Novel approach of aceclofenac fast dissolving tablet

Fast disintegrating tablets (FDTs) have received ever increasing demand during the last decade, and the field has become a hastily growing area in the pharmaceutical industry. Upon introduction into the mouth, these tablets dissolve or disintegrate in the mouth in the absence of additional water for easy administration of active pharmaceutical ingredients. Aceclofenac, an NSAID, has been recommended orally for the treatment of bone and connective tissue disorder and thus the formulation of the same resulted in development of several FDT technologies. The present aim is to formulate a tablet which disintegrate and dissolve rapidly and give its rapid onset of action: analgesic, antipyretic and anti-inflammatory action. Besides, the conventional tablets also show poor patient compliance an attempt had been made to formulate for FDT of aceclofenac by using various super disintegrants like sodium starch glycolate, croscarmellose sodium and crosspovidone (polyplasdone XL) and PEG 6000 followed by novel technique. The tablets were evaluated for friability, hardness, weight variation, disintegration time, wetting time, in vitro dissolution studies and drug content studies. It was concluded that the batch which was prepared by using combination of crosspovidone and sodium starch glycolate as a super disintegrant shows excellent disintegration time, enhance dissolution rate, taste masking and hence lead to improve efficacy and bioavailability of drug.

Gastroprotective activity of reconstituted red fruit pulp concentrate of Citrullus lanatus in rats

AIM

This study was carried out to evaluate the gastroprotective potential of the aqueous fruit pulp concentrate of Citrullus lanatus citroides (CLC) on pyloric ligation and indomethacin-induced ulcer in Wistar albino rats.

MATERIALS AND METHODS

In indomethacin-induced ulcer model, CLC was administered in the doses of 250 mg/kg, 500 mg/kg and 1000 mg/kg body weight orally, tds for 5 days. The antiulcer activity was determined via observing reduction in ulcer index whereas in the pyloric ligation model, the gastroprotective effect of CLC was assessed from the alteration in volume of gastric juice, pH, free and total acidity, protein concentration in gastric juice. Further lipid peroxide (LPO), and activities of enzymic antioxidants such as superoxide dismutase (SOD) and catalase (CAT) was also determined along with the levels of hexose, hexosamine, sialic acid, fucose in gastric mucosa.

RESULTS

In both models, treatment with CLC caused a significant reduction in lesion index when compared to vehicle treated group, providing evidence for antiulcer capacity. In pyloric ligation model, pretreatment with CLC resulted in significant increase in pH, enzymic antioxidants, that is, SOD, CAT, with a significant decrease in volume of gastric juice, free and total acidity, protein concentration, acid output, and LPO levels respectively. The presence of the flavonoids and polyphenols may be responsible for the gastroprotective effect of CLC.

CONCLUSIONS

The aqueous fruit pulp concentrate of CLC showed significant gastroprotective potential against pyloric ligation and indomethacin-induced ulceration in rats.

Pharmacokinetics of intravitreal antibiotics in endophthalmitis

Intravitreal antibiotics are the mainstay of treatment in the management of infectious endophthalmitis. Basic knowledge of the commonly used intravitreal antibiotics, which includes their pharmacokinetics, half-life, duration of action and clearance, is essential for elimination of intraocular infection without any iatrogenic adverse effect to the ocular tissue. Various drugs have been studied over the past century to achieve this goal. We performed a comprehensive review of the antibiotics which have been used for intravitreal route and the pharmacokinetic factors influencing the drug delivery and safety profile of these antibiotics. Using online resources like PubMed and Google Scholar, articles were reviewed. The articles were confined to the English language only. We present a broad overview of pharmacokinetic concepts fundamental for use of intravitreal antibiotics in endophthalmitis along with a tabulated compendium of the intravitreal antibiotics using available literature. Recent advances for increasing bioavailability of antibiotics to the posterior segment with the development of controlled drug delivery devices are also described.

Different treatment modalities for choroidal neovascularization in two eyes of one patient with bilateral type 2A parafoveal telangiectasia

A 60-year-old diabetic man presented with a history of decrease in vision in both eyes since 2 weeks. At presentation, best corrected visual acuity (BCVA) in the right eye (RE) was 20/30 and that in the left eye (LE) was 20/80. The right fundus revealed a grayish reflex, yellowish crystalline deposits and retinal pigment epithelial hyperplasia at the macula. The left fundus showed subretinal fluid and temporal subretinal hemorrhage near a grayish reflex at the macula. A diagnosis in both eyes of idiopathic macular telangiectasia (IMT) type 2A with RE stage 4 and LE stage 5, choroidal neovascularization (CNVM) was made. The patient was treated with photodynamic therapy (PDT) in LE. The visual acuity improved to 20/40 over the next 6 months. At a 4-year follow-up, he developed decreased vision in RE diagnosed as IMT with CNV and was treated with intravitreal ranibizumab. At 6-month follow-up post injection, the vision was 20/40p.

