Objective: To formulate diclofenac sodium as fast dissolving tablets (FDTs) using fenugreek gum as a natural superdisintegrant which also possess anti-inflammatory activity.Methods:physicochemical characterizations. The swelling index and viscosity of fenugreek gum was 221% and 293.4 mpa.s respectively. FDTs of diclofenac sodium was formulated by direct compression technique using different concentrations (1%-6%, w/w) of fenugreek gum as a natural superdisintegrant and compared with renowned synthetic superdisintegrants like sodium starch glycolate and croscarmellose sodium. The anti-inflammatory activity of a formulation was evaluated with carrageenan induced experimental rats.Results:An attempt was made to extract the fenugreek gum and evaluated it for various friability, hardness and results complied with the limits. The drug release from all the formulations ascertained first order kinetics. Among all the formulations F3 containing fenugreek gum with the concentration of 6% produced least disintegrating time 21 seconds resulting in higher drug release rate 93.74% at the end of 25 min. Hence, it was considered as optimized formulation. The present study revealed that the fenugreek gum as a natural superdisintegrant showed better disintegrating property than the most widely used synthetic superdisintegrants like sodium starch glycolate and croscarmellose sodium in the formulations of FDTs. The formulated tablets were evaluated for various physical tests like weight variation, Conclusions: The results suggested that the fenugreek gum act as a good super disintegrating agent and it showed promising additive anti-inflammatory activity with diclofenac sodium.

A 46-year-old man was referred to our hospital for treatment, complaining of swelling on the right mandibular molar region. Radiographic examination revealed a well defined multilocular radiolucent lesion with root resorption of right lower anteriors and molars. Following biopsy, a diagnosis of unicystic ameloblastoma of mural type was made and hemimandibulectomy was performed under general anesthesia. Histopathological examination of the surgical specimen exhibited a unicystic ameloblastoma of luminal, intraluminal, and mural type. Intraluminal proliferation was of plexiform pattern and mural proliferation showed unusual histopathological findings, which revealed follicular, acanthomatous areas coexisted with desmoplastic areas. This mural picture was similar to the so-called 'hybrid lesion of ameloblastoma', whose biological profile is not elicited due to the lack of adequate published reports. Two years follow up till date has not revealed any signs of recurrence.
Ameloblastoma ; Anesthesia, General ; Biopsy ; Chimera ; Follow-Up Studies ; Humans ; Mandibular Osteotomy ; Middle Aged ; Molar ; Odontogenic Tumors ; Phenobarbital ; Recurrence ; Root Resorption

Erdheim-Chester disease (ECD) was first reported by J. Erdheim and W. Chester, in 1930. There are less than 250 reported cases till date. We report a case of ECD in a 16- year-old Malay male, who initially presented with elusive anemic symptoms with more specific symptoms of bony pain, cardiorespiratory and hepatic involvement evolving as the disease progressed.

Since the outbreak of the novel influenza H1N1 in Mexico in April 2009, more than half a million cases have been recorded with close to 6000 deaths. In contrast to seasonal flu, this virus appears to have a predilection for the young, obese and pregnant. It’s most important and almost fatal complication is Acute Respiratory Distress Syndrome (ARDS). ICUs around the world have scrambled to upgrade various treatment modalities including high frequency oscillation ventilation, inotropes, antivirals and antibiotics in an effort to reduce the mortality arising out of this complication. More importantly, this complication appears reversible if adequate and early therapy is instituted. In particular, rescue therapies that allow the lung to rest appear to have brought success in some clinical settings. This article describes the experiences of six centres that have used Extracorporeal Membrane Oxygenation (ECMO) as rescue therapy in patients having ARDS. ECMO has been instituted in many of these cases not only as a bridge to therapy but also to reduce further barotrauma in these patients. ECMO experiences regarding 2 patients at the University of Michigan, 7 in Canada, 68 patients at Leicester UK, 68 in Australia and New Zealand, 1 in Hong Kong and 2 in Singapore are described. (JUMMEC 2010; 13(2): 80-87)
Influenza, Human

Fenofibrate is mainly used to reduce cholesterol level in patients at risk of cardiovascular disease. Thermal transition study with the help of differential scanning calorimetry (DSC) shows that the aforesaid active pharmaceutical ingredient (API) is a good glass former. Based on our DSC study, the molecular dynamics of this API has been carried out by broadband dielectric spectroscopy (BDS) covering wide temperature and frequency ranges. Dielectric measurements of amorphous fenofibrate were per-formed after its vitrification by fast cooling from a few degrees above the melting point (Tm ? 354.11 K) to deep glassy state. The sample does not show any crystallization tendency during cooling and reaches the glassy state. The temperature dependence of the structural relaxation has been fitted by single Vogel–Fulcher–Tamman (VFT) equation. From VFT fit, glass transition temperature (Tg) was estimated as 250.56 K and fragility (m) was determined as 94.02. This drug is classified as a fragile glass former. Deviations of experimental data from Kohlrausch–Williams–Watts (KWW) fits on high-frequency flank of α-peak indicate the presence of an excess wing in fenofibrate. Based on Ngai's coupling model, we identified the excess wing as true Johari–Goldstein (JG) process. Below the glass transition temperature one can clearly see a secondary relaxation (γ) with an activation energy of 32.67 kJ/mol.

