Study of the structure and functioning of referral mechanism of patients receiving treatment and records linkage under Revised National Tuberculosis Control Programme (RNTCP) of Government of India.

BACKGROUND: The reliable and successful performance of the Revised National Tuberculosis Control Programme (RNTCP) "referral mechanism" is profoundly important in the medical college scenario, and it is an important requirement of the programme to have feedback status report of the referred patients. METHODS: An observational study on tuberculosis (TB) patients referred from Directly Observed Treatment (DOT) Centre, Sri Venkateswara Institute of Medical Sciences (SVIMS) was conducted during the years 2010 to 2012 (n=622). Subjects referred to other TUs within the District but failed to report there within 45 days constituted "cases" and subjects, who obtained treatment from the TUs they were referred to "controls". The initial information or confirmation of registration for treatment status feedback were obtained from patient/Senior Treatment Supervisor (STS)/District Tuberculosis Centre (DTC) levels respectively both before using intervention (Phase I, year 2010) and after using intervention (Phase II, years 2011 and 2012) by sending day-to-day text messaging of referral details of patients to the STS and District Tuberculosis Officer (DTO). RESULTS: During Phase I, the distribution of subjects (n=242) in the ages ≤25, 26-50, and ≥51 years was similar in both the cases and control subjects (p=0.054). Further, there was no statistically significant difference in the median age of the cases and controls [34.5 (interquartile range, IQR 31-51) vs 39 (30-54); p=0.319]. There was no statistically significant difference in other parameters, such as gender distribution (p=0.9748); availability of phone numbers (p=0.9614); type of disease (p=0.8395); and type of case (p=0.0793). In Phase II, the effect of intervention on feedback related parameters showed statistically significant improvement in all the parameters such as initial feedback levels obtained within 15 days (p=0.0077); within 45 days (p<0.0001); above 45 days (p<0.0001); registration status confirmation within 45 days (p=0.0343); mismatch of feedback received by observer (p<0.0001); and telephone number of patients recorded (p<0.0001). CONCLUSION: Our findings suggest that text messaging reminders may be an important tool to achieve optimal feedback response in resource-limited settings.

Dissolution Rate Enhancement of Repaglinide Using Dietary Fiber as a Promising Carrier.

In present investigation, an innovative attempt has been made to enhance the solubility and dissolution rate of Repaglinide (RPGD) using hydrothermally treated water insoluble dietary bamboo fibers (HVBF) as potential nutraceutical used in the treatment of diabetes mellitus. RPGD was selected as a model drug due to its low aqueous solubility and dissolution rate. Characterization of HVBF demonstrated the outstanding features like high surface area, maximum drug loading and increase dissolution rate and making HVBF as an excellent drug carrier. RHVBF (Repaglinide loaded HVBF) tablets were prepared using direct compression method. Pre and post-compression parameters for blend and tablets were studied and found within acceptable limits. RHVBF and tablet showed significantly improved dissolution rate, when compared with pure crystalline RPGD, physical mixture, RVBF and commercial marketed tablet. This fact was further supported by FT-IR, DSC, XRPD and FESEM studies followed by in-vitro drug release profile. Stability studies showed no changes after exposing to accelerated conditions for a period of 3 months with respect to physical characteristics and in-vitro drug release studies. In a nut shell, it can be concluded that HVBF is a novel, smart and promising carrier for poorly water soluble drugs, when administered orally.

Seismic characterization and dynamic site response of a municipal solid waste landfill in Bangalore, India.

Seismic design of landfills requires an understanding of the dynamic properties of municipal solid waste (MSW) and the dynamic site response of landfill waste during seismic events. The dynamic response of the Mavallipura landfill situated in Bangalore, India, is investigated using field measurements, laboratory studies and recorded ground motions from the intraplate region. The dynamic shear modulus values for the MSW were established on the basis of field measurements of shear wave velocities. Cyclic triaxial testing was performed on reconstituted MSW samples and the shear modulus reduction and damping characteristics of MSW were studied. Ten ground motions were selected based on regional seismicity and site response parameters have been obtained considering one-dimensional non-linear analysis in the DEEPSOIL program. The surface spectral response varied from 0.6 to 2 g and persisted only for a period of 1 s for most of the ground motions. The maximum peak ground acceleration (PGA) obtained was 0.5 g and the minimum and maximum amplifications are 1.35 and 4.05. Amplification of the base acceleration was observed at the top surface of the landfill underlined by a composite soil layer and bedrock for all ground motions. Dynamic seismic properties with amplification and site response parameters for MSW landfill in Bangalore, India, are presented in this paper. This study shows that MSW has less shear stiffness and more amplification due to loose filling and damping, which need to be accounted for seismic design of MSW landfills in India.

