By Injection Research Articles

Gastric stasis in migraine and the efficacy of antimigraine drugs

Migraine is characterized by severe headache attacks with the development of accompanying symptoms. Among the most common are nausea and vomiting, which limit the intake of oral medications and thus reduce the speed of onset of pain relief and the efficacy of treatment in general. The development of gastric stasis in migraine is considered to be one of the most important reasons for the delayed absorption and inconsistent effect of oral triptans. The rapid action of triptans in the form of orally dispersible tablets, efficacy in relieving pain and accompanying symptoms, and ease of administration make this form favorable as a first-line agent for the relief of migraine attacks.

Oral Diabetes Medication Videos on Douyin: Analysis of Information Quality and User Comment Attitudes.

Oral diabetes medications are important for glucose management in people with diabetes. Although there are many health-related videos on Douyin (the Chinese version of TikTok), the quality of information and the effects on user comment attitudes are unclear. The purpose of this study was to analyze the quality of information and user comment attitudes related to oral diabetes medication videos on Douyin. The key phrase "oral diabetes medications" was used to search Douyin on July 24, 2023, and the final samples included 138 videos. The basic information in the videos and the content of user comments were captured using Python. Each video was assigned a sentiment category based on the predominant positive, neutral, or negative attitude, as analyzed using the Weiciyun website. Two independent raters assessed the video content and information quality using the DISCERN (a tool for assessing health information quality) and PEMAT-A/V (Patient Education Materials Assessment Tool for Audiovisual Materials) instruments. Doctors were the main source of the videos (136/138, 98.6%). The overall information quality of the videos was acceptable (median 3, IQR 1). Videos on Douyin showed relatively high understandability (median 75%, IQR 16.6%) but poor actionability (median 66.7%, IQR 48%). Most content on oral diabetes medications on Douyin related to the mechanism of action (75/138, 54.3%), precautions (70/138, 50.7%), and advantages (68/138, 49.3%), with limited content on indications (19/138, 13.8%) and contraindications (14/138, 10.1%). It was found that 10.1% (14/138) of the videos contained misinformation, of which 50% (7/14) were about the method of administration. Regarding user comment attitudes, the majority of videos garnered positive comments (81/138, 58.7%), followed by neutral comments (46/138, 33.3%) and negative comments (11/138, 8%). Multinomial logistic regression revealed 2 factors influencing a positive attitude: user comment count (adjusted odds ratio [OR] 1.00, 95% CI 1.00-1.00; P=.02) and information quality of treatment choices (adjusted OR 1.49, 95% CI 1.09-2.04; P=.01). Despite most videos on Douyin being posted by doctors, with generally acceptable information quality and positive user comment attitudes, some content inaccuracies and poor actionability remain. Users show more positive attitudes toward videos with high-quality information about treatment choices. This study suggests that health care providers should ensure the accuracy and actionability of video content, enhance the information quality of treatment choices of oral diabetes medications to foster positive user attitudes, help users access accurate health information, and promote medication adherence.

Perioperative medication therapy for Muslim patients in Germany undergoing oncological surgery: a retrospective study

PurposeEngagement of healthcare professionals with patients from diverse cultural and religious backgrounds is crucial in our multicultural society, where miscommunication and errors in medical history taking can lead to incorrect treatment. In particular, Muslim patients may present unique considerations due to their specific cultural and religious beliefs, which can significantly impact treatment outcomes. This study focuses on perioperative medication therapy for patients undergoing upper and lower gastrointestinal tract and pancreatic tumor surgery, specifically examining whether Islamic beliefs were duly considered in medication selection compared to a matching patient cohort.Materials and methodsData from January 2004 to July 2023 were analyzed. Muslim patients were identified using the onomastic method and matched with non-Muslim patients at a 1:3 ratio based on age, gender, and procedure. Analysis included examination of subcutaneous, oral, and intravenous medications, with attention to ingredients and compatibility with Islamic principles.ResultsAmong 5272 patients, only 5 met the study’s inclusion criteria as Muslim patients, undergoing procedures such as anterior rectum resection, gastrectomy, and pancreatic head resection. Their religious affiliations were not documented in the admission records. According to the matched-pair analysis, consistent treatment was performed regardless of religious beliefs. All patients received subcutaneous medication, primarily enoxaparin, instead of fondaparinux, an Islam-compliant alternative. Intravenous heparin was used once for short period. Contrary to Islamic dietary restrictions and the availability of alternatives, capsules containing animal-derived gelatin and other non-compliant medications were administered orally.ConclusionThis study underscores the importance of acknowledging Muslim patients’ cultural and religious backgrounds in the perioperative setting, as failure to do so may lead healthcare professionals to overlook their potential alternative medication needs, which are essential for providing tailored medical care in modern societies. Integration of diversity-related topics into medical curricula is essential for better preparing physicians for clinical practice and ensuring patient-centered care.

