DEVELOPMENT AND VALIDATION OF STABILITY INDICATING HPTLC METHOD FOR SIMULTANEOUS DETERMINATION OF LINAGLIPTIN AND METFORMIN

Objective: A simple, precise, and accurate stability indicating high-performance thin-layer chromatography (HPTLC) method was developed and validated for simultaneous estimation of linagliptin and metformin active pharmaceutical ingredients and fixed dose combination.Methods: Linagliptin and metformin densitograms were developed on silica gel 60 F254 HPTLC plates with acetone: methanol: chloroform: formic acid (3:1:5:1v/v) as the mobile phase. Densitometric quantification was performed at 230 nm.Results: For linagliptin and metformin RF values were found as 0.72 and 0.19, respectively. The method was validated for precision, accuracy, specificity, and robustness. The linearity curves were obtained in the concentration range of 100–600 ng per spot by area with correlation coefficients of 0.999 and 0.99 for linagliptin and metformin, respectively. Limit of detection was found to be 5.19 and 8.72 ng per spot for linagliptin and metformin, respectively; lowest possible quantity to be quantified by the proposed method was found to be 15.74 and 26.44 ng per spot for linagliptin and metformin, respectively. From stability studies, the noninterference of the linagliptin and metformin degradants with drugs demonstrated the suitability of the developed method.Conclusion: The developed method was validated and found to be selective, specific and suitable for application in pharmaceutical analysis of these drugs in bulk and fixed dose combination.Â

The effect of median nerve mobilization on two point discrimination

[Purpose] Two-point discrimination (TPD) is expressed as the minimum distance at which two mechanical stimuli applied simultaneously to the skin can be perceived as two separate points. The aim of this study was to investigate the effect of median nerve mobilization on TPD in healthy adults. [Participants and Methods] This study included 120 healthy adults. Participants were randomized according to their gender into the Neural Mobilization Group (NMG) and Control Group (CG). Demographic data of the participants (gender, age, height, weight, BMI, smoking) were recorded and TPD measurement was performed with baseline aesthesiometer on the palm with distal phalanges of the thumb, index and middle finger on the right-left hand. After the baseline TPD test, participants in the NMG performed Median Nerve Mobilization for 14 days. Measurements were taken before and after training. [Results] A statistically significant difference was found in all other measurements in both groups, except for the right and left palm TPD measurements in the control group. [Conclusion] It is thought that it would be beneficial to investigate the healing effects of the neural mobilization applications, which include all parts of the nerve line in disease conditions

Identity issues surrounding American skullcap (Scutellaria lateriflora) and an optimised high performance liquid chromatography method to authenticate commercially available products

Traditional use of American skullcap (Scutellaria lateriflora) for anxiety and related conditions is well documented. There is evidence of flavonoid instability in S. lateriflora and a high rate of substitution with other skullcap species or adulteration with potentially hepatotoxic germanders (Teucrium spp.). It is therefore essential for the identity, quality and safety of a commercial S. lateriflora product to be verified prior to clinical use. The objective was to review the literature relating to substitution and adulteration of S. lateriflora and to present a simple, optimised high performance liquid chromatography (HPLC) method to verify the absence of adulterants in a commercial sample of S. lateriflora, by comparing its chromatographic profile with that of authenticated S. lateriflora. S. lateriflora reference material and a freeze-dried commercial sample were extracted with methanol and water (80:20, v/v) and compared by HPLC analysis. The commercial sample showed reproducible retention times (RTs) of the flavonoid biomarkers baicalin (RT = 14.8 min; mean ± SD = 11.71 ± 1.16 mg/g); baicalein (RT = 20.4 min; 7.67 ± 0.89 mg/g); wogonin (RT = 23.7 min; 0.65 ± 0.06 mg/g). It appeared to be free from adulteration with germander (verbascoside was not detected; RT = 9.1 min) and its phytochemical profile was consistent with that of the S. lateriflora reference material. It is crucial that commercial products are adequately identified prior to use. The reported HPLC method has shown the potential to compare non-authenticated S. lateriflora samples with authenticated voucher specimens – essential when conducting any phytochemical analysis of the herb

Psychosocial Aspects of Rehabilitation in Neurodegenerative Diseases and Fields of Approach