Design and development of novel dual-compartment capsule for improved gastroretention.

The aim of the proposed research work was to develop a novel dual-compartment capsule (NDCC) with polymeric disc for gastroretentive dosage form, which will ultimately result in better solubility and bioavailability of Ofloxacin. Floating ring caps were formulated by using different natural polymers, separating ring band and swellable polymer located at the bottom of capsule. Formulated ring caps were assessed for coating thickness, In vitro buoyancy, In vitro drug release, release kinetics and stability studies. Coating attained by the capsule shell was found to be 0.0643 mm. Depending on nature of natural polymer used, most of the formulations showed buoyancy for more than 9 hrs. Developed formulation demonstrated considerably higher drug release up to 9 hrs. The developed formulation F(E2) depicted the drug release according to Korsmeyer-Peppas model. There was not any significant change in performance characteristics of developed ring caps after subjecting them to stability studies. The present study suggests that the use of NDCC for oral delivery of Ofloxacin could be an alternative to improve its systemic availability which could be regulated by the floating approach. The designed dosage system can have futuristic applications over payloads which require stomach-specific delivery.

Stimuli-sensitive layer-by-layer (LbL) self-assembly systems: targeting and biosensory applications.

Stimuli-sensitive layer-by-layer (LbL) self-assembly systems have generated much interest among researchers worldwide due to the simplicity of the process by which they are produced and their numerous applications in drug delivery. LbL self-assembly systems involve simple alternative adsorption of oppositely charged polyelectrolytes on core materials and are thus considered to be promising tools for drug delivery and biosensing. Here, we discuss the latest findings from research into LbL systems, with special emphasis on drug delivery systems. This review highlights various stimuli-responsive LbL systems and their targeting and biosensory applications. For the convenience of readers, these stimuli-responsive LbL systems are classified as exogenous stimuli-responsive LbL systems and endogenous stimuli-responsive LbL systems.

Design and statistical optimization of osmotically driven capsule based on push-pull technology.

In present investigation attempt was made to develop and statistically optimize osmotically active capsule tailor made from the concept of bilayer (push-pull) osmotic tablet technology. The capsule was comprised of active (drug) and push (osmogen) layer. Active layer was compressed in form of tablet by mixing known amount of drug and formulation excipients. Similarly push layer was made by compressing Mannitol with formulation excipients. Finally, both layers were packed in hard gelatin capsule having small aperture at top and coated with semipermeable membrane to form osmotically active capsule. Formulated and optimized capsules were characterized for Fourier transform infrared (FT-IR) spectroscopy, differential scanning calorimetric (DSC), scanning electron microscopy, In-vitro drug release study and Release models and kinetics. Statistically optimized formulation showed good correlation between predicted and experimented results, which further confirms the practicability and validity of the model.

Real-time nanomechanical and topographical mapping on live bacterial cells-Brevibacterium casei under stress due to their exposure to Co2+ ions during microbial synthesis of Co3O4 nanoparticles.

The study of elastic properties of microbial and mammalian cells using atomic force microscopy, with force-sensitivity as high as pico-Newtons and spatial resolution of a few nanometers, is proving to be a great tool for the real-time observation of the effects of drugs, biomolecules, metal ions, and nanoparticles on cell physiology in their natural environment. It has been shown that the Young's modulus of the cell surfaces is extremely sensitive to the surrounding environment. Recently, a broad array of microbes have been used successfully to synthesize nanocrystals of several metal and metal oxides in a controlled manner at room temperature after exposing them to various metal ion precursors. However, so far there is no report on the fate of their elastic properties and cell topography etc. during and after their exposure to the metal ions during the microbial synthesis of nanomaterials. Additionally, this information is also found to be extremely relevant to areas such as bioremediation, bioleaching, and biomineralization, where it is important to study the direct influence on the cell physiology in the presence of metal ions. Here, we report, for the first time, the use of AFM force-distance curves on live cells, to directly monitor (in real time) the changes in the surface-topography, surface-adhesion, indentation-depth, and Young's modulus of a metal-tolerant marine bacterium, Brevibacterium casei, isolated from the coast of the Arabian Sea, after its exposure to the Co2+ ions during the process of biosynthesis of nanoparticles. We earlier reported that this bacterium is capable of using the cobalt acetate as a precursor to synthesize protein-functionalized Co3O4 nanoparticles with very high crystallinity. Our study indicates a significant change in the morphology as well as elastic and adhesive properties of the Brevibacterium casei, where we found an increase in the adhesive properties and the indentation depth of the bacterial surfaces and a decrease in the cell stiffness after several hours of exposure to the cobalt acetate. We have discussed both qualitative and quantitative analysis of the force-spectroscopy data in detail.