Background: Genital prolapse is a very common gynaecological disorder in Bangladesh but women do not admit this problem due to shame, ignorance, social taboo and insolvency. The rural scenario is much more disastrous. Objective: To determine the risk factors & outcome of operative procedures of genital prolapse. Material & Methods: It was a cross sectional study. The research work had been carried out from July, 2019 to December, 2019 in the department of Obstetrics and Gynaecology at Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur. Hospital women patients had been caring with genital prolapse were considered in this study and asked for proper history. Data was collected by using pre-design questionnaire. All the patients included in the study were evaluated by detailed history, through physical examination and relevant laboratory investigations. The maximum extend of the prolapse was clinically measured during a valsalva maneuver or coughing and was confirmed by the patient as being the most severe protrusion. Written informed consent to participate in this study was taken. Result: The mean age was found 59±5.4 years with range from 50 to 70 years. Educational status of the patients, 85(85%) patients were illiterate & marital status more than half 52 (52%) Patients were living with husband and 47 (47%) patients were widow. Regarding occupational status, Three forth 72 (72%) Patients were housewives, 18(18%) were day laborer and 10 (10%) were worker. 23% patients were underweight, 67% patients had average body weight and 10 % were obese. Primi para were found 2(2%) multipara were 53 (53%) and grand multi para were 45 (45%). Number of living child of the patients. 1-2 child were found 10(10%) patients, 3-4 child were 48 (48%) and ≥5 child were 42 (42%) patients. History of abdominal surgery was found in 6(6%) patients, vaginal delivery was found in 100 (100%) Patients, home delivery was in 90 (90%), majority 44(44%) patients had prolong labour during delivery and 2% had instrumental delivery. 60% patients did heavy work during puerperium, 32% did moderate work and only 8% did light work. 31% patients were engaged in heavy physical activities, 20% suffered from chronic cough and 15 % suffered from chronic constipation. 85% patients were delivered by untrained birth attendant. 100(100%) patients had felling of something coming down, 20(20%) had retention of urine, 92(92%) had frequency of micturition, 51(51%) had backache, 53(53%) had difficulty in emptying bladder, 41(41%) had burning during micturition, 45(45%) had constipation, 38(38%) had stress incontinence, 25(25%) had dragging pain in lower abdomen, 22 (22.0%) had white discharge and 5 (5%) had irreducible prolapse. 80(80%) patients had 2nd degree of uterine prolapses, 15(15%) patients had 1st degree & only 5(5%) patients had 3rd degree of uterine prolapses. 90 (90%) patients had moderate cystocele, 69(69%) patients had moderate rectocele, 27(27%) patients had urethrocele, 36(36%) had decubitus ulcer, 40(40%) had stress incontinence and 17 (17%) had elongation of cervix. management of the study population by vaginal hysterectomy with anterior colporrhaphy and posterior colpoperineorrhaphy 70(70%), anterior colporrhaphy 15(15%), posterior colpoperineorrhaphy 5(5%), pelvic floor repair 10(10%).20(20%) had pyrexia, 5(5%) had hemorrhage, 15(15%) had urinary infection, 4 (4%) had local sepsis and 3(3%) had urinary retention. complete relief was found 93(93%) and 7 (7%) had partial relief. Conclusion: Genital Prolapse has a very high prevelance in multiparous women. There is a significant association between genital prolapse, history of collagen disease and childbirth-related pelvic floor trauma. Pyrexia and urinary infection were more common complication after surgical procedures of genital prolapse. Complete relief was found 93.0% of the patients.

The objective of this study was to formulate and evaluate Extended-release oxybutynin chloride tablets using a push-pull osmotic pump system. Oxybutynin HCL is a muscarinic antagonist used for the treatment of overactive bladder with symptoms of urinary incontinence, urgency, and frequency. PPOP are used to deliver drugs that are highly soluble in water. The drug is located in the upper compartment along with osmogent while the lower compartment consists of polymeric osmotic agents. The push pull technique has been formulated in the form of double-layer tablets by wet granulation. The nine formulations were prepared using oxybutynin chloride, HPMC, polyethylene oxide, Nacl, and other excipients, lubricants, and colouring agents. The tablets are coated with a semi-permeable membrane (cellulose acetate), followed by a film coating. The pre-compression parameters (Bulk density, tapped density, Carr’s index, Hausner ratio, and angle of repose) and post-compression parameters of the extended-release tablets (Hardness, friability, weight variation, thickness, and drug content) were all within limits. An FTIR study showed no interaction between API and HPMC and all excipients at the molecular level. In vitro release studies in 0.1 N HCl, and 6.0 phosphate buffer showed that the optimized F5 formulation extended the drug release by 93% after 24 h and the release profile was similar to a product from an innovator.

