Search results for: drug and alcohol prevention

Authors: A. M. H. Shokry, N. S. M. El-Tayeb

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The environmental impacts caused by fertilizers call for the adaptation of more sustainable technologies in order to increase agricultural production and reduce pollution due to high nutrient emissions. One particular technique has been to coat urea fertilizer granules with less-soluble chemicals that permit the gradual release of nutrients in a slow and controlled manner. The aim of this research is to develop a biodegradable slow-release fertilizer (SRF) with materials that come from sustainable sources; starch and polyvinyl alcohol (PVA). The slow-release behavior and water retention capacity of the coated granules were determined. In addition, the aqueous release and absorbency rates were also tested. Results confirmed that the release rate from coated granules was slower than through plain membranes; and that the water absorption capacity of the coated urea decreased as PVA content increased. The SRF was also tested and gave positive results that confirmed the integrity of the product.

Keywords: biodegradability, nitrogen-use efficiency, poly-vinyl alcohol, slow-release fertilizer, sustainability

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Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

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Introduction: It is well known that patients with Head and Neck Cancer (HNC) are at increased risk of subsequent head and neck cancers due to various aetiologies. Aim: We sought to determine the factors contributing to an increased risk of subsequent HNC primaries, and also to evaluate whether Aboriginal patients are at increased risk. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by site, histology, rurality, and age. We collected patient data including smoking and alcohol consumption, tumour and treatment data, and data on subsequent HNC primaries. Results: A subsequent HNC primary was seen in 37 patients (11.6%) overall. There was no significant difference in the rate of second primary HNCs between Aboriginal patients (12.5%) and nonAboriginal patients (11.2%) (p=0.408). Subsequent HNCs, were strongly associated with smoking and alcohol consumption however, with 95% of patients with a second primary being ever-smokers, and 54% of patients with a second primary having a history of excessive alcohol consumption. In the 37 patients with multiple HNC primaries, there were a total of 57 HNCs, with 29 patients having two primaries, six patients having 3 HNC primaries, one patient with four, and one with six. 54 out of the 57 cancers were in ever smokers (94.7%). There were only two multiple HNC primaries in a never smoker, non-drinker, and these cases were of unknown etiology with HPV/p16 status unknown in both cases. In the whole study population, there were 32 HPV-positive HNCs, and 67 p16-positive HNCs, with only two 2 nd HNCs in a p16-positive case, giving a rate of 3% in the p16+ population, which is actually much lower than the rate of second primaries seen in the overall population (11.6%), and was highest in the p16-negative population (15.7%). This suggests that p16-positivity is not a strong risk factor for subsequent primaries, and in fact p16-negativity appeared to be associated with increased risk, however this data is limited by the large number of patients without documented p16 status (45.3% overall, 12% for oropharyngeal, and 59.6% for oral cavity primaries had unknown p16 status). Summary: Subsequent HNC primaries were strongly associated with smoking and alcohol excess. Second and later HNC primaries did not appear to occur at increased rates in Aboriginal patients compared with non-Aboriginal patients, and p16-positivity did not predict increased risk, however p16-negativity was associated with an increased risk of subsequent HNCs.

Keywords: head and neck cancer, multiple primaries, aboriginal, p16 status, smoking, alcohol

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Authors: Tasnuva Tamanna, Aimin Yu

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Application of nanoscience in biomedical field has come across as a new era. This study involves the synthesis of nano drug carrier with antibiotic loading. Based on the founding that polydopamine (PDA) nanoparticles could be formed via self-polymerization of dopamine at alkaline pH, one-step synthesis of rifampicin coupled polydopamine (PDA-R) nanoparticles was achieved by adding rifampicin into the dopamine solution. The successful yield of PDA nanoparticles with or without the presence of rifampicin during the polymerization process was characterized by scanning electron microscopy, Fourier transform infrared spectroscopy, and Raman spectroscopy. Drug loading was monitored by UV-vis spectroscopy and the loading efficiency of rifampicin was calculated to be 76%. Such highly capacious nano-reservoir was found very stable with little drug leakage at pH 3.

Keywords: drug loading, nanoparticles, polydopamine, rifampicin

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Authors: Shahana Sharmin

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In the present study, the effect of cellulose polymers Ethyl Cellulose and Hydroxy Propyl Methyl Cellulose was evaluated on the release profile of drug from sustained release pellet. Diltiazem Hydrochloride, an antihypertensive, cardio-protective agent and slow channel blocker were used as a model drug to evaluate its release characteristics from different pellets formulations. Diltiazem Hydrochloride sustained release pellets were prepared by drug loading (drug binder suspension) on neutral pellets followed by different percentages of spraying, i.e. 2%,4%, 6%, 8% and 10% coating suspension using ethyl cellulose and hydroxy-propyl methyl cellulose polymer in a fixed 85:15 ratios respectively. The in vitro dissolution studies of Diltiazem Hydrochloride from these sustained release pellets were carried out in pH 7.2 phosphate buffer for 1, 2, 3, 4, 5, 6, 7, and 8 hrs using USP-I method. Statistically, significant differences were found among the drug release profile from different formulations. Polymer content with the highest concentration of Ethyl cellulose on the pellets shows the highest release retarding rate of the drug. The retarding capacity decreases with the decreased concentration of ethyl cellulose. The release mechanism was explored and explained with zero order, first order, Higuchi and Korsmeyer’s equations. Finally, the study showed that the profile and kinetics of drug release were functions of polymer type, polymer concentration & the physico-chemical properties of the drug.

