Effect of manufacturing process on stress relaxation in production of cefuroxime axetil tablets

The main objective of this study was to investigate the effects of compression forces applied during slugging on the dissolution rates of cefuroxime axetil, since the cefuroxime axetil is not stable during wet granulation and that aging affects the dissolution of core and film coated tablets where slugging was the method of choice in this study. Dissolution was found to be dramatically affected by the compression force on tablets. It has also been shown that interparticle bonding affects relaxation times, and that relaxation increases with decreased bonding. The results obtained in this study confirmed that controlling both the compression force during slugging and film coating process of the core tablets will result in dissolution profiles within the acceptable USP limits. Furthermore, it has been demonstrated that any increase in compression force during slugging leads to dissolution rates outside the Pharmacopoeia limits, and therefore the undesired consequences of longer relaxation times

Gastric volvulus caused by paraesophageal hernia complicating mid-trimester pregnancy.

A 36-year-old woman, who was 19 weeks pregnant presented with epigastric pain and a one-week history of repeated vomiting. Endoscopy revealed twisted stomach. CT scan of the chest showed figure of eight stomach consistent with gastric volvulus. Confirmation of diagnosis was made by laparatomy in which reduction of the oedematous stomach and excision of ischemic omental patch and repair of a huge paraesophageal hernia were performed. Two days after operation, abortion took place. Few days later, rapid deterioration in renal and hepatic function occurred followed by maternal death.

Omphalocele containing bowel, liver and spleen. A case report

In this case report, we describe a case of large omphalocele in which spleen was one of the contents in addition to the liver and bowel

Frequency of scrotal abnormalities detected by ultrasound in infertile men at King Hussein medical center

To determine the frequency of ultrasonographically detected intra-and extra-testicular abnormalities and the significance of oligospermia and azoospermia in men compared with that in normospermic controls. One hundred fifty six infertile men [117 oligospermia, sperm count <10x 10 [6] /ml, and 39 azoospermia, study group] aged 23-52 years [mean +/- SD, 27 +/- 7.3] and 100 control group aged 24-56 years [mean +/- SD, 26 +/- 8.4] were evaluated for the presence of scrotal abnormalities using high-frequency transducers and color Doppler imaging. Testicular volume, semen parameters, and hormonal levels were recorded. Fisher's exact test was used to determine difference between the two groups. One hundred thirty three of 156 [85.3%] patients in the study group had abnormal findings at scrotal ultrasonography compared with 30% of the controls. This difference was statistically significant [p<0.001]. These included varicocele in 53.8% vs 31% [p<0.01], testicular microlithiasis in 28.2% vs 2% [p<0.001], hydrocele in 46.2% vs 33% [p<0.05], epididymal cyst in 11.5% vs 3% [p<0.05], and epididymal enlargement in 10.3% vs 3% [p<0.05]. Utrasound shows a significantly higher frequency of intra- and extra-testicular abnormalities in oligospermia and azoospermia patients compared with the normospermic controls. Detection of these abnormalities by ultrasound may reflect their fertility status

Osteomalacia - A commonly misdiagnosed cause of gait difficulty

Osteomalacia is a metabolic bone disorder caused by deficiency of Vitamin D and its active metabolites. We report 46 cases of Osteomalacia diagnosed on the basis of clinical features of bone pain, gait difficulty and muscle weakness, plus biochemical findings of a low or normal serum calcium, low phosphorus and raised serum alkaline phosphatase level. Urinary calcium, phosphorus and serum paratharmone levels were also estimated in a few cases. Radiologic features included a typical fuzziness of bone architecture and Looser's zones. Out of 46 cases, 4 were males and 42 females. Age ranged from 13 to 45 years. In 3 males disease was attributed to drugs [Phenytoin, and Carbamazepine] and one to renal osteodystrophy. Out of the 42 female patients 4 were diagnosed as Renal Tubular Acidosis, 3 had Neurofibromatosis associated with Osteomalacia, 1 had malabsorption with Crohn's disease, 2 had hypophosphataemic Osteomalacia, and 2 were diagnosed to be associated with drugs [Rifampicin, Phenytoin and Phenobarbitone]. Eight female patients had onset of symptoms during or after pregnancy [mostly multiparous]. 10 female patients had history of deprivation of sunshine and low Vitamin D diet [deprivational Osteomalacia]. In 12 female patients cause could not be ascertained despite search. All showed good responses to Vitamin D or its analogues. The time between the onset of symptoms and presentation to the department of Neurology where they were diagnosed varied from 1 to 4 years. It is essential that the awareness level of the medical community be raised so that unnecessary morbidity from Osteomalacia may be prevented