The coracoid process is a bony projection arising from the antero-lateral aspect of the scapula. The variation in the height and length of the coracoid process are responsible for altered size and shape of the space between the coracoacromial arch and the rotator cuff. The study was conducted on sixty-four dry adult human scapulae of unknown age and sex with a view to elucidate the morphological and osteometric details. The length of coracoid process on right side was 41.01±3.55 mm and it was found to be 40.88±3.83 mm on left sided. The breadth of coracoid process was observed as 13.93±1.13 mm and 13.25±1.26 mm on right and left side respectively and the difference between the two sides was statistically significant (p=0.026). Thickness of the coracoid process was 8.59±1.32 mm and 8.01±1.16 mm in right and left sided scapulae. The acromiocoracoid distance was found to be 38.48±4.03 mm on right side and 35.51±3.83 mm on left sided scapulae and the difference between to the two sides showed high statistically significance (p=0.004). Mean coracoglenoid distance was noted 26.23±3.05 mm and 24.94±2.75 mm on right and left sided scapulae respectively. Values of the thickness of coracoid process recorded in the present study are at appreciable variance with the result of previous study. The coracoid process constitutes an important component of the scapular glenoid construct and is involved in many surgical interventions on the glenohumeral joint. Comprehension of standard morphometric details of the coracoid process is vital in traumatic cases, surgical interventions and replacement surgeries in the shoulder region.
Coracoid ; process ; scapula ; osteometric ; clinical

A rapid and sensitive ultra-performance liquid chromatography–tandem mass spectrometry (UPLC–MS/MS) method was developed and validated for the estimation of 17-desacetyl norgestimate in human plasma using solid-phase extraction technique. 17-desacetyl norgestimate D6 was used as the internal standard. Simple gradient chromatographic conditions and mass spectrometric detection enabled accurate and precise measurement of 17-desacetyl norgestimate at sub-picogram levels. The proposed method was validated for a linear range of 20–5000 pg/mL with a correlation coefficient Z 0.9988. The intra-run and inter-run precision and accuracy were within 10%. The overall recoveries for 17-desacetyl norgestimate and 17-desacetyl norgestimate D6 were 96.30%and 93.90%, respectively. The total run time was 4.5 min. The developed method was applied for the determination of the pharmacokinetic parameters of 17-desacetyl norgestimate following a single oral administration of a norgestimate and ethinyl estradiol 0.250 mg/0.035 mg tablets in 35 healthy female volunteers.

Serous ovarian cancer is the most common malignant ovarian tumour. Traditional management consists of surgical resection with postoperative chemotherapy. Currently neoadjuvant chemotherapy is offered to patients with advanced stage disease. The present study aims to analyse the histomorphological alterations in serous ovarian cancer following neoadjuvant chemotherapy. Correlation of these morphological alterations with survival is also presented here. Serous ovarian cancers from 100 advanced stage cases were included; 50 were treated with pre-surgery chemotherapy. Semi-quantitative scoring was used to grade the alterations in tumour morphology. Survival data was correlated with the final morphological score. Tumour morphology was significantly different in cases treated with neoadjuvant chemotherapy (CT group) as compared to cases with upfront surgery. The CT group cases showed more fibrosis, calcification, and infiltration by lymphocytes, plasma cells, foamy and hemosiderin-laden macrophages. The residual tumour cells had degenerative cytoplasmic changes with nuclear atypia. Patients with significant morphological response had a longer median survival, although it did not attain statistical significance in the current study. With the increasing use of neoadjuvant chemotherapy in management, the pathologist needs to be aware of the altered morphological appearance of tumour. Further studies are required to establish a grading system to assess the tissue response which can be helpful in predicting the overall therapeutic outcome and the prognosis of patients.

Multiple anomalies in the celiac arterial system presents as rare vascular malformations, depicting deviations of the normal vascular developmental pattern. We found a common left gastro-phrenic trunk and a hepato-spleno-mesenteric trunk arising separately from the abdominal aorta in one cadaver. We also found a common hepatic artery and a gastro-splenic trunk arising individually from the abdominal aorta in another cadaver. Even though many variations in the celiac trunk have been described earlier, the complex variations described here are not mentioned and classified by earlier literature. Knowledge of such variations has signifi cance in the surgical and invasive arterial radiological procedures in the upper abdomen.
Celiac Artery

Anaemia of chronic disease (ACD) is caused due to an underlying chronic inflammatory process. It is not due to marrow deficiency of iron. Chronic periodontitis is a chronic inflammatory condition which has been associated with anaemia of chronic disease. The aim of this study is to estimate various hematologic parameters suggestive of ACD in patients with chronic periodontitis and in the process to establish a relation between the two. Forty patients were selected and were categorized, based on the presence and absence of chronic periodontitis, into case and control groups, with 20 subjects in each group. Hematologic evaluation was done. Complete haemogram, haematocrit, erythrocyte sedimentation rate (ESR) and estimation of serum ferritin were done. An independent t-test was calculated. Statistically significant values (p<0.05) were obtained for neutrophil count, ESR, red blood cells (RBC), mean corpuscular haemoglobin concentration (MCHC) and serum ferritin. ESR, RBC and serum ferritin levels were significantly increased in subjects with chronic periodontitis. There were significant differences in neutrophil, ESR, RBC and serum ferritin in subjects having severe form of generalized chronic periodontitis. Thus, it was concluded that chronic generalized periodontitis, by means of an inflammatory process, influences various hematologic parameters are suggestive of anaemia of chronic disease.
Chronic Periodontitis ; Periodontitis