Hina Qamar - Academia.edu (original) (raw)

Papers by Hina Qamar

Blood

INTRODUCTION: We present a case of a young man with Klippel Trenaunay Weber Syndrome (KTWS) chara... more INTRODUCTION: We present a case of a young man with Klippel Trenaunay Weber Syndrome (KTWS) characterized by recurrent superficial vein thrombosis (SVT) complicated by an episode of disseminated intravascular coagulation (DIC) who ultimately was maintained on prophylactic rivaroxaban to prevent recurrent thrombotic events. We performed a literature search to identify similar cases and to summarize common presenting features and attempted treatment modalities. CASE DESCRIPTION: An 18 year old man with KTWS presented with a large vascular malformation over his left chest and arm developed acute worsening SVT post sodium tetradecyl injection. Further investigation revealed a severe DIC was also present. On exam, the venous malformation and left arm were extremely tender with significant bruising. Presenting labs: Hg 24, platelet 98, bilirubin 588 (unconjugated 212), LDH 1597, PTT 32, INR 1.9, fibrinogen 1.1, Ddimer >20. He was treated with aggressive supportive care for DIC and rout...

Canadian Journal of General Internal Medicine

Klippel-Trenaunay-Weber syndrome (KTWS) is a congenital malformation syndrome involving blood and... more Klippel-Trenaunay-Weber syndrome (KTWS) is a congenital malformation syndrome involving blood and lymph vessels and disturbed bone and soft tissue growth. Complications of KTWS include deep-vein thrombosis, pulmonary embolism, gastrointestinal bleeding, and vascular (usually lymphatic) blebs within capillary malformations. We present a case of a young male patient with KTWS who presented with superficial venous thrombosis and microangiopathic hemolytic anemia in a presentation similar to disseminated intravascular coagulation. He was ultimately maintained on prophylactic rivaroxaban to prevent recurrent thrombotic events. We performed a literature search to identify similar cases and to summarize common presenting features and treatment modalities that were offered. Résumé Le syndrome de Klippel-Trenaunay-Weber (KTWS) est un syndrome de malformation congénitale impliquant le sang et les vaisseaux lymphatiques et les os perturbés et la croissance des tissus mous. Les complications de...

Mediterranean journal of hematology and infectious diseases, 2017

Acquired von Willebrand syndrome (AVWS) is a rare hemorrhagic disorder that occurs in patients wi... more Acquired von Willebrand syndrome (AVWS) is a rare hemorrhagic disorder that occurs in patients with no prior personal or family history of bleeding. Here, we describe a case of AVWS occurring after autologous stem cell transplantation (ASCT). Interestingly, AVWS developed after bortezomib-based induction and conditioning regimens. Recent evidence suggests that the proximity of the bortezomib therapy to the collection of stem cells with consequent depletion of regulatory T cells after the conditioning regimen could explain some of the unusual autoimmune complications reported in patients receiving bortezomib prior to ASCT. In addition, this patient developed a secondary MGUS post-ASCT, which may have also contributed to the AVWS. To the best of our knowledge, this is the first case of post-ASCT AVWS reported. Prospective data is needed to better elucidate the mechanisms by which these unusual complications occur in patients receiving bortezomib prior to ASCT.

