Background and ObjectiveCervical cancer is one of the leading causes of morbidity and mortality amongst the gynecological cancers worldwide, especially in developing countries. It is imperative for at least health professionals in developing countries like Pakistan to have a sound knowledge about the disease. This study was carried out to assess the knowledge and awareness about cervical cancer and its prevention amongst health professionals in tertiary care hospitals in Karachi, Pakistan.Methods and DesignA cross-sectional, interview based survey was conducted in June, 2009. Sample of 400 was divided between the three tertiary care centers. Convenience sampling was applied as no definitive data was available regarding the number of registered interns and nurses at each center.ResultsOf all the interviews conducted, 1.8% did not know cervical cancer as a disease. Only 23.3% of the respondents were aware that cervical cancer is the most common cause of gynecological cancers and 26% knew it is second in rank in mortality. Seventy-eight percent were aware that infection is the most common cause of cervical cancer, of these 62% said that virus is the cause and 61% of the respondents knew that the virus is Human Papilloma Virus (HPV). Majority recognized that it is sexually transmitted but only a minority (41%) knew that it can be detected by PCR. Only 26% of the study population was aware of one or more risk factors. Thirty seven percent recognized Pap smear as a screening test. In total only 37 out of 400 respondents were aware of the HPV vaccine.ConclusionThis study serves to highlight that the majority of working health professionals are not adequately equipped with knowledge concerning cervical cancer. Continuing Medical Education program should be started at the hospital level along with conferences to spread knowledge about this disease.

Abstract. The present research work was aimed to formulate clotrimazole encapsulated Cavamax W7 composite ethosomes by injection method for improved delivery across epidermis. 3 2 factorial design was used to design nine formulations (F1-F9) and compared with ethosomal formulations (F10-F12). F9 with vesicle size of 202.8±4.8 nm, highest zeta potential (−83.6±0.96 mV) and %EE of 98.42±0.15 was selected as optimized composite ethosome and F12 as reference ethosomal formulation. As revealed by transmission electron microscopy F9 vesicles were more condensed, uniformly spherical in shape than F12 vesicles. Vesicular stability studies indicated F9 to be more stable as compared to F12. Both F9 and F12 were incorporated in carbopol 934 gel base to get G1-G8 gel formulations and evaluated for in vitro skin permeability. Cavamax W7 composite ethosomal optimized gel (G5) showed higher in vitro percent cumulative drug permeation (88.53±2.10%) in 8 h and steady state flux (J ss ) of 3.39±1.45 μg/cm 2 /min against the J ss of 1.57±0.23 μg/cm 2 /min for ethosomal gel (G1) and 1.13±0.06 μg/cm 2 /min for marketed formulation. The J ss flux of G5 was independent of amount of drug applied/unit area of skin. In vivo confocal laser scanning microscopic study of G5 depicted uniform and deeper penetration of rhodamine B (marker) in epidermis from Cavamax W7 composite ethosomal gel in comparison to G1. Finally, G5 demonstrated better (p<0.05) antifungal activity against Candida albicans and Aspergillus niger than G1 thus, signifying that Cavamax W7 composite ethosomes present a superior stable and efficacious vesicular system than ethosomal formulation for topical delivery of clotrimazole.

Onychomycosis constitutes the most common fungal infection of the nail (skin beneath the nail bed) that affects the finger as well as toe nails. It is an infection that is initiated by yeasts, dermatophytes, and nondermatophyte molds. Nail lacquers are topical solutions intended only for use on fingernails as well as toenails and have been found to be useful in the treatment of onychomycosis. Thus, in the present review an attempt has been made to focus on the treatment aspects of onychomycosis and the ungual delivery of antifungals via nail lacquer. Several patents issued on nail lacquer till date have also been discussed. Penetration efficiency was assessed by several researchers across the human nail plate to investigate the potentiality of nail lacquer based formulations. Various clinical trials have also been conducted in order to evaluate the safety and efficacy of nail lacquers in delivering antifungal agents. Thus, it can be concluded that nail lacquer based preparations are efficacious and stable formulations. These possess tremendous potential for clinical topical application to the nail bed in the treatment of onychomycosis.

As skin is one of the crucial and important organs of the human body, delivering the drug across it requires an effective development in the field of research. Topical drug delivery system is specifically designed with the objective to accomplish the delivery of therapeutically active drugs across the skin. Though skin is considered to be a multifunctional organ of a human body, it has the limitation of lesser permeability across the stratum corneum. As this layer constitutes an effective barrier for the drugs, various carrier systems have been developed to overcome this barrier. Vesicular carriers are one of the recently invented carriers. Liposomes, niosomes, transferosomes and ethosomes constitute the major part of these vesicles that have been sufficiently employed for the treatment of variety of topical skin diseases. In the past few years various research reports on the development of topical carrier systems showed that these carriers have emerged as a novel vesicular carrier. These are considered to be effective enough for the enhanced and safe delivery of both hydrophilic and lipophilic drugs. The present review focuses on the topical delivery via these vesicles, emphasizing on various aspects of all these carriers.

Onychomycosis constitutes the most common fungal infection of nail affecting finger and toe nails as well. Antifungals found to be effective in the treatment of onychomycosis. However, transport of oral antifungal agents exhibits more toxicity and requires longer treatment period. Medicated nail lacquers proved to cause lesser toxicity and required shorter treatment period. It provides not only finger/toe nail infection therapy and but also act as a protection for nails. Thus, the objective behind the present investigation was to develop nail lacquer for transungual delivery of tolnaftate. Its potency had been assessed by evaluating penetration efficiency across the bovine hoof membrane. Preliminary studies aided the optimization of thioglycolic acid as permeation enhancer (HEF max 0.60 ± 0.377) and menthol as local anaesthetic. n-butanol:isopropyl alcohol with optimum drying time of 60 sec was selected as optimum solvent system. In total nine formulations were developed based on 3 2 full factorial design and characterized for drying time, non-volatile content, in vitro adhesion and permeation study. Based on highest desirability, F6 was selected as an optimized formulation and evaluated for viscosity, stability and antifungal activity. Optimized formulation exhibited optimum viscosity and stability for 1 month period. Better antifungal activity was observed against Candida albicans in comparison to the control formulation. Thus, it can be concluded from the investigation that nail lacquer could proved to be a better alternative for transungual delivery of tolnaftate.