Exploring the Role of Social Support and Sexual Functioning: A Study of Chemsex and Sober Sex in Men Who Have Sex with Men

ABSTRACT Research on chemsex, the intentional use of certain drugs in sexual contexts by gay men and other men who have sex with men (MSM), has been growing in recent years although, even today, much of it focuses on drug use and its consequences, rather than on the sexual and social experiences of users. This study aimed to explore the influence of social support and sexual functioning on the frequency of chemsex and sober sex. A sample of 160 MSM WAS recruited through social media and NGOs. Through regression analysis, it was found that lower perceived social support and greater number of routes of drug administration predicted a higher frequency of chemsex practice. On the other hand, higher perceived social support, higher levels of desire and arousal, and fewer routes of drug administration predicted a higher frequency of engaging in sober sex. This study provides empirical evidence that both social support and sexual functioning are key elements in chemsex and have an impact on both the frequency of chemsex and sober sex. Given the importance of these elements, we suggest that interventions should be framed holistically. Nevertheless, not all chemsex is problematic and it is a free choice in sexuality.

Tethered gold-liposome nanoparticles for iontophoresis-enhanced topical delivery for anti-inflammation

Topical delivery is a widely utilized drug administration route globally due to its convenience, non-invasiveness, and minimal drug metabolism. However, the skin barrier, particularly the stratum corneum (SC), poses a challenge by hindering drug absorption and permeation. To address this issue, green-synthesized gold nanoparticles (AuG) were loaded into liposomes to increase electron density and facilitate cathodal iontophoresis for topical drug delivery enhancement. Ginger rhizome extract served as a model hydrophobic compound encapsulated within the gold-liposomes to evaluate its anti-inflammatory effect. Our study demonstrated that the ginger-gold loaded liposomes (AuGL) enhanced cellular uptake of the hydrophobic payload and improved drug penetration through skin layers compared to conventional liposomes following iontophoresis. We investigated different ratios of gold nanoparticles to liposomes and characterized the nanoparticles using DLS, TEM, and FT-IR. Additionally, AuGL significantly inhibited nitric oxide release and TNF-α in RAW 264.7 cells. Furthermore, we formulated AuGL-loaded topical emulgel, which exhibited good stability under accelerated conditions. Our findings suggest that the AuGL combined with iontophoresis offers superior benefits for topical drug delivery, potentially enabling the treatment of skin inflammations and inflammation-related skin cancers.

Advancements in Oral Drug Delivery of Insulin: A Review

Advancements in Oral Drug Delivery of Insulin: A Review

Ex vivo permeability study of poorly soluble drugs across gastrointestinal membranes: acceptor compartment media composition

Ex vivo drug permeability testing across gastrointestinal (GI) membranes is crucial in drug discovery and oral drug delivery. It is a reliable method for drugs with good solubility, but it poses challenges for poorly soluble drugs, which are common in development pipelines today. Although enabling formulations increase the apparent solubility in the GI compartment (dissolution vessel or permeation chamber's donor compartment), maintaining solubilized drug in the acceptor compartment during ex vivo testing remains largely unresolved. This review compiles and critically evaluates the diverse compositions of acceptor media used in ex vivo permeability studies for poorly soluble drugs, highlighting this significant yet underexplored aspect of pharmaceutical science. An algorithm is proposed for selecting solubility-enhancing additives for the acceptor media in ex vivo permeability studies of poorly soluble drugs.

