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Novel application of mixed hydrotropic solubilization technique in the formulation and evaluation of hydrotropic solid dispersion of aceclofenac
Maheshwari Rajesh,Indurkhya Arpna
Asian Journal of Pharmaceutics , 2010,
Abstract: In the present investigation, newly developed mixed hydrotropic solid dispersion (HSD) technology precludes the use of organic solvent and also decreases the individual concentration of hydrotropic agents, simultaneously decreasing their toxic potential. ′Mixed-hydrotropic solubilization′ technique is the phenomenon to increase the solubility of poorly water-soluble drugs in the aqueous solution containing blends of hydrotropic agents, which may give synergistic enhancement effect on solubility of poorly water-soluble drugs and to reduce concentrations of each individual hydrotropic agent to minimize their toxic effects due to high concentration of hydrotropic agents. Maheshwari has made HSD of paracetamol using urea. In the present study, the aqueous solution of hydrotropic blend (20% urea and 10% sodium citrate) has been found to increase aqueous solubility of poorly water-soluble drug, aceclofenac. This mixedhydrotropic blend was used to prepare solid dispersion of aceclofenac. The prepared solid dispersions have been characterized by IR and XRD studies. They have been studied for dissolution rate enhancement effect. The prepared solid dispersions were found very stable (chemically).
Tailoring of ketoprofen particle morphology via novel crystallocoagglomeration technique to obtain a directly compressible material
Chavda Vikash,Maheshwari Rajesh
Asian Journal of Pharmaceutics , 2008,
Abstract: Purpose: The purpose of this research was to develop a novel crystallo-co-agglomeration (CCA) method for ketoprofen to obtain its directly compressible spherical agglomerates with improved flowability and compressibility. Methodology: Dichloromethane-water system containing polyethylene glycol (PEG) 6000, polyvinyl alcohol (PVA), and hydroxypropylmethylcellulose (HPMC) 100 Centi Poise was used as the crystallization system. Ketoprofen was crystallized from dichloromethane and agglomerated with talc. Experimental parameters (concentration of PEG, PVA, and HPMC; effect of temperature; and agitation speed) were optimized. The agglomerates were evaluated for micrometric properties, mechanical properties, moisture content, compressibility, packability, and drug-release properties. The agglomerates were characterized by differential scanning calorimetry (DSC), powder x-ray diffraction (PXRD), infrared (IR) spectroscopy, and scanning electron microscopy (SEM). Main Findings: Remarkable improvement in micromeritic properties (angle of repose < 22°, percentage compressibility < 10, and Hausner ratio near to 1) and compactibility (mean yield pressure 55-93 MPa) enabled direct compression without any defect. Results of friability showed higher surface strength of agglomerates containing higher amount of talc. DSC, PXRD, and IR results showed no change in the crystalline form of ketoprofen. Dissolution study of batches KA, KB, KC, and KD(composition given in [Table 1]) showed 90% drug release in 120, 180, 240, and 420 min respectively. Principal Conclusions: Crystallo-co-agglomeration process can be considered as a suitable alternative to conventional granulation process to obtain agglomerates of ketoprofen with improved micromeritic and compressibility parameters. The CCA technique can be used for the design of sustained-release ketoprofen talc agglomerates containing lower amounts of polymers.
Giant Synovial Cyst of Thigh: A Rare Entity
Kushagra Sinha,Rajesh Maheshwari,Atul Agrawal
Case Reports in Orthopedics , 2013, DOI: 10.1155/2013/967215
Abstract: Synovial cyst occurs secondary to traumatic, degenerative, or inflammatory conditions. Synovial cysts represent abnormal distension of bursae, which communicate with the joint. Giant synovial cysts are typically due to rheumatoid arthritis, other causes being trauma and synovial pseudoarthrosis. A 33-year-old male presented to an outpatient clinic with a massive swelling on his posterolateral aspect of right thigh extending from upper one-third to the knee joint which had been increasing in size over the past six months. This was associated with dull aching pain. All laboratory investigations were within normal parameters. Even FNAC was inconclusive. With time, swelling was increasing in size. Ultrasound revealed the cystic nature of swelling. MRI showed large cystic lesion 24 × 10 × 12?cm in posterolateral aspect of thigh extending up to knee joint. Following the MRI, an excision was planned. After excision, histological examination confirmed the synovial nature of the cyst, which had a collagenous wall and dense chronic inflammatory cells. As the disease is extremely rare and asymptomatic, precise diagnosis is difficult and often delayed. We consider that open surgical excision should be reserved for cases of large synovial cysts because it can provide a complete resection of the lesion and minimize the risk of recurrence. 1. Case Report Synovial cyst occurs secondary to traumatic, degenerative, or inflammatory conditions. Synovial cysts represent abnormal distension of bursae, which communicate with the joint [1]. The popliteal region is the commonest site of synovial cysts [2]. Giant synovial cysts are typically due to rheumatoid arthritis, other causes being trauma and synovial pseudoarthrosis [3]. 2. Clinical Presentation A 33-year-old male presented to an outpatient clinic with a massive swelling on his posterolateral aspect of right thigh extending from upper one-third to the knee joint which had been increasing in size over the past six months. This was associated with dull aching pain. The patient also felt the mass to be aesthetically displeasing. Pain was aggravated by movement and alleviated to some extent by rest. There was no history of trauma, no history of any joint pain, and no personal and family history of gout, rheumatoid disease, or other arthritis. Physical examination revealed ?cm swelling, nontender, and the mass was cystic in consistency and transilluminated with well-defined margin (Figure 1). Flexion at the knee joint was restricted due to the size of the swelling and distal neurovascular status was intact. However,
