ABSTRACT
Introduction: Arteriovenous Fistula (AVF) is the preferredvascular access with the least rate of complications andmorbidities. Across the globe except European countriesAVF is created predominantly by surgeons. There are veryfew experiences shared by Nephrologists from Indiansubcontinent in creating AV fistulas and their follow up. Theaim of this study was to assess preoperative factors affectingthe outcome of AVF creation and the follow up of successfullycreated fistulas.Material and Methods: A prospective observational studywas carried at our hospital over a period of six months from01 October 2018 to 31 March 2019. All patients undergoingAVF creation by nephrologist from 01 October 2018 to 15Feb 2019 were included in the study and each patient wasfollowed for six weeks. Besides baseline parameter, historyof Diabetes, hypertension and coronary and peripheralvascular disease were noted. All the perioperative findingslike vascular calcification and Blood pressure were noted. Allsuccessful AVF were followed for six weeks with serial USGand Doppler at postoperative day 1, 2 week and 6 weeks.Results: A total of 20 (77%) out of 26 AVF were successfullycreated, The average age was 54.6±15.4 years, Among baselineparameters gender had statistical significance (p=0.03).During surgery more arterial diameter and hypertension wereassociated with successful outcome. During follow-up, botharterial and venous diameter as well as blood flow in arteryand AVF had significant correlation between postoperative 1st,2nd and 6th week (p<0.01). More than 35% and 80% of patientsat 2 and 6 weeks respectively achieved criteria for successfulmaturation as per NKF- KDOQI criteria and it was > 90% and100% as per UAB criteria.Conclusion: Our experience suggest good outcome of AVFcreation by nephrologist, even with those with risk factors forfailure and non maturation. Also we suggest early cannulationof AVF at four weeks or earlier.
ABSTRACT
Mucoadhesive buccal tablets containing ondansetron hydrochloride (ODH) were prepared using polymers like gelatin, chitosan, xanthan gum in varying concentration of 5, 10, 15% w/w and HPMC K4M 40% w/w by direct compression technique. Precompressional studies revealed good micromeritic properties of powder blend for compression and were found as per literature limits. The prepared tablets were evaluated for thickness, hardness, uniformity of weight, drug content, friability, swelling index, mucoadhesion strength, in vitro disintegration, dissolution time and permeation studies. The formulations containing xanthan gum gave better mucoadhesion, release characteristics compared to those containing gelatin and chitosan and the rank order of mucoadhesion and permeation across sheep buccal mucosa was xanthan gum > chitosan> gelatin. The tablets apart from fulfilling all the official specifications, exhibited higher rate of release, in vitro release from all ODH buccal tablets followed Super case II transport due to polymer chain disentanglement and relaxation. and found to be stable upon conducting stability studies as per ICH guidelines at 40ºC/75 % RH. The results revealed that mucoadhesive buccal tablets containing ODH were successfully formulated by direct compression technique as an alternative to conventional tablets for therapy of nausea condition in patients.