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Cilostazol, an anti-platelet aggregation medicine, is also known to have vasodilation properties and is commonly used for treating muscle soreness and cramps by increasing the muscle oxygen supply. The medication has limited oral bioavailability, is prone to pre-systemic metabolism, and is poorly soluble in aqueous media. A transdermal administration was planned to increase the drug’s solubility and therapeutic efficacy. The current work intended to develop cilostazol niosome-loaded transdermal gel, which was prepared, and with the use of Fourier transform infrared and differential scanning calorimetry analyses, drug-excipient interactions were observed. The medication was formulated utilizing Carbopol-934, Pluronic-F-127, and HPMC gel bases for the transdermally delivered niosomal gels. The produced niosomes had a maximum percentage of drug entrapment at 96.4%, with a particle size of 102 ± 11.30 nm and polydispersity index of 0.29 ± 0.069. The highest percentage of the medication that was entrapped was 96.4%, and the Carbopol-934 gel basis released the major part of the drug under in vitro conditions. A maximum transdermal flux was recorded at 3850.92 μg after 4 h, indicating a 10% increase in cilostazol permeation through rat skin. The flux rate for the niosomal preparation containing the drug ranged from 14.85 to 28.02 μg/cm2 h−1. In comparison to the pure cilostazol-loaded gels, the pharmacokinetics investigation showed that the niosomal gel formulations had considerably greater C max, T max, and AUC0. The niosomes loaded with cilostazol exhibited greater solubility, higher bioavailability, and improved effectiveness. Better therapeutic results may be achieved with systemic and site-directed delivery of cilostazol using the designed transdermal niosomal gel with appropriate molecular tagging modification/(s).

Vitiligo is a significant dermatological challenge affecting 0.5 to 2% of the global population. Despite the various existing medical approaches, current vitiligo treatments are far from ideal. The present study aimed to prepare and evaluate a film-forming gel of 5 fluorouracil (5FU) using different ratios of hydroxypropyl methylcellulose (HPMC) and Zein for treating vitiligo. The prepared film-forming gels were fully characterized in terms of morphology, Fourier-transform infrared spectroscopy, drug content, pH, drying time, in-vitro drug release, and clinical investigation. A 32-full factorial design was used to study the impact of varying concentrations of HPMC (X1) and Zein (X2) on the percentage of 5FU released (Y1) from the prepared film-forming gels. Scanning electron microscopy (SEM) revealed a cross-linked network structure between polymers. An increase in HPMC concentration (2–4%) correlated with higher 5FU release, whereas increased Zein concentration (1–2%) resulted in reduced 5FU release. Furthermore, patients treated with 5FU film-forming gel after dermabrasion with fractional CO2 (FCO2) laser exhibited a significant decrease in JAK3 gene expression and higher effectiveness than those treated with FCO2 laser alone. Our results suggest that the film-forming gel of 5FU is promising as an effective formulation for treating vitiligo. [ABSTRACT FROM AUTHOR]

Hesperidin (HSP) is a natural flavonoid glycoside with very low aqueous solubility and a slow dissolution rate, limiting its effectiveness. This study aims to address these issues by creating co-crystals of hesperidin with water-soluble small molecules (co-formers) such as L-arginine, glutathione, glycine, and nicotinamide. Using the solvent drop grinding method, we prepared three different molar ratios of hesperidin to co-formers (1:1, 1:3, and 1:5) and conducted in-vitro solubility and dissolution studies. The results demonstrated that the prepared co-crystals exhibited significantly enhanced solubility and dissolution rates compared to untreated hesperidin. Of particular note, the HSP co-crystals formula (HSP: L-arg 1:5) displayed approximately 4.5 times higher dissolution than pure hesperidin. Further analysis using FTIR, powder x-ray diffraction patterns, and DSC thermograms validated the formation of co-crystals between HSP and L-arginine. Additionally, co-crystallization with L-arginine improved the in vitro anti-inflammatory and antioxidant activities of hesperidin compared to the untreated drug. This study highlights the potential of using water-soluble small molecules (co-formers) through co-crystallization to enhance the solubility, dissolution, and biological activities of poorly water-soluble drugs. Furthermore, in vivo studies are crucial to validate these promising results. [ABSTRACT FROM AUTHOR]

