DEVELOPMENT OF A REVERSED PHASE - HPLC METHOD FOR DETERMINATION OF MELOXICAM IN TABLET FORMULATION AND HUMAN SERUM

Developing a simple, economic, sensitive and rapid isocratic RPHPLC method for determination of meloxicam (MX) in bulk drug, tablet formulation and human serum. The retention time observed for meloxicam was just 2.35 minutes using C18 column (150 x 3.0 mm, 5 μm) with a mobile phase consisting of acetonitrile: 0.2% formic acid (70:30 v/v%) at a flow rate of 1 ml/min with UV detector set at 355 nm. Linearity in concentration range of 0.05 – 50 µg/ml, with coefficient of determination, R² = 0.9956; slope= 25464 and intercept= -8872. The limit of detection and the limit of quantification were found to be 0.011 and 0.173 μg/ml, respectively. The precision and accuracy of method were checked by calculating RSD% and relative error E%, which were found to be reasonable. A RSD% (0.06 and 0.021%) for marketed brand and human serum, respectively and E% (0.64 and -0.47 %) for marketed brand and human serum, respectively. The method was found to be applicable for the analysis of MX in bulk, tablet formulation and human seru

DEVELOPMENT OF A REVERSED PHASE - HPLC METHOD FOR DETERMINATION OF MELOXICAM IN TABLET FORMULATION AND HUMAN SERUM

Developing a simple, economic, sensitive and rapid isocratic RPHPLC method for determination of meloxicam (MX) in bulk drug, tablet formulation and human serum. The retention time observed for meloxicam was just 2.35 minutes using C18 column (150 x 3.0 mm, 5 μm) with a mobile phase consisting of acetonitrile: 0.2% formic acid (70:30 v/v%) at a flow rate of 1 ml/min with UV detector set at 355 nm. Linearity in concentration range of 0.05 – 50 µg/ml, with coefficient of determination, R² = 0.9956; slope= 25464 and intercept= -8872. The limit of detection and the limit of quantification were found to be 0.011 and 0.173 μg/ml, respectively. The precision and accuracy of method were checked by calculating RSD% and relative error E%, which were found to be reasonable. A RSD% (0.06 and 0.021%) for marketed brand and human serum, respectively and E% (0.64 and -0.47 %) for marketed brand and human serum, respectively. The method was found to be applicable for the analysis of MX in bulk, tablet formulation and human seru

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Spectrophotometric Method for Determination of Meloxicam in Pharmaceutical Formulations Using N- bromosuccinimide as an Oxidant

Abstract A simple, rapid and sensitive spectrophotometric method has been developed for the determination of meloxicam (MX) in pure form and in its pharmaceutical preparations. The proposed method involve the addition of a measured excess of N-bromosuccinimide (NBS) in acid medium followed by determination of unreacted NBS by reacting with indigo carmine (IC) and measuring the absorbance at 610 nm. The optimum reaction conditions and other analytical parameters have been evaluated. Linearity was observed from 0.2-50 μg/ml meloxicam. Statistical analysis of the results and comparison with results by the British Pharmacopoeia method are also reported. Keywords: Meloxicam, Spectrophotometry, Indigo carmine, N-bromosuccinimide. 1. Introduction Meloxicam, chemically named 4-hydroxy-2-methyl-N (5-methyl-2-thiazolyl)-2H-1,2-benzothiazine-3-carboxamide-1,1-dioxide with chemical formula (C 14 H 13 N 3 O 4 S ) and molecular weight 351.4 g/mol ( 2. Experimental 2.1. Apparatus All spectral and absorbance measurements were performed on a (Cecil CE3021-England) UV-VIS spectrophotometer was used for all spectral and absorbance measurements with matched 1 cm quartz cells. Reagents All chemicals were of analytical reagents grade. Stock solution of meloxicam. A stock solution, 500 μg/ml, of the drug under investigation was prepared by dissolving 50 mg (provided by Awamedica Company for Drug Industries and Medical Applications Awa, Erbil, Iraq) in 100 ml of 0.02 M NaOH Shlear H. Hasan et a

Antispasmodic, bronchodilator and vasodilator activities of (+)-catechin, a naturally occurring flavonoid

Catechin is a well-known flavonoid found in many food plants and often utilized by naturopaths for the symptomatic treatment of several gastrointestinal, respiratory and vascular diseases. Our aim was to explore the biological basis for the medicinal use of this flavonoid by investigating whether catechin exhibits any pharmacological activity on smooth muscle preparations. We found that catechin dose-dependently relaxes both spontaneous and high K(+) (80 mM)-induced contraction in rabbit jejunum, showing specificity for the latter by causing a right-ward shift in the Ca(2+) dose-response curve. Similar results were observed with verapamil, a standard Ca(2+) channel blocker (CCB). Catechin also inhibited high K(+)-induced contraction in intact smooth muscle preparations from rat stomach fundus, guinea-pig ileum and guinea-pig trachea. In rat aorta, catechin inhibited phenylephrine (PE, 1 microM) and K(+)-induced contractions in a similar fashion. In PE-contracted, endothelium-intact aorta, this vasodilator effect was partially blocked by Nomega-nitro-L-arginine methyl ester and atropine, indicating activity at cholinergic receptors and possibly a CCB effect at higher doses of catechin. In guinea-pig atria catechin was found inactive. These data suggest that catechin may possess Ca(2+) antagonist activity--in addition to an endothelium-dependent relaxant component in blood vessels--thus providing a pharmacological basis for the efficacy of catechin in hyperexcitability disorders of gastrointestinal, respiratory and vascular smooth muscle

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research