Transdermal Delivery of Nandrolone Decanoate using Quality by Design Approach

Abstract

As per WHO Anemia is a condition in which the number and size of red blood cells, or the hemoglobin concentration, falls below an established cut-off value, consequently impairing the capacity of the blood to transport oxygen around the body . Anemia is an indicator of both poor nutrition and poor health. Anemia is defined as having Hb value below the established cut off defined by the World Health organization. Different defined groups have different cut offs. For adults: Men and postmenopausal women Hblt13.0g/dl and for premenopausal women Hblt12.0g/dl. Worldwide iron deficiency is the most common cause of anemia. Other causes of anemia are nutritional deficiencies (especially folate and vitamins B12, A and C), sickle cell diseases, complication of malaria during pregnancy, chronic kidney diseases (CKD) associated anemia. Chronic kidney disease is a prevalent condition worldwide and the number of patients affected continues to increase. The prevalence increased with the increase of stage of CKD, from 8.4% at stage 1 to 53.4% at stage 5. Anemia in CKD is typically normocytic, normochromic, and hypo-proliferative. Diabetes is one of the most common causes of CKD. Two crucial factors responsible for red blood cell production from bone marrow are Iron and EPO. Reduction in kidney function in CKD leads to reduction in EPO (Erythropoietin) production and this affect the erythropoiesis from bone marrow. Also with increase in uremic inhibitors shortened the RBC s (Red blood cells) life span. Optimal treatment of anemia due to CKD requires appropriate diagnosis, ESA (Erythropoietin stimulating agent) and iron therapy, and close monitoring of response patients with CKD who are not receiving dialysis or those on peritoneal dialysis, directly iron can be given orally or intravenously. Oral iron therapies are available but after sometime patients become iron intolerant or Iron deficient. And for IV (intravenous) administration, patients are required to visit clinic frequently. Recombinant ESAs are used to stimulate erythropo