Effect of Permeation Enhancers on the Release Behavior and Permeation Kinetics of Novel Tramadol Lotions

Purpose: The aim of this research work was to formulate, characterize and evaluate the in vitro permeation behavior of tramadol lotion containing propylene glycol (PG) and polyethylene glycol (PEG) as permeation enhancers.Methods: The permeation experiments were conducted in vitro using full thickness rabbit skin in Franz diffusion cells. The donor compartment was filled with PBS (phosphate buffered saline) at pH 7.4 ± 0.1. The receptor phase was continuously stirred PBS (pH 7.4) at 37 °C ± 0.5. The amount of tramadol permeated into the receptor phase was determined spectrophotometrically at 271 nm. Various permeation parameters such as permeation coefficient (Kp), diffusion coefficient (D), flux (J), input rate,and enhancement ratio were obtained using Fick’s diffusion laws.Results: Permeation increased with increase in the concentrations of both enhancers tested. Maximum cumulative amount permeated for control lotion (Lc) was 357 ìg/cm2/min with input rate 0.574 ìg/min and lag time (tlag) of 34.93 min, while for the optimum test lotion (L4, containing 8 % PG/PEG in ratio of 1:1 v/v), it was 926 ìg/cm2/min, 1.482 ìg/min and 58.36 min, respectively. The significantly (p < 0.05) higher permeability shown by the test lotion L4 can be attributed, in part, to the interaction of PG withintercellular lipids leading to the disruption of their organization and increasing their fluidity, and also partly as a result of solubilization of lipid bilayers by PEG.Conclusion: A binary system of PG and PEG in lotion can be successfully utilized for the permeation enhancement of tramadol.Keyword: Tramadol, Transdermal delivery, Permeation, Propylene glycol, Polyethylene glycol, Rabbit skin

Relationship of BMI and age with gallstone disease

Objective: To find out the relationship of BMI and age in patients with gallstone disease.  Methodology: This is a cross-sectional study done from March 2019 to February 2020 at the Department of General Surgery PIMS, Islamabad. All patients admitted with a diagnosis of Cholelithiasis were included and patients with previous abdominal surgery were excluded from the study. Patients’ data was collected about their age, sex, dietary habits, occupation and medical history. Their weight in kilograms and heights in centimeters were measured and BMI was calculated in kg/cm2. All data was collected, recorded and analyzed using SPSS 22. Results: A total of 158 patients were included in the study with mean age was 46.2±6.7 years (18 - 83 years). Majority (63%) of the patients were between 41 and 60 age group. There were 120 females and 38 males with ratio of 3:1. The mean BMI of the study population was 25.8 ± 7.61 (Range 19.37 - 33.12). Most of the patients were healthy (n=86, 54.4%) having their BMIs between 18 and 24.9 whereas 72 (46.6%) patients were overweight and obese. Conclusion: Increased frequency of cholelithiasis is found with increasing age even with normal BMI

Chylous ascites following radical nephrectomy: a case report

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

Impact of natural killer cells on outcomes after allogeneic hematopoietic stem cell transplantation: A systematic review and meta-analysis.

Background: Natural killer (NK) cells play a vital role in early immune reconstitution following allogeneic hematopoietic stem cell transplantation (HSCT). Methods: A literature search was performed on PubMed, Cochrane, and Clinical trials.gov through April 20, 2022. We included 21 studies reporting data on the impact of NK cells on outcomes after HSCT. Data was extracted following the PRISMA guidelines. Pooled analysis was done using the meta-package (Schwarzer et al.). Proportions with 95% confidence intervals (CI) were computed. Results: We included 1785 patients from 21 studies investigating the impact of NK cell reconstitution post-HSCT (8 studies/1455 patients), stem cell graft NK cell content (4 studies/185 patients), therapeutic NK cell infusions post-HSCT (5 studies/74 patients), and pre-emptive/prophylactic NK cell infusions post-HSCT (4 studies/77 patients). Higher NK cell reconstitution was associated with a better 2-year overall survival (OS) (high: 77%, 95%CI 0.73-0.82 vs low: 55%, 95%CI 0.37-0.72; n=899), however, pooled analysis for relapse rate (RR) or graft versus host disease (GVHD) could not be performed due to insufficient data. Higher graft NK cell content demonstrated a trend towards a better pooled OS (high: 65.2%, 95%CI 0.47-0.81 vs low: 46.5%, 95%CI 0.24-0.70; n=157), lower RR (high: 16.9%, 95%CI 0.10-0.25 vs low: 33%, 95%CI 0.04-0.72; n=157), and lower acute GVHD incidence (high: 27.6%, 95%CI 0.20-0.36 vs low: 49.7%, 95%CI 0.26-0.74; n=157). Therapeutic NK or cytokine-induced killer (CIK) cell infusions for hematologic relapse post-HSCT reported an overall response rate (ORR) and complete response (CR) of 48.9% and 11% with CIK cell infusions and 82.8% and 44.8% with NK cell infusions, respectively. RR, acute GVHD, and chronic GVHD were observed in 55.6% and 51.7%, 34.5% and 20%, and 20.7% and 11.1% of patients with CIK and NK cell infusions, respectively. Pre-emptive donor-derived NK cell infusions to prevent relapse post-HSCT had promising outcomes with 1-year OS of 69%, CR rate of 42%, ORR of 77%, RR of 28%, and acute and chronic GVHD rates of 24.9% and 3.7%, respectively. Conclusion: NK cells have a favorable impact on outcomes after HSCT. The optimal use of NK cell infusions post-HSCT may be in a pre-emptive fashion to prevent disease relapse

