Sociodemographic and Clinical Characteristics of Child Sexual Abuse Reported to an Urban Public Hospital in Southern India, 2019-22

Objective: To describe the profile of child sexual abuse (CSA) reported to a tertiary care hospital. Methods: A retrospective analysis of CSA reported in children aged below 18 years from January, 2019 to June, 2022. Results: Out of the 231 cases of sexual abuse reported, 115 (49.8%) were children below 18 years. Most of the victims were children from 10 to 15 years (37.4%), and there were only two male victims. In 89.6%, the perpetrator was known to the victim. Revictimization was seen in 31%. The reported perpetrators were friends (27%), neighbors (34.8%), strangers (10.4%), or fathers (7.8%). Penetrative abuse was seen in 58.3% of reports. External injuries were seen in 6.96%. Eight victims were pregnant and HIV screening was positive in one victim. Conclusion: Early identification of CSA is important to prevent revictimization. Children from all age groups can be victims of CSA. Perpetrators can hail from all walks of life of the children.

Chromatographic study of sitagliptin and ertugliflozin under quality-by-design paradigm

Abstract The present study entails the systematic development and validation of a stability-indicating RP-HPLC method for the analysis of sitagliptin and ertugliflozin in a fixed-dose combination. Analytical quality by design (AQbD) concepts were used to define critical method variables, employing Pareto risk assessment and a Placket-Burman screening design, preceded by a Box-Behnken design with response surface analysis to optimise critical method parameters such as % acetonitrile (X1), buffer pH (X2) and column oven temperature (X3). Multiple response optimisation (Derringer's desirability) of variables was accomplished by studying critical analytical attributes, such as resolution, retention time and theoretical plates. The title analytes were separated effectively on a PRONTOSIL C18 column at 37 °C using a mobile phase of acetonitrile:acetate buffer, pH 4.4 (36:64 percent v/v), pumped at a flow rate of 1 mL/min, and UV detection at 225 nm. Linearity was observed over a concentration range of 25-150 µg/mL and 3.75-22.5 µg/mL at retention times of 2.82 and 3.92 min for sitagliptin and ertugliflozin, respectively. The method obeyed all validation parameters of the ICH Q2(R1) guidelines. The proposed robust method allows the study of the selected drugs in pharmaceutical dosage forms as well as in drug stability studies under various stress conditions.

Morphological variations influencing the outcomes in posterior polar cataract

Purpose: To study the intraoperative complications and postoperative clinical outcomes in different types of posterior polar cataract (PPC) following phacoemulsification, based on morphological classification. Methods: All consecutive patients with PPC who underwent phacoemulsification during the study period from 2016 to 2019 were included and sub?grouped based on the morphological characteristics according to Daljit Singh’s classification. Intraoperative complications such as posterior capsular rupture (PCR), vitreous loss, nucleus drop, and Postoperative best?corrected visual acuity (BCVA) at day 1 and day 30 were documented. Results: A total of 388 eyes of 380 patients were included. Eighty nine (22.9%) eyes belonged to type 1, 135 (34.8%) belonged to type 2, 8 (2.1%) belonged to type 3, and 156 (40.2%) belonged to type 4. Thirty?five (9.3%) eyes had intraoperative PCR, with vitreous loss in 21 (60%) eyes, and nucleus/cortex drop in 5 (1.3%) eyes. Six (75%) eyes of type 3, 14 (10.04%) eyes of type 2, 12 (17.7%) eyes of type 4, and 3 (3.4%) eyes of type 1 PPC had PCR. PCR occurred more during the emulsification of the nucleus (18 cases, 51.4%). A significant correlation was seen between intraoperative PCR and type of PPC with a higher incidence in type 3 (P < 0.001). BCVA was found to be significantly worse on day 1 among patients with PCR compared to those who did not and improved well by day 30. Conclusion: PPC morphology is significantly co?related with the occurrence of PCR, emphasizing the need for careful grading of posterior polar cataracts in predicting the risk of intraoperative complications.