Psychosocial health is a concept included in definition of health by World Health Organization and corresponds to state of emotional and social well-being. In the context of neurological disorder, psychosocial health refers to social reintegration and psychological adjustment. Studies reporting that neurological diseases are associated with negative psychosocial health outcomes such as a decrease in the quality of life, a decrease in ability to establish and maintain social relationships, and an increase in high levels of depression, stress and anxiety have increased in recent years. Therefore, it is important to consider programs and interventions that can improve the psychosocial health of people with neurodegenerative diseases. Currently, it is not clear which psychosocial approaches can produce definitively positive results. The aim of this study is to examine how being an individual with Multiple Sclerosis and Parkinson's, which are the most common neurodegenerative diseases in the clinic, affects psychosocial health in the rehabilitation process and the existing evidence-based psychosocial approaches. For this purpose, a descriptive review was prepared by scanning English and Turkish articles with keywords on psychotherapeutic, psychosocial and mindfulness-based interventions and stress management, published in the determined databases in the last 10 years. Studies have shown that psychosocial approaches such as interventions for acquisition of social integration and adaptive coping strategies, cognitive and social behavioral therapy methods, concentration and movement-based mind-body exercises are effective in rehabilitation of neurodegenerative diseases. These approaches were reported to have benefits in reducing anxiety, depression and fatigue, improving sleep quality and quality of life, relationships, employment, level of participation, motivation and self-efficacy in exercise and physical activity, improving physical functions, facilitating difficult and personal experiences and adaptation to new life in rehabilitation processes and more evidence-based studies are needed

Migrenli hastalarda fiziksel aktivite seviyesinin ağrı, fonksiyonellik ve yaşam kalitesine etkisi

OBJECTIVES: This study aimed to determine the physical activity (PA) level of individuals with migraine and examine its effects on pain intensity (PI), disability, and quality of life (QoL). METHODS: Individuals diagnosed with migraine between the ages of 18 and 55 were included in the study. PA levels are assessed by the International PA Questionnaire Short Form (IPAQ-SF), PI with the McGill Melzack Pain Questionnaire, disability with the Migraine Disability Assessment Scale (MIDAS), and QoL with the World Health Organization QoL Scale Short Form (WHOQOL-BREF). RESULTS: A total of 88 individuals, with a mean age of 34.11±10.51 years, were included in the study; 53.41% were low active (LA), 30.68% were moderate active (MA), and 15.91% were high active (HA). The physical health of LAs (p=0.047) was lower than that of MAs. General (p<0.001), physical (p[removed].Amaç: Bu çalışmada, migrenli bireylerin fiziksel aktivite düzeylerinin belirlenmesi ve ağrı şiddeti, engellilik seviyesi ve yaşam kalitesi üzerindeki etkilerinin incelenmesi amaçlandı. Gereç ve Yöntem: Çalışmaya 18-55 yaş arası migren tanısı almış bireyler dahil edildi. Uluslararası Fiziksel Aktivite Anketi Kısa Formu (IPAQ-SF), McGill Melzack Ağrı Anketi ile ağrı şiddeti, Migren Özürlülük Değerlendirme Ölçeği (MIDAS) ile engellilik ve Dünya Sağlık Örgütü Yaşam Kalitesi Skalası Kısa Formu (WHOQOL-BREF) ile yaşam kalitesi değerlendirildi. Bulgular: Çalışmaya yaş ortalaması 34,11±10,51 yıl olan toplam 88 kişi dahil edildi; %53,41’i düşük aktif, %30,68’i orta aktif, %15,91’i yüksek aktifti. Düşük aktiflerin fiziksel sağlığı (p=0,047) orta aktiflerden daha düşüktü. Genel (p<0,001), fiziksel (p<0,001), psikolojik (p=0,003) sağlık puanları yüksek aktiflerden daha düşüktü. Düşük aktifler yüksek aktiflerden daha yüksek engelliliğe (p=0,042) ve ağrı şiddetine (p=0,001) sahipti. Fiziksel aktivite ile ağrı şiddeti (p=0,001) ve engellilik (p=0,005) arasında zayıf negatif korelasyon, fiziksel aktivite düzeyleri ile sosyal (p=0,007) ve çevresel (p=0,013) sağlık puanları arasında zayıf pozitif korelasyon ve fiziksel (p=0,000), genel (p=0,000) ve psikolojik (p=0,000) puanlarıyla orta düzeyde pozitif korelasyon vardı. Sonuç: Migrenli hastalarda fiziksel aktivite düzeyi arttıkça ağrı şiddetinin azaldığı, fonksiyonellik ve yaşam kalitesinin arttığı gözlendi. Egzersiz devamlılığının sağlanması migrenin olumsuz etkilerini iyileştirmede etkili görünmektedir

