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Article ; Online: Continuous quality improvement in rural health clinics.

Salman, Ghassan F

2005 Volume 20, Issue 9, Page(s) 862–865

Abstract: Aim: Continuous quality improvement has been shown to work in urban and suburban clinics. The objective of this project is to test whether continuous quality improvement would improve the quality of care for patients with diabetes mellitus and/or ... ...

Abstract	Aim: Continuous quality improvement has been shown to work in urban and suburban clinics. The objective of this project is to test whether continuous quality improvement would improve the quality of care for patients with diabetes mellitus and/or hypertension in a rural health clinic. Setting: Rural health clinic with 3 providers and two and half full-time registered nurses. Patients were mostly older adults with Medicare health insurance. Program description: Health care providers and nursing staff agreed on the quality improvement project. The intervention included providing quarterly feedback to health care providers, empowering the nurses to remind patients of diabetes care, and flagging the charts to remind providers. Program evaluation: The proportions of diabetic patients who had ophthalmologic exam, pneumococcal vaccine and lipid screening significantly improved over 12-month period. The proportions of patients with hypertension who had blood pressure less than 140/90 and patients who were taking aspirin also significantly improved over 12-month period. Conclusion: The quality of care for patients with diabetes and patients with hypertension could be improved in rural health clinics using repetitive cycles of measurements, implementation of interventions and evaluation of outcomes. This process could be used as the backbone for translation of evidence into practice and improving quality of care.
MeSH term(s)	Adolescent ; Adult ; Community Health Centers/standards ; Diabetes Mellitus/therapy ; Humans ; Hypertension/therapy ; Outcome and Process Assessment, Health Care ; Program Evaluation ; Quality Indicators, Health Care ; Rural Health Services/standards ; Total Quality Management ; United States
Language	English
Publishing date	2005-09-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1111/j.1525-1497.2005.0187.x
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Article ; Online: In vitro permeation and in vivo anti-inflammatory and analgesic properties of nanoscaled emulsions containing ibuprofen for topical delivery

Ibrahim M Salman / Ghassan Z Abdullah / Muthanna F Abdulkarim

International Journal of Nanomedicine, Vol 2011, Iss default, Pp 387-

2011 Volume 396

Abstract: Ghassan Z Abdullah1*, Muthanna F Abdulkarim1*, Ibrahim M Salman1, Omar Z Ameer1, Mun F Yam1,2 ... Ahmed F Mutee1, Mallikarjun Chitneni3, Elrashid S Mahdi1, Mahiran Basri4, Munavvar A Sattar1, Azmin M ...

Abstract	Ghassan Z Abdullah1, Muthanna F Abdulkarim1, Ibrahim M Salman1, Omar Z Ameer1, Mun F Yam1,2, Ahmed F Mutee1, Mallikarjun Chitneni3, Elrashid S Mahdi1, Mahiran Basri4, Munavvar A Sattar1, Azmin M Noor11School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; 2Faculty of Medicine and Health Science, Universiti Putra Malaysia, Selangor, Malaysia; 3School of Pharmacy and Health Sciences, International Medical University, Kuala Lumpur, Malaysia; 4Faculty of Science, Universiti Putra Malaysia, Selangor, Malaysia; *The first and second authors have contributed equally to this work.Introduction: As a topical delivery system, a nanoscaled emulsion is considered a good carrier of several active ingredients that convey several side effects upon oral administration, such as nonsteroidal anti-inflammatory drugs (NSAIDs).Objective: We investigated the in vitro permeation properties and the in vivo pharmacodynamic activities of different nanoscaled emulsions containing ibuprofen, an NSAID, as an active ingredient and newly synthesized palm olein esters (POEs) as the oil phase.Methodology: A ratio of 25:37:38 of oil phase:aqueous phase:surfactant was used, and different additives were used for the production of a range of nanoscaled emulsions. Carbopol® 940 dispersion neutralized by triethanolamine was employed as a rheology modifier. In some circumstances, menthol and limonene were employed at different concentrations as permeation promoters. All formulae were assessed in vitro using Franz diffusion cell fitted with full-thickness rat skin. This was followed by in vivo evaluation of the anti-inflammatory and analgesic activities of the promising formulae and comparison of the effects with that of the commercially available gel.Results and discussion: Among all other formulae, formula G40 (Carbopol® 940-free formula) had a superior ability in transferring ibuprofen topically compared with the reference. Carbopol® 940 significantly decreased the amount of drug transferred from formula G41 through the ...
Keywords	Medicine (General) ; R5-920
Language	English
Publishing date	2011-02-01T00:00:00Z
Publisher	Dove Medical Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A New Hematological Prognostic Index For Covid-19 Severity

