Non-parenteral Drug Research Articles

Assessment of HIV Awareness among Prisoners as a Determinant of Effectiveness of Preventive Measures in Risk Groups

Introduction: HIV prevention and spread of this infection remain key issues of epidemiology. In this respect, appropriate preventive measures are taken in the Tyumen Region among prisoners, a specific group at risk of HIV infection and spread. In terms of epidemiology, it seems important to analyze HIV awareness among convicts for further elaboration or amendment of preventive actions currently taken in the region for this contingent. Objective: To assess the level of awareness of HIV risks under conditions of the penitentiary system among prisoners. Materials and methods: The survey method, descriptive-evaluative, analytical, statistical and epidemiological research methods with the calculation of intensive and extensive indicators are used in the work. The method of collecting primary sociological information is a questionnaire survey (November, 2021) of prisoners by entering answers into the author's questionnaire on paper. HIV-negative prisoners took part in the survey (n = 60; 20-50 years old; CI = 95 %; criterion sample). Results: The questionnaire-based survey of 60 male prisoners showed that the respondents were confident in a zero risk of HIV infection. Half of them believed that they would never get HIV while 95 % (n = 57) considered prison to be a risk-free zone. Only 63.3 % (n = 38) of the inmates agreed that any sexual intercourse posed a HIV risk. Besides, 73.3 % (n = 44) had never used intravenous drugs (they used non-parenteral drugs or not on a regular basis); 16.6 % (n = 10) favored “light” psychoactive substances or their temporary use. Fifty-five percent (n = 33) of the respondents were unaware of the recommended frequency of HIV testing and 38.8 % (n = 23) of them had been tested for HIV more than a year before the survey. Consequently, the members of the risk group do not realize themselves part of the problem, are poorly informed, and know little about HIV prevention and factors contributing to the spread of this deadly disease. Conclusions: The social group of prisoners is an important component in containment of the HIV epidemic process in the region. The survey results necessitate improvement of the HIV outreach program in the correctional system.

Chitosan Nanoparticle And Its Application In Non- Parenteral Drug Delivery

This study's main goals are to give an overview of chitosan-based nanoparticles used in a variety of non-parenteral applications and to call attention to new research on mucoadhesive and sustained release chitosan dosage forms. Chitosan is a biodegradable, biocompatible polymer that has been certified for use in wound dressings and is suitable for inclusion in human diets. For a variety of drug delivery methods, chitosan has been employed as a drug carrier in polymeric nanoparticles. Chitosan is a polymer with numerous possible uses since it has chemical functional groups that can be altered to serve particular purposes. The positive surface charges and mucoadhesive qualities of nanoparticles (np) made of chitosan and chitosan derivatives enable them to stick to mucous membranes and gradually release the therapeutic payload. This review will include examples of non-parenteral drug delivery techniques for treating eye infections, cancer, gastrointestinal disorders, pulmonary disorders, and cancer. Both in vitro and a few in vivo investigations show that chitosan has a low level of toxicity. This review looks at recent investigations on the characteristics, modifications, toxicity, pharmacokinetics, and preclinical trials of nanoparticles (np) made of chitosan for non-parenteral drug delivery.

Noninvasive Drug Delivery System Progress in Protein and Peptide Delivery

Protein and peptide drugs have tremendous therapeutic potential, and their usage in the treatment of various severe diseases has revolutionized the fields of pharmaceuticals and biotechnology. For successful therapeutic effects, several efforts have been made to deliver protein/peptide drugs through various routes of administration. Parenteral and nonparenteral drug deliveries are regarded as significant routes of drug absorption. However, there is a need to improve nonparenteral drug delivery systems (DDSs) through subsequent routes, including buccal, pulmonary, oral, ocular, transdermal, and nasal routes to increase drug absorption effectively. The study evaluated various DDS routes proposed for the distribution of proteins and peptides in terms of both parenteral and nonparenteral delivery systems. For this purpose, numerous research articles were searched from the year 2000 to 2021 using search engines such as PubMed, Google Scholar, Medline, ISI Web of Knowledge, and Bioline International while applying different keywords such as “protein and peptide drugs,” “drug delivery systems,” “parenteral and nonparenteral routes of drug delivery,” and “physicochemical barriers.” The invasive/parenteral routes have several limitations associated with drug delivery, such as poor patient compliance and the pain and discomfort associated with these routes inconvenience in treating the pediatric population. The oral route is one of the most convenient routes of noninvasive or nonparenteral drug administration; here, no pain and discomfort arise, thus helping in maintaining higher patient compliance or acceptance. The other routes of administration of proteins and peptides through buccal, intranasal, pulmonary, transdermal, rectal, and ocular routes have also been showing successful results. The success of the therapeutics is strongly influenced by the differential delivery of the targeted antigen, the choice of targeting protein or peptide, and the drug-release characteristics of the linker used. Furthermore, there should be an improvement in nonparenteral DDSs so that the drugs might be administered appropriately.

