Myofascial Pain Syndrome: A Report of 11 Cases Treated by Myofascial Massage Therapy, Riyadh, Saudi Arabia | Chapter 2 | Trends in Pharmaceutical Research and Development Vol. 1

Background: Myofascial pain syndrome (MPS) is a common pain condition characterized by a key symptoms and signs, determined by multiple etiologies, comorbid with a variety of systemic diseases and regional pain syndromes (RPS) and managed by diverse integrative therapies including complementary and alternative modalities (CAM) with variable outcomes. Objective: This study aimed to concisely report 11 cases of myofascial pain syndrome managed by myofascial trigger point therapy.  Methods: The relevant information about 11 cases was collected prospectively using a semistructured proforma. All patients were diagnosed mainly by detailed history and gold standard palpation method that helps identify taut muscles, tender myofascial trigger points, local twitch response and autonomic manifestations.  Results: Most of the patients with variable age and profession presented in emergency room with acute pain, limited motion, weakness, referred pain of specific pattern and associated autonomic signs and symptoms. Myofascial trigger point therapy alone with a timeline of about 30-60 minutes of 1-3 sessions brought about good results in all 11 patients (100%) who remained stable at two to three months follow-up.   Conclusion: Myofascial pain syndrome linked with latent or active myofascial trigger points developed due to repeated strains and injuries needs to be diagnosed by history and palpation method, systemic evaluation and laboratory investigations. Though several interventions are used in myofascial pain syndrome, myofascial trigger point massage therapy alone is found to be reasonably effective with excellent results. This clinical case series is calling for double-blind randomized controlled trials among patients with myofascial pain syndrome not only in Saudi Arabia but also in other Middle East countries in future.

Author(s) Details

Naseem Akhtar Qureshi 
National Center for Mental Health Promotion, Ministry of Health, Riyadh, Saudi Arabia.

Hamoud Abdullah Alsubaie
National Center for Complementary and Alternative Medicine (NCCAM), Ministry of Health, Riyadh, Saudi Arabia.

Dr. Mohammed Khulaif Alharbi
Department of Anesthesia, Faculty of Anesthesiology, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Gazzaffi Ibrahim Mahjoub Ali
National Center for Complementary and Alternative Medicine (NCCAM), Ministry of Health, Riyadh, Saudi Arabia.

Dr. Saud Mohammed Alsanad
College of Medicine, Imam Muhammad Ibn Saud Islamic University (IMSIU), Riyadh, Kingdom of Saudi  

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Novel Separation and Quantitative Determination of Levofloxacin, Prulifloxacin, Gatifloxacin, Sparfloxacin, Moxifloxacin and Balofloxacin Fluoroquinolone Antibacterials in Pharmaceutical Dosage Forms by RP-HPLC Method | Chapter 1 | Trends in Pharmaceutical Research and Development Vol. 1

For the first time, Simple, selective, sensitive RP-HPLC method developed for the separation and quantitative estimation of Levofloxacin (LEVO), Prulifloxacin (PRFX), Gatifloxacin (GATI), Sparfloxacin (SPAR), Moxifloxacin (MOXI) and Balofloxacin (BALO) relating to fluoroquinolone antibacterials in pharmaceutical dosage forms. The important advantage of the developed method was that the six separate drugs could be estimated on a single chromatographic system without modifications in detection wavelength and mobile phase by RP-HPLC. The chromatographic separation of the selected drugs carried out on Welchrom C18 column consisting of 250 mm X4.6 mm, 5 µm particle size utilizing mixture of 10 mM phosphate buffer (pH 3.1): Acetonitrile in the ratio of 70:30,v/v as mobile phase at the flow rate of 1 mL/min with detection wavelength at 293 nm by using UV spectrophotometric detector with total run time of 10 minutes and 3.613, 4.230, 4.707, 5.497, 5.880 and 6.253 minutes of retention time, 12,261, 12,554, 13,157, 14,761, 14,912 and 15,916 of plate number, 1.106, 1.067, 1.040 and 1.073, 1.030 and 1.086 tailing factors were obtained for LEVO, PRFX, GATI, SPAR, MOXI and BALO respectively. All calibration curves for six drugs showed indicated linearity over a concentration range of 2-10 µg/mL. The results regarding to limit of detection (LOD) and limit of quantitation (LOQ) for LEVO, PRFX, GATI, SPAR, MOXI and BALO were found to be 0.116 µg/mL and 0.348 µg/mL; 0.152 µg/mL and 0.460 µg/mL; 0.084 µg/mL and 0.255 µg/mL; 0.186 µg/mL and 0.558 µg/mL, 0.162 and 0.493, 0.112 and 0.390 respectively. These results                clearly show the low values of LOD and LOQ. The said proposed method utilized for quantification             of the marketed formulation. The mean assay values for LEVO, PRFX, GATI, SPAR, MOXI and BALO arrived at 99.317±0.990%, 99.9±0.04%, 99.9±0.02%, 99.45±0.01%, 99.945±0.056% and 99.68±0.09% respectively

Author(s) Details

Prof. Panchumarthy Ravisankar
Department of Pharmaceutical Analysis, Vignan Pharmacy College, Vadlamudi, Guntur District – 522 213, Andhra Pradesh, India

Dr. Ch. V. Prasada Rao
Department of Pharmaceutics, Vignan Pharmacy College, Vadlamudi, Guntur District – 522 213, Andhra Pradesh, India.

