Comparative evaluation of dexmedetomidine versus magnesium sulphate on the adequacy of hypotensive anesthesia and post-operative recovery for patients undergoing endoscopic transnasal transsphenoidal pituitary tumor resection

Background: Perioperative use of magnesium sulfate (MgSO4), dexmedetomidine, have been tried in order to provide beneficial clinical effects during general anesthesia (GA). However, few literature discussed it with varying results. Several clinical researches have showed that usage of MgSO4 infusion was associated with a reduction in anesthetic requirement and postsurgical analgesic consumption during GA.Objective: This study aimed to assess the pharmacologic effects of the use of dexmedetomidine and MgSO4 on anesthetic requirement, intra operative haemodynamics stability and postsurgical analgesic effects on the adequacy of hypotensive anesthesia during transsphenoidal resection of pituitary tumours.Patients and methods: A total of 110 cases were enrolled in this prospective study. They were randomized into 2 groups: Group D (55 cases) that was commenced on dexmedetomidine, and group M (55 cases) which received MgSO4Results: The mean values of Boezaart score were significantly decreased in Group D in comparison to group M. In addition, isoflurane and propranolol consumption showed a significant decrease in group D. However, blood loss showed no significant difference when comparing the same groups. Group D expressed significantly longer emergence and extubation times compared to Group M.Conclusion: Dexmedetomidine appears to be superior compared to magnesium sulphate in achieving hypotensive anesthesia during pituitary surgery

Combination of FDM 3D Printing and Compressed Tablet for Preparation of Baclofen as Gastro-Floating Drug Delivery System (Conference Paper )#

This study aimed to develop an oral drug delivery system for gastro-retentive sustained drug release of baclofen by using a 3D printed capsular device since baclofen has a short half-life of 2.5 to 4 hours and has a narrow absorption window. Firstly sustained-release tablets of baclofen were formulated through the hot-melt extrusion of various thermoplastic polymers and direct compression of the extrudate, then a capsular device was designed and 3D printed to contain two air pockets to enable floating of the device and has four windows for drug release. 3D printing of the capsular device was done by an FDM printer using biodegradable PLA filament, and the sustained release tablets were inserted into the device to allow the medicine to be released into the stomach over a longer period. An in vitro buoyance test and an in vitro dissolution test were used to examine the buoyancy and sustained-release features of the formulated gastro-floating system. Five sustained release formulas were developed using different thermoplastic polymers in hot-melt extrusion. Produced tablets were assayed for drug content, hardness, and friability while a DSC study was done on the selected formula. F 5 which contains 20% baclofen, 55% Eudragit RS-100, 20% ethylcellulose, and 5% PEG 4000 showed sustained release where the complete dissolution of the drug occurred in 12 hours, and the gastro-floating device remained floating all the time. This method has a great potential for developing various floating drug delivery systems with the required release profile

Use of Oral Mini Pulse Dexamethasone in Vitiligo Patients: Review Article

Background: One to two percent of the population globally suffers from vitiligo, an acquired depigmentation condition of multifactorial etiology. Macules and patches of depigmentation characterize vitiligo. People's moods are affected greatly and depressingly by it. As a result, prompt and effective therapy is necessary. Many individuals are able to slow the advancement of the disease, acquire repigmentation, and achieve cosmetically appealing results with proper therapy.There is a wide range of treatments for vitiligo, including topical corticosteroids (TCS) as monotherapy (as for vitiligo local therapy) or in conjunction with phototherapy or other topical medications in generalized vitiligo. Intermittent administration of large (pharmacological) dosages to maximize therapeutic benefit and prevent side effects is known as dexamethasone oral mini pulse (OMP) treatment. Objective: to determine the success of oral dexamethasone in vitiligo management. Conclusion: In vitiligo patients, when corticosteroids are provided at the onset or at early stages of disease, they can reduce disease progression and promote repigmentation and in some cases total repigmentation