Keywords: diltiazem hydrochloride, ethyl cellulose, hydroxy propyl methyl cellulose, release kinetics, sustained release pellets

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Authors: Mohsin Ali Shaikh, Song Weiguo, Muhammad Kashan Surahio, Usman Shahid, Rehmat Karim

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When the area of a structure that is threatened by a disaster affects personal safety, the effectiveness of disaster prevention, evacuation, and rescue operations can be summarized by three assessment indicators: personal safety, property preservation, and attribution of responsibility. These indicators are applicable regardless of the disaster that affects the building. People need to get out of the hazardous area and to a safe place as soon as possible because there's no other way to respond. The results of the tragedy are thus closely related to how quickly people are advised to evacuate and how quickly they are rescued. This study considers present fire prevention systems to address catastrophes and improve building safety. It proposes the methods of Prevention Level for Deployment in Advance and Spatial Transformation by Human-Machine Collaboration. We present and prototype a real-time fire protection system architecture for building disaster prevention, evacuation, and rescue operations. The design encourages the use of simulations to check the efficacy of evacuation, rescue, and disaster prevention procedures throughout the planning and design phase of the structure.

Keywords: prevention level, building information modeling, quality management system, simulated reality

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Authors: Khushbu Priyadarshi, Chandramani Pathak

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Cancer cells can develop resistance to conventional therapies especially chemotherapeutic drugs. Resistance to chemotherapy is another challenge in cancer therapeutics. Therefore, it is important to address this issue. Gallic acid (GA) is a natural plant compound that exhibits various biological properties including anti-proliferative, anti-inflammatory, anti-oxidant and anti-bacterial. Despite of the wide spectrum biological properties GA has cytotoxic response and low bioavailability. To overcome this problem, GA was conjugated with the Polyamidoamine(PAMAM) dendrimer for improving the bioavailability and efficient delivery in drug-resistant HCT-116 Colon Cancer cells. Gallic acid was covalently linked to 4.0 G PAMAM dendrimer. PAMAM dendrimer is well established nanocarrier but has cytotoxicity due to presence of amphiphilic nature of amino group. In our study we have modified surface of PAMAM dendrimer with Gallic acid and examine their anti-proliferative effects in drug-resistant HCT-116 cells. Further, drug-resistant colon cancer cells were established and thereafter treated with different concentration of PAMAM-GA to examine their anti-proliferative potential. Our results show that PAMAM-GA conjugate induces apoptotic cell death in HCT-116 and drug-resistant cells observed by Annexin-PI staining. In addition, it also shows that multidrug-resistant drug transporter P-gp protein expression was downregulated with increasing the concentration of GA conjugate. After that we also observed the significant difference in Rh123 efflux and accumulation in drug sensitive and drug-resistant cancer cells. Thus, our study suggests that conjugation of anti-cancer agents with PAMAM could improve drug resistant property and cytotoxic response to treatment of cancer.

Keywords: drug resistance, gallic acid, PAMAM dendrimer, P-glycoprotein

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Authors: Hardeep

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The aim of this research work to improve the solubility and bioavailability of Simvastatin using a self nanoemulsifying drug delivery system (SNEDDS). Self emulsifying property of various oils including essential oils was evaluated with suitable surfactants and co-surfactants. Validation of a method for accuracy, repeatability, Interday and intraday precision, ruggedness, and robustness were within acceptable limits. The liquid SNEDDS was prepared and optimized using a ternary phase diagram, thermodynamic, centrifugation and cloud point studies. The globule size of optimized formulations was less than 200 nm which could be an acceptable nanoemulsion size range. The mean droplet size, drug loading, PDI and zeta potential were found to be 141.0 nm, 92.22%, 0.23 and -10.13 mV and 153.5nm, 93.89 % ,0.41 and -11.7 mV and 164.26 nm, 95.26% , 0.41 and -10.66mV respectively.

Keywords: simvastatin, self nanoemulsifying drug delivery system, solubility, bioavailability

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Authors: Melissa Langevin, Natalie Ward, Colleen Fitzgibbons, Christa Ramsey, Melanie Hogue, Anna Theresa Lobos

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Description: Root Cause Analysis (RCA) is used by health care teams to examine adverse events (AEs) to identify causes which then leads to recommendations for prevention Despite widespread use, RCA has limitations. Best practices have not been established for implementing recommendations or tracking the impact of interventions after AEs. During phase 1 of this study, we used simulation to analyze two fictionalized AEs that occurred in hospitalized paediatric patients to identify and understand how the errors occurred and generated recommendations to mitigate and prevent recurrences. Scenario A involved an error of commission (inpatient drug error), and Scenario B involved detecting an error that already occurred (critical care drug infusion error). Recommendations generated were: improved drug labeling, specialized drug kids, alert signs and clinical checklists. Aim: Use simulation to optimize interventions recommended post critical event analysis prior to implementation in the clinical environment. Methods: Suggested interventions from Phase 1 were designed and tested through scenario simulation in the clinical environment (medicine ward or pediatric intensive care unit). Each scenario was simulated 8 times. Recommendations were tested using different, voluntary teams and each scenario was debriefed to understand why the error was repeated despite interventions and how interventions could be improved. Interventions were modified with subsequent simulations until recommendations were felt to have an optimal effect and data saturation was achieved. Along with concrete suggestions for design and process change, qualitative data pertaining to employee communication and hospital standard work was collected and analyzed. Results: Each scenario had a total of three interventions to test. In, scenario 1, the error was reproduced in the initial two iterations and mitigated following key intervention changes. In scenario 2, the error was identified immediately in all cases where the intervention checklist was utilized properly. Independently of intervention changes and improvements, the simulation was beneficial to identify which of these should be prioritized for implementation and highlighted that even the potential solutions most frequently suggested by participants did not always translate into error prevention in the clinical environment. Conclusion: We conclude that interventions that help to change process (epinephrine kit or mandatory checklist) were more successful at preventing errors than passive interventions (signage, change in memory aids). Given that even the most successful interventions needed modifications and subsequent re-testing, simulation is key to optimizing suggested changes. Simulation is a safe, practice changing modality for institutions to use prior to implementing recommendations from RCA following AE reviews.

