Administration Of Tablets Research Articles

Comparative Pharmacokinetics and Bioequivalence of 2 Formulations of Bosentan Dispersible Tablets in Healthy Chinese Volunteers Under Fasting and Fed Conditions.

Bosentan is a dual endothelin receptor antagonist widely used in the treatment of pulmonary artery hypertension. However, there are few reports on the pharmacokinetics (PK) and bioequivalence of bosentan dispersible tablets (32mg) in the Chinese population. This study aimed to evaluate the PK characteristics and bioequivalence of the test and reference formulations of bosentan dispersible tablets in healthy Chinese volunteers under fasting and fed conditions. A randomized, single-dose, 2-sequence, 2-period crossover study (fasting) and a 4-period replicate crossover study (fed) were conducted with 48 and 30 healthy volunteers, respectively. The bosentan plasma concentrations were measured by a validated ultra-performance liquid chromatography coupled with a tandem mass spectrometry method, and PK parameters were analyzed using noncompartmental methods. The bioequivalence statistical analysis showed that 90% confidence intervals for the geometric mean ratios of peak plasma concentration, area under the concentration-time curve (AUC) from time zero to the last measurable concentration, and AUC from time zero to infinity for the test and reference formulations were within the bioequivalence range of 80%-125% under both fasting and fed conditions. After the administration of bosentan dispersible tablets under fed conditions, the systemic exposure (based on AUC from time zero to infinity) was increased by approximately 15%-20%. These findings confirm the bioequivalence of the 2 formulations, and both formulations were well tolerated, with no safety-related adverse events reported. Given the wide therapeutic dose range of bosentan dispersible tablets for the treatment of pulmonary artery hypertension in children, the impact of food on its PK is not considered clinically significant.

Effective treatment of non-union after internal fixation of femoral neck fracture using integrated traditional Chinese and western medicine.

Hip fractures, particularly femoral neck and intertrochanteric fractures, represent approximately 6.37 % of all fractures, with incidence rates showing an upward trend annually. This report presents a case of a 55-year-old female with a femoral neck fracture who underwent internal fixation. One-year post-surgery, the patient continued to experience hip pain, and computed tomography (CT) scans revealed non-union of the fracture. The patient received an integrated treatment approach combining traditional Chinese and Western medicine, involving the alternating administration of osteopeptide tablets and Guijia Jiangu capsules, a proprietary herbal formulation. No additional pharmacological or surgical interventions were employed. Seven months after initiating the treatment, digital radiography (DR) examinations showed that the fracture had largely healed. At the seven-month follow-up, and nearly four years thereafter, the patient reported no discomfort in the hip region. Subsequent DR examinations revealed no signs of avascular necrosis of the femoral head, and no adverse events were noted. The internal fixation device was removed five years post-fracture. The results indicate that integrated traditional Chinese and Western medicine may effectively treat non-union after internal fixation of femoral neck fractures, though further studies are warranted to confirm these outcomes.

The effect of a new product based on quercetin and a thick extract of carrot seed root on the histological state of the rat cardiac muscle in the adrenaline-hydrocortisone-induced myocardial infarction

