Comparative study between breast conservative surgery and modified radical mastectomy in early stage of breast carcinoma in a tertiary care hospital

Background: Breast cancer is the most prevalent cancer in women globally, with two million new cases and more than half a million deaths each year. Surgery is the key component of treating breast cancer and there are two primary types of breast surgery available: breast conservative surgery and modified radical mastectomy. The aim of this study was to compare BCS and MRM in the treatment of early-stage breast carcinoma. Methods: This was a prospective observational study that involved 74 patients and was carried out in the Department of Surgery at Shaheed Suhrawardy Medical College & Hospital and Enam Medical College & Hospital with an 18-months minimum follow-up. The time frame for inclusion was from July 2018 through July 2020. There were two patient groups, 37 patients in Group A who underwent breast conservative surgery and Group B was made up of 37 individuals who had MRM for early-stage breast carcinoma. Results: With a mean age of 47.65 years in the BCS group and 48.19 years in the MRM group, the operative time for BCS was 1.04±0.25 hours, whereas 3.20±0.48 hours for MRM. Statistically significant higher amount of post-operative drainage volume in MRM group compared to BCS group (p value=0.000). With an excellent aesthetic outcome rate in BCS group (p value<0.0001) as well as better quality of life than MRM group. Conclusions: Breast conservative surgery and modified radical mastectomy are both oncologically safe treatments for early-stage breast cancer with multidisciplinary approach. BCS offers less trauma, infection and hospital stay; better aesthetic outcome and quality of life than MRM, making it more deserving of being promoted clinically in the treatment of early-stage breast cancer

Supercritical fluid technology and its pharmaceutical applications: a revisit with two decades of progress

Over the past two decades, supercritical fluid technology has emerged as one of the most important technologies applied in many fields such as cosmetic, food and pharmaceutical. Supercritical fluid extraction process offers numerous advantages such as easy, effective, inexpensive, high quality of solute extraction and environmentally friendly. This mini-review describes the fundamentals of supercritical fluid technology, the function of supercritical fluid as solvent and anti-solvent, mechanism of supercritical fluid, advantages and disadvantages and revisit the application of supercritical fluid technology in pharmaceutical sciences. In-depth discussion with recent examples of extraction of natural products, particle design in drug delivery, preparation on pharmaceutical powder, drug solubilization, inclusion complex, polymer impregnation, liposomal formulations, purification and polymorphism as well as drug extraction analysis are also presented. Key aspects and processing considerations of supercritical fluid technologies are reviewed to assist scientists to generate other related experimental works. © 2020, Association of Pharmaceutical Teachers of India. All rights reserved

Agro-morphological characterization of lentil germplasm of Indian National Genebank and Development of a core set for efficient utilization in lentil improvement programs

Lentil (Lens culinaris Medik.) is one of the major cool-season pulse crops worldwide. Its increasing demand as a staple pulse has led to the unlocking of diverse germplasm collections conserved in the genebanks to develop its superior varieties. The Indian National Genebank, housed at the Indian Council of Agricultural Research (ICAR)-National Bureau of Plant Genetic Resources, New Delhi, India, currently has 2,324 accessions comprising 1,796 indigenous and 528 exotic collections. This study was conducted to unveil the potential of lentil germplasm by assessing its agro-morphological characteristics and diversity, identifying trait-specific germplasm, and developing a core set. The complete germplasm set was characterized for two years, i.e., 2017-2018 and 2018-2019, and data were recorded on 26 agro-morphological traits. High phenotypic variability was observed for nine quantitative and 17 qualitative traits. A core set comprising 170 accessions (137 Indian and 33 exotic) was derived based on the characterization data as well as geographical origin using a heuristic method and PowerCore software. This core set was found to be sufficiently diverse and representative of the entire collection based on the comparison made using Shannon-Weaver diversity indices and χ2 test. These results were further validated by summary statistics. The core set displayed high genetic diversity as evident from a higher coefficient of variance in comparison to the entire set for individual traits and overall Shannon-Weaver diversity indices (entire: 1.054; core: 1.361). In addition, the total variation explained by the first three principal components was higher in the core set (70.69%) than in the entire collection (68.03%). Further, the conservation of pairwise correlation values among descriptors in the entire and core set reflected the maintenance of the structure of the whole set. Based on the results, this core set is believed to represent the entire collection, completely. Therefore, it constitutes a potential set of germplasm that can be used in the genetic enhancement of lentils

Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019

Background Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (USMR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings Global U5MR decreased from 71.2 deaths per 1000 livebirths (95% uncertainty interval WI] 68.3-74-0) in 2000 to 37.1 (33.2-41.7) in 2019 while global NMR correspondingly declined more slowly from 28.0 deaths per 1000 live births (26.8-29-5) in 2000 to 17.9 (16.3-19-8) in 2019. In 2019,136 (67%) of 204 countries had a USMR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030,154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9.65 million (95% UI 9.05-10.30) in 2000 and 5.05 million (4.27-6.02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3.76 million 95% UI 3.53-4.021) in 2000 to 48% (2.42 million; 2.06-2.86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0.80 (95% UI 0.71-0.86) deaths per 1000 livebirths and U5MR to 1.44 (95% UI 1-27-1.58) deaths per 1000 livebirths, and in 2019, there were as many as 1.87 million (95% UI 1-35-2.58; 37% 95% UI 32-43]) of 5.05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve USMR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd

Orally disintegrating film: a revisit of its two decades development

For the last two decades, oral drug delivery system was extensively discussed in the pharmaceutical field which includes Orally Disintegrating Film (ODF) due to its advantages over other oral dosage form such as tablet and capsule. ODF can be taken without water and classified as patient friendly dosage form especially for geriatric and pediatric who affected the most with swallowing disorder. ODF manufactured by various methods such as solvent casting method, semi solid casting method, hot melting extrusion, solid dispersion extrusion, rolling method and spraying method. ODF formulated using several chemicals like hydrophilic polymers, plasticizer, saliva stimulating agent, surfactant, sweeteners, API, coloring, and flavoring agents. Validation tests such as thickness test, folding endurance, tensile strength, young modulus, disintegration, and dissolution test performed to analyze the mechanical properties, disintegration, and dissolution profile of the film. Some challenges will be encountered in the process of formulating ODF such as API insolubility, unpleasant taste of API, stability issue, and dose uniformity. Those challenges can be overcome with great formulations, high standard manufacturing methods and ideal storage management. In general, ODF have great potential in pharmaceutical market and can be a good tool to enhance the therapeutic convenient of patient which then lead to advancement of healthcare syste

Comparative Agronomic Performance and Reaction to Fusarium wilt of Lens culinaris × L. orientalis and L. culinaris × L. ervoides derivatives

The development of transgressive phenotype in the segregating populations has been speculated to contribute to niche divergence of hybrid lineages, which occurs most frequently at larger genetic distances. Wild Lens species are considered to be more resistant against major biotic and abiotic stresses than that of the cultivated species. In the present study, we assessed the comparative agronomic performance of lentil (Lens culinaris subsp. culinaris) inter-sub-specific (L. culinaris subsp. orientalis) and interspecific (L. ervoides) derivatives, also discussed its probable basis of occurrence. The F3, F4, and F5 inter sub-specific and interspecific populations of ILL8006 × ILWL62 and ILL10829 × ILWL30, respectively revealed a substantial range of variation for majority of agro-morphological traits as reflected by the range, mean and coefficient of variation. A high level of fruitful heterosis was also observed in F3 and F4 progeny for important traits of interest. Phenotypic coefficient of variation (PCV) was higher in magnitude than genotypic coefficient of variation (GCV) in all generations for several quantitative characters. The results showed high heritability estimates for majority of traits in conjunction with low to high genetic advance in F3 and F4 generations. Further, F5 progeny of ILL10829 × ILWL30, manifested resistant disease reaction for fifteen recombinant inbred lines (RILs) against (Fusarium oxysporum f. sp. lentis (Vasd. Srin.) Gord.). The multilocation agronomic evaluation of both crosses showed better results for earliness, desirable seed yield and Fusarium wilt resistance under two agro-ecological regions of north-western India. These better performing recombinants of ILL8006 × ILWL62 and ILL10829 × ILWL30 can be advanced for further genetic improvement and developing high yielding disease resistant cultivars of lentil

A review on the solubility enhancement technique for pharmaceutical formulations

Abstract Several properties of potential drug molecules such as the solubility of the drug molecule must be determined prior to developing dosage forms as the solubility of a drug molecule is one of the key criteria in achieving an effective drug concentration. Solubility is expressed as the number of parts by volume of solvent necessary to dissolve one part by weight of a solid or one part by volume of a liquid according to pharmacopoeias. Poor water solubility is a critical issue in the formulation development with more than 40% of the novel chemical entities being insoluble in water. Different strategies have been used to enhance the solubility of poorly soluble drugs which include physical and chemical modifications of drug and other methods like particle size reduction, crystal engineering, salt formation, solid dispersion, use of surfactant and so. The properties of a drug, site of absorption, and required dosage form characteristics helps in the selection of solubility enhancing techniques

Comparison of solvent casting and spray casting method on compounding of an orally disintegrating film containing amlodipine besylate

The amlodipine besylate tablet is one of the most highly prescribed medicines to manage hypertension in the geriatric population. However, the difficulty of swallowing tablets due to problems like dysphagia, fear of choking, and odynophagia has been identified as one of the contributing factors to non-compliance among geriatrics. Due to the swallowing factor among geriatrics, this study was conducted to compare two compounding methods of orally disintegrating films, namely solvent casting and spray casting, to produce an orally disintegrating film containing amlodipine besylate. Different polymers were used to develop the orally disintegrating films, and the formulations were subjected to validation tests such as thickness, folding endurance, tensile strength, percentage of elongation, Young’s modulus, disintegration, and dissolution. Chemicals like hydroxypropyl methylcellulose, carboxymethyl cellulose, glycerin, mannitol, sodium lauryl sulfate, citric acid, peppermint oil, and a coloring agent were used to formulate the orally disintegrating films. In addition, orally disintegrating films were prepared using the solvent casting and the spraying method. An increase in the polymer’s concentration resulted in the formation of a greater mechanical strength. After a comparison between the hydroxypropyl methylcellulose and the carboxymethyl cellulose as film-forming agents, it was discovered that hydroxypropyl methylcellulose had greater mechanical film properties than the carboxymethyl cellulose, except for the folding endurance. Moreover, hydroxypropyl methylcellulose was shown to have a better disintegration time, which was in the range of 30 minutes to 90 minutes, with a drug release of 95% to 100%, while carboxymethyl cellulose disintegrated at 6 minutes to 15 minutes with a drug release of 60% to 75%. On the other hand, both solvent casting and spraying methods produced an evenly matched orally disintegrating film quality. Orally disintegrating films containing amlodipine besylate were developed and characterized. It was concluded that these orally disintegrating films have a great potential in the market and a profound ability in the reduction of geriatric non-