Background: Nicotine replacement therapy (NRT) can help smokers to quit smoking. Nicotine chewing gum has attracted the attention from pharmaceutical industries to offer it to consumers as an easily accessible NRT product. However, the bitter taste of such gums may compromise their acceptability by patients. This study was, therefore, designed to develop 2 and 4 mg nicotine chewing gums of pleasant taste, which satisfy the consumers the most. Materials and Methods: Nicotine, sugar, liquid glucose, glycerin, different sweetening and taste-masking agents, and a flavoring agent were added to the gum bases at appropriate temperature. The medicated gums were cut into pieces of suitable size and coated by acacia aqueous solution (2% w/v), sugar dusting, followed by acacia-sugar-calcium carbonate until a smooth surface was produced. The gums' weight variation and content uniformity were determined. The release of nicotine was studied in pH 6.8 phosphate buffer using a mastication device which simulated the mastication of chewing gum in human. The Latin Square design was used for the evaluation of organoleptic characteristics of the formulations at different stages of development. Results: Most formulations released 79-83% of their nicotine content within 20 min. Nicotine-containing sugar-coated gums in which aspartame as sweetener and cherry and eucalyptus as flavoring agents were incorporated (i.e. formulations F _19-SC and F _20-SC , respectively) had optimal chewing hardness, adhering to teeth, and plumpness characteristics, as well as the most pleasant taste and highest acceptability to smokers. Conclusion: Taste enhancement of nicotine gums was achieved where formulations comprised aspartame as the sweetener and cherry and eucalyptus as the flavoring agents. Nicotine gums of pleasant taste may, therefore, be used as NRT to assist smokers quit smoking.

Background: Periodontitis is inflammation of the supporting tissues of the teeth caused by specific microorganisms. Intra-periodontal pocket, mucoadhesive drug delivery systems have been shown to be clinically effective in the treatment of periodontitis. The aim of this study was to formulate a mucoadhesive gel from the seed hull of Quercus brantii and fruits of Coriandrum sativum for the treatment of periodontitis. Materials and Methods: The semisolid concentrated extracts were incorporated in gel base. Mucoadhesive gels were prepared using carbopol 940‚ sodium carboxymethylcellulose (sodium CMC) and hydroxypropyl methylcellulose K4M (HPMC) as bioadhesive polymers. Physicochemical tests‚ mucoadhesive strength measurement and in vitro drug release study were carried out on two formulations containing carbopol 940 and sodium CMC polymers (Formulations F ₄ and F ₅ ). We investigated the antibacterial activity of formulation F ₅ against Porphyromonas gingivalis using the disk diffusion method on supplemented Brucella agar. Results: Eight gel formulations were prepared. Physical appearance, homogeneity and consistency of F ₄ and F ₅ were good. Mucoadhesion and viscosity of F ₅ (1% carbopol 940 and 3% sodium CMC) was more than F ₄ (0.5% carbopol 940 and 3% sodium CMC). Drug release from F ₅ was slower. Both of formulations were syringeable through 21 G needle. In the disk diffusion method, F ₅ produced significant growth inhibition zones against P. gingivalis. Conclusion: The ideal formulation for the treatment of periodontitis should exhibit high value of mucoadhesion, show controlled release of drug and be easily delivered into the periodontal pocket preferably using a syringe. Based on in vitro release and mucoadhesion studies‚ F ₅ was selected as the best formulation.