Aim. To study the effect of tablets with a thick extract of carrot seed root and quercetin on the histological state of the rat cardiac muscle in the experimental adrenaline-hydrocortisone-induced myocardial infarction. Materials and methods. The cardioprotective effect of tablets with a thick extract of carrot seed root and quercetin was studied on the model of acute adrenaline-hydrocortisone-induced myocardial infarction caused by subcutaneous administration of 0.1 % adrenaline hydrochloride solution in the dose of 1 mg/kg and 2.5 % hydrocortisone acetate emulsion in the dose of 12.5 mg/kg of the animal weight twice daily for a week. The tablets under research in the dose of 200 mg/kg and the reference drugs – “Thiotriazolin” and “Cratal” tablets were administered for 14 days – 7 days before the infarction modeling and 7 days of the myocardial infarction development, after which their effect on the histological state of the rat heart muscle was studied. Results. Modeling of the adrenaline-hydrocortisone-induced myocardial infarction in rats is accompanied by the appearance of focal necrotic changes in muscle cells, which in some cases are accompanied by initial regenerative manifestations in the form of granuloma formation; dystrophic processes of cardiomyocytes. The therapeutic and prophylactic administration of tablets from a thick extract of carrot seed root and quercetin on the model of the adrenaline-hydrocortisone-induced myocardial infarction has the cardioprotective effect, reducing the severity of necrotic and dystrophic changes in the cardiac muscle. Conclusions. As a result of modeling of the adrenaline-hydrocortisone-induced myocardial infarction in rats, focal necrotic changes in muscle cells were observed, sometimes accompanied by the initial formation of a matrix consisting of young fibroblasts; dystrophic processes of cardiomyocytes, in particular myocytolysis, fluctuations in the size of nuclei. The therapeutic and preventive administration of the tablets studied on the model of the adrenaline-hydrocortisone-induced myocardial infarction has the cardioprotective effect, reduces the severity of necrotic and dystrophic changes in the cardiac muscle. By the cardioprotective effect expressiveness, tablets with a thick extract of carrot seed root and quercetin on the model of the adrenaline-hydrocortisone-induced myocardial infarction are not inferior to the reference drugs – “Thiotriazolin” and “Cratal” tablets. The results experimentally substantiate the feasibility of creating a new combined drug from a thick extract of carrot seed root and quercetin for the prevention and pharmacocorrection of a cardiovascular pathology.

Ivermectin as a promising therapeutic option for onchocerciasis-associated epilepsy.

Onchocerciasis, commonly known as river blindness, is a neglected tropical disease caused by the parasite Onchocerca volvulus. It can lead to blindness and visual impairment. Studies have also demonstrated a link between onchocerciasis and epilepsy, with there being a correlation between onchocerciasis endemicity and epilepsy prevalence. Onchocerciasis-associated epilepsy (OAE) emerges predominantly in individuals aged 3-18, with a notable prevalence in regions where onchocerciasis transmission persists. These areas exhibit elevated rates of epilepsy, underscoring the significant impact of ongoing onchocerciasis on the incidence of epilepsy, particularly within the specified age range. Both epilepsy prevalence and incidence have evolved over the past three decades in a Tanzanian area endemic for onchocerciasis. Researchers have studied the effects of the antiparasitic drug ivermectin on OAE. About one third of Ugandan patients saw reduced seizure frequency or intensity after one 150 μg/kg dose. Clinical research in the Congo among infected epileptics on anti-seizure medications (ASMs) suggested ivermectin may decrease seizure frequency following oral administration of ivermectin tablets (3 mg). Beyond its antiparasitic properties, ivermectin has demonstrated anticonvulsant effects against clonic and tonic-clonic seizures, likely through modulation of GABAA receptor and neuroinflammation. There is evidence of synergistic effects when combined with GABAergic ASMs like diazepam. As neuroinflammation plays a key role in OAE, ivermectin's anti-inflammatory properties by inhibiting cytokines like TNF-α and IL-1β are also relevant. While certain other antiparasitic drugs can interact with ASMs and have side effects like seizures, no such interactions or side effects have been reported for ivermectin. However, there is a need for more randomized controlled trials specifically evaluating ivermectin's impact on seizures in O. volvulus-infected epileptics on ASMs. Given its efficacy against parasites, limited side effects, and potential anticonvulsant mechanisms, ivermectin could be a favorable first-line treatment option, but further research is warranted to confirm benefits for OAE. PLAIN LANGUAGE SUMMARY: This article explores the potential benefits of ivermectin, a drug commonly used to treat parasitic infections, for reducing seizures in people with epilepsy linked to onchocerciasis, also known as river blindness. Research shows that ivermectin not only targets the parasitic cause of the disease but may also help reduce brain inflammation, which plays a key role in epilepsy. While early results are promising, more research is needed to confirm whether ivermectin can be a reliable treatment for epilepsy in people affected by this condition.

Oral solid dosage form using alternate crystalline neratinib maleate anhydrous form: Pharmaceutical, bioequivalent, and clinical perspectives.

