Browsing by Author "S. Kant"

Now showing 1 - 7 of 7

An epidemiological study of dementia among the habitants of eastern Uttar Pradesh, India
(2011) K. Poddar; S. Kant; A. Singh; T.B. Singh
Dementia is one of the most serious health problems of the elderly and their caregivers. Objective: The objective of this study was to estimate the prevalence of dementia in the community, its sociodemographic and behavioral associates to determine the risk factors among resident of two districts of eastern Uttar Pradesh, India. Materials and Methods: This study was based on 2890 subjects aged 50 years and above, residing in rural areas of Mirzapur and urban areas of the Varanasi district of eastern Uttar Pradesh, India. Efforts were made to identify the subjects of age 50 years and above using cluster sampling. The Hindi Mental State Examination was used as the instrument tool to determine the score and a cut-off score of ≤23 was considered as the presence of dementia among the identified subjects. Results: The overall prevalence of dementia was found to be 5.1%. This percentage was increasing with age and decreasing with educational level. Among females, the prevalence of dementia was observed (7.2%) to be double than that in males (3.8%). Widows/widowers/ unmarried had a double prevalence (9.3%) as compared with married (4.3%) people. The age, gender, marital status, education, occupation, number of family members in the household and liquor addiction were found to be significantly associated with dementia. The relative risk for the above-mentioned variables was found to be more than 1.
Chitosan coated PLA nanoparticles for ophthalmic delivery: Characterization, in-vitro and in-vivo study in rabbit eye
(2010) Ramesh C. Nagarwal; P.N. Singh; S. Kant; P. Maiti; J.K. Pandit
The objective of the present study is to develop a poly (D, L-lactic acid) (PLA) nano-carrier for topical ocular applications. PLA nanoparticles (PLA-NPs) with 5-fluorouracil were prepared using varying concentration and molecular weight of PLA to regulate the particle size. The dimension and shape of nanoparticles were verified by using dynamic light scattering (DLS), atomic force microscope (AFM) and scanning electron microscope (SEM). Ex-vivo permeation study was conducted by goat and rabbit excised cornea. In-vivo experiment was conducted in rabbit eye and 5-FU concentration was measured in aqueous and vitreous humor by HPLC. In-vitro experiments indicated a diffusion controlled release of 5-FU. No significant interaction was observed in between mucin and PLA NPs that measured in terms of viscosity change. Ex-vivo permeation was significantly higher with rabbit cornea as compared to goat cornea. PLA and CH-PLA DNPs showed increased level of 5-FU as comparison to 5-FU solution. In-vivo study showed significantly higher concentration in case of uncoated and CH coated PLA nanoparticles in rabbit eye as compared to free 5-FU solution. PLA nanoparticle was found non-irritant in nature by modified Draize test. Copyright © 2010 American Scientific Publishers All rights reserved.
Efficient white light generation from 2,3-diphenyl-1,2-dihydro-quinoxaline complex
(2010) Y. Dwivedi; S. Kant; R.N. Rai; S.B. Rai
In this article, we report two organic materials dispersed in transparent poly (methyl methacrylate) matrix for efficient white light simulation under different optical excitations. A newly synthesized complex of benzoin and o-phenyldiamine is observed to be white on illumination with a blue LED. A new concept of white light emitting tube is also demonstrated. A mixture of 2,2"([1,1'-biphenyl]-4,4'diyldi-2,1-ethenediyl)-bis-benzenesulfonic acid disodium salt and complex is optimized to emit white light extended in the violet region on 355 nm laser excitation. The optical quality of the emitted white light is adjudged by the CIE coordinate, correlated color temperature and color rendition index in both the cases. © 2010 Springer-Verlag.
Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015
(Lancet Publishing Group, 2016) H. Wang; M. Naghavi; C. Allen; R.M. Barber; A. Carter; D.C. Casey; F.J. Charlson; A.Z. Chen; M.M. Coates; M. Coggeshall; L. Dandona; D.J. Dicker; H.E. Erskine; A.J. Ferrari; C. Fitzmaurice; K. Foreman; M.H. Forouzanfar; M.S. Fraser; N. Fullman; E.M. Goldberg; N. Graetz; J.A. Haagsma; S.I. Hay; C. Huynh; C.O. Johnson; N.J. Kassebaum; X.R. Kulikoff; M. Kutz; H.H. Kyu; H.J. Larson; J. Leung; S.S. Lim; M. Lind; R. Lozano; N. Marquez; J. Mikesell; A.H. Mokdad; M.D. Mooney; G. Nguyen; E. Nsoesie; D.M. Pigott; C. Pinho; G.A. Roth; L. Sandar; N. Silpakit; A. Sligar; R.J.D. Sorensen; J. Stanaway; C. Steiner; S. Teeple; B.A. Thomas; C. Troeger; A. VanderZanden; S.E. Vollset; V. Wanga; H.A. Whiteford; T. Wolock; L. Zoeckler; T. Achoki; A. Afshin; L.T. Alexander; G.M. Anderson; B. Bell; S. Biryukov; J.D. Blore; A. Brown; J. Brown; K. Cercy; A. Chew; A.J. Cohen; F. Daoud; E. Dossou; K. Estep; A. Flaxman; J. Friedman; J. Frostad; W.W. Godwin; J. Hancock; L. Kemmer; I.A. Khalil; P.Y. Liu; F. Masiye; A. Millear; M. Mirarefin; A. Misganaw; M. Moradi-Lakeh; K. Morgan; M. Ng; A. Pain; J. Quame-Amaglo; P. Rao; M.B. Reitsma; K.A. Shackelford; P. Sur; J.A. Wagner; T. Vos; A.D. Lopez; C.J.L. Murray; R.G. Ellenbogen; C.N. Mock; D.A. Quistberg; B.O. Anderson; C.D. Blosser; N.D. Futran; S.R. Heckbert; P.N. Jensen; T.J. Montine; D.L. Tirschwell; D.A. Watkins; Z.A. Bhutta; M.I. Nisar; N. Akseer; N.K.M. Alam; L.D. Knibbs; R. Lalloo; H.N. Gouda; J.J. McGrath; P. Jeemon; R. Dandona; G.A. Kumar; P.W. Gething; C. Cooper; S.C. Darby; A. Deribew; R. Ali; D.A. Bennett; V. Jha; K. Rahimi; Y. Kinfu; I.D.A. Faghmous; S.M. Langan; M. McKee; G.V.S. Murthy; N. Pearce; B. Roberts; I.R. Campos-Nonato; J.C. Campuzano; H. Gomez-Dantes; I.B. Heredia-Pi; F. Mejia-Rodriguez; J.C. Montañez Hernandez; P. Montero; M.J. Rios Blancas; E.E. Servan-Mori; S. Villalpando; L. Duan; S. Liu; L. Wang; P. Ye; X. Liang; S. Yu; G.A. Mensah; J.A. Salomon; A.L. Thorne-Lyman; O.N. Ajala; T. Bärnighausen; E.L. Ding; M.S. Farvid; G.R. Wagner; P. James; M. Osman; M.G. Shrime; J.R.A. Fitchett; A.K. Knudsen; C.L. Ellingsen; N.H. Krog; M. Savic; A.D. Hailu; O.F. Norheim; K.H. Abate; T.T. Gebrehiwot; A.T. Gebremedhin; C. Abbafati; K.M. Abbas; F. Abd-Allah; S.F. Abera; Y.A. Melaku; F.H. Tesfay; G.Y. Abyu; A.F. Aregay; B.D. Betsu; A.A. Gebru; G.B. Hailu; A.Z. Yalew; H.G. Yebyo; D.M.X. Abreu; E.B. Franca; L.J. Abu-Raddad; A.L. Adelekan; R.O. Akinyemi; F.A. Ojelabi; Z. Ademi; T. Fürst; P. Azzopardi; B.C. Cowie; K.B. Gibney; J.H. MacLachlan; A. Meretoja; K. Alam; R. Borschmann; S.M. Colquhoun; G.C. Patton; R.G. Weintraub; C.E.I. Szoeke; L. Vijayakumar; M.A. Bohensky; H.R. Taylor; T. Wijeratne; A.K. Adou; J.C. Adsuar; K.A. Afanvi; E.E. Agardh; J. Rehm; A. Badawi; M.P. Lindsay; S. Popova; A. Agarwal; A. Agrawal; P.J. Hotez; A. Ahmad; B. Norrving; A.S. Akanda; T.F. Akinyemiju; D.C. Schwebel; J.A. Singh; F.H. Al