A COMPREHENSIVE REVIEW ON NOVEL MICROSPONGES DRUG DELIVERY APPROACH

ABSTRACTMicrosponges drug delivery approach (MDA) has been introduced in topical products to facilitate the controlled and targeted release of activedrug into the skin to decrease systemic exposure and minimize local cutaneous reaction. Microsponges are highly cross-linked, polymeric sponge,porous in nature, spherical shape consisting of high drug content within their interconnecting voids, releasing bioactive agent at a target site withinpredetermined time. They are mostly used for prolonged topical administration, enhanced efficacy for topically therapeutic agent with safety, stabilityand reduced side effects followed by improved aesthetic properties in an efficient and novel manner. More ever, it is found to be stable over wide pHrange and compatible with most vehicles. We here complied recent data regarding properties of microsponges, their methodology pharmaceuticalapplication and list of patent till date.Keywords: Microsponges, Bioactive, Porous, Interconnecting voids, Aesthetic

Assessment of depression, anxiety and stress among Indian infertile couples in a tertiary health care centre in Bihar

Background: Infertility rate is on rising trend. It is often associated with a chronic state of stress which may manifest itself in anxiety-related and depressive symptoms. Also, the affected family faces social discrimination, ostracism and stigma which leads to increased anxiety or depression among infertile couples. The motive of this study was to assess the quality of life among infertile couples; to determine the relationship between various domains of quality of life of infertile couples i.e. emotional, mind/body, relational, social, environmental and tolerability and to determine the association of levels of quality of life of infertile couples with the selected variables visiting  IGIMS.Methods: This was a cross-sectional based study; carried out in the department of reproductive medicine, IGIMS, Patna, Bihar for one-year duration (January 2017 to December 2017), on 122 infertile patients attending outpatient department for treatment. Data was collected by using self-administered questionnaire i.e. Ferti QoL questionnaire and HADS.Results: Among all these 96 cases was found to be suffering from primary infertility and 26 cases from secondary infertility. In primary infertile patient social domain was the most affected domain having the greatest impact on their quality of life. In secondary infertile patients the tolerability domain was the most affected domain having the greatest impact on their quality of life. The total fertility quality of life score in primary infertility patients showed a lesser quality of life (55.41) than secondary infertility patients (66.29).Conclusions: This study points at the necessity of specific psychological interventions, presently absent from the public healthcare routine, for women struggling with infertility, to help them manage potential mental health problems and meet their reproductive goals

Preoperative evaluation of superficial cortical venous drainage

Objectives and methodology: The preoperative exact localization of superficial intracranial lesions and superficial cortical veins is often necessary for making craniotomy and evaluation of cortical veins. We developed a simple and cheap method for such localization using cod liver oil capsule during the preoperative MRI and MRV brain examination. With the help of MRV brain, 3DCEMRV and 2DTOF images were taken and superficial cortical veins studied in the marked area for comparison between both modalities of MRV and planning of surgery for avoiding venous injury. Results: Most of the cases were in the age group 16-60 years (91.6%). The most common clinical manifestation was headache (85.4%) and meningioma (60.4%) was found to be the most common pathology. Clear visualization (Grade 3) of the individual superficial cortical vein was observed in 48 cases (100%) in 3DCEMRV as compared to 2DTOF 22 cases (45.8%) P <0.001S. Clear visualization (Grade3) of superior sagittal sinus was observed in 48 cases (100%) in 3DCEMRV as compared to 2DTOF 33 cases (68.6%) P <0.001S.  In post-operative CT Head, we found 4 (8.3%) cases were having venous infarction.  5 patients (10.4%) developed motor weakness postoperatively. In 3 cases, postoperative MRV were done and found no venous injury. Conclusion: This study showed that preoperative localization and evaluation of the tumoral area and cortical veins with the help of cod liver oil in MRI and MRV brain was very helpful in planning the surgery, making craniotomy and to avoid injury of the veins. This technique is easy to perform and the capsule is easily constructed and inexpensive. 3DCEMRV was found to be better modality than 2DTOF for delineation of veins. Final neurosurgical outcomes were better