High rate, fast timing Glass RPC for the high {\eta} CMS muon detectors

The HL-LHC phase is designed to increase by an order of magnitude the amount of data to be collected by the LHC experiments. To achieve this goal in a reasonable time scale the instantaneous luminosity would also increase by an order of magnitude up to $6.10^{34} cm^{-2} s^{-1}$ . The region of the forward muon spectrometer ($|{\eta}| > 1.6$) is not equipped with RPC stations. The increase of the expected particles rate up to $2 kHz/cm^{2}$ (including a safety factor 3) motivates the installation of RPC chambers to guarantee redundancy with the CSC chambers already present. The actual RPC technology of CMS cannot sustain the expected background level. The new technology that will be chosen should have a high rate capability and provides a good spatial and timing resolution. A new generation of Glass-RPC (GRPC) using low-resistivity (LR) glass is proposed to equip at least the two most far away of the four high ${\eta}$ muon stations of CMS. First the design of small size prototypes and studies of their performance in high-rate particles flux is presented. Then the proposed designs for large size chambers and their fast-timing electronic readout are examined and preliminary results are provided.Comment: 14 pages, 11 figures, Conference proceeding for the 2016 Resistive Plate Chambers and Related Detector

Improvements in wheat productivity and soil quality can accomplish by co-application of biochars and chemical fertilizers

The beneficial role of biochar is evident in most of infertile soils, however this is argued that increment in crop yield owing to biochar application does not always achieve in cultivated/fertile soils. The nutrient biochar believed to enhance crop yield and soil fertility than structural biochar that may offset the positive effect of chemical fertilizer on crop performance but improves soil structural properties. Therefore, we investigated the effect of biochars [produced from nutrient rich feedstocks like poultry manure (PMB) and farmyard manure (FMB) and structural feedstocks such as wood chips (WCB) and kitchen waste (KWB)], and chemical fertilizers (CF) when applied alone or in combination on soil chemical properties, wheat growth, yield and nitrogen uptake in a cultivated clay loam soil. Sole biochar treatments increased the total carbon and mineral nitrogen content that were 21 and 106% higher, respectively compared to control after 128 days (P 0.05) except PMB, the nutrient biochar (P < 0.05). Compared to control, grain yield was 6 and 12% lower in WCB and FMB, respectively but not differed from KWB, PMB or WCB-CF. Conversely, co-application of biochars and CF treatments increased crop biological yield but the increment was the highest in nutrient biochars FMB or PMB (29 or 26%), than structural biochars WCB and KWB (15 and 13%), respectively (P < 0.05). For N uptake, this increment varies between 16 and 27% and again nutrient biochar has significantly higher N uptake than structural biochars. Hence, nutrient biochars (i.e. PMB) benefited the soil fertility and crop productivity more than structural biochars. Therefore, for immediate crop benefits, it is recommended to use nutrient biochar alone or in combination with chemical fertilizer. Such practice will improve crop performance and the quality of cultivated soil

Phenytoin versus Leviteracetam for seizure prophylaxis after brain injury - A meta analysis

Background: Current standard therapy for seizure prophylaxis in Neuro-surgical patients involves the use of Phenytoin (PHY). However, a new drug Levetiracetam (LEV) is emerging as an alternate treatment choice. We aimed to conduct a meta-analysis to compare these two drugs in patients with brain injury.Methods: An electronic search was performed in using Pubmed, Embase, and CENTRAL. We included studies that compared the use of LEV vs. PHY for seizure prophylaxis for brain injured patients (Traumatic brain injury, intracranial hemorrhage, intracranial neoplasms, and craniotomy). Data of all eligible studies was extracted on to a standardized abstraction sheet. Data about baseline population characteristics, type of intervention, study design and outcome was extracted. Our primary outcome was seizures.Results: The literature search identified 2489 unduplicated papers. Of these 2456 papers were excluded by reading the abstracts and titles. Another 25 papers were excluded after reading their complete text. We selected 8 papers which comprised of 2 RCTs and 6 observational studies. The pooled estimate\u27s Odds Ratio 1.12 (95% CI = 0.34, 3.64) demonstrated no superiority of either drug at preventing the occurrence of early seizures. In a subset analysis of studies in which follow up for seizures lasted either 3 or 7 days, the effect estimate remained insignificant with an odds ratio of 0.96 (95% CI = 0.34, 2.76). Similarly, 2 trials reporting seizure incidence at 6 months also had insignificant pooled results while comparing drug efficacy. The pooled odds ratio was 0.96 (95% CI = 0.24, 3.79).Conclusions: Levetiracetam and Phenytoin demonstrate equal efficacy in seizure prevention after brain injury. However, very few randomized controlled trials (RCTs) on the subject were found. Further evidence through a high quality RCT is highly recommended

Performance of Resistive Plate Chambers installed during the first long shutdown of the CMS experiment

The CMS experiment, located at the CERN Large Hadron Collider, has a redundant muon system composed by three different detector technologies: Cathode Strip Chambers (in the forward regions), Drift Tubes (in the central region) and Resistive Plate Chambers (both its central and forward regions). All three are used for muon reconstruction and triggering. During the first long shutdown (LS1) of the LHC (2013-2014) the CMS muon system has been upgraded with 144 newly installed RPCs on the forth forward stations. The new chambers ensure and enhance the muon trigger efficiency in the high luminosity conditions of the LHC Run2. The chambers have been successfully installed and commissioned. The system has been run successfully and experimental data has been collected and analyzed. The performance results of the newly installed RPCs will be presented.Comment: 5 pages, 6 figures, proceeding to The XIII workshop on Resistive Plate Chambers and Related Detectors (RPC2016