Keywords: adverse events, patient safety, pediatrics, root cause analysis, simulation

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Authors: Nagasamy Venkatesh Dhandapani

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The objective of the present study was to develop sustained release oral matrix tablets of anti epileptic drug levetiracetam. The sustained release matrix tablets of levetiracetam were prepared using hydrophilic matrix hydroxypropyl methylcellulose (HPMC) as a release retarding polymer by wet granulation method. Prior to compression, FTIR studies were performed to understand the compatibility between the drug and excipients. The study revealed that there was no chemical interaction between drug and excipients used in the study. The tablets were characterized by physical and chemical parameters and results were found in acceptable limits. In vitro release study was carried out for the tablets using 0.1 N HCl for 2 hours and in phosphate buffer pH 7.4 for remaining time up to 12 hours. The effect of polymer concentration was studied. Different dissolution models were applied to drug release data in order to evaluate release mechanisms and kinetics. The drug release data fit well to zero order kinetics. Drug release mechanism was found as a complex mixture of diffusion, swelling and erosion.

Keywords: levetiracetam, sustained-release, hydrophilic matrix tablet, HPMC grade K 100 MCR, wet granulation, zero order release kinetics

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Authors: Raphael C. Zero, Thiago A. S. S. Rocha, Marita V. Cardozo, Caio C. C. Santos, Alisson D. S. Fechis, Antonio C. Shimano, FabríCio S. Oliveira

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Biomechanical analysis is an important factor in tissue studies. The objective of this study was to determine the feasibility of a new anatomical technique and quantify the changes in skin and the jejunum resistance of cats’ corpses throughout the process. Eight adult cat cadavers were used. For every kilogram of weight, 120ml of fixative solution (95% 96GL ethyl alcohol and 5% pure glycerin) was applied via the external common carotid artery. Next, the carcasses were placed in a container with 96 GL ethyl alcohol for 60 days. After fixing, all carcasses were preserved in a 30% sodium chloride solution for 60 days. Before fixation, control samples were collected from fresh cadavers and after fixation, three skin and jejunum fragments from each cadaver were tested monthly for strength and displacement until complete rupture in a universal testing machine. All results were analyzed by F-test (P <0.05). In the jejunum, the force required to rupture the fresh samples and the samples fixed in alcohol for 60 days was 31.27±19.14N and 29.25±11.69N, respectively. For the samples preserved in the sodium chloride solution for 30 and 60 days, the strength was 26.17±16.18N and 30.57±13.77N, respectively. In relation to the displacement required for the rupture of the samples, the values of fresh specimens and those fixed in alcohol for 60 days was 2.79±0.73mm and 2.80±1.13mm, respectively. For the samples preserved for 30 and 60 days with sodium chloride solution, the displacement was 2.53±1.03mm and 2.83±1.27mm, respectively. There was no statistical difference between the samples (P=0.68 with respect to strength, and P=0.75 with respect to displacement). In the skin, the force needed to rupture the fresh samples and the samples fixed for 60 days in alcohol was 223.86±131.5N and 211.86±137.53N respectively. For the samples preserved in sodium chloride solution for 30 and 60 days, the force was 227.73±129.06 and 224.78±143.83N, respectively. In relation to the displacement required for the rupture of the samples, the values of fresh specimens and those fixed in alcohol for 60 days were 3.67±1.03mm and 4.11±0.87mm, respectively. For the samples preserved for 30 and 60 days with sodium chloride solution, the displacement was 4.21±0.93mm and 3.93±0.71mm, respectively. There was no statistical difference between the samples (P=0.65 with respect to strength, and P=0.98 with respect to displacement). The resistance of the skin and intestines of the cat carcasses suffered little change when subjected to alcohol fixation and preservation in sodium chloride solution, each for 60 days, which is promising for use in surgery training. All experimental procedures were approved by the Municipal Legal Department (protocol 02.2014.000027-1). The project was funded by FAPESP (protocol 2015-08259-9).

Keywords: anatomy, conservation, fixation, small animal

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Authors: Nsenga Bakinahe

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Background: Adolescent girls and young women (AGYW) globally and, particularly in Rwanda, face significant challenges related to HIV prevention and sexual and reproductive health (SRH). Rwanda has a young population, with 65.3% below 30 years of age, demonstrating a need for SRH promotion and HIV prevention for this population. We aimed to determine the knowledge, attitudes, and practices (KAP) of integrated HIV prevention and SRH services among AGYW in Rwanda. Methodology: We conducted a cross-sectional survey among 384 AGYW aged 15-24 years who had ever been pregnant and currently reside in Nyagatare district, Eastern Rwanda from January to April 2023. A questionnaire was developed to collect data, participants were randomly selected and data were collected by one-on-one interviews and were analyzed using SPSS V21. The statistical relationship between variables was significant at P-Value of 0.05 and 95% confidence interval. Results: The majority (97.9%) of respondents demonstrated a good level of knowledge, (52.2%) of the respondents had positive attitudes towards integrated HIV prevention and SRH services. Looking at the practice of integrated HIV prevention and SRH services use, 51.4% of respondents have a low level of practice. The practice of integrated HIV prevention and SRH services was significantly associated with school drop-out and family status (P>0.05). Conclusion: The findings from these studies collectively emphasize the need for comprehensive education, targeted interventions, and community-based support to achieve better health outcomes regarding HIV prevention and overall sexual and reproductive health among adolescent girls and young women. Empowering adolescent girls and young women with accurate information and comprehensive support will enable them to make informed decisions, protect their health effectively, and contribute to reducing the burden of HIV and improving sexual and reproductive health outcomes.

