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Fulltext Intra-articular Steroid alone vs Hydrodilatation with intra-articular Steroid in Frozen Shoulder - A Randomised Control Trial

Swaroop S, Gupta P, Patnaik S, Reddy SS

Malays Orthop J, 2023 Mar;17(1):34-39.
PMID: 37064640 DOI: 10.5704/MOJ.2303.005

INTRODUCTION: Various non-operative treatment modalities have been advocated for a frozen shoulder. In the present study we compared the efficacy of single intra-articular steroid injection vs hydrodilatation with intra-articular steroids for frozen shoulder (FS) in the frozen phase.
MATERIALS AND METHODS: This was a prospective, randomised control trial (RCT) done at a tertiary care centre. A total of 108 participants were randomised into two groups-one group received intra-articular steroid with hydrodilatation (HDS) and other group received intra-articular steroid injection only (S). Shoulder Pain and Disability Index (SPADI) scores were taken, and statistical analysis was done to measure the outcome at two weeks, six weeks and three-month intervals after the injection.
RESULT: There was significant improvement in symptoms at each interval for both the groups (p=0.0). There was no statistically significant difference in the SPADI score between the two groups at two weeks post injection, however at six weeks (p=0.04) and 3 months (p=0.001) significant difference in the SPADI score was demonstrated with better scores in group S. The mean duration of analgesia required in group HDS was 5.17 days (S.D.=1.73) and for group S was 4.28 days (S.D.=1.01), with a statistical significance (p=0.002).
CONCLUSION: Better clinical results were obtained at six weeks and three months with the group receiving corticosteroid only and also had a lesser requirement of analgesia post-intervention. Thus, intra-articular steroid injection only seems to be a more desirable method of management during the frozen phase of FS than that of hydrodilatation with intra-articular steroid injection.
Fulltext Fabrication of Second Generation Smarter PLGA Based Nanocrystal Carriers for Improvement of Drug Delivery and Therapeutic Efficacy of Gliclazide in Type-2 Diabetes Rat Model

Panda BP, Krishnamoorthy R, Bhattamisra SK, Shivashekaregowda NKH, Seng LB, Patnaik S

Sci Rep, 2019 11 22;9(1):17331.
PMID: 31758056 DOI: 10.1038/s41598-019-53996-4

Drug delivery and therapeutic challenges of gliclazide, a BCS class II drug used in type 2 diabetes mellitus (T2DM) can be overcome by exploring smarter carriers of second-generation nanocrystals (SGNCs). A combined method of emulsion diffusion, high-pressure homogenization and solvent evaporation method were employed in the preparation of gliclazide loaded poly (D, L-lactide-co-glycolide) (PLGA) SGNCs. Taguchi experimental design was adopted in fabrication of Gliclazide SGNc using Gliclazide -PLGA ratio at 1:0.5, 1:0.75, 1:1 with stabilizer (Poloxamer-188, PEG 4000, HPMC E15 at 0.5, 0.75, 1% w/v). The formulated gliclazide of SGNCs were investigated for physicochemical properties, in vitro drug release, and in vivo performance studies using type-2 diabetes rat model. The formulation (SGNCF1) with Drug: PLGA 1: 0.5 ratio with 0.5% w/v Poloxamer-188 produced optimized gliclazide SGNCs. SGNCF1 showed spherical shape, small particle size (106.3 ± 2.69 nm), good zeta potential (-18.2 ± 1.30 mV), small PDI (0.222 ± 0.104) and high entrapment efficiency (86.27 ± 0.222%). The solubility, dissolution rate and bioavailability of gliclazide SGNCs were significantly improved compared to pure gliclazide. The findings emphasize gliclazide SGNCs produce faster release initially, followed by delayed release with improved bioavailability, facilitate efficient delivery of gliclazide in T2DM with better therapeutic effect.
Recent update of toxicity aspects of nanoparticulate systems for drug delivery

Patnaik S, Gorain B, Padhi S, Choudhury H, Gabr GA, Md S, et al.

Eur J Pharm Biopharm, 2021 Apr;161:100-119.
PMID: 33639254 DOI: 10.1016/j.ejpb.2021.02.010

Potential research outcomes on nanotechnology-based novel drug delivery systems since the past few decades attracted the attention of the researchers to overcome the limitations of conventional deliveries. Apart from possessing enhanced solubility of poorly water-soluble drugs, the targeting potential of the carriers facilitates longer circulation and site-specific delivery of the entrapped therapeutics. The practice of these delivery systems, therefore, helps in maximizing bioavailability, improving pharmacokinetics profile, pharmacodynamics activity and biodistribution of the entrapped drug(s). In addition to focusing on the positive side, evaluation of nanoparticulate systems for toxicity is a crucial parameter for its biomedical applications. Due to the size of nanoparticles, they easily traverse through biological barriers and may be accumulated in the body, where the ingredients incorporated in the formulation development might accumulate and/or produce toxic manifestation, leading to cause severe health hazards. Therefore, the toxic profile of these delivery systems needs to be evaluated at the molecular, cellular, tissue and organ level. This review offers a comprehensive presentation of toxicity aspects of the constituents of nanoparticular based drug delivery systems, which would be beneficial for future researchers to develop nanoparticulate delivery vehicles for the improvement of delivery approaches in a safer way.

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