Effect of coating method on release of Glimepiride from porosity osmotic pump tablets (POPTs)

In this study, once-daily porosity osmotic pump tablets (POPTs) of Glimepiride were prepared using HPMC K100M (61%), osmotic agent (30% NaCl) coated using two different coating techniques spraying and dipping methods. The coating solution composed of ethyl cellulose (7.5%) w\w in ethanol (90%), castor oil (2%) as water-insoluble plasticizer and Gingo red color (0.5% w\w). In both techniques, the coating level was adjusted to give a 10% increase in the weight of the tablets. The effect of the coating by dipping technique with an increase in the weight of tablet (10 %, 20% & 50%) was also investigated to see the effect coating level on the percentage of drug release from POPTs. The results of the in vitro release of Glimepiride from tablets coated by the spraying method showed longer release time (24 hrs) than those coated with dipping method. On the other hand, increasing the coating level by dipping method retarded the release of the drug from tablets. However, the same retardation effect on release as shown with the spraying technique was only obtained by increasing the coating level with a 50% increase in the weight of the tablet. Thus, coating by spraying is more efficient to prepare POPTs to give a continuous release of Glimepiride from once daily table with the lowest increase in the total weight of the tablet.

Breast Cancer in Mosul: A Survival Analysis

Breast cancer is the most common cancer in women, and the major cause of death. This study was conducted in order to make a descriptive study and survival analysis for breast cancer patients in Mosul. Two hundred forty-six early diagnosed women with breast cancer out of 290 patients were included during the period from March 2007 to February 2012. The average follows up was 36. months (range: 11-67 months). The patients were undergone modified radical removal of the breast, chemotherapy and deep radiation. Patients with estrogen positive were given tamoxifen for five years. Patients with Her2/neu positive were given trastuzumab with docytaxil for one year. Only 25 patients (10.2%) died during the study. The highest incidence of breast cancer (35.8%) was between the ages 51 ≥ 60 years. The presentation of cancer was high (90.1%) in the lumber. Tumor in the right side (66.35%) was significantly higher than the left side. Metastasis was high (25%) and most of them in the liver (19.1%). The percentage of patients with positive estrogen, progesterone, and Her2/neu receptors were not different from negative receptors. Cox regression analysis showed that metastasis had significant effect on death (hazard ratio=2.917). Age 31 ≥ 40 years was the least affected age (hazard ratio=0.034). In conclusion, survival rate of breast cancer patients in Mosul is high due to good management. The early detection of cancer is the best way for survival of the patients, by developing the educational programs.

Treatment Trends of Myocarditis with Coxsackievirus B3 infection

Viral myocarditis occurred after viral invasion of the cardiocytes and followed by the releasing of viral particles and inflammatory cells. Acute viral myocarditis is relatively common phase of the disease cured spontaneously in some cases or leading to sever acute heart failure and cardiac damage ended with chronic heart failure with increased mortality rate. The fully understand mechanism of viral myocarditis is unclear but some hypothesis trying to illustrate the events of the disease. Regardless of etiological cause, myocarditis is treated depending on disease phase and by following the instructions of Heart Failure Society of America guideline. This article provides the basic knowledge available in literatures to review some important informations of viral myocarditis, with a special focusing on viral myocarditis caused by coxsackievirus B3 infection.

Molecular Drug Design, Synthesis and Antibacterial study of Novel 4-Oxothiazolidin-3-yl Derivatives

New compounds containing 4-thiazolidinone pharmacophore 5(a) and (5b) have been synthesized. The chemical structures of the intermediate and final compounds were characterized and confirmed by using FT-IR and 1H-NMR spectroscopy. All final compounds were tested against gram-positive and gram-negative bacteria using a well-diffusion technique for their ability as antimicrobial agents. The tested compounds 5a and 5b showed variable and modest antibacterial activity against gram-negative bacteria and gram-positive bacteria. Molecular docking simulations were studied to understand the molecular core. The results were achieved by docking, the most active compounds into the active site of protein of the bacteria which completely accorded with in vitro results.

