Fauzia Tabassum

Misoprostol, a synthetic prostaglandin E₁ analogue, is effective for gastric ulcer healing but suffers from a short half‑life (20–30 min), frequent dosing (3–4 times daily), and dose‑dependent gastrointestinal side effects due to systemic absorption. Gastroretentive floating microbeads offer a strategy to prolong gastric residence and deliver misoprostol locally. Floating microbeads were prepared by extruding a sodium alginate‑misoprostol‑NaHCO₃ dispersion into CaCl₂ solution. A Box‑Behnken design (BBD) was employed to optimize three independent factors: alginate concentration (1.5–2.5% w/v), NaHCO₃ concentration (0.5–1.5% w/v), and CaCl₂ concentration (6–9% w/v). Responses included encapsulation efficiency (%EE), floating lag time (FLT), and cumulative drug release at 12 h. The optimized formulation was characterized for particle size, morphology (SEM), swelling, mucoadhesion, in vitro release kinetics, and stability. In vivo pharmacodynamic study was conducted in an indomethacin‑induced gastric ulcer rat model (n=6/group) comparing optimized microbeads (once daily, 100 µg/kg) with plain misoprostol suspension (twice daily) and marketed Cytotec®. The optimized formulation (2.2% alginate, 1.2% NaHCO₃, 7.2% CaCl₂, alginate:chitosan 2:1) achieved %EE of 89.4 ± 1.6%, FLT of 42 ± 4 s, and 12‑h release of 88.6 ± 2.4%. SEM revealed spherical, porous beads. Release followed Korsmeyer‑Peppas kinetics (n=0.62, anomalous transport). The microbeads exhibited good swelling (183% at 2 h) and mucoadhesion (detachment time 8.2 h). In vivo, optimized beads reduced ulcer index by 83% (vs. 55% for plain drug, p<0.001), restored near‑normal histology, and significantly improved biochemical markers (MDA, GSH, SOD, MPO) compared to plain misoprostol. The formulation was stable for 12 months at 25°C/60% RH. Misoprostol‑loaded floating microbeads prepared by ionotropic gelation with effervescent agent provide sustained gastric retention, enhanced ulcer healing, and once‑daily dosing potential, overcoming the limitations of conventional misoprostol therapy.

The most common metabolic endocrine illness in women, polycystic ovarian syndrome (PCOS), swiftly impacts not only physical health but also psychological perception related to social and cultural ties that health-related quality of life (HRQOL). The HRQOL of women with PCOS is greatly affected by the constellation of symptoms that mainly accompany menstrual disorder and androgen excess. Several illnesses and conditions are more common in women with PCOS, such as obesity, insulin resistance, cardiovascular disease, infertility, cancer, and mental health issues. Managing the cases includes patient education, healthy lifestyle implementations, and the best possible therapeutic interventions, particularly based on targeting their symptoms. Therapeutic interventions include use of metformin, combined oral contraceptive pills, clomiphene citrate, spironolactone, surgery (ovarian laparoscopic drilling), and cosmetic interventions. Moreover, various new therapeutic approaches, such as use of inositol, statins, supplementation of vitamin D, miRNA therapy, interleukin-22 therapy, and faecal microbiota transplantation, bring new opportunities as well as challenges in PCOS management. This review will look at the different aspects of PCOS, other conditions that are linked to it, and the current and future ways that people with PCOS who are having trouble getting pregnant can improve their quality of life.

Natural anti-inflammatory nutraceuticals may be useful in preventing rheumatoid arthritis from worsening. Resveratrol (RV) and chia seed oil, having antioxidant potential, can assist in avoiding oxidative stress-related disorders. This investigation developed and evaluated resveratrol-loaded chia seed oil-based nanoemulsion (NE) gel formulations through in vitro and in vivo studies. The physical stability and in vitro drug permeability of the chosen formulations (NE1 to NE10) were studied. The optimized RV-loaded nanoemulsion (NE2) had droplets with an average size of 37.48 nm that were homogeneous in shape and had a zeta potential of −18 mV. RV-NE2, with a permeability of 98.21 ± 4.32 µg/cm²/h, was gelled with 1% carbopol-940P. A 28-day anti-arthritic assessment (body weight, paw edema, and levels of pro-inflammatory mediators including TNF-α, IL-6, IL-1β, and COX-2) following topical administration of RV-NE2 gel showed significant reversal of arthritic symptoms in arthritic Wistar rats induced by Freund’s complete adjuvant injection. Therefore, RV-NE2 gel demonstrated the potential to achieve local therapeutic benefits in inflammatory arthritic conditions due to its increased topical bioavailability and balancing of pro-inflammatory mediators.