Keywords: integrated HIV prevention, sexual and reproductive health services, among adolescentes girls, and young women

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Authors: Sajjad Seifi Mofarah, S. K. Sadrnezhaad, Shokooh Moghadam, Javad Tavakoli

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In recent years a new method of combination treatment for cancer has been developed and studied that has led to significant advancements in the field of cancer therapy. Hyperthermia is a traditional therapy that, along with a creation of a medically approved level of heat with the help of an alternating magnetic AC current, results in the destruction of cancer cells by heat. This paper gives details regarding the production of the spherical nanocomposite PVA/γ-Fe2O3 in order to be used for medical purposes such as tumor treatment by hyperthermia. To reach a suitable and evenly distributed temperature, the nanocomposite with core-shell morphology and spherical form within a 100 to 200 nanometer size was created using phase separation emulsion, in which the magnetic nano-particles γ-Fe2O3 with an average particle size of 20 nano-meters and with different percentages of 0.2, 0.4, 0.5, and 0.6 were covered by polyvinyl alcohol. The main concern in hyperthermia and heat treatment is achieving desirable specific absorption rate (SAR) and one of the most critical factors in SAR is particle size. In this project all attempts has been done to reach minimal size and consequently maximum SAR. The morphological analysis of the spherical structure of the nanocomposite PVA/γ-Fe2O3 was achieved by SEM analyses and the study of the chemical bonds created was made possible by FTIR analysis. To investigate the manner of magnetic nanocomposite particle size distribution a DLS experiment was conducted. Moreover, to determine the magnetic behavior of the γ-Fe2O3 particle and the nanocomposite PVA/γ-Fe2O3 in different concentrations a VSM test was conducted. To sum up, creating magnetic nanocomposites with a spherical morphology that would be employed for drug loading opens doors to new approaches in developing nanocomposites that provide efficient heat and a controlled release of drug simultaneously inside the magnetic field, which are among their positive characteristics that could significantly improve the recovery process in patients.

Keywords: nanocomposite, hyperthermia, cancer therapy, drug releasing

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Authors: Alexander Glebovskiy

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Practitioners charged with fraud prevention and investigation strongly rely on the Fraud Triangle framework developed by Joseph T. Wells in 1997 while analyzing the causes of fraud at business organizations. The Fraud Triangle model explains fraud by elements such as pressure, opportunity, and rationalization. This view is not fully suitable for effective fraud prevention as the Fraud Triangle model provides limited insight into the causation of fraud. Fraud is a multifaceted phenomenon, the contextual factors of which may not fit into any framework. Employee criminal behavior in business organizations is influenced by environmental, individual, and organizational aspects. Therefore, further criminogenic factors and processes facilitating fraud in organizational settings need to be considered in the root-cause analysis: organizational culture, leadership style, groupthink effect, isomorphic behavior, crime of obedience, displacement of responsibility, lack of critical thinking and unquestioning conformity and loyalty.

Keywords: criminogenesis, fraud triangle, fraud prevention, organizational culture

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Authors: M. Mourad, K. Abdelgawwad

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This experimental investigation aimed to determine the influence of using different types of alcohol and gasoline blends such as ethanol - butanol - propanol on the performance of spark ignition engine. The experimental work studied the effect of various fuel blends such as ethanol – butanol/gasoline and propanol/gasoline with two rates of 15% and 20%, at different operating conditions (engine speed and loads), on engine performance emission characteristics. Laboratory experiments are carried out on a four-cylinder spark ignition (SI) engine. In this practical study, all considerations and precautions are taken into account to ensure the quality and accuracy of practical experiments and different measurements. The results show that the performance of the engine improved significantly in the case of ethanol/butanol-gasoline blends. The results also indicated that the engine emitted pollutants such as CO, hydrocarbon (HC) for alcohol fuel blends compared to base gasoline NOx emission increased for different fuel blends either ethanol/butanol-gasoline or propanol-gasoline fuel blend.

Keywords: gasoline engine, performance, emission, fuel blends

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Authors: Tamer M. Shehata, Heba S. Elsewedy, Mashel Al Dosary, Alaa Elshehry, Mohamed A. Khedr, Maged E. Mohamed

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Objective: 2,4-Dichlorophenoxy acetic acid (2,4-D) is a well-known herbicide widely used as a weed killer. Recently, 2,4-D was rediscovered as a new anti-inflammatory agent through in silico as well as in-vivo experiments. However, poor solubility of 2,4-D could represent a problems during pharmaceutical development in addition to lower bioavailability. Solid dispersion (SD) refers to a group of solid products consisting of at least two different components, usually a hydrophobic drug and hydrophilic matrix. It is well known technique for enhancing drug solubility. Therefore, selecting SD as a tool for enhancing 2,4-D could be of great interest to the formulator. Method: In our project, several polymers were investigated (such as PEG, HPMC, citric acid and others) in addition to drug polymer ratios and its effect on solubility. Evaluation of drug polymer interaction was investigated through both Fourier Transform Infrared (FTIR) and Differential Scanning Calorimetry (DSC). Finally, in-vivo evaluation was performed for the best selected preparation through inflammatory response of rat induce hind paw. Results: Results indicated that, citric acid 2,4-D and in ratio of 0.75 : 1 showed modified the dissolution profile of the drug. The FTIR resltes indicated no significant chemical interaction, however DSC showed shifting of the drug melting point. Finally, Carragenan induced rat hind paw edema showed significant reduction of the drug solid dispersion in comparison to the pure drug, indicating rapid and complete absorption of the drug in solid dispersion form. Conclusion: Solid dispersion technology can be utilized efficiently to enhance the solubility of 2,4-D.

