VNUHCM Journal of Health Sciences

In vivo evaluation of floating tablet clarithromycin 500mg

Thị Thanh Thảo Cao — 2023-05-15

Floating drug delivery system (FDDS) containing Clarithromycin 500mg (CLA) designed to prolong the retention time in the stomach is also an approach to optimize the plasma CLA concentration in the gastric. However, the development of FDDS meets many obstacles about physiology such as cannot control and locate FDDS in gastrointestinal because of the process of stomach emptying. CLA is rapidly absorbed from the gastrointestinal tract, bioavailability in intact form is only about 55% with a relatively short half-life, about 5-7 hours when taking a 500mg dose. Therefore, this research approaching a dosage form CLA to prolong the gastric retention time by in vivo in living body is local dog because the test subject is a dog beagle because anatomically it is quite similar in size to the gastrointestinal tract with the human model. The technical to show CLA image in vivo by X - ray method each time before and after oral administration of a pill and finished until there is no more pill images in the stomach. In addition, plasma drug concentrations were also calculated at each time point using the HPLC with LCMS IT-TOF method and compared with tablets without buoyancy properties. Results of research FDDS containing CLA has been the floating tablet time is 3,5 to 4,5 hours. And plasma concentration between testing group reached at 6 and 8 hours (1964,00 ± 104,25 ng/ml and 1203,00 ± 191,68 ng/ml); and the drud’s peak group reached at 2,5 -3 hours (1169,88 ± 109,42 ng/ml and 1982,63 ± 266,48 ng/ml), respectivety.

Concordance between HB&L system and conventional culture method for bacterial antibiotic susceptibilities from positive blood samples at Hospital for Tropical Diseases from 03/2020 to 04/2021

Nhu Nguyen Ngoc Quynh — 2023-06-30

Presently, shortening the time-to-result of antimicrobial susceptibility test (AST) is of the utmost importance for sepsis management in an effort to reduce mortality and antibiotic resistance rate. HB&L ((Human Biological Liquid Culture), a product of the Alifax company (Italy), can detect replicating microorganisms and their antibiotic resistance in a few hours with high sensitivity and specificity by using light scattering technique. This study aims to evaluate the correlation between rapid antibiogram using the HB&L system and the routine methods on positive blood cultures at the Hospital for Tropical Diseases in Ho Chi Minh City from March 2020 to April 2021. Gram-positive bacteria blood samples were tested against Cefoxitin, Vancomycin while Gram-negative bacteria samples were trialed with Ceftriaxone, Levofloxacin, Piperacillin-Tazobactam and Meropenem. The concordance of the two methods was defined by the categorical agreement (CA), very major errors (VME), major errors (ME) and minor errors (mE) in Cumitech 31A. Of the 81 blood culture samples containing Gram-negative bacteria, the CA of Ceftriaxone, Meropenem, Levofloxacin and Piperacillin-Tazobactam were 90%, 100%, 67% and 88%. The maximum VME was 22% for Levofloxacin. On the other hand, of the 32 Gram-positive samples, CA and VME of Cefoxitin were 53% and 65% respectively while CA of Vancomycin was 100%. The median time to receive rapid AST results of the HB&L system is 4.43 hours faster than the standard that.

Optimisation of a floating tablet containing clarithromycin 500 mg

Thị Thanh Thảo Cao — 2023-06-30

The purpose of the research is to optimize the formulation of a gastric floating drug delivery system of clarithromycin 500 mg (CLA). CLA is a macrolide antibiotic, indicated in the treatment of sinusitis, pharyngitis, pneumonia, acute and chronic bronchitis, especially in the treatment of Helicobacter pylori (H. pylori) infection. The formulation design is retained in the stomach for prolonging the floating time to improve bioavailability, drug absorption. The excipients include polymers such as hydroxypropyl methyl cellulose (HPMC) to control drug release. Besides, sodium bicarbonate is generally used in pharmaceuticals as a source of carbon dioxide in effervescent tablets – has been used as a gas-forming agent in floating to prolong floating time and reducing gastric irritation. Preformulating testing is not the interaction between the ingredients together. In vitro floating time and vitro dissolution studies were carried out that the results of the best formulation with HPMC K100M, HPMC K15M and NaHCO3 are 22%; 12.5% và 14.7% based on concentrate of CLA. The formulations were designed by Design - Expert and BCPharsolf OTP. The result of research showed that the floating time is approximately 8.53 – 9.34 hours and drug release for 12 hours, respectively 25% (after 2 hours), 20 – 40% (after 4 hours) and over 80% (12 hours). The analytical method for determination and quantification of CLA such as high-performance liquid chromatography (HPLC) and Fourier transform infrared FTIR.