Reasons for delay in cataract surgery in patients with advanced cataracts during the COVID-19 pandemic

Purpose: To analyze the reasons for delay in cataract surgery in patients with advanced cataracts during the COVID?19 pandemic. Methods: This was a prospective, cross?sectional, multicenter questionnaire study which included patients with mature cataract, nuclear sclerotic cataract grade IV, and cataracts with best corrected visual acuity (BCVA) <5/60, during the COVID?19 pandemic from December 2020 to April 2021. Reasons for delay in presentation to the hospital were analyzed. Results: One thousand four hundred seventy two patients were recruited with advanced cataracts. Absence of ophthalmic care nearby (44.2%), lack of awareness regarding elective surgeries (42.6%), lack of public transportation (37%), fear of contracting COVID?19 (23.4%), and waiting for outreach camps (20.4%) were found to be the reasons behind the delay in cataract surgery. 53.7% of the patients had worsening of defective vision and 55.3% of them had difficulty in carrying out activities of family living. 30.8% of the patients faced difficulty in commuting and 8.4% of the patients suffered a fall during this pandemic due to worsening of the visual acuity. Conclusion: The lockdown imposed during the pandemic has created a significant backlog of patients who are progressing to advanced cataracts due to lack of ophthalmic care nearby, lack of awareness regarding elective surgeries, lack of public transportation, and no outreach camps. Proactive measures to deal with this backlog are of utmost need to prevent blindness due to cataract

Comparative evaluation of antimicrobial potential of herbal extracts on Streptococcus mutans and Enterococcus faecalis An in vitro study / Avaliação comparativa do potencial antimicrobiano de extratos de ervas em Streptococcus mutans e Enterococcus faecalis: estudo in vitro

Though aloe vera extract, green tea extract and coriander oil are proven antimicrobial agents, very little information is available regarding its effects on oral bacteria, Streptococcus mutans, which is responsible for initiating caries and Enterococcus faecalis, responsible for failure of root canal treatment. Objective: To find the antimicrobial activity of aloe vera extract, black tea extract and coriander oil against S. mutans and E. faecalis. Materials and Methods: The agar well diffusion method was used to determine the antibacterial activity of Aloe vera extract, black tea extract and coriander oil. Different concentration of prepared plant extracts and coriander seed oil (50 & 100 µl) was incorporated into the wells and the plates containing S. mutans and E. faecalis were incubated at 37 °C for 24 h. The antibiotic (amoxicillin 30 µl) was used as positive control. Zone Of Inhibition (ZOI) was recorded in each plate. Results: For S. mutans, the maximum ZOI was created by coriander oil with a diameter of 25.00±0.58 mm at 50 µl and for E. faecalis, maximum ZOI was created by aloe vera extract 16.00±0.58 mm at 100 µl concentration which were far better than the control: amoxicillin 30 µl concentration. Conclusion: The extracts of Aloe vera, black tea and coriander oil, showed significant activity against the investigated microbial strains, Streptococcus mutans and Enterococcus faecalis which further helps in the development of new topical agents that help in reducing the numbers of these organisms present in the oral cavity. (AU)

Embora o extrato de aloe vera, extrato de chá verde e óleo de coentro sejam agentes antimicrobianos comprovados, há pouca informação disponível sobre seus efeitos nas bactérias orais, Streptococcus mutans, que é responsável por iniciar cáries e Enterococcus faecalis, responsável pela falha do tratamento de canal radicular. Objetivo: Avaliar a atividade antimicrobiana do extrato de aloe vera, extrato de chá preto e óleo de coentro contra S. mutans e E. faecalis. Materiais e Métodos: O método de difusão em agar foi usado para determinar a atividade antibacteriana do extrato de Aloe vera, extrato de chá preto e óleo de coentro. Diferentes concentrações dos extratos de plantas e óleo de semente de coentro (50 e 100 µl) foram preparados e colocados nos poços e nas placas contendo S. mutans e E. faecalis e foram incubadas a 37°C por 24 h. O antibiótico (amoxicilina 30 µl) foi utilizado como controle positivo. A zona de inibição (ZOI) foi registrada em cada placa. Resultados: Para S. mutans, a ZOI máxima foi obtida com o óleo de coentro com um diâmetro de 25,00 ± 0,58 mm a 50 µl e para E. faecalis, a ZOI máxima foi obtiada pelo extrato de aloe vera 16,00 ± 0,58 mm na concentração de 100 µl, as quais foram melhores do que o controle: concentração de 30 µl de amoxicilina. Conclusão: Os extratos de Aloe vera, chá preto e óleo de coentro apresentaram atividade significativa contra as cepas microbianas investigadas, Streptococcus mutans e Enterococcus faecalis auxiliando no desenvolvimento de novos agentes tópicos visando a redução do número desses organismos presentes no cavidade oral. (AU)