Lami; S. Alabed; Z. Al-Aly; T.R. Driscoll; A.H. Kemp; J. Leigh; A.B. Mekonnen; D. Alasfoor; S.F. Aldhahri; K.A. Altirkawi; A.S. Terkawi; R.W. Aldridge; A. Banerjee; T. Tillmann; M.A. Alegretti; A.V. Aleman; F. Cavalleri; V. Colistro; Z.A. Alemu; S. Alhabib; A. Alkerwi; F. Alla; P. Allebeck; J.J. Carrero; S. Fereshtehnejad; E. Weiderpass; R. Havmoeller; R. Al-Raddadi; U. Alsharif; E. Alvarez Martin; N. Alvis-Guzman; A.T. Amare; L.G. Ciobanu; G.A. Tessema; A.K. Amegah; A.A. Kudom; E.A. Ameh; H. Amini; C.K. Karema; W. Ammar; H.L. Harb; S.M. Amrock; H.H. Andersen; C.A.T. Antonio; E.J.A. Faraon; J. Ärnlöv; A. Larsson; V.S. Arsic Arsenijevic; A. Barac; A. Artaman; H. Asayesh; R.J. Asghar; S. Atique; E.F.G.A. Avokpaho; F.G. Gankpé; A. Awasthi; U. Bacha; M.C. Bahit; K. Balakrishnan; S.L. Barker-Collo; S. Mohammed; L. Barregard; M. Petzold; L.H. Barrero; A. Basu; S. Basu; Y.T. Bayou; S. Bazargan-Hejazi; J. Beardsley; N. Bedi; E. Beghi; K. Deribe; H.A. Belay; A.Z. Giref; D. Haile; T. Jibat; W.A.A. Manamo; W.M. Tefera; B.D. Yirsaw; K.N. Sheth; M.L. Bell; B.J. Biroscak; A.K. Bello; I.S. Santos; I.M. Bensenor; P.A. Lotufo; A. Berhane; C.D.A. Wolfe; E. Bernabé; A.S. Beyene; M.D. Gishu; N. Bhala; A. Bhalla; S. Biadgilign; B. Bikbov; A.A. Bin Abdulhak; E. Bjertness; A.S. Htet; D. Bose; R.R.A. Bourne; M. Brainin; C.E.G. Brayne; A. Brazinova; M. Majdan; J. Shen; N.J.K. Breitborde; H. Brenner; B. Schöttker; J.D. Brewer; T.S. Brugha; G.C. Buckle; R.A. Gosselin; Z.A. Butt; B. Calabria; A. Lal; R.M. Lucas; L. Degenhardt; S. Resnikoff; J.R. Carapetis; R. Cárdenas; D.O. Carpenter; C.A. Castañeda-Orjuela; J. Castillo Rivas; F. Catalá-López; J. Cerda; W. Chen; P.P. Chiang; M. Chibalabala; C.E. Chibueze; R. Mori; O. Chimed-Ochir; Y. Jiang; K. Takahashi; V.H. Chisumpa; C.C. Mapoma; J.J. Choi; R. Chowdhury; H. Christensen; D.J. Christopher; M. Cirillo; M. Colomar; L.T. Cooper; J.A. Crump; R.G. Poulton; J. Damsere-Derry; H. Danawi; A.H. Refaat; P.I. Dargan; J. das Neves; J. Massano; J.M. Pedro; G. Davey; A.C. Davis; F. Greaves; J.N. Newton; D.V. Davitoiu; E.F. de Castro; P. de Jager; D. De; R.P. Dellavalle; S.D. Dharmaratne; P.K. Dhillon; P. Ganguly; D.K. Lal; S. Zodpey; C. Diaz-Torné; K.P.B. dos Santos; M. Dubey; M.H.U. Rahman; A. Singh; B.B. Duncan; C. Kieling; M.I. Schmidt; I. Elyazar; A.Y. Endries; S.P. Ermakov; B. Eshrati; A. Esteghamati; N. Hafezi-Nejad; S. Fahimi; R. Malekzadeh; G. Roshandel; S.G. Sepanlou; F. Farzadfar; A. Kasaeian; M. Parsaeian; P. Heydarpour; V. Rahimi-Movaghar; S. Sheikhbahaei; M. Yaseri; T.A. Farid; A.R. Khan; C.S.E.S. Farinha; A. Faro; V.L. Feigin; B.J. Te