Sensitive and rapid spectrophotometric methods for sertraline monitoring in pharmaceutical formulations

Purpose: To develop simple, rapid, and selective spectrophotometric methods for the assay of sertraline in a pharmaceutical formulation. Method: These methods depend on the formation of colored ion-pair complexes between the drug and five different reagents; methyl blue (MB), bromophenol red (BPR), methyl green (MG), phenol red (PR), and methyl orange (MO) in B-R buffer solutions of pH ranging from 2.0 – 8.0. The colored products were measured at 668, 747, 647, 717, and 553 nm, respectively. Results: The calibration graphs were linear over the concentration range of 2 – 18 μg/mL for MB and BPR, and 2 – 16 μg/mL for MG, PR, and MO. In all cases, the reaction stoichiometry was 1:1. The proposed methods were successfully applied to solid-dose pharmaceutical preparations (tablets). Excipients in the commercial formulation did not interfere with the analysis. Conclusion: The investigated methods can be recommended for routine analysis and quality control where cost-effectiveness, high specificity of the analytical technique, and time are of great importance

Spectrophotometric and theoretical studies on the determination of etilefrine hydrochloride in pharmaceutical formulations and biological samples

Purpose: To develop a simple and cost effective spectrophotometric method for the determination of etilefrine hydrochloride (ET) in pharmaceutical formulations and human plasma.Methods: The method is based on extraction of ET into chloroform as ion-pair  complexes with bromocresol green (BCG) and methyl orange (MO) in acidic medium. The interaction of ET with BCG and MO reagents were investigated using  B3LYP/6-31G(d) level of theory. The geometrical parameters of the interacting species and the ion pairs formed were characterized based on their frontier  molecular orbitals, atomic charges, electrostatic potential map, as well as NBO analysis.Results: The colored species exhibited absorption maxima at 410 and 479 nm for the two systems in universal buffer of pH range (3.0 - 3.5), with molar absorptivity of 2.4 × 104 and 1.7 × 104 Lmol-1cm-1, for BCG and MO methods, respectively. The methods demonstrated good linearity with correlation coefficient ranging from  0.9987 – 0.9991 in the concentration ranges 0.5 – 16 and 2.0 – 18 μgmL-1 for BCG and MO methods, respectively. The composition ratio of the ion-association complexes was 1:1 in all cases as established by Job’s method. Sandell,s  sensitivity, correlation coefficient, detection and quantification limits were also calculated. Molecular descriptors were obtained based on optimized structures of the molecules under investigation, by applying the B3LYP/6-31G(d) method, and used to interpret the mode of interaction between these molecules to form the investigated ion pairs.Conclusion: The proposed methods make use of simple reagents, which a basic  analytical laboratory can afford. No interference was observed from common  pharmaceutical excipients and additives. ETMO ion pair has a larger interaction energy (higher stability) than ET-BCG ion pair as inferred from their interaction energies.Keywords: Density functional theory, Etilefrine hydrochloride, Ion pair complex, Spectrophotometry, Bromocresol green, Methyl orange, Geometric analysi

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Determination of Pioglitazone Hydrochloride in Tablets by High-Performance Liquid Chromatography

A rapid and accurate HPLC method has been developed for the determination of pioglitazone hydrochloride in tablets. Chromatographic analysis was performed on a Nova-Pak® C18 column (3.9mm x 150mm, 5µm) with a mixture of ammonium formate buffer adjusted with formic acid to pH 3 and acetonitrile (75:25, v/v) as mobile phase, at flow rate of 1.0 mL min-1, and UV detection at 225 nm. The determination was completed in less than 12 min. Linearity ≥ 0.5 µgmL-1, accuracy ≥ 99.14 %, and precision ≤ 0.6 % were found to be acceptable over the range 0.5 - 20 µgmL-1

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially