Development of Sublingual tablets of Bisoprolol Hemifumarate / Hydroxypropyl -β-Cyclodextrin Complex for Potential treatment of Angina Pectoris

Fast-disintegrating tablet drug delivery is gaining an importance for drug delivery technology especially for geriatric and pediatric patient because of swallowing difficulties.   In certain diseases such as hypertension and angina pectoris therapy, taking a fast pharmacological response is of important criteria. Thus, the aim of the present work was to prepare a novel fast disintegrating Bisoprolol Hemifumarate (BH) tablet formulation for sublingual administration based on the use of 2-hydroxypropyl-βcyclodextrin (HP-βCD) which forms an inclusion complex with (BH) to improve the permeability of the drug to sublingual membrane, in addition to mask the taste of the drug through the inclusion complex.  Attempt has been made to prepare fast disintegrating tablets of (BH) using superdistintegrants like crosscarmellose sodium and crospovidone in concentration of (5%). Eight different formulae (B1-B8) with variation in tablet excipients were prepared by direct compression method using different mucoadhesive polymers such as chitosan and polyethylene glycol 6000 at different concentration (3% and 6%) for reduction the flushing action of saliva and to provide enough contact time for drug to be absorbed. The tablets were evaluated for the weight variation, hardness, friability, wetting time, disintegration time and dissolution study. The formulae B2 and B7 possessed the lowest disintegration time due to the presence of the high concentration of chitosan, which has some disintegration action, thus were subjected to a pharmacokinetic study using human volunteers. The bioavailability of B2 was significantly higher than that of the reference (Concor®) (p > 0.05).  Thus, the present investigations suggest that (BH) sublingual tablets allowed the rapid tablet disintegration, improved bioavailability and effective in emergency treatment of anginal pain and hypertension

Development of Sublingual tablets of Bisoprolol Hemifumarate / Hydroxypropyl -β-Cyclodextrin Complex for Potential treatment of Angina Pectoris

Fast-disintegrating tablet drug delivery is gaining an importance for drug delivery technology especially for geriatric and pediatric patient because of swallowing difficulties.   In certain diseases such as hypertension and angina pectoris therapy, taking a fast pharmacological response is of important criteria. Thus, the aim of the present work was to prepare a novel fast disintegrating Bisoprolol Hemifumarate (BH) tablet formulation for sublingual administration based on the use of 2-hydroxypropyl-βcyclodextrin (HP-βCD) which forms an inclusion complex with (BH) to improve the permeability of the drug to sublingual membrane, in addition to mask the taste of the drug through the inclusion complex.  Attempt has been made to prepare fast disintegrating tablets of (BH) using superdistintegrants like crosscarmellose sodium and crospovidone in concentration of (5%). Eight different formulae (B1-B8) with variation in tablet excipients were prepared by direct compression method using different mucoadhesive polymers such as chitosan and polyethylene glycol 6000 at different concentration (3% and 6%) for reduction the flushing action of saliva and to provide enough contact time for drug to be absorbed. The tablets were evaluated for the weight variation, hardness, friability, wetting time, disintegration time and dissolution study. The formulae B2 and B7 possessed the lowest disintegration time due to the presence of the high concentration of chitosan, which has some disintegration action, thus were subjected to a pharmacokinetic study using human volunteers. The bioavailability of B2 was significantly higher than that of the reference (Concor®) (p > 0.05).  Thus, the present investigations suggest that (BH) sublingual tablets allowed the rapid tablet disintegration, improved bioavailability and effective in emergency treatment of anginal pain and hypertension

Structured Health Literacy Intervention for Mothers Regarding Stem Cells Therapy

Background: Stem cells have tremendous promise uses for the future to treat a variety of diseases, injuries, and other health-related conditions. Their potential is evident to promote the repair response of diseased, dysfunctional or injured tissue. Aim: This study aimed to assess the effectiveness of applying a structured health literacy intervention regarding stem cells therapy (SCT) on the mothers' level of knowledge and attitude. Methodology: A quasi-experimental one-group pre-post test design was utilized. The study involved 302 mothers recruited from the pediatric outpatient clinics of Mansoura University Children Hospital (MUCH), Egypt. Data were collected using two structured interview sheets (knowledge and attitude). Results: There were highly statistically significant differences in mothers’ knowledge and attitude one-month post-application of the structured health literacy intervention regarding stem cells therapy compared to pre-application (P=<0.001). Conclusion: Application of a structured health literacy intervention showed a significant improvement in mothers' level of knowledge and attitude regarding stem cells therapy. Keywords: Attitude, Health Literacy, Knowledge, Stem Cells Therapy. DOI: 10.7176/JHMN/61-06 Publication date: April 30th 201

