Everting Sutures for Involutional Entropion: A Non-incision, Simple and Cost-Effective Technique.

Entropion is one of the common eyelid marginal malposition and it causes irritation, and ulceration of the cornea that leads to visual loss of a patient. Patient may present with watering and foreign body sensation of the eye initially. Entropion may occur in the upper or lower eyelid. Involutional entropion is common and affected the lower eyelid. There are various non-surgical and surgical options to correct the entropion. Non-surgical procedures include taping the lower eyelid which relieves the entropion temporarily, botulinum toxin type-A injection into lower eyelid may temporarily relief the discomfort from entropion up to 6 months. This study was carried out to assess the outcome of the everting sutures for the correction of lower eyelid involutional entropion and to describe the cost effective of the procedure. A nonrandomized, non control group quasi experimental study was conducted in a Tertiary Eye Hospital, in Gopalganj, Bangladesh from January 2016 to December 2019. A less invasive everting sutures technique was applied for the correction of involutional entropion of eyelid. Follow up was maintained at regular intervals and we assess the outcome of the surgical techniques. We evaluated 33 eyes of 31 patients. The success rate was 87.88%. Recurrences were observed in 5(15.15%) eyelids in the 18 months follow up times. The time of the procedure was only 10 minutes, and the cost of the procedure was cheaper. Everting sutures was minimal invasive, non-incision, cost effective procedure for the correction of involutional entropion.

Ziprasidone-loaded arabic gum modified montmorillonite-tailor-made pectin based gastroretentive composites.

Novel diethanolamine-grafted high-methoxyl pectin (DGP)-arabic gum (AG) modified montmorillonite (MMT) composites were developed for intragastric ziprasidone HCl (ZIP) delivery by combining floating and mucoadhesion mechanisms. The ZIP-loaded clay-biopolymer matrices were accomplished by ionotropic gelation protocol utilizing zinc acetate in the presence or absence of covalent crosslinker, glutaraldehyde (GA). Various formulations exhibited excellent drug entrapment efficiency (DEE, %) and sustained drug release profiles, which were influenced by the polymer-blend (DGP:AG) ratios, reinforcing filler (MMT) existence and crosslinking procedure. The optimal composites (F-3) demonstrated DEE of 61% and Q8h of 52% with outstanding buoyancy, mucin adsorption ability and biodegradability. The release profile of F-3 was best fitted in the Korsmeyer-Peppas model with Fickian diffusion driven mechanism. The mucin adsorption to composites F-3 followed Freundlich isotherms. The molar mass between crosslinks of composites (F-3) calculated employing Flory-Rehner equation was increased with temperature. Moreover, the thermal, X-ray and infrared analyses confirmed a compatible environment of drug in the composites, except certain extent of transformation of the crystalline drug to its amorphous form. The SEM studies revealed the spherical morphology of the composites. Thus, the newly developed DGP-AG-MMT composites are appropriate for gastroretentive ZIP delivery over an extended period of time.

Metabolism-mediated interaction potential of standardized extract of Tinospora cordifolia through rat and human liver microsomes.

OBJECTIVE: Tinospora cordifolia is used for treatment of several diseases in Indian system of medicine. In the present study, the inhibition potential of T. cordifolia extracts and its constituent tinosporaside to cause herb-drug interactions through rat and human liver cytochrome enzymes was evaluated. MATERIALS AND METHODS: Bioactive compound was quantified through reverse phase high-performance liquid chromatography, to standardize the plant extracts and interaction potential of standardized extract. Interaction potential of the test sample was evaluated through cytochrome P450-carbon monoxide complex (CYP450-CO) assay with pooled rat liver microsome. Influence on individual recombinant human liver microsomes such as CYP3A4, CYP2D6, CYP2C9, and CYP1A2 isozymes was analyzed through fluorescence microplate assay, and respective IC50 values were determined. RESULTS: The content of tinosporaside was found to be 1.64% (w/w) in T. cordifolia extract. Concentration-dependent inhibition was observed through T. cordifolia extract. Observed IC50 (µg/ml) value was 136.45 (CYP3A4), 144.37 (CYP2D6), 127.55 (CYP2C9), and 141.82 (CYP1A2). Tinosporaside and extract showed higher IC50 (µg/ml) value than the known inhibitors. T. cordifolia extract showed significantly less interaction potential and indicates that the selected plant has not significant herb-drug interactions relating to the inhibition of major CYP450 isozymes. CONCLUSIONS: Plant extract showed significantly higher IC50 value than respective positive inhibitors against CYP3A4, 2D6, 2C9, and 1A2 isozymes. Consumption of T. cordifolia may not cause any adverse effects when consumed along with other xenobiotics.