Much progress has been made in understanding the pathophysiology and treatment of atypical hemolytic uremic syndrome (aHUS). Plasma therapy is the mainstay of treatment for aHUS. The availability of the first effective anti-complement therapeutic agent, eculizumab, has dramatically changed the outlook of this disease. However, its use in clinical practice raises important questions, such as who should receive the drug, when to start such therapy, and is it safe to stop treatment once the disease is controlled. We describe here for the 1st time in India, use of eculizumab in a 12-year-old boy with aHUS. We also describe in this report challenges faced in procuring the drug, and an ideal, evidence-based method of treating aHUS in children.
Diabetes mellitus is a long-lasting disease that is very common in the age group above 20 years and is characterized by hyperglycemia with other complications like Diabetic Nephropathy (DN). The management of DN focuses on mainly four regions: reduction of cardiovascular risks, control of blood glycemic levels, control of the blood pressure (BP) profile, and the use of therenin–angiotensin system (RAS). Although BP management and RAS-acting agents can postpone the onset of DN, they cannot prevent it. In the modern era, nanotechnological interventions have spread rapidly in the field of medicine. Patient defiance is considered important in diabetes management when long-term or continuous management is required. Nano pharmaceuticals have been shown to increase compliance of diabetic patients by providing multiple ways of drug delivery, controlling release profile, increasing biological steadiness, targeting efficacy, and decreasing toxic profile. Nanoscale formulations of botanical antidiabetic molecules improve clinical efficacy and treatment compliance by overcoming associated biopharmaceutical and pharmacokinetic barriers. Therefore, the development of nanopharmaceuticals can be considered to be a possible answer to attain the finest scientific effect of the plant-based anti-diabetic molecule. Nevertheless, further studies are needed to create clinical research-based and therapeutically effective nanoforms of antidiabetic plant-based molecules to combat the most dreaded disease of diabetes and its known present complications.
Background: Diabetes is a prevailing disease worldwide and its complications are also hazardous including nephropathy. Drug available to treat Diabetic Nephropathy (DN) faces bioavailability issues related to solubility and absorption of drugs. Cilostazol (CLT) is a BCS class II drug that is poorly water-soluble which affects its therapeutic efficacy. CLT reduces reactive oxygen species (ROS) increased in DN. Curcumin (Cur) is also hydrophobic but Cur has many therapeutic efficacies like anti-inflammatory and antioxidant properties that help for the treatment of DN. Objective: The objective of the current study was to develop and optimize the Cilostazol Solid Dispersion Nanoparticle (SDN) to improve the bioavailability of the drug by tagging it with Cur by using PVP VA S 630 as polymer and Poloxamer 407 as surfactant. Method: Different formulations were developed using the emulsion solvent evaporation method, PVP VA S 630 as the hydrophilic polymer, and Poloxamer 407 as a surfactant. Two-factor, threelevel Box-Behnken Design (BBD) was used for statistical analysis of the selected process variable's main effect and interactive effect on the response. Curcumin tagging was also done for the entire batches. Nanoparticles were characterized by FT-IR spectroscopy, DSC, Particle size, Zeta potential, Drug entrapment efficiency, Solubility, and % CDR studies. Results: Among the 17 different formulations (CLT1-CLT 17), with a solubility of 39.5 µg/ml, a % CDR of 99.55, a typical particle size of 219.67 nm with a PDI of 0.258, entrapment efficiency of 73.47%, and a -10.6 mV of Zeta potential, CLT-15 was optimized. To determine CLT and curcumin, the simultaneous UV calibration method was created. Overall, the DSC study indicated the amorphous nature of the Nano Dispersion, which in turn means the successful entrapment of the CLT in the Nano Dispersion matrix. TEM images also confirmed the spherical nanoparticles. The optimized batch of drugs tagged with curcumin was compared with the plain drug Solid Dispersion Nanoparticles. Conclusion: Together with the molecules of curcumin, the solid nano dispersion of CLT was produced, which will add to the benefits of the management of Diabetic Nephropathy. In the current study, we underline the importance of utilising both API and phytochemicals in the treatment of Diabetic Nephropathy, and we anticipate further basic research or clinical trials to support innovative treatments. It is possible to use these matrix-forming polymers for active ingredients with poor solubility, whether they are natural or synthetic. It has also been demonstrated that these carriers (PVP VA S 630 & Poloxamer) increase the dissolution rate (in-vitro).
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