SOME MULTIFUNCTIONAL LIPID EXCIPIENTS AND THEIR PHARMACEUTICAL APPLICATIONS

This review is generally focussed on lipid-based excipients in solid oral formulations which increase its bioavailability. Several approaches have been used to deliver the drug efficiently in the body, and lipid excipients are one of the promising drug delivery systems which address challenges like solubility and bioavailability of water-soluble drugs. Lipids excipients can be tailored to meet a wide range of product requirements like disease indication, route of administration, stability, toxicity, and efficacy. This review discusses novel lipids like Compritol 888 ATO, Dynasan 114, and Precirol ATO 5 and how these can be employed for devicing efficient drug delivery models and thereby have used in cosmetic and pharmaceutical industries

Unusual presentation of scrub typhus in pregnancy with postpartum dilated cardiomyopathy: a case report

Though scrub typhus is one of the uncommon causes of fever in peripartum period it must be kept in differential diagnosis of any febrile illness particularly when the signs and symptoms points towards rickettsial etiology. Weil-Felix test can be used for diagnosis. Uncommon complications such as cardiomyopathy must be suspected in cases who present with undue dyspnea and signs of congestive heart failure. Patients with cardiomyopathy needs appropriate management in intensive care units. ECG and 2D echocardiography (2D echo) needs to be done in these patients which may show arrhythmias and ventricular hypokinesia and decreased ejection fraction respectively. A 21 years aged first gravida female at 34 weeks of gestational age was admitted with complaints of high-grade fever since 4-5 days with no previous antenatal visits. A diagnosis of rickettsial fever was suspected on the basis of presenting complaints and clinical examination. Weil-Felix test turned out to be positive with OX19 titre of 1:160. She underwent LSCS in view of fetal distress and delivered a healthy male child. In immediate postpartum period she developed respiratory distress. Her 2D echo showed features suggestive of dilated cardiomyopathy. She was managed in medical intensive care unit and was eventually discharged. Though uncommon rickettsial diseases should be kept in the differential diagnosis of any febrile illness particularly when presenting with characteristic rash. Serious complications such as cardiomyopathy must be diagnosed early and treated appropriately in these patients to prevent mortality

Beyond lucky: measuring and modelling the impact of ‘probability control’ on risky choice

Managers frequently deal with risk by considering uncertainty as an element of the decision problem over which they can exert control — for example, lobbyists trying to exert influence over regulators or managers trying to mitigate Operational Risks related to human processes. This perspective that the probabilities of uncertain events are at times ‘mutable’ — i.e. subject to one’s influence — has an important and previously under-appreciated role in decision-making under risk. The present research, structured as a series of three papers, addresses this gap between theory and practice on the topic of ‘control’ from a descriptive, theoretical and prescriptive perspective. The descriptive paper discusses a novel empirical test of the behavioural effect of ‘control’ on risk taking. The key finding that control does not always enhance risk taking but, instead, has a moderating effect on attitudes to risk, extends insights from related research. Strong preference for exerting control to eliminate uncertainty is also revealed. Affective and cognitive interpretations of the findings are offered and their correspondence with managerial attitudes to risk taking is discussed. The theoretical paper builds on methods in Decision Analysis and Philosophy, and develops a new probability revision rule for modelling control as interventions on uncertainties. This rule is shown to dramatically alleviate the judgmental burden of analysing multiple interventions. Foundational properties for probability revision rules for interventions, similar to the coherence criterion for Bayes rule, are also constructed and a proof that the proposed rule satisfies these properties is offered. In the prescriptive paper, a real world application of the probability revision rule is illustrated in the context of Operational Risk assessment, where several uncertainties are controllable (e.g. staff strikes). It is shown how this rule can be integrated with Operational Risk calculations to explicitly incorporate the effect of managerial mitigations on loss events, thus making a useful contribution to the field. In summary, this research explores the concept of ‘probability control’ as a way to manage risks in the context of Decision Sciences. It furthers our behavioural understanding of risk attitudes to better resonate with managerial perspectives on risk taking and extends the relevance of Decision Analysis methods to corporate risk management

Utility of Papanicolaou test in diagnosis of cervical lesions: a study in a tertiary care centre of western Uttar Pradesh

