Formulation And Development Of Nanosuspension As An Alternative Approach For Solubility And Dissolution Enhancement Of Aceclofenac

Main objectives to develop Aceclofenac Nanosuspension are to enhance solubility and dissolution rate of poorly soluble Drug (aceclofenac), substantially leading to its bioavailability enhancement and Improvement of aqueous and saturation solubility in turn rapid release of Drug which leads to enhancing therapeutic efficacy. Aceclofenac Nanosuspension was prepared by quasi solvent evaporation method with help of different polymer and concentration. There was changes polymer ratio, volume of organic solvent and stirring speed. Aceclofenac nanosuspension gives immediate release. Aceclofenac nanosuspension were showing highest dissolution rate within 10 minutes comparison with marketed formulations. Aceclofenac Nanosuspension compacts may enhance aqueous solubility and dissolution rate in compare to other solubility enhancement technique hence, this research work may be useful to formulate Aceclofenac Nanosuspension which may give rapid onset of action by rapid absorption, maximize efficacy, dose frequency and hence increase patient Compliance

A review- Recent research on microsponge a novel new drug delivery system

Microsponge is recent novel technique for control release and target specific drug delivery system. Therefore many scientist or researcher attracted towards the microsponge drug delivery system. Also Microsponge technology has been introduced in topical drug products to facilitate the controlled release of active drug into the skin in order to reduce systemic exposure and minimize local cutaneous reactions to active drugs. More and more developments in delivery systems are being integrated to optimize the efficacy and cost-effectiveness of the therapy. Microsponge technology offers entrapment of ingredients and is believed to contribute towards reduced side effects, improved stability, increased elegance, and enhanced formulation flexibility. In addition, numerous studies have confirmed that microsponge systems are non-irritating, non-mutagenic, non-allergenic, and non-toxic. Microsponge drug delivery system technology is being used currently in cosmetics, over-the-counter (OTC) skin care, sunscreens and prescription products

Liquisolid Compacts: A Review

Solubility is a major problem for nearly one third drugs in their development phase. Liquisolid technique is a most promising technique for promoting dissolution by increase in solubility. Liquisolid compact technology is a novel concept for oral drug delivery. Liquisolid compact technology was first described by spireas et.al. (1998). According to the new formulation method of liqui-solid compacts, liquid medications such as solutions or suspensions of water insoluble drugs in suitable nonvolatile liquid vehicles can be converted into acceptably flowing and compressible powders by blending with selected powder excipients

Physician Chief Executive Officers and Hospital Performance: A Contingency Theory Perspective

Years ago it was typical for a physician to serve as a hospital\u27s Chief Executive Officer (CEO). However, with the development of Master of Health Administration, Master of Public Health, and Master of Business Administration programs, hospitals began to move away from this model. Today however, as hospitals search for innovative ideas to reduce healthcare costs and improve the quality of care, the idea of the physician hospital CEO has returned. Little empirical research is available in the health services literature on the physician hospital CEO. The study aims to examine the relationship between organizational and environmental factors and physician CEOs, and whether or not physician CEOs are associated with improved hospital performance.The conceptual framework is adapted from Donabedian\u27s structure, process, and outcome perspective, which when applied to the organizational level becomes context design-performance. The theoretical perspective applied to the conceptual framework to guide the development of hypotheses is contingency theory, which suggests that organizations are most successful when they can adapt their structures to fit their environment.Data for this study were obtained from multiple sources: American Hospital Association Annual Survey, the Centers for Medicare and Medicaid Services Hospital Cost Reports, SK&A, Area Resource File, and the Centers for Medicare and Medicaid Services Hospital Quality Alliance.Besides descriptive analyses, logistic regression was used in this study to evaluate the relationship between the organizational and environmental hospital characteristics. Ordinary least squares regression was used to explore the relationship between physician CEOs and hospital performance.Results indicate that hospitals in markets with greater physician competition are more likely to have physician CEOs. Hospitals that are affiliated with a system are also more likely to have physician CEOs. The study found that while teaching hospitals and specialty hospitals were associated with placement of physician CEOs, it was in the opposite direction of what was hypothesized. This may be a result of the small sample size of both teaching and specialty hospitals in the study sample. The study concludedthat having a physician CEOs is associated with hospital financial outcomes but not associated with its quality of care outcomes