Expanding Treatment Opportunities: Reviewing the Current State of Injectable Antiretrovirals for Treatment of HIV.

Antiretroviral therapy has evolved significantly over the last 20-30years, from requiring multiple tablets multiple times per day to single-tablet regimens and most recently, in 2021, long-acting injectable antiretrovirals. These long-acting antiretrovirals have expanded the treatment options for individuals with HIV who may have difficulty adhering to daily oral medications, difficulty taking oral medications, and/or individuals with multidrug-resistant HIV. This article reviews the currently available long-acting injectable antiretrovirals, including cabotegravir/rilpivirine, lenacapavir, and ibalizumab. The available data supporting these agents and current place in therapy will be discussed. Data supporting the use of additional long-acting injectable agents, broadly neutralizing antibodies, currently in the pipeline will be reviewed as well.

Innovations in Nanoemulsion Technology: Enhancing Drug Delivery for Oral, Parenteral, and Ophthalmic Applications.

Nanoemulsions (NEs) are submicron-sized heterogeneous biphasic liquid systems stabilized by surfactants. They are physically transparent or translucent, optically isotropic, and kinetically stable, with droplet sizes ranging from 20 to 500 nm. Their unique properties, such as high surface area, small droplet size, enhanced bioavailability, excellent physical stability, and rapid digestibility, make them ideal for encapsulating various active substances. This review focuses on recent advancements, future prospects, and challenges in the field of NEs, particularly in oral, parenteral, and ophthalmic delivery. It also discusses recent clinical trials and patents. Different types of in vitro and in vivo NE characterization techniques are summarized. High-energy and low-energy preparation methods are briefly described with diagrams. Formulation considerations and commonly used excipients for oral, ocular, and ophthalmic drug delivery are presented. The review emphasizes the need for new functional excipients to improve the permeation of large molecular weight unstable proteins, oligonucleotides, and hydrophilic drugs to advance drug delivery rapidly.

An mHealth App to Support Caregivers in the Medical Management of Their Child With Cancer: Beta Stage Usability Study.

Previous research demonstrated that caregivers of children with cancer desired a mobile health (mHealth) tool to aid them in the medical management of their child. Prototyping and alpha testing of the Cope 360 app (Commissioning Agents, Inc) resulted in improvements in the ability to track symptoms, manage medications, and prepare for urgent medical needs. This study aims to engage caregivers of children with cancer in beta testing of a smartphone app for the medical management of children with cancer, assess acceptance, identify caregivers' perceptions and areas for improvement, and validate the app's design concepts and use cases. In this pilot, study caregivers of children with cancer used the Cope 360 mHealth app for 1 week, with the goal of daily logging. Demographics and a technology acceptance survey were obtained from each participant. Recorded semistructured interviews were transcribed and analyzed iteratively using NVivo (version 12, QSR International) and analyzed for information on usage, perceptions, and suggestions for improvement. A total of 10 caregivers participated in beta testing, primarily women (n=8, 80%), married, with some college education, and non-Hispanic White (n=10, 100%). The majority of participants (n=7, 70%) had children with acute lymphocytic leukemia who were being treated with chemotherapy only (n=8, 80%). Overall, participants had a favorable opinion of Cope 360. Almost all participants (n=9, 90%) believed that using the app would improve their ability to manage their child's medical needs at home. All participants reported that Cope 360 was easy to use, and most would use the app if given the opportunity (n=8, 80%). These values indicate that the app had a high perceived ease of use with well-perceived usefulness and behavioral intention to use. Key topics for improvement were identified including items that were within the scope of change and others that were added to a future wish list. Changes that were made based on caregiver feedback included tracking or editing all oral and subcutaneous medications and the ability to change the time of a symptom tracked or medication administered if unable to do so immediately. Wish list items included adding a notes section, monitoring skin changes, weight and nutrition tracking, and mental health tracking. The Cope 360 app was well received by caregivers of children with cancer. Our validation testing suggests that the Cope 360 app is ready for testing in a randomized controlled trial to assess outcome improvements.