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A Critical Study of Late Presenting Urachal Remnant Tumour: Rare Adenocarcinoma Originated from Developmental Defect |Chapter 10 | Trends in Pharmaceutical Research and Development Vol. 1

Occupying only 0.01% of all adult cancer patients, the rare entity urachal adenocarcinoma constitutes 22-35% of adenocarcinomas originating from urinary bladder. Though with the gradual descend of the bladder in the course of development urachus should turn into median umbilical ligament, exceptional persistence of it can give rise to urachal cyst or urachal adenocarcinoma in adulthood. With only 43% of survival rate for 5 years and mean survival between 12 and 24 months urachal carcinoma is a devastating disease. Diagnosis of it is based on the MD Anderson Cancer Centre (MDACC) criteria. Computed Tomography (CT) Scan and/or Magnetic Resonance Imaging (MRI) Scan of abdomen and pelvis are the major imaging modalities to proceed towards diagnosis and staging. Not only histopathological examination but also immune-histochemical expression of both CK7 and CK20 suffice to clinch the diagnosis. Though surgical intervention forms the mainstay of treatment, several regimens of chemotherapy have also been tried to fight against unresectable, residual, extensive urachal carcinomas. This case took place in a 52 years old male patient who was presented with a gradually enhancing infra-umbilical swelling with slow growing urinary symptoms. By dint of Ultrasonography (USG) and Contrast Enhanced CT (CECT) scan of whole abdomen the tumour was detected involving the bladder wall and the anterior abdominal wall. Cystoscopy was followed by upfront cytoreductive surgery. Histopathological examination revealed the diagnosis of an adenocarcinoma which was further confirmed to be an urachal remnant carcinoma with the help of immunohistochemistry. Postoperative CT scan showed residual disease involving bladder wall and was treated with an adjuvant platin based chemotherapy regimen.

Author (s) Details

Ipsita Dey
Department of Pathology, R. G. Kar Medical College and Hospital, Kolkata, India.

Tushar Kanti Das
Department of Pathology, R. G. Kar Medical College and Hospital, Kolkata, India.

Chhaya Roy
Department of Radiation Oncology, R. G. Kar Medical College and Hospital, Kolkata, India.

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Quantification of Propranolol in Rat Plasma by LCMS/MS Using Tramadol as an Internal Standard for Pharmacokinetic Studies in TAA-induced Liver Fibrotic Rats | Chapter 9 | Trends in Pharmaceutical Research and Development Vol. 1

A simple, rapid and selective liquid chromatography coupled with tandem mass spectrometry (LCMS/MS) is developed and validated for quantification of propranolol without the sample extraction step in rat plasma using tramadol as an internal standard (IS). The analytes are separated using an isocratic mobile phase which consist of methanol and 10 mm ammonium formate (70/30, v/v) on an isocratic UK-C18 (Imtakt Unison 2.0 × 50 mm, 3 μm) column and was analyzed by MS/MS in the multiple reaction monitoring (MRM) mode using the transitions of respective (M+H)+ ions, m/z 260.0→116.2 and m/z 264.2→58.2 for quantification of propranolol and IS, respectively. The standard calibration curves showed good linearity within the range of 2.0 to 800.0 ng/ml (r2 = 0.999, 1/x2 weight). The lower limit of quantification (LLOQ) was 2 ng/ml. The retention time of propranolol and IS were 1.12 and 0.939 min which means that it is the potential for the high-through put potential of the proposed method. In addition, no significant metabolic compounds were found to interfere with the analysis. Acceptable precision and accuracy were obtained for the concentrations over the standard curve range. The validated method was successfully applied for the pharmacokinetic studies after 2 mg/kg of propranolol HCl in the thioacetamide (TAA)-induced fibrotic rats

Author(s) Details

Ju-Seop Kang
Department of Pharmacology, Clinical Pharmacology Lab, College of Medicine, Hanyang University, Seoul 133-791, South Korea.

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Research on Evaluation of the Effect of Crude Extract of Datura innoxia on the Cardiovascular Action of Detomidine in Rabbits | Chapter 8 | Trends in Pharmaceutical Research and Development Vol. 1

Datura innoxia indigenous shrub in South Asia region belongs to the family Solanaceae which contains medicinal important alkaloids (hyoscine, atropine, hycosamine, etc). Thirty adult rabbits of mixed breed, male and female were pretreated with 0.1 mg/500 mg of crude extract (1% of dimethyl sulfoxide (DMSO) solution) and injected 5 min later with 0.01 mg/500 mg of detomidine (group A, n=15) or Saline (group B, n=15). Mean arterial pressure, measurements and electrocardiography were performed for 65 min. After injecting crude extract of D. innoxia, the heart rate was increased by 45 and 46.34% in groups A and B, respectively. Heart rate remained increased after the injection of detomidine returning to base line values after 15 min. No increase in the mean arterial  pressure (MAP) was noted in group B rabbits. Crude extract shortened PR and QT interval in both groups but after detomidine, PR and QT interval were enlarged significantly at the end of the experiment. The second degree atrioventricular was blocked in two rabbits after 40 min only in group B. It was concluded that alkaloid present in D. innoxia prevented detomidine induced Bradycardia  and might be useful during combination against the Bradycardia induced by alpha-2 agonist in the rabbits.

Author(s) Details Dr. S. U. Rehman
Faculty of Sciences, University of Central Punjab, Lahore, Pakistan.

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