1.Validated gradient stability indicating HPLC method for determining Diltiazem Hydrochloride and related substances in bulk drug and novel tablet formulation
Chatpalliwara A. Vivekanand ; Porwal K. Pawan ; Upmanyu Neeraj
Journal of Pharmaceutical Analysis 2012;02(3):226-237
A stability-indicating liquid chromatographic method has been developed and validated for the determination of Diltiazem Hydrochloride (DTZ) together with its six related substances (Diltiazem sulphoxide,Imp-A,Imp-B,Imp-D,Imp-E,and Imp-F) in a laboratory mixture as well as in a novel tablet formulation developed in-house.Efficient chromatographic separation was achieved on a Hypersil BDS C18 (150mm ×4.6mm,5.0μm) with mobile phase containing 0.2% Triethylamine (TEA) in gradient combination with acetonitrile (ACN) at a flow rate of 1.0 mL/min and the eluent was monitored at 240 nm.In the developed method,the resolution of DTZ from any pair of impurities was found to be greater than 2.0.The test solution and related substances were found to be stable in the diluent for 24 h.The developed method resolved the drug from its known impurities,stated above,and also from additional impurities generated when the formulation was subjected to forced degradation; the mass balance was found close to 99.9%.Regression analyses indicate correlation coefficient value greater than 0.997 for DTZ and its six known impurities.The LOD for DTZ and the known impurities was at a level below 0.02%.The method has shown good,consistent recoveries for DTZ (99.8-101.2%) and also for its six known impurities (97.2-101.3%).The method was found to be accurate,precise,linear,specific,sensitive,rugged,robust,and stability-indicating.
2.Analysis of Postural Control following Anterior Cruciate Ligament Reconstruction with Ipsilateral Peroneus Longus Tendon Graft
Malaysian Orthopaedic Journal 2023;17(No.1):133-141
Introduction: Harvesting peroneus longus for ACL
reconstruction is thought to create ankle instability which
could add to postural instability from an ACL injury. This
apprehension prevents its use as a graft of primary choice for
many surgeons. To date, there is no evidence available
describing changes in postural control after its use in ACL
reconstruction. The purpose of the study was to analyse the
changes in postural control in the form of static and dynamic
body balance after ACL reconstruction with Peroneus
Longus Tendon Graft and compare it with the unaffected
limb at different time intervals.
Materials and methods: Thirty-one participants with ACL
injury were selected and subjected to an assessment of static
and dynamic balance before and after ACL reconstruction
using the HUMAC balance system. Outcome measures for
Centre of Pressure (COP) assessment were average velocity,
path length, stability score, and time on target. Comparison
of scores was done pre-operatively as well as at three- and
six-months post-reconstruction with Peroneus longus tendon
graft.
Results: Static balance of the affected limb showed
significant improvement with a decrease in average velocity
(F=4.522, p=0.026), path length (F=4.592: p=0.024) and
improvement of stability score (F=8.283, p=0.001).
Dynamic balance measured by the time on the target variable
also showed significant improvement at six-month follow-up
(F=10.497: p=0.000). There was no significant difference
between the affected and non-affected limb when compared
at the different time intervals.
Conclusion: The static and dynamic balance, which is
impaired after ACL injury, improves with ACL
reconstruction with PLT autologous graft. Hence PLTG can
be safely used as a graft for ACL reconstruction without
affecting postural control and body balance.
3.Global Kidney Health Atlas: a spotlight on the Asia-Pacific sector
Joyita BHARATI ; Vivekanand JHA
Kidney Research and Clinical Practice 2022;41(1):22-30
Chronic kidney disease (CKD) is a unique public health problem in terms of high expenses required for its management and its increasing worldwide incidence. Understanding the existing structure of CKD treatment and its epidemiology is pivotal for equitable kidney care globally. The Global Kidney Health Atlas (GKHA) was launched by the International Society of Nephrology (ISN) in 2017 as a part of its “Bridging the Gaps” strategy with a vision to understand the global kidney care capacity. Two rounds of GKHA surveys were conducted and published in 2017 and 2019, respectively. The GKHA surveys showed significant variability in kidney care among global regions. Asia is the largest of all continents and distinct for its heterogeneity. The Asia-Pacific sector comprises four main regional constructs of the ISN; North and East Asia, Oceania and South East Asia, South Asia, and the Middle East. Kidney care capacity varies among these regions in terms of government spending, epidemiology of kidney diseases, and workforce availability. In this narrative review, we highlight the differences in kidney care delivery among the regions of the Asia-Pacific sector based on information from GKHA and emphasize the priority areas on which stakeholders should concentrate their efforts.
