Abdominal midline wound closure with small bites versus large bites: a randomized comparative trial

Background: The optimal strategy of abdominal wall closure after midline laparotomy has remained an issue of ongoing debate to minimize incidence of incisional hernia which occurs in 10 to 23% cases postoperatively. The main objective of the study was to evaluate the efficacy of small bites versus large bites suture technique in reduction of incidence of the complications like pain, wound infection, wound dehiscence, seroma formation and incisional hernia by using polydioxanone no.1.Methods: The present study was conducted on 100 patients undergoing elective surgery who were randomly allocated into group A and B. Group A were the patients in which midline abdominal wound closure was done with small bites and group B were the patients in which midline abdominal wound closure was done with large bites. Then the patients were followed up for 6 months to observe any complications.Results: A mean additional closure time of 9 minutes was seen with the small bites technique. The mean suture length was more in small bites group as compared to large bites technique. There was no difference in the visual analog scale score between the two groups. No significant difference was seen in the incidence of major and minor wound infection postoperatively in both the groups. Small bites technique reduced the incidence of suture sinus and incisional hernia compared to conventional large bites technique.Conclusions: It can be concluded that the small bites suture technique is more effective than the traditional large bites technique for prevention of all post-operative complications.

Abdominal Sonography: Evaluation of Image Quality in Patients with Varying BMI Using Tissue Harmonic Imaging and Standard Sonography

Background: The study was conducted at the Department of Radiodiagnosis and Imaging, Army Base Hospital Delhi Cantt on 200 patients (114 females, 86 males) with varying age and BMI (Body Mass Index) from year 2005 to 2009. Methods: Abdominal sonography was done using standard B mode using HDI 5000 (Philips/ATL) system. This equipment awarded a U.S. patent for Tissue Harmonic Imaging (THI).The study was done using broadband curvilinear 2 to 5 MHz (C 5-2) transducer. This transducer can be used for both standard conventional B-mode (CUSS) and tissue harmonic imaging (THI). Results: Correlation was done for BMI of the study population and was found that greater percentage of lesionswere seen better THI in patients having BMI >25. The p value was < 0.05 (significant). Conclusion: Out of the 258 positive findings assessed for total image quality in THI in comparison to CUSS the p value was < 0.001 (significant).

Formulation and evaluation of Paclitaxel loaded PSA-PEG nanoparticles.

The main objective of this study was to prepare and evaluate PSA-PEG nanoparticles containing paclitaxel as a model drug by nanoprecipitation method. The influence of different experimental parameters on the particles size, entrapment efficiency, percent drug released etc was evaluated. SEM indicated that nanoparticles have discrete spherical structure without aggregation. The average particle size was found to be 123 -405 nm. The particle size of nanoparticles increases gradually with PSA-PEG polymer concentration. The drug content of nanoparticles also increases with increasing polymer concentration up to particular value. The in-vitro drug release behavior from all drug loaded batches was found to be zero order and provided sustained release over a period of 24 hours. Nanoparticles were stored at different temperatures and humidity as per ICH guidelines to check the stability.

Orally disintegrating tablets : formulation, preparation techniques and evaluation.

Oral delivery is currently the gold standard in the pharmaceutical industry where it is regarded as the safest, most convenient and most economical method of drug delivery having the highest patient compliance. Formulation of a convenient dosage form for oral administration, by considering swallowing difficulty especially in case of geriatric and pediatric patient leads to poor patient compliance. To troubleshoot such problems a new dosage form known as orally disintegrating tablet (ODT), has been developed which rapidly disintegrate & dissolve in saliva and then easily swallowed without need of water which is a major benefit over conventional dosage form. In addition, patients suffering from dysphasia, motion sickness, repeated emesis and mental disorders prefer such preparation because they cannot swallow large quantity of water. Further, drugs exhibiting satisfactory absorption from the oral mucosa or intended for immediate pharmacological action can be advantageously formulated in such type of dosage form. The popularity and usefulness of the formulation resulted in development of several ODT technologies for preparation. The current article is focused on ideal characteristics, advantages and disadvantages, formulation aspects, formulation technologies, evaluation of products and future potential. Various marketed preparations along with numerous scientific advancements made so far in this avenue have also been discussed.

Iontophoretic drug delivery: History and applications.

The goal of delivery system is to get optimal therapeutic management. But, it still remains a challenge in the field of pharmaceuticals for delivery of ionic species and some non ionic. Several transdermal approaches have been used and recently there has been a great attention in using iontophoretic technique for the transdermal drug delivery of medications, both ionic and non ionic. This technique of facilitated movement of ions across a membrane under the influence of an externally applied electric potential difference is one of the most promising physical skin penetrations enhancing method. The payback of using iontophoretic technique includes improved systemic bioavailability ensuing from bypassing the first metabolism. Variables due to oral administration, such as pH, the presence of food or enzymes and transit times can all be eliminated. This article is an overview of the history of iontophoresis, mechanism, principles and factors influencing iontophoresis and its application for various dermatological conditions.