The use of Scutellaria lateriflora: a pilot survey amongst herbal medicine practitioners

American skullcap (Scutellaria lateriflora) is a popular herb in traditional medicine systems and western Materia medica for anxiety and related disorders. It is reported to be one of the most widely used medicinal herbs, with anecdotal evidence for minimal side-effects and with no known toxicity. This article summarises the results of a pilot survey conducted amongst herbal medicine practitioners on their use of S. lateriflora. An email survey was conducted amongst herbal medicine practitioners in the UK and Ireland. It aimed to gather information on the extent of, and indications for, current use of S. lateriflora, its perceived effectiveness and its safety. Herbal medicine practitioners were selected from the membership list of the National Institute of Medical Herbalists (NIMH). All members with identifiable email addresses were contacted (n = 377) and responses were received from 62 (a 16% response rate). The results of the survey suggested that S. lateriflora is highly regarded among herbal medicine practitioners as an effective intervention for reducing anxiety and stress and is commonly prescribed for these conditions and related co-morbidities. The results were not conclusive as the response rate was low and respondents were only those with email access

Investigation of the effects of dance-based exercise therapy on strength, flexibility, balance, and quality of life in elderly living in the nursing home: A pilot study

Amaç: Bu çalışma, huzurevinde yaşayan yaşlı bireylerde dans temelli egzersiz terapisi (DTET) uygulaması sonrası kuvvet, esneklik, denge ve yaşam kalitesindeki değişimleri araştırmak için planlandı.Yöntem: Çalışmaya 65 yaş üzeri, yaş ortalaması 77,33±2,53 yıl (72-82) olan 12 yaşlı birey dahil edildi. Egzersizler, sabah saatlerinde, grup egzersizi olarak, 8 hafta süresince, haftada 1 seans olmak üzere uzman fizyoterapist eşliğinde uygulandı. Egzersiz programı; 10 dakika ısınma, 45 dakika müzik eşliğinde DTET ve 10 dakika soğuma egzersizleri idi. Tüm değerlendirmeler eğitim sürecinin başında ve sonunda olmak üzere 2 defa uygulandı. Bireylerin fonksiyonel üst ekstremite kas kuvveti Jamar El Dinamometresi ile, alt ekstremite kas kuvveti 30 saniye Otur-Kalk Testi ile, üst gövde esneklikleri Sırt Kaşıma Testi ile, dengeleri hem Tek Bacak Üzerinde Durma Testi hem de düşme korkuları açısından Uluslararası Düşme Etkinlik Ölçeği (U-DEÖ) ile, yaşam kaliteleri EQ-5D Yaşam Kalitesi Ölçeği ile değerlendirildi.Bulgular: DTET sonrası üst ve alt ekstremite kas kuvveti, üst gövde esnekliği ve denge parametrelerinde gelişme elde edilirken (p0,05).Sonuç: Yapılan bu pilot çalışma ile toplamda 8 saat süren 8 haftalık DTET uygulanması ile kuvvet, esneklik, denge parametrelerine yansıyan iyileşmeler elde edilse de bu süre ve program içeriğinin düşme korkusuna ve yaşam kalitesine etkisi olmadığı görüldü. Edinilen veriler doğrultusunda yaşam kalitesi ve düşme korkusunda iyileşme sağlayabilmek için DTET’ye ilave eğitim parametreleri eklenerek, daha uzun süre takip ve kontrol grubu varlığında çalışmanın devam edilmesine karar verildi.Purpose: This study was planned to investigate changes in strength, flexibility, balance, and quality of life after dance-based exercise therapy (DBET) application in elderly, living in a nursing home.Methods: The study included 12 people over 65 years of age with 77.33±2.53 years (72-82). Exercises were performed in mornings, as group exercise, for 8 weeks, with 1 session per week, with specialist physiotherapist. Therapy was created with 10 minutes warm-up, 45 minutes DBET accompanied by music, 10 minutes cool-down exercises. Evaluations were applied twice, at beginning and end of training process. Functional upper limb muscle strength of individuals with Jamar Hand Dynamometer, lower limb strength with sit-up test for 30 seconds, upper body flexibility with Back Scratch Test, balance; with both one leg standing test and Fall Efficiency Scale (FES-I) in terms of fear of falling (FOF), quality of life (QOL) was evaluated with EQ-5D Quality of Life Scale.Results: After therapy, improvement was obtained in upper and lower extremity muscle strength, shoulder flexibility, balance parameters (p0.05).Conclusion: With this pilot study, although 8 weeks of DBET application, lasted 8 hours, improvements reflected in strength, flexibility, balance parameters; duration and program content didn’t affect FOF and QOL. To improve QOL and FOF in line with data obtained, it was decided to continue study in presence of a follow-up and control group by adding additional training parameters to DBET