Ao; J.G. Fernandes; J.C. Fernandes; F. Fischer; N. Foigt; I. Shiue; F.G.R. Fowkes; R.C. Franklin; F.B. Piel; A. Majeed; S.L. Gall; K. Gambashidze; A. Gamkrelidze; M. Kereselidze; M. Shakh-Nazarova; V.J. Iyer; T. Gebre; J.M. Geleijnse; B.D. Gessner; A.G. Ghoshal; R.F. Gillum; A. Mehari; S. Gilmour; M. Inoue; N. Kawakami; K. Shibuya; M. Giroud; E. Glaser; Y.A. Halasa; D.S. Shepard; E.A. Undurraga; P. Gona; A. Goodridge; S.V. Gopalani; C.C. Gotay; N. Kissoon; J.A. Kopec; S. Murthy; F. Pourmalek; A. Goto; H.C. Gugnani; R. Gupta; R. Gupta; V. Gupta; R.A. Gutiérrez; R.R. Hamadeh; S. Hamidi; A.J. Handal; G.J. Hankey; P.E. Norman; Y. Hao; S. Harikrishnan; J.M. Haro; H.B. Hilderink; H.W. Hoek; A.K. Tura; R.S. Hogg; M. Horino; N. Horita; H.D. Hosgood; D.G. Hoy; M. Hsairi; M.M.T. Htike; G. Hu; C. Huang; H. Huang; L. Huiart; A. Husseini; I. Huybrechts; G. Huynh; K.M. Iburg; K. Innos; T.A. Jacobs; K.H. Jacobsen; N. Jahanmehr; M. Katibeh; Z. Rajavi; M.B. Jakovljevic; M. Javanbakht; S.P. Jayaraman; A.U. Jayatilleke; D. Prabhakaran; G. Jiang; A. Jimenez-Corona; J.B. Jonas; T.K. Joshi; Z. Kabir; R. Kamal; C.N. Kesavachandran; J. She; Z. Shen; H. Zhang; H. Kan; S. Kant; A. Karch; C. Karimkhani; D. Karletsos; G. Karthikeyan; N. Naik; V.K. Paul; A. Roy; R. Sagar; M. Satpathy; N. Tandon; A. Kaul; J.F. Kayibanda; P.N. Keiyoro; R.A. Lyons; C.D. Parry; A.P. Kengne; R. Matzopoulos; C.S. Wiysonge; D.J. Stein; B.M. Mayosi; A. Keren; Y.S. Khader; E.A. Khan; Y.H. Khang; S. Won; S. Khera; M. Tavakkoli; T.A.M. Khoja; D. Kim; Y.J. Kim; B.M. Kissela; Y. Kokubo; D. Kolte; S.T. McGarvey; S. Kosen; P.A. Koul; A. Koyanagi; B. Kuate Defo; B. Kucuk Bicer; E.J. Kuipers; V.S. Kulkarni; G.F. Kwan; S.R. Rao; H. Lam; J.O. Lam; J.B. Nachega; B.X. Tran; V.C. Lansingh; D.O. Laryea; A.A. Latif; A.E.B. Lawrynowicz; M. Levi; Y. Li; S.E. Lipshultz; J.D. Wilkinson; E.P. Simard; Y. Liu; M.R. Phillips; Q. Xiao; L. Lo; G. Logroscino; R. Lunevicius; S. Ma; V.M. Machado; M.T. Mackay; H. Magdy Abd El Razek; M. Magdy Abd El Razek; J. Mandisarisa; S. Mangalam; W. Marcenes; P.A. Meaney; D.J. Margolis; D.H. Silberberg; G.R. Martin; J. Martinez-Raga; M.B. Marzan; A.J. Mason-Jones; B.J. McMahon; M.M. Mehndiratta; S.M. Woldeyohannes; B.A. Tedla; B.M. Zeleke; P. Memiah; Z.A. Memish; W. Mendoza; T.J. Meretoja; T. Lallukka; F.A. Mhimbira; R. Micha; D. Mozaff; P. Shi; G.M. Singh; T.R. Miller; K.A. Mohammad; A. Mohammadi; V. Mohan; G.L.D. Mola; L. Monasta; M. Montico; L. Ronfani; L. Morawska; A. Werdecker; U.O. Mueller; R. Westerman; K.I. Musa; A.J. Paternina; S. Seedat; G. Nagel; D. Rothenbacher; K.S. Naidoo; B. Sartorius; L. Naldi; G. Remuzzi; V. Nangia; D. Nash; C. Nejjari; S. Neupane; C.R. Newton; F.N. Ngalesoni; J.D. Ngirabega; Q.L. Nguyen; P.M. Nkamedjie Pete; M. Nomura; L. Nyakarahuka; F.A. Ogbo; T. Ohkubo; P.R. Olivares; B.O. Olusanya; J.O. Olusanya; J.N. Opio; E. Oren; A. Ortiz; E. Ota; R. Ozdemir; P.A. Mahesh; J.D. Pandian; P.R. Pant; C. Papachristou; E. Park; J. Park; S.B. Patten; M. Tonelli; L. Stokic