Nigella sativa's protective effect in acetaminophen induced liver toxicity in mice

Acetaminophen has contributed to acute liver failure disease in more than half of the USA and Britain but as an analgesic and antipyretic it is very effective. For many decades in Europe, Middle East and Africa, Nigella sativa has been used for various medical purposes, it is part of the botanical family Ranunculaceae of Gently sloping plants, and is called black cumin seed., Nigella sativa conjugated sterols could be used as precursors to many hydrosoluble steroids for hemisynthesis. The aim of the Study is to examine the promising hepatoprotective effects of Nigella sativa against Acetaminopheninduce hepatotoxicity in mice in this experiment Forty adult male albino mice, incorporated in the experiment and Acetaminophenwas used to induce hepatotoxicity in a dose of 1 gm /kg by the oral route. A number of biochemical and histopathological tests have been used to evaluate liver damage and Nigella sativa protective effects. The result showed a significant protective effect of Nigella sativa against acetaminophenhepatotoxic effect as Nigella sativa in this study tended to normalize the serum levels of liver enzymes, and the protective effects observed clearly by the histopathological evaluation confirming that it effectively protected mouse livers against severe damage caused by acetaminophen. Conclusion in our study it shows that Nigella sativa have a very significant protective effects against acetaminophen induced liver toxicity which is recommended to be fully investigation on human especially to people on risk of acetaminophen liver toxicity

Studying the Toxicity of Hydroalcoholic Caraway Seeds Extract in Female Rats

Caraway seeds are widely used as spice for flavoring and seasoning foods, like bread and salads, because of their pungent and anise like flavor and aroma. Carum carvi was utilized in folk medicine for the management of many diseases. It is useful in hypothyroidism, liver and gall bladder problems, common cold, fever, bronchitis, diarrhea, and eczema. It also relives GIT spasms, fullness feelings and relieves baby's flatulent colic. The extracts of caraway have diverse compounds, including carvone and limonene, linalool, γ-terpinene and α-pinene. One or combination of these compounds may participate in the pharmacologic effects of caraway. Aim of this study was to assess toxicity of caraway extract on female rats. Carium carvi extract submitted to chemical analysis (Phytochemical screening and Gas chromatography-mass spectrometry (GC-MS) analysis). Acute toxicity study has been performed using 24 female rats divided randomly in 4 groups (n=6 for each group) that received different doses of hydroalcoholic seed extract of caraway 1000, 3000 and ,5000 mg/kg for 14 days. On day 15, the rats were euthanized and whole blood collected to examine complete blood picture. The liver, kidney and the heart have been harvested for histopathologic study and relative organ weight changes. Caraway extract considered relatively safe on blood profile and immune system within the studied doses, as it shown a non-significant change on complete blood counts (CBCs) in a dose-dependent manner (Hb and RBCs increased slightly, while WBCs and PLTs decreased slightly) and without any change in body weight and relative weight percentage of different organs. As conclusion, hydroalcoholic extract of caraway seeds was relatively safe in rats at a dose up to 5000 mg/kg

Therapeutic Drug Monitoring of Cyclosporine Using Single Sampling Strategy

Cyclosporine is mainly used as Immunosuppressant after different kinds of transplantation including bone marrow, lungs, kidneys, liver, heart, and other types of organ transplantations. Immunosuppressants diminish organ rejection and elongate the survival of the transplanted organs. Due to the narrow therapeutic ranges and significantly high interindividual and intraindividual variability in blood levels of cyclosporine, there is essential and vital need of therapeutic drug monitoring (TDM) of this drug in order to maintain the patient within the required therapeutic concentrations, which consequently lead to optimizing the clinical outcome and decrease the hazard of toxicity or rejection following organ transplantations. The current review article was aimed to present data for using a single or possibly two blood sampling strategy to be used for TDM of cyclosporine in order to assess the optimal blood levels of cyclosporine used in organ transplant recipients. The results showed that steady state blood concentration of cyclosporine obtained after 2 hours (C2) and possibly after 3 hours (C3) of drug administration are the best sampling time points which reflect total drug exposure (area under blood concentration versus time curve=AUC) and consequently reflecting the effect and the adverse effect(s) of cyclosporine. On the other hand, blood samples obtained at other time points particularly steady state trough concentration obtained before the next dose (C0) demonstrated poor correlation with total drug exposure and consequently the clinical outcome of the drug. Moreover, this study also demonstrated that for organs transplantations TDM of cyclosporine and assessing the clinical conditions of the patients should be routinely performed in order to adjust the dose to get optimal effect and to diminish the adverse effects of the drug. This review article focused on the findings which indicated that monitoring steady-state blood levels of cyclosporine after 2 hours (C2) and likely after 3 hours (C3) of drug intake may be used as ideal surrogate index in TDM of cyclosporine and for predicting the clinical outcome of the drug in all and different types of organs transplantations.

