The present study describes the optimization of a simple and reliable method for the determination of four first line antitubercular drugs in human plasma. The studied analytes were Isoniazid (H),...

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A new family of biofunctionalized chitosan decorated nanocochleates-mediated drug delivery system was developed that involves uniquely combining nanocochleates with anticancer drug for controlled drug release, targeted delivery, improved bioavailability with reduced toxicity. This system was developed by loading of doxorubicin (DOX) to nanocochleates (DOX-NC) through conversion of negatively charged dimyristoylphosphatidylcholine (DMPC) phospholipid and cholesterol-bearing vesicles on addition of calcium ions, followed by encapsulation DOX-NC with folic acid conjugated chitosan (FA-CHI-DOX-NC). The release of DOX indicated strong pH dependence and implies hydrogen-bonding interaction between nanocochleates and DOX. Formulated FA-CHI-DOX-NC demonstrated higher in-vitro anticancer activity in folate overexpressed human breast cancer MCF-7 cells. The targeting effect for the FA-CHI-DOX-NC was also demonstrated. The concentration of the drug needed for growth inhibition of 50% of cells in a designed time period (GI50) was 9.1 µg/ml for DOX while it was decreased by 31.68% for the DOX-NC (6.2 µg/ml). Furthermore, the GI50 value of FA-CHI-DOX-NC was 4.4 µg/ml, i.e. a 51.64% decrease was observed as compared to DOX solution. Moreover, bioavailability of DOX from FA-CHI-DOX-NC increased by 4-fold with long circulation time, slower plasma elimination and no sign of tissue toxicity as compared to DOX solution. The proposed strategy is advantageous in terms of targeted drug delivery and has high potential to address the current challenges in drug delivery. Thus, the prepared new carrier offers a novel formulation that combines the unique properties of a biodegradable material, chitosan and nanocochleates for biomedical applications.

To evaluate antibiotic consumption and compliance to hospital antibiotic policy in the surgery, orthopedics and gynecology wards of a tertiary care hospital. Methods: A prospective observational study was conducted over eight months on adult inpatients prescribed with antibiotics. Data were collected using a predesigned antibiotic form and evaluated using Defined Daily Dose per 100 bed-days. Antibiotics prescribed were classified using World Health Organization Access, Watch and Reserve classification (WHO AWaRe) and assessed for compliance to the hospital antibiotic policy which is in accordance with the National Treatment Guidelines for Antimicrobial use in Infectious Diseases (version 1.0.2016). Results: Out of 2653 patients enrolled, 44.3% were males and 55.7% were females. The antibiotic usage rate was 29%. Cephalosporins were the most frequently prescribed class of antibiotics. The top three antibiotics prescribed were cefuroxime, metronidazole, and ceftriaxone. Classification of antibiotics using WHO AWaRe policy showed that 36% of antibiotics were prescribed from the Access group and 53% from the Watch group. The use of antibiotic combinations from the not recommended group of AWaRe was also observed. Total compliance observed towards the hospital's antibiotic policy was 77.7%. The most common reason for non-compliance to hospital policy was inappropriate duration of antibiotic therapy. Conclusions: The use of watch group of antibiotics over access group due to concerns of antimicrobial resistance shows the need for local adaptation of WHO AWaRe classification. Despite good adherence to the hospital's antibiotic policy, extended duration of antibiotic therapy requires special attention. Further optimization of antibiotic use can be achieved by timely revision and implementation of hospital antibiotic policy.

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