FORMULATION AND CHARACTERIZATION OF NANO LIPID CARRIER DRY POWDER INHALER CONTAINING CIPROFLOXACIN HYDROCHLORIDE AND N-ACETYL CYSTEINE

ABSTRACT Nanolipid carriers (NLC) are developed as an alternative to solid lipid nanocarriers in order to increase the payload and to prevent drug expulsion. In this study, NLCs loaded with ciprofloxacin hydrochloride (CIP) and N-Acetyl cysteine (NAC) were prepared and evaluated for its delivery to the lung for treatment of the symptoms of cystic fibrosis and chronic obstructive pulmonary disorder. NLCs prepared by emulsification and sonication technique using cetyl palmitate (the solid lipid, 2%) and oleic acid (as the liquid lipid, 2%) and Tween80 (surfactant, 0.25%) showed smaller particle sizes (of199.1 ±1.859 nm) and relatively high encapsulation efficiencies (72.143±1.8 %.) and optimum zeta potential (-38.27 ± 0.384 mV).A novel DPI formulations loaded with the NLC containing CIP(CIP-DPI), NAC (NAC-DPI) and CIP/NAC combination (CIP-NAC-DPI) were prepared by freeze drying method using Lactose (8%w/v) as a cryoprotectant. The DPI prepared showed good flow properties, prolonged drug release and improved stability. In-vitro drug release profile of CIP HCl in case of CIP-NLC showed 55 % release in 15 hours while it was 60% in case of CIP-NLC-DPI formulation. Similar is the case with NAC formulations. Following intratracheal administration in rat model, the percentage of CIP extracted from lungs was 70.2% in case on CIP-NAC-DPI against 49.8% for CIP-DPI and 42.1% for plain CIP. This amount is about 1.6 times increase in CIP in lungs by co-administration with NAC. However, no appreciable change in the residence time of CIP in lungs after intratracheal administration of CIP-DPI and combined DPI (CIP-NAC-DPI) was noted. Keywords: Ciprofloxacin Hydrochloride, N-Acetyl Cysteine, Nano lipid Carriers, Dry powder inhaler, cystic fibrosis.

Incidental finding of a double orifice mitral valve in an elderly patient: value of 3D imaging.

A rare isolated double orifice mitral valve (DOMV) was diagnosed in a 77-year-old male patient, being assessed for surgical repair of the ascending aorta. This is a rare congenital abnormality, usually discovered as an incidental finding during investigation of other congenital heart defects. This case shows that a detailed assessment of all cardiac structures is necessary, not only in young patients, but also in the elderly population, to minimise the under-diagnosis of such rare anomalies. The use of 3D transthoracic echocardiography (TTE) has an increasingly significant role in establishing the diagnosis and extending the morphological and functional understanding of the anomaly. LEARNING POINTS: Thoroughly assessing all cardiac structures, in accordance with the minimum dataset guidelines for transthoracic echocardiography, ensures not only a comprehensive assessment of the primary indication for the scan, but also improves the detection of concomitant and otherwise unknown lesions. Despite falling under the category of congenital heart defects, several rare anomalies such as DOMV can be present in elderly patients, and the adult echocardiographer should have appropriate knowledge and awareness for detecting these conditions. 3D TTE provides a comprehensive assessment of the morphology of DOMV, over and above the information obtained by 2D imaging

Mitral annular fibrous band - a unique morphological variant of a rare congenital mitral valve anomaly: a case report

Background: Left atrial bands are rare and can be associated with mitral valve dysfunction, heart failure, and stroke. Most cases are identified on autopsy, and the demonstration in vivo is very uncommon. Various anatomical configurations have been reported. This description of a mitral annular fibrous band contributes to the literature as the first reported case to traverse the supravalvular mitral inflow region, without involving the left atrium. Case summary: A 59-year-old man with a history of metastatic duodenal carcinoma was admitted with a 2-week history of fever and rigors. Inflammatory markers were elevated and blood cultures positive for Enterococcus feacium. Transoesophageal echocardiography performed to investigate for infective endocarditis revealed a 2.3 cm long, thin fibrous band attached to the posterior mitral annulus and extending to the base of the middle scallop of the anterior mitral valve leaflet causing localized tethering, but no valve dysfunction. The band was felt to represent a bystander anatomic variant unrelated to the sepsis, which was most likely gastrointestinal in origin. The patient responded well to intravenous antibiotics. Conclusions: The presence of an abnormal intracardiac structure in the setting of occult infection should always raise the suspicion of infective endocarditis. Using detailed 2D multiplanar and 3D transoesophageal echocardiography, we were able to identify the anomalous band and exclude any overt infective vegetations attached to the band or the leaflets. Once identified, treatment options range from conservative management to surgical resection and mitral valve surgery if concomitant valvular dysfunction is demonstrated

Single and Double Diamond Circular Microstrip Patch Antenna

Volume 1 Issue 3 (May 2013

FORMULATION AND CHARACTERIZATION OF NANO LIPID CARRIER DRY POWDER INHALER CONTAINING CIPROFLOXACIN HYDROCHLORIDE AND N-ACETYL CYSTEINE

