Preparation and investigation the release behaviour of wax microspheres loaded with salicylic acid

Salicylic acid-beeswax microspheres were prepared by melt dispersion technique. The effects of formulation parameters on the microscopic characteristic, drug loading and cumulative amount of released drug were investigated by experimental design. Results showed that all of the microparticles were spherical with porous surfaces. The average size of microspheres was 24–48 µm, the drug content was in the range of 22–45% and the encapsulation efficiency was 46–93%. Drug loading was influenced by emulsification speed as a main factor. All the microspheres had a burst release initially. The emulsifier concentration did not have a significant effect on drug release. The release behaviour of microspheres conformed best to Korsmeyer-Peppas semi-empirical model and the release of SA from beeswax microspheres was Fickian (n < 0.45).     

Survival of Thalassemic Patients Referred to the Boo Ali Sina Teaching Hospital,Sari, Iran

β-Thalassemia major (TM) is the most prevalent genetic disease in Mazandaran Province. Currently, about 2,700 TM patients have been registered and are under treatment in the province. This study was undertaken to evaluate the survival of patients attending a dedicated clinic at the Boo Ali Sina Teaching Hospital, Sari, Iran, which was established in 1986. This survival analysis was conducted from July 2004 to September 2006. New deaths were updated in September 2006. A total of 1,010 medical records were reviewed. Place of residence, date of birth, first transfusion, initiation date of chelation, diagnosis of cardiac complications, diabetes and death were recorded. Compliance to treatment assessed by calculating the percentage of actual usage to prescribed iron chelator medicine and also by asking the attending nurse who was constantly present throughout the last 15 years. Validity of the opinion of the nurse was ascertained in a previous study. Kaplan-Meier statistics were used for analysis. The odds ratio (OR) and its 95% confidence interval (CI) for some risk factors of death were calculated. The survival rate of patients born before and after 1986 was also compared. Survival of both genders for birth cohort before and after 1986 was not statistically significant although the cohort of patients born after 1986 was better at 30 years old (68 vs. 80%). The survival of TM patients is improving but the prevalence of complications is high.     

Decreasing Trend of Upper Gastrointestinal Bleeding Mortality Risk Over Three Decades

Background

Upper gastrointestinal bleeding (UGIB) causes over $1 billion in medical expenses annually.

Aims

The purpose of this study was to examine changes of UGIB mortality risks and trends over the last three decades.

Methods

We analyzed the National Hospital Discharge Sample from 1979 to 2009. Patients with primary ICD-9 code representing a diagnosis of UGIB were included. The UGIB mortality risks and trends in each decade by anatomical sites, bleeding causes, comorbidities, and other important variables were analyzed.

Results

UGIB mortality risk decreased by 35.4 % from 4.8 % in the first decade to 3.1 % in the third decade (P < 0.001). Age and number of hospitalization days were significant risk factors in all decades. Most significant decreases were observed in patients over 65 years and during the first day of admission. Gastric (P < 0.001) and esophageal (P = 0.018) bleedings showed significant decreasing mortality risk trends. Duodenal bleeding mortality risk was stable in three decades. Mortality risk declined significantly among patients with renal failure (from 50.0 to 4.0 %) and heart failure (from 17.9 to 5.2 %; both P < 0.001) while changes in cases with ischemic heart disease, cancer, and liver failure were less significant.

Conclusion

UGIB morality risks, especially of the first hospital day and geriatric patients, significantly decreased over the last three decades, presumably from recent advances in emergency medical care. Mortality risk of gastric, but not duodenal, bleeding had the most significant reduction. Critical care improvements in patients with various comorbidities may explain significant UGIB mortality risk reductions. This study provides invaluable insight into the causes and trends of UGIB mortality risks for future studies.     

Meta-Analysis of Steel Fiber-Reinforced Concrete Mixtures Leads to Practical Mix Design Methodology

The analysis of hundreds of SFRC mixtures compiled from papers published over the last 20 years is reported. This paper is focused on the relationships between the size and dosage of steel fibers and the relative amounts of the constituents of SFRC mixtures. Multiple linear regression is applied to the statistical modeling of such relationships, leading to four equations that show considerable accuracy and robustness in estimating SFRC mixture proportions as a function of fiber content and dimensions, maximum aggregate size, and water-to-cement ratio. The main trends described by these equations are discussed in detail. The importance of the interactions between aggregates, supplementary cementitious materials, and fibers in proportioning SFRC mixtures, as well as implications for workability and stability, are emphasized. The simplicity of these data-driven equations makes them a valuable tool to guide the proportioning of SFRC mixtures. Their predictive performance when used together as a data-driven mix design methodology is confirmed using a validation dataset.     