Chitosan/poly(lactic-co-glycolic)acid Nanoparticle Formulations with Finely-Tuned Size Distributions for Enhanced Mucoadhesion.

Non-parenteral drug delivery systems using biomaterials have advantages over traditional parenteral strategies. For ocular and intranasal delivery, nanoparticulate systems must bind to and permeate through mucosal epithelium and other biological barriers. The incorporation of mucoadhesive and permeation-enhancing biomaterials such as chitosan facilitate this, but tend to increase the size and polydispersity of the nanoparticles, making practical optimization and implementation of mucoadhesive nanoparticle formulations a challenge. In this study, we adjusted key poly(lactic-co-glycolic) acid (PLGA) nanoparticle formulation parameters including the organic solvent and co-solvent, the concentration of polymer in the organic phase, the composition of the aqueous phase, the sonication amplitude, and the inclusion of chitosan in the aqueous phase. By doing so, we prepared four statistically unique size groups of PLGA NPs and equally-sized chitosan-PLGA NP counterparts. We loaded simvastatin, a candidate for novel ocular and intranasal delivery systems, into the nanoparticles to investigate the effects of size and surface modification on drug loading and release, and we quantified size- and surface-dependent changes in mucoadhesion in vitro. These methods and findings will contribute to the advancement of mucoadhesive nanoformulations for ocular and nose-to-brain drug delivery.

A review on chitosan nanoparticles applications in drug delivery

Chitosan is a polymer naturally obtained by deacetylation of chitin. It is a polymer which is biodegradable and biocompatible regarded as safe for human dietary use and also approved for wound dressing applications. Because of their better stability, low toxicity, simple and mild preparation method and providing versatile routes of administration, chitosan nanoparticles have gained more attention as drug delivery carriers. Nanoparticles (NP) are prepared with chitosan and its derivatives possess a positive surface charge and mucoadhesive properties such that can adhere to mucus membranes and release the drug payload in a sustained release manner. Their sub-micron size is suitable for various applications in non-parenteral drug delivery for the treatment of cancer, gastrointestinal diseases, pulmonary diseases, drug delivery to the brain and ocular infections.

An Overview of Chitosan Nanoparticles and Its Application in Non-Parenteral Drug Delivery.

The focus of this review is to provide an overview of the chitosan based nanoparticles for various non-parenteral applications and also to put a spotlight on current research including sustained release and mucoadhesive chitosan dosage forms. Chitosan is a biodegradable, biocompatible polymer regarded as safe for human dietary use and approved for wound dressing applications. Chitosan has been used as a carrier in polymeric nanoparticles for drug delivery through various routes of administration. Chitosan has chemical functional groups that can be modified to achieve specific goals, making it a polymer with a tremendous range of potential applications. Nanoparticles (NP) prepared with chitosan and chitosan derivatives typically possess a positive surface charge and mucoadhesive properties such that can adhere to mucus membranes and release the drug payload in a sustained release manner. Chitosan-based NP have various applications in non-parenteral drug delivery for the treatment of cancer, gastrointestinal diseases, pulmonary diseases, drug delivery to the brain and ocular infections which will be exemplified in this review. Chitosan shows low toxicity both in vitro and some in vivo models. This review explores recent research on chitosan based NP for non-parenteral drug delivery, chitosan properties, modification, toxicity, pharmacokinetics and preclinical studies.

A randomized controlled trial of sublingual misoprostol and intramuscular oxytocin for prevention of postpartum hemorrhage.

In India, two third of maternal deaths occur in rural areas where there is lack of transportation facilities, lack of refrigeration to store the injectable uterotonic drug such as oxytocin, lack of skilled personnel to administer them and lack of sterile syringes and needles. Hence, this study was conceived to evaluate misoprostol as a safe, effective, easily administered non-parenteral drug in the prevention of postpartum hemorrhage. This study was conducted during the period from August 2012 to July 2014. Low risk women with singleton pregnancy at term admitted for vaginal delivery were eligible for the study. A total of 500 women were randomized to two groups, 250 in each group, either to receive 400 mcg misoprostol sublingually or 10 units oxytocin intramuscularly at the delivery of anterior shoulder. Patient factors, labor parameters, blood loss and side effects were noted. The women in both the groups were well matched with respect to age, parity, gestational age and labor parameters. There was statistical significance in the blood loss (p = 0.04) between the two groups. The average blood loss was 70 ml in misoprostol group and 75 ml in oxytocin group. Shivering was the statistically significant side effect (p = 0.004) in the misoprostol group and nausea was the statistically significant side effect (p = 0.003) in the oxytocin group. Sublingual misoprostol is as effective as intramuscular oxytocin as a prophylactic oxytocic in the active management of third stage of labor for prevention of postpartum hemorrhage.