Lactobacillus attenuates progression of nonalcoholic fatty liver disease by lowering cholesterol and steatosis

Background/Aims@#Nonalcoholic fatty liver disease (NAFLD) is closely related to gut-microbiome. There is a paucity of research on which strains of gut microbiota affect the progression of NAFLD. This study explored the NAFLD-associated microbiome in humans and the role of Lactobacillus in the progression of NAFLD in mice. @*Methods@#The gut microbiome was analyzed via next-generation sequencing in healthy people (n=37) and NAFLD patients with elevated liver enzymes (n=57). Six-week-old male C57BL/6J mice were separated into six groups (n=10 per group; normal, Western, and four Western diet + strains [109 colony-forming units/g for 8 weeks; L. acidophilus, L. fermentum, L. paracasei, and L. plantarum]). Liver/body weight ratio, liver pathology, serum analysis, and metagenomics in the mice were examined. @*Results@#Compared to healthy subjects (1.6±4.3), NAFLD patients showed an elevated Firmicutes/Bacteroidetes ratio (25.0±29.0) and a reduced composition of Akkermansia and L. murinus (P<0.05). In the animal experiment, L. acidophilus group was associated with a significant reduction in liver/body weight ratio (5.5±0.4) compared to the Western group (6.2±0.6) (P<0.05). L. acidophilus (41.0±8.6), L. fermentum (44.3±12.6), and L. plantarum (39.0±7.6) groups showed decreased cholesterol levels compared to the Western group (85.7±8.6) (P<0.05). In comparison of steatosis, L. acidophilus (1.9±0.6), L. plantarum (2.4±0.7), and L. paracasei (2.0±0.9) groups showed significant improvement of steatosis compared to the Western group (2.6±0.5) (P<0.05). @*Conclusions@#Ingestion of Lactobacillus, such as L. acidophilus, L. fermentum, and L. plantarum, ameliorates the progression of nonalcoholic steatosis by lowering cholesterol. The use of Lactobacillus can be considered as a useful strategy for the treatment of NAFLD.

A study of association between thyroid dysfunction and serum anti-mullerian hormone levels in women presenting with infertility

Background: This study was conducted to study the association between thyroid dysfunction and serum AMH levels in women presenting with infertility.Methods: An institution based cross-sectional study including, was conducted at Kamineni hospital fertility clinic among 70 women presenting with infertility during a two year period from May 2016 to April 2018 after fulfilling inclusion criteria.Results: Hypothyroidism was the most common thyroid dysfunction observed in the study participants and subclinical hypothyroidism was seen predominantly. Age of the women did not seem to influence the prevalence of thyroid disease. Low serum AMH indicating poor ovarian reserve was observed in 70% of women over 34yrs suggesting a significant correlation. All the women diagnosed with overt hypothyroidism had low serum AMH levels and half of the women with subclinical hypothyroidism also had low serum AMH levels suggesting a close association between thyroid dysfunction and ovarian reserve. Women with hyperthyroidism had normal AMH levels.Conclusions: Serum AMH levels in infertile patients, were inversely correlated with TSH levels.

Knowledge, Awareness, And Practices (KAP) Among Health Science Students And Primary Health Care Physicians Regarding Updated Guidelines Towards Covid-19 Pandemic Infection In Andhra Pradesh: A Cross Sectional Study