HIV (human immunodeficiency virus) is a virus that attacks the body's system. AIDS could be a chronic potentially life threatening condition caused by HIV. This article provides a summary of studies assessing the pharmacokinetics of antiretroviral drug Darunavir. Darunavir is a BCS class II drug which inhibits the HIV protease enzyme by forming an inhibitor-enzyme complex there by preventing cleavage of the polyproteins. This research work aims to increase the penetration of Darunavir into deeper layers of skin by formulating cubosomes of Darunavir into a genital Gel that helps in enhancing the Bioavailablity by providing first pass metabolism. Cubosomes were prepared by the Top- down approach (Emulsification method) employing GMO as a lipid phase vehicle, poloxamer 407 as a stabilizer and distill water as an aqueous phase. Darunavir is an antiretro viral drug with good bioavailablity. The prepared cubosomes were characterized by Visual examination, Entrapment efficiency, Particle size, Zeta potential, In-vitro drug release studies. Optimised formulation (F4) showed good response among all the opposite cubosomal preparation. This (F4) cubosomal prepration was made as Gel using Carbopol 974 BP,and are studied for pH, Drug content,and Diffusion studies. Among all the prepration DARf6 was found for example the utmost drug release. This novel cubosomal genital gel would be promising system for effective drug delivery.

In order to treat Hyperlipidaemia, Rosuvastatin, a Dyslipidaemia drug, inhibits the HMG-CoA reductase enzyme. However, the calcium form of Rosuvastatin (RST) has low bioavailability, undesirable dissolving characteristics, and issues with absorption. Thus objective of the study is to increase the solubility and dissolution rate of Rosuvastatin calcium a poorly water-soluble 3-hydroxy 3-methyl glutaryl CoA (HMG-CoA) Reductase inhibitor through inclusion Complexation with β-cyclodextrin (β-CD). Therefore, the goal of the current study was to create a Rosuvastatin tablet formulation for oral dissolution. Rosuvastatin immediate tablets were developed using the direct compression showed good results, the prepared inclusion complex with β-CD by kneading method exhibited greatest enhancement in solubility and fastest dissolution (97.363) % RST release in 15 min. The inclusion complex contains RST: β-CD (1:1) and (1:2) was formulated into tablets using super disintegrants like Sodium starch glycolate, Cross povidone and Croscarmellose. All the mentioned batches were prepared and granules were evaluated for pre-compression parameters such as bulk density, tapped density and compressibility index. Tablets were evaluated for weight variation, thickness, hardness, friability; disintegration time and were found to be within the limits. In vitro dissolutions were carried out in 0.05M phosphate buffer with a pH of 6.8. The prepared tablet was evaluated for various post compression parameters like hardness, friability, weight variation, thickness, and in-vitro dissolution.

Transdermal patches are cutting-edge drug delivery methods that are essential to the management of many diseases. Due to the avoidance of first pass metabolism the drug molecules are delivered into the systemic circulation at a controlled and predefined pace with the help of TDDS, which also helps to achieve efficient bioavailability. This study's goal was to create matrix-type Olmesartan medoxomil transdermal patches utilizing the solvent evaporation method and various polymer ratios, including HPMC 15 cps, HPMC 5 cps, and Eudragit S 100. Plasticizers like glycerin, propylene glycol, and PEG 200 are used, along with solvents like methanol and chloroform. According to FT-IR studies, pure drugs and excipients are compatible with each other. The generated patches are assessed for their thickness, weight variation, folding endurance, moisture content, drug content, surface pH, and in vitro diffusion studies. Among all the formulations, F6 showed the best characteristic properties and in vitro drug diffusion.

