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

Good Clinical Practice in Children and Adolescents

Good clinical practice (GCP) is a series of systematically developed ethical and quality standard of designing, registering, running, recording, and reporting of the clinical trials. Good clinical practice is very important regarding the trials usually performed on the vulnerable populations especially children and adolescents. The sensitivity of the issue is even higher in the children with psychiatric disorders. Usually, these children have little legal protection. Hence, the safety of interventions and the ethical considerations are among the most important issues in this field. The purpose of this chapter is to deal with above problems and globally applicable standards for the conduct of clinical trials on the under legal age subjects especially those with psychiatric disorders. Selection of trial subjects, ethical principles, regulatory requirements, protection of trial subjects, monitoring (compliance with the protocol), responsibilities of the investigator, and other requirements to perform a clinically and ethically sound clinical trial in children and adolescents will be discussed in this chapter

Essential Thrombocytosis Following Multiple Psychic Traumas

The associations between exposure to traumatic events and psychiatric disorders such as posttraumatic stress disorder (PTSD), depression, and anxiety have been established. It is important that clinicians notice to this phenomenon and avoid from inappropriate interpretations and additional laboratory tests. Here, a case of 45-year-old man with Essential thrombocytosis developed after multiple psychic traumas was introduced

An imperialist competitive algorithm for the winner determination problem in combinatorial auction

Winner Determination problem (WDP) in combinatorial auction is an NP-complete problem. The NP-complete problems are often solved by using heuristic methods and approximation algorithms. This paper presents an imperialist competitive algorithm (ICA) for solving winner determination problem. Combinatorial auction (CA) is an auction that auctioneer considers many goods for sale and the bidder bids on the bundle of items. In this type of auction, the goal is finding winning bids that maximize the auctioneer’s income under the constraint that each item can be allocated to at most one bidder. To demonstrate, the postulated algorithm is applied over various benchmark problems. The ICA offers competitive results and finds good-quality solution in compare to genetic algorithm (GA), Memetic algorithm (MA), Nash equilibrium search approach (NESA) and Tabu search

Comparison of aspirin plus heparin with heparin alone on asymptomatic perioperative deep vein thrombosis in candidates for elective off-pump coronary artery bypass graft: A randomized clinical trial

Background: Symptomatic or asymptomatic deep vein thrombosis (DVT) is a commoncomplication following coronary artery bypass graft (CABG), in which less than 1% of thesepatients suffer from clinically evident pulmonary embolism (PE). DVT and PE can increaseother morbidities of coronary revascularization from short to long period, but no clear consensusstill exists regarding proper thromboprophylaxis strategy in the literatures. This study wasdesigned to compare the anti-platelet prophylaxis of aspirin plus heparin with heparin alone onasymptomatic perioperative DVT in patients that are candidates for elective off-pump CABG.Methods: One hundred and twenty patients, who are candidates for elective off-pump CABG, wererandomly assigned to two groups: the aspirin plus heparin group (Group 1, n = 60) that received80 mg daily aspirin orally and 5000 U unfractionated heparin per 8 h subcutaneously fromadmission to discharge time, and the heparin group (group 2, n = 60) that received same doseof heparin alone. All patients underwent right and left leg venous ultrasound examinationduring hospitalization, after which post-operative off-pump CABG complications such as deepvein thrombosis, bleeding and pulmonary embolism were evaluated in this study cases.Results: The mean age of the patients was 62.10 ± 10.71 years with a male to female ratioof 2.24. Asymptomatic DVT occurred in 12 (10%) patients who underwent electiveoff-pump CABG. DVT was found more in Group 2 (16.6%) as compared to Group 1 (3.3%)with statistical signifi cant difference (p = 0.015). Bleeding was detected in 5 (4.1%) cases inthe patients sampled in this study (p = 0.34), 4 cases of which are from Group 1 and 1 casefrom Group 2. However, PE was shown in none of this study cases.Conclusions: The incidence of DVT decreased more with aspirin plus heparin as comparedto heparin alone in patients who underwent elective off-pump CABG. As regards the resultsobtained in this study, more studies need to be conducted to establish this strategy for prophylaxisof DVT in CABG

Prevalence of Nocturnal Enuresis in School-age Children in Rafsanjan

Introduction: Nocturnal enuresis is an important developmental problem for school age children and it can cause emotional and social problems for children and their families. This study was aimed to determine the prevalence of enuresis in school children aged 6-8 years in Rafsanjan, Iran, during 2014.Material and Methods: In this cross-sectional study, 1080 school children aged 6-8 were selected using a random cluster sampling method. Questionnaires were distributed among the children to be answered by their parents.Results: The overall prevalence of nocturnal enuresis was10.6% (CI 95%: 8.76 – 12.44); 91.3 % of them had primary and 8.7% had secondary nocturnal enuresis. Prevalence in girls and boys were 8.44% and 12.3% respectively. Factors such as parental education, family income, and age were significantly associated with nocturnal enuresis.Conclusions: The results showed that the prevalence of nocturnal enuresis in our study is average. Since a minority of families seek medical advice and treatment for their children, family education and awareness is essential in this regard.Keywords: Nocturnal enuresis, Child, Prevalence, School

