Design and Evaluation of Controlled Release Formulations of Ibuprofen Tablet.

Therapeutic efficacy and safety of drugs, administrated by conventional methods, can be improved by more precise spatial and temporal placement within the body, thereby reducing both the size and number of doses by using controlled drug delivery system. An ideal controlled drug delivery system is the one which delivers the drug at predetermined rate, locally or systemically for a specified period of time. An ideal targeted drug delivery system delivers the drug only to its site of action. An ideal drug delivery system should deliver the drug at a rate dictated by the needs of the body over the period of treatment channel the active entity solely to the site of action. To make it in practice various controlled and targeted drug delivery system are introduced. Controlled delivery of drugs, proteins and other bioactive agents can be achieved by incorporating them either in dissolved or dispersed form in polymers. In general controlled delivery attempts to, Sustain drug action at a predetermined rate by maintaining a relatively constant, effective drug level in the body with concomitant minimization of undesirable side effects associated with a saw tooth kinetic pattern. Localize drug action by spatial placement of a controlled release system (rate controlled) adjacent to or in the diseased tissue or organ. Target drug action by using carriers to deliver drugs to particular target cell type. Oral controlled drug delivery system is perhaps the relatively very advanced, newer area of research of its kind. This state-of-the-art formulation development offers several benefits like increased therapeutic efficacy, decreased side effects etc. Biocompatible and biodegradable xanthum gum, glyceryl behanate and stearic acid were experimented with ibuprofen which has served as a model drug for development of controlled release oral tablet. Oral control tablet of ibuprofen with very good physical characteristics were developed. The method of preparation of tablet of ibuprofen was found to be simple and reproducible. The sustained release of ibuprofen from the development oral tablet will help to improve the therapeutic efficacy and patient compliance by reducing the dose and frequency of dosing of ibuprofen perhaps as in vitro dissolution study suggested only 74 % (F2) release of drug over 24 h period. This work shows that stearic acid loaded tablet of ibuprofen could be oral control drug delivery system for ibuprofen for prolonged release. Thus concluding control release tablet of ibuprofen could improve upon physicochemical and biological properties of ibuprofen

Cardiac Catheterisation and Intervention on ECMO

Cardiac catheterisation is an essential tool to evaluate patients who require ECMO support for severe haemodynamic impairment. In the first part of this chapter, we describe the equipment, teamwork, expertise, techniques and precautions that are necessary to carry out safe and effective cardiac catheterisation on ECMO. We have moved on from an early pioneering era to a stage where the multidisciplinary team approach has been worked out in detail, using operational procedures that deal with the technical challenges and minimise the risks of ECMO catheterisation and intervention. In the second part of the chapter, we explain in detail how cardiac catheterisation and intervention on ECMO contribute to the management of (1) post-operative congenital heart disease patients, (2) cardiac patients who suffer sudden haemodynamic deterioration, (3) patients with low cardiac output who require left heart decompression because of extracorporeal support, (4) patients with haemodynamically unstable arrhythmias and (5) haemodynamically unstable patients who require percutaneous coronary intervention. We also provide state-of-the-art information on the elective use of ECMO to support congenital and structural catheter interventions. Acute survival and long-term outcome are now related to the underlying conditions rather than complications of the catheterisation procedure itself

Coxsackie B viral infection presenting with hemorrhagic pericardial effusion and pleural effusion

We report an 11-year-old female child presenting with hemorrhagic pericardial effusion causing cardiac tamponade along with moderate left ventricular dysfunction, who screened positive for Coxsackie B infection in the setting of cough, shortness of breath, and chest pain. She needed emergency pericardiocentesis. She also had massive bilateral hemorrhagic pleural effusions requiring bilateral chest drains placement. With a presumed diagnosis of acute myopericarditis, she was treated with steroids and ibuprofen. She made a full recovery without any further recurrence of pericardial or pleural effusion