Thyroid abnormality in abnormal uterine bleeding: an observational study from Medical College in Western UP, India

Background: Abnormal Uterine Bleeding (AUB) is one of the commonest gynecological complain in reproductive age group. Menstrual abnormalities are commonly seen when there is any alteration in thyroid function. Objective of present study was to investigate the prevalence of AUB and to determine the menstrual pattern in cases with thyroid dysfunction.Methods: The present cross sectional observational study was conducted Teerthankar Mahaveer Medical College and Research Center Moradabad. Total 400 cases presenting with AUB were included in the study. Routine blood test, ultrasonography and thyroid function tests were done in these cases.Results: Among all the cases presenting with menstrual abnormalities 26% had hypothyroidism and 9% have hyperthyroidism and rest had euthyroid status. Menorrhagia (45.2%) and polymenorrhoea (37.5%) were commonest menstrual abnormality seen in cases with hypothyroidism. Most cases with hyperthyroidism presented with hypomenorrhoea (27.8%).Conclusions: Thyroid function abnormality is common in cases presenting with AUB and it gets relieved in correcting hormonal imbalance

Ectopic pregnancy an obstetric emergency: retrospective study from medical college Ambala, Haryana, India

Background: Ectopic pregnancy remains the leading cause of maternal death in early pregnancy, the overall incidence of ectopic pregnancy is increasing but with improved diagnostic techniques and conservative management, case fatality rate has reduced. This study was undertaken to evaluate the incidence, clinical profile, associated risk factors, management and outcome of cases diagnosed as ectopic pregnancy.Methods: This retrospective study was conducted at MMIMSR Mullana, Ambala from 1st January 2014 to 31 December 2015. All women admitted with ectopic pregnancy in the gynae department were taken in the study.Results: The incidence of ectopic pregnancy in our institute was 0.97 %, mainly affecting young multiparous women, out of 36 cases 15 (41.7%) patients had risk factors previous abortion was commonest (19.4%), followed by history of infertility, tubal ligation, ectopic pregnancy, Cu T insertion. Acute abdominal pain was the commonest (94.4%) symptom 2/3 patients had tachycardia and abdominal tenderness, 10 were in shock. mild to moderate anemia present, while 17 % severely anemic, urine pregnancy test was positive in all. 5 hemodynamically stable patients given single dose intramuscular methotrexate, surgical intervention in 31 cases by either laparoscopy or laparotomy, laparoscopy in 4 patients, 1 had to be converted to laparotomy. Fallopian tubes were commonest site; Ampulla was the commonest site in tubal rupture.Conclusions: The ectopic pregnancy remains a public health issue. Timely diagnosis and transfer to higher center in hemodynamically stable state along with the use of conservative surgery or medical management can reduce morbidity and mortality

Analysis of caesarean rate, indications and complications: review from medical college Ambala, Haryana, India

Background: Cesarean section remains the most commonly performed obstetric surgery but indications of it have been changed. Earlier it used to be done for health of the mother but now fetal interest has played a major role. The aim of the study was to find out incidence, indication of LSCS, maternofetal outcome in our rural medical college.Methods: This retrospective study was conducted at MMIMSR Mullana, Ambala, Haryana, India between 1st April 2015 - 30th March 2016. All women admitted for delivery in OBG department via OPD or emergency were taken in the study.Results: The total no of deliveries was 2196. There were 474 (21.6%) case of caesarean sections (LSCS). Among them 156 (32.9%) patients had elective LSCS, and 318 (67.1%) had emergency LSCS. Mean age of the study was 27.2 years. Fetal distress was the commonest indication of LSCS (25.1%) followed by pregnancy with previous LSCS. Post-partum hemorrhage (PPH) and adhesion were commonly encountered complications. Conclusions: LSCS due to maternal fetal indication is inevitable. Timely performed LSCS decrease the morbidity and mortality. Government also has taken initiative in making cesarean deliveries more acceptable and affordable to patients belonging to the rural areas

Burden of anxiety in Adolescent: A community-based study in Western Uttar Pradesh

Background: Anxiety is a prevalent issue among adolescents and can adversely affect their academic performance and everyday functioning. Aims & Objectives: To estimate the prevalence of anxiety among adolescents in urban and rural areas and to study the socio-demographic correlates of anxiety among adolescents in urban and rural areas. Methods: A comprehensive survey was conducted in the field practice area of Department of Community Medicine of a Medical College in western district of Uttar Pradesh. The survey was aimed at young people between the ages of 10 and 19 who lived in the practice area of the medical college. Result: The burden of anxiety was observed to be 19.6 % (n=92). Female gender, urban residence, early adolescent age-group (10-13 yr), nuclear family, day-time somnolence and family history of mental illness were factors having statistical significance. Poor education level of parents was also statistically significant. Physical activity and substance abuse did not have significant contribution in burden of anxiety. Conclusion: Anxiety in adolescents is a significant issue influenced by various factors. Early intervention and support are crucial

DISCRIMINATORY POTENTIAL OF BIPHASIC MEDIUM OVER COMPENDIAL AND BIORELEVANT MEDIUM FOR ASSESSMENT OF DISSOLUTION BEHAVIOR OF TABLETS CONTAINING MELOXICAM NANOPARTICLES