4.Natural bioceramics: our experience with changing perspectives in the reconstruction of maxillofacial skeleton
Vivekanand Sabanna KATTIMANI ; Krishna Prasad LINGAMANENI
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2019;45(1):34-42
OBJECTIVES: Various bone graft substitute materials are used to enhance bone regeneration in the maxillofacial skeleton. In the recent past, synthetic graft materials have been produced using various synthetic and natural calcium precursors. Very recently, eggshell-derived hydroxyapatite (EHA) has been evaluated as a synthetic bone graft substitute. To assess bone regeneration using EHA in cystic and/or apicectomy defects of the jaws through clinical and radiographic evaluations. MATERIALS AND METHODS: A total of 20 patients were enrolled in the study protocol (CTRI/2014/12/005340) and were followed up at 4, 8, 12, and 24 weeks to assess the amount of osseous fill through digital radiographs/cone-beam computed tomography along with clinical parameters and complications. Wilcoxon matched pairs test, means, percentages and standard deviations were used for the statistical analysis. RESULTS: The sizes of the lesions in the study ranged from 1 to 4 cm and involved one to four teeth. The study showed significant changes in the formation of bone, the merging of material and the surgical site margins from the first week to the first month in all patients (age range, 15-50 years) irrespective of the size of the lesions and the number of teeth involved. Bone formation was statistically significant from the fourth to the eighth week, and the trabecular pattern was observed by the end of 12 weeks with uneventful wound healing. CONCLUSION: EHA showed enhancement of bone regeneration, and healing was complete by the end of 12 weeks with a trabecular pattern in all patients irrespective of the size of the lesion involved. The study showed enhancement of bone regeneration in the early bone formative stage within 12 weeks after grafting. EHA is cost effective and production is environment friendly with no disease transfer risks. Thus, natural bioceramics will play an important role in the reduction of costs involved in grafting and reconstruction.
Apicoectomy
;
Bone Regeneration
;
Calcium
;
Durapatite
;
Humans
;
Jaw
;
Osteogenesis
;
Skeleton
;
Tooth
;
Transplants
;
Wound Healing
6.Natural bioceramics: our experience with changing perspectives in the reconstruction of maxillofacial skeleton
Vivekanand Sabanna KATTIMANI ; Krishna Prasad LINGAMANENI
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2019;45(1):34-42
OBJECTIVES:
Various bone graft substitute materials are used to enhance bone regeneration in the maxillofacial skeleton. In the recent past, synthetic graft materials have been produced using various synthetic and natural calcium precursors. Very recently, eggshell-derived hydroxyapatite (EHA) has been evaluated as a synthetic bone graft substitute. To assess bone regeneration using EHA in cystic and/or apicectomy defects of the jaws through clinical and radiographic evaluations.
MATERIALS AND METHODS:
A total of 20 patients were enrolled in the study protocol (CTRI/2014/12/005340) and were followed up at 4, 8, 12, and 24 weeks to assess the amount of osseous fill through digital radiographs/cone-beam computed tomography along with clinical parameters and complications. Wilcoxon matched pairs test, means, percentages and standard deviations were used for the statistical analysis.
RESULTS:
The sizes of the lesions in the study ranged from 1 to 4 cm and involved one to four teeth. The study showed significant changes in the formation of bone, the merging of material and the surgical site margins from the first week to the first month in all patients (age range, 15-50 years) irrespective of the size of the lesions and the number of teeth involved. Bone formation was statistically significant from the fourth to the eighth week, and the trabecular pattern was observed by the end of 12 weeks with uneventful wound healing.
