Development of New Formulation for Mouth Disintegrating Tablets of Metoclopramide by Sublimation Method

The main purpose of the present research work was to mask the bitter taste of the active drug and to formulate the MD tablets by sublimation method. Metoclopramide HCl tablets were prepared by masking the bitter taste with the help of Eudragit E-100, then preparing the tablets by using subliming agents i.e. camphor and ammonium bicarbonate. The  formulations were evaluated for weight variation, hardness, friability, drug content, wetting time, In vitro disintegration time and In vivo dispersion, mouth feel and in vitro dissolution studies. All the formulations comply with the test for weight variation as per Indian Pharmacopeia (IP) and found to be within the limits. The drug content of all the formulations was within the acceptable limits. Disintegration time of all the formulations was found less than 1 min. Wetting time values were giving direct relation to the  disintegration time values because by increasing tablet porosity, more water can be absorbed. The best formulation showed good release profile with maximum drug being released at all time intervals. The present  research work helped in understanding the effect of formulation processing variables especially the subliming agent on the drug release profile for MD tablets. The present study demonstrated good potentials in quick absorption, improved bioavailability and patient compliance

Effects of complexity of handwashing instructions on handwashing procedure replication in low-income urban slums in Bangladesh: a randomized non-inferiority field trial

Abstract Handwashing instructions vary in complexity, with some recommending multiple steps. To assess whether complex handwashing instructions changed handwashing procedure replication, we conducted a randomized non-inferiority trial in a low-income area, Dhaka. We randomly assigned mothers and children aged 5–10 years to one of three handwashing instruction sets: simple (N = 85 mothers/134 children), moderate (N = 75 mothers/148 children), or complex (84 mothers/147 children). Simple instructions had three steps: wet, lather, and rinse hands, and moderate included the simple instructions plus steps to scrub palms, backs of hands, and dry hands in the air. Complex instructions included moderate instructions plus steps to scrub between fingers, under nails, and lather for 20 s. After baseline, cue cards were used to promote handwashing instructions, and adherence after 2 weeks of interventions was evaluated. Compliance with handwashing procedure replication to all instructions in simple, moderate, and complex increased after the intervention among mothers and children. Compliance to all instructions in the simple group was higher in the simple group (100%) compared to all instructions in moderate (47%) and complex instruction groups (38%). Simple handwashing steps are easier to remember for long time periods compared to complex steps.</jats:p

Single lesion multibacillary leprosy, a treatment enigma: a case report

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Zinc intake, status and indices of cognitive function in adults and children: a systematic review and meta-analysis

In developing countries, deficiencies of micronutrients are thought to have a major impact on child development; however, a consensus on the specific relationship between dietary zinc intake and cognitive function remains elusive. The aim of this systematic review was to examine the relationship between zinc intake, status and indices of cognitive function in children and adults. A systematic literature search was conducted using EMBASE, MEDLINE and Cochrane Library databases from inception to March 2014. Included studies were those that supplied zinc as supplements or measured dietary zinc intake. A meta-analysis of the extracted data was performed where sufficient data were available. Of all of the potentially relevant papers, 18 studies met the inclusion criteria, 12 of which were randomised controlled trials (RCTs; 11 in children and 1 in adults) and 6 were observational studies (2 in children and 4 in adults). Nine of the 18 studies reported a positive association between zinc intake or status with one or more measure of cognitive function. Meta-analysis of data from the adult’s studies was not possible because of limited number of studies. A meta-analysis of data from the six RCTs conducted in children revealed that there was no significant overall effect of zinc intake on any indices of cognitive function: intelligence, standard mean difference of <0.001 (95% confidence interval (CI) –0.12, 0.13) P=0.95; executive function, standard mean difference of 0.08 (95% CI, –0.06, 022) P=0.26; and motor skills standard mean difference of 0.11 (95% CI –0.17, 0.39) P=0.43. Heterogeneity in the study designs was a major limitation, hence only a small number (n=6) of studies could be included in the meta-analyses. Meta-analysis failed to show a significant effect of zinc supplementation on cognitive functioning in children though, taken as a whole, there were some small indicators of improvement on aspects of executive function and motor development following supplementation but high-quality RCTs are necessary to investigate this further

Seeking Clarity within Cloudy Effluents: Differentiating Fungal from Bacterial Peritonitis in Peritoneal Dialysis Patients

Fungal peritonitis is a serious complication of peritoneal dialysis (PD) therapy with the majority of patients ceasing PD permanently. The aims of this study were to identify risk factors and clinical associations that may discriminate between fungal from bacterial peritonitis.We retrospectively identified episodes of fungal peritonitis from 2001-2010 in PD patients at Liverpool and Westmead Hospitals (Australia). Fungal peritonitis cases were matched in a 1:2 ratio with patients with bacterial peritonitis from each institution's dialysis registry, occurring closest in time to the fungal episode. Patient demographic, clinical and outcome data were obtained from the medical records.Thirty-nine episodes of fungal peritonitis (rate of 0.02 episodes per patient-year of dialysis) were matched with 78 episodes of bacterial peritonitis. Candida species were the commonest pathogens (35/39; 90% episodes) with Candida albicans (37%), Candida parapsilosis (32%) and Candida glabrata (13%) the most frequently isolated species. Compared to bacterial peritonitis, fungal peritonitis patients had received PD for significantly longer (1133 vs. 775 catheter-days; p = 0.016), were more likely to have had previous episodes of bacterial peritonitis (51% vs. 10%; p = 0.01), and to have received prior antibacterial therapy (51% vs. 10%; p = 0.01). Patients with fungal peritonitis were less likely to have fever and abdominal pain on presentation, but had higher rates of PD catheter removal (79% vs. 22%; p<0.005), and permanent transfer to haemodialysis (87% vs. 24%; p<0.005). Hospital length of stay was significantly longer in patients with fungal peritonitis (26.1 days vs. 12.6 days; p = 0.017), but the all-cause 30-day mortality rate was similar in both groups. Fluconazole was a suitable empiric antifungal agent; with no Candida resistance detected.Prompt recognition of clinical risk factors, initiation of antifungal therapy and removal of PD catheters are key considerations in optimising outcomes