Protective effects of N-acetylcysteine on 3, 4-methylenedioxymethamphetamine-induced neurotoxicity in male Sprague–Dawley rats

Exposure to 3, 4-methylenedioxymethamphetamine (MDMA) leads to spatial memory impairment and hippocampal cell death. In the present study we have examined the protective effects of N-acetyl-L-cysteine (NAC) on MDMA-induced neurotoxicity. A total of 56 male Sprague Dawley rats (200–250 g) received twice daily intraperitoneal (IP) injections of 5, 10 or 20 mg/kg MDMA plus NAC (100 mg/kg). Rectal temperatures were recorded before and after daily treatment. We used a Morris water maze (MWM) to assess spatial learning and memory. At the end of the study rats’ brains were removed, cells were counted and the level of Bcl-2, Bax and caspase-3 expression in the hippocampi were measured. NAC pretreatment significantly reduced MDMA-induced hyperthermia. In the MWM, NAC significantly attenuated the MDMA-induced increase in distance traveled; however the observed increase in escape latency was not significant. The decrease in time spent in the target quadrant in MDMA animals was significantly attenuated (p?<?0.001, all groups). NAC protected against MDMA-induced cell death and the up -regulation of Bax and Caspase-3, in addition to the down-regulation of Bcl-2. This data suggested a possible benefit of NAC in the treatment of neurotoxicity among those who use MDMA.     

Septic versus inflammatory arthritis: discriminating the ability of serum inflammatory markers

Early diagnosis of septic arthritis is very important. Few studies showed diagnostic accuracy of serum inflammatory markers in septic arthritis. The aim of our study was to compare the serum and synovial fluid markers [procalcitonin, serum IL-6, TNF-α, C-reactive protein, erythrocyte sedimentation rate, synovial fluid white blood cell counts and PMN percentage] in septic and inflammatory arthritis. Seventy-five patients, including 25 and 50 septic and non-septic arthritis, were enrolled in the study. The serum and synovial fluid markers [procalcitonin, serum IL-6, TNF-α, C-reactive protein, erythrocyte sedimentation rate, synovial fluid white blood cell counts, and PMN percentage] were compared in septic and inflammatory arthritis. Patients with septic arthritis had significantly elevated levels of procalcitonin, serum TNF-α, C-reactive protein, erythrocyte sedimentation rate, synovial fluid white blood cell counts, and PMN percentage in comparison with the inflammatory arthritis group (P < 0.00). Serum IL-6 level does not differ among the two groups. In a receiver operating characteristic curve analysis, synovial fluid WBC counts, PMN percentage, TNF-α, ESR, and serum PCT preformed best in distinguishing between septic and non-septic arthritis. Our study suggests that PCT can be used to diagnose the septic arthritis, but more studies warranted in order to determine the specificity and sensitivity of the test.     

Effect of IMOD? on the inflammatory process after acute ischemic stroke: a randomized clinical trial

Background and purpose of the study

Considering the role of inflammation in acute cerebrovascular accidents, anti-inflammatory treatment has been considered as an option in cerebrovascular diseases. Regarding the properties of Setarud (IMOD™) in immune regulation, the aim of the present study was to evaluate the role of this medication in treating patients with acute ischemic stroke.

Methods

In this randomized clinical trial, 99 patients with their first ever acute ischemic stroke were divided into two groups of IMOD™ (n = 49) and control (n = 50). The control group underwent routine treatment and the intervention group underwent routine treatment plus daily intermittent infusion of IMOD™ (250mg on the first day and then 375mg into DW5% serum during a 30-minute period for 7 days). The serum levels of inflammatory markers were evaluated on the first day (baseline) and on 4th and 7th days. Data were analyzed and the results were compared.

Results and major conclusion

58 males (58.6%) and 41 females (41.4%) with a mean age of 67.00 ± 8.82 years, who had their first ever stroke attack, were enrolled in this trial. Treatment with IMOD™ showed a decreasing trend in IL-6 levels compared to the control group (p = 0.04). In addition, the treatment resulted in the control of increasing serum levels of hsCRP after 7 days compared to the control group (p = 0.02). There was an insignificant decrease in TNF-α and IL-1 levels in the IMOD™ group. Considering the prominent role of inflammation after an ischemic cerebral damage, it appears that treatment with IMOD™ improves the inflammatory profile. Therefore, IMOD™ (Setarud) might be considered as a therapeutic option in the acute ischemic stroke. However, future studies are necessary on its long-term results and clinical efficacy.     

Memantine-induced speech problems in two patients with autistic disorder

Stuttering is a complex speech disorder. There are two forms of stuttering: developmental stuttering and acquired stuttering. Developmental stuttering is a disorder of early childhood but acquired stuttering can develop at any age. Some medications can induce or deteriorate stuttering as an adverse effect. There are several reports of stuttering due to psychotropic drugs. Memantine, a glutamate antagonist used in the treatment of Alzheimer’s disease, has also been studied for the treatment of autism spectrum disorders. This report presents deterioration of stuttering and speech problem in two children with autistic disorder who were receiving memantine. Based on our knowledge, this is the first time these adverse drug reactions have been attributed to memantine. In conclusion clinicians should consider that speech problems including stuttering may be due to the consumption of memantine, especially, in children may be a side effect of memantine especially in children.