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.
Topic 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
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The reason for conducting this study is to prolong release of miconazole in the ocular site of action by ocular-based gels (OBGs) formulations. The formulation factors affecting on the release from OBG should be studied using various gelling agents in various concentrations to achieve the improvement in retention and residence time in response to prolonged release. In this study, the formulations were prepared using carbopol 940, pectin, sodium alginate, poloxamer 407, and poly(methacrylic acid) at 0.5%, 1%, and 1.5% w/v, respectively. Hydroxypropyl methylcellulose E5 (HPMC E5) 1% was added as thickening agent/viscosity builder. The formulation containing carbopol 940, pectin and sodium alginate at 1.5% w/v, displayed a noticable im
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The present study tackles the complex issue of the urgent need for Environmental Auditing (EA) in Iraq in the absence of laws that support environmental management and in the light of the high rates of cancerous diseases in Iraq, which coincided significantly with the increase in oil production, according to the numbers indicated in the Iraqi Ministry of Health. The study aimed to investigate the mediating role of Management Systems (MS) related to the role of EA supporting sustainability reports concerning the reduction of the negative effects of gas emissions from oil companies. We adopted the descriptive approach which relies on studying relationships through a questionnaire that was distributed to a group of workers at Doura Refinery in
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This research aims to understand complexity management and its impact on the use of the dynamic capabilities of a sample of private colleges. Private colleges are currently facing many crises, changes, unrest and high competitive pressures. Which is sometimes difficult or even impossible to predict. The recruitment of dynamic capabilities is also one of the challenges facing senior management at private colleges to help them survive and survive. Thus, the problem of research was (there is a clear insufficiency of interest in Complexity Management and trying to employ it in improving the dynamic capabilities of Colleges that have been discussed?). A group of private colleges was selected as a
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Sufficient high-quality data are unavailable to describe the management approach and guideline of COVID-19 disease in pediatric and adolescent population which may be due to mild presentation in most of cases and less severe complications than older ages.
World Health Organization was concerned with the establishment of an approved guideline to manage the increasing number of COVID-19 patients worldwide aiming to prevent or lessen COVID-19 global burden.
The clinical features have a wide spectrum starting from uncomplicated mild illness, mild-moderate pneumonia, severe pneumonia, acute respiratory distress syndrome, sepsis, septic shock, and multisystem inflammatory syndrome in children.
Many important definitions
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To identify and explore the factors nurses perceive as influencing their knowledge acquisition in relation to diabetes care and its management in Saudi Arabia.
Diabetes continues to pose major healthcare challenges despite advances in diabetes management. Nurses have a crucial role in diabetes care, but diabetes knowledge deficits deter effective collaboration with other healthcare providers in educating patients about diabetes self‐management.
An exploratory descriptive qualitative design.
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Objective: The aim of this study was to formulate and in vitro evaluate fast dissolving oral film of practically insoluble bromocriptine mesylate to enhance its solubility and to improve its oral bioavailability by avoiding first pass effect as well as to produce an immediate release action of the drug from the film for an efficient management of diabetes mellitus type II in addition to an improvement of the patient compliance to this patient- friendly dosage form. Methods: The films were prepared by the solvent casting method using hydroxypropyl methylcellulose of grades (E3, E5, E15), polyvinyl alcohol (PVA), pectin and gelatin as film-forming polymers in addition to polyethene glycol 400 (PEG400), propylene glycol (PG) and glycerin were
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