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El-Sayed Ibrahim, Sayed Ismail, Gihan Fetih, Omar Shaaban, Khaled Hassanein and Noura Abdellah

Development and characterization of thermosensitive pluronic-based metronidazole in situ gelling formulations for vaginal application

The purpose of this study was to develop pluronic-based in situ gelling formulations of metronidazole (MTZ) for treatment of bacterial vaginosis, aimed at prolonging the residence time, controlling drug release, enhancing efficacy, decreasing recurrence, and increasing patient compliance. The in situ gel formulations were prepared using different concentrations of pluronic F-127 (PF-127) alone and in combination with pluronic F-68 (PF-68). The prepared formulations were evaluated for their gelation temperature (T gel), in vitro drug release, rheological properties, mucoadhesion properties and tolerability by vaginal mucosa in tissue levels. The T gel decreased with increasing PF-127 concentration. The T gel was modulated by addition of PF-68 to be within the acceptable range of 25-37 °C. With increasing pluronic concentration, the in vitro drug release decreased, viscosity and mucoadhesive force increased. Histopathological examination of rabbit vaginas from the control and treated groups revealed normal histology of the vagina and cervix. Based on the in vitro evaluation of prepared formulations, the in situ gelling liquid formulated with PF-127/PF-68 (20/10 %, m/m) was selected for further clinical evaluation.

Open access

Melih Malkoc, Ozgur Korkmaz, Adnan Kara, Ismail Oltulu and Ferhat Say

ABSTRACT

Plantar fasciitis is a disorder caused by inflammation of the insertion point of the plantar fascia over the medial tubercle of the calcaneus. Foot orthotics are used to treat plantar fasciitis. Heel pads medialise the centre of force, whereas medial arch supporting insoles lateralise the force. We assessed the clinical results of the treatment of plantar fasciitis with silicone heel pads and medial arch-supported silicone insoles.

We retrospectively reviewed 75 patients with heel pain. A total of 35 patients in the first group were treated with medial arch supporting insoles, and 40 patients in the second group were treated with heel pads. The patients were evaluated with the Visual Analogue Scale (VAS) and the Foot and Ankle Ability Measure (FAAM) at the first and last examinations.

The mean VAS score in the first group was 8.6±1,2 (6-10); the FAAM daily activity score was 66.2±16 (41.2-95.0), and the sporting activity score was 45.4±24,4 (0.1-81) before treatment. At the last follow-up in this group, the mean VAS score was 5.3±1,5 (0-9); the FAAM daily activity score was 83,0±15,1 (55,9-100), and the sporting activity score was 73,5±26,2 (25-100). The mean VAS score in the second group was 8,6±0,9 (7-10); the FAAM daily activity score was 66.4±17 (41.4-95.2), and the sporting activity score was 45.8±24,2 (0.8-81, 3) before the treatment. At the last follow-up in this group, the mean VAS score was 5.5±1,2 (0-9); the FAAM daily activity score was 83.4±14,9 (60, 2-100), and the sporting activity score was 73.8±26 (28-100).

There was no significant difference in the clinical results of both groups. The force distribution by the use of silicone heel pads and medial arch-supported silicone insoles had no effect on the clinical results of the treatment of plantar fasciitis.