Clinical Gastroenterology and Hepatology, 2016

The severe depletion of muscle mass at the 3rd lumbar vertebral level (sarcopenia) is a marker of... more The severe depletion of muscle mass at the 3rd lumbar vertebral level (sarcopenia) is a marker of malnutrition and is independently associated with mortality in patients with cirrhosis. Instead of monitoring sarcopenia by cross-sectional imaging, we investigated whether ultrasound-based measurements of peripheral muscle mass, measures of muscle function, along with nutritional factors, are associated with severe loss of muscle mass. We performed a prospective study of 159 outpatients with cirrhosis (56% male; mean age 58±10 years; mean MELD score, 10±3; 60% Child-Pugh class A) evaluated at the Cirrhosis Care Clinic at the University of Alberta Hospital from March 2011 through September 2012. Lumbar skeletal muscle indices were determined by computed tomography or magnetic resonance imaging. We collected clinical data and data on patients' body composition, nutrition, and thigh muscle thickness (using ultrasound analysis). We also measured mid-arm muscle circumference, mid-arm circumference, hand grip, body mass index (BMI), and serum level of albumin; patients were evaluated using the subjective global assessment scale. Findings from these analyses were compared with those from cross-sectional imaging, for each sex, using logistic regression analysis. Based on cross-sectional imaging analysis, 43% of patients had sarcopenia (57% of men and 25% of women). Results from the subjective global assessment, serum level of albumin, and most nutritional factors were significantly associated with sarcopenia. We used multivariate analysis to develop a model to identify patients with sarcopenia, and developed a nomogram based on BMI and thigh muscle thickness for patients of each sex. Our model identified men with sarcopenia with an area under the receiver operating characteristic curve (AUROC) value of 0.78 and women with sarcopenia with an AUROC value of 0.89. In a prospective study of patients with cirrhosis, we found that the combination of BMI and thigh muscle thickness (measured by ultrasound) can identify male and female patients with sarcopenia almost as well as cross-sectional imaging (AUROC values of 0.78 and 0.89, respectively). These factors might be used in screening and routine nutritional monitoring of patients with cirrhosis.

Doxycycline is a semi-synthetic, lipophilic and potent tetracycline congener, widely used in huma... more Doxycycline is a semi-synthetic, lipophilic and potent tetracycline congener, widely used in human and veterinary medicine and as an animal feed supplement to prevent disease. It is the drug of choice in the treatment of Lyme disease, Brucellosis, and several Rickettsial infections, and it is also utilized in the treatment of sexually transmitted diseases. Forced degradation commonly includes exposure of drug to heat, range of pH values, UV light, forced degradation study helps to determine the loss of drug substance and the degradation product under diverse conditions.. According to ICH guidelines Doxycycline was exposed to different stress conditions. For the analysis of drug in the presence of degradation products, UV spectroscopic method was developed which calculate the amount of the degradaded product. According to the BP, the official assay limit of th content should NLT 95% and NMT 105% of labelled amount. On exposure to acidic medium (1 N HCl) shows heavy degradation, whereas comparatively less degradation occurs with heat, in addition UV light and basic medium (1 N NaOH) has least degradation effect on doxycycline. The method was found to be simple, cost effective and less time consuming. Hence this method can be successfully used.

Amlodipine besylate is a potent long-acting calcium channel blocking agent.. An efficient least t... more Amlodipine besylate is a potent long-acting calcium channel blocking agent.. An efficient least time consuming and simple spectrophotometric method for the assay of Amlodipine has been used. The assay is based on the ultraviolet UV absorbance maxima at about 238nm wavelength of Amlodipine using water as solvent. A sample of drug was dissolved in water to produce a solution containing Amlodipine. Similarly, various dilutions were made. The absorbance of sample preparation was measured at 238nm against the solvent blank and the assay was determined. In our study a simple and quick assay method using U.V spectrophotometer has been used. The assay is based on measuring the absorbance of formulation of Amlodipine dilutions at the wavelength of 238 nm. Four different dilutions of 50ppm, 25ppm, 12.5ppm and 6.25ppm are prepared and their percent assay is calculated.

Glimepride belongs to sulfonylurea oral anti diabetic. A efficient least time consuming and simpl... more Glimepride belongs to sulfonylurea oral anti diabetic. A efficient least time consuming and simple spectrophotometric method for the assay of Glimepride has been used. The assay is based on the ultraviolet UV absorbance maxima at about 200nm wavelength of Glimepride using water as solvent. A sample of drug was dissolved in water to produce a solution containing Glimepride. Similarly, various dilutions were made. The absorbance of sample preparation was measured at 200nm against the solvent blank and the assay was determined. In our study a simple and quick assay method using U.V spectrophotometer has been used. The assay is based on measuring the absorbance of formulation of Glimepride dilutions at the wavelength of 200 nm. Four different dilutions of 50ppm, 25ppm, 12.5ppm and 6.25ppm is prepared and their percent assay is calculated.

