Multivariate optimization of formulation variables influencing flurbiprofen proniosomes characteristics

Flurbiprofen was formulated as a proniosomal transdermal gel with high drug loading (55.4%, w/w), using a series of nonionic surfactant and cholesterol. A two-factor, three-level randomized full factorial strategy was developed to optimize simultaneously the effect of surfactant fatty acid side chain length and the amount of cholesterol on the properties of the proniosomes, namely drug permeation characteristics such as steady-state transdermal flux (SSTF), permeability coefficient (PC), and drug entrapment efficiency. Graphical and mathematical analysis of the results allowed the identification and quantification of the formulation variables that showed significant effects on the selected responses. Polynomial equations fitted to the data were used to predict the responses in the optimal region. For maximizing the selected responses using a generalized desirability function, an optimum formulation was found to have a maximum side chain length and minimum cholesterol content. Optimized formulation showed highest entrapment of 39.45%, percentages drug permeated through cellulose ester membrane of 3.1 and 28.93 after 0.5 and 8 h, respectively, and SSTF and PC of 152 μg/cm(2) h and 0.263 cm/h, respectively, through rabbit skin. These results demonstrated the efficacy of statistical experimental design to unveil the critical formulation interactions and variability affecting the performance of proniosomal formulations.     

Antioxidant enzymatic activities in Alzheimer's disease: the relationship to acetylcholinesterase inhibitors

The mode of action of acetylcholinesterase inhibitors (AChEIs) in Alzheimer's disease (AD) is mainly by potentiating neuronal transmission. Animal studies have also consistently described a role for AChEIs in enhancement of antioxidants and attenuation of oxidative stress. The influence of AChEIs on blood antioxidants in AD patients has not been established before. Furthermore, AChEI treatment, or lack of it, may have contributed to the inconsistent antioxidant data reported by other studies so far. Here we sought to investigate the potential modulation effect of AChEIs on blood antioxidants in AD patients. Catalase (CAT) and glutathione reductase (GR) activities were analyzed in 25 drug na?ve patients (Group A), 43 patients receiving AChEIs (Group B) and 34 cognitively unimpaired controls (Group C). A statistically significant difference for CAT and GR was observed between the two AD groups (A and B) when compared to the control group C (KW-H = 36.530, p < 0.001; post hoc tests p < 0.001 and KW-H = 37.814, p < 0.001; post hoc tests p < 0.001, respectively). In contrast, CAT and GR activities did not differ significantly between the two AD groups, and were not influenced by AChEI treatment. Hence, these results do not replicate the extensively reported data from animal studies and question whether AChEI efficacy in AD is mediated by processes beyond neuron to neuron enhancement of transmission. Studies assessing a wider range of oxidative/inflammatory markers taking into account type, dosage, and treatment duration of the various acetylcholinesterase inhibitors are now needed.     

Prosthetic rehabilitation of a patient with partial ear amputation using a self suspension technique

BACKGROUND AND AIM: Partial ear amputations are one of the forms of ear loss. A user-friendly design of prosthesis with safe suspension and an aesthetic appearance can be helpful to a patient who has lost part of their ear due to congenital absence or trauma. Prosthetic use has social and psychological effects on the patient and their family. The aim of this paper is to describe a technique of ear prosthesis fabrication with self suspension for these patients. TECHNIQUE: To provide a snugly fitting prosthesis, the only parts of the residual ear that were covered by the prosthesis were accurately manufactured and reduced in thickness to 0.5-1 mm and 10 mm in width, so that the silicone extended over the stumps to provide adequate suspension. Discussion: This paper proposes the designing and constructing of a silicone ear prosthesis which had good suspension, low cost, was easy to use and was acceptable in appearance to the patient.     

Clinicopathological and radiological study of Egyptian β-thalassemia intermedia and β-thalassemia major patients: relation to complications and response to therapy

The clinico epidemiological characteristics, frequency of complications, and response to various therapeutic modalities in 80 Egyptian β-thalassemia intermedia (β-TI) patients were compared with 70 β-thalassemia major (β-TM) patients. β-Thalassemia intermedia patients had a higher incidence of left atrium dilatation, right ventricular dilatation and pulmonary hypertension, whereas, β-TM patients showed a higher incidence of left ventricular (LV) dilatation, restrictive LV filling and impaired LV contractility, with an overall higher incidence of heart disease (p <0.001). Short stature, delayed puberty, osteoporosis, bone fractures, diabetes mellitus and viral hepatitis was frequently observed in β-TM patients compared with β-TI patients (p <0.05). Administration of hydroxyurea (HU) alone was associated with significant improvement in hematological parameters and quality of life for β-TI patients. In conclusion, the risk of complications still burdens the life of Egyptian thalassemia patients and their frequency varies between β-TI and β-TM. We provide evidence that calls for the use of HU in β-TI patients.     

Mitigating effects of antioxidant properties of black berry juice on sodium fluoride induced hepatotoxicity and oxidative stress in rats

Fluorosis is a serious public health problem in many parts of the world. As in the case of many chronic degenerative diseases, increased production of reactive oxygen species has been considered to play an important role, even in the pathogenesis of chronic fluoride toxicity. Black berry is closely linked to its protective properties against free radical attack. Therefore, the aim of this study was to demonstrate the role of black berry juice (BBJ) in decreasing the hepatotoxicity and oxidative stress of sodium fluoride (NaF). Results showed that NaF caused elevation in liver TBARS and nitric oxide (NO), and reduction in superoxide dismutase (SOD), catalase (CAT), total antioxidant capacity (TAC) and glutathione (GSH). Plasma transaminases (AST and ALT), creatine kinase (CK), lactate dehydrogenase (LDH), total lipids (TL), cholesterol, triglycerides (TG), and low density lipoprotein–cholesterol (LDL–c) were increased, while high density lipoprotein–cholesterol (HDL–c) was decreased. On the other hand, BBJ reduced NaF-induced TBARS, NO, TL, cholesterol, TG, LDL–c, AST, ALT, CK and LD. Moreover, it ameliorated NaF-induced decrease in SOD, CAT, GSH, TAC and HDL–c. Therefore, the present results revealed that BBJ has a protective effect against NaF-induced hepatotoxicity by antagonizing the free radicals generation and enhancement of the antioxidant defence mechanisms.     

Adenolipoma of the skin

Adenolipoma of the skin (ALS) is an uncommon histological variant of lipoma, characterized by the presence of normal eccrine sweat glands inside the fat proliferation. A 32-year-old woman presented to our department with a slow-growing, painless subcutaneous soft tumour located on the upper part of the right thigh. Microscopically, there was lobulated adipose tissue proliferation with well-differentiated eccrine glands and ducts in the periphery and centre of the nodule. These features were suggestive of ALS. ALS is a rare microscopic variant of cutaneous lipoma having similar clinical features to lipoma. The most frequent locations of this tumour are thighs (as in our patient), shoulders, chest and arms. Histologically, the tumour is composed of lobulated adipose tissue with larger and more prominent lobules than those in normal subcutaneous adipose tissue. A well-developed capsule may also be identified. Eccrine glands and ducts, without proliferative changes, are well-differentiated within the adipose tissue. Differential diagnosis of adenolipoma includes the common lipoma and its variants, skin tag and other hamartomatous lesions, such as nevus lipomatosus superficialis, and the lipomatous variant of eccrine angiomatous hamartoma.