestinal sacs which were pretreated with ashwagandha and Aloe vera juice. It suggests that both ashwagandha and Aloe vera might be acting by inhibiting the transporters and enzymes which are responsible for transport/metabolism of buspirone.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Bactericidal activity of biosynthesized silver nanoparticles against human pathogenic bacteria

Green synthesis is an attractive and eco-friendly approach to generate potent antibacterial silver nanoparticles (Ag-NPs). Such particles have long been used to fight bacteria and represent a promising tool to overcome the emergence of antibiotic-resistant bacteria. In this study, green synthesis of Ag-NPs was attempted using plant extracts of Aloe vera, Portulaca oleracea and Cynodon dactylon. The identity and size of Ag-NPs was characterized by ultraviolet–visible spectrophotometer and scanning electron microscopy. Monodispersed Ag-NPs were produced with a range of different sizes based on the plant extract used. The bactericidal activity of Ag-NPs against a number of human pathogenic bacteria was determined using the disc diffusion method. The results showed that Gram positive bacteria were more susceptible than Gram negative ones to these antibacterial agents. The minimum inhibitory concentration was determined using the 96-well plate method. Finally, the mechanism by which Ag-NPs affect bacteria was investigated by SEM analysis. Bacteria treated with Ag-NPs were seen to undergo shrinkage and to lose their viability. This study provides evidence for a cheap and effective method for synthesizing potent bactericidal Ag-NPs and demonstrates their effectiveness against human pathogenic bacteria

Viscoelastic haemostatic assay augmented protocols for major trauma haemorrhage (ITACTIC): a randomized, controlled trial

Purpose: Contemporary trauma resuscitation prioritizes control of bleeding and uses major haemorrhage protocols (MHPs) to prevent and treat coagulopathy. We aimed to determine whether augmenting MHPs with Viscoelastic Haemostatic Assays (VHA) would improve outcomes compared to Conventional Coagulation Tests (CCTs). Methods: This was a multi-centre, randomized controlled trial comparing outcomes in trauma patients who received empiric MHPs, augmented by either VHA or CCT-guided interventions. Primary outcome was the proportion of subjects who, at 24 h after injury, were alive and free of massive transfusion (10 or more red cell transfusions). Secondary outcomes included 28-day mortality. Pre-specified subgroups included patients with severe traumatic brain injury (TBI). Results: Of 396 patients in the intention to treat analysis, 201 were allocated to VHA and 195 to CCT-guided therapy. At 24 h, there was no difference in the proportion of patients who were alive and free of massive transfusion (VHA: 67%, CCT: 64%, OR 1.15, 95% CI 0.76–1.73). 28-day mortality was not different overall (VHA: 25%, CCT: 28%, OR 0.84, 95% CI 0.54–1.31), nor were there differences in other secondary outcomes or serious adverse events. In pre-specified subgroups, there were no differences in primary outcomes. In the pre-specified subgroup of 74 patients with TBI, 64% were alive and free of massive transfusion at 24 h compared to 46% in the CCT arm (OR 2.12, 95% CI 0.84–5.34). Conclusion: There was no difference in overall outcomes between VHA- and CCT-augmented-major haemorrhage protocols