A B S T R A C T Forced degradation is a extensively employed method carried out in pharmaceutical... more A B S T R A C T Forced degradation is a extensively employed method carried out in pharmaceutical development in order to develop stability, demonstrating methods that provides quality and steadiness information to comprehend the degradation pathways of the drug substance and its impurities. There are various distinctive brands accessible in market for diltiazem. It will be a calcium opponent profitable in the medicine about secure, variant and unstable (flimsy angina pectoris). Concomitant perusing parallel β-adrenoceptor opponent therapy, happen infrequently as an adverse impact about diltiazem medication. The reason for this examine create the investigations from claiming two diverse brands for diltiazem 60mg. It might have been subjected under different stress condition concerning illustration for every (ICH) worldwide meeting with respect to harmonization rules. Sresses like Acid/base, variability in temperature, photo degradation and with time (7days). Also with occasion when ...

Canadian journal of gastroenterology = Journal canadien de gastroenterologie

Canadian journal of gastroenterology & hepatology, 2014

Spontaneous bacterial peritonitis (SBP) is the most prevalent bacterial infection in patients wit... more Spontaneous bacterial peritonitis (SBP) is the most prevalent bacterial infection in patients with cirrhosis. Although studies from Europe have reported significant rates of resistance to third-generation cephalosporins, there are limited SBP-specific data from centres in North America. To evaluate the prevalence of, predictors for and clinical impact of third-generation cephalosporin-resistant SBP at a Canadian tertiary care centre, and to summarize the data in the context of the existing literature. SBP patients treated with both antibiotics and albumin therapy at a Canadian tertiary care hospital between 2003 and 2011 were retrospectively identified. Multivariate logistic regression was used to determine independent predictors of third-generation cephalosporin resistance and mortality. In 192 patients, 25% of infections were nosocomial. Forty per cent (77 of 192) of infections were culture positive; of these, 19% (15 of 77) were resistant to third-generation cephalosporins. The p...

Pharmacology & Pharmacy, 2014

Objective: To analyze the use of all subsidized prescription drugs including their use of drug co... more Objective: To analyze the use of all subsidized prescription drugs including their use of drug combination generally accepted as carrying a risk of severe interactions. Methodology: In a cross sectional study, we analyzed all prescriptions (n = 1014) involving two or more drugs dispensed to the population (age range 4 -85 years) from all pharmacies, clinics and hospitals. Data were stratified by age and sex, and frequency of common interacting drugs. Potential drug interactions were classified according to clinical relevance as significance of severity (types A: major, B: moderate, and C: minor) and documented evidence (types 1, 2, 3, and 4). Result and Discussion: The growing use of pharmacological agents means that drug interactions are of increasing interest for public health. Monitoring of potential drug interactions may improve the quality of drug prescribing and dispensing, and it might form a basis for education focused on appropriate prescribing. To make the manifestation of adverse interaction subside, management strategies must be exercised if two interacting drugs have to be taken with each other, involving: adjusting the dose of the object drug; spacing dosing times to avoid the interaction. The pharmacist, along with the prescriber has a duty to ensure that patients are aware of the risk of side effects and a suitable course of action they should take. Conclusion: It is unrealistic to expect clinicians to memorize the thousands of drug-drug interactions and their clinical significance, especially considering the rate of introduction of novel drugs and the escalating appreciation of the importance of pharmacogenomics. Reliable regularly updated decision support systems and information technology are necessary to help avert dangerous drug combinations.