Neratinib (an active pharmaceutical ingredient [API]) is an irreversible pan-human epidermal growth factor receptor (HER) inhibitor used to treat HER2-positive breast cancer. The dosage form (marketed in the United States, China, Europe, and other regions) is a tablet for oral administration, and the brand product (NERLYNX) has patent protection for the crystalline neratinib maleate monohydrate form. This paper describes the product development using stable crystalline neratinib maleate anhydrous form, stability study, bioequivalence (BE) study of the products, and discussion of the adverse effects observed in the clinical study.

The Analgesic and Side Effects of Tramadol Hydrochloride Immediate-Release and Extended-Release Tablets in Patients With Chronic Low Back Pain.

There are no established treatments for low back pain. Conventional treatments includephysiotherapyand pharmacological treatments, such as non-steroidal anti-inflammatory drugs (NSAIDs). Recently, analgesics with mechanisms of action different from those of NSAIDs have emerged. Tramadol formulations have especially attracted attention for being effective among patients in whom NSAIDs are not entirely effective. However, they are associated with side effects that can disrupt treatment. Tramadol hydrochloride immediate-release and extended-release tablets havebeen recently launched. Herein, we report our experience with these formulations in chronic low back pain patients. To investigate the incidence of side effects and the analgesic effect of tramadol hydrochloride immediate-release and extended-release tablets in patients with chronic low back pain. This was a multicenter retrospective observational study. The study included patients prescribed tramadol hydrochloride immediate-release and extended-release tablets for chronic low back pain at 13 facilities in Japan between January 2021 and December 2023. The primary outcome was the incidence of side effects observed during the study period. The secondary outcomes were changes in the visual analog scale (VAS) score. The incidence of side effects was 37.7% (40/106 cases), which included constipation, nausea, drowsiness, and dizziness in 23 (21.7%), 13 (12.3%), 4 (3.8%), and 2 (1.9%) cases, respectively. The rate of treatment discontinuation owing to side effects was relatively low (16/106 cases, 15.1%). Furthermore, after four weeks of treatment, we found a significant reduction in the VAS scores for low back pain from baseline. This study shows the incidence of side effects following the administration of tramadol hydrochloride immediate-release and extended-release tablets. Regarding the breakdown of side effects, constipation, nausea, drowsiness, and dizzinesswere noted. Regarding pain evaluation, we found a significant reduction in the VAS scores for low back pain from baseline after four weeks of treatment, suggesting that tramadol hydrochloride immediate-release and extended-release tablets may provide excellent analgesic effects owing to their pharmacokinetic properties that ensure stable tramadol concentrations in the bloodstream.

Pharmacokinetics and bioequivalence of two formulations of mifepristone tablets in healthy Chinese subjects under fasting conditions: a single-center, open, randomized, single-dose, double-period, two-sequence, crossover trial.

A bioequivalence (BE) study was performed to evaluate the pharmacokinetics, safety, and bioequivalence of two formulations of mifepristone tablets in healthy Chinese volunteers under fasting conditions. A single-center, open, randomized, single-dose, double-period, two-sequence, crossover study in healthy subjects under fasting conditions was performed. The subjects received a single fasting dose of mifepristone (10mg/tablet) during the first and second periods, followed by a 14-day washout period, during which frequent pharmacokinetic (PK) sampling occurred up to 120h. The pharmacokinetic parameters of mifepristone were calculated based on the plasma drug concentration-time profile. Primary endpoints were the BE of major pharmacokinetic parameters (AUC0-t and AUC0-∞) and the maximum observed serum concentration (Cmax). Secondary endpoints were safety parameters. Forty subjects (34 male and 6 female subjects) were randomly assigned to treatment, with 39 completing the two-period study. After the single administration of mifepristone tablets (test preparation vs. reference preparation) under fasting conditions, the geometric mean ratios (GMRs) of Cmax, AUC0-t, and AUC0-∞ were 98.76%, 104.28%, and 104.83%, respectively. The primary metabolites of mifepristone (RU42633 and RU42698),the GMRs of Cmax, AUC0-t, AUC0-∞ were 102.33% and 100.97%, 103.17% and 103.71%, 104.02% and 103.84%, respectively. Similarly, for another metabolite of mifepristone (RU42698), the GMRs of Cmax, AUC0-t, and AUC0-∞ were 100.97%, 103.71%, and 103.84%, respectively. All 90% confidence intervals (CIs) for the test/reference AUC ratio and Cmax ratio were within the acceptable range (80%-125%) for BE, which met the requirements of bioequivalence. No serious adverse events (AEs) occurred, and all AEs were classified as level 1 or 2. The PK parameters of mifepristone and its metabolites (RU42633 and RU42698) were measured using the (GMRs) of AUC0-t, AUC0-∞, and Cmax and were similar between the test and reference drug. The two formulations of mifepristone showed good tolerability and a similar safety profile. chinadrugtrials.org.cn, identifier CTR20182413.