Pejin; D.M. Pereira; M. Cortinovis; G. Giussani; N. Perico; K. Pesudovs; J.D. Pillay; D. Plass; J.A. Platts-Mills; S. Polinder; C.A. Pope; M. Qorbani; A. Rafay; S.M. Rana; M. Rahman; S.U. Rahman; R.K. Rai; S. Rajsic; M. Raju; I. Rakovac; C.L. Ranabhat; T. Rangaswamy; A.L. Ribeiro; S. Ricci; A. Roca; D. Rojas-Rueda; N.K. Roy; G.M. Ruhago; B.F. Sunguya; S. Saha; R. Sahathevan; M.M. Saleh; J.R. Sanabria; M.D. Sanchez-Niño; L. Sanchez-Riera; R. Sarmiento-Suarez; M. Sawhney; M.P. Schaub; I.J.C. Schneider; D.A.S. Silva; A.E. Schutte; G. Shaddick; A. Shaheen; S. Shahraz; M.A. Shaikh; R. Sharma; B.P. Shetty; M. Shin; R. Shiri; I.D. Sigfusdottir; D.G.A. Silveira; J.I. Silverberg; Y. Yano; O.P. Singh; P.K. Singh; V. Singh; S. Soneji; K. Søreide; J.B. Soriano; L.A. Sposato; C.T. Sreeramareddy; V. Stathopoulou; M.B. Stein; S. Stranges; K. Stroumpoulis; S. Swaminathan; B.L. Sykes; R. Tabarés-Seisdedos; K.M. Tabb; J.S. Takala; R.T. Talongwa; B. Taye; M. Ten Have; E.M. Tuzcu; A.J. Thomson; A.G. Thrift; G.D. Thurston; R. Topor-Madry; F. Topouzis; J.A. Towbin; J. Traebert; T. Truelsen; U. Trujillo; U.S. Uchendu; K.N. Ukwaja; O.A. Uthman; R. Van Dingenen; A. van Donkelaar; T. Vasankari; A.M.N. Vasconcelos; N. Venketasubramanian; R. Vidavalur; F.S. Violante; V.V. Vlassov; M.T. Wallin; S. Weichenthal; R.A. White; H.C. Williams; J.Q. Wong; A.D. Woolf; D. Xavier; G. Xu; B. Yakob; L.L. Yan; P. Yip; N. Yonemoto; G. Yonga; M.Z. Younis; Z. Zaidi; M.E. Zaki; F. Zannad; D.E. Zavala; H. Zeeb; D. Zonies; L.J. Zuhlke
Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography–year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4–61·9) in 1980 to 71·8 years (71·5–72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7–17·4), to 62·6 years (56·5–70·2). Total deaths increased by 4·1% (2·6–5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8–18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6–16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9–14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1–44·6), malaria (43·1%, 34·7–51·8), neonatal preterm birth complications (29·8%, 24·8–34·9), and maternal disorders (29·1%, 19·3–37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000–183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000–532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Funding Bill & Melinda Gates Foundation. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
In Vitro and In Vivo Characterization of Scleral Implant of Indomethacin: Role of Plasticizer and Cross-Linking Time
(Taylor and Francis Inc., 2003) M. Thilek Kumar; C. Rajeswari; J. Balasubramaniam; J.K. Pandit; S. Kant
Film-type scleral implants of indomethacin using sodium alginate and PEG 400 and 600 (3, 5, 8, and 10% w/w w.r.t. sodium alginate) as plasticizers were fabricated by solvent casting. The prepared implants were cross-linked by treatment with calcium chloride 10, 20, and 30% w/v solution, for periods between 1 to 24 hr. Uniformity of thickness, weight, and drug content and surface pH of the implants were evaluated. The influence of plasticizer type/concentration and crosslinking time/concentration of calcium chloride on indomethacin release was studied on a static dissolution setup developed by us. Selected batches of the implants were subjected to pharmacodynamic studies, after scleral placement, in uveitis-induced (intravitreal injection of bovine serum albumin 50 μg/ml) rabbit eyes. The release