A. Hammadi, Abdulmajeed / Al Jubouri, Adnan M. / Ahmed, Ghassan / H. Hayyawi, Ali / Kareem, Khalil / Gorial, Faiq I. / Waheeb Salman, Muhammed / Ghanim, Mohammed / F. Jameel, Basil / Jawad, Ali M. / Abbas, Hassan M. / Al-Gharawi, Ali A. / Al-shareef, Jawad I / Ali, Chasib L. / Nasser, Kawthar F. / Y. Abdulrazaq, Mohammad

medRxiv

Abstract: Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or Covid-19 is a nationwide public health emergency with significant impact on human life. Objective: To develop a new simple hematological prognostic index for Covid-19 severity ... ...

Abstract	Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or Covid-19 is a nationwide public health emergency with significant impact on human life. Objective: To develop a new simple hematological prognostic index for Covid-19 severity state. Patients and methods: This observational cross sectional study was conducted on 250 patients with Covid-19 disease. Age, gender, and severity of Covid -19 were recorded. Complete blood count and lactate dehydrogenase were measured. New index: COVID-19 severity-Iraqi-index = CSI index to predict COVID-19 severity. CSI index is monocyte/lymphocyte absolute counts multiplied by LDH (lactate dehydrogenase)/upper normal reference laboratory range of LDH value. Results: Mean age of patients was 50.4 + 15.1 years. Majority of patients were Males 148 (59.2%)..Most of patients were in stage 2 and 3 (> 94% ). There was a significant difference between means of White Blood Cells, lymphocytes and Monocytes among the different stages of the disease (P = 0.0001, 0.036, 0.012). There was a significant moderate correlation between the prognostic index and the stage of the disease (r=0.41, p=0.0001). Conclusions: CSI index is a new simple predictor of clinical outcome in patients with covid-19 during early stage of the disease.
Keywords	covid19
Language	English
Publishing date	2021-02-19
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2021.02.11.21251285
Database	COVID19

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Article ; Online: Preparation and in vitro evaluation of mebeverine HCl colon-targeted drug delivery system.

Abdullah, Ghassan Z / Abdulkarim, Muthanna F / Chitneni, Mallikarjun / Mutee, Ahmed F / Ameer, Omar Z / Salman, Ibrahim M / Noor, Azmin M

Pharmaceutical development and technology

2011 Volume 16, Issue 4, Page(s) 331–342

Abstract: Mebeverine HCl is a water soluble drug commonly used to treat irritable bowel syndrome by acting directly on the smooth muscles of the colon. This work was aimed at the formulation and in vitro evaluation of a colon-targeted drug delivery system ... ...