OALib, 2014

The objective of this study is to develop the degradation studies of different brands of glimepir... more The objective of this study is to develop the degradation studies of different brands of glimepiride available in market. Forced degradation is a powerful tool used routinely in pharmaceutical development in order to develop stability-indicating methods that lead to quality stability data and to understand the degradation pathways of the drug substances and drugs. Glimepiride is a mediumto long-acting sulfonylurea antidiabetic drug as it is the most prescribed oral antihyper glycaemic agent indicated to treat type 2 diabetes mellitus. Its mode of action is to increase insulin production by the pancreas. This is not used for type 1 diabetes because in type 1 diabetes the pancreas is not able to produce insulin. Glimepiride was subjected to different stress conditions as per (ICH) International Conference on Harmonization guidelines. Distilled water was used as solvents and the amount of drug was calculated after degradation by taking absorbance at 200 nm. According to the assay limit of USP specified that the content should not be less than 95% and not more than 105% of labelled amount. On basic pH brand A, and E showed degradation after the addition of 0.1 N base while other brands degraded as base has no impact on glimepiride concentration. On addition of 0.1 N HCl only brand E showed heavy degradation. After 48 hours the absorbance of all brands are different compared with initial absorbance which shows degradation of all brands.

The American journal of gastroenterology, 2013

Clinicians do not have a validated tool for estimating the short-term mortality associated with s... more Clinicians do not have a validated tool for estimating the short-term mortality associated with spontaneous bacterial peritonitis (SBP). Accurate prognosis assessment is important for risk stratification and for individualizing therapy. We aimed therefore to develop and validate a model for the prediction of 30-day mortality in SBP patients receiving standard medical treatment (antibiotics and if indicated by guidelines, intravenous albumin therapy). We retrospectively identified SBP patients treated at a tertiary care center between 2003 and 2011 (training set). Multivariate regression modeling and receiver operating characteristic (ROC) curves were utilized for statistical analysis. An external data set of 109 SBP patients was utilized for validation. Of the 184 patients in the training set, 66% were men with a median age of 55 years, a median MELD (Model for End-Stage Liver Disease) score of 20, and a 30-day mortality of 27%. Peripheral blood leukocyte count ≥11×10⁹ cells/l (odds...

Blood

INTRODUCTION: We present a case of a young man with Klippel Trenaunay Weber Syndrome (KTWS) chara... more INTRODUCTION: We present a case of a young man with Klippel Trenaunay Weber Syndrome (KTWS) characterized by recurrent superficial vein thrombosis (SVT) complicated by an episode of disseminated intravascular coagulation (DIC) who ultimately was maintained on prophylactic rivaroxaban to prevent recurrent thrombotic events. We performed a literature search to identify similar cases and to summarize common presenting features and attempted treatment modalities. CASE DESCRIPTION: An 18 year old man with KTWS presented with a large vascular malformation over his left chest and arm developed acute worsening SVT post sodium tetradecyl injection. Further investigation revealed a severe DIC was also present. On exam, the venous malformation and left arm were extremely tender with significant bruising. Presenting labs: Hg 24, platelet 98, bilirubin 588 (unconjugated 212), LDH 1597, PTT 32, INR 1.9, fibrinogen 1.1, Ddimer >20. He was treated with aggressive supportive care for DIC and rout...

Canadian Journal of General Internal Medicine

Klippel-Trenaunay-Weber syndrome (KTWS) is a congenital malformation syndrome involving blood and... more Klippel-Trenaunay-Weber syndrome (KTWS) is a congenital malformation syndrome involving blood and lymph vessels and disturbed bone and soft tissue growth. Complications of KTWS include deep-vein thrombosis, pulmonary embolism, gastrointestinal bleeding, and vascular (usually lymphatic) blebs within capillary malformations. We present a case of a young male patient with KTWS who presented with superficial venous thrombosis and microangiopathic hemolytic anemia in a presentation similar to disseminated intravascular coagulation. He was ultimately maintained on prophylactic rivaroxaban to prevent recurrent thrombotic events. We performed a literature search to identify similar cases and to summarize common presenting features and treatment modalities that were offered. Résumé Le syndrome de Klippel-Trenaunay-Weber (KTWS) est un syndrome de malformation congénitale impliquant le sang et les vaisseaux lymphatiques et les os perturbés et la croissance des tissus mous. Les complications de...