Transdermal patches are a cutting-edge drug delivery technology that is essential in the management of many disorders. As first-pass metabolism is avoided, TDDS can effectively increase bioavailability and aid in the delivery of drug molecules into the systemic circulation at a planned and controlled rate. This study's goal was to create matrix-type simvastatin transdermal patches utilising the solvent evaporation method and various polymer ratios, including HPMC 15 cps, HPMC E5, and Eudragit S 100. Plasticizers like glycerine, propylene glycol, and PEG 200 are utilised, along with solvents like methanol and chloroform. According to FTIR studies, pure drugs and excipients are compatible with each other. The tested patches are assessed for thickness, weight variation, folding endurance, moisture content, drug content, surface pH, and in vitro diffusion studies. The results indicated that the formulation F5 showed better characteristic properties and in vitro drug diffusion.

Verapamil Hydrochloride, an antihypertensive agent which is used as a calcium channel blocker. The aim of the present study was to formulate and evaluate Verapamil HCL sustained release pellets. The work is to obtain Verapamil HCL sustained release pellets by using HPMC based polymers i.e., HPMC AN6, HPMC E5, HPMC E15 in the sustained release layer. The verapamil Hydrochloride has pH-dependent solubility. To overcome the pH dependent solubility Fumaric acid was used that which provides micro-acidic environment. Different Ratios of Ethyl-cellulose and HPMC polymers were used to optimise and evaluate the formulation for the sustained release of the drug. It uses the Pelletization technology. This technique is practised to produce pellets of uniform size with high drug loading capacity and also to prevent the segregation and dust.

Cardiovascular diseases (CVDs) are common in patients with Non-insulin-dependent diabetes mellitus (NIDDM). Lack of exercise and obesity in the population; the main causes of T2D prevalence. Therefore there is a need for joint treatment of diabetes and CVDs. Calcium-channel-blocking drugs and angiotensin-converting–enzyme (ACE) inhibitors are considered very effective. Angiotensin-converting–enzyme (ACE) inhibitors are thought to be very efficient in reducing the risk of death and hospitalization in patients with HF (heart failure). These inhibitors act as potential regulators of insulin and cardiac failure. This review article focused on the mechanism of action of two the action of drugs, Enalapril (angiotensin-converting–enzyme (ACE) inhibitors) and nifedipine (Calcium-channel-blocker), and their clinical effect on reducing the CVDs and heart failure in T2DM patients. Furthermore, novel immuno targets are needed to discover in future that may lower the risk of deaths among diabetes patients.

Non-steroidal anti-inflammatory drugs (NSAIDs) like Ketorolac Tromethamine are frequently prescribed to alleviate pain associated with osteoarthritis, ankylosing spondylitis, acute sciatica, rheumatoid arthritis, and low back pain. Hydrogels are polymeric three-dimensional networks that are able to consume significant volumes of water and remain insoluble in water due to their physical and chemical crosslinking. They respond to temperature, pH and ionic strength. They can be prepared by using natural polymers such as dextran, pectin, alginate, or synthetic polymers such as polyvinyl alcohol, polyethylene oxide, and poly–hydroxy ethyl methacrylate. Hydrogels are used to deliver several drugs. Today, hydrogels have found a wide range of applications due to their non-toxic nature and low cost. The purpose of the current research was to formulate and assess a topical gel based on hydrogel that contained Ketorolac Tromethamine to treat inflammation and pain while reducing the gastrointestinal side effects associated with oral treatment. According to the FTIR analysis, Ketorolac Tromethamine doesn't interact with other excipients in a significant way. The physical characteristics, pH level, extrudability, spreadability, swelling property, in-vitro drug release study of hydrogel formulations were assessed. Using a dialysis membrane and a phosphate buffer solution with a pH of 7.4, in vitro and ex vivo release studies were conducted on the Franz diffusion cell. Among all formulations, HF4 showed high spreadability of 25.2 ±0.3 gm./cm/sec, extrudability, swelling index, in vitro drug release, and ex vivo drug diffusion. HF4 hydrogel showed no signs of skin irritation. The final formulation HF4 hydrogel shows an equal analgesic and anti-inflammatory effect as standard Ketorolac gel. It was found from the drug release kinetics that the Topical Ketorolac hydrogel HF4 drug release mechanism follows the Higuchi model and zero order.