Abstract	Mebeverine HCl is a water soluble drug commonly used to treat irritable bowel syndrome by acting directly on the smooth muscles of the colon. This work was aimed at the formulation and in vitro evaluation of a colon-targeted drug delivery system containing mebeverine HCl. Matrix tablets were prepared using ethyl cellulose (EC), Eudragit RL 100 either solely or in combination by wet granulation technique. Dissolution was carried out in 0.1 N HCl for 2?h followed by pH 6.8 phosphate buffer for eight hours. Uncoated forms released more than 5% drug in 0.1 N HCl therefore, Eudragit L100 was used as a coat. The results indicated very slow release profile. As a result, single retardant was used to prepare the matrix and coated by Eudragit L 100. The matrix containing 7% Eudragit RL 100 and 6% of binder was subjected to further studies to assess the effect of different coats (Eudragit L 100-55 and cellulose acetate phthalate) and different binders (pectin and sodium alginate) on the release profile. Eudragit L 100 and pectin were the best coating agent and binder, respectively. The final formula was stable and it can be concluded that the prepared system has the potential to deliver mebeverine HCl in vivo to the colon.
MeSH term(s)	Alginates/chemistry ; Cellulose/analogs & derivatives ; Cellulose/chemistry ; Colon/metabolism ; Drug Delivery Systems/methods ; Excipients/chemistry ; Glucuronic Acid/chemistry ; Hexuronic Acids/chemistry ; Humans ; Hydrogen-Ion Concentration ; Parasympatholytics/administration & dosage ; Pectins/chemistry ; Phenethylamines/administration & dosage ; Phenethylamines/pharmacokinetics ; Polymethacrylic Acids/chemistry ; Solubility ; Tablets, Enteric-Coated/chemistry ; Tablets, Enteric-Coated/pharmacokinetics
Chemical Substances	Alginates ; Excipients ; Hexuronic Acids ; Parasympatholytics ; Pectins ; Phenethylamines ; Polymethacrylic Acids ; Tablets, Enteric-Coated ; methylmethacrylate-methacrylic acid copolymer (25086-15-1) ; mebeverine (7F80CC3NNV) ; ethyl cellulose (7Z8S9VYZ4B) ; pectin (89NA02M4RX) ; Glucuronic Acid (8A5D83Q4RW) ; alginic acid (8C3Z4148WZ) ; Cellulose (9004-34-6) ; cellulose acetate phthalate (9004-38-0)
Language	English
Publishing date	2011-08
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1331774-x
ISSN	1097-9867 ; 1083-7450
ISSN (online)	1097-9867
ISSN	1083-7450
DOI	10.3109/10837451003739255
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Article ; Online: In vitro pharmacodynamic profile of Loranthus ferrugineus: evidence for noncompetitive antagonism of norepinephrine-induced vascular contraction.

Ameer, Omar Z / Salman, Ibrahim M / Najim, Hafsa S / Abdullah, Ghassan Z / Abdulkarim, Muthanna F / Yam, Mun Fei / Sadikun, Amirin / Asmawi, Mohamed Z

Journal of acupuncture and meridian studies

2010 Volume 3, Issue 4, Page(s) 272–282

Abstract: The mode by which Loranthus ferrugineus methanol extract antagonizes and/or modulates norepinephrine-induced vasoconstriction was investigated in rat aortic rings. The vascular effects of three different concentrations of this extract were challenged ... ...

