Cytopathological study of salivary gland lesion in patients at a tertiary care centre, Indore: a one-year study

Background: Fine needle aspiration cytology (FNAC) is being increasingly used in the diagnosis of salivary gland lesions. However, the diagnosis is still difficult sometimes. Salivary gland lesions account for 2-6.5% of all the neoplasms of the head and neck. The objective of this study was to evaluate the diagnostic accuracy and the sensitivity and specificity of FNAC in various salivary gland lesions and their histological correlation wherever possible.Methods: A total of 123 FNACs were done on salivary gland swellings in the Department of Pathology, M.G.M. Medical College, Indore, Madhya Pradesh, India. The PAP stained cytological and H and E stained histopathological slides were studied and correlated.Results: On FNAC, slides were studied and analyzed and the following lesions were observed: Inflammatory lesion (69), Inflammatory cystic lesion (1), Pleomorphic adenoma (29), monomorphic adenoma (1), Warthin’s tumour (2), Benign Cystic lesion (4), Benign lesion (not specified) (4), Adenoid cystic carcinoma (3), Mucoepidermoid carcinoma (2), Metastatic carcinoma (3), and malignant tumour (unspecified) (5). Histopathological correlation was available in 41 cases and studied respectively.Conclusions: The overall sensitivity, specificity and the diagnostic accuracy were 90.2%, 97.6%, and 90.2%, respectively. Hence, the appropriate therapeutic management could be planned earlier. This study documents that FNAC of the salivary gland tumours is accurate, simple, rapid, inexpensive, well tolerated and harmless procedure for the patient

Study of drug prescription pattern in ischemic heart disease patients

Background: Drug utilization pattern studies helps to screen, assess and propose appropriate modifications in prescription practices, this would help to make patient care rational and cost effective. Study was intended to analyse the drug prescribing pattern for treatment of Ischemic heart disease using WHO indicators.Methods: This is a cross sectional observational study conducted on ischemic heart disease patients admitted at inpatient department of medicine in a tertiary care teaching hospital. The study consisted of analysis of drug utilization pattern of prescribed drugs.Results: IHD was more commonly seen in males (70.06%) than females (29.94%). IHD was most commonly seen in patients of age group of 61-70 year. Drugs prescribed to patients belong to various therapeutic classes ranging from anti-platelets, anticoagulants, anti-anginal, antithrombin, thrombolytic, hypolipidemics. The most commonly prescribed therapeutic class of drugs was antiplatelet (86.26%) followed by hypolipidemic (82.25%) and ACE inhibitors drugs (46.60%). Average number of drugs per encounter was 7.70. Drugs were prescribed by their generic names were 29.99%. Out of total study group 22.06% patients were prescribed at least one antibiotic. Injections were prescribed only in 1392 (27.86%) out of 4995 drugs. Of total drugs 3270 (65.45%) of drugs were from National List of Essential Medicines-2016 (NLEM -2016) and 2774 (55.53%) drugs prescribed were from WHO-EML-2016.Conclusions: Risk of artery disease increased with increasing age. IHD was more common in males than females. The most commonly prescribed drug classes in Ischemic heart disease were anti-platelet drugs followed by hypolipidemic agents

Laparoscopic Management of Median Arcuate Ligament Syndrome: A Case Report

Median arcuate ligament syndrome (MALS) is an uncommon disorder characterized by postprandial abdominal pain, vomiting, anorexia, and weight loss. The symptoms are due to the MAL compressing the celiac artery and irritating the celiac plexus/ganglion. We report the case of one patient who presented with chronic abdominal pain, bloating, vomiting, and weight loss. Computed tomography angiography led to the diagnosis of MALS. The patient was treated surgically by laparoscopic division of the MLA and excision of the celiac plexus. He was discharged on day two without complications. On one-month follow-up, he was symptom-free, eating well, and had gained weight. He is on regular follow-up

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Study on the behaviour of rubber aggregates concrete beams using analytical approach

Concrete is one the most extensively used construction material all over the world. Many scientists and researchers are in quest for developing alternate construction material that are environment friendly and contribute towards sustainable development. Huge amount of rubber tyres waste is being generated day by day which creates the disposal problem and has many environmental issues. As this scrap rubber waste is an elastic material having less specific gravity, energy absorbent material can be used as a replacement material for obtaining lightweight concrete. In present study an attempt is made to partially replace the rubber aggregates by coarse aggregates in concrete and to study its impact on properties of concrete. A modified concrete is prepared by replacing coarse aggregates in concrete with rubber aggregates by varying the replacement proportion from 0% to 20% with increment of 5%. 3 cubes for each percentage of replacement are casted and tested after 28th days of curing. The physiomechanical properties like density, compressive strength and elastic properties of modified concrete are determined from concrete cubes experimentally and further stresses and displacement at every 50 mm depth of beams are determined analytically by method of initial functions (MIF). MIF is an analytical method in which elastic properties and theoretical loads are used to analyse the beams without conducting any experimental programme. The analytical results by MIF are compared with bending theory

Formulation and Evaluation of Microsponge Gel for Topical Delivery of Antifungal Drug

The quasi emulsion solvent diffusion technique was used to create the clotrimazole microsponges, which were eventually recognized as an efficient carrier for the topical delivery of the medicine. The characteristics of the created system were significantly affected by the drug:polymer ratio. It was discovered that microsponges made for prolonged release formulation were effective, and clotrimazole microsponges with gel produced results that were equivalent. Microsponge gel compositions that were prepared beforehand showed regulated medication release. It has been shown that microsponges can transport medications for topical antifungal therapy successfully. Given how well the formulations kept the medication on the skin, it appears that microsponge gel is a more effective drug delivery mechanism than ordinary gel

Formulation and Evaluation of Topical Microsponge Based Gel of Clotrimazole

The study's overarching goal is to develop a novel medication delivery method based on microsponge gel containing clotrimazole. Clotrimazole is poorly absorbed from the gastrointestinal tract (GIT), has a short half-life of only 2 h, & is metabolized into inert molecules by the liver. Therefore, clotrimazole's drug delivery method must be modified for topical application. Microsponge delivery is a novel approach to sustained drug release. Microsponges were made with a polymer solution of Eudragit RS 100 in dichloromethane (DCM) and ethanol (1:1) using a quasi-emulsion solvent diffusion technique. A number of metrics, including production yield, entrapment efficiency, particle size measurement, and in vitro drug release studies, were used to each microsponge formulation. For topical administration, the optimized microsponge formulation F6 was transformed into a gel formulation. Prepared gel was compared to a commercially available formulation based on physical factors such as pH, viscosity, spreadability, drug content, and an in vitro diffusion investigation. Most of the formulations were discrete and spherical in shape, indicating a satisfactory production yield, suggesting quasi-emulsion solvent diffusion method is a promising methodology for the fabrication of microsponge. Clotrimazole was released steadily over the course of 12 hours from the microsponge gel formulation MGI (F6). Therefore, the medicine in the form of a microsponge can reduce the risk of adverse effects and increase patient compliance by avoiding skin contact