of indomethacin from the implants was influenced by the concentration and nature of plasticizers used. Chemical cross-linking with calcium chloride was successful in retarding the drug release. The pharmacodynamic studies showed a marked improvement in the various clinical parameters (congestion, keratitis, flare, clot, aqueous cells, and synechias) in the implanted eye when compared with the control eye in the rabbits. The implants survived for 2 weeks in vivo.
Newer approaches for optimal bioavailability of ocularly delivered drugs: Review
(2011) K. Kesavan; J. Balasubramaniam; S. Kant; P.N. Singh; J.K. Pandit
Eye diseases can cause discomfort and anxiety in patients, with the ultimate fear of loss of vision and facial disfigurement. Many regions of the eye are relatively inaccessible to systemically administered drugs and, as a result, topical drug delivery remains the preferred route in most cases. Drugs may be delivered to treat the precorneal region for conjunctivitis and blepharitis, or to provide intraocular diseases such as glaucoma, uveitis, and cytomegalovirus retinitis. Most of the ophthalmic formulation strategies aim at maximizing ocular drug permeability through prolongation of the drug residence time in the cornea and conjunctival sac, as well as minimizing precorneal drug loss. The conventional topical ocular drug delivery systems show drawbacks such as increased precorneal elimination and high variability in efficacy. Attempts have been made to overcome these problems and enhance ocular bioavailability by the development of newer drug delivery systems. This review is concerned with classification, recent findings and applications and biocompatibility of newer drug delivery systems for the treatment of ocular diseases. © 2011 Bentham Science Publishers Ltd.
pH-induced in situ gelling systems of indomethacin for sustained ocular delivery
(2005) M. Thilek Kumar; D. Bharathi; J. Balasubramaniam; S. Kant; J.K. Pandit
The low bioavailability and ocular residence time exhibited by the topical conventional liquid opht halmic formulations because of spillage by overflow, dilution of drug by tear turn over, nasolacrimal drainage and systemic absorption may be overcome by the use of in situ forming systems that are instilled as liquid drops into the cul-de-sac of the eye, where they transform into a gel or semisolid phase. The present work describes the formulation and evaluation of an opthalmic delivery system of an antiinflammatory drug, indomethacin for the treatment of uveitis based on the concept of pH induced in situ gelation. The carbopol solutions which are acidic and less viscous, transform into stiff gels upon increase in pH of eyes as the gelling agents and its combination with hydroxypropylmethylcellulose-K15M, a well known ocular viscosity enhancing agent. The enhanced therapeutic efficacy and sustained release of indomethacin over 8 hour period in vitro make them an excellent candidate for in situ gelling ocular delivery systems.