The development of novel excipients with enhanced functionality has been explored using particle engineering by co-processing. The aim of this study was to improve the functionality of tapioca starch (TS) for direct compression by co-processing with gelatin (GEL) and colloidal silicon dioxide (CSD) in optimized proportions. Design of Experiment (DoE) was employed to optimize the composition of the co-processed excipient using the desirability function and other supporting studies as a basis for selecting the optimized formulation. The co-processed excipient (SGS) was thereafter developed by the method of co-fusion. Flow and compaction studies of SGS were carried out in comparison to its parent component (TS) and physical mixture (SGS-PM). Tablets were prepared by direct compression (DC) containing ibuprofen (200 mg) as a model for poor compressibility using SGS, Prosolv®, and StarLac® as multifunctional excipients. The optimized composition of SGS corresponded to TS (90%), GEL (7.5%), and CSD (2.5%). The functionality of SGS was improved relative to SGS-PM in terms of flow and compression. Tablets produced with SGS were satisfactory and conformed to USP specifications for acceptable tablets. SGS performed better than Prosolv® in terms of disintegration and was superior to StarLac with respect to tensile strength and disintegration time. The application of DoE was successful in optimizing and developing a starch-based co-processed excipient that can be considered for direct compression tableting.
Idiopathic minimal change disease is a disorder of T-cell dysfunction. The relative predominance of regulatory T cells (Tregs), Th1, and Th2 cells in nephrotic syndrome (NS) remains controversial. Imbalance in peripheral blood regulatory and effector T cells (Teff) are linked to cell mediated immune response and may be associated with steroid response in NS. Peripheral blood CD4 + CD25 + FoxP3 + (Tregs), CD4 + IFN-γ+ (Th1), and CD4 + IL-4 + (Th2) lymphocytes were analyzed in 22 steroid-sensitive NS (SSNS) patients in sustained remission, 21 steroid-resistant NS (SRNS) and 14 healthy controls. The absolute percentage values and ratio of Th1/Tregs, Th2/Tregs, and Th1/Th2 were compared between SSNS, SRNS and control subjects. The percentage of Tregs was lower in SRNS patients (P = 0.001) compared with that of SSNS and healthy control. The percentage of Th1 cells was higher in SRNS (P = 0.001) compared to that of SSNS patients; however, it was similar to healthy controls (P = 1.00). The percentage of Th2 cells in SRNS (P = 0.001) was higher as compared to SSNS and controls. The ratio of Th1/Treg cells in SRNS (P = 0.001) was higher as compared to SSNS patients and controls. The ratio of Th2/Treg was also higher in SRNS as compared to SSNS and controls. The ratio of Th1/Th2 cells in SSNS, SRNS, and healthy controls were similar. The cytokines secretion complemented the change in different T-cell subtypes in SSNS, SRNS and healthy controls. However, the IFN-γ secretion in healthy controles was low inspite of similar percentage of Th1 cells among SRNS cases. We conclude that greater ratio of Tregs compared to that Th1 and Th2 favor steroid sensitivity and reverse ratio results in to SRNS. The difference in ratio is related to pathogenesis or it can be used as marker to predict steroid responsiveness needs further evaluation.
Advances and wide acceptance of information and communication technology (ICT) have made development and implementation of web-based electronic personal health records (PHRs) more feasible than ever before, and previous studies have demonstrated some of its potential and promises. However, this type of ICT-dependent approach inherits its own vulnerabilities of exposing the society to "digital divide", commonly described as the gap that exists among individuals and communities with regards to the 'haves' and 'have-nots' of information and modern communications technologies. To address these concerns and improve healthcare outcomes, we have developed and customized a web-based patient-centered electronic PHR, named the Personal Health Information Management System (PHIMS), and evaluated the system at the Everett Housing Authority, which provides housings for low-income families and elderly or disabled populations. A preliminary study demonstrates that 92% of the participating residents are satisfied with the PHIMS system in general. Some of the residents found PHIMS records very useful for their clinic visits.
Introduction: Kites were first introduced by the Chinese more than three thousand years ago, but in places like India, Pakistan and Afghanistan, Kite flying is celebrated in unique way. People enjoy cutting down others kites and there is an instinct to catch the threads of the “Cut-Kite” and rejoice the gain. In this study conducted at a tertiary care emergency medicine department to understand demographic profile and injuries related in such a festive celebration, occurring in one urban area, to spread awareness and reduce such incidence. Methodology: This cross-sectional descriptive study was conducted using preformatted form in consecutive two year. Results: Among 83 cases we studied, 81% were male. 65% were in the age group of 11-40. 70% incidences took place in noon and evening hours. 68.67 % presented in 108 ambulance services, 43% presented with fall from height (terraces), 34 % had road traffic accidents because of strings and festival related excitement. Maximum had fall from 1 storey buildings. 56% received Out Patient based treatment. Among the admitted patients 15% had head injury, 2 cut throat, 9.7% had fractures and 1 had to undergo laparotomy, 2 died eventually during the hospital stay because of grievous injuries. Conclusion: This study re-emphasizes the importance of spreading awareness and increasing the care, particularly of children during such an enjoyable festival.
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