A Review on Niosomes - A novel approach for drug targeting

This is a general review on niosome as drug carrier, which improves the bioavailability of drugs, increases penetration through skin, releases drug in a controlled or sustained manner, and used for targeting of drugs to specic sites in the body.Niosomal drug delivery system can be considered as an emerging novel drug delivery system, which consists of microscopic non-ionic vesicles composed of non-ionic surfactants. These are biodegradable, relatively nontoxic, more stable and inexpensive, and an alternative to liposomes. Methods of preparation, characterisation and application of niosomes have been reviewed. Niosome has potential to reduce the side effects of drugs and increase therapeutic effectiveness in various diseases. It can also be used as a carrier to deliver drugs topically. This review presents an overview of the types of niosomes, techniques of preparation of niosome characterisation and their applications

Association of PCSK9 Inhibitor Initiation on Statin Adherence and Discontinuation

Background PCSK9is (proprotein convertase subtilisin/kexin type 9 inhibitors) are well tolerated, potently lower cholesterol, and decrease cardiovascular events when added to statins. However, statin adherence may decrease after PCSK9i initiation and alter clinical outcomes. We evaluate the association of PCSK9i initiation on statin discontinuation and adherence. Methods and Results In this retrospective pre‐post difference‐in‐difference analysis, new PCSK9i claims were propensity matched with statin‐alone users (April 2017–September 2019). The primary outcomes were statin adherence (proportion of days covered) and statin discontinuation (absence of statin coverage for at least 60 days) 12 months following PCSK9i initiation. Secondary outcomes included low‐density lipoprotein cholesterol levels after 1 year. A total of 220 538 statin users and 700 PCSK9i users were identified, from which 178 on PCSK9i were included and matched to 712 on statins alone. At 12 months, mean statin proportion of days covered decreased from 67% to 48% in the PCSK9i group but increased from 68% to 86% in the statin‐alone groups (P<0.0001). Statin discontinuation rates increased from 11% to 39% in the PCSK9i group and from 7% to 9% in the statin‐alone group (P=0.0041). Patients with low‐density lipoprotein cholesterol <70 mg/dL increased from 5% to 68% with PCSK9i but increased from 16% to 24% with statins alone (P<0.0001). Changes in hospitalization rates were similar between both groups during the follow‐up period. Conclusions PCSK9i initiation was associated with decreased low‐density lipoprotein cholesterol, higher statin discontinuation, and reduced statin adherence

Evaluation Of Chronic Disease Management On Outcomes And Cost Of Care For Medicaid Beneficiaries

Objectives: To evaluate the impacts of the chronic disease management program on the outcomes and cost of care for Virginia Medicaid beneficiaries. Methods: A total of 35,628 patients and their physicians and pharmacists received interventions for five chronic diseases and comorbidities from 1999 to 2001. Comparisons of medical utilization and clinical outcomes between experimental groups and control group were conducted using ANOVA and ANCOVA analyses. Results: Findings indicate that the disease state management (DSM) program statistically significantly improved patient\u27s drug compliance and quality of life while reducing (ER), hospital, and physician office visits and adverse events. The average cost per hospitalization would have been $42 higher without the interventions. Conclusions: A coordinated disease management program designed for Medicaid patients experiencing significant chronic diseases can substantially improve clinical outcomes and reduce unnecessary medical utilization, while lowering costs, although these results were not observed across all disease groups. The DSM model may be potentially useful for Medicaid programs in states or other countries. If the adoption of the DSM model is to be promoted, evidence of its effectiveness should be tested in broader settings and best practice standards are expected. © 2007 Elsevier Ireland Ltd. All rights reserved

Evaluation of chronic disease management on outcomes and cost of care for Medicaid beneficiaries

Objectives To evaluate the impacts of the chronic disease management program on the outcomes and cost of care for Virginia Medicaid beneficiaries.Methods A total of 35,628 patients and their physicians and pharmacists received interventions for five chronic diseases and comorbidities from 1999 to 2001. Comparisons of medical utilization and clinical outcomes between experimental groups and control group were conducted using ANOVA and ANCOVA analyses.Results Findings indicate that the disease state management (DSM) program statistically significantly improved patient's drug compliance and quality of life while reducing (ER), hospital, and physician office visits and adverse events. The average cost per hospitalization would have been $42 higher without the interventions.Conclusions A coordinated disease management program designed for Medicaid patients experiencing significant chronic diseases can substantially improve clinical outcomes and reduce unnecessary medical utilization, while lowering costs, although these results were not observed across all disease groups. The DSM model may be potentially useful for Medicaid programs in states or other countries. If the adoption of the DSM model is to be promoted, evidence of its effectiveness should be tested in broader settings and best practice standards are expected.