Dissolution enhancement of gliclazide using pH change approach in presence of twelve stabilizers with various physico-chemical properties

Purpose. The micronization using milling process to enhance dissolution rate is extremely inefficient due to a high energy input, and disruptions in the crystal lattice which can cause physical or chemical instability. Therefore, the aim of the present study is to use in situ micronization process through pH change method to produce micron-size gliclazide particles for fast dissolution hence better bioavailability. Methods. Gliclazide was recrystallized in presence of 12 different stabilizers and the effects of each stabilizer on micromeritic behaviors, morphology of microcrystals, dissolution rate and solid state of recrystallized drug particles were investigated. Results. The results showed that recrystallized samples showed faster dissolution rate than untreated gliclazide particles and the fastest dissolution rate was observed for the samples recrystallized in presence of PEG 1500. Some of the recrystallized drug samples in presence of stabilizers dissolved 100% within the first 5 min showing at least 10 times greater dissolution rate than the dissolution rate of untreated gliclazide powders. Micromeritic studies showed that in situ micronization technique via pH change method is able to produce smaller particle size with a high surface area. The results also showed that the type of stabilizer had significant impact on morphology of recrystallized drug particles. The untreated gliclazide is rod or rectangular shape, whereas the crystals produced in presence of stabilizers, depending on the type of stabilizer, were very fine particles with irregular, cubic, rectangular, granular and spherical/modular shape. The results showed that crystallization of gliclazide in presence of stabilizers reduced the crystallinity of the samples as confirmed by XRPD and DSC results. Conclusion. In situ micronization of gliclazide through pH change method can successfully be used to produce micron-sized drug particles to enhance dissolution rate

Rehydration: Comparison of Isotonic and Hypotonic Saline with Dextrose in Children

Introduction: Early rehydration with bolus fluid can be life saving. We compared isotonic saline with a hypotonic fluid which was composed of saline 0.9%, dextrose, and bicarbonate in our clinical setting.Materials and Methods: 71 children entered to this study , 41 cases received isotonic saline and the remaining 30 cases received hypotonic fluid which was composed of 750 cc saline 0.9%, 28 cc bicarbonate 7.5%, and 222cc dextrose 5% for resuscitation fluid challenge at a dose of 20ml/kg over 20 minutes that could be repeated up to 3 times as needed. Serum sodium (Na), potassium (K), blood sugar (BS) and bicarbonate (HCo3) were measured before initiating rehydration and after 3 hours. T independent test was used to compare the values between the two groups and T paired test in each group in SPSS 16. The level of significance was set at 0.05.Results: Serum Na, K, BS, and HCo3 were 134±5, 3.8 ±0.6, 90±16, and 11.6±3.6 before and 135±4, 3.7±0.5, 73±13, and 15±3 three hours after rehydration in the isotonic group, respectively.In the isotonic rehydrated group, BS drop and HCo3 rise significantly (p<0.001). Serum Na, K, BS, and HCo3 were 134±6, 3.6±0.6, 91±15, and 10.1±1.9 before and 136±3, 3.6±0.4, 94±10, and 15±2 three hours after rehydration in the hypotonic saline group, respectively. Serum sodium increased 2meq/dl (p<0.04) and bicarbonate increased 4.9 meq/l (P< 0.001).Conclusions: The hypotonic serum containing 115meq/l of sodium chloride combined with 25meq/l of sodium bicarbonate and dextrose 1.1% is not associated with a decrease in BS or hyponatremia. It also increases serum HCo3 prominently.Keywords: Hypotonic Solutions; Isotonic Solutions; Dehydration; Child

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

A Knowledge Base for Automatic Feature Recognition from Point Clouds in an Urban Scene

LiDAR technology can provide very detailed and highly accurate geospatial information on an urban scene for the creation of Virtual Geographic Environments (VGEs) for different applications. However, automatic 3D modeling and feature recognition from LiDAR point clouds are very complex tasks. This becomes even more complex when the data is incomplete (occlusion problem) or uncertain. In this paper, we propose to build a knowledge base comprising of ontology and semantic rules aiming at automatic feature recognition from point clouds in support of 3D modeling. First, several modules for ontology are defined from different perspectives to describe an urban scene. For instance, the spatial relations module allows the formalized representation of possible topological relations extracted from point clouds. Then, a knowledge base is proposed that contains different concepts, their properties and their relations, together with constraints and semantic rules. Then, instances and their specific relations form an urban scene and are added to the knowledge base as facts. Based on the knowledge and semantic rules, a reasoning process is carried out to extract semantic features of the objects and their components in the urban scene. Finally, several experiments are presented to show the validity of our approach to recognize different semantic features of buildings from LiDAR point clouds

A Knowledge Base for Automatic Feature Recognition from Point Clouds in an Urban Scene

