Atorvastatin-80mg/day and Rosuvastatin-40mg/day are the commonest high-dose statin (3-hydroxy-3-methylglutaryl coenzyme-A reductase inhibitors) regimes for post-PCI (Percutaneous Coronary ...Interventions) patients to lower (by ≥50%) blood low-density-lipoprotein cholesterol (LDL-C). Dearth of conclusive evidence from developing world, regarding overall safety, tolerability and comparative effectiveness (outcome/safety/tolerability/endothelial inflammation control) of Rosuvastatin over Atorvastatin in high-dose, given its higher cost, called for an overall and comparative assessment among post-PCI patients in a tertiary cardiac-care hospital of Kolkata, India.
A record-based non-concurrent cohort study was conducted involving 942 post-PCI patients, aged 18-75 years, on high-dose statin for three months and followed up for ≥one year. Those on Atorvastatin-80mg (n = 321) and Rosuvastatin-40mg (n = 621) were compared regarding outcome (death/non-fatal myocardial infarction: MI/repeated hospitalization/target-vessel revascularisation/control of LDL and high-sensitivity C-reactive protein: hsCRP), safety (transaminitis/myopathy/myalgia/myositis/rhabdomyolysis), tolerability (gastroesophageal reflux disease: GERD/gastritis) and inflammation control adjusting for socio-demographics, tobacco-use, medications and comorbidities using SAS-9.4.
Groups varied minimally regarding distribution of age/gender/tobacco-use/medication/comorbidity/baseline (pre-PCI) LDL and hs-CRP level. During one-year post-PCI follow up, none died. One acute MI and two target vessel revascularizations occurred per group. Repeated hospitalization for angina/stroke was 2.18% in Atorvastatin group vs. 2.90% in Rosuvastatin group. At three-months follow up, GERD/Gastritis (2.18% vs 4.83%), uncontrolled hs-CRP (22.74% vs 31.08%) and overall non-tolerability (4.67% vs. 8.21%) were lower for Atorvastatin group. Multiple logistic regression did show that compared to Atorvastatin-80mg, Rosuvastatin-40mg regime had poorer control of hs-CRP (A3OR = 1.45,p = 0.0202), higher (A3OR = 2.07) adverse effects, poorer safety profile (A3OR = 1.23), higher GERD/Gastritis (A3OR = 1.50) and poorer overall tolerability (A3OR = 1.50).
Post-PCI high dose statins were effective, safe and well-tolerated. High dose Rosuvastatin as compared to high dose Atorvastatin were similar in their clinical efficacy. Patients treated with Atrovastatin had significantly lower number of patients with hs-CRP (high-sensitivity C-reactive protein)/C-reactive protein (CRP) level beyond comparable safe limit and relatively better tolerated as opposed to Rosuvastatin-40mg.Thus given the lower price, Atorvastatin 80mg/day appeared to be more cost-effective. A head-to-head cost-effectiveness as well as efficacy trial may be the need of the hour.
Capsular polysaccharides (SPS) are the integral component of gram-negative bacteria, and also have potential uses as vaccines. In this paper, interaction of anionic SPS, isolated from Klebsiella K28, ...K43, K51 and K20, with cationic surfactants and cationic-nonionic mixed surfactants were investigated by turbidimetric titration, viscometric method. Variation of size and zeta-potential was measured using dynamic light scattering method. Due to binding of the surfactants size enhancement and charge reversal takes place. The interaction between oppositely charged polymer-surfactants are governed by the nature of the charged head group and of the counter ion, charge density and rigidity of the polymer architecture, CMC of the surfactant systems, concentration of surfactant (Cs). The binding is influenced both by electrostatic and hydrophobic interaction.
Background: To identify prevalence of the novel risk factors among young patients with Acute Coronary Syndrome (ACS) and having no or minimal conventional risk factors. ...Methods: Total 70 patients ( male 48 , female 22 ) who were admitted in our hospital with ACS, without any traditional risk factors were analyzed for hsCRP highly sensitive C reactive protein , Lp(a) Lipoprotein(a), Homocysteine and uric acid level.Results: 44.29% of the study population have high values of hs-CRP, more in older age group but not significant (<40 vs >40 yrs) (P=0.79). High homocysteine present in 42.86% of cases, more in older age ( >40 yrs) (54.55%) than <40 years age (23.08%) which is statistically significant (P-0.01). High uric acid level found in 32.86% of cases without any significant age and sex difference. High Lp(a) level is found in 41.43% of cases more among ≥40 years (50%) than <40 years (26.92%), the difference was not found to be statistically significant. Chi-square = 3.587; P=0.058; OR=2.71 95% CI= 0.95 – 7.7.Conclusion: hsCRP is most useful cost effective screening method for ACS in younger individual among all other parameters in this part of world .
Capsular polysaccharides (SPS) are the integral component of gram-negative bacteria, and also have potential uses as vaccines. In this paper, interaction of anionic SPS, isolated from Klebsiella K28, ...K43, K51 and K20, with cationic surfactants and cationic-nonionic mixed surfactants were investigated by turbidimetric titration, viscometric method. Variation of size and zeta-potential was measured using dynamic light scattering method. Due to binding of the surfactants size enhancement and charge reversal takes place. The interaction between oppositely charged polymer-surfactants are governed by the nature of the charged head group and of the counter ion, charge density and rigidity of the polymer architecture, CMC of the surfactant systems, concentration of surfactant (Cs). The binding is influenced both by electrostatic and hydrophobic interaction.
Over the decades, orally disintegrating tablet (ODTs) has expanded much attention as a preferred alternative to conventional oral dosage form such as tablet and capsules. Recently, ODTs have acquired ...an important position in the market by overcoming previously encountered administration problems and contributing to extension of patient life, which includes dysphagic, bed ridden, psychic, geriatric and pediatric patients, who have difficulty in swallowing conventional tablets and capsules. ODTs have the unique property of rapidly disintegrating and/or dissolving and releasing the drug as soon as they come in contact with saliva, thus obviating the requirement of water during administration. Conventional preparation technologies like direct compression, lyophilization, spray drying, molding, phase transition process, melt granulation, sublimation, mass extrusion, etc., while various patented technologies like like Zydis, Lyoc, Quicksolv, Orasolv, Durasolv, Flashtab, Oraquick, Wowtab, Ziplet etc., have been developed for the production of ODTs. The present review addresses briefly about the current developments in ODT technologies and various leading technologies for their manufacturing. In addition, important aspects of ODT technology are discussed. PUBLICATION ABSTRACT
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