Role of Magnetic Resonance Venogram as a Tool in Planning for Various Neurosurgical Operations

Objectives and methodology: Exact localization of superficial cortical veins is very important in planning for avoiding venousinjuries. Cod liver oil capsules were placed on anterior and posterior ends of medial and lateral border of the tumor at scalpaccording to location of tumor and thus tumor boundaries were marked. Then 3DCEMRV and 2DTOF images were taken andthen superficial cortical vein studied in marked area for comparison between both modalities of MRV and planning of surgeryfor avoiding venous injury.Results: Most of the cases were in age group 16-60 years (89%). Most common clinical manifestation was headache (86.2%)and meningioma (58.2%) was found to be most common pathology. Clear depiction and morphology of superficial corticalvein was observed in 58 cases (100%) in 3DCEMRV as compared to 2DTOF 24 cases (41.3%) P <0.001S. Clear depictionand morphology of superior sagittal sinus was observed in 58 cases (100%) in 3DCEMRV as compared to 2DTOF 33 cases(60.3%) P <0.001S. In post operative CT Head, we found 6 (10.3%) cases of venous infarction. 7 patients (12%) developedmotor weakness post operatively. In 3 cases, post operative MRV were done and found no venous injury.Conclusion: This study showed that preoperative marking of tumor area and associated venous anatomy with the help of codliver oil capsule and MRV was very helpful in planning the surgery and to avoid injury of the vein. 3DCEMRV was found to bebetter modality than 2DTOF for delineation of veins.

Supraorbital Keyhole Approach for Anterior Circulation Aneurysms: An Institutional Experience

Background: Pterional approach is most accepted and most common approach for clipping of intracranial anterior circulationaneurysms. This approach imparts good exposure of anterior and middle skull base. However the Pterional approach haspotential adverse effects, such as long operative time, excessive blood loss, long hospital stay, and temporal muscle atrophy.Supraorbital keyhole via eyebrow incision is a minimal invasive approach for anterior circulation aneurysm surgery. This approachhas advantages of less operative time, less blood loss, less brain retraction, short hospital stay and no temporal muscle atrophy.Objective: Objective of this study to emphasize the advantages and limitations of supra orbital key hole approach for anteriorcirculation aneurysm surgery based on our institutional experience.Material and Methods: Between September 2017 and February 2020, total 16 patients with anterior circulation aneurysmswere operated by suprorbital keyhole craniotomy approach. All patients included were ≥18 years of age with Subarachnoidhemorrhage grade 1, grade 2, grade 3 on modified fischer scale. Intra operative and postoperative parameter noted andanalyzed over a period of 3 months follow up.Results: There were good cosmetic results with less approach related complications. We achieved good recovery (4/5) onGlasgow outcome scale score 4 or 5 were achieved in 87.5% of the patients in follow period of 3 months.Conclusion: Supra orbital key hole approach is not a standard approach for all kind of anterior circulation aneurysms, it can beapplied for small sized aneurysms with SAH grade up to 3 on modified fischer scale. An thorough pre-op work up, experience,skilled hand are prerequisites for supra orbital keyhole approach in aneurysm surgery. Selection of this approach should bebased on aneurysms morphology, size of aneurysm, grade of SAH, brain edema, and the surgeon’s experience.

Obstructive Hydrocephalus Produced by Venous Ectasia of Dural AV Fistula

Dural arteriovenous fistula (Dural AVF) is an anomalous shunt between dural arterial and venous channels. About 10–15% ofall intracranial vascular malformation are dural fistulas which represent anomalous shunts among arterial branches and duralvenous sinuses, meningeal, or cortical veins.We are presenting a rare case of dural AVF treated by transarterial embolizationand complicated by hydrocephalus.

Bioanalytical Method Development and Validation for the Determination of Levocetirizine in Pharmaceutical Dosage Form and Human Plasma by RP-HPLC.