Abstract	The mode by which Loranthus ferrugineus methanol extract antagonizes and/or modulates norepinephrine-induced vasoconstriction was investigated in rat aortic rings. The vascular effects of three different concentrations of this extract were challenged against cumulative additions of norepinephrine. Phentolamine, a nonselective α-adrenoceptor antagonist, verapamil, an L-type calcium channel blocker, and papaverine, a phosphodiesterase inhibitor, were used in three different concentrations as positive controls. Log concentration-response curves and double-reciprocal plots were constructed for the extract and each vasorelaxant. To characterize antagonism reversibility, the norepinephrine maximum contractile effect was examined before extract addition to the aortic ring chamber and after its removal. Phentolamine shifted the norepinephrine log concentration-response curve to the right with no significant depression in the maximum response. Similar to verapamil and papaverine, the extract produced a rightward shift in norepinephrine log concentration-response curve and a significant drop in maximum response. The double-reciprocal plots showed comparable y-intercept values for all phentolamine concentrations, a characteristic of competitive antagonism. In contrast, different y-intercept values on double-reciprocal plots were obtained for each concentration of extract, verapamil, and papaverine, typical of noncompetitive antagonism. The norepinephrine maximum contractile response was approximately similar before the addition of extract and after its removal. The data collectively showed that L. ferrugineus methanol extract exerted its vascular effect by reversible noncompetitive antagonism of norepinephrine-induced vasoconstriction. These findings add to the understanding of the cardiovascular mechanisms by which L. ferrugineus, a plant traditionally used for the management of hypertension, elicits its action.
MeSH term(s)	Animals ; Aorta, Thoracic/drug effects ; Aorta, Thoracic/physiology ; Drug Antagonism ; In Vitro Techniques ; Loranthaceae/chemistry ; Male ; Norepinephrine/antagonists & inhibitors ; Norepinephrine/pharmacology ; Plant Extracts/pharmacokinetics ; Rats ; Rats, Sprague-Dawley ; Vasoconstrictor Agents/antagonists & inhibitors ; Vasoconstrictor Agents/pharmacology ; Vasodilator Agents/pharmacokinetics
Chemical Substances	Plant Extracts ; Vasoconstrictor Agents ; Vasodilator Agents ; Norepinephrine (X4W3ENH1CV)
Language	English
Publishing date	2010-12
Publishing country	Korea (South)
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2093-8152
ISSN (online)	2093-8152
DOI	10.1016/S2005-2901(10)60048-9
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Rehabilitation for patients with chronic obstructive pulmonary disease: meta-analysis of randomized controlled trials.

Salman, Ghassan F / Mosier, Michael C / Beasley, Brent W / Calkins, David R

Journal of general internal medicine

2003 Volume 18, Issue 3, Page(s) 213–221

Abstract: Objective: To develop a meta-analysis to determine the effectiveness of rehabilitation in patients with chronic obstructive pulmonary disease (COPD).: Data sources: medline, cinhal, and Cochrane Library searches for trials of rehabilitation for COPD ... ...

Abstract	Objective: To develop a meta-analysis to determine the effectiveness of rehabilitation in patients with chronic obstructive pulmonary disease (COPD). Data sources: medline, cinhal, and Cochrane Library searches for trials of rehabilitation for COPD patients. Abstracts presented at national meetings and the reference lists of pertinent articles were reviewed. Study selection: Studies were included if: trials were randomized; patients were symptomatic with forced expiratory volume in one second (FEV1) <70% or FEV1 divided by forced vital capacity (FEV1/FVC) <70% predicted; rehabilitation group received at least 4 weeks of rehabilitation; control group received no rehabilitation; and outcome measures included exercise capacity or shortness of breath. We identified 69 trials, of which 20 trials were included in the final analysis. Data extraction: Effect of rehabilitation was calculated as the standardized effect size (ES) using random effects estimation techniques. Results: The rehabilitation groups of 20 trials (979 patients) did significantly better than control groups on walking test (ES = 0.71; 95% confidence interval [95% CI], 0.43 to 0.99). The rehabilitation groups of 12 trials (723 patients) that used the Chronic Respiratory Disease Questionnaire had less shortness of breath than did the control groups (ES = 0.62; 95% CI, 0.35 to 0.89). Trials that used respiratory muscle training only showed no significant difference between rehabilitation and control groups, whereas trials that used at least lower-extremity training showed that rehabilitation groups did significantly better than control groups on walking test and shortness of breath. Trials that included severe COPD patients showed that rehabilitation groups did significantly better than control groups only when the rehabilitation programs were 6 months or longer. Trials that included mild/moderate COPD patients showed that rehabilitation groups did significantly better than control groups with both short- and long-term rehabilitation programs. Conclusion: COPD patients who receive rehabilitation have a better exercise capacity and they experience less shortness of breath than patients who do not receive rehabilitation. COPD patients may benefit from rehabilitation programs that include at least lower-extremity training. Patients with mild/moderate COPD benefit from short- and long-term rehabilitation, whereas patients with severe COPD may benefit from rehabilitation programs of at least 6 months.
MeSH term(s)	Dyspnea/etiology ; Dyspnea/prevention & control ; Exercise Tolerance ; Forced Expiratory Volume ; Humans ; Pulmonary Disease, Chronic Obstructive/complications ; Pulmonary Disease, Chronic Obstructive/rehabilitation ; Randomized Controlled Trials as Topic ; Rehabilitation/methods ; Walking
Language	English
Publishing date	2003-03-17
Publishing country	United States
Document type	Journal Article ; Meta-Analysis
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1046/j.1525-1497.2003.20221.x
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Article ; Online: Modification and Validation of an HPLC Method for Quantification of Piroxicam