The main aim of this research article is to Formulate and Evaluate the S-SNEDDS of Darunavir. Darunavir is an anti-retroviral protease inhibitor which is in use from long time, but it has poor bioavailability because of poor aqueous solubility and extensive first pass metabolism, when used in the form of conventional dosage form. As it is a BCS Class II drug, which shows low solubility and high permeability. The S-SNEDDS of Darunavir was prepared to improve its oral bioavailability and its release rate was evaluated by in vitro release. The solubility of Darunavir in various oils was to decide and identify the oil phase of formulations. Different oils, surfactants and co-surfactants were screened for their ability to emulsify the selected oil. The pseudo ternary phase diagram was used to know the self -emulsification region of formulation. The optimized S-SNEDDS formulation contain Darunavir (150mg), Caproyl®90(50mg), Labrasol® and Transcutol® mix (45 mg). The data of the FTIR confirms that there is no interaction observed and the drug and excipients was compatible with each other. The developed SNEDDS formulations were examined for nano emulsifying capabilities, and the resulting nano emulsions were investigated for self-emulsification efficiency, dispersibility and in-vitro dissolution. Centrifugation tests, particle size distribution, heating cooling cycle, zeta potential, and freeze thaw cycling were performed on the optimised formulations to establish the stability of the produced SNEDDS formulation. Further produced S-SNEDDS micromeritics studies were done. The formulation was shown to significantly improve drug release, with total drug release occurring within 60 minutes. Darunavir self-emulsifying formulation was thus effectively produced.

The main aim of this study was to develop hydrogel based controlled drug delivery system of Saquinavir mesylate as hard gelatin capsule which are able to deliver the drug at prolonged rate. The hydrogel was prepared by crosslinking HPMC 15 cps and Carbopol 971P and then granules are developed using MCC as diluent. Drug excipient compatibility was studied by FT-IR. The prepared hydrogels formulation are evaluated for Swelling index. Drug release from hydrogel was performed by using Franz diffusion cell. The prepared granules are evaluated for pre formulation studies (Bulk density, Tapped density, Angle of repose). The Saquinavir hydrogel capsule are evaluated for weight variation, Drug content uniformity (95%), Disintegration time (11 mins). In-vitro drug release studies are conducted for 12hrs by using USP type I apparatus which is showing drug release of 98%. From the drug release kinetics, it can be determined that the saquinavir hydrogel capsules drug release mechanism follows both the zero-order and Higuchi models. For all metrics, the formulation SHCF4 has demonstrated the best performance in accordance with pharmacopoeia standards.

Dabigatran Etexilate (DE), a prodrug of dabigatran, is a strong oral, reversible, and direct thrombin inhibitor with low oral bioavailability because of active efflux via intestinal P-glycoprotein receptors. By creating a self-emulsifying drug delivery system, the current work largely focused on improving the solubility of dabigatran. Dabigatran is a BCS class II medication with high permeability and poor water solubility. UV-spectroscopy was used to determine Dabigatran's saturated solubility in different oils, surfactants, and co-surfactants. Based on their maximum solubility and compatibility with Dabigatran, the excipients were chosen. Different oils, surfactants, and co-surfactant combinations were used to create SEDDS formulations of dabigatran (4:1 and 3:1). Pseudo ternary phase diagrams were created, and the nano emulsification area was assessed using these. Formulations were created utilising different ratios of oil (Capmul MCM NF), surfactant (Labrasol ALF), and co-surfactant (Transcutol HP) based on the pseudo ternary phase diagram. The produced formulations were chosen, and the 4:1 formulation underwent optimization and was subjected to additional tests, including self-emulsification time, phase separation and stability tests, thermodynamic stability studies, droplet size and zeta potential, and in vitro drug release investigations. According to the report's results, Dabigatran SEDDS are a viable system to increase Dabigatran's solubility.