Role of bilateral internal iliac artery ligation in severe obstetric and gynaecological hemorrhage

Background: Massive pelvic haemorrhage is a potentially lethal complication while undergoing obstetric and gynaecological surgery. The objective of this study was to study of role of bilateral internal iliac artery ligation in severe obstetric and gynaecological haemorrhage. It was a prospective interventional study carried out in a multi-speciality tertiary care hospital in New Delhi.Methods: Thirty-five patients (31 obstetric and 4 gynaecological) fulfilling the inclusion criteria over a period of 2 years were included in the study cohort after informed consent. After laparotomy, internal iliac arteries were exposed by incising the peritoneal fold between the infundibulo-pelvic and round ligaments. A number 1 silk suture and right-angled artery forceps were used to tie the internal iliac arteries approximately 1 inch below their origin. The success and complications of the procedure were analysed.Results: In the present study 31 out of 35 cases underwent BIIAL for obstetrical cause of haemorrhage and rest 4 for gynaecological cause. In 19 out of 31 patients, hysterectomy preceded or followed BILAL depending upon the clinical situation making a uterine salvation rate of 38.7%. The success rate of BIIAL was 67.7% in 31 obstetric cases. In the 4 gynaecological cases BILAL was done to arrest post-hysterectomy haemorrhage and success rate was 100%. Among 35 patients one patient died of haemorrhagic shock and 4 other died of full blown sepsis and MODS in surgical ICU. No significant procedure related complications were encountered.Conclusions: BILAL is a very effective procedure to control PPH and pelvic haemorrhage due to other causes and helps save the much precious lives and uteri. This procedure can always be tried where procedures like embolization are unavailable

Comparison of airway maneuvers (manual in line stabilization, modified jaw thrust, and conventional maneuver) for orotracheal intubation during direct laryngoscopy

Background: During performing orotracheal intubation with direct laryngoscopy adequate laryngeal visualization depends on proper airway maneuvers. There are different types of airway maneuvers. Aims and Objectives: This study aimed to compare airway maneuvers; manual in line stabilization (MILS), jaw thrust, and conventional maneuver to assess better laryngeal visualization and ease of intubation among them and associated complications. Materials and Methods: This observational study was conducted in 90 adult patients. Patients divided into three groups. Laryngoscopy and intubation in Group M were done in MILS and in group J jaw thrust. In Group C, as conventional maneuver performed. Laryngeal visualization assessed using modified Cormack–Lehane grading and ease of intubation assessed using intubation time, number of attempts between these three groups. The data were compared using ANOVA test, Chi-square test. Results: While comparing between these groups better laryngeal visualization seen in jaw thrust group, while the MILS maneuver worsen the view. Conclusion: The present study concluded that jaw thrust maneuver improved the laryngeal visualization and conventional maneuver made intubation faster and easy

Six senses while considering hydatid cyst as a differential for a swelling at nape of the neck: a case report

While cervical swellings usually are located in anterior midline like thyroglossal cyst, thyroid swellings, or in antero-lateral aspect of neck like cold abscess, branchial cyst, lymphangioma, cervical lymphadenopathy etc. Nape of the neck swelling is even less common with differentials including lipoma, sebaceous cyst, lymphangioma, etc. Hydatid cyst (HC) is often missed as a differential resulting in intraoperative surprises. This case report might change the mind of the readers to keep HC in back of their minds while approaching a case of swelling of the neck. Here we report a case of 15 years’ female who presented with swelling of nape of neck which on evaluation was inclining towards lipoma/epidermal cyst. With an intention for surgical exploration and excision, the patient was taken for operation, where we discovered it to be HC and the same was later confirmed by histopathology as well. Because of its rare presentation the primary diagnosis of HC is often missed out in spite of having sensitive cytology and imaging modalities. Hence, by reporting this case we intend to emphasize six facts a clinician, a radiologist and also a pathologist must consider while keeping primary HC at an unusual site as a differential diagnosis.