Determination of QLNC-3A6 in canine plasma by UHPLC-MS/MS and its application in pharmacokinetic studies

Multi-targeted tyrosine kinase inhibitor QLNC-3A6 Di-maleate, a structurally novel small molecule compound, has therapeutic efficacy for the treatment of canine cutaneous mast cell tumor (CMCT) caused by mutations in the c-Kit gene. Since pharmacokinetic (PK) information plays an important role in the development and application of new drugs, etc., a rapid, highly sensitive and selective UHPLC-MS/MS analytical method was developed and validated for the first time in this study for the quantitative detection of QLNC-3A6 in canine plasma. 100 µL of plasma was precipitated using 350 µL of acetonitrile, and Chromatographic separation was performed on a Phenomenex Kinetex C18 column (50 × 2.1 mm, 2.6 µm) at a flow rate of 0.4 mL/min, the mobile phases were set to 0.1% formic acid aqueous solution (A) and 0.1% formic acid acetonitrile (B). The calibration curve linear range was 0.5–100 ng/mL (R 2>0.99). The intraday and interday precision values (relative standard deviation, RSD) were 2.06–13.57% and 6.90–9.14%. Intraday and interday accuracies were −10.73 to 9.54% and −3.86 to 0.70% respectively. The dilution integrity RSD value and stability RSD value were less than 3.77 and 7.45%, respectively. Subsequently, the pharmacokinetics were investigated in canine after oral administration of QLNC-3A6 Di-maleate tablets at a dose of 3 mg/kg BW using this method. The results showed that QLNC-3A6 showed fast absorption rate, rapid distribution and slow metabolic elimination in canine plasma. The results of the main PK parameters including λz, T 1/2λz, C max, T max and AUC last were 0.07 ± 0.01/h, 11.00 ± 2.57 h, 50.88 ± 31.94 ng/mL, 9.08 ± 11.57 h and 836.48 ± 230.53 ng h/mL, respectively.

Imipramine in dogs: A pharmacokinetic study following oral administration under fasted and fed conditions

This study investigates the pharmacokinetics (PK) of imipramine, a tricyclic antidepressant used in human psychiatric disorders and increasingly considered in veterinary medicine. Despite its longstanding use in canines, prior research on imipramine's PK in dogs is lacking. This study aimed to determine the PK of imipramine in dogs in regards to feeding conditions, and to ascertain whether desipramine (active metabolite) is formed or not. In this study, six male Labrador dogs underwent oral administration (1.5 mg/kg) of imipramine tablets (10 mg each; Tofranil®, Novartis) in both fasted and fed conditions. Dogs were randomly allocated to one of two treatment groups, employing an open, single-dose, two-treatment, two-phase, cross-over design, with a washout period of one week. Blood was drawn from the left cephalic vein to heparinized tubes at 0, 0.25, 0.5, 0.75, 1, 1.5, 2, 4, 6, 8, 10, 24, and 48 h. Plasma concentrations were quantified using a validated HPLC method, and the data were analyzed using PKanalix™ software with a non-compartmental approach.Concentrations of imipramine remained quantifiable up to 1.5 hr after administration under both conditions. Desipramine, in both feeding states, was detectable for a short duration, but not quantifiable. No significant differences were observed in the PK parameters of imipramine between the fasting and fed states. The rapid attainment of maximum concentration (Cmax) occurred within 0.25 h, indicating a swift absorption rate. Notably, the terminal half-life in dogs was remarkably short at 0.25 h, prompting a re-evaluation of dosing strategies. Considering the recommended therapeutic plasma concentrations in humans, the administered dose might result in effective levels for a brief period of time. Future research should explore intravenous administration, multiple-dose studies, and metabolic investigations to further elucidate imipramine's PK in dogs.