Beliefs surrounding the use of inhaled asthma medication in The Gambia: a qualitative study of asthma patients and healthcare workers

Asthma-related mortality is high in low- and middle-income countries. Little is known about public perceptions of inhaled medicines. We conducted semi-structured interviews with asthma patients and healthcare workers at three secondary care facilities in The Gambia, between August and November 2022. Thematic analysis was used to interpret these data. A total of 20 patients and 15 healthcare workers were interviewed. Both groups noted limited access to inhalers was an issue resulting in continued use of oral medications. Some patients recognised the benefits of inhalers, yet beliefs that inhalers were dangerous were common. Reliance on oral short-acting beta agonists meant patients saw asthma as a recurrent acute condition resulting in an emphasis on hospital management with little awareness of inhaled preventative medicines. Increasing access to inhaled medicines has the potential to reduce costly avoidable admissions, but socio-cultural factors, in addition to medication supply, need addressing.

Efficacy of Microneedle as an Assisted Therapy for Melasma: A Meta-analysis and Systematic Review of Randomized Controlled Trials.

Melasma is a common hyperpigmentary disorder, it has variety of treatment options, but it usually has a poor curative effect and high recurrence rate. Microneedles have shown certain prospects in the treatment of melasma as an assisted therapy, but there is no consensus on its efficacy and safety. To evaluate the efficacy and safety of microneedles as an adjuvant treatment for melasma. Statistical tools were used to adjust the improvement of MASI scores in all studies to obtain standardized mean differences (SMD), and then, meta-analysis were performed. Risk ratio (RR) was utilized to assess adverse reactions, clinical effectiveness, and patient satisfaction. The effects of microneedle-assisted treatment for melasma begin to manifest at the 4th week, with optimal results observed at the 24th week, and with a high patient satisfaction. Compared with oral medication alone, microneedle-assisted therapy began to be more effective at week 12 and continued by 24weeks. Compared with laser therapy alone, microneedle-assisted therapy also showed stronger efficacy, at the 8th week, microneedle-assisted treatment was significantly more effective, reaching its peak at the 12th week. Finally, in the comparison of microneedle and microinjection therapy, microneedle has always been more significant than micro-injection. Microneedle is a valuable adjunctive therapy for melasma treatment. It enhances long-term clinical outcomes compared to monotherapy and is associated with high patient satisfaction. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Metal-organic-framework-based sitagliptin-release platform for multieffective radiation-induced intestinal injury targeting therapy and intestinal flora protective capabilities

In patients with abdominal or pelvic tumors, radiotherapy can result in radiation-induced intestinal injury (RIII), a potentially severe complication for which there are few effective therapeutic options. Sitagliptin (SI) is an oral hypoglycemic drug that exhibits antiapoptotic, antioxidant, and anti-inflammatory activity, but how it influences RIII-associated outcomes has yet to be established. In this study, a pH-responsive metal-organic framework-based nanoparticle platform was developed for the delivery of SI (SI@ZIF-8@MS NP). These NPs incorporated mPEG-b-PLLA (MS) as an agent capable of resisting the effects of gastric acid, and are capable of releasing Zn2+ ions. MS was able to effectively shield these SI@ZIF-8 NPs from rapid degradation when exposed to an acidic environment, enabling the subsequent release of SI and Zn2+ within the intestinal fluid. Notably, SI@ZIF-8@MS treatment was able to mitigate radiation-induced intestinal dysbiosis in these mice. restored radiation-induced changes in bacterial composition. In summary, these data demonstrate the ability of SI@ZIF-8@MS to protect against WAI-induced intestinal damage in mice, suggesting that these NPs represent a multimodal targeted therapy that can effectively be used in the prevention or treatment of RIII.

