Preparation and <em>in vitro</em> Characterisation of Solid Dispersion Floating Tablet by Effervescent Control Release Technique with Improved Floating Capabilities

In this research, an effort has been done for the development of effervescent controlled release floating tablet (ECRFT) from solid dispersions (SDs) of diclofenac sodium (DS) for upsurge the solubility and dissolution rate. ECRFT of DS was prepared by using SDs of DS and its SDs prepared with PEG as carrier using thermal method (simple fusion). SDs of DS was formulated in many ratios (1:1, 1:2, 1:3 and 1:4). Prepared SDs were optimised for its solubility, % drug content and % dissolution studies. Tablets were formulated by using optimised SDs products and all formulation was evaluated for various parameters. A clear rise in dissolution rate was detected with entirely SD, amid that the optimised SD (SD4) was considered for ECRFT. Among all the tablet formulations, its F3 formulation was better in all the terms of pre-compression and post-compression parameters. It had all the qualities of a good ECRFT, based on this F3 formulation was selected as the best formulation. Data of in vitro release were fitted in several kinetics models to explain release mechanism. The F3 formulation shows zero order release. From this study, we can conclude that ECRFT containing SDs of DS can be successfully used for achieving better therapeutic objective

A comparative study to evaluate the effectiveness of 0.5% Levobupivacaine versus 0.5% Ropivacaine in Axillary Brachial plexus block

Objective: Levobupivacaine and Ropivacaine having better pharmacological profile in respect of less cardiac and neurological toxicity in comparison of Bupivacaine on accidental intravascular injection. Present study is aimed to compare onset and duration of sensory, motor blockade and analgesia between groups receiving axial plexus block with 0.5% Levobupivacaine/Ropivacaine. Methods: This randomized study included 50 patients of ASA grade I, II, age of 18-65 years of either sex undergoing surgery for forearm and hand. Group L/R received 0.5% Levobupivacaine/Ropivacaine 40ml respectively through axillary brachial plexus block. The onset of sensory and motor block and duration of sensory/motor block and analgesia were recorded. Vital parameters were recorded in intraoperative and postoperative period. Result: Time to onset of sensory and motor block was significantly faster in group R as compared to group L. The mean duration of analgesia in group L was 674.04 ± 82.89 minutes and group R was 513.68 ± 20.14 minutes( p value &lt; 0.001), showing significantly longer duration of analgesia with levobupivacaine . The mean duration of motor block in group L/R was 622.96 ± 99.74 and 407.80 ± 20.72 minutes respectively (p value &lt; 0.001). No clinically significant difference in vital parameters was noted. Conclusion: Onset of sensory and motor block was significantly faster with ropivacaine than levobupivacaine, but duration of analgesia and motor block was significantly prolonged with levobupivacaine hence suggesting levobupivacaine a better choice in axillary block to address the need of longer postoperative analgesia and motor block

Impact of Pressure Control Ventilation and Volume Control Ventilation on oxygenation, pulmonary mechanics and haemodynamics during One Lung Ventilation in patients undergoing thoracic surgery: Arandomised controlled crossover study

Backgroud: Anaesthesia for thoracic surgery is nowadays performed with one lung ventilation (OLV) using volume control ventilation (VCV). Mechanical characteristics of pressure control ventilation (PCV) are thought to allow more homogenous distribution and improve oxygenation and reduce airway pressure so decrease chances of airway trauma and acute lung injury (ALI). This study was aimed to evaluate impact of two lung ventilation strategy (PCV/VCV) on oxygenation, pulmonary mechanics and haemodynamics during one lung ventilation in patient undergoing thoracic surgery.Method: After institutional ethical committee clearance this randomised single blind crossover study includes 30 patients of ASA I,II,III for elective thoracic surgery, using OLV and minimum duration of surgery of one hour were included in this study. Divided in two groups A and B using VCV first then PCV and vice versa. Haemodynamic parameters, ABG analysis and respiratory parameters were recorded, data collected and analysed by IBM SPSS statistics version 20.Results: Demographic, haemodynamic and ABG parameters were comparable in both groups higher Ppeak during VCV than PCV (p=0.004). Ppeak during OLV with VCV was significantly higher than during two lung ventilation (TLV) before starting OLV and end of the study (p&lt;0.05). Higher dynamic compliance in OLV – PCV group than OLV – VCV group (p&lt;0.001). Conclusion: PCV s a better ventilation mode than VCV in OLV with respect to reducing the incidence of barotrauma and ALI in patient undergoing elective thoracic surgery. Both modes are equivalent with respect to arterial oxygenation

Safety and feasibility of revisional bariatric surgery following Laparoscopic Adjustable Gastric Band - Outcomes from a large UK private practice.

BACKGROUND Revisional bariatric surgery is unavoidable in a proportion of patients. Despite its need, the development of this speciality has been hampered by its complexity and preferred delivery in institutional set ups. Although primary bariatric surgery can be delivered in the private sector; safety and feasibility of revisional bariatric surgery remains unexplored in this setting. MATERIALS AND METHODS Patients undergoing revisional bariatric surgery following previous Laparoscopic Adjustable Gastric Band (LAGB) between 2008 and 2019 at a single private bariatric unit with a minimum follow up of at least 6 months were included. The primary aim was safety outcomes and 30-day morbidity. RESULTS 178 patients with BMI of 45.6 ± 8.2 kg/m underwent revisional bariatric surgery. One stage conversion was performed for 86.5% of the cases. At 9.5 ± 5.3 months follow up, BMI and percentage excess BMI loss were 31.8 ± 6.2 kg/m and 62.6 ± 40% respectively. There was no mortality, and the major complication rate was 2.8%. There was no statistically significant difference in the incidence of complications based on one-stage vs. two-stage conversion (p = 0.52). There were no differences in weight loss outcomes post-revisional surgery according to the indication for revision (p = 0.446) or weight loss following primary surgery (p = 0.12). CONCLUSION Revisional bariatric surgery can be delivered safely in the private sector with good outcomes. One-stage conversions are feasible and do not detrimentally affect the morbidity of the procedure or the weight loss outcomes. More importantly, success following revisional surgery is independent of the indication for revision and weight loss outcomes following primary surgery