Tubularized parameatal based dartos-spongiosum flap urethroplasty in distal hypospadias with flat glans, shallow meatal groove, and severe glans tilt

Objective: To report the technique and results of single stage tubularized parameatal based dartos-spongiosum flap urethroplasty for distal hypospadias with flat glans, shallow meatal groove, and severe glans tilt. Materials and Methods: The study was conducted over a period of 2-year from October 2013 to October 2015, and 19 patients with distal hypospadias were included in the study with flat glans, poor urethral groove, and severe glans tilt, who otherwise would have been subjected to transection of urethral plate and a two-stage procedure. In this technique, bilateral flaps were fashioned along the preputial edge beginning from the hypospadiac meatus with intact dartos, keeping the base of the flaps attached to the bifurcated spongiosum. The urethral plate was transected. Glans was split wide open. Bilateral flaps joined at ventral midline creating new urethral plate which was tubularized with the creation of slit like wide meatus at the tip of glans. Neourethral coverage was provided with double dartos flap. Complications and aesthetic appearance on a score of 1-10 were outcome measures. Results: There was no urethral stricture, residual chordee, penile rotation, or asymmetrical penis. The average aesthetic score was 8.5. Meatus was at the tip of glans with adequate caliber in all patients. Two (10.5%) out of 19 patients developed subcoronal fistula that required surgical closure. Conclusion: Tubularized parameatal-based dartos-spongiosum flap urethroplasty is viable and easy to reproduce option for management of a specific group of patients with distal hypospadias (with flat glans, poor urethral plate, and glans tilt) and is associated with very low complication rate

Comparison of clinical outcomes in patients with congenital anorectal malformation treated with posterior sagittal anorectoplasty and laparoscopically assisted anorectal pull through

Aim: To compare the complications and outcomes of laparoscopic-assisted anorectoplasty (LAARP) for anorectal malformation(ARM) with that of posterior sagittal anorectoplasty (PSARP) using Kelly’s score. Materials and Methods: This was a single-centerstudy conducted over a period of 4-year. A total of 95 male ARM patients were included in the study, of which 25 patients underwentLAARP, whereas 70 patients underwent PSARP. Result: Superficial wound infection was seen in 2 (2.85%) cases of the PSARPgroup while in 1 (4%) case in LAARP group. 12 (17.14%) cases of PSARP group had wound dehiscence at the neo-anal site, of which6 (8.57%) had complete wound dehiscence and the remaining 6 (8.57%) had partial dehiscence, whereas 4 (16%) cases had wounddehiscence in LAARP group of which 3 (12%) had partial and 1 (4%) had complete dehiscence. Retraction of the neo-anus was seenin 6 (8.57%) cases of PSARP group while in 2 (8%) cases of LAARP group. Ectopically placed neo-anus was seen in 3 (4.28%)patients of PSARP group while in none of the cases in LAARP group. None of the patients in LAARP group had anal stenosis,whereas 2 (2.85%) patients underwent redoanoplasty in PSARP group for anal stenosis. Mucosal prolapse was seen in 8 (11.42%)cases of PSARP group, as compared to 3 (12%) patients of LAARP group. The net average Kelly’s score in LAARP group was 4.56,whereas, in PSARP group, it was 4.10. Conclusion: This study emphasizes the emerging laparoscopic technique for the managementof ARMs. Using this approach, it is possible to achieve better continence rates as the extent of perineal dissection is minimal

ENHANCEMENT OF SOLUBILITY AND DISSOLUTION RATE OF ACETYLSALICYLIC ACID VIA CO-CRYSTALLIZATION TECHNIQUE: A NOVEL ASA-VALINE COCRYSTAL

Objective: This study aims to synthesize acetylsalicylic acid (ASA) cocrystals using valine as a coformer via a co-crystallization technique to increase the solubility and dissolution rate of ASA. Methods: The ASA-valine cocrystal (1:1 molar ratio) was prepared using the solvent evaporation technique with ethanol: water (50:50). The cocrystal was characterized using Fourier transform infrared spectroscopy (FT-IR), Differential scanning calorimetry (DSC), Powder X-ray diffraction (PXRD), Scanning electron microscopy (SEM), melting point to confirm the formation of cocrystal. The evaluation of cocrystal was done by drug content determination, solubility and dissolution studies. Results: The prepared cocrystal was successfully confirmed for the formation of a hydrogen bond. The melting point of prepared cocrystal was decreased compared to pure ASA and valine, which indicated the formation of a new crystalline form. The FT-IR studies showed the formation of a new hydrogen bond by shifting the-O-H,-C=O and-N-H functional groups. SEM studies ensured that the prepared cocrystals were in needle-like appearance. Finally, DSC and PXRD studies were also indicated the successful formation of ASA-valine cocrystal. The drug release of cocrystal was found to be 100% at 60th min. Where in the case of pure ASA and marketed product of ASA exhibited the dissolution rate of 59% and 69% at 60th min respectively. Conclusion: The co-crystallization technique can be adopted as the best strategy to increase the solubility and dissolution rate of BCS class 2 drugs. Therefore the prepared ASA-valine cocrystal can be a greater alternative to increase the solubility and dissolution rate compared with pure and marketed ASA

