A Study Of Orbital Fractures In A Tertiary Health Care Center

A retrospective study of patients with orbital fractures had 48% patients in the age group of 20 – 40 years with male : female ratio of 10:1. Road traffic accidents (71.43%) were the most common cause followed by injury due to fall (20%). Eighty five percent of patients had normal visual acuity at presentation and 65.57% patients had no ocular complaints. Diplopia was present in 14.2% of patients. Of the orbital fractures infraorbital rim was involved in 43.13%, floor in 19.6%, lateral wall in 13.7%, pure blow out in 14.28% and the roof in 2.9%. Important ocular findings were extraocular movements restriction in 9 (10.3%), infraorbital dysaesthesia in 3 (3.4%), enophthalmos in 2, RAPD and globe rupture in 1 patient each. 32 patients underwent surgical management. At the end of 4 months of follow up, 3 had restriction of EOM, 1 patient had vision loss due to globe rupture, 2 had RAPD (optic nerve compression), 1 had lagophthalmos, 1 had exotropia and 1 had atrophic bulbi

PRECLINICAL PHARMACOKINETIC EVALUATION OF VALSARTAN FLOATING TABLETS FORMUALTED USING CROSS LINKED STARCH UREA - A NEW MODIFIED STARCH

The objective of the present study is optimization of valsartan floating tablet formulation by 23 factorial design and to evaluate the optimized valsartan floating tablets for in vitro drug release, preclinical pharmacokinetics and also for in vitro – in vivo correlation (IVIVC). Valsartan is an orally active anti-hypertensive drug, majorly absorbed from stomach and upper small intestine. Formulation of sustained release floating tablets of valsartan is needed because of its poor oral bioavailability and short biological half-life. Valsartan floating tablets were formulated as per 23 factorial design and were evaluated. Valsartan floating tablets prepared as per 23 factorial design were non-disintegrating in water and aqueous acidic (pH 1.2) and alkaline (pH 7.4) fluids and were of good quality with regard to drug content, hardness, friability and suitable for controlled release. Formulations Fa, Fab, Fac and Fabc exhibited excellent floating over >12 h with a floating lag time in the range 12-40 seconds. Higher levels (20 %) of sodium bicarbonate gave shorter floating lag time. Valsartan release from the floating tablets prepared except formulation Fa was slow and spread over 12 h and dependent on the composition of the tablets. Drug release from formulation Fa was very rapid. Valsartan release from the floating tablets was by non-fickian diffusion mechanism in all the cases except Fa. In the case of formulation Fa that gave rapid release of drug fickian diffusion was the drug release mechanism. Optimization of valsartan floating tablet formulation was done taking floating lag time as the parameter for optimization. For optimization, floating lag time was taken as response (Y) and level of sodium bicarbonate as (X1), level of bees wax as (X2) and level of starch acetate as (X3). The polynomial equation describing the relationship between the response, Y and the variables, X1 , X 2 and X3 based on the observed data was found to be Y = 8.996 - 8.596 (X1) + 2.396 (X2) – 2.431 (X1 X2) + 0.561 (X3) - 0.521 (X1 X3) + 0.396 (X2 X3) - 0.271 (X1 X2 X3). Based on the polynomial equation developed, the optimized valsartan floating tablet formulation with a floating lag time of 20 seconds could be formulated employing sodium bicarbonate (160mg/tablet), beeswax (28mg/tablet) and starch acetate (10mg/tablet). The optimized formulation (Fopt) exhibited a floating time of 12-14 h with a lag time of 21 seconds fulfilling the target floating lag time set indicating validity of the optimization technique employed. Formulations Fopt and Fab prepared exhibited excellent floating characteristics (floating over 12 h with a lag time of 21 and 12seconds respectively) and good sustained release of valsartan over 12– 14h. The optimized valsartan tablets formulated at two strengths 80 mg/tablet and 40 mg/tablet gave slow, gradual and complete release of valsartan in 12h. Valsartan was absorbed rapidly from IR tablets and slowly over longer period of time from floating tablets. Based on (AUC)o α , the relative bioavailability ( BA) of Valsartan from FTs was 166.0 % when compared to Valsartan IR tablets (100%). A good level A correlation (r = 0.961) was observed between percent drug released (in vitro) and (AUC)o α (in vivo) Key words: Cross Linked starch Urea, Floating tablets, Valsartan, Optimization, Preclinical, Pharmacokinetic

Automated skin lesion segmentation using multi-scale feature extraction scheme and dual-attention mechanism

Segmenting skin lesions from dermoscopic images is essential for diagnosing skin cancer. But the automatic segmentation of these lesions is complicated due to the poor contrast between the background and the lesion, image artifacts, and unclear lesion boundaries. In this work, we present a deep learning model for the segmentation of skin lesions from dermoscopic images. To deal with the challenges of skin lesion characteristics, we designed a multi-scale feature extraction module for extracting the discriminative features. Further in this work, two attention mechanisms are developed to refine the post-upsampled features and the features extracted by the encoder. This model is evaluated using the ISIC2018 and ISBI2017 datasets. The proposed model outperformed all the existing works and the top-ranked models in two competitions