The effect of physical activity status on quality of life during social isolation in Covid-19 epidemic

Bu çalışmada Türkiye’deki COVİD-19 salgını ve halk sağlığı kısıtlamaları sırasında genç-yetişkinbireylerin fiziksel aktivite (FA) durumlarını raporlamak, FA'nın yaşam kalitesi üzerindeki etkisiniaraştırmak amaçlandı. Bireyler, en katı halk sağlığı kısıtlamaları sırasında demografik bilgiler, FA, yaşamkalitesi bölümlerinden oluşan çevrimiçi anket ve sosyal medya duyurusu aracılığıyla çalışmaya dahil edildi.Bireyler arasında en yüksek oran inaktif bireylerde idi, bunu minimal aktif ile yeterince aktif bireyler izledi.FA seviyelerine göre, yaşam kalitesinin psikolojik alanı (PA) açısından farklılık görüldü; minimal aktifbireylerde PA’nın, inaktif bireylere göre yüksek olduğu ve FA’nin PA üzerinde etkili olduğu bulundu.Salgın süreçlerinde hükümetlerin halkı FA’ya teşvik etmesinin, sağlık uzmanlarının FA’yı artırmayayönelik önerilerde bulunmalarının, egzersiz yapmaya başlama ve sürdürmeyi sağlamaları adına yolgöstermelerinin özellikle ruhsal sağlığı korumak açısından gerekli olduğu düşünüldü. Sürecin aşırı egzersizyapma zamanı olmadığı; zihinsel refahlarını sürdürecek orta seviyede aktivite yapılmasının yaşam kalitesiüzerinde daha faydalı olacağı belirlendi.It was aimed to report physical activity (PA) levels of young-adult individuals and investigate effect of PA on quality of life (QOL) during COVID-19 outbreak and public health restrictions in Turkey. Individuals included through online questionnaire consisting demographic information, PA, quality of life sections and social media during strictest public health restrictions. Among individuals, highest rate was inactive individuals, followed by minimally active, sufficiently active. According PA levels, QOL was different in terms of psychological domain (PD); PD of minimally active individuals was found to be higher than inactive individuals; PA was effective on PD. In pandemic processes, it was thought; it is necessary for governments to encourage public to PA, health professionals to guide public towards increasing, starting and maintaining FA especially in terms of protecting mental health. Process isn’t time for excessive exercise; performing moderate activities that will maintain their mental well-being will be more beneficial on QOL

Therapeutic Monitoring of Antiretroviral Drugs in Immunologically Stable HIV Patients on ART Treatment

In HIV, highly active anti-retroviral therapy helps patients to regain the immune CD4+ cell count. Among all antiretroviral therapy (ART) regimens tenofovir based regimen (TLE; Tenofovir (TDF) + Lamivudine (3TC) + Efavirenz (EFV)) has become the most preferred first line regimen. Present study aimed to identify the therapeutic levels of drugs in tenofovir based regimen in immunologically stable HIV patients. A total of 35 dried blood samples were obtained from HIV patients on TLE treatment visiting ART centre, Mahatma Gandhi Memorial (MGM) Hospital, Warangal, Telangana, during September 2017 to March 2018. Patients with good adherence, without history of smoking &amp; alcoholism and with CD4+ cell count &gt; 350 cells/mm3 were included. Estimation of drugs was done using pre validated liquid chromatographic method. In total of 35 patients, females were accounted for 62.86%. Patients of this study showed high percentage of illiterates (48.57%) and daily labors (34.29%). As EFV is a narrow therapeutic index drug it showed significant difference in its plasma therapeutic levels (0.005**) whereas TDF &amp; 3TC were not. Total of 8.57% and 91.43% patients were showed EFV plasma levels below and above therapeutic levels respectively. Though the study patients observed with good immunological status, high percentage of patients identified with toxic levels of EFV concentrations. But none of the patients showed any symptoms of toxicity, they are at risk to develop clinical toxicity in future. Present study results suggesting dose adjustments and monitoring of drug levels in these patients to avoid early treatment failures and toxicity. Keywords: HIV, CD4+ cell count, Tenofovir regimen, Therapeutic level, Monitoring