Performance Enhancement of a Variable Speed Permanent Magnet Synchronous Generator Used for Renewable Energy Application

The paper aims to develop an improved control system to enhance the dynamics of a permanent magnet synchronous generator (PMSG) operating at varying speeds. The generator dynamics are evaluated based on lowing current, power, and torque ripples to validate the effectiveness of the proposed control system. The adopted controllers include the model predictive power control (MPPC), model predictive torque control (MPTC), and the designed predictive voltage control (PVC). MPPC seeks to regulate the active and reactive power, while MPTC regulates the torque and flux. MPPC and MPTC have several drawbacks, like high ripple, high load commutation, and using a weighting factor in their cost functions. The methodology of designed predictive voltage comes to eliminate these drawbacks by managing the direct voltage by utilizing the deadbeat and finite control set FCS principle, which uses a simple cost function without needing any weighting factor for equilibrium error issues. The results demonstrate several advantages of the proposed PVC technique, including faster dynamic response, simplified control structure, reduced ripples, lower current harmonics, and decreased computational requirements when compared to the MPPC and MPTC methods. Additionally, the study considers the integration of blade pitch angle and maximum power point tracking (MPPT) controls, which limit wind energy utilization when the generator speed exceeds its rated speed and maximize wind energy extraction during wind scarcity. In summary, the proposed PVC enhanced control system exhibits superior performance in terms of dynamic response, control simplicity, current quality, and computational efficiency when compared to alternative methods

Management of Chronic Myeloid Leukemia with Sever COVID 19: A Case Report

Coronavirus disease-19 (COVID-19) is a pandemic viral disease that can cause devastating complications such as acute respiratory disease, especially in patients with comorbidities. We do not know yet full pictures of this disease, especially in hematological malignancies. Here, we present management of a 57-year-old male with chronic phase chronic myeloid leukemia, tested positive for COVID-19, then complicated with acute respiratory distress syndrome

Promising anti-microbial effect of apple vinegar as a natural decolonizing agent in healthcare workers

Introduction: Colonized Healthcare workers (HCWs) are an essential reservoir of nosocomial infections. This study aims to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carriage rate among HCWs, to evaluate at Fayoum University Hospital the susceptibility of isolates to mupirocin and Chlorhexidine and to investigate the antimicrobial effect of different vinegars on MRSA as a natural decolonizing agent. Methods: Nasal and hand swabs were collected from 124 HCWs at Fayoum University Surgical Hospital. Isolates were identified using the standard microbiological methods. Susceptibilities to mupirocin and Chlorhexidine were determined by disk diffusion and broth micro-dilution. Screening antimicrobial effect of commercial vinegars was determined by agar well-diffusion method and microdilution method. Results: About one tenth 11.3% (14/124) of HCWs showed nasal carriage of MRSA. Workers were the predominant carriers (P = 0.013). The overall non-nasal carriage rate of MRSA was 6.5% (8/124). Among MRSA isolates Low-level Mupirocin resistance (LLMR) showed in (36.4%, 8/22). MICs ranged from 0.25 to 32 μg/ml. Also, (13.6 %, 3/22) showed Chlorhexidine resistance, MICs ranged from 0.039 to 5 μg/ml. Apple vinegar showed the highest susceptibility among vinegars (p < 0.0001) with MIC values varied from 0.058 to 1.87 μg/ml Discussion: The emergence of mupirocin (36.4%) and Chlorhexidine (13.6%) resistant Staphylococcus aureus among HCWs should be of excessive concern. Apple vinegar has a promising antimicrobial effect against MRSA isolates and could be used as a decolonizing agent

The Shigella ProU system is required for osmotic tolerance and virulence : Shigella ProU in osmotic tolerance and virulence