Muthanna F. Abdulkarim / Ghassan Z. Abdullah / M.H.F. Sakeena / Mallikarjun Chitneni / Mun F. Yam / Elrashid S. Mahdi / Ibrahim M. Salman / Omar Z. Ameer / Munavvar A. Sattar / Mahiran Basri / Azmin M. Noor

International Journal of Drug Delivery, Vol 3, Iss

2011 Volume 1

Abstract: Piroxicam is a NSAID that is widely used in the treatment of joint pain and osteoarthritis. The objectives of the study were to modify and validate HPLC method so as to obtain an accurate, sensitive and precise method to quantify piroxicam concentrations ...

Abstract	Piroxicam is a NSAID that is widely used in the treatment of joint pain and osteoarthritis. The objectives of the study were to modify and validate HPLC method so as to obtain an accurate, sensitive and precise method to quantify piroxicam concentrations without interference from the other ingredients presence in the formulation. The method published by Owen et al. was adapted and modified to suit the above requirements. The modification was carried out on the mobile phase as the mobile phase used by the authors was not able to separate the drug peak from the interference of the formulation excipients. The modified mobile phase consisted of 5 mM of disodium hydrogen phosphate adjusted to pH 3 with concentrated ortho phosphoric acid, methanol, acetonitrile and glacial acetic acid at ratios of 27:20:52:1 respectively. The method was validated and found to be specific, precise, accurate and reproducible even when run at different times of the same day or on different times on different days. The limit of detection and quantification were determined to be 0.035 μg/ml and 0.0625 μg/ml respectively. It could be concluded that this method could be used to determine piroxicam concentration in the samples collected from in vitro study of permeability through the synthetic membrane and excised rat skin. Keywords: Piroxicam, HPLC, Quantification analysis, Modification.
Keywords	Piroxicam ; HPLC ; Quantification analysis ; Modification. ; Pharmacy and materia medica ; RS1-441 ; Medicine ; R ; DOAJ:Pharmacy and materia medica ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Subject code	540
Language	English
Publishing date	2011-04-01T00:00:00Z
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Study of Pseudoternary Phase Diagram Behaviour and the Effect of Several Tweens and Spans on Palm Oil Esters Characteristics

Muthanna F. Abdulkarim / Ghassan Z. Abdullah / M.H.F. Sakeena / Mallikarjun Chitneni / Mun F. Yam / Elrashid S. Mahdi / Ibrahim M Salman / Omar Z. Ameer / Munavvar A. Sattar / Mahiran Basri / Azmin M. Noor

International Journal of Drug Delivery, Vol 3, Iss

2011 Volume 1

Abstract: Palm oil esters are high molecular weight esters oil that has been newly synthesized by University Putra Malaysia researchers. It has received a lot of attention for its pharmaceutical and chemical application. The aim of this study is to study the ... ...