ABSTRACT Nanolipid carriers (NLC) are developed as an alternative to solid lipid nanocarriers in order to increase the payload and to prevent drug expulsion. In this study, NLCs loaded with ciprofloxacin hydrochloride (CIP) and N-Acetyl cysteine (NAC) were prepared and evaluated for its delivery to the lung for treatment of the symptoms of cystic fibrosis and chronic obstructive pulmonary disorder. NLCs prepared by emulsification and sonication technique using cetyl palmitate (the solid lipid, 2%) and oleic acid (as the liquid lipid, 2%) and Tween80 (surfactant, 0.25%) showed smaller particle sizes (of199.1 ±1.859 nm) and relatively high encapsulation efficiencies (72.143±1.8 %.) and optimum zeta potential (-38.27 ± 0.384 mV).A novel DPI formulations loaded with the NLC containing CIP(CIP-DPI), NAC (NAC-DPI) and CIP/NAC combination (CIP-NAC-DPI) were prepared by freeze drying method using Lactose (8%w/v) as a cryoprotectant. The DPI prepared showed good flow properties, prolonged drug release and improved stability. In-vitro drug release profile of CIP HCl in case of CIP-NLC showed 55 % release in 15 hours while it was 60% in case of CIP-NLC-DPI formulation. Similar is the case with NAC formulations. Following intratracheal administration in rat model, the percentage of CIP extracted from lungs was 70.2% in case on CIP-NAC-DPI against 49.8% for CIP-DPI and 42.1% for plain CIP. This amount is about 1.6 times increase in CIP in lungs by co-administration with NAC. However, no appreciable change in the residence time of CIP in lungs after intratracheal administration of CIP-DPI and combined DPI (CIP-NAC-DPI) was noted. Keywords: Ciprofloxacin Hydrochloride, N-Acetyl Cysteine, Nano lipid Carriers, Dry powder inhaler, cystic fibrosis.

Torrential mitral regurgitation following right ventricular apical pacing in rheumatic mitral valve disease: a case report

Background Mitral regurgitation may develop or worsen following right ventricular apical pacing due to dyssynchronous left ventricular contraction. Pre-existing secondary mitral annular dilation is a well-recognized and important contributing factor. This description of pacing-induced torrential mitral regurgitation in the setting of rheumatic mitral valve disease is a rare case in which a primary mitral valve lesion was the antecedent mechanism. Case summary A 60-year-old man was admitted with dizziness and pre-syncope. Twelve-lead electrocardiogram showed complete heart block. A dual-chamber pacemaker was implanted and programmed in DDD mode. Transthoracic echocardiography performed a day later demonstrated a left ventricular ejection fraction (LVEF) of 63% and moderate mitral regurgitation. The patient presented 4 months later with breathlessness and orthopnoea. Pacemaker interrogation demonstrated a 98% right ventricular pacing burden. Echocardiography revealed torrential mitral regurgitation secondary to left ventricular dyssynchrony and complete loss of leaflet coaptation with preserved systolic function. Post-capillary pulmonary hypertension was diagnosed following right heart catheterization. The patient underwent metallic mitral valve replacement, tricuspid annuloplasty, and left internal mammary artery grafting to the left anterior descending artery for a severe proximal stenosis. On inspection, the native mitral valve was notably rheumatic in appearance, and this was confirmed histologically. Discussion It is important to closely monitor the progression of mitral regurgitation in those with primary mitral valve disease undergoing right ventricular pacing. Early follow-up may prevent the adverse haemodynamic consequences of worsening mitral regurgitation, with a greater chance of recovery of left ventricular function following surgery

A rare case of extensive biventricular cardiac sarcoidosis with reversible torrential tricuspid regurgitation

Reversal of torrential tricuspid regurgitation is rarely seen. We describe a case in which effective immunosuppression alongside conventional heart failure therapies lead to reversibility of torrential tricuspid regurgitation in a patient with cardiac sarcoidosis. We also discuss the diagnostic challenge in distinguishing cardiac sarcoidosis from other myocardial diseases in a patient presenting with biventricular failure

A Kernel of Truth: Determining Rumor Veracity on Twitter by Diffusion Pattern Alone

Recent work in the domain of misinformation detection has leveraged rich signals in the text and user identities associated with content on social media. But text can be strategically manipulated and accounts reopened under different aliases, suggesting that these approaches are inherently brittle. In this work, we investigate an alternative modality that is naturally robust: the pattern in which information propagates. Can the veracity of an unverified rumor spreading online be discerned solely on the basis of its pattern of diffusion through the social network? Using graph kernels to extract complex topological information from Twitter cascade structures, we train accurate predictive models that are blind to language, user identities, and time, demonstrating for the first time that such "sanitized" diffusion patterns are highly informative of veracity. Our results indicate that, with proper aggregation, the collective sharing pattern of the crowd may reveal powerful signals of rumor truth or falsehood, even in the early stages of propagation.Comment: Published at The Web Conference (WWW) 202