Purpose: Since Kellgren and Lawrence (KL) originally classified knee osteoarthritis, several authors have reported varying levels of reliability and a lack of uniformity in the use of this classification system. We propose several modifications to the KL classification including the use of a compartment‐specific approach that we hypothesize will lead to a better understanding of knee OA while maintaining an adequate interobserver and intraobserver reliability. Methods: We propose the addition of the lateral and skyline‐view radiographs to the standard anteroposterior (AP) and lateral projections in the evaluation. Also suggest a more precise definition of the evaluated parameters; the addition of the subchondral cancellous bone as parameter of evaluation; and the assessment of medial tibiofemoral compartment (MTFC), lateral tibiofemoral compartment (LTFC) and patellofemoral compartment (PFC) separately resulting in a compartment‐specific KL staging score rather than a single overall KL score. Six evaluators (two knee surgeons, two radiologists and two knee fellows) used the modified KL classification to classify 230 randomly selected knees on two separate occasions. Reliabilities were assessed by calculating Krippendorff's ⍺ coefficients. Results: Two hundred and ten knees were included for final evaluation and analyses (53% left knees; 65% females; mean age 56 years old). Average interobserver reliability was moderate for all compartments (0.51 for the MTFC; 0.51 for the LTFC; and 0.56 for the PFC). Average intraobserver reliability was substantial for all compartments (0.63 for the MTFC; 0.65 for the LTFC; and 0.7 for the PFC). Experienced evaluators showed a higher intraobserver reliability than less‐experienced evaluators. Conclusions: A modified compartment‐specific KL classification enables a practical and detailed description of knee OA involvement and demonstrates acceptable interobserver and intraobserver reliability. Level of Evidence: Level III [ABSTRACT FROM AUTHOR]

Conventional pesticide formulations are addressed along with several issues connected to environmental pollution. Lipophilic properties and resistance solubility in the water phase led to low-effective pesticide utilization. In order to improve pesticide solubility and efficacy and reduce the dose and side effects, nanotechnology approaches are applied. The efforts and chances to develop nanoemulsions as preparation for agriculture chemicals have been the issues of heavy investigation. The lambda-cyhalothrin-loaded nano-delivery system was developed, using Tween 80 as a hydrophobic surfactant through a solvent evaporation method. The novel compound of lambda-cyhalothrin has unique chemical, physical, and biological properties. The recorded properties of lambda-cyhalothrin nano-emulsion showed spherical particles having an average size of 70.3 nm using transmission electron microscopy. Dynamic light scattering--Zetasizer--reached 77.51 nm and Zeta potential has a negative surface charge value of -17.8 mV. Lambda-cyhalothrin and lambda-cyhalothrin nano-emulsion showed a strong absorption band at different wavelengths. Fourier transform infrared spectroscopy analysis revealed the addition of new bonds in the lambda-cyhalothrin nano-emulsion compound. Larvicidal activity indicated a significant difference between the mortality means in the larvae of Culex pipiens. The produced lambda-cyhalothrin nano-emulsion has a new hydrophilic attendance and better efficacy for pest control resulting in promising nano-pesticide formulations to improve agricultural practice. [ABSTRACT FROM AUTHOR]

Abstract Background Over the past decade several studies have questioned current standards of patient safety in health care delivery. In response, our institution started a clinical pathway for total hip replacement in 1996. Prospective monitoring with regular feedback sessions to the individuals involved in patient care did however not start until 2003. The present study evaluates the effect of prospective monitoring on outcomes of total hip replacement. Methods Clinical records of patients undergoing primary elective total hip replacement between 1997 and 2004 were reviewed. Data on adverse events as well as adherence to protocols for venous thromboembolism prophylaxis were extracted retrospectively for the period 1997 to 2001 and prospectively from 2003 to 2004. Results were compared and analyzed in order to establish possible improvement in outcomes. Data was analyzed with Chi-square or Fisher's Exact test for categorical variables and Student's t-test for continuous variables. Alpha was set as less than 5% and analysis was performed with Stata 9.0 for Macintosh. Results Two-hundred and eighty-three patients were included from 1997 to 2001, and 62 from 2003 to 2004. Mean age, male to female ratio and initial diagnosis were similar in both groups. At least one adverse event occurred in 45% of patients in 1997–2001 and in 21% in 2003–2004 (p < 0.001). In-hospital hip dislocations occurred in 6% and 0% (p = 0.05), oliguria in 19% and 5% (p = 0.007), SSI and VTE in 3% and 0% (p = 0.37), adverse drug reactions in 11% and 13% (p = 0.66) and non-adherence to VTE prophylaxis protocols in 15% and 2% of cases respectively (p = 0.002). Conclusion Overall rate of adverse events as well as in-hospital hip dislocations, oliguria and non-adherence to VTE prophylaxis protocols were significantly reduced during the second period. We conclude that clinical pathways alone are insufficient to improve patient safety and require prospective monitoring and continuous feedback to health care providers in order to achieve the desired effect.