Abstract	Palm oil esters are high molecular weight esters oil that has been newly synthesized by University Putra Malaysia researchers. It has received a lot of attention for its pharmaceutical and chemical application. The aim of this study is to study the effects of the palm oil esters with different HLB surfactant mixture on the ternary diagrams behaviour and to confine the various systems resulted from these combinations. These systems include traditional emulsion, gel area, transpernat micro-emulsion area, O/W and W/O emulsions. In this study, pseudoternary phase diagrams of water, POEs and non-ionic surfactant mixture of several HLB values were constructed using water titration method. The resultant mixtures collected after each addition and mixing of water were analysed visually, along with conductivity, dilution in water and dye test (methylene blue) to classify them as O/W emulsion (transparent and opaque) or W/O (opaque) and liquid or gel. As a conclusion, palm oil esters were found to be suitable for the formulation of different types of emulsion. Additionally, different HLB value of non-ionic surfactant(s) exhibited different pseudoternary phase diagram characteristics. Keywords: palm oil esters, Tween, Span, Pseudoternary phase diagram, O/W emulsion
Keywords	palm oil esters ; Tween ; Span ; Pseudoternary phase diagram ; O/W emulsion ; Pharmacy and materia medica ; RS1-441 ; Medicine ; R ; DOAJ:Pharmacy and materia medica ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Subject code	571
Language	English
Publishing date	2011-04-01T00:00:00Z
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Study of Pseudoternary Phase Diagram Behaviour and the Effect of Several Tweens and Spans on Palm Oil Esters Characteristics

International Journal of Drug Delivery, Vol 3, Iss

2011 Volume 1

Abstract	Palm oil esters are high molecular weight esters oil that has been newly synthesized by University Putra Malaysia researchers. It has received a lot of attention for its pharmaceutical and chemical application. The aim of this study is to study the effects of the palm oil esters with different HLB surfactant mixture on the ternary diagrams behaviour and to confine the various systems resulted from these combinations. These systems include traditional emulsion, gel area, transpernat micro-emulsion area, O/W and W/O emulsions. In this study, pseudoternary phase diagrams of water, POEs and non-ionic surfactant mixture of several HLB values were constructed using water titration method. The resultant mixtures collected after each addition and mixing of water were analysed visually, along with conductivity, dilution in water and dye test (methylene blue) to classify them as O/W emulsion (transparent and opaque) or W/O (opaque) and liquid or gel. As a conclusion, palm oil esters were found to be suitable for the formulation of different types of emulsion. Additionally, different HLB value of non-ionic surfactant(s) exhibited different pseudoternary phase diagram characteristics. Keywords: palm oil esters, Tween, Span, Pseudoternary phase diagram, O/W emulsion
Keywords	palm oil esters ; Tween ; Span ; Pseudoternary phase diagram ; O/W emulsion ; Pharmacy and materia medica ; RS1-441 ; Medicine ; R
Subject code	571
Language	English
Publishing date	2011-04-01T00:00:00Z
Publisher	Advanced Research Journals
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Modification and Validation of an HPLC Method for Quantification of Piroxicam

International Journal of Drug Delivery, Vol 3, Iss

2011 Volume 1

Abstract	Piroxicam is a NSAID that is widely used in the treatment of joint pain and osteoarthritis. The objectives of the study were to modify and validate HPLC method so as to obtain an accurate, sensitive and precise method to quantify piroxicam concentrations without interference from the other ingredients presence in the formulation. The method published by Owen et al. was adapted and modified to suit the above requirements. The modification was carried out on the mobile phase as the mobile phase used by the authors was not able to separate the drug peak from the interference of the formulation excipients. The modified mobile phase consisted of 5 mM of disodium hydrogen phosphate adjusted to pH 3 with concentrated ortho phosphoric acid, methanol, acetonitrile and glacial acetic acid at ratios of 27:20:52:1 respectively. The method was validated and found to be specific, precise, accurate and reproducible even when run at different times of the same day or on different times on different days. The limit of detection and quantification were determined to be 0.035 μg/ml and 0.0625 μg/ml respectively. It could be concluded that this method could be used to determine piroxicam concentration in the samples collected from in vitro study of permeability through the synthetic membrane and excised rat skin. Keywords: Piroxicam, HPLC, Quantification analysis, Modification.
Keywords	Piroxicam ; HPLC ; Quantification analysis ; Modification. ; Pharmacy and materia medica ; RS1-441 ; Medicine ; R
Subject code	540
Language	English
Publishing date	2011-04-01T00:00:00Z
Publisher	Advanced Research Journals
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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