The aim of the present study is to develop Doxorubicin–Erlotinib nanoparticles (Dox–Erlo NPs) and folate-armored Dox–Erlo-NP conjugates for targeting glioma cancer. Glioma is one of the most common progressive cancerous growths originating from brain glial cells. However, the blood–brain barrier (BBB) is only semi-permeable and is highly selective as to which compounds are let through; designing compounds that overcome this constraint is therefore a major challenge in the development of pharmaceutical agents. We demonstrate that the NP conjugates studied in this paper may ameliorate the BBB penetration and enrich the drug concentration in the target bypassing the BBB. NPs were prepared using a biopolymer with a double-emulsion solvent evaporation technique and functionalized with folic acid for site-specific targeting. Dox–Erlo NPs and Dox–Erlo-NP conjugates were extensively characterized in vitro for various parameters. Dox–Erlo NPs and Dox–Erlo-NP conjugates incurred a z-average of 95.35 ± 10.25 nm and 110.12 ± 9.2 nm, respectively. The zeta potentials of the Dox–Erlo NPs and Dox–Erlo-NP conjugates were observed at −18.1 mV and −25.1 mV, respectively. A TEM image has shown that the NPs were well-dispersed, uniform, de-aggregated, and consistent. A hemolytic assay confirmed hemocompatibility with the developed formulation and that it can be safely administered. Dox–Erlo-NP conjugates significantly reduced the number of viable cells to 24.66 ± 2.08% and 32.33 ± 2.51% in U87 and C6 cells, respectively, and IC50 values of 3.064 µM and 3.350 µM in U87 and C6 cells were reported after 24 h, respectively. A biodistribution study revealed that a significant concentration of Dox and Erlo were estimated in the brain relative to drug suspension. Dox–Erlo-NP conjugates were also stable for three months. The findings suggest that the developed Dox–Erlo-NP conjugates may be a promising agent for administration in glioma therapy.

Inotropic agents are generally recommended to use in patients with acute decompensated heart failure (HF) with reduced ejection fraction (HFrEF) concurrent to end-organ dysfunction. However, due to certain pharmacological limitations like developing life threatening arrhythmia and tolerance, cannot be employed as much as needed. Meanwhile, Calcium ion (Ca²⁺) sensitisers exhibits their inotropic action by increasing the sensitivity of the cardiomyocyte to intracellular Ca²⁺ ion and have been reported as emerging therapeutic alternative in HF cases. Levosimendan (LEVO) is an inodilator and with its unique pharmacology justifying its use in a wide range of cardiac alterations in HF particularly in undergoing cardiac surgery. It is also reported to be better than classical inotropes in maintaining cardiac mechanical efficacy and reducing congestion in acute HF with hypotension. This review paper was designed to compile various evidence about basic pharmacology and potential clinical aspects of LEVO in cardiac surgery and other HF associated alterations. This will benefit directly to the researcher in initiating research and to fill the gaps in the area of thrust.

Objectives: Polycystic ovary syndrome (PCOS) is a multifaceted endocrine disorder in reproductive age having a greater impact on health-related quality of life (HRQOL). The aim of this study was to find out PCOS demographics and its related HRQOL effects for improving psychological understanding in disease management. Materials and Methods: A prospective questionnaire-based study was conducted for a period of twelve months at All India Institute of Medical Sciences, Patna, India. The data of 100 PCOS cases were collected about socio-demographic status, clinical history, and dietary intake. Then, a validated PCOS questionnaire (PCOSQ) was used to observe the impact of PCOS symptoms on patients’ HRQOL. Results: The overall 57% and 48% of PCOS cases belonged to the age range of 20-30 years and had a body mass index (BMI) of >25-30, respectively. Based on the results, a significant difference was observed in the mean score of PCOSQ vs. marital status in PCOS cases with respect to emotion (P=0.039), body weight (P=0.002), and infertility (P=0.001). Furthermore, the result showed a significant difference in the domain of emotion (P=0.008), body hair (P=0.035), body weight (PP=0.018) among BMI group, and a high score was observed in the BMI group Conclusions: In general, our findings indicated that infertility, emotions, and BMI had extremely higher impacts on the HRQOL of women suffering from PCOS although their educational status failed to affect HRQOL.