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome with Multiple Drugs (Leflunomide and Cefuroxime): A Case Report

Background: Adverse Drug Reactions (ADRs) are unexpected reactions to a medicine administered in the correct manner and at the proper dosage. Drug Rash with Eosinophilia and Systemic Symptoms syndrome (DRESS syndrome) is a Severe Cutaneous Adverse Reaction (SCAR) type of ADR with complicated clinical features involving several organ systems of the body; frequently involved organs are the liver, kidney, lungs, and other organs. Prompt recognition and correct diagnosis, followed by withdrawal of the causative agent, can promote appropriate treatment, accelerate recovery, and reduce the related morbidity and mortality. Case presentation: We have, herein, presented a case of a 42-year-old female with a history of leflunomide intake for plantar fasciitis. The patient subsequently developed fever, gastrointestinal tract disturbance, facial edema, liver injury, skin rash, hematologic abnormalities (eosinophilia), hepatosplenomegaly, and lymph node enlargement. The probability of leflunomide-induced DRESS syndrome was rated as “definite”, with seven scores graded by RegiSCAR. The suspected causative agent was withdrawn, and the patient was managed symptomatically. Following her management and discharge, she again encountered similar complaints after administration of the cefuroxime tablet. The causality assessment of the reactions was done using the WHO-UMC scale and Naranjo’s assessment scale, and a “probable” reaction was found for both drugs. Conclusion: The presented case contributes to the existing global literature regarding exceptional clinical presentations. Leflunomide and cefuroxime drugs have the potential to cause DRESS syndrome. Thus, they should be handled cautiously, and if such a reaction occurs, it should be reported to the responsible authorities.

Etiological Tracing Test and Drug Efficacy Test in a Case of Clinical Canine Toxic Liver Disease

This experiment is divided into three parts. A typical case report of canine toxic liver disease was recorded at the Huazhong Agricultural University Animal Hospital. The etiology tracing test focused on the daily life risk factors that induced the disease. The pathological model of toxic liver disease in mice was successfully established by the administration of household formaldehyde, floor cleaner and chlorine-containing disinfectant tablets. The drug efficacy test was carried out by the administration of self-made traditional Chinese medicine to the model mice, and to observe the therapeutic effect of traditional Chinese medicine prescription on the mice pathological model. It can be concluded that the daily life risk factors should be paid enough attention to in the dog's toxic liver disease. In comparison, within households that own dogs, the toxicity of chlorine-containing disinfectant is low in the normal dilution range, and its liver damage to mice is very light during the test. However, caution should be exercised when using floor cleaners and formaldehyde. Self-made traditional Chinese medicine has a good effect on this type of liver disease, but it should also pay attention to the dose, concentration and usage cycle.

Retrospective cohort study on the postoperative survival rate enhancement of patients with colorectal cancer using three traditional Chinese medicine formulations: evidence from 1,361 cases

Background: Prior studies have affirmed the safety and effectiveness of traditional Chinese medicine in treating colorectal cancer patients. However, definitive evidence regarding whether traditional Chinese medicine can significantly enhance the survival of colorectal cancer patients remains elusive. This study seeks to provide conclusive insights by examining the postoperative administration of Xihuang capsules, Pingxiao capsules, and Zilongjin tablets and its impact on the 5-year overall survival (OS) and disease-free survival (DFS) rates among colorectal cancer patients. Methods: A retrospective study was conducted, involving 1,361 patients selected from the medical center. This retrospective study was carried out at a medical center in Tianjin, China. We assessed differences in postoperative OS and DFS between the control group and the medication group using Kaplan–Meier survival analysis and Cox proportional hazards modeling. Additionally, propensity score matching was used to mitigate imbalances in baseline characteristics among patients. Results: Before propensity score matching, Xihuang capsules could prolong the 5-year OS (79.9% vs. 81.4%, P = 0.0480) and 5-year DFS (74.9% vs. 79.5%, P = 0.0046) of patients after surgery. Similar conclusions were obtained after propensity score matching: OS (74.8% vs. 78.3%, P = 0.0084), DFS (72.7% vs. 78.9%, P = 0.008). Patients taking Pingxiao capsules showed improved 5-year OS (77.2% vs. 84.0%, P = 0.0383) and 5-year DFS (69.9% vs. 80.0%, P = 0.0157) after propensity score matching. Patients taking Zilongjin tablets showed improvement in the 2-year OS (84.2% vs. 93.1%, P = 0.0390) and 1-year DFS (88.2% vs. 92.0%, P = 0.0320) after propensity score matching. Conclusion: Xihuang capsules and Pingxiao capsules significantly improved the 5-year OS and DFS of patients with colorectal cancer after surgery. Zilongjin tablets showed improvement in the 2-year OS and 1-year DFS after surgery for patients.