The role of indigenous healers in treating surgical conditions in the rural Eastern Cape of South Africa.

Indigenous knowledge healers (IKHs) provide alternative healthcare to formal health services in rural South Africa, but there is a gap in knowledge regarding their treatment of surgical conditions. This study evaluated IKH surgical care and described their perspective of the dual health system. A cross sectional survey of IKHs in the Madwaleni Hospital catchment of the Eastern Cape, South Africa was conducted. Topics included the training and experience of IKHs, treatment of nine common surgical conditions, referral patterns, disease origin beliefs, benefits and limitations of care, and collaborative opportunities between the two health systems. Thirty-five IKHs completed the survey. IKHs were consulted by persons with all nine surgical conditions. The most common forms of treatment were application of an ointment on the affected site (88%) and oral medication (82%). Operative treatment was only done for abscess. Referrals to the formal healthcare sector were made for all surgical conditions. IKHs reported that they were limited by their lack of training and resources to perform operations. On the other hand, they perceived the treatment of the spiritual aspect of surgical disease as a benefit of their care. Thirty-five (100%) IKHs were interested in closer collaboration with the formal health sector. IKHs treat surgical conditions but refer to the formal health sector when diagnostic and operative services are needed. More research is needed to determine the potential advantages and disadvantages between the formal health sector and IKH collaboration.

Biomolecular Condensates Based on Amino Acid for Enhancing Oral Bioavailability and Therapeutic Efficacy of Hydrophobic Drugs.

The oral administration of chemo- or immunotherapeutic drugs presents a compelling alternative for patients with malignant colorectal cancer, offering a convenient and patient-compliant "hospital-free" strategy. Unfortunately, the hydrophobic nature of many drug candidates, alongside the harsh conditions of the gastrointestinal tract, frequently results in suboptimal bioavailability and heightened systemic toxicity. To address these challenges, we harnessed the unique properties of biomolecular condensates, which form through a liquid-liquid phase separation mechanism, to develop a versatile platform for drug encapsulation and delivery. In this study, we introduce a reliable and effective amorphous oral drug delivery system based on biomolecular condensates derived from the amino acid derivative N-(benzyloxycarbonyl)-l-proline (ZP). These ZP condensates exhibit dynamic intermolecular interactions and possess unique physicochemical attributes such as fluidity and viscoelasticity. They significantly improve the solubility of hydrophobic drugs, ensuring enhanced stability and optimized pharmacokinetics under physiological and gastrointestinal conditions. By maintaining drugs in an amorphous state, we substantially increased drug bioavailability and markedly improved pharmacokinetics. Furthermore, the ZP condensates demonstrate potential as an integrated therapeutic platform capable of potentiating the synergies between chemotherapy and immunotherapy while concurrently reducing systemic toxicity. This has resulted in a significant enhancement of chemo-immunotherapy efficacy in the treatment of colorectal cancer, representing a notable advancement in drug delivery and oncology.

Innovative Oral Nano/Gene Delivery System Based on Engineered Modified Saccharomyces cerevisiae for Colorectal Cancer Therapy.

The efficient delivery of RNA-based drugs to solid tumors remains a formidable obstacle. We aim to develop a safe and efficient oral drug delivery system compatible with RNA-based drugs that is urgently needed to overcome challenges such as enzymatic degradation and gastrointestinal barriers to facilitate effective treatment for treating colorectal cancer (CRC). To address these challenges, we utilized engineered modified Saccharomyces cerevisiae to evaluate the delivery efficacy of miR21-antagomir for treating CRC in preclinical mouse models, including adenomatosis polyposis coli mutant transgenic mice ApcMin/+ and in situ tumor-bearing mice. An orally deliverable gene delivery system, YS@NPs21, was designed. This gene delivery system demonstrated effectively suppressed tumor growth in both ApcMin/+ and in situ tumor-bearing mice models. This system exhibited tumor-targeting capability, effective inhibition of tumor growth, and low toxicity toward nontumor cells. Successful implementation of this innovative oral drug delivery system could offer a straightforward, safe, and RNA drug-compatible approach to CRC treatment, ultimately improving patient outcomes and reducing medical costs.