TOPICAL NANOEMULSION-BASED GEL OF ISOCONAZOLE NITRATE

This study aimed to make an o/w nanoemulsion of isoconazole the drug nitrate (ISN) for topical use. Low aqueous solubility is a characteristic feature of the imidazole antifungal ISN. Therefore, ISN nanoemulsion would increase dispersibility and decreases skin resistance by enhancing the drug penetration to the first layers of skin (stratum corneum). The work included constructing the pseudo-ternary phase diagrams by using the aqueous titration method. The prepared o/w nanoemulsions were composed of oil, Smix (a mixture of surfactant and co-surfactant) and deionized water (DW). ISN nanoemulsions were subjected to characterization studies to choose the best formula. According to the characterization studies, the optimal formula, designated NE14 contains 1% ISN, 66% Smix ((1:3) tween60: propylene glycol:ethanol), 7% oleic acid, and 27% deionized water was reached. Formula NE14 is characterized by having a polydispersity index of (0.146), pH (5.76), droplet size (84.6 nm), percent transmittance (98.8%), viscosity (80m Pa.s) and a high release of isoconazole propably due low viscosity. The droplet size of NE14 (84.6nm) was also confirmed by an atomic force microscopy (AFM) research. The improved formula (ISN NE14) was found to be a promising nanoemulsion formula for enhancing the topical bioavailability of ISN and thus could increase its efficacy for the treatment of topical fungal infections

Investigation of Solubility Enhancement Approaches of Ticagrelor

ABSTRACT                    Ticagrelor is an orally administered antiplatelet medicine, direct-acting P2Y12-receptor antagonist. Ticagrelor binds reversibly and noncompetitively to the P2Y12 receptor at a site distinct from that of the endogenous agonist adenosine diphosphate (ADP). Inhibition of platelet aggregation stimulated by ADP is a commonly used pharmacodynamic parameter for P2Y12-receptor antagonists.                   Ticagrelor is a crystalline powder with an aqueous solubility of approximately 10?g/mL at room temperature. Ticagrelor exhibits no pKa value within the physiological range. Ticagrelor does not exhibit pH-dependent solubility and is defined as ‘low solubility low permeability’ under the Biopharmaceutics Classification System (Class IV). The mean absolute bioavailability of ticagrelor in healthy volunteers is 36 %                    Nanoparticles preparation and complexation is one of the recently used approaches to enhance the solubility of drugs. The aim of the present work was to improve the solubility and dissolution of ticagrelor by preparing nanoparticles and cyclodextrin inclusion complex of ticagrelor and then incorporated in to tablet dosage form. Fifteen formulas of nanoparticles were prepared by antisolvent precipitation method (solvent displacement method) utilizing one of the three polymers (PVP, Poloxamer, and HPMC) at three different drugs: polymer and solvent: anti-solvent ratios and nine formulas of cyclodextrin inclusion complex with HP?CD  by three preparation methods, physical trituration, kneading and solvent evaporation, which increase the solubility and dissolution rate of ticagrelor via formation of inclusion complex with HP?CD.               The prepared formulas were characterized regarding the saturated solubility, polydispersity index, particle size by nano laser particle size analyzer, % yield, entrapment efficiency, and flowability, FTIR, DSC, and SEM. The selected formulas were prepared as tablets.              The prepared tablets were evaluated for drug content, weight variation, hardness, and friability. In vitro dissolution data of the prepared tablets were analyzed using similarity factor (f2) and dissolution efficiency (DE).              Among all the prepared nanoparticles formulas, formula (F12) which contain HPMC as a polymer at polymer: drug ratio of (1:1) and solvent: antisolvent ratio of (1:1) was considered as the optimum formula which shows good evaluation parameters in addition to the increment in the solubility to about 9 times than that of the pure drug. The nanoparticle of the selected formula (F12) incorporated tablets showed an acceptable tablet properties in addition to a considerable increase in the dissolution efficiency to (DE=92 % and 88 % in PH 1.2 and PH 6.8 respectively) in comparison to that of the marketed tablet (DE=89% and 85% in PH 1.2 and PH 6.8 respectively).  Moreover, the analysis by DSC and SEM of the nanoparticles of the selected formula (F12) indicate a reduction in the crystallinity and amorphization of the drug. It can be concluded that the selected formula is a promising formula for the preparation of ticagrelor nanoparticles the incorporation in a tablet dosage form.           Regarding ticagrelor inclusion complex with HP?CD Solvent evaporation method was the most effective method regarding ticagrelor solubilization and optimum formula of inclusion complex (F23) show increment in saturated solubility about ten times that of pure drug.           The ticagrelor inclusion complex of the selected formula (F23) incorporated tablets showed an acceptable tablet properties in addition to a considerable increase in the dissolution efficiency to (DE=92 % and 90 % in PH 1.2 and PH 6.8 respectively) in comparison to that of the marketed tablet (DE=89% and 85% in PH 1.2 and PH 6.8 respectively).  

