DEVELOPMENT OF CIPROFLOXACIN LOADED THROAT PAINT FOR THE TREATMENT OF STREP THROAT INFECTION

Objective: This study is to enhance the solubility and sustained release of ciprofloxacin (CPX) drug by amplifying the adhesive capability of formulation by forming throat paint for the Streptococcal pharyngitis, a sore throat infection. Methods: Solid dispersion was prepared by solvent evaporation technique, in which three different ratios of Polyethylene glycol-6000 (PEG-6000) were selected, and the best ratio of solid dispersion was selected after characterization including Scanning electron microscopy (SEM) and Differential scanning calorimetry (DSC) with evaluation parameters including % yield, drug content, and drug solubility. In the case of throat paint, out of six different formulations, the best formulation was selected through viscosity, in vitro mucoadhesion, in situ release study, and spreadability parameters. Results: The DSC and SEM data proved that solid dispersion has a different moiety than its ingredients but it is quite a stable form. Formulation MD-2 was selected as the best formulation which able to increase the solubility of the drug by more than 3.5 folds, at the same time it shows the highest rate of drug dissolution of 13.951 μg/ml with % yield (97.199±0.167%) and drug content (96.425%). Throat paint was formed by fusion and trituration process and out of all six formulations F3 was selected as the best formulation on the basis of Viscosity (11932 Centi poise), Spreadability (17.621), Mucoadhesion (3937.481 dyne/cm2), and drug release (90.336±0.6%). Conclusion: Solid dispersion was successfully prepared with 3.5 times of solubility enhancement capability in comparison with pure CPX drug. The throat paint releases the drug (≥3 h) in a sustained manner with high mucoadhesive force.

Diagnostic accuracy of FEVER-Pain and centor criteria for bacterial throat infection in adults with sore throat: a secondary analysis of a randomised controlled trial

BackgroundSore throat is a common and self-limiting condition. There remains ambiguity in stratifying patients to immediate, delayed or no antibiotic prescriptions. NICE recommends two clinical prediction rules (CPRs), FeverPAIN and CENTOR, to guide decision-making.AimDescribe the diagnostic accuracy of CPRs in identifying streptococcal throat infections.Design and SettingAdults presenting to UK primary care with sore throat, who did not require immediate antibiotics.MethodsAs part of the Treatment Options without Antibiotics for Sore Throat (TOAST) trial, 565 participants, aged ≥18, were recruited on day of presentation to general practice. Physicians could opt to give delayed prescriptions. CPR scores were not part of the trial protocol but calculated post-hoc from baseline assessments. Diagnostic accuracy was calculated by comparing scores to throat swab cultures.Results81/502 (16.1%) of patients had Group A, C or G streptococcus cultured on throat swab. Overall diagnostic accuracy of both CPRs was poor: area under receiver-operating-characteristics curve 0.62 for Centor; 0.59 for FeverPAIN. Post-test probability of a positive or negative test was 27.3% (95% confidence intervals: 6.0%–61.0%) and 84.1% (80.6%–87.2%) for FeverPAIN ≥4, vs 25.7% (16.2%–37.2%) and 85.5% (81.8%–88.7%) for Centor ≥3. Higher CPR scores were associated with increased delayed antibiotic prescriptions (χ2=8.42, P=0.004 for FeverPAIN ≥4; χ2=32.0, P<0.001 for Centor ≥3).ConclusionsIn those that do not require immediate antibiotics in primary care, neither CPR provide a reliable way of diagnosing streptococcal throat infection. However, clinicians were more likely to give delayed prescriptions to those with higher scores.

Role of calcium channel blocker in excessive mast cell degranulation

Background:I present a case of a female patient, age 45 years, for whom the uncontrolled mast cell degranulation created many issues related to allergy like, skin rash, itching, breathing discomfort, frequent throat infection, GERD, migraine, fibromyalgia, peripheral neuropathy, depression, anxiety disorder, constipation etc. For the patient, it was observed that calcium channel blockers seem to control the unnecessary and uncontrolled mast cell degranulation. CCB seemed to have a role to play in mast cell degranulation.Case presentation:When the patient is taking either Flunarizine or Pregabalin or both together, the need for antihistamine and montelukast are very low. The patient suffers less throat infection while Flunarizine or Pregabalin are being taken. More the dose of Pregabalin less the occurrence of any type of allergy (food, pollen, dust etc.). The requirement of corticosteroid inhaler for breathing discomfort is also less. Frequency of body pain, migraine is minimal. Occurrence of stomach acid or GERD or digestion disorder is also very less. In terms of mood or anxiety, body is stable too. So, per day when 3 Pregabalin (75mg) were taken with 1 Amitriptyline (50mg) and 1 Duloxetine (60mg) health is completely stable with no need for H1 Blocker, H2 Blocker, Montelukast and Corticosteroid inhaler. Conclusion:CCB, specifically L-type CCB must have role in controlling the degranulation of mast cells, thus reducing all problem together at the root. But there are disadvantages like aggravated IBS (lazy gut), aggravated RLS and fluid retention (swelling of palm).We must check the use of Gabapentin and Sodium cromoglycate too. They should also control the unnecessary mast cell degranulation. Thus, fixing the problem at the root.

A Study on Working Conditions of Women Beedi Workers at Aralvoimozhi Town Panchayat of Kanniyakumari District

In the unorganized sector, beedi manufacturing provides employment opportunities, particularly for the women in Aralvoimozhi of Tamil Nadu. Since beedi work is undertaken at home without basic facilities, all the household members, including children, are exposed to the hazards of inhaling tobacco smell. The most common problem experienced by them was backache, eyesore, rickets, thyroid and tuberculosis, and throat infection.