Background: In 2019, a novel virus belonging to the coronavirus (CoV) family, SARS-CoV-2, emerged in Wuhan,China’s Hubei province. This was first reported to the WHO Country Office in China at the end of that year and isnow known as COVID -19.Although this is a new strain, related coronaviruses can cause illnesses ranging fromthe common cold to more severe diseases such as SARS and MERS as per the literature.The clinical presentationis generally that of a respiratory infection with a symptom severity ranging from a mild common cold-like illness,to a severe viral pneumonia leading to acute respiratory distress syndrome that is potentially fatal.Aim and Objective of the study: Unprecedented measures have been espoused to control the rapid spread of theenduring COVID-19 epidemic in Andhra Pradesh. Health science students and primary health care physician’sadherence to control measures is prejudiced by their knowledge, attitudes, and practices (KAP) towards COVID19.The battle against COVID-19 is continuing in India. To guarantee the final success, public adherence to thesecontrol measures are vital, which is mostly pretentious by their knowledge, Awareness, and practices (KAP)towards COVID-19 in accordance with KAP theory.Materials and Methods: A cross sectional study is designed to include health sciences students and primary healthcare physicians in Andhra Pradesh state. An interview questionnaire has been designed to assessKnowledge,Awareness and Practices of health sciences students and primary health care physicians, regardingCOVID -19.Results and Discussion: All the registered study participants after giving their consent,completed the questionnaireperfectly. Regarding the Sociodemographic characteristics, out of 243,Male 79 (32.5), Female 164 (67.5) in Gender.Majority of the study participants 128(52.7%) were from Allied Health Science background, 95 (39.1% ) medicinebackground 10(4.1%) and others 10(4.1%). Knowledge variables,Type of Locality and Educational qualificationsvariables, *Awareness variable and *Practices variables i.e.,Occupation variable unvarying with demographicsusing Multiple linear regression endured significant.Educational qualifications variables and Monthly incomewise most of the study participants are students 208.

An empirical study on maternal and perinatal outcome of placenta previa-risk factors, morbidity and mortality in JNIMS, Imphal, India

Background: The observational study to analyse the maternal and perinatal outcome in pregnancies complicated with placental previa evaluating the potential risk factor, associated with morbidity and mortality.Methods: The study was a prospective longitudinal comprising of all the pregnant women after 28 week of gestation irrespective of gravid and parity that attended or admitted in the department of obstetrics and gynaecology, JNIMS, diagnosed as having placental previa by transabdominal ultrasonography and conducted for the period of 20 months i.e. from October 2017 to June 2019 analyzing 54 cases of placenta previa.Results: During this period there were total of 9967 deliveries with incidence of placenta previa being 0.54% in JNIMS, Porompat. The estimated risk factors out of total 54 cases were 20-30 (52%) years by age group, 25 (46%) gravida, 18 (32%) parity, 36 low lying placenta and 11 cases (20%) preterm.Conclusions: Highest levels of placenta previa are associated with poor maternal and perinatal outcome.

A study of correlation of antenatal uterine scar thickness by transabdominal ultrasound with intraoperative lower uterine segment scar grading in elective repeat cesarean delivery

Background: Caesarean section (CS) is the most common obstetric surgery performed world-wide. The objective of this study was to correlate the antenatal sonographic lower uterine segment (LUS) scar thickness in women with previous one cesarean section with intra operative LUS scar grading.Methods: A Prospective observational study was conducted from December 2014 to November 2015. In a tertiary care center. 200 pregnant women from ANC clinic with previous one LSCS were recruited. Transabdominal USG done between 36-38 weeks. LUS thickness was measured from bladder wall-myometrium interphase and myometrium-chorioamniotic membrane inter phase. Intraoperative grading of LUS scar was done. Based on grading of scar participants were assigned into scar dehiscence group (grade III and IV LUS scar) and non-dehiscence group (Grade I and II LUS scar).Results: Mean LUS thickness was 3.41±0.623 mm (range: 2-7 mm). Mean LUS thickness in the scar dehiscence group and non-dehiscence group was 2.98±0.55 mm and 3.48±0.60 mm (P value < 0.05) respectively. A cut off value of 3.5 mm was derived from ROC with sensitivity, specificity, positive and negative predictive value of 92.6%, 54.3%, 24.0%, 97.8%, respectively. The present study reported 27 (13.5%) cases of scar dehiscence.Conclusions: Ultra-sonographic evaluation of LUS thickness correlated significantly with intraoperative LUS appearance. USG evaluation of LUS can be used as a screening test to predict the LUS scar integrity. Risk of dehiscence is increased in women with thin LUS i.e. sonographic LUS thickness of < 3.5 mm and needs to be further evaluated. Women with previous one LSCS with thick LUS i.e. sonographic LUS thickness of > 3.5 mm, can be counselled regarding TOLAC if not contraindicated.

