Aerodynamic measurement-Maximum Phonation Time in young patients with benign vocal fold lesions and with normal voice: a comparative analysis

Background: Clinicians use Maximum Phonatory Time (MPT) as one of tool to verify the glottic efficiency objectively. Impairment of vocal fold mucosa integrity due to lesions results in alteration in MPT. The aim of current study was to compare MPT in young adults with vocal fold lesions and age and sex matched normal subjects.Methods: This study was conducted in the Department of ENT & Head and Neck surgery of Government Medical College Srinagar on 41 adult patients with benign vocal fold lesions and 41 healthy subjects matched for age and sex for a period of 2 years from April 2017- April 2019. The aerodynamic measure was measured as maximum phonation time in seconds and the results were analysed statistically. Both patients and controls were explained the procedure. Results: Mean MPT in seconds in males with vocal fold lesion was 14.42 seconds with SD of 5.62 seconds and in females was 10.81 seconds with SD of 3.44 seconds. Coefficients of variation (CV) was 0.35 and 0.21 respectively. In control group it was 18.15 seconds with SD of 5.88 in males and in females it was 15.72 seconds with a SD of 6.21. Mean difference between patients and controls in males and females was 3.8 and 4.9 respectively. P-Value in males and females was 0.053 and 0.003 respectively.Conclusion: Vocal cord lesions decrease MPT in both sexes even in young adults.

Foreign Body Ingestion an Otorhinolaryngological Emergency in a Tertiary Care Center in Kashmir

Background: Foreign Body ingestion is a common event most often seen in children from 6 months to 6 years of age. In adults, foreign bodies are usually ingested accidentally along with food. This happens more commonly in persons with certain pathological changes of the gastrointestinal tract mostly in elderly. Children ingest foreign bodies because of their natural tendency of tasting everything and putting things in mouth along with weak reflexes. Methods: This study was conducted in the department of ENT SMHS Hospital Govt. Medical College Srinagar, a tertiary care center in Kashmir. All those patients were included in this study who reported directly to our emergency department or were referred from peripheral hospitals with history of ingested foreign bodies. Results: The foreign bodies most commonly ingested were fishbones and chicken bones, coins, button batteries, ear rings, nails, screws and meat bolus. Conclusion: The clinical approach to the problem depends on the type of material ingested and on the patient’s symptoms and physical findings. In children mostly coin and button batteries were ingested however in adults fish bone, chicken and meat bones were among the commonly ingested foreign bodies observed in our study.

Formulation, evaluation and release rate characteristics of medicated jelly of vitamin C

Medicated jelly formulations are patient friendly dosage form for pediatric, geriatric and dysphagic patients. These formulations offer rapid dissolution and absorption of drugs through oral mucosa therefore show the early onset of action. The objective of the study was to develop and evaluate oral jelly formulations of vitamin C. Slurry method was adopted using glucose 103gm, sugar 67gm, gelatin 10gm and sorbitol 6.56gm. Preformulation studies were performed including the organoleptic profile, pH, and solubility of both drugs. The medicated jelly of Vitamin C was prepared and evaluated for physical characteristics, weight variation, syneresis, pH, taste and palatability, drug content, release rate characteristics and stability studies. All the jellies were found to have patient welcoming taste and were palatable. All formulations showed more than 50% drug release within 15 minutes, while 93% drug was released in 30 minutes. The results of release kinetics showed that the formulation followed the zero order release kinetics. Thus the drug was released at constant rate independent of the drug concentration involved in the process. All the medicated jellies were found to remain stable stored for 60 days at different temperatures. The present study revealed that medicated jellies of vitamin C could be employed orally in an effective form as an alternative solid oral dosage form for special population such as pediatrics, geriatrics and patients with dysphagia

The evaluation of coated granules to mask the bitter taste of dihydroartemisinin / A avaliação de grânulos revestidos para mascarar o sabor amargo da diidroartemisina

The purpose of this study was to mask the bitter taste imparted by dihydroartemisinin (DHA) by the use of different coating materials. Trial-1 and trial-2 were conducted to prepare the DHA granules. The granules produced from trial-1 were irregular in shape and smaller in size while the trial-2 granules were more regular and larger in size. The granules obtained from both trials were then coated with two different coating methods, namely A and B, depending upon coating material. The trial-2 granules showed better flow properties than trial-1 granules. In vitro dissolution studies in phosphate buffer at pH 6.8 revealed that granules of trial-2B released only 34 percent ± 3 DHA in two minutes compared with trial-1A (57 percent ± 2), trial-1B (48 percent ± 2) and trial-2A (53 percent ± 7). The pleasant taste perception (PTP) test also confirmed the taste masking efficacy of trial-2B (P < 0.05). Scanning electron microscopy (SEM) revealed the more regular and smooth surface of trial-2B granules. In addition, the differential thermal and thermogravimetric analysis (TG-DTA) confirmed no interaction between the materials and pure DHA. DHA has shown its characteristic peaks in the x-ray diffraction (XRD) patterns which were also prominent in all the granules. In conclusion, the granules obtained from trial-2B displayed considerable decrease in the bitter taste of DHA thereby fulfilling the purpose of this study.

