Introduction: Methadone hydrochloride (MDN) is an effective pharmacological substitution treatment for opioids dependence, adopted in different countries as methadone maintenance treatment (MMT) programmes. However, MDN can exacerbate the addiction problem if it is abused and injected intravenously, and the frequent visits to the MMT centres can reduce patient compliance. The overall aim of this study is to develop a novel extended-release capsule of MDN using the sol-gel silica (SGS) technique that has the potential to counteract medication-tampering techniques and associated health risks and reduce the frequent visits to MMT centres. Methods: For MDN recrystallisation, a closed container method (CCM) and hot-stage method (HSM) were conducted, and MDN crystals were characterised using the polarised light microscope (PLM). MDN crystal thickness was determined by scanning electron microscopy (SEM) and confocal microscopy (CM) to establish a relationship between MDN crystals thickness and their birefringence colours using the Michel-Levy Birefringence Colour Chart. The experimental series was continued to produce novel silica-based MDN formulations A and B capsules by adding MDN powder at the end and beginning of the SGS process, respectively. The silica-based MDN formulations were characterised by Fourier transform infrared (FT-IR), SEM, differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), PLM and mean grey value (MGV) analyses. The in vitro release studies (n=3) for the silica-based MDN formulations and pure MDN capsules were conducted in a phosphate buffer solution (pH= 7.2) for 7 days. Stability studies were conducted for 1 month by keeping the silica-based MDN capsules under 25°C and 57% RH. Results: The optimal method to produce large numbers of MDN crystals was the CCM, and MDN crystals were characterised as diamond shaped with an intrinsic angle of 62o. The SEM surpassed the CM in measuring MDN crystal thickness, and Mann-Whitney U Test showed statistically significant differences between SEM and confocal thickness measurements (U= 1283, p < 0.05) as the SEM exhibited thinner diamond crystals (6.62 ± 2.9 µm) than the CM measurements (9.6 ± 4.6µm). According to the Michel-Levey birefringence colour chart (using the SEM mean thickness of MDN crystals and their retardation value of 428 nm), most of MDN crystals demonstrated a yellow colour. The FT-IR, SEM, DSC, MGV and PLM analyses of both silica-based MDN formulations revealed that MDN was successfully incorporated inside the silica network producing amorphous material (with no appearance of the melting peak of pure MDN at 233.4°C) with evidence of no physical or chemical interaction between sol-gel silica and MDN. However, the TGA analysis revealed a significantly greater amount of MDN was loaded inside the silica-based MDN formulation B compared to A (t = 2.80, p = 0.009, n=6), as 28.3 ± 0.6 mg of MDN was loaded in the former while 25.6 ± 0.7 mg in the latter. In addition, the silica-based MDN formulation B released 10% more MDN after 7 days than formulation A, and both formulations were stable when stored for 1 month under 57% RH and 25°C. Conclusion: The novel combined use of SEM and PLM techniques shows a potential for the identification of MDN in forensic science as it established a range of birefringence colours of MDN crystals. Moreover, the new silica-based MDN formulation B can help to deter MDN abuse and increase patient adherence to MMT due to its potential to sustain MDN release and reduce the frequent visits to MDN treatment centres.
Objective: The aim of the study to evaluate the nursing care management for diabetes mellitus patient
with total hip replacement after fractured hip.
Methodology: A field study carried out on patients with diabetes mellitus and have total hip
replacement after fractured hip in orthopedic ward at the hospital of surgical specialization (malefemale)during
January 2002 to January 2003.Physical and psychological nursing
assessment
immediately after the surgery was done for the both subjects (control and experimental) and then a
scientific management with daily nursing care were provided to the experimental subject with daily
nursing care to the patient condition by using a scientific and practical methods and leave th
Nisoldipine (NSD) is a dihydropyridine class of calcium channel blockers used for hypertension treatment, it belongs to class II BCS (low solubility with high permeability), its absolute bioavailability is only 5% due to presystemic metabolism in the gut wall. It is also a substrate for a CYP3A and P-gp. Bilosomes are lipid bilayer vesicles incorporating bile salts in their walls to prevent degredation by GIT bile salts. The aim of this study is to prepare nisoldipine bilosomes as vesicular carrier and assess the effect of different formulation variables such as type of surfactant, amount of cholesterol, surfactant and sonication time on particle size, entrapment efficiency and poly dispersity index of the prepared bilos
... Show MoreDue to the importance of the relationship between the phenomenon of inflation and the exchange rate in the formulation of monetary policy in Iraq, the exchange rate plays a strategic role in limiting the inflation caused by the monetary expansion due to government spending, as a point of a view, the inefficiency of interest to achieve the monetary market balance and stability of the general level of prices as an overall goal of monetary policy in Iraq, the exchange rate has emerged as a brake on inflation in Iraq, as the research found that the monetary authority in the period 2003-2018 provided a methodical development in the formulation of monetary policy towards realizing the effects of inf
... Show MoreTopic management is the awareness of how speakers deal with initiating, developing, changing, and ending a topic and how they fix the relationship when a misunderstanding occurs. It is such an important unit of conversation as it includes the transition from one strategy to the other to be accomplished in a systematic and orderly manner. These strategies are impaired in dementia patients thus lead to communication breakdown. This study aims at detecting the dementia patients' topic management strategies in selected speeches and answering the questions of which of these strategies are fully or partially detected in these speeches. The researchers use a qualitative method to examine the speeches of those patients and they adopt an eclectic
... Show MoreThe unpredictable and huge data generation nowadays by smart computing devices like (Sensors, Actuators, Wi-Fi routers), to handle and maintain their computational processing power in real time environment by centralized cloud platform is difficult because of its limitations, issues and challenges, to overcome these, Cisco introduced the Fog computing paradigm as an alternative for cloud-based computing. This recent IT trend is taking the computing experience to the next level. It is an extended and advantageous extension of the centralized cloud computing technology. In this article, we tried to highlight the various issues that currently cloud computing is facing. Here
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