Determination of fruit quality of calcium carbide induced ripening in mango (Mangifera indica L. cv. Alphonso) by physiological, biochemical, bio-enzymatic and elemental composition analysis (EDX)

The aim of the study was to determine the postharvest fruit quality of mango cv. Alphonso treated with the laboratory grade (LG) and commercial grade (CG) Calcium Carbide (CaC2) at the reported highest acceptable dose, and elemental composition analysis (EDX) results to support the statements for traceability of hazardous trace elements in CaC2, which can serve as a basis towards developing sensors for identifying CaC2 treated mangoes through detection of trace elements. Physical, physiological, biochemical and EDX of mango cv. Alphonso harvested from farmers’ field of Santur village in Krishnagiri district of Tamil Nadu, India were used for the study. All studied physical characteristics except fruit firmness of CG CaC2 treated fruits did not correlate to desirable fruit characteristics like total soluble solids (TSS), pH, titrable acidity, total sugars and ascorbic acid. Besides, these parameters were only in control fruits, though a number of days taken to reach fruit consumption stage was relatively more compared to CaC2 treatment. In vitro, free radical scavenging potential of DPPH was comparatively higher in control fruits than CaC2 treated fruits of both grades. Lab grade (LG) CaC2 treated fruits were non-significant in modifying physical, physiological and biochemical properties of mango cv. Alphonso except for TSS. However, at the end of the experimental period, CG CaC2 treated fruits recorded higher TSS than LG CaC2 treated fruits. Energy Dispersive X-Ray (EDX) results confirmed traceability of health hazardous chemical substances of arsenic (As) and phosphorous (P) in both LG and CG CaC2 lumps. Calcium carbide when used as an artificial ripening agent was not in contact with the fruit surface, the presence of arsenic and phosphorus were not detected in the EDX spectrum, a novel finding of our study.

Evaluation of Arogyasri Seva Scheme in a Government Maternity Hospital, Govt Victoria Hospital, Visakhapatnam

A prospective observational study was conducted in Government Victoria Hospital, Visakhapatnam from 2013 to 2018 to evaluate Arogyasri scheme. Arogyasri scheme provides end to end cashless services for identified diseases in Andhra Pradesh. During this period, 891 gynecological surgeries were conducted under this scheme. Out of them, 44 were not approved for claim. A total of 10,880,238 rupees were claimed.

Risk Factors for Mortality in Asian Children Admitted to the Paediatric Intensive Care Unit after Haematopoietic Stem Cell Transplantation

<p><b>INTRODUCTION</b>This study aimed to investigate the risk factors associated with mortality in haematopoietic stem cell transplant (HSCT) patients admitted to our paediatric intensive care unit (PICU) over an 8-year period.</p><p><b>MATERIALS AND METHODS</b>A retrospective chart review was conducted of all HSCT patients requiring PICU admission at our centre (a tertiary care university hospital in Singapore) from January 2002 to December 2010. Chief outcome measures were survival at the time of PICU discharge and survival at 6 months after initial PICU admission.</p><p><b>RESULTS</b>Ninety-eight patients underwent HSCT during this period; 18 patients (18%) required 24 PICU admissions post-HSCT. The overall survival to PICU discharge was 62.5%. Of those who survived discharge from the PICU, 33% died within 6 months of discharge. Non-survivors to PICU discharge had a higher incidence of sepsis (89% vs 33%,= 0.013) and organ failure as compared to survivors (cardiovascular failure 100% vs 20%,= 0.0003; respiratory failure 89% vs 20%,= 0.002; and renal failure 44% vs 7%,= 0.047). Mortality rates were higher in patients requiring mechanical ventilation (70% vs 14%,= 0.010) and inotropic support (70% vs 14%,= 0.010). Mortality in all patients with renal failure requiring haemodialysis (n = 4) was 100%. Presence of 3 or more organ failures was associated with 80% mortality (= 0.003).</p><p><b>CONCLUSION</b>Sepsis, multiple organ failure and the need for mechanical ventilation, inotropes and especially haemodialysis were associated with increased risk of mortality in our cohort of HSCT patients.</p>

Management of Nasolacrimal-Cutaneous Fistula – A Maxillofacial Review and Sharing Experience.