O objetivo deste estudo foi o de mascarar o gosto amargo característico da diidroartemisinina (DHA) pelo uso de diferentes materiais de revestimento. Experimento-1 e experimento-2 foram realizados para preparar grânulos de DHA. Os grânulos produzidos pelo experimento-1 mostraram-se irregulares e menores se comparados aos obtidos pelo experimento-2, que foram mais regulares e maiores. Os grânulos obtidos em ambos os experimentos foram, então, revestidos por dois métodos distintos de revestimento, designados como A e B, dependendo do material de revestimento empregado. Os grânulos do experimento-2 mostraram melhor propriedade de fluxo que os obtidos no experimento-1. Estudos de dissolução in vitro em tampão fosfato pH 6,8 revelaram que grânulos do experimento-2B liberaram apenas 34 por cento ± 3 da DHA em dois minutos se comparado com experimento-1A (57 por cento ± 2), experimento-1B (48 por cento ± 2) e experimento-2A (53 por cento ± 7). A Análise Sensorial quanto ao sabor (Pleasant Taste Perception - PTP) também confirmou a eficácia do experimento-2B (P <0,05) em mascarar o gosto amargo da DHA. Microscopia Eletrônica de Varredura (SEM) revelou a superfície mais regular e lisa dos grânulos obtidos pelo experimento-2B. Além disso, Análise Termogravimétrica e Análise Térmica Diferencial (TG-DTA) confirmaram que não há nenhuma interação entre os materiais e a DHA pura. DHA mostrou seus picos característicos na Difração de Raios X (XRD) em padrões que também foram proeminentes em todas as amostras. Em conclusão, os grânulos obtidos pelo experimento-2B exibiram diminuição considerável no gosto amargo da DHA, o que era o propósito deste estudo.

Effect of partial replacement of different defatted oil seed cakes as substrate in biosynthesis of bacitracin in solid-state fermentation by bacillus licheniformis

The present study was conducted to ascertain the effect of partial replacement of different defatted oil seed cakes as substrate i.e. sunflower meal, rice hulls and soybean meal, in biosynthesis of Bacitracin in Solid-State fermentation by Bacillus licheniformis on laboratory scale. In solid-state fermentation, wheat bran, soybean meal, sunflower meal, rice hulls and their different combinations were used. The antibiotic activity was determined at various intervals and recorded 48 hours gave maximum yield, 4375 i.u/gm when only soybean was used. However, maximum titre 4820 i.u/gm of antibiotic were obtained when wheat bran and soybean meal was in ratio of 1:3. The raw material for its production is readily available and cheap such as soybean meal, sunflower meal and wheat bran. Thus development of this technology in our country would result in utilizing our own resources in Pakistan

Antibiotic resistance pattern gramong gram-negative bacteria isolated from raw milk in multan

The use of raw milk in Pakistan has led to the antibiotics resistance. This investigation has showed incidence and antibiotic resistance among Coliform and Klebsiella to nalidixic acid, urixin and little to chloramphenicol. Enterobacter was sensitive to nalidixic acid, tetracycline and showed little resistance to chloramphenicol. E. coli were very sensitive to nalidixic acid, tetracycline, chloramphenicol, urixin, amoxil and with no resistance to ceftriaxone

Patterns of pancytopenia patients in a general medical ward and a proposed diagnostic approach

Background: There has been little systematic study on the clinical spectrum of pancytopenia. This study was done to describe the etiology, presentation and outcome of patients with pancytopenia presenting in a general medical ward

Methods: Hundred patients with pancytopenia were included in the study from October 2001 to October 2002. Patients on cancer chemotherapy were excluded. Blood counts, bone marrow examinations and trephine biopsies were performed according to standard methods

Results: In all cases, megaloblastic anemia constituted the largest group [n=39], and also seen in conjunction with hemolytic anemia and septicemia. Hypersplenism secondary to portal hypertension [cirrhosis] was the second most common diagnosis [n=19]. Aplastic anemia, septicemia and myelodysplasia were other common causes. Two patients were the suspected cases of viral hemorrhagic fever. Thirteen [13%] patients expired. Absolute neutrophil count [ANC] less than 500 /microl was seen in 14 [14%] patients, among which 6 [15.3%] had megaloblastic anemia, 3 [37.5%] had aplastic anemia, and 2 [40%] had myelodysplasia. Eleven patients with platelet counts 100fL and > 110fL were more frequent in patients with megaloblastic anemia with most prominent anisopoikilocytosis, microcytosis and fragmented RBCs. Macrocytosis was noted in 35 [89.7%] patients with megaloblastic anemia and 12 [63.1%] with hypersplenism, 4 [50%] with aplastic anemia. Hypersegmented neutrophils were noted in the blood films of 36 [92.3%] patients with megaloblastic anemia

Conclusion: Megaloblastic anemia, hypersplenism and aplastic anemia are the common causes of pancytopenia in our study