Anaphylactic shock is medical emergency characterized by circulatory collapse resulted from severe acute allergic reactions, namely anaphylaxis and anaphylactoid reaction. Anaphylaxis is an acute, systemic, IgE-mediated, and immediate hypersensitivity reaction caused by the release of mediators by mast cells and basophils after exposure to antigens. The pathophysiology involves activated mast cells and basophils releasing preformed, granule-associated mediators, and newly formed lipid mediators, as well as generating cytokines and chemokines. These cause vasodilatation, increased capillary permeability, and smooth muscle contraction, and attract new cells to the area. Positive feedback mechanisms amplify the reaction, although conversely reactions can self-limit. Anaphylaxis is a clinical diagnosis with a combinations of symptoms and signs that include weakness, dizziness, flushing, angioedema, urticaria of the skin, congestion, and sneezing. More severe symptoms include bronchial constriction, hypotension, vascular collapse associated with angioedema and urticaria, gastrointestinal distress, cardiovascular arrhythmias, and arrest. Prompt administration of epinephrine is critical for the success in the treatment of acute anaphylaxis.

The incidence of anaphylaxis during anesthesia has been reported to range from 1 in 4000 to 1 in 25,000. Anaphylaxis during anesthesia can present as cardiovascular collapse, airway obstruction, and/or skin manifestation. It can be difficult to differentiate between immune and nonimmune mast cell-mediated reactions and pharmacologic effects from the variety of medications administered during general anesthesia. In addition, cutaneous manifestations of anaphylaxis are less likely to be apparent when anaphylaxis occurs in this setting. The evaluation of IgE-mediated reactions to medications used during anesthesia can include skin testing to a variety of anesthetic agents. Specifically, thiopental allergy has been documented by skin tests. Neuromuscular blocking agents such as succinylcholine can cause nonimmunologic histamine release, but there have also been reports of IgE-mediated reactions in some patients. Reactions to opioid analgesics are usually caused by direct mast cell mediator release rather than IgE-dependent mechanisms. Antibiotics that are administered perioperatively can cause immunologic or nonimmunologic reactions. Protamine can cause severe systemic reactions through IgE-mediated or nonimmunologic mechanisms. Blood transfusions can elicit a variety of systemic reactions, some of which might be IgE-mediated or mediated through other immunologic mechanisms. The management of anaphylactic reactions that occur during general anesthesia is similar to the management of anaphylaxis in other situations.

Aims: The aim of this prospective study was to evaluate the quality and stability of autogenous tibial bone graft for the correction of alveolar bone defects in cleft patients in a long-term study as well as to evaluate the postoperative morbidity and risk of complications. Materials and Methods: A total of 47 patients with 55 donor sites were involved in this study. The first author performed all the procedures from 2003 to 2011. Medial and lateral approaches were used to harvest the bone with standardized surgical technique. Evaluation in both donor and recipient sites was done by clinical examination, postoperative pain and recovery, and radiographic examination by Panoramic and occlusal X-rays and lateral X-ray for the tibia. Moreover, the donor site was assessed for functionality and mobility based on the Lysholm score. Finally, the patient's experience was evaluated subjectively utilizing a visual analog scale. Results: The surgical outcome was satisfied in all except two cases with total graft resorption for unknown reasons. Regarding the postoperative patient experience we found that patients experienced pain in the recipient site more than they did at the donor site at 24-hour and two-week follow-ups. Conclusion: We conclude that the proximal tibia is a safe site from which cancellous bone graft can be harvested to repair the alveolus as it carries less early and late morbidity. Thus, we suggest that the tibia is an excellent choice as a donor site for alveolar bone grafting in children and adult with cleft lip and palate with satisfactory long-term stability.

Purpose: To evaluate the usefulness of orthomorphic surgery in correcting mandibular dysmorphology. Materials and Methods: This is a prospective study in which five patients having mandibular dysmorphology were treated using orthomorphic surgery. The patients were evaluated for outcome in terms of duration of surgery, assessment of mandibular split, mental nerve paresthesia/ neurosensory changes after surgery, assessment of mouth opening before and after surgery, postoperative assessment of mandibular symmetry, and postoperative complications. Statistical Analysis Used: Descriptive statistics, frequencies, contingency coefficient test (cross tabs). Results: Our study has revealed results in support of the technique mentioned, showing good success rate in terms of mandibular dysmorphology correction when used in mild to moderate dysmorphology cases. Conclusion: Orthomorphic surgery will play an increasingly important role in the repertoire of the maxillofacial surgeon in correcting mandibular dysmorphology.