To cope with hyperosmotic stress encountered in the environments and in the host, the pathogenic as well as non-pathogenic microbes use diverse transport systems to obtain osmoprotectants. To study the role of Shigella sonnei ProU system in response to hyperosmotic stress and virulence, we constructed deletion and complementation strains of proV and used an RNAi approach to silence the whole ProU operon. We compared the response between wild type and the mutants to the hyperosmotic pressure in vitro, and assessed virulence properties of the mutants using gentamicin protection assay as well as Galleria mellonella moth larvae model. In response to osmotic stress by either NaCl or KCl, S. sonnei highly up-regulates transcription of proVWX genes. Supplementation of betaine greatly elevates the growth of the wild type S. sonnei but not the proV mutants in M9 medium containing 0.2 M NaCl or 0.2 M KCl. The proV mutants are also defective in intracellular growth compared with the wild type. The moth larvae model of G. mellonella shows that either deletion of proV gene or knockdown of proVWX transcripts by RNAi significantly attenuates virulence. ProU system in S. sonnei is required to cope with osmotic stress for survival and multiplication in vitro and ex vivo, and for infection

Hepatitis B virus and hepatitis C virus in pregnant Sudanese women

<p>Abstract</p> <p>Background</p> <p>The epidemiology of viral hepatitis during pregnancy is essential for health planners and programme managers. While much data exist concerning viral hepatitis during pregnancy in many African countries, no proper published data are available in Sudan.</p> <p>Aim</p> <p>The study aimed to investigate the sero-prevalance and the possible risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) among antenatal care attendants in central Sudan.</p> <p>Methods</p> <p>During 3 months from March–June 2006, sera were collected from pregnant women at Umdurman Maternity Hospital in Sudan, and they were tested for markers of hepatitis B virus (HBVsAg) and HCV.</p> <p>Results</p> <p>HBVsAg was detected in 41 (5.6%) out 728 women, Anti-HCV was detected in 3 (0.6%) out of 423 women, all of them were not aware of their condition. Age, parity, gestational age, residence, history of blood transfusion, dental manipulations, tattooing and circumcision did not contribute significantly to increased HBVsAg sero-positivity.</p> <p>Conclusion</p> <p>Thus 5.6% of pregnant women were positive for HBVsAg irrespective of their age, parity and socio-demographic characteristics. There was low prevalence of Anti-HCV.</p

Regulatory natural killer cell expression in atopic childhood asthma

Introduction: Different subsets of natural killer (NK) cells were found to play a role in pathogenesis of allergy. We sought to investigate the expression of regulatory NK cells (CD56+CD16+CD158+) in atopic children with bronchial asthma in order to outline the value of these cells as biomarkers of disease severity and/or control.Methods: A cross sectional controlled study was carried out in the Pediatric Allergy and Immunology Unit, Ain Shams University. The study included 45 atopic children [mean age(SD)= (2.9) years] with bronchial asthma (BA) and/or allergic rhinitis (AR)as well as 40 healthy matched controls. Enrolled subjects underwent complete blood counting and flow cytometric measurement of NK cell (CD16+ CD56+) and regulatory NK cells (CD16+CD56+CD158+).Results: Patients had significantly higher regulatory NK cell percentages [mean (SD)= 41 (52) %] than controls [mean (SD)=15 (7.1)]; p≤0.001. Regulatory NK cell counts and percentages did not vary with the concomitant presence of AR or the degree of asthma control. Regulatory NK cell counts tended to be higher in children with moderate/severe BA compared to those with mild asthma but the difference did not reach statistical significance (U= -1.8, p=0.06). NK cell counts [mean (SD)= 159 (164) cells/μl] and percentages [mean (SD)= 3.7 (3.2) %] were comparable among patients and controls and did not vary with the presence of AR (p= 0.51, 0.95) or with the degree of asthma control. NK cells absolute counts and percentages tended to be higher among patients with moderate/severe compared to mild asthma but the difference did not reach statistical significance.Conclusions: Regulatory NK cells seem to be increased in childhood asthma. We recommend wider scale prospective studies on steroid-naïve subjects involving measurement of cytokines that are secreted by different types of NK cells.Keywords: Natural killer, regulatory, asthma, children, allerg

A practical guide to managing hypertension, hyperlipidemia, and hyperglycemia in patients with chronic myeloid leukemia

Tyrosine kinase inhibitors (TKIs) have significantly improved the prognosis of chronic myeloid leukemia (CML) since their approval. Although safe in general, TKIs carry concerns about cardiovascular adverse events. Hypertension, diabetes, and dyslipidemia are among the most common baseline comorbidities among CML patients. Guidelines for the management of the existing comorbidities or those related to TKI therapy are lacking. This paper will review hypertension, hyperglycemia and hyperlipidemia reported in CML patients or associated with TKI therapy and then propose a simple guide on their management