Transverse magnetic field driven modification in unsteady peristaltic transport with electrical double layer effects

The influence of transverse magnetic field on time-dependent peristaltic transport of electrically-conducting fluids through a microchannel under an applied external electric field with induced electric field effect is considered, based on lubrication theory approximations. The electrohydrodynamic (EHD) problem is also simplified under the Debye linearization. Closed-form solutions for the linearized dimensionless boundary value problem are derived. With increasing Hartmann number, the formation of bolus in the regime (associated with trapping) is inhibited up to a critical value of magnetic field. Flow rate, axial velocity and local wall shear stress are strongly decreased with greater Hartmann number whereas pressure difference is enhanced with higher Hartmann number at low time values but reduced with greater elapse in time. With greater electro-osmotic parameter (i.e. smaller Debye length), maximum time-averaged flow rate is enhanced, whereas the axial velocity is reduced. An increase in electrical field parameter (i.e. maximum electro-osmotic velocity) causes an increase in maximum time-averaged flow rate. The simulations find applications in electromagnetic peristaltic micro-pumps in medical engineering and also “smart” fluid pumping systems in nuclear and aerospace industries

Comparison of Airway Maneuvers Manual in line stabilization[MILS],Modified Jaw thrust, Conventional maneuver for Oro tracheal Intubation during Direct Laryngoscopy

Background: During performing orotracheal intubation with direct laryngoscopy adequate laryngeal visualization depends on proper airway maneuvers. There are different type of airway maneuvers. Aim: This study aimed to compare airway maneuvers ; MILS, jaw thrust , conventional maneuver to assess better laryngeal visualization and ease of intubation among them and associated complications. Material & Methods: This observational study was conducted in 90 adult patients. Patients divided in to three groups. Laryngoscopy and intubation in group M was done in MILS and in group J jaw thrust , In Group C as conventional maneuver performed. Laryngeal visualization assessed using modified Cormack lehane (CL)grading and ease of intubation assessed by usingintubation time, number of attempts between these three groups. The data were compared using Anova test, chi-square test. Results: While comparing between these groups better laryngeal visualization seen in jaw thrust group while the MILS maneuver worsen the view. Conclusion: The present study concluded that jaw thrust maneuver improved the laryngeal visualization and conventional maneuver made intubation faster and easy

Role of bilateral internal iliac artery ligation in severe obstetric and gynaecological hemorrhage

Background: Massive pelvic haemorrhage is a potentially lethal complication while undergoing obstetric and gynaecological surgery. The objective of this study was to study of role of bilateral internal iliac artery ligation in severe obstetric and gynaecological haemorrhage. It was a prospective interventional study carried out in a multi-speciality tertiary care hospital in New Delhi.Methods: Thirty-five patients (31 obstetric and 4 gynaecological) fulfilling the inclusion criteria over a period of 2 years were included in the study cohort after informed consent. After laparotomy, internal iliac arteries were exposed by incising the peritoneal fold between the infundibulo-pelvic and round ligaments. A number 1 silk suture and right-angled artery forceps were used to tie the internal iliac arteries approximately 1 inch below their origin. The success and complications of the procedure were analysed.Results: In the present study 31 out of 35 cases underwent BIIAL for obstetrical cause of haemorrhage and rest 4 for gynaecological cause. In 19 out of 31 patients, hysterectomy preceded or followed BILAL depending upon the clinical situation making a uterine salvation rate of 38.7%. The success rate of BIIAL was 67.7% in 31 obstetric cases. In the 4 gynaecological cases BILAL was done to arrest post-hysterectomy haemorrhage and success rate was 100%. Among 35 patients one patient died of haemorrhagic shock and 4 other died of full blown sepsis and MODS in surgical ICU. No significant procedure related complications were encountered.Conclusions: BILAL is a very effective procedure to control PPH and pelvic haemorrhage due to other causes and helps save the much precious lives and uteri. This procedure can always be tried where procedures like embolization are unavailable