Simultaneous determination of Obeticholic acid and its two major metabolites in human plasma after administration of Obeticholic acid tablets using ultra-high performance liquid chromatography tandem mass spectrometry

Obeticholic acid (OCA), a semisynthetic bile acid derivative, was approved for its therapeutic use in primary biliary cirrhosis. OCA has a enterohepatic circulation and host-gut microbiota metabolic interaction, which produce various metabolites. Such metabolites, especially structural isomers of OCA, together with the need to achieve idea lower limit of quantitation (LLOQ) with minimum matrix interference, bring about significant difficulties to the bioanalysis of OCA. Herein, by applying a combination of solid-phase extraction (SPE) and ultra-high performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS), we introduced an approach for the bioanalysis of OCA along with its two major metabolites—glyco-OCA (GOA) and tauro-OCA (TOA) in human plasma, the full validation results of which showed excellent performance. The quantitative range is 0.2506 ∼ 100.2 ng/mL for OCA, 0.2500 ∼ 100.0 ng/mL for GOA, as well as 0.1250 ∼ 50.00 ng/mL for TOA, respectively. This method was successfully applied to the pharmacokinetic studies in healthy subjects following administration of OCA tablets.

The efficacy and mechanism of action of the Umei decoction in insomnia: A randomized active-controlled clinical trial

Insomnia, affecting the quality of life of millions globally, necessitates urgent and effective treatment strategies. This study conducted a randomized controlled trial to compare traditional and novel treatment methods in a cohort of 60 insomnia patients. Sleep quality and symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS). Additionally, transcranial Doppler (TCD) technology was employed to measure cerebral hemodynamic parameters. We divided the patients into two groups for insomnia treatment: (1) Control group: oral administration of zopiclone tablets; (2) Treatment group: oral administration of WuMei Decoction. The findings revealed that novel treatment approaches significantly improved sleep quality, disturbances, daytime functionality, and cerebral hemodynamic indicators. Furthermore, identifying 220 potential target genes through systems biology approaches offers new insights into the molecular mechanisms of insomnia and opportunities for drug development.

Exploiting the Applicability of Polytetrahydrofuran-Modified Polyester for the Fabric Phase Sorptive Extraction of Doxycycline from Human Urine.

In this report, a polytetrahydrofuran-coated polyester fabric phase sorptive extraction (FPSE) for the determination of doxycycline in human urine was described. The sol-gel polytetrahydrofuran sorbent proved to be superior against other sol-gel coated cellulose and polyester membranes tested. The effect of the extraction parameters including membrane surface area, sample pH and volume, salt concentration, extraction time, stirring rate, etc., on the extraction efficiency of the analyte was studied using the "one-factor-at-a-time" (OFAT) and Box-Behnken design approaches. The analytical method proposed was validated in compliance with FDA guidelines for bioanalytical procedures. The method was linear in the determination range of 100-5000 ng/mL with the determination coefficient of 0.9953. The limit of detection (LOD) and the lower limit of quantification for doxycycline was 17 and 100 ng/mL, respectively. The relative recoveries for intra-day and inter-day studies ranged from 98.5-112.2% and 89.6-96.8%, respectively. The relative standard deviation was lower than 14.7% in all cases, exhibiting good precision. The sol-gel polytetrahydrofuran-modified FPSE membranes were reusable for at least 30 times. The greenness of the developed method was evaluated using Sample Preparation Metric of Sustainability (SPMS) and Blue Applicability Grade Index (BAGI) metric tools. Finally, the analytical scheme was successfully employed for the quantitation of urinary doxycycline collected at various time points following the administration of doxycycline-containing tablets.