Keywords: solid dispersion, 2, 4-D solubility, carragenan induced edema

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Authors: Boukhiar Aissa, Halladj Fatima, Iguergaziz Nadia, Lamrani yasmina, Benamara Salem

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Determining the alcohol content in alcoholic fermentation bioprocess is of great importance. In fact, it is a key indicator for monitoring this bioprocess. Several methodologies (chemical, spectrophotometric, chromatographic) are used to the determination of this parameter. However, these techniques are very long and they require: rigorous preparations, sometimes dangerous chemical reagents and/or expensive equipment. In the present study, the date juice is used as the substrate of alcoholic fermentation. The extracted juice undergoes an alcoholic fermentation by Saccharomyces cerevisiae. The study of the possible use of refractometry as a sole means for the in situ control of alcoholic fermentation revealed a good correlation (R2=0.98) between initial and final °Brix: °Brixf=0.377×°Brixi. In addition, the relationship between Δ°Brix and alcoholic content of the final product (A,%) has been determined: Δ°Brix/A=1.1. The obtained results allowed us to establish iso-responses abacus, which can be used for the determination of alcohol and residual sugar content, with a mean relative error (MRE) of 5.35%.

Keywords: alcoholic fermentation, date juice, refractometry, residual sugar

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Authors: Brajesh Tiwari, Yuvraj Dangi, Abhishek Jain, Ashok Jain

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The purpose of the investigation was to evaluate the potential of sphingosomes as nanoscale drug delivery units for site-specific delivery of anti-cancer agents. Doxorubicin Hydrochloride (DOX) was selected as a model anti-cancer agent. Sphingosomes were prepared and loaded with DOX and optimized for size and drug loading. The formulations were characterized by Malvern zeta-seizer and Transmission Electron Microscopy (TEM) studies. Sphingosomal formulations were further evaluated for in-vitro drug release study under various pH profiles. The in-vitro drug release study showed an initial rapid release of the drug followed by a slow controlled release. In vivo studies of optimized formulations and free drug were performed on albino rats for comparison of drug plasma concentration. The in- vivo study revealed that the prepared system enabled DOX to have had enhanced circulation time, longer half-life and lower elimination rate kinetics as compared to free drug. Further, it can be interpreted that the formulation would selectively enter highly porous mass of tumor cells and at the same time spare normal tissues. To summarize, the use of sphingosomes as carriers of anti-cancer drugs may prove to be a fascinating approach that would selectively localize in the tumor mass, increasing the therapeutic margin of safety while reducing the side effects associated with anti-cancer agents.

Keywords: sphingosomes, anti-cancer, doxorubicin, formulation

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Authors: Rajinikanth Siddalingam, Poonguzhali Subramanian

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The present study aims to prepare and evaluate the self-nano emulsifying drug delivery (SNEDDS) system to enhance the dissolution rate of a poorly soluble drug dutasteride. The formulation was prepared using capryol PGMC, Cremophor EL, and polyethylene glycol (PEG) 400 as oil, surfactant and co-surfactant, respectively. The pseudo-ternary phase diagrams with presence and absence of drug were plotted to find out the nano emulsification range and also to evaluate the effect of dutasteride on the emulsification behavior of the phases. Prepared SNEDDS formulations were evaluated for its particle size distribution, nano emulsifying properties, robustness to dilution, self-emulsification time, turbidity measurement, drug content and in-vitro dissolution. The optimized formulations are further evaluated for heating cooling cycle, centrifugation studies, freeze-thaw cycling, particle size distribution and zeta potential were carried out to confirm the stability of the formed SNEDDS formulations. The particle size, zeta potential and polydispersity index of the optimized formulation found to be 35.45 nm, -15.45 and 0.19, respectively. The in vitro results are revealed that the prepared formulation enhanced the dissolution rate of dutasteride significantly as compared with pure drug. The in vivo studies in was conducted using rats and the results are revealed that SNEDDS formulation has enhanced the bioavailability of dutasteride drug significantly as compared with raw drug. Based the results, it was concluded that the dutasteride-loaded SNEDDS shows potential to enhance the dissolution of dutasteride, thus improving the bioavailability and therapeutic effects.

Keywords: self-emulsifying drug delivery system, dutasteride, enhancement of bioavailability, dissolution enhancement

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Authors: Nabil A. Albaser

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Background: There is a serious problem with adverse drug reactions (ADRs) everywhere, including Yemen. Since it helps with the detection, assessment, reporting and prevention of ADRs, pharmacovigilance (PV) is an essential part of the healthcare system. The unbiased reporting of ADRs remains the foundation of PV. Students majoring in healthcare should acquire the knowledge and skills necessary to conduct PV in a range of clinical settings. The primary objective of this study was to evaluate the understanding and attitudes of final-year Pharmacy, Nursing, and Midwifery students at Al-Razi University in Sana'a, Yemen, regarding PV and ADRs reporting. Methods: The study followed descriptive cross-sectional approach. A validated, self-administered questionnaire with three parts—demographic information, knowledge, and perceptions of Pharmacovigilance was online distributed to final-year Pharmacy, Nursing, and Midwifery students. The questionnaire was given to 175 students; 122 of them responded with a percentage (69.7%). Results: The majority of respondents were male (79.5%). More than the tow-third of the students, 68.9%, were beyond the age of 23. Although the majority of students, 80%, heard about the terms of ADRs and PV, but only 50% and 57.4% of the respondents, respectively, could define the both terms correctly. However, only 11.48 % of them, nevertheless, took a PV course. More than a half of them (56.6%) had a positive perceptions towards pharmacovigilance and ADR reporting and had a moderate degree of knowledge (68.9%). Conclusion: The study demonstrated that the participants lacked sufficient knowledge of pharmacovigilance and ADR reporting. They showed a moderate level of understanding of reporting ADRs as well as a favorable opinion of dealing with and reporting ADRs. Yemen's health care curriculum should include lessons on pharmacovigilance.