A Review Paper on Technical Data of Present HVDC Links in India

HVDC trend is increasing day by day due to its technical advantages over AC like long distance bulk power transmission, asynchronous integration of AC systems etc. One of the important applications of HVDC is bulk power wind energy transmission from offshore to onshore grid. This paper provides present complete individual technical data of HVDC links of both Bi-polar and Back-to-back transmissions projects commissioned in India. DOI: 10.17762/ijritcc2321-8169.16044

Role of ocean initial conditions to diminish dry bias in the seasonal prediction of Indian summer monsoon rainfall: A case study using climate forecast system

Coupled models tend to underestimate Indian summer monsoon (ISM) rainfall over most of the Indian subcontinent. Present study demonstrates that a part of dry bias is arising from the discrepancies in Oceanic Initial Conditions (OICs). Two hindcast experiments are carried out using Climate Forecast System (CFSv2) for summer monsoons of 2012-2014 in which two different OICs are utilized. With respect to first experiment (CTRL), second experiment (AcSAL) differs by two aspects: usage of high-resolution atmospheric forcing and assimilation of only ARGO observed temperature and salinity profiles for OICs. Assessment of OICs indicates that the quality of OICs is enhanced due to assimilation of actual salinity profiles. Analysis reveals that AcSAL experiment showed 10 reduction in the dry bias over the Indian land region during the ISM compared to CTRL. This improvement is consistently apparent in each month and is highest for June. The better representation of upper ocean thermal structure of tropical oceans at initial stage supports realistic upper ocean stability and mixing. Which in fact reduced the dominant cold bias over the ocean, feedback to air-sea interactions and land sea thermal contrast resulting better representation of monsoon circulation and moisture transport. This reduced bias of tropospheric moisture and temperature over the Indian land mass and also produced better tropospheric temperature gradient over land as well as ocean. These feedback processes reduced the dry bias in the ISM rainfall. Study concludes that initializing the coupled models with realistic OICs can reduce the underestimation of ISM rainfall prediction. © 2018. The Authors

Incidental diagnosis of granulosa cell tumour in a 25-year-old woman

A 25-year-old woman presented with backache of 2 weeks duration and had 45-60 days menstrual cycle. On transvaginal sonography (TVS), her left adnexa showed a heterogenous solid mass of 5.3×4.2 cm and moderate vascularity on color doppler. Serum inhibin B was raised to 2249 pg/ml. MRI showed 5.5× 4.5 cm solid mass in the left ovary with lobulated margins suggestive of sex cord-stromal/ germ cell tumor. Laparoscopy showed an enlarged left ovary with intact surface. Left adnexectomy with staging biopsies and infracolic omentectomy was performed. Histopathology showed adult granulosa cell tumor with intact ovarian capsule. One-month post-surgery, inhibin B level was 44 pg/ml. She wishes to conceive after six months follow-up.

PYODERMA GANGRENOSUM SECONDARY TO TAKAYASU'S ARTERITIS

Pyoderma gangrenosum (PG) is an uncommon & noninfectious neutrophilic dermatosis commonly associated with underlying systemic disease in more than 50% of cases. About 20-30% of cases are commenced and aggravated by minor trauma or surgery, a phenomenon named pathergy. PG is associated with many systemic diseases, but association with Takayasu's arteritis (TA) / pulseless disease, which is chronic inflammatory and stenotic disease of large sized arteries is less common. These conditions responded well with systemic corticosteroids. The association of PG with TA has been less reported in the literature so far. KEYWORDS: Pyoderma gangrenosum; Takayasu's arteritis;Pulseless disease

A case benign struma ovarii

Struma ovarii is a rare ovarian tumor and a monodermal variant of dermoid tumors of the ovary in which thyroid tissue components constitute more than 50% of the mass. Struma ovarii accounts for 0.5–1.0% of all ovarian tumors and 2-5% of ovarian teratomas. Most cases are benign, but malignant transformation is found in a small percentage. It usually presents as a unilateral adnexal mass at fifth and sixth decades of life, with symptoms like other ovarian tumors. The definitive diagnosis is made by histological examination. Adnexectomy remains the standard line of treatment for benign disease. A 41-year-old lady presented with pain in abdomen for 3 months. On ultrasonography and MRI, a multiloculated solid cystic lesion of 7×6 cm with internal echoes was found in the right adnexa. Laparoscopic right adnexectomy was performed. Histopathology was consistent with struma ovarii. Due to its vague clinical manifestations and diverse imaging characteristics, pre-operative diagnosis is challenging.