Evaluation of drug-excipient interaction in the formulation of celecoxib tablets

In the present study, the possible interactions between celecoxib and some excipients (colloidal silicon dioxide (Aerosil), microcrystalline cellulose (Avicel PH 102), lactose anhydrous, magnesium stearate, cross-povidone and talc) were evaluated by examining the pure drug or drug-excipient powder mixtures which were stored under different conditions (25 +/- 2 degrees C, 60% RH +/- 5% RH or 40 + 2 degrees C, 75% RH +/- 5% RH) and different period (30 or 60 days) using DSC, FT-IR and HPLC. In order to investigate the possibility of celecoxib-excipient interaction in aqueous medium, dispersions of the pure drug or drug in physical powder mixture (1:1 w/w) in water (1%, w/v) were also prepared and evaluated by FT-IR and HPLC at day 0 and day 7 (40 +/- 2 degrees C). The interaction between celecoxib and magnesium stearate or colloidal silicon dioxide were determined in the aqueous dispersions by FT-IR. Different tablet formulations with or without excipients tested were prepared, and assessed for drug dissolution and permeability.     

How the COVID-19 pandemic is affecting paediatric orthopaedic practice in Turkey

PurposeChanges to routine clinical approaches during the corona virus disease 2019 (COVID-19) pandemic are necessary to decrease the risk of infection in patients and healthcare providers. Because the treatment of many conditions is time sensitive, it is crucial to modify the management of paediatric orthopaedic cases by minimizing any subsequent morbidity. Our purpose was to describe the different measures and management strategies that have been applied by paediatric orthopaedic surgeons and to show how paediatric orthopaedic practice is affected in Turkey.MethodsAll active practicing members of the Turkish Society of Children’s Orthopedic Surgery (TSCOS) were contacted via telephone and asked to fill out a survey (24 questions). For participants, either an email or web link was sent to their mobile phones. An online survey generator was used.ResultsA total of 54 survey responses were collected, for a response rate of 55%. In all, 62% reported a 75% decrease in their outpatient frequency, whilst 75% reported a 75% decrease in their surgery frequency. A total of 86% of the performed surgeries were emergency cases. None of the participants performed elective surgeries, and 61% did not have the consent form specific to COVID. Choice of protective measures have changed considerably; 96% stated that they needed an algorithm to follow for situations such as pandemic.ConclusionThis national survey revealed that the COVID-19 pandemic has had a detrimental effect on paediatric orthopaedic practice and practitioner response varies in terms of reactions and precautions. The necessity of creating a protocol based on what we have learned must be taken into consideration.Level of evidenceV     

Sedation with intranasal midazolam in adults undergoing upper gastrointestinal endoscopy

The use of intranasal (IN) midazolam in adults for sedation in upper gastrointestinal endoscopy has been evaluated in a controlled clinical study. Eighty-one patients with a mean age of 37.02 +/- 12.50 years who underwent upper gastrointestinal endoscopy for various reasons were included in the study. Three groups were formed according to the sedation regimen. In the first group (n = 30), patients received IN midazolam. In the second group (n = 28) intravenous (IV) midazolam was given for sedation, and the third group of patients (n = 23) received placebo before the procedures. Patients were monitored (using a pulse oximeter with an interval of 5 minutes until the 45th minute after the procedure) for arterial oxygen saturation, heart rate, systolic and diastolic arterial blood pressure, and respiratory rate. Efficacy of sedation, amnesia, side effects, and patients' preferences were evaluated. Superior results regarding the efficacy of sedation has been documented with the use of IV midazolam (p < 0.001), and this was the preferred route for drug application according to the patients' answers (p < 0.01). However, regarding amnesia, IN midazolam was found to be almost equally effective as IV midazolam (p < 0.05); moreover, IN route of drug application caused significantly fewer side effects than did the IV form (p < 0.001 ). Intranasal application of midazolam for gastrointestinal endoscopy appeared to be an interesting alternative to the IV route, the usage of which might be limited because of its potentially serious side effects. In contrast to the IV application of midazolam, the IN route may not even necessitate the monitoring of the patient during upper gastrointestinal endoscopy.     