A Single Center Study on the Evaluation of Safety after Single Oral Administration of Peony Root Extract Tablets

A Single Center Study on the Evaluation of Safety after Single Oral Administration of Peony Root Extract Tablets

Impact of iron tablet administration and nutritional counseling: Hemoglobin level improvement in anemic pregnant women

Background: According to the 2013 Riskesdas, the prevalence of anemia in Indonesia was 37.1%. Data from the Pariaman City Health Office showed that the prevalence of anemia in 2014 was 43.1%. This study aims to determine the effect of iron (Fe) tablets and nutritional counseling on hemoglobin levels in pregnant women with anemia in the Pariaman City area in 2016. Methods: This study is a quantitative study using a quasi-experimental design. The study population consisted of third-trimester pregnant women with anemia, divided into two groups: the Fe tablet group (n=20) and the Fe tablet plus nutritional counseling group (n=20). Data analysis was performed using univariate and bivariate analysis with the Dependent T-Test statistical test. Findings: The results showed that the average knowledge score in the Fe group was 0.3, while in the Fe plus nutritional counseling group it was 1.4. The average change in knowledge scores between the two groups showed a significant increase (p=0.002). The average attitude score in the Fe group was 2.15, while in the Fe plus nutritional counseling group it was 2.75. The average change in attitude scores between the two groups was not significant (p=0.205). The average action score in the Fe group was 1.050, while in the Fe plus nutritional counseling group it was 2.7. The average change in action scores between the two groups showed a significant increase (p=0.002). The average difference in hemoglobin levels in the Fe group was 0.280, while in the Fe plus nutritional counseling group it was 0.690. The average change in hemoglobin levels between the two groups showed a significant increase (p=0.008). Conclusion: It can be concluded that the provision of Fe supplementation and nutritional counseling results in a higher increase in hemoglobin levels compared to Fe tablets alone. It is hoped that nutritionists in the field will be more active in providing nutritional counseling to pregnant women with anemia to increase their knowledge about anemia. Novelty/Originality of this article: This study proposes an integrated nutritional intervention model combining Fe tablets with a community-based interactive nutritional counselling program. This model can increase the effectiveness of anaemia control programs in pregnant women by combining supplementation and education.

KNOWLEDGE AND ATTITUDE WITH ADHERENCE TO FE TABLET CONSUMPTION IN ANEMIC ADOLESCENT GIRLS

Background: Iron anemia could be prevented through the administration of Fe tablets (TTD). Several studies had shown that one of the obstacles often encountered in the Fe tablet administration program was the problem of compliance. The low compliance of Fe tablets consumption in adolescent girls was influenced by several factors, one of which was the knowledge of female students regarding the benefits of consuming Fe tablets. Knowledge affected the attitudes and behavior of adolescents in choosing food, consuming Fe tablets supplementation, and further affected the overall nutritional condition of individuals including the condition of anemia status. Objective: This study aimed to demonstrate the connection between attitudes and knowledge about adherence to Fe tablets use in anemic adolescents at Pondok Pesantren Mambaus Sholihin, Gresik District, East Java. Methods: This type of research was quantitative research with a cross-sectional design, sampling using the total sampling method. Method in this research was an analytical observational study with a cohort retrospective design. The samples in this study were 81 adolescent girls aged 15-17 years who experienced anemia. The variables used in this study were knowledge, attitude and compliance. The instruments used were questionnaires and checklist forms. Compliance with Fe tablet consumption was carried out for the last 3 months. Results: Most respondents had sufficient knowledge related to anemia and Fe tablets around (31.1%) and most responders had a positive attitude of (56.8%) most respondents were not compliant with the consumption of Fe tablets by (58.0%). After the chi square test, the significance value (p=0.002) was obtained, which means that statistically there is a significant relationship between knowledge and Fe tablet consumption, and (p=0.000) there is a significant relationship between attitude and Fe tablet consumption. Conclusion: The study concluded that among teenage girls attending the Mambaus Sholihin Islamic Boarding School, there was a relationship between knowledge and attitude regarding the intake of Fe tablets.