Background: Cervical cancer is the most common cancer among females in India. It is also one of the major causes of deaths among them. Papanicolaou (Pap) cytological test helps in detecting the early epithelial abnormalities in cervical cells. The morbidity and mortality due to cervical cancer has come down in countries with well-established screening programmes at national level. This study was conducted to emphasize the value of cervical screening as a tool for early detection of non-neoplastic and neoplastic lesions of cervix. Slide positivity rate was computed and clinico-pathological correlation was done.Methods: This cross-sectional study was conducted from January 2012 to December 2014 (3 years), on 2202 women aged between 20-70 years coming for a Pap smear examination in a tertiary care hospital in Bareilly, India. After staining with conventional Papanicolaou technique, all cases were classified as per Bethesda nomenclature (2001).Results: Out of 2202 cases, 85.16% slides were found to be negative for intraepithelial abnormalities and 14.84% slides were labelled as positive for epithelial lesions. 97.67% of high grade lesions were found in women more than 40 years. Smears with epithelial cell abnormality were found more common in older age groups whereas smears negative for epithelial cell abnormality were found more common in young age groups.Conclusion: Pap test is a cost effective cancer screening and is a simple method to detect various lesions of cervix, non-neoplastic as well as neoplastic. High risk screening programmes should be directed to all women >40 years. Pap test is especially useful to diagnose precancerous lesions of cervix, thereby early detection of these lesions & subsequent proper treatment can be helpful in prevention of cervical cancer.

An analytical study of intraoperative, immediate post-operative and perinatal complications in previous two caesarean section

Background: Lower segment caesarean section is one of the commonest operations performed now a day.It has been seen that in cases with previous caesarean section there is increased maternal morbidity and mortality due to placenta previa, adherent placenta and caesarean hysterectomy.The present study was conducted to know the fetomaternal outcome and intra and immediate post-operative complications in cases with previous two lower segment caesarean section.Methods: The present study was conducted in TMMC Moradabad between January 2017-January 2018.Total 68 cases were previous two lower segment caesarean section were included in the study. Neonatal outcome and intraoperative and immediate postoperative complications were seen in these cases.Results: In the present study majority of the cases were in 30-34 years age group (39.7%), the maximum number of caesarean sections were done between gestational age of 37-39.6 weeks (47.1%). Intraoperatively adhesions between uterus, anterior abdominal wall and bladder was seen in less than half of the cases i.e. in 42.6% cases. Out of 68 cases with previous two lower segment caesarean operated 13 cases had placenta previa and 4 cases had adherent placenta.Conclusions: The present study shows that the maternal and perinatal morbidity and mortality is increased with increasing number of caesarean sections. So, there should be reduction in rate of primary caesarean section which can reduce the rate of placenta previa and adherent placenta in subsequent pregnancies

A prospective study of demographic profile, risk factors and pregnancy outcome in Hepatitis B and Hepatitis C virus positive pregnant women in a tertiary care centre

Background: Viral hepatitis is the most common liver disease in pregnancy and is also the most common cause of jaundice in pregnancy in tropical countries. Risk factors for transmission are intravenous drug abuse, surgical and dental procedures done without adequate sterilization of instruments, sexual route etc. Early diagnosis and management can prevent maternal and fetal complications. This study was done to evaluate the frequency, risk factors and pregnancy outcome in hepatitis B virus (HBV) and hepatitis C virus (HCV) positive antenatal women.Methods: This case control study was conducted in Teerthankar Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India from January 2017 to June 2018 on total 2511 pregnant women. The serum samples were checked for presence of hepatitis B surface antigen (HBsAg) and presence of IgG antibodies to HCV. Analysis of sociodemographic profile, risk factors and pregnancy outcome were done in all HBV and HCV positive women.Results: Out of 2511 pregnant women, 292 were tested positive for hepatitis. Maximum number of women were in the age group of 21-30 years. Most of the seropositive women were multipara. Frequency of positivity was maximum for HCV (67.1%). The risk factors for transmission in study population were intravenous drug abuse, blood transfusion, history of surgery and tattooing.Conclusions: Hepatitis infection rate is increasing. Universal screening for HBV and HCV can be recommended in pregnant women in developing countries. Education and awareness of public and health care workers can reduce the risk of transmission.

Factors associated with induced second trimester abortion at a tertiary level hospital of Uttarakhand region: a 6-year retrospective study

Background: Despite the liberalization of the abortion services since the early 1970s in India, access to safe abortion services remains limited for the vast majority of Indian women particularly from rural areas. Second trimester abortions have different indications and associated with increased maternal morbidity and mortality as compared to the first trimester abortions.Methods: This study was a retrospective study conducted from the January 2014 to December 2019 at obstetrics and genecology department of Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India. All patients of 12 weeks to 20 weeks of confirmed gestational age were given medical method of second trimester abortion. Data was collected and analyzed regarding demographic features, gestational age, indications, and induction-abortion interval and post abortion contraceptive methods accepted by patient.Results: During this study period a total of 180 patients had second trimester abortion at study institute. Maximum number of patients 69 (38.3%) were of 25-30 years of age group and 161 (85%) patients were of Hindu religion. Major indication was failure of contraception (42.8%) and congenital anomalies in the fetus (45.6%). There was one case of failed medical abortion in which emergency hysterectomy was done for undiagnosed adherent placenta. All patients were compliant of using contraceptive methods after the abortion because of recent medical and mental stress and majority 82 (45.6%) of the patients preferred oral combined contraceptive pills.Conclusions: Apart from congenital anomalies rest all indications can be reduced if women in our country are empowered to control their fertility, get education to become more aware and provided with social security