CONCLUSION
EHA showed enhancement of bone regeneration, and healing was complete by the end of 12 weeks with a trabecular pattern in all patients irrespective of the size of the lesion involved. The study showed enhancement of bone regeneration in the early bone formative stage within 12 weeks after grafting. EHA is cost effective and production is environment friendly with no disease transfer risks. Thus, natural bioceramics will play an important role in the reduction of costs involved in grafting and reconstruction.
7.Dexmedetomidine infusion as an anesthetic adjuvant to general anesthesia for appropriate surgical field visibility during modified radical mastectomy with i-gel®: a randomized control study.
Kumkum GUPTA ; Bhawana RASTOGI ; Prashant K GUPTA ; Ivesh SINGH ; Vijendra Pal SINGH ; Manish JAIN
Korean Journal of Anesthesiology 2016;69(6):573-578
BACKGROUND: Modified radical mastectomy is associated with appreciable blood loss, while endotracheal intubation leads to elevated hemodynamic responses. The present study aimed to evaluate the clinical efficacy of dexmedetomidine infusion as an anesthetic adjuvant to general anesthesia during modified radical mastectomy with I-Gel. METHODS: Sixty adult consenting female patients, of American Society of Anesthesiologists physical status 1 to 2 and aged 4,065 years, were blindly randomized into two groups of 30 patients each. The patients in Group I received intravenous dexmedetomidine at a loading dose of 1 µg/kg over 10 min, followed by maintenance infusion of 0.4 to 0.7 µg/kg/h, while patients in Group II were administered an identical amount of saline infusion until 15 min prior to the end of surgery. The primary end point was bleeding at the surgical field and hemodynamic changes; requirement of isoflurane, intraoperative fentanyl consumption and recovery time were assessed as secondary outcomes. RESULTS: The patients receiving dexmedetomidine infusion showed significantly less bleeding at the surgical field (P < 0.05). A statistically significant reduction was also observed in the percentage of isoflurane required (0.82 ± 0.80%) to maintain the systolic blood pressure between 100 and 110 mmHg in patients receiving dexmedetomidine infusion compared with the Group II (1.50 ± 0.90%). The mean intraoperative fentanyl consumption in patients in the Group I was also significantly lower compared with that of the Group II (38.43 ± 5.40 µg vs. 75.12 ± 4.60 µg). The mean recovery time from anesthesia did not show any clinically significant difference between the groups. CONCLUSIONS: Dexmedetomidine infusion can be used safely to decrease the bleeding at the surgical field with smooth recovery from anesthesia.
Adult
;
Anesthesia
;
Anesthesia, General*
;
Blood Pressure
;
Dexmedetomidine*
;
Female
;
Fentanyl
;
Hemodynamics
;
Hemorrhage
;
Humans
;
Intubation, Intratracheal
;
Isoflurane
;
Mastectomy, Modified Radical*
;
Treatment Outcome
8.Percutaneous elevation of depressed lunate fossa: A surgical technique.
Atin JAISWAL ; Yashwant Singh TANWAR
Chinese Journal of Traumatology 2018;21(5):304-307
Die-punch fractures or impaction fractures of distal radius articular surface are difficult to treat and hard to achieve satisfactory reduction. We present a unique, percutaneous and minimally invasive technique to elevate the depressed lunate fossa and maintain the reduction of the elevated fragment with no need of grafting in such fractures. This technique is simple, reproducible and can be executed with simple instrumentations. We think it deserves a variety of implications in the treatment of distal radius fractures.
9.Socket preservation using eggshell-derived nanohydroxyapatite with platelet-rich fibrin as a barrier membrane: a new technique
Vivekanand Sabanna KATTIMANI ; Krishna Prasad LINGAMANENI ; Girija Easwaradas KREEDAPATHI ; Kiran Kumar KATTAPPAGARI
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2019;45(6):332-342
OBJECTIVES:
Socket grafting is vital to prevent bone resorption after tooth extraction. Several techniques to prevent resorption have been described, and various bone graft substitutes have been developed and used with varying success. We conducted this pilot study to evaluate the performance of nanohydroxyapatite (nHA) derived from chicken eggshells in socket preservation.