Keywords: adverse drug reaction reporting, pharmacovigilance, yemen, knowlegde

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Authors: Ana-Maria Gheldiu, Bianca M. Abrudan, Maria A. Neag, Laurian Vlase, Dana M. Muntean

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Background information: The objective of this study was to investigate the effect of multiple-dose fluvoxamine on the pharmacokinetic profile of single-dose carvedilol in rats, in order to evaluate this possible drug-drug pharmacokinetic interaction. Methods: A preclinical study, in 28 white male Wistar rats, was conducted. Each rat was cannulated on the femoral vein, prior to being connected to BASi Culex ABC®. Carvedilol was orally administrated in rats (3.57 mg/kg body mass (b.m.)) in the absence of fluvoxamine or after a pre-treatment with multiple oral doses of fluvoxamine (14.28 mg/kg b.m.). The plasma concentrations of carvedilol were estimated by high performance liquid chromatography-tandem mass spectrometry. The pharmacokinetic parameters of carvedilol were analyzed by non-compartmental method. Results: After carvediol co-administration with fluvoxamine, an approximately 2-fold increase in the exposure of carvedilol was observed, considering the significantly elevated value of the total area under the concentration versus time curve (AUC₀₋∞). Moreover, an increase by approximately 145% of the peak plasma concentration was found, as well as an augmentation by approximately 230% of the half life time of carvedilol was observed. Conclusion: Fluvoxamine co-administration led to a significant alteration of carvedilol’s pharmacokinetic profile in rats, these effects could be explained by the existence of a drug-drug interaction mediated by CYP2D6 inhibition. Acknowledgement: This work was supported by CNCS Romania – project PNII-RU-TE-2014-4-0242.

Keywords: carvedilol, fluvoxamine, drug-drug pharmacokinetic interaction, rats

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Authors: Sumeet Dwivedi, Shweta Shriwas, Raghvendra Dubey

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The number of products based on new drug delivery systems has significantly increased in the past few years, and this growth is expected to continue in the near future. These biopharmaceuticals present challenges to drug delivery scientists because of their unique nature and difficulty in delivery through conventional routes. Therefore, future research will focus on the delivery of these complex molecules through different routes, including oral, nasal, pulmonary, vaginal, rectal, etc. The aim of present study was to formulate and evaluate ethosomes of Plumeria indica flowers which may deliver the drug to targeted site more efficiently than marketed preparation and also overcome the problems related with oral administration of drug. The formulations were prepared with ethanol, lecithin, propylene glycol and were evaluated.

Keywords: ethosomes, herbal extract, plumeria alba, lecithin

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Authors: Najmin Sultana, Maneesha Pahlani

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A hospital is one of the most suitable places for acquiring an infection because it harbors a high population of virulent strains of microorganisms that may be resistant to antibiotics, especially the prevalence of Methicillin-Resistant Staphylococcus Aureus (MRSA) infections. The hospital-acquired infection has become a global challenge. In developed countries, healthcare-associated infections occur in 5-15% of hospitalized clients, affecting 9-37% of those admitted to intensive care units (ICU). A non-experimental descriptive study was conducted among 50 nursing officers working in a selected hospital in bengaluru to assess the nursing officers’ level of knowledge regarding the prevention and management of MRSA infections and to associate the pre-test knowledge mean scores of nursing officers with selected socio-demographic variables. Data was collected using a structured questionnaire consisting of socio-demographic data and a structured questionnaire on knowledge regarding the prevention and management of MRSA infections. The data was analyzed in terms of frequencies and percentages for the analysis of demographic variables and computing chi-square to determine the association between knowledge means scores and selected demographic variables. The study findings revealed that the nursing officer had an overall good level of knowledge (63.05%) regarding the prevention and management of MRSA infections, and there is no significant association found between the level of knowledge mean scores for prevention and management of MRSA infection with the selected socio-demographic variables. However, the categorization of knowledge items showed that the nursing officer must thoroughly receive education on correct guidance and information regarding MRSA infection control policy, including measures and practices on hygiene precautions and information regarding antibiotic resistance for effective nursing care to patients with MRSA infections. The conclusions drawn from the study findings showed that it is necessary that the nursing officer thoroughly receive education on correct guidance and information regarding MRSA infection control policy, including measures and practices on hygiene precautions and information regarding antibiotic resistance to provide effective nursing care to patients with MRSA infection as they constantly care for the patient who can be at risk for multi-drug resistance organisms to reduce the risk of MRSA infection in hospital care settings as well community settings.

Keywords: MRSA, knowledge, nursing officers', prevention and management

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Authors: Elena K. Schneider, Johnny X. Huang, Vincenzo Carbone, Mark Baker, Mohammad A. K. Azad, Matthew A. Cooper, Jian Li, Tony Velkov

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Ivacaftor is a novel CF trans-membrane conductance regulator (CFTR) potentiator that improves the pulmonary function for cystic fibrosis patients bearing a G551D CFTR-protein mutation. Because ivacaftor is highly bound (>97%) to plasma proteins, there is the strong possibility that co-administered CF drugs that compete for the same plasma protein binding sites and impact the free drug concentration. This in turn could lead to drastic changes in the in vivo efficacy of ivacaftor and therapeutic outcomes. This study compares the binding affinity of ivacaftor and co-administered CF drugs for human serum albumin (HSA) and α1-acid glycoprotein (AGP) using surface plasmon resonance and fluorimetric binding assays that measure the displacement of site selective probes. Due to their high plasma protein binding affinities, drug-drug interactions between ivacaftor are to be expected with ducosate, montelukast, ibuprofen, dicloxacillin, omeprazole and loratadine. The significance of these drug-drug interactions is interpreted in terms of the pharmacodynamic/pharmacokinetic parameters and molecular docking simulations. The translational outcomes of the data are presented as recommendations for a staggered treatment regimen for future clinical trials which aims to maximize the effective free drug concentration and clinical efficacy of ivacaftor.

