Paracetamol 150mg / Sodium salicylate 100mg tablets

-β-D-xylopyranosyl-(1→6)-β-D-glucopyranoside] is a natural salicylate found in some plant species belonging primarily to the Ericaceae and Rosaceae families. Biological studies conducted since the beginning of the 21st century have suggested the potential use of gaultherin in treating various diseases related to inflammation and oxidative stress, including rheumatoid arthritis, sciatica, neuralgia, and muscular pain. The accumulated results indicated a targeted range of biological effects, particularly anti-inflammatory, antipyretic, and anti-rheumatic properties associated with reduced adverse outcomes. The molecular mechanisms involve the influence on several signalling pathways, including NF-κB, MAPK, and potentially AMPK, as well as the inhibition of critical pro-inflammatory enzymes, such as COX-2. This inhibition is achieved without affecting the COX-1 isoform, thereby preventing side effects such as bleeding ulcers or intracranial haemorrhage. This overview summarises the current knowledge about pharmacokinetics, molecular mechanisms, pharmacology, and biocompatibility of gaultherin. Additionally, four methods for isolating gaultherin from plant material and its distribution within the plant kingdom were the focal points of review and discussion. The paper also describes significant differences between synthetic aspirin and natural gaultherin in their biological potential and side effects, resulting from their different mechanisms of action. As a prodrug of salicylic acid, gaultherin releases salicylic acid gradually through enzymatic hydrolysis in the gastrointestinal tract. This controlled release minimises direct gastric irritation and accounts for its superior gastrointestinal safety profile compared to aspirin. Unlike aspirin, which irreversibly inhibits COX-1 and can lead to serious side effects with chronic use, gaultherin selectively inhibits COX-2 while sparing COX-1. These properties position gaultherin as a compelling natural alternative for patients requiring long-term anti-inflammatory therapy with reduced risk of gastrointestinal or bleeding complications.

Abstract licence: CC BY

INTRODUCTION: Subacute thyroiditis is a self-limiting condition caused by thyroid inflammation. It usually presents with fever, neck pain and symptoms of thyrotoxicosis. Atypical presentations without neck pain are rare and often lead to misdiagnosis, especially in low-resource settings. CASE REPORT: We report a case of atypical subacute thyroiditis in a man of Middle Eastern descent that was initially misdiagnosed as tuberculosis, with lymphoma, painless sporadic thyroiditis, and laryngeal malignancy being differentials. The patient, a 41-year-old male, presented with progressively worsening fevers, night sweats, and weight loss, with thyroid cartilage thickening and tenderness on physical exam. He was diagnosed with subacute thyroiditis through Doppler ultrasound scanning of the thyroid gland, elevated inflammatory markers, and the presence of antibody-negative hyperthyroidism on his biochemical thyroid screen. Symptomatic relief was provided with salicylate and prednisolone. The patient experienced transient asymptomatic hypothyroidism 4 months after disease onset, which was not treated. Euthyroidism was achieved 6 months after symptom onset. CONCLUSION: Subacute thyroiditis is a rare disease thought to be postviral in origin. It generally presents with fever, neck pain, and signs of thyrotoxicosis and evolves in three phases-a hyperthyroid, hypothyroid, and euthyroid phase. Atypical subacute thyroiditis without neck pain is even rarer; therefore, clinicians should maintain a high index of suspicion for thyroid disorders whenever symptoms suggestive of thyrotoxicosis are encountered, and should always consider thyroid abnormalities when investigating weight loss or persistent fevers in an African setting.

Abstract licence: CC BY-NC-ND

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely administered in all age groups due to their effectiveness in reducing fever, relieving pain, and reducing inflammation. However, they have also been identified as the second most common cause of drug-induced hypersensitivity reactions, after beta-lactam antibiotics. Adverse reactions to NSAIDs can range from expected pharmacological side effects such as gastritis to severe allergies, including anaphylaxis. It is important to distinguish true hypersensitivity reactions from other side effects to ensure proper management and patient safety. Four patients aged 35-60 years were treated with NSAIDs for pain management and subsequently developed hypersensitivity reactions to NSAIDs such as ketorolac, ketoprofen, and diclofenac sodium in the type of allergic reactions such as NSAIDs-induced urticaria/angioedema (NIUA). This case series provides valuable insights into the clinical presentations and potential mechanisms of NSAID hypersensitivity in the documented cases in one of the hospitals in Indonesia. It highlights important areas for future investigation, including the need for larger, controlled studies to better understand incidence, risk factors, and generalizability to broader populations.