An unusual array of extensor musculature and tendons of the hand clinico-anatomical insight

Extensor tendon injury is a frequent finding in clinical practice. During a routine dissection class of undergraduate medical students examining the extensor aspect of the right hand, they found an interesting pattern of extensor tendons. The extensor digitorum (ED) exhibited three tendons for the middle and ring fingers. The intermediate tendon of the ED was found to pass to the junctura connecting the tendons of the ring and middle fingers. Additionally the Extensor carpi ulnaris displayed two tendinus slips. The lateral slip was inserted on the base of fifth metacarpal as usual, whereas the medial slip divided into two strands- proximal and distal. Apart from the above findings in the current case specimen, there was an accessory muscle belly for the index finger and the extensor digiti minimi bifurcated into two tendinus slips which gained attachment to the dorsal digital expansion of the little finger. These accessory muscle bellies and tendons could possibly be utilized for tendon reconstructions such as repairs, tenoplasties or tendon transfers.

A novel approach to formulation factor of aceclofenac eye drops efficiency evaluation based on physicochemical characteristics of in vitro and in vivo permeation

The purpose of the present study was to evaluate aceclofenac eye drop through excised goat cornea. Raising pH of the formulation from 6.0 to 8.0, effect of different preservatives or effect of viscosity enhancer decreases apparent permeability coefficient. Topical ophthalmic NSAID are used to treat ocular surface and anterior segment inflammation as well as post operative management of pain and inflammation. Aceclofenac's unique chemical structure makes it both a potent anti inflammatory drug and lipophilic molecule that penetrates ocular tissue, ensuring relief of pain in cataract and refractive surgery and corneal abrasion. The octanol/water partition coefficient of aceclofenac drug is 1.86 ± 0.75. Permeation characteristics of the drug were evaluated by putting 1 ml formulation on freshly excised goat cornea fixed between donor and receptor compartments of an all-glass modified Franz diffusion cell and measuring the drug permeated in the receptor by spectrophotometry at 275 nm, after 120 min. The results suggest that aceclofenac ophthalmic solution (pH 7) containing BAC provides increased in vitro ocular availability through goat corneas. The combination of methyl paraben and propyl paraben MP-PP preservative in aceclofenac ophthalmic eye drop 0.1% formulated in phosphate buffer increases transcorneal permeation. The developed formulations were evaluated for their pharmacodynamics in albino rabbits, by measuring in-vivo study and were compared to a marketed voltrane ophthalmic solution.

Unusual architecture of extensor digitorum muscle of hand in conjunction with accessory belly of extensor carpi radialis brevis: a clinico-anatomical insight

The present article highlights an unusual combination of variations of the extensor digitorum and extensor carpi radialis brevis muscles in the dorsum of forearm and hand. The extensor carpi radialis brevis exhibited an accessory musculotendinous belly which inserted into the dorsal digital expansion of index finger. The extensor digitorum showed trifurcation into three distinct parts. Resultant multiple extensor tendon insertion pattern is reported upon highlighting the embryological basis and clinical importance. Knowledge of such anatomical variations adds upon the already existing information in literature and is also of profound interest to the clinician. Anatomical awareness of accessory multiple extensor tendons in the dorsum of hand is essential for successful management of extensor tendon injuries and graft transfer operations.

Traumatic endophthalmitis presenting as isolated retinal vasculitis and white-centered hemorrhages: Case report and review of literature

The article reports a case and review of the literature of endophthalmitis presenting as isolated retinal vasculitis. A 26-year-old male was observed to have white-centered retinal hemorrhages and retinal vasculitis following an occult scleral perforation. At presentation, the visual acuity was 20/60. With clinical suspicion of early endophthalmitis, he underwent wound exploration, scleral tear repair, vitreous biopsy and administration of intravitreal antibiotics. Microbiology evaluation revealed significant presence of methicillin-resistant coagulase-negative Staphylococcus epidermidis. Final visual acuity improved to 20/20 at 6 weeks postoperatively. Literature search revealed eight similar cases, all of them due to Staphylococcus species. Retinal vasculitis and white-centered retinal hemorrhages can be a presenting sign of early endophthalmitis, especially with non-fulminant pathogens like S. epidermidis.

Multifocal electroretinography in type 2 idiopathic macular telangiectasia

BACKGROUND

To characterize the electroretinographic response of the macula by multifocal electroretinography (mfERG) in patients with type 2 idiopathic macular telangiectasia (MacTel).