Effects of Zhoutian moxibustion on pain symptoms and inflammatory factors in patients with ankylosing spondylitis of cold-damp obstruction

To observe the effects of Zhoutian moxibustion on pain symptoms and serum inflammatory factors in patients with ankylosing spondylitis of cold-damp obstruction. Eighty-four patients with ankylosing spondylitis of cold-damp obstruction were randomly divided into a Zhoutian moxibustion group (42 cases, 2 cases dropped out) and a governor vessel moxibustion group (42 cases, 2 cases dropped out, 1 case discontinued). Both groups were given oral administration of sulfasalazine enteric-coated tablets as basic treatment. The governor vessel moxibustion group was treated with moxibustion box from Dazhui (GV 14) to Yaoyangguan (GV 3), one hour per treatment; the Zhoutian moxibustion group was treated with moxibustion box from Tiantu (CV 22) to Zhongji (CV 3) in addition to the governor vessel moxibustion group, two hours per treatment. Both groups were treated once every 3 days, twice a week, for a total of 9 weeks. The pain symptom scores of the two groups were observed before treatment and at the 3rd, 6th, and 9th weeks into treatment. ELISA was used to detect the levels of serum interleukin (IL)-1β, IL-18, and tumor necrosis factor-α (TNF-α) before and after treatment, and the clinical efficacy of the two groups was evaluated after treatment. Except for the joint pain scores at the 3rd week into treatment, the total scores and the each sub-item score of pain symptom in the two groups were lower than those before treatment at the 3rd, 6th, and 9th weeks into treatment (P<0.05); at the 3rd, 6th, and 9th weeks into treatment, the total scores of pain symptom and the scores of lumbar sacral pain, back pain, joint cold pain, and limited mobility in the Zhoutian moxibustion group were lower than those in the governor vessel moxibustion group (P<0.05). After treatment, the levels of serum IL-1β, IL-18 and TNF-α in both groups were lower than those before treatment (P<0.05), and the levels of serum IL-1β, IL-18, and TNF-α in the Zhoutian moxibustion group were lower than those in the governor vessel moxibustion group (P<0.05). The total effective rate was 90.0% (36/40) in the Zhoutian moxibustion group, which was higher than 76.9% (30/39) in the governor vessel moxibustion group (P<0.05). Zhoutian moxibustion could effectively improve various pain symptoms in patients with ankylosing spondylitis of cold-damp obstruction, and reduce the expression of inflammatory factors.

Study of the Efficacy of Sublingual Route Administration of Levothyroxine Na Tablets vs Oral Route in Cases with Refractory Primary Hypothyroidism

Abstract Background Hypothyroidism is a common disorder, with a prevalence of approximately 5% and incidence of approximately 250 /100,000 per year in the adult population both prevalence and incidence keep raising. Levothyroxine is the recommended hormone for replacement therapy in both overt and subclinical hypothyroidism. Aim of the Work Levothyroxine (L-T4) is the standard therapy of hypothyroidism. Our purpose was to compare the efficacy of the L-T4 sublingual tablet administration to standard oral L-T4 tablet in hypothyroid patients with refractory hypothyroidism. Subjects and Methods Our study was conducted on 40 patients who were documented to be refractory to oral thyroxine age range 18- 55, 38 females and 2males. Patients were recruited from Endocrinology and Metabolism clinic at Ain-Shams University and Internal medicine outpatient clinic at 6th of October University during the period from June 2019 to October 2020 Informed consent was obtained from all subjects. Results In our study showed a significant decrease in mean TSH (write the figures) on sublingually administrated levothyroxine tablets compared to orally administrated levothyroxine tablets and a significant rise of mean free T4 after 1 week. yet after 6 weeks there was insignificant difference of FT4 compared to oral levothyroxine. Patients who were antiparietal cell antibody positive demonstrated a non significant rise of free T4 level with almost doubling of level compared to oral levothyroxine at 1 week and 6 weeks interval, this was associated with a significant decline of serum TSH at 6 weeks interval. Also This was associated with a significant improvement in hypothyroidism symptoms Conclusion In conclusion, our study indicated that sublingual route for LT4 tablet administration was safe and innovative route for LT4 administration,it could improve compliance, overcome many obstacles with oral administration for intake with food,coffee,drug interaction and GI malabsorption.