The present work mainly emphasized on the enhancement of solubility of Ticagrelor by developing Self- Micro emulsifying drug delivery system. Ticagrelor is a BCS class IV drug with poor aqueous solubility and permeability. The saturated solubility of Ticagrelor in various oils, surfactants and co-surfactants was determined by using UV-spectroscopy. The excipients were selected based on their maximum solubility and compatibility for Ticagrelor. SMEDDS formulations od Ticagrelor were developed using different oils, surfactants and co-surfactant combinations (4:1 and 3:1). Pseudo ternary phase diagrams were constructed and based on pseudo ternary phase diagrams, Nano emulsification area was evaluated .Formulations were designed based on the pseudo ternary phase diagram using various proportions of oil (Capmul MCM E8 EP), surfactant (Labrasol), co-surfactant (PEG-400). The prepared formulations were selected among them F1 was optimized and carried out for further evaluations like dispersibility test, self-emulsification time ,phase separation and stability test, thermodynamic stability studies, droplet size and zeta potential, invitro drug release studies. The results of present study demonstrate that Ticagrelor SMEDDS can be used as a potential means for improving the solubility of Ticagrelor.

The objective of the present study is aimed to formulate and evaluate sustained-release Mebeverine hydrochloride capsules using the Pelletization technique. Mebeverine hydrochloride, an anti-spasmodic drug is highly water soluble with a half-life of 2h and is suitable to develop sustained action for the treatment of irritable bowel syndrome. Mebeverine hydrochloride prolongs medication release in the GIT and, as a result, into the plasma, while reducing the frequency of drug administration, adverse effects, and patient compliance. Mebeverine hydrochloride were prepared by using polymers The drug-polymer and excipient compatibility was defined by the FTIR studies in the pre-formulation study. The calibration curve for the drug is plotted and checked the physicochemical properties. Six formulations (F1-F6) of Mebeverine hydrochloride pellets were prepared using different quantities of Ethylcellulose N 50 and other standard excipients. In vitro, drug release studies were performed for the pellets for 1.2, 4, 6, 8, and 12hrs. The optimized formulation F6 showed 76.8 % drug release after 12h showing that ethyl cellulose N 50 acts as a rate-controlling agent. The drug release of the chosen formulation follows first-order kinetics with a zero-order mechanism, according to absorption kinetics.

Dental complications are the main health problems worldwide and can cause harmful and irreversible loss to general human health. Therefore, there is a need to treat these problems. Most of the techniques for the prevention of these oral diseases are costly and lengthy; therefore, there is a need to introduce some effective, low-cost, and easy methods or medicine to deal with oral health issues. The combined mixture of extracts from T. chebula and A. nilotica proven to treat sore throat and ulcers of the mouth. Eucalyptol is one of the main compounds in the essential oil used for the preparation of an endodontic solvent and mouthwash. The important components present in the rhizome of the turmeric plant which can be used for the treatment of oral complications are essential oils (turmerones) and curcuminoids. Plant-based extracts can be used to prepare several types of mouthwash, toothpaste, and gel due to the presence of anti-microbial activities and a large number of beneficial compounds. This review paper aims to find the role of medicinal plants and their properties for the effective treatment of oral diseases in dentistry.

Background: Good storage practice is fundamental to prevent the deterioration of medications and to ensure their quality and safeties are maintained. This case study focuses on maintaining proper storage conditions without risking degradation. Case Presentation: An incident occurred in a paediatric pharmacy in Al-Sabah hospital, Al-Sabah medical area, Kuwait, in September 2021; an 11-year-old child diagnosed with weakness in the gastroesophageal valve and a physician prescribed omeprazole suspension preparation as an oral dosage form for daily based using. After dispensing 30 bottles from the pharmacy, the patient's parent stored all quantities dispended at room temperature rather than refrigerated. However, the medication company stated that the patient or healthcare giver should refrigerate before and after opening the bottle. Due to this inappropriate storage practice, the suspension preparations deteriorated and spoiled. Conclusion: Inappropriate dosage practices are preventable by simple solutions. Preparing training and assessment programs for pharmacists is essential to focus on the importance of proper and complete patient counselling and to ensure that the patient or healthcare giver stores medications in special storage conditions. Moreover, creating a policy for dispensing drugs that require specific storage conditions, such as labelling medications with specific storage conditions with specific-coloured labels and dispensing cooling boxes for them.