Potential effect of pharmaceutical care to improve outcomes in patients with chronic kidney disease-mineral bone disorder in Sulaimani dialysis centers

Objective: the present study was aimed to evaluate the role of pharmaceutical services in improving the outcome of mineral bone disorder in patients with advanced chronic kidney disease. Methodology: One hundred and twenty patients with chronic kidney disease-mineral bone disorder (CKD-MBD) screened for eligibility, seventy-six patients enrolled in the study and randomly allocated into two groups: pharmaceutical care and usual care, both groups interviewed by the pharmacist using specific questionnaire for assessing the quality of life (QoL). All the drug related problems (DRPs) including drug-drug interactions (DDIs) were recorded by the pharmacist. Blood samples were collected and utilized for analyzing the levels of vitamin D, phosphorous, calcium, albumin and parathyroid hormone at baseline and three months after. The pharmaceutical care group received all the educations about their medications and how to minimize DRPs; improve the QoL. Additionally, the pharmaceutical intervention included correcting the biochemical parameters. Results: Pharmaceutical care significantly improved patients QoL and minimized DRPs and DDIs. It was also effective in improving the biochemical parameters. Conclusion: Pharmaceutical care has a positive impact on improving the outcome of patients with CKD-MBD through attenuating DRPs, improving the biochemical parameters and the QoL.

Curcumin as adjuvant therapy to Meloxicam in treatment of patients with knee Osteoarthritis; Evaluation of antioxidant activity

Osteoarthritis (OA) is a chronic degenerative joint disease that doubled in prevalence since the mid of 20th century most commonly due to obesity and aging. Osteoarthritis can affect any joint in the body. The pathogenesis of OA is multifactorial influenced by range of biochemical and mechanical factors. Oxidative stress is described to play an important role in many diseases including OA. Accumulating evidences suggested the beneficial effect of anti-oxidants for reducing OA severity. Curcumin is a well-known antioxidant agent that acts by different mechanisms in modulating oxidative stress status. This study was designed to evaluate the antioxidant effect of curcumin as adjuvent therapy to a non-steroidal anti-inflammatory drug, meloxicam, in the management of knee osteoarthritis. This prospective open-labelled randomized controlled study was carried out on forty-two eligible patients who were allocated in two groups, serum superoxide dismutase 3 (SOD3) and glutathione reductase (GR) were measured at baseline and after 3 months of the study. Pain and physical function assessment were evaluated by oxford knee score (OKS). Results illustrated highly significant improvement in pain and physical function scores when curcumin used as adjuvant to meloxicam, also curcumin supplementation resulted in significant increase in SOD3 serum level and only a modest decrease in GR serum level when compared to meloxicam alone. In conclusion, this study demonstrated benefit of curcumin when used in combination with meloxicam over using meloxicam alone in modulating antioxidant parameters in blood, in addition to significantly improving pain and physical function after 3 months of treatment.

Studying the Effect of Adding Alpha Lipoic Acid to Gabapentin to Improve Nerve Conduction Velocity and Glycemic Control of Patients with Diabetic Neuropathy (Sample of Iraqi population)

Diabetic neuropathy (DN) is the most common chronic complication of diabetes mellitus. Hyperglycemia-induced oxidative stress induces programmed cell death of nerves, which contributes to the pathology of Diabetic neuropathy. Many clinical trials depend on supplement, in an attempt to improve neuropathy symptoms such as (pain & tingling) and patient quality of life, one of them is alpha-lipoic acid (ALA). Alpha-lipoic acid is a potent anti-inflammatory and antioxidant with insulin-mimetic activity, it has been shown to improve clinical symptoms in experimental Diabetic neuropathy and protect peripheral nerves from ischemia, in addition to stimulate the nerve growth factor and promote fiber regeneration. This study is aimed to evaluate the effect of Alpha-lipoic acid supplement as adjuvant therapy to gabapentin in patients with diabetic neuropathy, which can reflect by the improvement in nerve conduction velocity (NCV) a test was conducted to assess the severity of iabetic neuropathy and clinical symptoms. A prospective randomized- open-label interventional study for 3 months include 33 DN patients, aged (18-69) years were divided into two groups; group A include 16 patients received gabapentin 300 mg once daily at night, and group B include 17 patients received gabapentin 300 mg once daily at night plus alpha-lipoic acid 600mg once daily. Pre and post 3 months of treatment, blood samples used to measure metabolic biomarkers (FBG, HbA1c), in addition to Nerve conduction velocity. The results showed that, the intervention group produced a highly significant change in HbA1c & no significant change in FBG levels after 3months of Alpha-lipoic acid supplementation. Meanwhile, there is no significant change in HbA1c & FBG levels in patients treated with gabapentin alone. Moreover, results showed highly significant improvement (P˂0.01) in Nerve conduction velocity for two groups at the end of the study. Addition of Alpha-lipoic acid to gabapentin in diabetic neuropathy patients result to improve the glycemic control & Nerve conduction velocity. after three months of treatment.