Keywords: human α-1-acid glycoprotein, binding affinity, human serum albumin, ivacaftor, cystic fibrosis

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Authors: Cesar Torres, Robert Briber, Nam Sun Wang

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Eye drops are the most commonly used treatment for short-term and long-term ophthalmic diseases. However, eye drops could deliver only about 5% of the functional ingredients contained in a burst dosage. To address the limitations of eye drops, the use of therapeutic contact lenses has been introduced. Drug-loaded contact lenses provide drugs a longer residence time in the tear film and hence, decrease the potential risk of side effects. Nevertheless, a major limitation of contact lenses as drug delivery devices is that most of the drug absorbed is released within the first few hours. This fact limits their use for extended release. The present study demonstrates the application of long-alkyl chain ionic surfactants on extending drug release kinetics from commercially available silicone hydrogel contact lenses. In vitro release experiments were carried by immersing drug-containing contact lenses in phosphate buffer saline at physiological pH. The drug concentration as a function of time was monitored using ultraviolet-visible spectroscopy. The results of the study demonstrate that release kinetics is dependent on the ionic surfactant weight percent in the contact lenses, and on the length of the hydrophobic alkyl chain of the ionic surfactants. The use of ionic surfactants in contact lenses can extend the delivery of drugs from a few hours to a few weeks, depending on the physicochemical properties of the drugs. Contact lenses embedded with ionic surfactants could be potential biomaterials to be used for extended drug delivery and in the treatment of ophthalmic diseases. However, ocular irritation and toxicity studies would be needed to evaluate the safety of the approach.

Keywords: contact lenses, drug delivery, controlled release, ionic surfactant

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Authors: Mabruka S. Elashheb, Adullah Ali Bakush

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Schizophrenia is referred to as a disorder, not a disease, because there has not been any clear, reliable, and specific etiological factor. Even if schizophrenia is not a very frequent disease, it is among the most burdensome and costly illnesses worldwide. Prevention of relapse is a major goal of maintenance treatment in patients with psychotic disorders. We performed a comparison of a newer, atypical antipsychotic drug, Risperidone, and an older, conventional neuroleptic drug, Haloperidol, in terms of the effect on the usual kidney and liver functions and negative and positive symptoms in patients with schizophrenia and schizoaffective disorder after three and five weeks of their treatments. It is apparent from the comparative data of Haloperidol and Risperidone treatments in schizophrenic patients that Resperidone had superior improvement of negative and positive symptoms of patients, no harmful effect on liver and kidney functions and greater efficacy and faster recovery from schizophrenic symptoms in patients. On the basis of our findings of the present study, we concluded that treatment with Risperidone is superior to Haloperidol in reducing the risk of relapse among outpatients with schizophrenic disorders.

Keywords: schizophrenia, Haloperidol, Risperidone, positive and negative symptom

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Authors: Juariah Salam Suryadi

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North coast (Pantura) line is known as a high-risk area related to reproductive health. This is because along the line, there are many food stalls and entertainment industries that at night the function changed to be sexual transaction areas. This business line also facilitate circulation and transaction of drug and substance abuse. The environment conditions can influence adolescents who live in this area. It is because of adolescence characteristics that has high curiosity and looking for their identities. Therefore, purposes of this study were to explore reproductive health behaviour of early adolescents who lived in Pantura line and to suggest intervention based on the adolescents reproductive health conditions. This study was conducted in November 2016 among the seventh-grade students of Pusakajaya Junior High School 1 and 2, Subang District. Number of respondents were 269 students (Male=135, Female=134). The students were interviewed using a semi-structured questionnaire. Some teachers also interviewed to complement the data. The quantitative data was analyzed with univariate analysis, while content analysis was used for the qualitative data. Findings of this study showed that 85,2% of male students were smoker. Most of them started smoking at elementary school. Male students who often drunk alcohol were about 25,2% and all of them initiated to drink at elementary school. There were about 21,5% of male students ever used drug and substance abuse. There were 54,6% of the students that confessed having a lover. Most of them were female students. Sexual behaviour that ever done with their lovers were: holding hands (37,4%), kissing (4%) and embracing (6,8%). Although all of the students claimed to have never had sexual intercourse, but 5,9% of them said that they had friends who have had sexual intercourse. Most of the students also had friends with negative characteristics. Their friends were smoker (82,2%), drinker (53,2%) and drug abuse (42%). Most of the students recognized that they took the risks behaviour to get pleasure with their peers. Information from the teachers indicated that most problem of male students were smoking and drug and substance abuse; while sexuality including unwanted pregnancies were reproductive problems of many female students. Therefore, It is recommended to enhance understanding of the adolescents about risks of unhealthy behaviour through continuing reproductive health education, both in school and out of school. Policy support to create positive social environment and adolescents friendly is also suggested.

Keywords: reproductive health, behaviour, early adolescents, pantura line

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Authors: Azwin Lubis, Rika Hapsari, Zahrah Hikmah, Anang Endaryanto, Ariyanto Harsono

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Erythema Multiforme Exudativum Major (EMEM) is one of the drug allergy diseases. Drug allergies caused by isoniazid rarely causes EMEM. Cutaneous reactions caused by isoniazid were obtained in 0.98% of patients, but the precise occurrence of Steven Johnson’s Syndrome (SJS) and Toxic Epidermolisis Necrolisis (TEN) due to isoniazid is not known for certain. We present this case to show hypersensitivity of isoniazid in a child. Based on the history of drug intake, physical diagnostic tests, drug elimination and provocation; we established the diagnosis of isoniazid hypersensitivity. The child showed improvement on skin manifestation after stopped isoniazid therapy.