Mediterranean journal of hematology and infectious diseases, 2017

Acquired von Willebrand syndrome (AVWS) is a rare hemorrhagic disorder that occurs in patients wi... more Acquired von Willebrand syndrome (AVWS) is a rare hemorrhagic disorder that occurs in patients with no prior personal or family history of bleeding. Here, we describe a case of AVWS occurring after autologous stem cell transplantation (ASCT). Interestingly, AVWS developed after bortezomib-based induction and conditioning regimens. Recent evidence suggests that the proximity of the bortezomib therapy to the collection of stem cells with consequent depletion of regulatory T cells after the conditioning regimen could explain some of the unusual autoimmune complications reported in patients receiving bortezomib prior to ASCT. In addition, this patient developed a secondary MGUS post-ASCT, which may have also contributed to the AVWS. To the best of our knowledge, this is the first case of post-ASCT AVWS reported. Prospective data is needed to better elucidate the mechanisms by which these unusual complications occur in patients receiving bortezomib prior to ASCT.

Clinical Gastroenterology and Hepatology, 2016

The severe depletion of muscle mass at the 3rd lumbar vertebral level (sarcopenia) is a marker of... more The severe depletion of muscle mass at the 3rd lumbar vertebral level (sarcopenia) is a marker of malnutrition and is independently associated with mortality in patients with cirrhosis. Instead of monitoring sarcopenia by cross-sectional imaging, we investigated whether ultrasound-based measurements of peripheral muscle mass, measures of muscle function, along with nutritional factors, are associated with severe loss of muscle mass. We performed a prospective study of 159 outpatients with cirrhosis (56% male; mean age 58±10 years; mean MELD score, 10±3; 60% Child-Pugh class A) evaluated at the Cirrhosis Care Clinic at the University of Alberta Hospital from March 2011 through September 2012. Lumbar skeletal muscle indices were determined by computed tomography or magnetic resonance imaging. We collected clinical data and data on patients' body composition, nutrition, and thigh muscle thickness (using ultrasound analysis). We also measured mid-arm muscle circumference, mid-arm circumference, hand grip, body mass index (BMI), and serum level of albumin; patients were evaluated using the subjective global assessment scale. Findings from these analyses were compared with those from cross-sectional imaging, for each sex, using logistic regression analysis. Based on cross-sectional imaging analysis, 43% of patients had sarcopenia (57% of men and 25% of women). Results from the subjective global assessment, serum level of albumin, and most nutritional factors were significantly associated with sarcopenia. We used multivariate analysis to develop a model to identify patients with sarcopenia, and developed a nomogram based on BMI and thigh muscle thickness for patients of each sex. Our model identified men with sarcopenia with an area under the receiver operating characteristic curve (AUROC) value of 0.78 and women with sarcopenia with an AUROC value of 0.89. In a prospective study of patients with cirrhosis, we found that the combination of BMI and thigh muscle thickness (measured by ultrasound) can identify male and female patients with sarcopenia almost as well as cross-sectional imaging (AUROC values of 0.78 and 0.89, respectively). These factors might be used in screening and routine nutritional monitoring of patients with cirrhosis.

Doxycycline is a semi-synthetic, lipophilic and potent tetracycline congener, widely used in huma... more Doxycycline is a semi-synthetic, lipophilic and potent tetracycline congener, widely used in human and veterinary medicine and as an animal feed supplement to prevent disease. It is the drug of choice in the treatment of Lyme disease, Brucellosis, and several Rickettsial infections, and it is also utilized in the treatment of sexually transmitted diseases. Forced degradation commonly includes exposure of drug to heat, range of pH values, UV light, forced degradation study helps to determine the loss of drug substance and the degradation product under diverse conditions.. According to ICH guidelines Doxycycline was exposed to different stress conditions. For the analysis of drug in the presence of degradation products, UV spectroscopic method was developed which calculate the amount of the degradaded product. According to the BP, the official assay limit of th content should NLT 95% and NMT 105% of labelled amount. On exposure to acidic medium (1 N HCl) shows heavy degradation, whereas comparatively less degradation occurs with heat, in addition UV light and basic medium (1 N NaOH) has least degradation effect on doxycycline. The method was found to be simple, cost effective and less time consuming. Hence this method can be successfully used.