Fusidic acid/tea-tree oil nanoemulsions : a potentially safe and effective anti MRSA/MSSA topical agent for chronic wound healing

Fusidic acid (FA) is clinically used as an antibacterial agent for the treatment of Gram-positive bacterial infections. It interferes with bacterial protein synthesis, specifically by preventing the translocation of the elongation factor G on the ribosome. In the present work, oil-in-water nanoemulsion (NE) was developed as a carrier for the transdermal delivery of FA. Different oils, surfactants and co-surfactants were screened. The solubility of FA, the emulsifying capacity of the surfactants and phase diagrams for each oil and surfactant mix were constructed. From the analysis, eight stable NE formulations were chosen, and their physicochemical properties were further evaluated. The antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) were also evaluated, and cytotoxicity was conducted on HS-27 cell line to determine the safety of the formula. It was found that the NE produced from tea tree oil has the most optimal stability with promising antibacterial activity against MRSA as compared to a commercially available product. The safety profile of the NE was also comparable to the commercial product; thus, the formulated FA-NE is promising for clinical use

The Relationship Between Serum 25 hydroxy Vitamin D Deficiency and Dietary Pattern in Baxshin Hospital, Sulaimani City

Vitamin D is one of the fat-soluble vitamins that have a great role in phosphate and calcium balance and bone structure. To our knowledge, there are limited data on the relation between dietary pattern and serum vitamin d concentration. Therefore, the aim of the current study is find out whether, there are any associations between serum vitamin D and with any specific dietary pattern. A cross sectional study was implemented in Baxshen hospital in order to find the prevalence of vitamin D deficiency and its relation with dietary pattern among healthy participants. 1131 participants were enrolled in the current study male and female with age 18 – 65 years old, living in Sulaimani city and its districts have not used any supplement in the past 6 months before enrolling the study.  Two questionnaires were used for collecting of data, the first one was included demographical data of the participants. Including their age, gender, marital status, educational level, address, and etc. The second one was data on dietary pattern; particularly we focused on some vitamin D dietary sources. A three-day dietary records estimate was taken from the patients and this data were coded and put in dietary software (windiet) and then analyzed. The age of the sample ranged from 18 to 65 years old with the mean of 34.34 years old with a standard deviation of 12.6. One hundred sixty-two (14.3%) of the 1131 participants were female, nine hundred sixty-nine (85.7%) of the participants were male. 65.5 % of them exposure to sun less than 30, 34.5% exposure to sun more than half hour. About 84.6% of participants had severe deficiency of vitamin D and 6.9% of participants had adequate vitamin D. Fish, eggs and yogurt conception was common among those participants whom their serum vitamin D was adequate, in contrary, there were less consumed among those who had vitamin D deficiency.  The percentage of obese (99.8%) was significantly higher than normal weight and overweight among severe deficiency Vitamin D. Furthermore, a highly percentage of adequate was (93.6%) in the normal weight. The mean of vitamin D intake was 761 ± 195.65 IU, in normal weight group, and the mean of vitamin d intake was 125.98 ± 53.15 IU, in obese group. This study has concluded that the reach Dietary sources of vitamin D is not enough to provide the body adequate amount of vitamin D, in addition, Obese and overweight individuals tend to have less serum vitamin D status compared to normal weight individuals and finally recommended daily amount of vitamin d intake should be established for Kurdistan people

Bio-fabricated zinc oxide nanoparticles mediated by endophytic fungus Aspergillus sp. SA17 with antimicrobial and anticancer activities: in vitro supported by in silico studies