External root resorption in mandibular second molars associated with mesial, impacted third molars on CBCT images

Khoa Dang Hoang — 2023-06-30

Objectives: The study aimed to investigate the condition of the external root resorption (ERR) of the distal surface of the root of the second molars when the third molar are impacted, mesial on CBCT images and the relationship between the ERR and the morphological characteristics of third molars Methods: A descriptive cross-sectional study was performed on a sample consisting of 215 CBCT images of the third molars impacted of 145 patients who visited and treated at the Department of Odonto-Stomatology, University of Medicine and Pharmacy. Ho Chi Minh City from March 2016 to June 2022. On the CBCT image, the morphological characteristics of third molars were examined, including: mesial angulations, vertical and horizontal positions, impaction depth, degree of root formation, contact position between second and third molars. ERR of the distal surface of the root of the second molars assessed according to the Ericson and Kurol criteria. Results: The rate of ERR on the distal surface of the second molar was 21.39%, in which the cervical was the most frequent position, followed by the middle of the root and finally the apex; most of the cases were slight resorptions. There was no statistically significant difference between the rate, location and degree of ERR by age and sex. There was no statistically significant relationship between the rate of ERR and the morphological characteristics of third molars except the vertical position of third molars. Conclusion: The second RCL root resorption related to impacted third molars is not uncommon and can be accurately determined by CBCT.

Uterine leiomyoma in a 14 – year – old girl: Case report and literature review

Phạm Công Toàn — 2023-06-30

Background: Uterine leiomyomas are benign tumors arising from the smooth muscle cells of the uterus or extracellular matrix, that are very common among women of reproductive age between 30 and 50 years of age. However, their incidence is extremely rare in women under 15-year-old (<1%) with unknown etiology. Ultrasound and magnetic resonance imaging (MRI) comfirms the location, number, size of mass, which plays an important role in prognosis and treatment. Leiomyomas have been managed in a variety of methods and are considered to decide the most optimal way to preserve fertility in adolescents.

Case: A 14 year of age female patient was admitted with increased abdominal volume and pelvic mass over 6 months. Physical examination revealed the mass from the pelvic, corresponding in size to a pregnant uterus of 18 weeks (fundal height is 14cm). Ultrasound and MRI showed a uterine leiomyoma type 2 -5 (FIGO) and a differential diagnosis of leiomyosarcoma. The patient was managed successfully with complete tumor resection through abdominal myomectomy to preserve fertility. Histological results confirmed the final diagnosis was “benign degeneration of uterine leiomyoma”.

Summary and conclusion: Although the occurrence of uterine leiomyomas in adolescents is very rare, this diagnosis is considered since a pelvic mass in this age group is discovered. Through rare but the differential diagnosis of uterine leiomyoma in the young population is leiomyosarcoma. Myomectomy is a suitable management to preserve fertility.

Pediatric uveitis complicating in cataract formation regained normal visual acuity – a challenging case

Bao Hong Tran — 2023-06-30

Background: Pediatric uveitis and its complications are important causes of child blindness. Strong inflammatory response and unstable treatment compliance result in worse treatment outcome than adults and frequent recurrence. However, effective anti-inflammatory treatment can still lead to good result. Case report: We report a case of pan-uveitis in a 13-year-old patient, complicating in cataract formation who was successfully treated and regained 20/20 final visual acuity. The patient was admitted to us due to blurry vision, pain and redness on her left eye, with best-corrected visual acuity 12/20, intraocular pressure 15 mmHg, ciliary flush, anterior chamber cell and constricted pupil with poor light reflex. Her left eye was diagnosed with anterior uveitis and treated with topical prednisone acetate along with peri-orbital injection of dexamethasone. At 1-week follow-up, her left eye showed significant progress with best-corrected visual acuity being 16/20 and no inflammatory reaction detected. Due to social distancing in Covid-19 pandemic, she was unable to have follow-up examinations; her condition worsened to pan-uveitis which complicated in cataract formation and her visual acuity fell down to counting finger 0.5m. She was then treated with systemic methylprednisolone in 2 weeks and local corticosteroids in 6 months, including 3 consecutive peri-orbital injections of triamcinolone acetate with monthly interval and topical prednisone acetate; after that she underwent cataract surgery with anterior vitreous humor removed and intraocular lens implanted in the ciliary sulcus. At 1-month follow-up, best-correct visual acuity of her left eye was 20/20 and intraocular pressure was 16 mmHg, the inflammatory response of her left eye was completely in control. Conclusion: Effective anti-inflammatory treatment even after surgery (if existed) takes the decisive role in regaining patient’s vision. Cataract removal surgery on pediatric uveitis patients should combine with vitrectomy and the surgeon should be prepared to place the intraocular lens in the ciliary sulcus.