Amlodipine besylate is a potent long-acting calcium channel blocking agent.. An efficient least t... more Amlodipine besylate is a potent long-acting calcium channel blocking agent.. An efficient least time consuming and simple spectrophotometric method for the assay of Amlodipine has been used. The assay is based on the ultraviolet UV absorbance maxima at about 238nm wavelength of Amlodipine using water as solvent. A sample of drug was dissolved in water to produce a solution containing Amlodipine. Similarly, various dilutions were made. The absorbance of sample preparation was measured at 238nm against the solvent blank and the assay was determined. In our study a simple and quick assay method using U.V spectrophotometer has been used. The assay is based on measuring the absorbance of formulation of Amlodipine dilutions at the wavelength of 238 nm. Four different dilutions of 50ppm, 25ppm, 12.5ppm and 6.25ppm are prepared and their percent assay is calculated.

Glimepride belongs to sulfonylurea oral anti diabetic. A efficient least time consuming and simpl... more Glimepride belongs to sulfonylurea oral anti diabetic. A efficient least time consuming and simple spectrophotometric method for the assay of Glimepride has been used. The assay is based on the ultraviolet UV absorbance maxima at about 200nm wavelength of Glimepride using water as solvent. A sample of drug was dissolved in water to produce a solution containing Glimepride. Similarly, various dilutions were made. The absorbance of sample preparation was measured at 200nm against the solvent blank and the assay was determined. In our study a simple and quick assay method using U.V spectrophotometer has been used. The assay is based on measuring the absorbance of formulation of Glimepride dilutions at the wavelength of 200 nm. Four different dilutions of 50ppm, 25ppm, 12.5ppm and 6.25ppm is prepared and their percent assay is calculated.

A B S T R A C T Forced degradation is a extensively employed method carried out in pharmaceutical... more A B S T R A C T Forced degradation is a extensively employed method carried out in pharmaceutical development in order to develop stability, demonstrating methods that provides quality and steadiness information to comprehend the degradation pathways of the drug substance and its impurities. There are various distinctive brands accessible in market for diltiazem. It will be a calcium opponent profitable in the medicine about secure, variant and unstable (flimsy angina pectoris). Concomitant perusing parallel β-adrenoceptor opponent therapy, happen infrequently as an adverse impact about diltiazem medication. The reason for this examine create the investigations from claiming two diverse brands for diltiazem 60mg. It might have been subjected under different stress condition concerning illustration for every (ICH) worldwide meeting with respect to harmonization rules. Sresses like Acid/base, variability in temperature, photo degradation and with time (7days). Also with occasion when ...

Canadian journal of gastroenterology = Journal canadien de gastroenterologie

Canadian journal of gastroenterology & hepatology, 2014

Spontaneous bacterial peritonitis (SBP) is the most prevalent bacterial infection in patients wit... more Spontaneous bacterial peritonitis (SBP) is the most prevalent bacterial infection in patients with cirrhosis. Although studies from Europe have reported significant rates of resistance to third-generation cephalosporins, there are limited SBP-specific data from centres in North America. To evaluate the prevalence of, predictors for and clinical impact of third-generation cephalosporin-resistant SBP at a Canadian tertiary care centre, and to summarize the data in the context of the existing literature. SBP patients treated with both antibiotics and albumin therapy at a Canadian tertiary care hospital between 2003 and 2011 were retrospectively identified. Multivariate logistic regression was used to determine independent predictors of third-generation cephalosporin resistance and mortality. In 192 patients, 25% of infections were nosocomial. Forty per cent (77 of 192) of infections were culture positive; of these, 19% (15 of 77) were resistant to third-generation cephalosporins. The p...