Keywords: erythema multiforme exudativum major, hypersensitivity, elimination test, provocation test

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Authors: Nitin Dwivedi, Jigna Shah

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Aim and objective of study: This article indicates a comparison among various generations of dendrimers, a dendrimer is a bioactive material has repetitively branched molecule and used for delivery of various therapeutic active agents. This debut report compares the effect various generations of PPI dendrimers for brain targeting and management of neurodegenerative disorders potential on single platform. This report involves the study of the various mechanism of synthesis ligand anchored various generations PPI dendrimers deliver the drug directly to the CNS, prove their effectiveness in the management of the various neurodegenerative disease. Material and Methods: The Memantine an anti-Alzheimer drug loaded in different generations (3.0G, 4.0G, and 5.0G) of PPI dendrimers which were synthesized were synthesized. The various studies investigate the effect of PPI dendrimers generation on different characteristic parameters i.e. synthesis procedure, drug loading, release behavior, hemolysis profile at different concentration, MRI study for determine the route drug from olfactory transfer, animal model study in vitro, as well as in vivo performance. The outcomes of the investigation indicate drug delivery benefit as well as superior biocompatibility of 4.0G PPI dendrimer over 3.0G and 5.0G dendrimer, respectively. Results and Conclusion: The above study indicate the superiority of in drug delivery system with maximum drug utilization and minimize the drug dose for neurodegenerative disorder over 5.0G PPI dendrimers. So, 4.0G PPI dendrimers are the safe formulations for the symptomatic treatment of the neurodegenerative disorder. The fifth-generation poly(propyleneimine) (PPI) dendrimers, inherent toxicity due to the presence of many peripheral cationic groups is the major issue that limits their applicability.

Keywords: Alzheimer disease, generation, memantine, PPI

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Authors: Shilpa Bhilegaonkar, Ram Gaud

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Candesartan cilexetil is a poorly soluble antihypertensive agent with solubility limited bioavailability (15%). To initiate process of solubilisation, it is very much necessary to displace the air at the surface and wet the drug surface with a solvent, with which drug is compatible. Present research adopts the same principle to improve solubility and dissolution of candesartan cilexetil. Solvents used here are surfactant and modified surfactant in different drug: solvent (1:1-1:9) ratio’s for preparation of adsorbates. Adsorbates were then converted into free flowing powders as liquisolid compacts and compressed to form tablets. Liquisolid compacts were evaluated for improvement in saturation solubility and dissolution of candesartan cilexetil. All systems were evaluated for improvement in saturation solubility and dissolution in different medias such as water, 0.1 N HCl, Phosphate buffer pH 6.8 and media given by office of generic drugs along with other physicochemical testing. All systems exhibited a promising advantage in terms of solubility and dissolution without affecting the drug structure as confirmed by IR and XRD. No considerable advantage was seen of increasing solvent ratio with drug.

Keywords: candesartan cilexetil, improved dissolution, solubility, liquisolid

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Authors: Ifeyinwa Victor-Uadiale, Georgina Pearson, Sophie Witter, D. Reidpath

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Introduction: Smoking, alcohol misuse, unhealthy diet, and physical inactivity are the primary drivers of noncommunicable diseases (NCD), including cardiovascular diseases, cancers, respiratory diseases, and diabetes, worldwide. Collectively, these diseases are the leading cause of all global deaths, most of which are premature, affecting people between 30 and 70 years. Empirical evidence suggests that these risk behaviors can be modified by community-based interventions (CBI). However, there is little insight into the mechanisms and contextual factors of successful community interventions that impact risk behaviours for chronic diseases. This study examined “Under what circumstances, for whom, and how, do community-based interventions modify smoking, alcohol use, unhealthy diet, and physical inactivity among adults”. Adopting the Capability (C), Opportunity (O), Motivation (M), Behavior (B) (COM-B) framework for behaviour change, it sought to: (1) identify the mechanisms through which CBIs could reduce tobacco use and alcohol consumption and increase physical activity and the consumption of healthy diets and (2) examine the contextual factors that trigger the impact of these mechanisms on these risk behaviours among adults. Methods: Pawson’s realist review method was used to examine the literature. Empirical evidence and theoretical understanding were combined to develop a realist program theory that explains how CBIs influence NCD risk behaviours. Documents published between 2002 and 2020 were systematically searched in five electronic databases (CINAHL, Cochrane Library, Medline, ProQuest Central, and PsycINFO). They were included if they reported on community-based interventions aimed at cardiovascular diseases, cancers, respiratory diseases, and diabetes in a global context; and had an outcome targeted at smoking, alcohol, physical activity, and diet. Findings: Twenty-nine scientific documents were retrieved and included in the review. Over half of them (n = 18; 62%) focused on three of the four risk behaviours investigated in this review. The review identified four mechanisms: capability, opportunity, motivation, and social support that are likely to change the dietary and physical activity behaviours in adults given certain contexts. There were weak explanations of how the identified mechanisms could likely change smoking and alcohol consumption habits. In addition, eight contextual factors that may affect how these mechanisms impact physical activity and dietary behaviours were identified: suitability to work and family obligations, risk status awareness, socioeconomic status, literacy level, perceived need, availability and access to resources, culture, and group format. Conclusion: The findings suggest that CBIs are likely to improve the physical activity and dietary habits of adults if the intervention function seeks to educate, incentivize, change the environment, and model the right behaviours. The review applies and advances theory, realist research, and the design and implementation of community-based interventions for NCD prevention.

Keywords: community-based interventions, noncommunicable disease, realist program theory, risk behaviors

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