This study describes the development of a rapid, selective, precise and sensitive reverse phase high-performance liquid chromatography method for the quantitative determination of Levocetirizine Dihydrochloride (LCD) in human plasma and pharmaceutical dosage form. Extraction of drug from plasma was done by employing optimized liquid-liquid extraction procedure. The sample was analyzed using Acetonitrile: Methanol: 20mM Ammonium Acetate Buffer pH-5 (25:55:20 % v/v/v) as mobile phase. Chromatographic separation was achieved on Prontosil C-18 column (4.6 x 250mm, 5μ particle size) as stationary phase using isocratic elution (at a flow rate of 1 mL/min). The peak was detected using UV-PDA detector set at 232 nm and retention time was found to be 8 min for LCD. The calibration curve obtained was linear (r2= 0.9998) over the concentration range of 2-10 μg/mL. Method was validated for precision, robustness and recovery. The limit of detection (LOD) and limit of quantitation (LOQ) was 0.0057 and 0.174 µg/mL respectively. There was no significant difference between the amount of drug spiked in plasma and the amount recovered and plasma did not interfere in estimation. Thus, the proposed method is suitable for the analysis of LCD in tablet dosage forms and human plasma.

Eco friendly spectrophotometric method for quantitative estimation of lomefloxacin using hydrotropic approach.

The present work describes a novel, accurate, sensitive and economic safe spectrophotometric method was developed by application of hydrotropy, using 8 M Urea solution as hydrotropic solubilizing agent, for the quantitative determination of poorly watersoluble lomefloxacin HCl in tablet dosage form. There were more than 43 times enhancements in the solubility of lomefloxacin HCl increases in hydrotropic solution as compared to solubilities in distilled water. Lomefloxacin HCl shows maximum absorbance at 281 nm. Urea and other tablets excipents did not show any absorbance above 230 nm, and thus no interference in the estimation was seen. Lomefloxacin HCl was obeyed Beer,s law in the concentration range of 5 to 25μg/ml (r2= 0.9998) in hydrotropic solvent with mean recovery ranging from 98.03±0.65 to 98.59±0.32%. Proposed method is new, simple, economic, safe, rapid, accurate and reproducible. The developed methods were validated according to ICH guidelines and values of accuracy, precision and other statistical analysis were found to be in good accordance with the prescribed values. The method can be used for routine analysis in both research laboratories, and pharmaceutical and chemical industries to analyze the drugs without the use of organic solvents thus make the environment eco-friendly.

Effect of superdisintegrants on formulation of taste masked fast disintegrating Ciprofloxacin tablets.

The present investigation deals with the formulation of taste masked fast disintegrating tablets of Ciprofloxacin that disintegrate in the oral cavity upon contact with saliva and thereby improve therapeutic efficacy. Ciprofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. It is a second-generation fluoroquinolone antibacterial that kills bacteria by interfering with the enzymes that cause DNA to rewind after being copied, which stops synthesis of DNA and protein. It may also be used to prevent or slow anthrax after exposure. The influence of superdisintegrants, crospovidone and sodium starch glycolate on disintegration time, wetting time and water absorp-tion ratio were studied. Tablets were evaluation for weight and thickness variation, disintegration time, drug content, in vitro dissolution, wetting time and water absorption ratio. The in vitro disintegration time of the best fast disinte-gration tablets was found to be within 36 seconds. Tablets containing crospovidone (40%) exhibits quick disintegration time than tablets containing sodium starch glycolate. The fast disintegrating tablets of ciprofloxacin with shorter disintegration time, acceptable taste and sufficient hardness could be prepared using crospovidone and other excipients at optimum concentration.

Effect of superdisintegrants on formulation of taste masked fast disintegrating Ciprofloxacin tablets.

The present investigation deals with the formulation of taste masked fast disintegrating tablets of Ciprofloxacin that disintegrate in the oral cavity upon contact with saliva and thereby improve therapeutic efficacy. Ciprofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. It is a second-generation fluoroquinolone antibacterial that kills bacteria by interfering with the enzymes that cause DNA to rewind after being copied, which stops synthesis of DNA and protein. It may also be used to prevent or slow anthrax after exposure. The influence of superdisintegrants, crospovidone and sodium starch glycolate on disintegration time, wetting time and water absorp-tion ratio were studied. Tablets were evaluation for weight and thickness variation, disintegration time, drug content, in vitro dissolution, wetting time and water absorption ratio. The in vitro disintegration time of the best fast disinte-gration tablets was found to be within 36 seconds. Tablets containing crospovidone (40%) exhibits quick disintegration time than tablets containing sodium starch glycolate. The fast disintegrating tablets of ciprofloxacin with shorter disintegration time, acceptable taste and sufficient hardness could be prepared using crospovidone and other excipients at optimum concentration.