Association between tuberculosis and smoking.

BackgroundThe association between smoking and tuberculosis (TB), which has been proven in multiple studies with different study population ethnicity, has not yet received sufficient attention in terms of TB control.ObjectivesThe aim of the present study was to determine the association between TB and cigarette smoking in southeastern Iran, an endemic area for tuberculosis.Patients and MethodsThis prospective case-control study conducted at a University-Affiliated Hospital (Boo-Ali Hospital, Zahedan, and Southeastern Iran) from March 2007 to March 2012 enrolled 253 TB patients and 312 healthy controls. Factors including history of cigarette smoking, duration of smoking, number of cigarettes smoked per day, consumption of other drugs (parenteral and non-parenteral), and family history of tuberculosis and smoking, were evaluated in both cases and controls. Univarate and multivariate logistic regressions were performed to compare TB cases and controls. The odds ratio (OR) and 95% confidence intervals (CI) were also estimated.ResultsThe results of the study revealed a significant difference between TB and control groups in relation to smoking (P < 0.0001). In multivariate logistic regression, cigarette smokers were 3.1 (95% CI: 1.4-10.3) times more frequent in TB patients compared with controls. Other factors that showed significant differences between TB patients and controls were the use of non-parenteral drugs (OR = 3.6, 95% CI: 2.2-21.4), family history of TB (OR = 6.6, 95% CI: 2.3-18.2), family history of smoking (OR = 2.8, 95% CI: 1.1-8.4), and smoking history of more than 10 years (OR = 1.6, 95% CI: 1.2-9.8).ConclusionsThe present study evidenced the association between TB and smoking. It is therefore recommended to include interventions for smoking cessation in the current TB control practice.

Incidence and risk factors for heterosexually acquired HIV in an inner-city cohort of women: temporal association with pregnancy.

A growing proportion of AIDS cases in the United States are due to heterosexual transmission of HIV, particularly in women. The risk of heterosexually acquired HIV was prospectively studied in a cohort of inner-city women with no history of parenteral drug use. Study participants were evaluated at 6-month intervals for the presence of HIV antibody, sexually transmitted diseases, self-reported sexual behavior, and drug use by self-report and urine screening. Of 449 initially HIV-negative women who were seen at least once in follow-up, 4 seroconverted to HIV, with a cumulative incidence of 2.4% at 30 months. Risk factors for HIV seroconversion included nonparenteral drug use (p < .02) and anal intercourse (p < .01). Sexually transmitted diseases were not associated with HIV, although the power to detect such an association was limited. In addition, 3 of 4 seroconverters became pregnant, yielding a rate of 55.5 pregnancies/100 person-years of follow-up compared with a rate of 11.1 pregnancies/100 person-years of follow-up in nonseroconverters (p < .03). The incident rate of heterosexually acquired HIV in this inner-city U.S. cohort of women who were not using parenteral drugs is comparable with that reported in some developing countries where heterosexually acquired HIV is endemic. Most seroconversions appeared related to risk behavior seen in association with nonparenteral drug use. The previously unreported association of incident HIV infection with pregnancy in this cohort may be related to either behavioral or biologic factors.

Validity of self-reported sexually transmitted diseases in a cohort of drug-using prostitutes in Amsterdam: trends from 1986 to 1992.

Rates of self-reported sexually transmitted diseases (STD) among drug-using prostitutes in Amsterdam have been shown to be declining. However, self reports may provide biased estimates. We determined the prevalence of risk indicators for and time trends in incorrect self-reported STD in a cohort of drug-using prostitutes. Rates of self-reported STD were validated with diagnosed STD from a special STD clinic for drug-using prostitutes. Between 1986 and 1992, 314 STD were diagnosed in 85 (65%) of 131 studied prostitutes. Overall, 34% of diagnosed STD was not reported in the cohort, referred to as underreporting. For 40% of reported STD, no diagnosis was obtained ('overreporting'). In spite of these misclassifications, absolute numbers of reported and diagnosed STD practically balanced. Underreporting was independently associated with longer residence in Amsterdam (OR = 2.34 per 5 years), more than six clinic visits between two cohort visits (OR = 0.31), daily use of non-parenteral drug (OR = 8.45) and mainly injecting heroin (OR = 6.93); overreporting was independently associated only with a lower frequency of clinic visits. Multivariate analyses showed that trends in underreporting and overreporting were in part explained by a higher number of visits in the cohort and by lower numbers of clinic visits between two cohort visits. Self-reporting of STD in our cohort is unreliable and misclassification prevalent; risk factors for and associates of self-reported STD are biased. Inferences drawn from self reports are potentially misleading and therefore such data need to be validated. Trends in misclassification can be interpreted as recall errors and as a study participation effect. For monitoring of STD prevalences in relation to trends in sexual risk behaviours, diagnosed STD should be used in preference to self reports.