METHODS

A prospective study of mfERG in patients with type 2 MacTel was conducted from April 2009 to November 2009. mfERGs were recorded using a visual evoked response imaging system (MonElec2, Metrovision, Perenchies, France). The International Society for Clinical Electrophysiology of Vision (ISCEV) guidelines were followed. Patients with type 2 MacTel confirmed by fundus fluorescein angiography without subretinal neovascularisation were included. For recording purposes, 61 stimulus hexagonal elements were used. The first-order kernel mfERG responses were analyzed. Individual mfERG responses for the hexagons were grouped into concentric rings centered on the fovea for analysis (< 2, 5-10, 10-15 and >15°). Student's t-test and Mann-Whitney U test and linear regression analysis was performed with STATA ver 11.1 (StataCorp, College Station , TX, USA).

RESULTS

Twenty eight eyes of 14 patients and 20 eyes of ten normal controls were included in the study. The mean logMAR visual acuity of the patients was 0.51 (Snellen equivalent 20/63). The mean N1 amplitude (nv/deg(2)) of patients were significantly reduced compared to controls and were as follows: 8.91 ± 14.00 vs 43.44 ± 9.55 (p < 0.0001) in less than 2°, 9.24 ± 10.47 vs 22.00 ± 3.87 (p < 0.0001) in 5-10°, 8.57 ± 10.02 vs 15.24 ± 1.89 (p < 0.0001) in 10-15°, and 7.03 ± 6.52 vs 12.47 ± 2.62 in > 15° (p < 0.001). The mean P1 amplitude (nv/deg(2)) was also significantly reduced in patients compared to controls and was as follows: 27.66 ± 37.44 vs 96.20 ± 12.41 (p < 0.0001) in less than 2°, 22.61 ± 19.38 vs 53.78 ± 9.79 (p < 0.0001) in 5-10°, 18.75 ± 20.21 vs 35.22 ± 4.16 (p < 0.001) in 10-15°, and 17.10 ± 12.54 vs 25.71 ± 3.93 (p < 0.001). The implicit time of N1 and P1 were also delayed significantly in all the rings. The mean central foveal thickness assessed by optical coherence tomography (OCT) scan was 84.78 ± 45.12 μm. There was poor correlation between mfERG amplitudes or implicit times with either the visual acuity or OCT central thickness.

CONCLUSION

mfERG showed significant reduction in amplitudes and implicit times of the waveforms in patients with type 2 MacTel in all the rings, suggesting a more generalized affection of the macula. The maximum reductions were seen in the <2(o) rings. Although there was poor correlation between the visual acuity and the amplitudes a of the waveforms, mfERG is a useful investigative modality for functional assessment of macula in type 2 MacTel patients.

Posterior scleritis in a 9-year-old boy: a case report

PURPOSE

To report a case of posterior scleritis in a 9-year-old boy.

METHOD

A case report.

RESULTS

Uniocular presentation in a 9-year-old boy.

CONCLUSION

Posterior scleritis is seen commonly in middle-aged women, associated with mild ocular congestion, globe tenderness, and varying amount of vision loss. We report an uncommon presentation of posterior scleritis in a young male child. The patient presented with decreased vision and extraocular and intraocular inflammatory signs in the left eye. Fundus examination showed disk and macular edema with a T-sign on B-scan ultrasound. The patient showed good response to oral steroids with resolution of inflammation and recovery of vision.

Esotropia in Kabuki syndrome

Kabuki syndrome is a mental retardation-malformation syndrome affecting multiple organ systems. The typical facies resembles the make-up worn in Japanese Kabuki theater. Although there are several clinical findings, the ocular findings affecting vision have been underreported. The current patient shows esotropia and previously unreported nummular corneal opacities.

Anti-inflammatory activity of Dalbergia lanceolaria bark ethanol extract in mice and rats

Topical anti-inflammatory activity of Dalbergia lanceolaria Linn. bark ethanol extract was demonstrated in albino mice using TPA-, EPP- and AA-induced ear edema models. The systemic activity of extract was confirmed using acute and sub-acute anti-inflammatory models in albino rats. The ethanol extract exhibited significant systemic anti-inflammatory activity in Carrageenan-induced rat paw edema, by inhibition of histamine and prostaglandin phases of acute inflammation. The extract also showed significant activity against turpentine-induced exudative changes and no activity against granular tissue formation in cotton pellet-induced granuloma in albino rats. Thus, resultant anti-inflammatory activity might be due to effects on several mediators involving cyclo-oxygenase pathway resulting in prostaglandin formation and leukocyte migration from the vessels.