Successful Outcome of Secondary Infertility with Multidrug Therapy in a Long-Standing Case of multisystem involvement

A case of secondary infertility with multisystem involvement is being presented herewith. Secondary infertility indicates previous pregnancy but failure to conceive subsequently. Numbers of secondary infertility are growing day by day. Many factors like age, unwholesome lifestyle, disturbed schedule, diet, stress is accountable for it. Due to involvement of these all factors sometimes a female may expose to multiple metabolic disorders resulting into infertility. Aim: To study the outcome of Ayurvedic treatment in management of secondary infertility. Objective: To access the role of Ayurvedic management in secondary infertility. Methodology: It is a single case study of secondary infertility due to multiple metabolic disorders. Case description: A female aged 31years, had pain during menstruation and regular cycles with history of left tube removal due to ectopic pregnancy visited for wants to conceive. She had history of treatment at various private centers and had multisystem metabolic disorders. She was advised Ayurvedic oral medications along with yogabasti. Outcome: After Ayurveda interventions she conceived. Conclusion: Ayurvedic management by improving the health and reproductive ability of a woman may help to conceive. The probable mechanism for the efficacy of multidrug therapy in multisystem disorders gives ray of hope to numerous. Keywords: Infertility, Conception, Menstrual Cycle, Hydrosalpinx

Trends in Oral and Injectable HIV Preexposure Prophylaxis Prescriptions in the US, 2013-2023

This study examines the prescribing trends of 3 oral preexposure prophylaxis medications and a long-acting injectable option from 2013 to 2023.

Microbiota modulation by teriflunomide therapy in people with multiple sclerosis: An observational case-control study

Multiple sclerosis (MS) is a chronic immune-mediated and heterogeneous disease characterized by demyelination, axonal damage, and physical and cognitive impairment. Recent studies have highlighted alterations in the microbiota of people with MS (pwMS). However, the intricate nature of the disease and the wide range of treatments available make it challenging to identify specific microbial populations or functions associated with MS symptoms and disease progression. This study aimed to characterize the microbiota of pwMS treated with the oral drug teriflunomide (TF) and compare it with that of pwMS treated with beta interferons (IFNβ), pwMS treated with no previous disease modifying therapies (naïve), and healthy controls. Our findings demonstrate significant alterations in both the composition and function of the gut microbiota in pwMS that are further influenced by disease-modifying therapies. Specifically, oral treatment with TF had a notable impact on the gut microbiota of pwMS. Importantly, the dysregulated microbial environment within the gut was associated with symptoms commonly experienced by pwMS, including fatigue, anxiety, and depression.

Management of Lumbar Radiculopathy with Ayurveda: A Single Case Study

Background Lumbar radiculopathy refers to the compression of a nerve root as it exits the lumbosacral column. The word “radiculopathy” describes symptoms that develop when the lumbosacral nerve roots are compressed. This comprises varying degrees of radiating pain, numbness or tingling, weakness, and irregular gait. The patient was treated with Panchakarma procedures and Ayurvedic oral medications, resulting in satisfactory outcomes with no reported side effects. Purpose The study aimed to evaluate the effectiveness of Panchakarma and Ayurvedic oral medications in treating lumbar radiculopathy. Methods A single case study of a 21-year-old male suffering from pain in the lumbar region radiating to the right leg, restricted movement, and difficulty walking and standing for nine months. He was treated with Panchakarma, including local massage, Katibasti, Matravasti, Niruha Vasti, and Patrapottali Sweda, followed by oral medications. Treatment was continued for 14 days. Results The patient’s symptoms have been monitored for 14 days. The outcome was satisfactory, and the patient’s quality of life significantly improved. Conclusion Interventions stated earlier give significant relief in the management of lumbar Radiculopathy.