Pharmacology & Pharmacy, 2014

Objective: To analyze the use of all subsidized prescription drugs including their use of drug co... more Objective: To analyze the use of all subsidized prescription drugs including their use of drug combination generally accepted as carrying a risk of severe interactions. Methodology: In a cross sectional study, we analyzed all prescriptions (n = 1014) involving two or more drugs dispensed to the population (age range 4 -85 years) from all pharmacies, clinics and hospitals. Data were stratified by age and sex, and frequency of common interacting drugs. Potential drug interactions were classified according to clinical relevance as significance of severity (types A: major, B: moderate, and C: minor) and documented evidence (types 1, 2, 3, and 4). Result and Discussion: The growing use of pharmacological agents means that drug interactions are of increasing interest for public health. Monitoring of potential drug interactions may improve the quality of drug prescribing and dispensing, and it might form a basis for education focused on appropriate prescribing. To make the manifestation of adverse interaction subside, management strategies must be exercised if two interacting drugs have to be taken with each other, involving: adjusting the dose of the object drug; spacing dosing times to avoid the interaction. The pharmacist, along with the prescriber has a duty to ensure that patients are aware of the risk of side effects and a suitable course of action they should take. Conclusion: It is unrealistic to expect clinicians to memorize the thousands of drug-drug interactions and their clinical significance, especially considering the rate of introduction of novel drugs and the escalating appreciation of the importance of pharmacogenomics. Reliable regularly updated decision support systems and information technology are necessary to help avert dangerous drug combinations.

OALib, 2014

The objective of this study is to develop the degradation studies of different brands of glimepir... more The objective of this study is to develop the degradation studies of different brands of glimepiride available in market. Forced degradation is a powerful tool used routinely in pharmaceutical development in order to develop stability-indicating methods that lead to quality stability data and to understand the degradation pathways of the drug substances and drugs. Glimepiride is a mediumto long-acting sulfonylurea antidiabetic drug as it is the most prescribed oral antihyper glycaemic agent indicated to treat type 2 diabetes mellitus. Its mode of action is to increase insulin production by the pancreas. This is not used for type 1 diabetes because in type 1 diabetes the pancreas is not able to produce insulin. Glimepiride was subjected to different stress conditions as per (ICH) International Conference on Harmonization guidelines. Distilled water was used as solvents and the amount of drug was calculated after degradation by taking absorbance at 200 nm. According to the assay limit of USP specified that the content should not be less than 95% and not more than 105% of labelled amount. On basic pH brand A, and E showed degradation after the addition of 0.1 N base while other brands degraded as base has no impact on glimepiride concentration. On addition of 0.1 N HCl only brand E showed heavy degradation. After 48 hours the absorbance of all brands are different compared with initial absorbance which shows degradation of all brands.

The American journal of gastroenterology, 2013

Clinicians do not have a validated tool for estimating the short-term mortality associated with s... more Clinicians do not have a validated tool for estimating the short-term mortality associated with spontaneous bacterial peritonitis (SBP). Accurate prognosis assessment is important for risk stratification and for individualizing therapy. We aimed therefore to develop and validate a model for the prediction of 30-day mortality in SBP patients receiving standard medical treatment (antibiotics and if indicated by guidelines, intravenous albumin therapy). We retrospectively identified SBP patients treated at a tertiary care center between 2003 and 2011 (training set). Multivariate regression modeling and receiver operating characteristic (ROC) curves were utilized for statistical analysis. An external data set of 109 SBP patients was utilized for validation. Of the 184 patients in the training set, 66% were men with a median age of 55 years, a median MELD (Model for End-Stage Liver Disease) score of 20, and a 30-day mortality of 27%. Peripheral blood leukocyte count ≥11×10⁹ cells/l (odds...