Abstract licence: CC BY-NC

This study examined an improved and simplified method for solid-phase extraction that provides rapid and accurate determination and identification of 116 pharmaceutical and personal care products (PPCPs) in an aqueous environment using ultra-high performance liquid chromatography-tandem mass spectrometry. The common active compounds include 22 sulfonamides, 18 quinolones, 8 macrolides, 18 β-agonists, 6 sedative-hypnotics, 3 antipyretic-analgesics, 3 antihypertensives, 2 antidiabetic drugs, 3 antihistamines, 8 sex hormones, 2 antivirals, 6 nitroimidazoles, 8 glucocorticoids, and 3 amphenicols, lincomycin, pimaricin, levothyroxine sodium, bisphenol A, aldosterone, and melamine in water samples. Key parameters of tandem mass spectrometry, ultra-high performance liquid chromatography, and solid-phase extraction were optimized to enhance the analytical performance. The calibration curves were accomplished at seven concentration levels, and a satisfactory linear relationship (R > 0.99) was observed within the range of 5-800 ng/mL. Results showed varying limits of detection (0.0136-13.3 ng/L for different analytes based on signal-to-noise (S/N) = 3) and limits of quantitation (0.0452-44.4 ng/L). Recoveries of the spiked samples ranged from 53.1% to 116.5% with relative standard deviation lower than 9.9%. This approach effectively minimized matrix interference, improved extraction efficiency, and enhanced detection sensitivity, enabling more accurate PPCP residue analysis in water. The validated method was applied to raw water, treated water, and river water samples from Hangzhou, detecting 47 compounds at concentrations ranging from nondetected to 359 ng/L. Our findings provided critical technical support for the preliminary establishment of an environmental monitoring system targeting emerging pollutants. Notably, to the best of our knowledge, this study represented the first reported detection of melamine, loratadine, aldosterone, and levothyroxine sodium in aquatic environments. In particular, melamine was detected in aquatic environment for the first time, thus expanding the understanding of PPCPs' pollution status.

Abstract licence: CC BY-NC-ND

Background: The dissolution of oral solid dosage forms is a key determinant of drug bioavailability, yet traditional testing methods do not capture the real-time surface dynamics of drug release. This study introduces a novel framework combining surface dissolution imaging (SDi2) with an interpretable, dual-wavelength convolutional neural network (CNN) to predict and understand dissolution behavior. Methods: Eight tablet formulations containing acetylsalicylic acid, sodium salicylate, or salicylamide, combined with either lactose or methylcellulose, were analyzed under two distinct, compendial conditions (pH 1.2 and pH 6.8). Results: Our final CNN model, which synergistically processes spectral images (280 nm for API release and 520 nm for structural changes), temporal data, and formulation composition, accurately predicted dissolution profiles, achieving a coefficient of determination of 0.89 and a root mean square error (RMSE) of 11.57. To overcome the “black-box” nature of deep learning, we employed Gradient-weighted Class Activation Mapping (Grad-CAM) to interpret the model’s predictions. The analysis revealed that the model focused on tablet edges at 280 nm, consistent with surface dissolution, and on bulk regions at 520 nm, reflecting structural changes including erosion and gel-layer growth. Conclusions: These findings suggest that integrating real-time imaging with explainable AI methods can support better understanding of dissolution processes in pharmaceutical formulation development.

Abstract licence: CC BY

Compound paracetamol and amantadine hydrochloride capsules are commonly used over-the-counter medications at the primary care level. The primary component, amantadine, is excreted via the kidneys and poses a risk of accumulation in older patients, while chlorphenamine may increase the risk of delirium. This study examines the relationship between this medication and abnormal behavior by presenting case studies of two older patients and discussing clinical management strategies. Case 1 involved a 78-year-old Chinese male with an estimated glomerular filtration rate (eGFR) of 87 mL/min/1.73 m2, who developed visual hallucinations, delirium, and balance disturbances after five consecutive days of medication. He scored 8 on the Nursing Delirium Screening Scale. Symptoms resolved within 8 days following hydration therapy and antipsychotic treatment. Case 2 featured a 75-year-old Chinese male with an estimated glomerular filtration rate of 37 mL/min/1.73 m2, who exhibited disorientation and hallucinations within 24 hours of starting the medication, scoring 10 on the Nursing Delirium Screening Scale. His symptoms completely resolved in 3 days. Both cases excluded alternative etiologies, and Naranjo Adverse Drug Reaction Probability Scale scores of 7 indicated a “probable” association between the drug and the behavioral abnormalities. Pharmacokinetic analysis revealed a strong correlation between drug accumulation, renal function status, and treatment duration. The central toxicity of amantadine is significantly enhanced in older patients with renal insufficiency, and chlorphenamine may increase the risk of delirium. The risks associated with using this medication in older patients suffering from the common cold far outweigh the benefits, warranting cautious use in clinical practice; adverse reactions should be managed with prompt discontinuation of the medication and hydration to facilitate drug clearance. This study provides crucial warnings about medication safety in the older population.

Abstract licence: CC BY-NC-ND