Nasolacrimal cutaneous fistula can be presented with a complaint of discharge from an opening found below the eye and beside the nose. The patient’s history can be remarkable with repair of severe maxillofacial injuries. Examination reveals a nasolacrimal-cutaneous fistula extending from lacrimal sac to the overlying skin with co-existing nasolacrimal duct obstruction. To correct a lacrimal-cutaneous fistula, an endoscopic dacryocystorhinostomy should be performed to create a new opening to the lacrimal apparatus medially. Simultaneous irrigation and probing of the common canaliculus and fistula tract under direct visualization allows identification of the origin of the lacrimal fistula in relation to the internal ostium on the lateral lacrimal sac wall. Post-traumatic nasolacrimal disturbances are not uncommon findings in trauma patients and management of these chronic fistulas may be helpful for complete rehabilitation of the patient.

Preprosthetic Surgery: Review of Literature.

Following the loss of natural teeth after extraction, the bone begins to resorb. Th e results of this resorption are accelerated by wearing dentures and tend to aff ect the mandible more severely than the maxilla. Besides, general factors include the presence of nutritional abnormalities and systemic bone disease such as osteoporosis; endocrine dysfunction may aff ect bone metabolism. Preprosthetic surgical treatment must begin with a thorough history and physical examination of the patient. Sometimes, there are contraindications to surgery because the patient suff ers from serious general disease. Specifi c attention should also be given to laboratory tests which could inform us as to a degree of bone resorption. Successful treatment with removable prosthesis is dependent on many factors. One component that can profoundly aff ect treatment success is the condition of the denture-bearing tissues. Every eff ort should be made to ensure that both the hard and soft tissues are developed in a form that will enhance the patient’s ability to wear a denture. It is the responsibility of the practitioner to carefully evaluate and identify the need for any alteration of the denture-bearing areas and to educate the patient as to the importance of accomplishing this vital procedure.

Newborn observation track and trigger [NOTT] chart

Use of early warning system scores and track-and-trigger charts is widespread in adult and paediatric hospitalized patients; but its use in neonatal group is not well recognized. The authors aimed to develop and implement neonatal observation track-and-trigger chart for use in babies on postnatal wards and to assess its efficacy in identifying neonates in need of urgent medical assessment and intervention. Core group developed Newborn Observation Track and Trigger [NOTT] chart for "At-Risk" and "At-High-Risk" Infants. A decision tree was devised based on 'low', 'medium' and 'high' scores. Sensitivity and specificity of NOTT chart's 'medium' and 'high' score was 96% and 90%, respectively. Positive and negative predictive value was 43% and 100%, respectively. NOTT chart is a valuable tool for assessment of neonates on postnatal wards. A prospective study, using large number of participants, would be beneficial to further corroborate this useful tool

Y Chromosome Microdeletions and Partial AZFc Deletions in Infertile Men from South India.

Aim: Yq microdeletions involving the azoospermia factor (AZF) region are the second most frequent genetic cause of spermatogenic failure next to Klinefelter syndrome. These deletions occur in about 10-15 percent of men with azoospermia and severe oligozoospermia. Molecular screening for AZF deletions has become mandatory in the work-up of infertile men. Further, partial AZFc deletions categorized as gr/gr, b2/b3, b1/b3 and b2/b4 deletions have also been known to affect spermatogenesis. This study aimed to screen for both classical AZF deletions in 250 karyotypically normal infertile men from south India and partial AZFc deletions as a case-control analysis involving 108 fertile men. Methods: PCR amplification involving two multiplex reactions was carried out using primers for six STSs sY84, sY86 (AZFa), sY127, sY134 (AZFb), and sY254, sY255 (AZFc) with two internal controls (SRY, ZFY). Further, those men who showed deletions with one or both STSs sY1291 and sY1191 were subsequently tested with sY1189 and sY1192 to detect partial AZFc deletions. Results: One individual showed deletion of all the three AZF regions while two men had only AZFc deletion. Deletion of partial AZFb (sY127) was seen besides complete AZFc region in the fourth patient. The gr/gr, b2/b3 and b1/b3 deletions were detected in 24 (9.6%), one (0.4%) and nine (3.6%) infertile men in comparison with five, one and two fertile men respectively. The b2/b4 deletion was observed in a single azoospermic individual. Conclusion: Screening for AZF deletions would help in not only determining the cause for male infertility but also in its management and accurate genetic counselling.