Background: Polycystic ovary syndrome (PCOS) is the major endocrine disorder in women that promptly affects psychological perception and associated social and cultural relations with women. Health-related quality of life (HRQOL) was assessed to explore the effects of PCOS in terms of emotional aspects and related anxiety in women. Objective: The purpose of this study was to explore the psychological burden in adolescent women due to PCOS. Methods: A prospective questionnaire-based study was conducted at a tertiary care hospital, and 100 PCOS and 200 healthy cases were enrolled based on Rotterdam criteria during the year 2017 and 2018. Pre-validated HRQOL questionnaires like Short Form Health survey-36 (SF-36) were used for evaluating the impact of PCOS in women. Results: In PCOS cases, mean age and body mass index was 22.81±5.33 and 24.35±5.49 respectively. A significant difference (P=0.001) regarding age was observed between PCOS and healthy control. The higher percentage of PCOS cases (90 %) were among the category of less than 5 years of PCOS symptoms. In addition, we observed a significant (P=0.001) reduction in quality of life in all eight domains of SF-36 questionnaire between PCOS and healthy control cases. Moreover, a decreasing pattern of SF-36 score was observed with an increase in the duration of PCOS symptoms. Conclusion: Altogether, our result of this study concluded that HRQOL especially emotional changes were more affected in adolescent and middle age group patients that may be due to fear of infertility and cosmetic problems.

Objective: The objective of this study is to determine the phenotypic and genotypic expression of inducible clindamycin resistance due to the expression of ermA, ermB, and ermC genes in clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) by double disc diffusion and uniplex PCR.Method: This cross-sectional study was conducted in microbiology department of an university teaching hospital. A total of 604 non-duplicate clinical isolates of S. aureus evaluated for MRSA and were subjected to uniplex PCR for ermA, ermB, and ermC genes, respectively.Result: The analysis of 604 isolates showed that 220 (36.42%) were of MRSA. Out of which, 69 (11.42%) were demonstrated as inducible clindamycin resistance by double-disc diffusion method, and among inducible resistant isolates, 25 isolates of ermC (84%) were positive and 4 (16%) were negative, whereas, ermA and ermB genes could not be demonstrated by the genotypic method.Conclusion: We observed that clindamycin may serve as a good alternative and advocated in severe MRSA infection based on susceptibility pattern. We observed D test as a mandatory method to detect inducible clindamycin Staphylococcus. Importantly, ermC gene is a major determinant of resistance to macrolides among MRSA.

Purpose: The purpose of this paper is to assess medicines information sources accessed by clinicians, if sources differed in theory and practice and to find out the barriers and facilitators to effective guideline adoption. Design/methodology/approach: In all, 183 doctors were surveyed. Barriers and facilitators were classified as: communication; potential adopters; innovation; organization characteristics and environmental/social/economic context. Findings: Most of the clinicians accessed multiple information sources including standard treatment guidelines, but also consulted seniors/colleagues in practice. The top three factors influencing clinical practice guideline adoption were innovation characteristics, environmental context and individual characteristics. The respondents differed in the following areas: concerns about flexibility offered by the guideline; denying patients’ individuality; professional autonomy; insights into gaps in current practice and evidence-based practice; changing practices with little or no benefit. Barriers included negative staff attitudes/beliefs, guideline integration into organizational structures/processes, time/resource constraints. Fearing third parties (government and insurance companies) restricting medicines reimbursement and poor liability protection offered by the guidelines emerged as the barriers. Facilitators include aligning organizational structures/processes with the innovation; providing leadership support to guide diffusion; increasing awareness and enabling early innovation during pre/in-service training, with regular feedback on outcomes and use. Practical implications: Guideline adoption in clinical practice is partly within doctors’ control. There are other key prevailing factors in the local context such as environmental, social context, professional and organizational culture affecting its adoption. Organizational policy and accreditation standards necessitating adherence can serve as a driver. Originality/value: This survey among clinicians, despite limitations, gives helpful insights. While favourable attitudes may be helpful, clinical adoption could be improved more effectively by targeting barriers.