IntroductionIn recent years, the world’s attention has been drawn to antimicrobial resistance (AMR) because to the frightening prospect of growing death rates. Nanomaterials are being investigated due to their potential in a wide range of technical and biological applications.MethodsThe purpose of this study was to biosynthesis zinc oxide nanoparticles (ZnONPs) using Aspergillus sp. SA17 fungal extract, followed by characterization of the produced nanoparticles (NP) using electron microscopy (TEM and SEM), UV-analysis, X-ray diffraction (XRD), and Fourier-transform infrared spectroscopy (FT-IR).Results and DiscussionThe HR-TEM revealed spherical nanoparticles with an average size of 7.2 nm, and XRD validated the crystalline nature and crystal structure features of the generated ZnONPs, while the zeta potential was 18.16 mV, indicating that the particles’ surfaces are positively charged. The FT-IR was also used to identify the biomolecules involved in the synthesis of ZnONPs. The antibacterial and anticancer properties of both the crude fungal extract and its nano-form against several microbial strains and cancer cell lines were also investigated. Inhibition zone diameters against pathogenic bacteria ranged from 3 to 13 mm, while IC50 values against cancer cell lines ranged from 17.65 to 84.55 M. Additionally, 33 compounds, including flavonoids, phenolic acids, coumarins, organic acids, anthraquinones, and lignans, were discovered through chemical profiling of the extract using UPLC-QTOF-MS/MS. Some molecules, such pomiferin and glabrol, may be useful for antibacterial purposes, according to in silico study, while daidzein 4’-sulfate showed promise as an anti-cancer metabolite

In Vivo Investigation of the Ameliorating Effect of Copper Albumin Complex on chondroitin sulfate in Monosodium iodoacetate -Induced Knee Osteoarthritis

Osteoarthritis (OA) is a condition that manifests as cartilage deterioration and subchondral bone sclerosis in the joint tissues. The weight-bearing joint is most severely impacted by OA. According to some research, consuming foods high in copper albumin complex (cu-albumin complex) can help with OA-related joint degeneration and pain relief. The current study's objective to determine how oral administration of the cu-albumin complex as an anti-inflammatory medication affected the development of rat knee osteoarthritis (KOA). Fifty adult albino rats were divided into three groups: negative control untreated (n= 10, no KOA induction); positive untreated control (n= 20, KOA induction); and treated group (n= 20, KOA induction with administration of cu-albumin complex). According to the severity of the clinical symptoms, treated and untreated arthritic groups were equally divided into mild and severe groups (n=10). Monosodium iodoacetate (MIA) was used as intra-articular injection for osteoarthritis induction. Rats were euthanized after a month of the beginning of the experiment, and the joints were examined histopathologically and immunohistochemically. It was indicated that the treatment was effective in reducing KOA severity and in improvement of chondroitin sulfate of the affected cartilages. In conclusion, the structure of the chondroitin sulphate in the knee joint cartilages of KOA-affected rats was modified by the cu-albumin complex

COVID-19 Vaccination Among Diverse Population Groups in the Northern Governorates of Iraq

Objectives: The present study was carried out to investigate COVID-19 vaccination coverage among populations of internally displaced persons (IDPs), refugees, and host communities in northern Iraq and the related underlying factors.Methods: Through a cross-sectional study conducted in five governorates in April–May 2022, 4,564 individuals were surveyed. Data were collected through an adapted questionnaire designed to gather data on participants.Results: 4,564 subjects were included (59.55% were 19–45 years old; 54.51% male). 50.48% of the participants (51.49% of host communities, 48.83% of IDPs, and 45.87% of refugees) had been vaccinated with at least one dose of COVID-19 vaccine. 40.84% of participants (42.28% of host communities, 35.75% of IDPs, and 36.14% of refugees) had been vaccinated by two doses, and 1.56% (1.65% of host communities, 0.93% of IDPs, and 1.46% of refugees) were vaccinated with three doses.Conclusion: Sociodemographic factors including age, gender, education, occupation, and nationality could affect vaccination coverage. Moreover, higher acceptance rate of vaccination is associated with belief in vaccine safety and effectiveness and trust in the ability of the vaccine to prevent complications