Inefficient and ineffective SCM in hospitals result in many consequences that may affect the quality of health services that are provided to patients. The implementation of an effective SCM practices required the existence of a set of factors that help and facilitate the successful implementation processes. These factors are known as Critical Success Factors (CSFs).This study aimed to identify the existed CSFs for effective SCM implementation in PSMC. The study population was all supply department's staffs and supply representatives from other departments who are involved in the SCM practices in (PSMC). A questionnaire was developed and distributed to collect data from the target population. The results showed that the existed CSFs included information sharing (63.9%). training and education on SCM activities (62%), communication (62%), organizational culture (58.3%), top management support (52.8%) and the recruitment standards for SCM staffs (47.2%). In addition, the results showed that there are two of the CSFs were not existed in PSMC. These CSFs are the using of a moderate IT applications (42.6%) and the adequate logistic information system (40.7%).From this study, it is recommended to provide the medical city with a moderated logistical information system, provide the medical city with moderated logistics technologies and software, implementing formal training on SCM practices, ensuring the applying of the recruitment standards which includes specific certificates for all new staffs and finally, developing a collaborative environment and using the cross functional teams that backed by the top management support.

Ginger (Zingiber officinale Roscoe), a popular herbaceous plant, has been generally used as a flavoring agent and herbal medicine for centuries. The main components of ginger rhizome are corbohydtrates, lipids, essential oils, terpenes and phenol compounds such as shogaol and gingerol. This systematic review aims to provide a comprehensive discussion in terms of the clinical effects of ginger in all reported areas. Clinical applications of ginger with an expectation of clinical benefits are receiving significant attention. The consumption of the ginger rhizome is a typical traditional remedy to relieve common health problems. Ginger shows the wide range of pharmacological and biological potential in the prevention and treatment of various diseases, like colds, nausea, arthritis, migraines, diabetes, allergy and hypertension.

Most of the desert lands contain sandy soils, which include large areas in the world. The sandy or loam soils in Upper Egypt were placed under investigate of soil texture, and moisture content –in addition some chemical analyses. Where, had very low organic matter (mean= 0.28) with available total dissolved salts (mean= 0.53) and alkaline pH-value (mean= 9.00). The moisture content of samples was very low (mean= 2.59). All of desert soil samples (100% of the samples) proved to be contaminated by filamentous fungi. A total of 121 fungal species + 7 varieties of 32 genera were isolated and identified on the isolation medium (1% glucose Czapek’s agar) at 28°C, based on dilution plate method. The gross fungal count was 94.36 colonies/mg dry soil. Aspergillus (36 sp. + 4 var.) was the most dominant genus based on frequency (95% of the samples) and count (55.34% of total fungal counts). Penicillium (28 sp. + 1 var.) had the second place (70% of the sample and 26.83% of grass count). Ulocladium occupied the third place (22.5% and 3.18%). Acremonium was one of the dominant genera (4th place). It occurred in 20% of the samples examined and 1.61% of gross fungal counts. The dematiaceous hyphomycetes, in addition ascospore-forming fungi were dominant in rare frequency. Whereas, sterile mycelia were high in frequency (52.5% of the samples) and low count (1.99% of gross fungal count).

Background/Purpose: Diabetes is a metabolic disease characterised by chronic hyperglycaemia, with disturbance of carbohydrate, lipid and protein metabolism, resulting from a defect in insulin secretion and/or action. The International Diabetes Federation (IDF) estimated in 2017 that 425 million people were living with diabetes worldwide. It is estimated that by 2045, 629 million adults will have diabetes. In Cameroon, a prevalence of 5.59% was recorded in 2018, regardless of gender [1]. In the Department of Dja and Lobo, an ethnopharmacological study was set up to identify and characterize the medicinal flower used in the management of metabolic syndrome. Material and methods: Surveys were conducted among 135 people. Data on medicinal recipes used in the management of diabetes, hypertension and obesity were collected according to a standardized framework. The plant samples mentioned were collected and identified at the National Herbarium of Cameroon and characterized. Phytochemical screening was performed on each species. Results: A total of 135 natives from six different villages were interviewed about plants used in the management of metabolic syndrome in the Department of Dja and Lobo. The study identified 85 species in 49 families. The fabaceae, asteraceae and flacourthiaceae families each had at least five species cited by the stakeholders who participated in our investigation. The medicinal plants inventoried totaled 7 biological types. In total 41 species were involved in the treatment of diabetes. The most used preparation methods were decoction and trituration. Phytochemical screening revealed the presence of flavonoids, Phenols, Polyphenols, Tannins, Saponins in almost all the extracts collected. Anthocyanins were extremely abundant in almost all extracts. Conclusion: The results obtained constitute a very valuable source of information for the region studied. The valorization of these plants and the determination of the health profile of the local populations of the Dja and Lobo department requires the establishment of modern processing units specialised in the manufacture of medicines.