Atorvastatin acutely reduces the reactivity to spasmogens in rat aorta: implication of the inhibition of geranylgeranylation and MYPT‐1 phosphorylation

Statins are known to display benefits in various diseases independently from their cholesterol lowering properties. In this study, we investigated the acute effects of atorvastatin on vascular reactivity to various spasmogens in isolated rat aorta. The responses to noradrenaline (NA, 10^?8–10^?4 m ), endothelin‐1 (ET‐1, 10^?10–10^?7 m ), and potassium chloride (KCl, 10–100 mm ) were evaluated in aortic rings pretreated with atorvastatin (10^?7–10^?4 m , 30 min). To verify the mechanism of action, the effects of atorvastatin were studied in the presence of cholesterol precursor, mevalonate (10^?2 m , 45 min), mevalonate‐derived isoprenoids, namely geranylgeranyl pyrophosphate (GGPP, 5 × 10^?6 m , 30 min) and farnesyl pyrophosphate (FPP, 5 × 10^?6 m , 30 min), and in the absence of endothelium. In parallel, aortic rings were pretreated with the specific inhibitor of Rho kinase, Y‐27632 (10^?7–10^?6 m ). Atorvastatin significantly and concentration‐dependently reduced the contractions to spasmogens in rat aorta. This acute inhibitory effect was also evident in endothelium‐denuded rings. Pretreatment with mevalonate and GGPP, but not with FPP, reversed the inhibitory effect of atorvastatin (10^?4 m ) on NA and ET‐1 induced contractions. Similar to atorvastatin, pretreatment with Y‐27632 inhibited the contractions to NA and KCl in a concentration‐dependent manner. Western blot analysis revealed that both atorvastatin (10^?4 m ) and Y‐27632 (10^?6 m ) pretreatment inhibited the phosphorylation of myosin phosphatase target subunit‐1 (MYPT‐1) triggered by NA, indicating an inhibitory influence on myosin phosphatase. In conclusion, atorvastatin displayed an acute inhibitory effect on vascular contractility evoked by various spasmogens and the inhibitory effect was possibly mediated by the inhibition of mevalonate and GGPP synthesis as well as the prevention of MYPT‐1 phosphorylation induced by Rho/Rho kinase.     

Serum leptin concentration and advanced gastrointestinal cancers: a case controlled study

Background  

Serum leptin level is associated with appetite and energy expenditure in healthy individuals. We aimed to evaluate the serum leptin concentration and the other factors which may be associated with weight loss in patients with advanced gastrointestinal cancer.     

Genitourinary infection prevalence among women who used an intrauterine device or oral contraceptives

Purpose

The study aimed at investigating genitourinary infection prevalence among women who used an intrauterine device (IUD) and oral contraceptives (OC) in relation with their socio-demographic characteristics.

Methods

The study was conducted at the Mother and Child Health and Family Planning center between October 2011 and February 2012 and included 81 women who used IUD, 84 who used OC, and 84 who did not use artificial contraceptive methods (coitus interraptus).

Results

It was found that there was a difference between the three groups in terms of urinary system infection (X ² = 9.85, p = 0.000) and genital infection (X ² = 8.29, p = 0.001). It was also observed that urinary infection was more common in the OC group, whereas genital infection was more common in the IUD group. In urinary culture, it was seen that Enterobacter species was the most common microorganism among the group who used an IUD, while Escherichia coli was the most common microorganism in the group who used OC and the control. In vaginal cultures, Candida albicans was determined to be the first isolated microorganism among the group who used OC, IUD, and the control.

Conclusion

It is believed that the most significant reason for genitourinary infections among women was inadequate hygiene practices rather than use of different contraception methods.     

Neural networks for improved target differentiation and localization with sonar.

This study investigates the processing of sonar signals using neural networks for robust differentiation of commonly encountered features in indoor robot environments. Differentiation of such features is of interest for intelligent systems in a variety of applications. Different representations of amplitude and time-of-flight measurement patterns acquired from a real sonar system are processed. In most cases, best results are obtained with the low-frequency component of the discrete wavelet transform of these patterns. Modular and non-modular neural network structures trained with the back-propagation and generating-shrinking algorithms are used to incorporate learning in the identification of parameter relations for target primitives. Networks trained with the generating-shrinking algorithm demonstrate better generalization and interpolation capability and faster convergence rate. Neural networks can differentiate more targets employing only a single sensor node, with a higher correct differentiation percentage (99%) than achieved with previously reported methods (61-90%) employing multiple sensor nodes. A sensor node is a pair of transducers with fixed separation, that can rotate and scan the target to collect data. Had the number of sensing nodes been reduced in the other methods, their performance would have been even worse. The success of the neural network approach shows that the sonar signals do contain sufficient information to differentiate all target types, but the previously reported methods are unable to resolve this identifying information. This work can find application in areas where recognition of patterns hidden in sonar signals is required. Some examples are system control based on acoustic signal detection and identification, map building, navigation, obstacle avoidance, and target-tracking applications for mobile robots and other intelligent systems.