Recent Advances in the development of Modified Release Tablets by amalgamating both Solubility Enhancement and Polymer Matrix Sintering Technologies.

Background: The fact that about 90 % of newly discovered API’s or new molecular entity(NME) have little or no aqueous solubility, causes a significant protest to the initialization of development and their scale up of dosage form in the Pharma Industry. Aqueous solubility of API’s has critical role in drug dissolution or availability of drug at the site of action or bioavailability, when a dosage form is administered orally.Objective: The object of this study is to formulate a modified release tablet dosage form of a poorly aqueous soluble drug, which not only have higher aqueous solubility or bioavailability but also have sustained release characteristics with high mechanical strength &their commercial viability. Numerous techniques are available for the solubility enhancement but all individual techniques have its own limitations for commercialization.Method: Aqueous solubility of drugs is improved by the known Solubility enhancement techniques like Micronization &Solid dispersions. After successful solubility enhancement, sustained release or modified release tablets of poorly aqueous soluble drug can be easily formulated into a suitable shape or size by using a known Polymer Matrix Sintering Technology with commercial feasibility. Micronization of poorly water-soluble drugs can be performed by Air Jet Mill or Ball Mill. Whereas Solid dispersion technique involves, molecular dispersion of poorly soluble drug in a suitable inert carrier, to form an amorphous and highly soluble compounds. Sintering Technology is defined as the bonding of adjacent particle surfaces in a mass of powder, or in compact, by the application of heat. Conventional sintering technique involves the heating of compact at a temperature below the melting point of the solid constituents in a controlled environment under atmospheric pressure.Results: Enhanced solubility of poorly soluble API’s by these proposed techniques is due to either conversion of crystalline compound in to amorphous form or reduction of particle size to its molecular level by the application of Micronization or solid dispersion techniques. The developed modified release tablets will show a sustained release characteristic due to Sintering aspect and provides enhanced solubility of BCS class II or IV drugs.Conclusion: Novel modified release tablets have been designed through consolidation of Solubility enhancement and Polymer Matrix Sintering technologies. Simultaneous exploitation of well-known and established approaches- Micronization (optimum particle size reduction) or solid dispersion, optional surfactant and Polymer Matrix Sintering Technique in the recent concept, produces significant enhancement of solubility of poorly water soluble API’s without compromising the content uniformity of dosage form and also provide a modified or sustained release characteristics with high mechanical strength. The release profile of drug can be easily tailored by using combination of both techniques where challenges of low solubility are prominent.

Usual interstitial pneumonia - secondary vs idiopathic pulmonary fibrosis

Background: Interstitial Lung Diseases is a group of disorders where the pulmonary interstitium, alveolar structures and the small airways are affected. Identification of a specific pattern on HRCT, with a thorough clinical evaluation can help a physician in narrowing down the differential diagnosis for the underlying cause. Usual Interstitial Pneumonia (UIP) is a frequently identified pattern. Differentiating patients with definite UIP pattern, into IPF and non-IPF spectrums is important. Aim of this study is to compare UIP patients with a secondary cause vs Idiopathic Pulmonary Fibrosis.Methods: Statistically 33 patients having UIP pattern on HRCT were evaluated based on the history of extrapulmonary symptoms, environmental exposure, drugs and subsequent serology testing. Patients were divided into two groups - IPF and UIP with a secondary cause. Both groups were compared on various clinical parameters. Inferences were drawn from the same.Results: Total 66.6% patients were identified to have Idiopathic Pulmonary Fibrosis, 33.3% had UIP with a secondary cause. Majority of patients with a secondary cause had Connective Tissue Disorder (90.9%) and one patient of Chronic Hypersensitivity Pneumonitis (HP).Conclusions: Absence of extrapulmonary symptoms in UIP patients need no further investigations and can be diagnosed as a case of IPF. However, presence of extrapulmonary symptoms needs further evaluation to diagnose the underlying disease and start treatment for the same.

Assessment of Symptomatic Post Tuberculosis Patients by Spirometry and Chest X Ray

Introduction: TB is an infectious disease caused by thebacillus Mycobacterium tuberculosis which typically affectsthe lungs. The disease is spread by the people who are sick withactive pulmonary TB. Up to half of TB survivors have someform of persistent pulmonary symptom despite microbiologiccure. The aim of the study was to assess the symptomatic posttuberculosis patients by using spirometry and chest x ray.Material and methods: The study was conducted in theDepartment of Respiratory Medicine, Rohilkhand MedicalCollege and Hospital after seeking clearance from theInstitutional Ethical Committee. The aim of the study was toassess the symptomatic post tuberculosis patients by usingspirometry and chest x ray. The study duration was from 1stNovember 2018 to 31st October 2019 and 100 patients wereenrolled in the study. Data was collected from patients whopresented with symptoms within 6 months of completing theirtreatment for tuberculosis.Results: All the patients (post tubercular) enrolled in thestudy had symptoms (in some form) even after full courseof antitubercular treatment and bacteriological cure andamong these breathlessness was the most common presentingsymptom (96%) followed by cough (58%). Maximum patientshad abnormal findings on chest examination (80%). Fibrosisfollowed by cavitary lesions were the most common findingson chest x ray in post tuberculosis patients. Maximum patientshad restriction (56%) in their spirometry followed by mixedpattern (23%).Conclusion: In patients with restriction on spirometry andhaving symptom of breathlessness and cough, reassurance andpulmonary rehabilitation may play a major role in relievingtheir symptoms whereas in patients with mixed or obstructivepattern on spirometry, bronchodilator therapy along withpulmonary rehabilitation may be helpful in relieving theirsymptoms post tuberculosis treatment.

Pectoralis major myocutaneous flap in head and neck reconstruction: an interesting experience from central India regional cancer center.

Background: Head and neck cancer are sixth most common cancers worldwide with cancer of oral cavity most common. The primary treatment modality for oral cavity cancer has been surgery and defects resulting from the ablation of the tumors require reconstruction. the PMMC flap offer an easy, less time consuming with minimal postoperative complication as a reconstructive option in the hands of reconstructive surgeon. The objective of our study was to give a precise description of our experience with the PMMC flap as a reconstructive option in post-ablative head and cancer surgery. Methods: The current prospective study was conducted in the Department of Surgical Oncology, Regional cancer center, Pt. JNMC, Raipur (C.G.), India from the January 2014 to June 2015. Detailed clinical history and examination of the patients were recorded. All Investigations relevant to the study were done before the surgical procedure. Procedure was performed as per standard protocol and reconstruction was made with PMMC flap. Data was compiled in MS Excel and checked for its completeness and correctness. Then it was analyzed. Results: In the present study male to female ratio was 2:1. Most of the patients belongs to the age group of 41-60 (55.55%) followed by 21-40 (30.15%). In the present study majority of patient of oral malignancy presented with lower alveolus malignancy (36.5%) followed by buccal mucosa malignancy (19.06%). Conclusions: Pectoralis major myocutaneous flap was found to be a versatile flap for reconstruction of large defects in Head and Neck region with minimal complication rate.