MATERIALS AND METHODS:
This was a prospective, single center, outcome assessor-blinded evaluation of 23 sockets (11 patients) grafted with nHA and covered with platelet-rich fibrin (PRF) membrane as a barrier. Bone width and radiographic bone density were measured using digital radiographs at 1, 12, and 24 weeks post-procedure. Postoperative histomorphometric and micro-computed tomography (CT) evaluation were performed. The study protocol was approved by the Institutional Ethics Committee.
RESULTS:
All patients had uneventful wound healing without graft material displacement or leaching despite partial exposure of the grafted socket. Tissuere-epithelialized with thick gingival biotype (>3 mm). Width of the bone was maintained and radiographic density increased significantly with a trabecular pattern (73.91% of sockets) within 12 weeks. Histomorphometric analysis showed 56.52% Grade 3 bone formation and micro-CT analysis revealed newly formed bone with interconnecting trabeculae.
CONCLUSION
Use of a PRF membrane with nHA resulted in good bone regeneration in sockets. Use of a PRF membrane prevents periosteal-releasing incisions for primary closure, thereby facilitating the preservation of keratinized mucosa and gingival architecture. This technique, which uses eggshell-derived nHA and PRF membrane from the patient's own blood, is innovative and is free of disease transfer risks. nHA is a promising economic bone graft substitute for bone regeneration and reconstruction because of the abundant availability of eggshell waste as a raw material.
10.Socket preservation using eggshell-derived nanohydroxyapatite with platelet-rich fibrin as a barrier membrane: a new technique
Vivekanand Sabanna KATTIMANI ; Krishna Prasad LINGAMANENI ; Girija Easwaradas KREEDAPATHI ; Kiran Kumar KATTAPPAGARI
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2019;45(6):332-342
OBJECTIVES: Socket grafting is vital to prevent bone resorption after tooth extraction. Several techniques to prevent resorption have been described, and various bone graft substitutes have been developed and used with varying success. We conducted this pilot study to evaluate the performance of nanohydroxyapatite (nHA) derived from chicken eggshells in socket preservation.MATERIALS AND METHODS: This was a prospective, single center, outcome assessor-blinded evaluation of 23 sockets (11 patients) grafted with nHA and covered with platelet-rich fibrin (PRF) membrane as a barrier. Bone width and radiographic bone density were measured using digital radiographs at 1, 12, and 24 weeks post-procedure. Postoperative histomorphometric and micro-computed tomography (CT) evaluation were performed. The study protocol was approved by the Institutional Ethics Committee.RESULTS: All patients had uneventful wound healing without graft material displacement or leaching despite partial exposure of the grafted socket. Tissuere-epithelialized with thick gingival biotype (>3 mm). Width of the bone was maintained and radiographic density increased significantly with a trabecular pattern (73.91% of sockets) within 12 weeks. Histomorphometric analysis showed 56.52% Grade 3 bone formation and micro-CT analysis revealed newly formed bone with interconnecting trabeculae.CONCLUSION: Use of a PRF membrane with nHA resulted in good bone regeneration in sockets. Use of a PRF membrane prevents periosteal-releasing incisions for primary closure, thereby facilitating the preservation of keratinized mucosa and gingival architecture. This technique, which uses eggshell-derived nHA and PRF membrane from the patient's own blood, is innovative and is free of disease transfer risks. nHA is a promising economic bone graft substitute for bone regeneration and reconstruction because of the abundant availability of eggshell waste as a raw material.
Bone Density
;
Bone Regeneration
;
Bone Resorption
;
Chickens
;
Ethics Committees
;
Fibrin
;
Humans
;
Membranes
;
Mucous Membrane
;
Osteogenesis
;
Pilot Projects
;
Prospective Studies
;
Tooth Extraction
;
Transplants
;
Wound Healing