Introduction: The Fibroscan® is a non-invasive test that assesses liver fibrosis by measuring the degree of liver elasticity. It occupies an important place in the evaluation of hepatic fibrosis in patients with chronic liver disease.The aim is to evaluate the interest of Fibroscan® in the evaluation of hepatic fibrosis in chronic HbeAg negative infections. Materials and methods: All patients with a chronic HbeAg negative infection from April 2019 to June 2022 were included. Chronic HbeAg negative infection is defined by: a normal clinical examination, a normal abdominal ultrasound, normality of transaminases at several times, AgHbs positive, AgHbe negative, and viral DNA less than 2000 IU/ml on quarterly monitoring over 1 year. The interpretation of the Fibroscan® results took into account 10 measurements validated by the device with the interquartile range (IQR) < 30% of the median and a success rate > 60%. Results: Out of a total of 753 Fibroscans® performed, 163 patients had a chronic HbeAg negative infection, i.e. 21.6%. The mean age of the patients was 49.6 ± 11.2. We note a female predominance of 52.1% with a sex ratio of 0.9. The median elasticity value was 5.6 Kpa (2.5 – 20 Kpa). Fibrosis was non-significant in 83.3% and fibrosis was significant in 16.6% (moderate fibrosis: 12%; severe: 1.3% and cirrhosis: 3.3%). There was a failure of the fibroscan in 13 patients (7.9%) with a BMI > 35 kg/m2 despite the XL probe. Conclusion: Fibroscan® showed the absence of significant fibrosis in the majority of patients with chronic HbeAg negative infection. It allowed the diagnosis of significant fibrosis and cirrhosis in 16.6% of cases. The fibroscan is an excellent non-invasive examination for the evaluation of fibrosis in chronic HbeAg negative infections.

Objectives of the study: the metabolic syndrome (MS) consists of a group of metabolic alterations that have insulin resistance as their common denominator and identifies a pathophysiological condition at high risk of developing cardiovascular disease and type 2 diabetes. 20% and 30% of the adult population is affected by MS Design and method: in this article the authors try to make a scientific contribution regarding the problems of some patient populations often having to necessarily take drugs with an important metabolic impact while developing an iatrogenic-based MS (IMS) and propose to further investigate the aspects and the clinical pharmacological problems of the population of psychiatric patients at risk of MS. Results: Although the prevalence of MS has been observed to be often higher in the urban population of some developing countries, there are patient populations who develop MS due to the extensive use of certain drugs with obesogenic-metabolic adverse effects, in particular some generations of antidepressant and neuroleptic drugs (NL) used in mental disorders and antiretroviral drugs, such as integrase inhibitors used in HIV infection. Conclusions: Populations at risk of IMS should be at the center of the search for an individualized precision medicine with the careful choice of pharmacological therapies and appropriate lifestyle. Unfortunately, precision medicine in the psychiatric field seems to be stopping its growth due to the lack of identification of biomarkers and indicators of psychopathology.

The positive diagnosis of autoimmune pancreatitis (AIP) can be challenging and poses a problem of differential diagnosis with pancreatic cancer. It’s most sensitive and specific biological marker is the serum IgG4 level. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) plays a key role in the positive and differential diagnosis. Treatment is based on corticosteroid therapy. We report the case of a 43-year-old female patient admitted for cholestatic jaundice with a cephalic pancreatic mass on imaging simulating pancreatic cancer.

Chemotherapy induced peripheral neuropathy is a disabling pain condition resulting from cancer therapy. However, no scientific data available for many herbal drugs which are locally used and evaluating these drugs would be worth to have scientific approach of using them. In this study an indigenous plant called Clerodendrum viscosum leaves have been used to evaluate the effect of plant in vincristine induced peripheral neuropathy in rat model. Vincristine sulfate was administered to Male sprague dawley rats to induce neuropathy. Pain behavior was assessed by Hot plate, Cold plate, sciatic function index and formalin test were also estimated. Animals were sacrificed and the sciatic nerve excised for histopathological studies. The whole preclinical studies revealed that the aforementioned plant extract exhibited less neuronal damage. The study concluded that methanolic extract of Cleodendrum Viscosum leaves can used against chemotherapy induced peripheral neuropathy.

Inflammatory bowel diseases (IBD) are Ulcerative colitis (UC) and Crohn‘s disease (CD). Conventional therapies are inadequate and are associated with several systemic side effects due to lack to localization of active moiety at the inflamed site. Colonic drug targeting is a novel potentially active area of research intended and focused on drug delivery for treating localized disease. Targeted drug delivery to the colon would ensure direct treatment at the disease site, lower dosing and fewer systemic side effects.