Small but crucial : the novel small heat shock protein Hsp21 mediates stress adaptation and virulence in Candida albicans

Peer reviewedPublisher PD

Finite element computation of multi-physical micropolar transport phenomena from an inclined moving plate in porous media

Non-Newtonian flows arise in numerous industrial transport processes including materials fabrication systems. Micropolar theory offers an excellent mechanism for exploring the fluid dynamics of new non-Newtonian materials which possess internal microstructure. Magnetic fields may also be used for controlling electrically-conducting polymeric flows. To explore numerical simulation of transport in rheological materials processing, in the current paper, a finite element computational solution is presented for magnetohydrodynamic (MHD), incompressible, dissipative, radiative and chemically-reacting micropolar fluid flow, heat and mass transfer adjacent to an inclined porous plate embedded in a saturated homogenous porous medium. Heat generation/absorption effects are included. Rosseland’s diffusion approximation is used to describe the radiative heat flux in the energy equation. A Darcy model is employed to simulate drag effects in the porous medium. The governing transport equations are rendered into non-dimensional form under the assumption of low Reynolds number and also low magnetic Reynolds number. Using a Galerkin formulation with a weighted residual scheme, finite element solutions are presented to the boundary value problem. The influence of plate inclination, Eringen coupling number, radiation-conduction number, heat absorption/generation parameter, chemical reaction parameter, plate moving velocity parameter, magnetic parameter, thermal Grashof number, species (solutal) Grashof number, permeability parameter, Eckert number on linear velocity, micro-rotation, temperature and concentration profiles. Furthermore, the influence of selected thermo-physical parameters on friction factor, surface heat transfer and mass transfer rate is also tabulated. The finite element solutions are verified with solutions from several limiting cases in the literature. Interesting features in the flow are identified and interpreted

Observed hand cleanliness and other measures of handwashing behavior in rural Bangladesh

<p>Abstract</p> <p>Background</p> <p>We analyzed data from the baseline assessment of a large intervention project to describe typical handwashing practices in rural Bangladesh, and compare measures of hand cleanliness with household characteristics.</p> <p>Methods</p> <p>We randomly selected 100 villages from 36 districts in rural Bangladesh. Field workers identified 17 eligible households per village using systematic sampling. Field workers conducted 5-hour structured observations in 1000 households, and a cross-sectional assessment in 1692 households that included spot checks, an evaluation of hand cleanliness and a request that residents demonstrate their usual handwashing practices after defecation.</p> <p>Results</p> <p>Although 47% of caregivers reported and 51% demonstrated washing both hands with soap after defecation, in structured observation, only 33% of caregivers and 14% of all persons observed washed both hands with soap after defecation. Less than 1% used soap and water for handwashing before eating and/or feeding a child. More commonly people washed their hands only with water, 23% after defecation and 5% before eating. Spot checks during the cross sectional survey classified 930 caregivers (55%) and 453 children (28%) as having clean appearing hands. In multivariate analysis economic status and water available at handwashing locations were significantly associated with hand cleanliness among both caregivers and children.</p> <p>Conclusions</p> <p>A minority of rural Bangladeshi residents washed both hands with soap at key handwashing times, though rinsing hands with only water was more common. To realize the health benefits of handwashing, efforts to improve handwashing in these communities should target adding soap to current hand rinsing practices.</p

Impact of disaster-related mortality on gross domestic product in the WHO African Region

BACKGROUND: Disaster-related mortality is a growing public health concern in the African Region. These deaths are hypothesized to have a significantly negative effect on per capita gross domestic product (GDP). The objective of this study was to estimate the loss in GDP attributable to natural and technological disaster-related mortality in the WHO African Region. METHODS: The impact of disaster-related mortality on GDP was estimated using double-log econometric model and cross-sectional data on various Member States in the WHO African Region. The analysis was based on 45 of the 46 countries in the Region. The data was obtained from various UNDP and World Bank publications. RESULTS: The coefficients for capital (K), educational enrolment (EN), life expectancy (LE) and exports (X) had a positive sign; while imports (M) and disaster mortality (DS) were found to impact negatively on GDP. The above-mentioned explanatory variables were found to have a statistically significant effect on GDP at 5% level in a t-distribution test. Disaster mortality of a single person was found to reduce GDP by US$0.01828. CONCLUSIONS: We have demonstrated that disaster-related mortality has a significant negative effect on GDP. Thus, as policy-makers strive to increase GDP through capital investment, export promotion and increased educational enrolment, they should always keep in mind that investments made in the strengthening of national capacity to mitigate the effects of national disasters expeditiously and effectively will yield significant economic returns