The effect of thermocycling on fracture toughness and hardness of different core build up materials

Introduction: Core build up materials are routinely used to restore grossly decayed teeth and in the oral environment they are subjected to changes in the temperature due to consumption of hot and cold food. Aims: The purpose of this study was to determine the effect of thermocycling on the fracture toughness and hardness of 5 core build up materials. Materials and Methods: Fifteen specimens were prepared for each of the following materials: DPI alloy, Miracle-mix, Vitremer, Fuji II LC and Photocore. American Standard for Testing Materials guidelines were used for the preparation of single-edge notch, bar-shaped specimens. Ten specimens of each material were thermocycled for 2000 cycles and the other 5 specimens were not thermocycled (non-thermocycled group). All specimens were subjected to 3-point bending in a universal testing machine. The load at fracture was recorded and the fracture toughness (K IC ) was calculated. Vickers hardness test was conducted on the thermocycled and non-thermocycled group specimens. Results: Photocore had the highest mean K IC in both thermocycled and non-thermocycled groups. Miracle-mix demonstrated the lowest mean fracture toughness (K IC ) for both thermocycled and non-thermocycled groups. By applying Mann Whitney ′U′ test the Vickers hardness value in all materials used in the study is highly superior in non-thermocycled group as compared to thermocycled group (P < 0.01). Non-thermocycled Photocore showed highest hardness values of 87.93. Vitremer had lowest hardness of 40.48 in thermocycled group. Conclusion: Thermocycling process negatively affected the fracture toughness and hardness of the core build-up materials

The Past and Present of Transfusion Medicine

BbOd transfusion has developed os a clinical nique. Its development has progressed from ignorance to science and from cruelty to civilization over hundreds Of years. Transfusion has mode great contribution {or saving lives ond expanding operation coverage. Blood letting wos Widely practiced for a variety Of conditions from the time Of Hippocrates and yet transfusion Only became a common place theropeutic intervention less thon pears 090. Although the association Of blood with life and vitality was recognized by primitive man, the transfusion Of wos not possible until Hervey described circulation in 1628. transfusion Of blood wos only one of the mo ny scientific competitions in Which thecitizensofFranceondEnglandengogedin 16005. This foundation for transfusion theropy that were built in 100 years later The developrnent Of transfusion medicine started from the attempts to transfuse blood in c nirnols in the 1 71b centu ry and the first fruits were seen in the half of century

Conjunctival impression cytology and its varying patterns in controlled and uncontrolled diabetic patients

Context: Diabetes mellitus (DM) is the most common endocrine disorder and is a significant cause of ocular morbidity, unstable refraction, corneal abnormalities, neovascular glaucoma, nerve palsies, and diabetic retinopathy (DR); it is being increasingly recognized that even the ocular surface is adversely affected in diabetic patients. Aims: The present study was undertaken to analyze the conjunctival surface changes by conjunctival impression cytology (CIC) and correlate them with glycosylated hemoglobin (HBA1c) levels. Settings and Design: Known cases of DM satisfying the inclusion criteria were included in this nonrandomized prospective study, which was undertaken after ethical clearance was obtained from our institutional ethical review board. Subjects and Methods: Eighty patients with DM who presented to the Department of ophthalmology at our center were included in the study; they were divided into Group 1 (HbA1c ≤6.5%) and Group 2 (HbA1c >6.5%). A detailed history, general physical examination, complete ophthalmological examination, and CIC were performed in all of the participants. Statistical Analysis Used: Data were analyzed using Chi-square test and statistical software EPI INFO Version 6 and Microsoft Excel. P 6.5%). Conclusions: Dry eye disease and ocular surface disorders are increasingly recognized in patients suffering from DM. The ocular surface evaluation must be included in the routine examination of all diabetic patients. CIC is a safe, minimally invasive procedure with no side effects and can serve as one of the diagnostic tools for the evaluation of the ocular surface