ABSTRACTObjective: Dissolution test serves as a quality control tool for assessment of drug release from dosage form as well as a research tool to optimize newformulations. The existing guidelines by FDA, EMA, ICH, USP, etc., describe specifications for the dissolution of immediate release as well as modifiedrelease oral dosage form. However, none of them have discussed about the discriminatory potential of the medium to differentiate release profile of twoor more products that are pharmaceutically equivalent. It is pertinent to add here that the pharmaceutical equivalents are not always bioequivalent.Hence, a discriminatory dissolution procedure is a must requirement to differentiate the release behavior of drug from a pharmaceutically equivalentproduct that contains different types and amount of excipient in the formulation. This also becomes more cumbersome when it is desirable forprediction of in vivo behavior of a drug when it is converted into a novel delivery system like nanoparticles. The reason could be the presence ofexcipients used to formulate drug nanoparticles into solid oral dosage form, may change the drug disintegration as well as dissolution behavior, whichultimately may lead to altered bioavailability.Methods: In this study, the nanoparticles of meloxicam were prepared using wet media milling and the milled samples were dried using spray drier.The dried nanoparticles were converted into tablet dosage form by varying the type of diluent. To one batch lactose was used and another one wascontaining dicalcium phosphate (DCP). The assessment of release of meloxicam from these two batches was evaluated in various dissolution media.Results: The study revealed that in all the cases the nanoparticulate tablets of Batch 1 have given increased dissolution profile as compared tomarketed formulation (Muvera), Batch 2 and controlled tablets of meloxicam. This proved that the excipients also play a major role in the releasebehavior of drug otherwise if it was not so, the nanoparticulate tablets of Batch 1 and Batch 2 would have given the same dissolution profile in all thetried media. Batch 1 containing lactose with a higher surface area provided more and rapid wetting of the drug by the dissolution media compared toBatch 2 that contained DCP as a major diluent.®Conclusion: Among all the dissolution media tried to evaluate the discriminatory power and simulation with a biorelevant medium, the biphasicmedium of pH 1.8, 4.8 and 6.8 has promised to simulate with biorelevant media. However, the medium of pH 6.8 has shown the best dissolution profile.Keywords: Solubility, Compendial media, Biphasic media, Dissolution, Meloxicam

INFLUENCE OF FORMULATION PARAMETERS ON DISSOLUTION RATE ENHANCEMENT OF PIROXICAM USING LIQUISOLID TECHNIQUE

ABSTRACTObjective: This study revealed formulation of a liquisolid system of poorly soluble piroxicam to enhance its dissolution rate. To formulate a liquisolidsystem loaded with piroxicam, solubility study was carried out in various non-volatile liquids.Methods: In 1 ml of polyethylene glycol (PEG) 600, 100 mg piroxicam was added and stirred with gentle heating. To the above liquid medication, 1 gmicrocrystalline cellulose (MCC) 102 (as MCC has given better results), 1 g Syloid 244 FP, 2 g PEG 4000, 500 mg aerosil 200, and 0.255 g sodium starchglycolate (SSG) (5%) were added and mixed properly. The blend was compressed and subjected for quality control parameters.Results: Among all the non-volatile liquids evaluated, piroxicam was most soluble in PEG 600. Using this as liquid medication, several liquisolid compactswere prepared by varying the ratios of MCC PH 102 as carrier and Syloid 244FP as coating material and evaluated for precompression studies. To furtheraccelerate the release of drug, various additives were added in the formulation. Among them, PEG 4000 has shown better flow as well as compressionproperties. Hence, the final formulation (LS-16B) was prepared using a combination of MCC PH 102, Syloid 244 FP, PEG 4000 and SSG as superdisintegrant.The dissolution studies revealed that about 92.18% drug got released from liquisolid compacts in 120 minutes, whereas only 68.16% release wasobserved for pure piroxicam. X-ray diffraction and scanning electron microscopy images revealed the successful formation of liquisolid system.Conclusion: It was concluded that dissolution rate of poorly soluble piroxicam could be enhanced using liquisolid technique.Keywords: Piroxicam, Polyethylene glycol 600, Microcrystalline cellulose PH 102, Syloid 244 FP, Polyethylene glycol 4000

Topical therapy with clobetasol propionate 0.025% for various dermatological conditions

Topical corticosteroids (TC) are the most commonly prescribed medications for the treatment of several dermatoses. Owing to their potent effect of relieving symptoms, these drugs are indicated for the use of inflammatory and pruritic presentations of dermatologic conditions. Clobetasol propionate (CP) is the most common TC used to treat itching, redness, and swelling caused by some skin conditions. It possesses anti-inflammatory, antipruritic, and vasoconstrictive properties. To exert its effect, CP binds to cytoplasmic glucocorticoid receptors and subsequently activates glucocorticoid receptor-mediated gene expression, thus resulting in the synthesis of certain anti-inflammatory proteins, while inhibiting the synthesis of certain inflammatory mediators. This case series discusses the efficacy, safety, and clinical experience of using CP 0.025% cream for the treatment of different dermatologic conditions