Goat’s eye integrated with a human cataractous lens: A training model for phacoemulsification.

A relatively simple and inexpensive technique to train surgeons in phacoemulsification using a goat’s eye integrated with a human cataractous nucleus is described. The goat’s eye is placed on a bed of cotton within the lumen of a cylindrical container. This is then mounted on a rectangular thermocol so that the limbus is presented at the surgical field. After making a clear corneal entry with a keratome, the trainer makes a 5–5.5 mm continuous curvilinear capsulorhexis in the anterior lens capsule, creates a crater of adequate depth in the cortex and inserts the human nucleus within this crater in the goat’s capsular bag. The surgical wound is sutured, and the goat’s eye is ready for training. Creating the capsulorhexis with precision and making the crater of adequate depth to snugly accommodate the human nucleus are the most important steps to prevent excessive wobbling of the nucleus while training.

Development of dissolution test method for a telmisartan/amlodipine besylate combination using synchronous derivative spectrofluorimetry

The dissolution process is considered an important in vitro tool to evaluate product quality and drug release behavior. Single dissolution methods for the analysis of combined dosage forms are preferred to simplify quality control testing. The objective of the present work was to develop and validate a single dissolution test for a telmisartan (TEL) and amlodipine besylate (AML) combined tablet dosage form. The sink conditions, stability and specificity of both drugs in different dissolution media were tested to choose a discriminatory dissolution method, which uses an USP type-II apparatus with a paddle rotating at 75 rpm, with 900 mL of simulated gastric fluid (SGF without enzymes) as the dissolution medium. This dissolution methodology provided good dissolution profiles for both TEL and AML and was able to discriminate changes in the composition and manufacturing process. To quantify both drugs simultaneously, a synchronous first derivative spectrofluorimetric method was developed and validated. Drug release was analyzed by a fluorimetric method at 458 nm and 675 nm for AML and TEL, respectively. The dissolution method was validated as per ICH guidance.

O processo de dissolução é considerado como uma importante ferramenta in vitro para avaliar a qualidade do produto e o comportamento de liberação do fármaco. Prefere-se um ensaio único de dissolução para formas farmacêuticas contendo associação de fármacos pela simplificação dos testes de controle de qualidade. O objetivo do presente trabalho foi desenvolver e validar um teste de dissolução único para forma farmacêutica comprimidos contendo telmisartana (TEL) e besilato de anlodipino (AML) associados. Condições "sink", estabilidade e especificidade de ambos os fármacos nos diferentes meios de dissolução foram avaliadas para selecionar um método de dissolução discriminatório, que utiliza um aparato do tipo II da USP, com pás girando a 75 rpm e 900 mL de fluido gástrico simulado (SGF sem enzima) como o meio de dissolução. Estas condições proporcionaram bons perfis de dissolução para ambos, TEL e AML, sendo capaz de discriminar as mudanças na composição e processo de fabricação. Para quantificar os dois fármacos simultaneamente, um método de fluorescência derivada sincronizado foi desenvolvido e validado. A quantidade de fármaco liberado foi analisada pelo método fluorimétrico em 458 e 675 nm para a AML e TEL, respectivamente. O método de dissolução foi validado de acordo com a orientação da ICH.

A case of endophthalmitis associated with limbal relaxing incision.

Limbal relaxing incisions (LRIs) are considered a relatively safe procedure with rapid stabilization and absence of infectious complications. Do we need to readdress this last impression? We report a case of nocardia endophthalmitis associated with an exudate at the site of an LRI in a patient who underwent routine cataract surgery. This case, to the best of our knowledge, is the first report of its kind, stressing the need for a cautious approach to the adoption of this method of astigmatic correction.