Joint position sense and its relationship with pain, range of motion, muscle strength, fear of movement, functionality, and quality of life parameters in chronic neck pain

Amaç: Çalışmanın amacı, kronik boyun ağrısı olan bireylerde eklem pozisyon hissini (EPH) değerlendirmek; ağrı seviyesi, eklemhareket açıklığı (EHA), kas kuvveti, yaşam kalitesi, hareket korkusu ve boyun ağrısı ile ilişkili fonksiyonel etkilenim seviyelerinideğerlendirerek sağlıklı bireylerle karşılaştırmak ve bu parametreler ile EPH arasında ilişki olup olmadığını belirlemektir.Yöntem: Kronik boyun ağrısı olan 50 birey kronik boyun ağrı grubuna (KBAG), 50 sağlıklı birey kontrol grubuna dahil edildi.Katılımcılara Lazer İmleç Yardımlı Açı Tekrarlama Testi (Lİ-YATT), manuel kas testi, gonyometre ölçümü, Vizüel Analog Skalası(VAS), Tampa Kinezyofobi Ölçeği (TKÖ), Northwick Park Boyun Ağrısı Anketi (NPBAA) ve Kısa Form-36 (KF-36) uygulandı, gruplarkarşılaştırıldı. EPH değerleri ile EHA, ağrı düzeyi, kas kuvveti, hareket korkusu, fonksiyonel etkilenim ve yaşam kalitesi değerleriarasındaki ilişki araştırıldı.Bulgular: EPH değerleri, sol lateral fleksiyon hariç değerlendirilen diğer tüm yönlerde, kontrol grubuna göre KBAG’de dahaolumsuz etkilendiği görüldü. Fleksiyon, ekstansiyon, sağ ve sol rotasyon yönlerindeki EPH ile sadece M. Trapezius kas kuvvetiile arasında zayıf kuvvette anlamlı negatif korelasyonlar elde edildi. EPH ile TKÖ ve NPBAA değerleri arasında zayıf ve ortakuvvette anlamlı pozitif korelasyonlar elde edildi (p<0,05). Ek olarak KBAG’de, EPH ile orta ve yüksek kuvvette olmak üzere tümyönlerdeki EHA’ları arasında anlamlı düzeyde pozitif; ağrı seviyesi, süresi ve NPBAA verileri arasında anlamlı düzeyde negatifkorelasyonlar elde edildi (p<0,001).Sonuç: Çalışmamızda kronik boyun ağrılı bireylerin değerlendirilen tüm parametreler açısından sağlıklı bireylere göre olumsuzyönde etkilendiği; EHA’daki kısıtlılık, ağrı seviyesi, M. Trapezius zayıflığı, hareket korkusu, fonksiyonel etkilenim ve yaşamkalitesi değerlerindeki artışın, EPH’deki azalma ile ilişkili olduğu gösterilmiştir.Purpose: Aim of the study is to evaluate joint position sense (JPS) in individuals with chronic neck pain; to evaluate level of pain,range of motion (ROM), muscle strength, quality of life, fear of movement, functionality associated with neck pain and comparewith healthy individuals, determine whether there is relationship between these parameters and JPS.Methods: 50 subjects with chronic neck pain were included in chronic neck pain group (CNPG), 50 healthy subjects included incontrol group. The Laser Pointer Assisted Angle-Reproduction Test (LP-ART), manual muscle test, goniometer measurement,Visual Analogue Scale (VAS), Tampa Kinesiophobia Scale (TKS), Northwick Park Neck Pain Questionnaire (NPNPQ) and ShortForm-36 (SF-36) applied to all participants, groups compared. Relationship between JPS and ROM, pain level, muscle strength,fear of movement, functionality, quality of life investigated.Results: Joint position sense affected more negatively in CNPG compared to control group in all directions evaluated except leftlateral flexion. Significant, negative weak correlations obtained between JPS and M. Trapezius muscle strength in flexion,extension, right, left rotation directions. Significant, positive weak-moderate correlations obtained between JPS and TKS andNPNPQ (p<0.05). In CNPG, there is significant, positive, medium-high correlations between JPS and ROM in all directions. Thereis significantly, negative correlations obtained between JPS and pain level, duration, NPNPQ levels (p<0.001).Conclusion: In our study, individuals with chronic neck pain affected negatively in all parameters evaluated compared to healthyindividuals. It has been shown that decrease of ROM, M. Trapezius muscle strength, functionality and increase in quality of life,fear of movement, and pain level are associated with decrease in JPS