LiDAR technology can provide very detailed and highly accurate geospatial information on an urban scene for the creation of Virtual Geographic Environments (VGEs) for different applications. However, automatic 3D modeling and feature recognition from LiDAR point clouds are very complex tasks. This becomes even more complex when the data is incomplete (occlusion problem) or uncertain. In this paper, we propose to build a knowledge base comprising of ontology and semantic rules aiming at automatic feature recognition from point clouds in support of 3D modeling. First, several modules for ontology are defined from different perspectives to describe an urban scene. For instance, the spatial relations module allows the formalized representation of possible topological relations extracted from point clouds. Then, a knowledge base is proposed that contains different concepts, their properties and their relations, together with constraints and semantic rules. Then, instances and their specific relations form an urban scene and are added to the knowledge base as facts. Based on the knowledge and semantic rules, a reasoning process is carried out to extract semantic features of the objects and their components in the urban scene. Finally, several experiments are presented to show the validity of our approach to recognize different semantic features of buildings from LiDAR point clouds

The Effect of Diclofenac Mouthwash on Periodontal Postoperative Pain

Background: The need to relieve pain and inflammation after periodontal surgery and the side effects of systemic drugs and advantages of topical drugs, made us to evaluate the effect of Diclofenac mouthwash on periodontal postoperative pain. Methods: In this double-blind, randomized clinical trial study 20 quadrants of 10 patients(n = 20) aged between 22-54 who also acted as their own controls, were treated using Modified Widman Flap procedure in two quadrants of the same jaw with one month interval between the operations. After the operation in addition to ibuprofen 400 mg, one quadrant randomly received Diclofenac mouthwash (0/01%) for 30 seconds, 4 times a day (for a week) and for the contrary quadrant, ibuprofen and placebo mouthwash was given to be used in the same manner. The patients scored the number of ibuprofen consumption and their pain intensity based on VAS index in a questionnaire in days 1, 2, 3 and the first week after operation. The findings were analysed using two-way ANOVA, t-test and Wilcoxon. P-value less than 0.05 considered to be significant. Results: There was a significant difference between the mean values of pain intensity of two quadrants in four periods (P = 0.031). But, there was no significant difference between the average ibuprofen consumption in two groups (P = 0.51). Postoperative satisfaction was not significantly different in two quadrants (P = 0.059). 60% of patients preferred Diclofenac mouthwash. Conclusion: Diclofenac mouthwash was effective in reducing postoperative periodontal pain but it seems that it isn′t enough to control postoperative pain on its own

The Role of Social Factors in the Accessibility of Urban Areas for People with Motor Disabilities

The United Nations Convention on the Rights of People with Disabilities recognizes the right of people with disabilities to attain full social participation without discrimination on the basis of disability. Furthermore, mobility is one of the most important life habits for achieving such participation. Providing people with disabilities with information regarding accessible paths and accessible urban places therefore plays a vital role in achieving these goals. The accessibility of urban places and pedestrian networks depends, however, on the interaction between human capabilities and environmental factors, and may be subdivided into physical or social factors. An optimal analysis of accessibility requires both kinds of factors, social as well as physical. Although there has been considerable work concerning the physical aspects of the environment, social aspects have been largely neglected. In this paper, we highlight the importance of the social dimension of environments and consider a more integrated approach for accessibility assessment. We highlight the ways by which social factors such as policies can be incorporated into accessibility assessment of pedestrian networks for people with motor disabilities. Furthermore, we propose a framework to assess the accessibility of pedestrian network segments that incorporates the confidence level of people with motor disabilities. This framework is then used as a tool to investigate the influence of different policies on accessibility conditions of pedestrian networks. The methodology is implemented in the Saint-Roch neighborhood in Quebec City and the effectiveness of three policy actions is examined by way of illustration

Acetaminophen as Adjuvant to Risperidone in Chronic Schizophrenia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Objective: Although the pathogenesis of schizophrenia is still uncertain, a variety of predisposing mechanisms have been implicated including inflammatory cascades. The present study was conducted to investigate the effectiveness of acetaminophen as a cyclooxygenase inhibitor in treating patients with schizophrenia. Method: A double-blind clinical trial was performed on 52 patients with chronic schizophrenia. Patients received risperidone (up to 6 mg/day) plus either acetaminophen (975mg/day) or placebo. Psychotic symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS) at the onset of the trial, and at 2, 4, 6, and 8 weeks post therapy. Results: Compared to the placebo group, the acetaminophen group showed no significant difference in any subtypes of PANSS. Moreover, the side effect profiles of the 2treatment regimens were not significantly different. Conclusion: Acetaminophen adjuvant to risperidone showed no significant effect in ameliorating symptoms of schizophrenia. Trial Registration: The trial was registered at the Iranian Registry of Clinical Trials (registration number: IRCT201410251556N67)