Osteopetrosis is a rare genetic disorder that causes generalized sclerosis of the bone due to defect in bone resorption and remodeling. Albergs-Schonberg disease or autosomal dominant osteopetrosis type II is a rare form of osteopetrosis. Osteomyelitis is a well-documented complication of osteopetrosis. Any associated dental abnormality may be attributed to the pathological changes in bone remodeling. This case report discusses a case of osteopetrosis with osteomyelitis as a complication in a 8-year-old boy.

Despite the proven effectiveness of the prevention of mother to child transmission (PMTCT) of human immunodeficiency virus (HIV) program, Nigeria currently has the highest burden of vertical transmission of HIV in the world due to poor coverage of the PMTCT program partly as a result of poor knowledge of PMTCT interventions amongst healthcare providers in the country. This paper aims at making information on PMTCT interventions more readily available to healthcare providers in developing countries. The internet was searched using Google and Google scholar. In addition, relevant electronic journals from the Universities library including PubMed and Scirus, Medline, Cochrane library, and World Health Organization (WHO)'s Hinari were used. There was paucity of published work on PMCT from Nigeria. Most of the information concerning PMCT in Nigeria was obtained from technical reports from the Federal Ministry of Health and WHO. It is expected that this article will help in improving healthcare providers' knowledge of PMTCT interventions and thus help in the urgently needed rapid scale-up of PMTCT services in Nigeria.

The purpose of the present research is to investigate systematically the tablettability and drug release properties of ethyl cellulose (EC) in compact form. A total of nine batches of compacts containing metformin hydrochloride (MTF) as model drug and ECs with varying viscosity grades (7, 10, and 100 cps) at 10, 20 and 30% w/w contents were prepared. Profound effect of viscosity grades and content of EC on compression behavior of granules and drug release from compacted matrices was observed. An increase in EC 7 cps content resulted improvement in tensile strength and compactibility. However, compression susceptibility gets inversely affected. EC 7 cps has shown MTF release, which is extended upto 10 hours (t _90% ), attributed to high interparticulate interactions. Similar trend was observed with both EC 10 cps (t _90% ; upto 13 hours) and 100 cps (t _90% ; upto 10 hours). Surprising results were observed for matrices of EC 10 cps at 20% w/w, which showed moderate compactibility and tensile strength, but extended the MTF release for maximum time among all compact formulations (t _90% ; 13 hours; peppas model). These results show the use of EC 10 cps in formulations desired for extended drug release at its optimum content. Matrices containing EC 100 cps have shown better compressibility and compactibility among all batches. The anomalous behavior of high viscosity EC (at 20% w/w content) matrices releasing drug in shorter time (t _90% , 8 hours; zero order) can be ascribed to poor matrixing of MTF in EC network due to high molecular weight of EC 100 cps.

The present work is to formulate effective hand rub disinfectant by selecting broad-spectrum antimicrobial and antifungal agents. Increased need of easy-to-use hand rub disinfectant in pharmaceutical, food processing industry, hospitals, and in clinical labs necessitated development of the best possible product. Formulations were prepared using Benzalkonium chloride, chlorhexidine gluconate as potent disinfectants along with alcohol 70%. In low concentration they were highly effective without leaving any toxic effect on the user's skin. A synergistic effect was observed when ethyl alcohol 70% was used in combination. Suitable emollient and skin conditioning agents were used to avoid possible dehydrating effect on the user's skin. Excellent volatility of the preparation was observed after use, leaving a thin antimicrobial film on the user's hand. The use of suitable excipient brought effective removal of after the use leaving a soothening effect on the skin. The aim of present work is to develop hand rub formulation which evaporates quickly after applications leaving no trace on hands as in case of hand rub gels. The present formulation was found to be effective when compared with marketed liquid hand rub.