Neurologic Disease in Human Immunodeficiency Virus-Infected Drug Abusers

Previous studies of human immuno-deficiency virus-related neurologic disease have been either retrospective or have included mostly homosexual patients. We sought to determine (1) the true prevalence of neurologic abnormalities in patients with acquired immunodeficiency syndrome or lymphadenopathy acquired immunodeficiency-related complex, and (2) whether differences in prevalence or type of neurological abnormality exist between parenteral drug abusers and non-parenteral drug abusers. We prospectively evaluated 190 adult inpatients with either acquired immunodeficiency syndrome (129) or lymphadenopathy acquired immunodeficiency-related complex (61); 151 (80%) were parenteral drug abusers, and 172 patients (91%) had neurologic symptoms or signs. There was no significant difference in prevalence of neurologic disease between parenteral drug abusers and non-parenteral drug abusers, or between patients with acquired immunodeficiency syndrome and those with lymphadenopathy acquired immunodeficiency-related complex. The prevalence of neurologic symptoms in these patients with lymphadenopathy acquired immunodeficiency-related complex and acquired immunodeficiency syndrome is the highest reported to date and appears to reflect the prospective nature of the study.

Clinical and demographic features of patients admitted to a new chemical dependency program in New York City

We reviewed the clinical and demographic features of all 128 patients who were admitted to a new 28-day in-patient chemical dependency program in New York City during the first six months of operation. The medical records were reviewed retrospectively. Alcohol, cocaine, heroin, marijuana and diazepam were the most common substances abused. Parenteral drug abuse at any time was reported by 51 (40%) of the 128 patients, and 42 (33%) were current parenteral drug abusers. Abusers of alcohol only were significantly older than parenteral drug abusers or non-parenteral drug abusers. Patients who were employed at admission had a significantly longer mean length of stay and a higher rate of completion of the program than those who were not employed. We conclude that: (1) parenteral drug abuse is likely to be commonly seen in chemical dependency programs serving middle-income patients in urban areas, (2) alcohol abusers are older than abusers of other drugs, (3) a higher educational level is associated with successful completion of the chemical dependency program, and (4) evaluation programs are needed in all types of chemical dependency treatment.

Report on Cancer Risks Associated with the Ingestion of Asbestos

Cancer risks associated with ingestion of asbestos are discussed. Asbestos contamination of drinking water is considered. At least 66.5% of the United States water systems are capable of eroding asbestos cement pipes. The ability of water to leach asbestos from asbestos cement pipes can be modified by coatings applied to the inside pipe surface. Asbestos contamination in foods or pharmaceuticals is discussed. Asbestos fibers at concentrations of 1.1 to 172.7 million fibers per liter have been found in beverages. To date, studies supported by the Food and Drug Administration (FDA) have provided no evidence that ingesting asbestos results in an increased cancer risk. The FDA has determined that no prohibition on using asbestos filters in processing food, beverages, and non-parenteral drugs is needed. Toxicological studies on asbestos ingestion and carcinogenicity are reviewed. Epidemiological evaluations of the association between drinking-water supplies containing asbestos and cancer mortality are discussed. It is concluded that the available information is insufficient for assessing the risk of cancer associated with ingesting asbestos.

"Nonparenteral" Means "Enteric"

To the Editor.— Re: Liver Disease in Nonparenteral Drug Abusers (233:964, 1975): As a Greek by birth and quasilinguist by hobby, I should like to challenge the use of the term nonparenteral for other than needle-administered. Parenteral, as the Greek word is defined and all dictionaries agree, means other than intestinal (enteric); substances administered by inhalation are still parenteral, since they bypass the gastrointestinal canal. Furthermore, nonparenteral would mean nonnonenteric, or enteric. (Even by algebraic logic, [—a]×[—b]=+ab.) I suggest that authors find another term for other-than-needle-administered; what about nonmechanically invasive?

Liver Disease in Nonparenteral Drug Abusers

Liver function tests were performed in 500 young servicemen with a history of drug abuse. Serum glutamic oxaloacetic transaminase (SGOT) level was abnormal in 66% of 68 patients with a history of parenteral drug abuse. Forty-one percent of 432 patients with a history of only nonparenteral drug abuse also had elevated SGOT levels. A high incidence of liver disease in parenteral drug abusers is well established; however, to our knowledge, the magnitude of the problem in nonparenteral drug abusers has not been noted previously. Liver biopsy specimens in 34 of our patients showed either a classic viral hepatitis or a mild nonspecific hepatitis. Limited follow-up suggested a slowly resolving process. We conclude that hepatitis may be a common sequel to epidemic nonparenteral drug abuse.

Liver disease in nonparenteral drug abusers

Liver disease in nonparenteral drug abusers