Background: Fractures of the tibial plateau, which are intra-articular injuries of the knee joint, are often difficult to treat and have a high complication rate, including early-onset osteoarthritis. Various treatment options including proximal tibial plating with locking compression plates are available for the treatment of tibial plateau fracture. Objective: The purpose of this research was to evaluate the functional outcome of tibial plateau fractures treated with locking compression plating; a technique found to effectively reduce post-operative co-morbidities. Material and Methods: This prospective and observational study was carried out in Multicentral base with Department of Orthopedic Surgery, Rajshahi Medical College, Rajshahi, Bangladesh from January 2020 to June 2022. All patients (n=256) enrolled in the study for the study were included and treated with a locking compression plate for tibial plateau fractures (Schatzker III-VI) after receiving informed written permission. Patients were monitored continuously with clinically, radiographically, and functionally at 6-weeks and 3-6 Month, fellow-up after surgery. Results: In our study of 256 cases, the mean age was 37.77 ±15.65 years. Most of the cases were Schatzker type VI (161 patients) 63% and type III (89 patients) 35%. The average duration for fractures union was 23.4 ±2.1 weeks. Superficial wound infection was the common complication seen in (6 patient) 2% cases. At six months, the mean knee society score (KSS) was 85 ±7.22 and majority of patients (245 patients) 95% had good results. Conclusion: The radiological and functional outcome of a locking compression plate is quite excellent. Tibial plateau fractures in adults can be effectively treated with this implant.

Background: Cholecystectomy is now has become a common abdominal surgery which is mostly laparoscopic in developed countries. In USA, almost 90% of cholecystectomies are laparoscopic. For gallstone surgery, laparoscopic cholecystectomy is considered as a "gold standard". Methods: This study was a cross-sectional study which was conducted at Kumudini Women’s Medical College, Mirzapur, Tangail, Bangladesh. The study was conducted in between March 2020- April 2022. The total sample size for this study was 121. Result: Most of the patients 29(24%) were aged between 20-29 years. Most of the patients 102(84%) were female whereas only 19(16%) were male. Most of the patients 61(50.4%) required 15-30 mint, 54(44.6%) required 30-60 mint and 6(5%) required more than 60 patients. 67(55%) patients stayed in the hospital for only 24 hours whereas most of the patients 42(35%) stayed for 2 days and only 12(10%) had to stay more than 2 days. Dense Adhesion was found in 4(3.3%) cases, Uncontrolled Bleeding in 3(2.5%), Fibrotic Gallbladder in 2(1.7%), and huge distended and thick Gallbladder in only 1(0.8%) case. Most common complication Wound infection was seen in 12(9.9%) patients whereas 4(3.3%) had Biliary leakage, 2(1.7%) had bile duct stricture, 2(1.7%) had Post-site Hernia. Conclusion: Laparoscopic cholecystectomy is considered to have the utmost advantages and is also related with less postoperative complications, reduce hospital stay, reduce the overall morbidity and mortality in comparison with open cholecystectomy.

Introduction: Ear diseases have been found to be important health problems among children. Nearly one third of Otorhinolaryngology outdoor attendance in the hospital comprised of paediatric age group. The problem is compounded by the fact that the children are economically dependent on their parents who are largely poor. However, the cause of hearing loss in children is more varied, including the etiologies. Objective: To find out ear diseases in children presenting at Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh. Materials and Methods: This hospital-based prospective study was carried at Department of ENT & Head-Neck Surgery, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh from January to December 2021. 985 patients below sixteen years of age presented to the ENT OPD during the study period. Of them, 450 had ear disease. All patients aged 16 years or younger presenting with ear diseases to the ENT clinic of the hospital and seen by ENT surgeons were enrolled into the study. The diagnoses were made on the basis of history and clinical examination. Results were expressed in numbers and percentages. Results: Out of 985 patients below sixteen years of age presented to the ENT OPD during the study period. Of them, 450 had ear disease. Five hundred and sixty one (64.4%) were males. The male to female sex ratio was 1.8:1. Table 2 the various types of ear disease were as CSOM (Chronic Suppurative Ottitis Media), ASOM (Acute Suppurative Ottitis Media) and OME (Ottitis Media with Effusion). Wax (33.6%) followed by CSOM (18.7%) and ASOM (13.8%) were the most common ear diseases in paediatric patients in tertiary care centre. Ear diseases commonly found in this study were in the age group of 6-10 years and most ear diseases were more common in boys. It was found that wax (33.6%) was the most common diagnosed ear disease. Conclusion: Ear diseases are most common condition in ENT OPD among paediatric age group. Wax, CSOM and ASOM were the three most common ear diseases. Improvement of health care facilities and awareness amongst health care providers would definitely be helpful in reducing the prevalence of ear diseases in developing countries.