Hydatidosis of the Pelvic Cavity: A Big Masquerade

We report and discuss a case of primary hydatidosis of the pelvic cavity in a woman who presented with severe weight loss and abdominal pain. This unusual presentation was initially considered as a tumor process until surgical exploration and microscopic studies confirmed the diagnosis. The gynecologists should be aware of possibility of primary hydatid cyst of the pelvic cavity and should be considered in the differential diagnosis of cystic pelvic masses, especially in areas where the disease is endemic

Reliability and validity of the Persian version of Food Craving Questionnaire-Trait-Reduced (FCQ-T-r) in overweight and obese women

Introduction: Food Craving Questionnaire (FCQ) is a popular tool in assessing food craving which consisted of a trait (FCQ-T) and state (FCQ-S). The aim of the current study was to provide reliability and validity of the Persian version of FCQ-Trait-reduced (FCQ-T-r 15-items) in overweight and obese women. Material and methods: The subjects were 168 overweight and obese women who were consented to participate. The subjects completed the FCQ-T-r and subsequently, anthropometric, body composition and psychometric assessments performed to assess the inter-correlations and concurrent validity. The confirmatory factor analysis was done to derive the potential factors and internal consistency of the questionnaire was assessed. Two weeks later, FCQ-T-r repeated for 126 subjects to assess test-retest reliability. Results: The confirmatory factor analysis of by varimax rotation, show that three principal components were loaded on expected factors. The Cronbach’s alpha coefficient was 0.90. (0.91, 0.78, and 0.71, for factors). The test–retest analysis shows an acceptable level of reliability ( P=0.001) and Pearson correlation coefficient  of 0.92 between the two administrations. In split-half reliability analysis the Cronbach’s alpha coefficient of the part 1 was 0.80 and for the part 2 was 0.86. The correlation coefficient between part 1 and part 2 was 0.81. Conclusion: This preliminary study provides evidences in favor of reliability and validity of the Persian version of the FCQ-T-r. In general, the results showed a high level of internal consistency for FCQ-T-r, and none of the 15 items had to be deleted to improve α

Epidemiology of Psychiatric Disorders in Children and Adolescents in Chaharmahal and Bakhtiari Province, Iran, 2017

Background: This study aimed to investigate the epidemiology of psychiatric disorders in children and adolescents in Chaharmahal and Bakhtiari Province of Iran. Methods: This community-based cross-sectional study included 1038 children and adolescents aged 6-18 years from Chaharmahal and Bakhtiari province selected by the multistage cluster sampling method. Samples were interviewed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Also, demographic data (gender, age, child education, parent education, and economic situation) were obtained. Binary logistic regression was used to analyze the data. Results: A total of 16.1% of participants were diagnosed to have psychiatric disorders. Total psychiatric disorders were significantly more prevalent in boys than in girls (P = 0.025). Unemployment of fathers was significantly related to increased prevalence of psychiatric disorders in children (P = 0.016). Other demographic variables had no significant correlation with prevalence of psychiatric disorders in children. Anxiety disorders were highly comorbid with behavioral problems (16.4%). Behavioral disorders also had high comorbidity with elimination disorders (16.7%) and substance use disorders (10%). Enuresis was the most frequent psychiatric disorder (5.8%), followed by epilepsy (3.5%), tobacco use (3.4%), and attention deficit hyperactivity disorder (3%). Total anxiety disorders were the most prevalent group of psychiatric disorders in the sample (21.9%), followed by behavioral disorders (16.3%), elimination disorders (8.2%), and neurodevelopmental disorders (4.5%). Conclusion: Our findings suggest that psychiatric disorders affect a significant number of children and adolescents. Prevalence estimates and identification of sources of heterogeneity have important implications to service providers and modifications are needed in mental health services in the community

Munchausen syndrome as scorpion biting:a misdiagnosis

Factitious disorder as Munchausen syndrome is a time and money consuming condition that is presented with different signs and symptoms. In emergent situations, it is not a differential diagnosis with high priority, but when it becomes recurrent with atypical symptoms, factitious disorder and malingering should be considered as well. In this survey, we report an odd and interesting presentation of a factitious disease as a scorpion sting which misled some professional healthcare providers until the patient finally confessed that she used turmeric to mimic the signs of a scorpion sting. She exaggerated her symptoms when asked about the details of the mechanism of the scorpion bite. When encountering an emergent condition, after ruling out the critical conditions especially when the symptom is recurrent, factitious disorders should be considered. Consultation with a psychiatrist help the team manage the patient properly