Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52411811EnglishN2026June15Healthcare Formulation, Optimization, and Evaluation of Liposomal Amphotericin B for Improved Antifungal Therapy     English0107Priti GuptaEnglish Manali RaiEnglish Saket Singh ChandelEnglish Background: Amphotericin B (AmB) remains a first-line therapeutic agent due to its broad-spectrum fungicidal activity and low microbial resistance. However, conventional formulations are severely restricted by dose-limiting nephrotoxicity driven by drug self-aggregation. Nanotechnology-driven drug delivery systems, particularly liposomes (L), have been widely adopted to over come these biopharmaceutical constraints. Objectives: This research aimed to formulate and optimize L-AmB using the thin-film hydration method to enhance drug stabil ity and reduce systemic toxicity, achieving high entrapment efficiency and controlled release through precise lipid-to-drug ratio modulation. Methods: L-AmB was prepared using HSPC, DSPG, and cholesterol via thin-film hydration. Preformulation studies included organoleptic evaluation, solubility analysis, melting point determination, and drug-excipient compatibility via FT-IR and DSC. The optimized formulation was characterized through standard methods. Results: The optimized formulation (Batch F4) exhibited a mean particle size of 82.4 ± 2.1 nm with a PDI of 0.142 and zeta potential of -32.5 ± 1.2 mV, indicating excellent physical stability. Entrapment efficiency reached 94.2 ± 1.5% with 92.8% yield. In vitro release studies demonstrated a sustained profile following the Higuchi model, with only 22% drug released in the first 8 hours. Stability studies confirmed refrigeration (4°C) as optimal for maintaining liposomal integrity. Conclusions: The optimized L-AmB formulation represents a safer alternative to conventional deoxycholate treatments. The sub-micron size ensures long-term stability and enhanced circulation via EPR effect. The sustained release profile minimizes the “burst effect” associated with nephrotoxicity. This study demonstrates that L-AmB offers a promising platform for improved clinical outcomes in systemic fungal infections. EnglishLiposomes, Amphotericin B, Invasive Fungal Infections, Drug Delivery Systems, Nephrotoxicity, Nanocarriers, Thin-Film Hydration.http://ijcrr.com/abstract.php?article_id=4911http://ijcrr.com/article_html.php?did=4911 1. Atole AS, Barge VU. A review on liposomes: a promising technique for drug delivery system. Int J Sci Res Sci Technol. 2023;10(3):439-461. 2. Akbarzadeh A, Rezaei-Sadabady R, Davaran S, et al. Liposome: classification, preparation, and applications. Nanoscale Res Lett. 2013;8(1):102. 3. Bulbake U, Doppalapudi S, Kommineni N, Khan W. Liposomal formulations in clinical use: an updated review. Pharmaceutics. 2017;9(2):12. 4. Stone NR, Bicanic T, Salim R, Hope W. 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Development, characterization, effi cacy and mode of action of AmBisome, a unilamellar liposomal formulation of amphotericin B. J Liposome Res. 1993;3(3):429 450. 11. Boswell GW, Bekersky I, Buell D, Hiles R, Walsh TJ. Toxico logical profile and pharmacokinetics of a unilamellar liposomal preparation of amphotericin B (AmBisome) in rats. Antimicrob Agents Chemother. 1998;42(10):2568-2573. 12. Walsh TJ, Finberg RW, Arndt C. Liposomal amphotericin B for empirical therapy in patients with persistent fever and neutrope nia. N Engl J Med. 1999;340(10):764-771. 13. Moen MD, Lyseng-Williamson KA, Scott LJ. Liposomal am photericin B: a review of its use as empirical therapy in febrile neutropenia and in the treatment of invasive fungal infections. Drugs. 2009;69(3):361-392. 14. Groll AH, Rijnders BJA, Walsh TJ. Clinical pharmacokinetics, pharmacodynamics, safety and efficacy of liposomal ampho tericin B. Clin Infect Dis. 2019;68(Suppl 4):S260-S274. 15. Adler-Moore J, Lewis RE, Brüggemann RJM. 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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52411811EnglishN2026June15Healthcare Metformin-Associated Vitamin B12 Deficiency: A Narrative Review of Diagnosis and Management   Agnieszka Dobrowolska, Marta Rz?sa, Martyna Grzywacz, Bartlomiej Markowski, Adam Skrobarczyk, Agata Kaczmarzyk   English0813Agnieszka DobrowolskaEnglish Marta Rz?saEnglish Martyna GrzywaczEnglish Bartlomiej MarkowskiEnglish Adam SkrobarczykEnglish Agata KaczmarzykEnglish Long-term metformin therapy is associated with reduced vitamin B12 status, but the clinical significance of biochemical abnor malities and optimal monitoring remain uncertain. This narrative review evaluates evidence on mechanisms, risk factors, clinical consequences, diagnosis, monitoring, and management, with emphasis on clinically actionable risk stratification and recent guidance. Targeted, non-systematic PubMed/MEDLINE and reference-list searches identified relevant English-language evidence primar ily from 2000 to August 2026. Earlier seminal studies were retained when relevant. Randomised, longitudinal, observational, and evidence-synthesis studies and current ADA, NICE, and MHRA guidance were prioritised. No preregistered protocol, formal inclusion/exclusion criteria, or risk-of-bias assessment was applied. Long-term metformin exposure is consistently associated with lower circulating vitamin B12 concentrations and biochemical defi ciency; higher dose and longer or cumulative exposure increase risk in several studies. Low serum vitamin B12 concentrations are not equivalent to clinical vitamin B12 deficiency. Neurological manifestations may occur without anaemia and overlap with diabetic neuropathy. Total or active vitamin B12 are appropriate initial tests, while methylmalonic acid may clarify indeterminate results. Cur rent guidance favours symptom-triggered testing and periodic monitoring in higher-risk users over universal screening. Current guidance supports symptom-triggered testing and periodic monitoring in higher-risk patients rather than universal screening. Metformin can generally be continued while confirmed deficiency is treated. Oral or intramuscular vitamin B12 re placement should be individualised according to deficiency severity, malabsorption, neurological involvement, adherence, and patient preference. Further prospective studies are needed to define optimal monitoring intervals and the role of preventive supplementation. EnglishCobalamin; Diabetes Mellitus, Type 2; Metformin; Methylmalonic Acid; Peripheral Neuropathy; Vitamin B12 Deficiencyhttp://ijcrr.com/abstract.php?article_id=4912http://ijcrr.com/article_html.php?did=4912 1. 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