Rupture of the ilio-psoas tendon after a total hip arthroplasty: an unusual cause of radio-lucency of the lesser trochanter simulating a malignancy
Aditya V Maheshwari, Rajesh Malhotra, Deepak Kumar, J David Pitcher
Journal of Orthopaedic Surgery and Research , 2010, DOI: 10.1186/1749-799x-5-6
Abstract: Avulsion fracture of lesser trochanter of the femur is a well known entity in children and adolescents [1]. However, its fracture or progressive radiolucency is considered a pathognomic finding in adults with malignancies [2]. Spontaneous rupture of ilio-psoas tendon is rare and has not been described before in the setting of a total hip arthroplasty (THA). We present here such a case who had a spontaneous rupture of the ilio-psoas tendon few days after a THA with subsequent progressive radiolucency of the lesser trochanter, simulating a malignancy. Awareness of this entity would aid in the diagnosis, prevent confusion with malignant disease, and allow appropriate management along with patient reassurance.A 77-year old, otherwise healthy, sedentary male was referred to the orthopedic oncology service for a progressive radiolucency of the lesser trochanter on radiographs (Fig. 1). He had undergone a hybrid THA for degenerative right hip disease at another institute six years ago but had persistent groin pain after the surgery. During a physiotherapy session at two weeks postoperatively, he felt a sudden increase in groin pain and then a 'pop' while negotiating stairs, and was not able to ambulate independently after that. He stopped his therapy and did not see his primary surgeon for the next six weeks. He was then prescribed further therapy which he did not comply and thereafter had been using an assistive device all the time. His pain gradually improved but he had been having persistent difficulty and weakness while walking on uneven surface, getting in and out of car, getting in and out of bed and negotiating stairs. He denied any prolonged medication or any prior injection in his hip.On examination, he ambulated with a single crutch. Active straight leg raise was not sustainable. Seated hip flexion was graded as 3/5. There was no tenderness or palpable mass in the groin. Distal neuro-vascular status was intact. The previous surgeons did not recall any intraoperat
ELECTRONIC WASTE: ITS HEALTH HAZARDS AND MANAGEMENT FOR SUSTAINABLE ERA
Bina Rani,Upma Singh,Rajesh Kumar Yadav,Raaz Maheshwari
Journal of Current Research in Science , 2013,
Abstract: In a world of technological advancement and countless gadgets, the quest to acquire the latest models is overwhelming: a slimmer desktop, new music system, televisions and so on. However the downside of the constant quest for better gadgetry is the rapidly piling hazardous wastes in our landfills. Discarded electronics are generated when users or owners of the products decide that they no longer want them. E-waste encompasses ever growing range of obsolete electronic devices such as computers, servers, main frames, monitors, TVs and monitor devices, telecommunication devices such as cell phones and pagers, calculators, audio and video devices, printers, scanners, copiers and fax machines besides refrigerators, air conditioners, washing machines and microwave ovens, E-waste also covers recording devices such as DVDs, CDs, floppies, tapes, printing cartridges, military electronic waste, automobile catalytic converters, electronic components such as chips, processors, mother boards, printed circuit boards, industrial electronics such as sensors, alarms, sirens, security devices, automobile electronic devices. In this manuscript impact of E-waste on health and environment, and various management strategies have been delineated.
Evaluation of hydroxyapatite and beta-tricalcium phosphate mixed with bone marrow aspirate as a bone graft substitute for posterolateral spinal fusion
Bansal Sanjay,Chauhan Vijendra,Sharma Sansar,Maheshwari Rajesh
Indian Journal of Orthopaedics , 2009,
Abstract: Background: Autologous cancellous bone is the most effective biological graft material. However, harvest of autologous bone is associated with significant morbidity. Since porous hydroxyapatite and beta-tricalcium phosphate are biodegradable materials and can be replaced by bone tissue, but it lacks osteogenic property. We conducted a study to assess their use as a scaffold and combine them with bone marrow aspirate for bone regeneration using its osteogenic property for posterolateral spinal fusion on one side and autologous bone graft on the other side and compare them radiologically in terms of graft incorporation and fusion. Materials and Methods: Thirty patients with unstable dorsal and lumbar spinal injuries who needed posterior stabilization and fusion were evaluated in this prospective study from October 2005 to March 2008. The posterior stabilization was done using pedicle screw and rod assembly, and fusion was done using hydroxyapatite and beta-tricalcium phosphate mixed with bone marrow aspirate as a bone graft substitute over one side of spine and autologous bone graft obtained from iliac crest over other side of spine. The patients were followed up to a minimum of 12 months. Serial radiographs were done at an interval of 3, 6, and 12 months and CT scan was done at one year follow-up. Graft incorporation and fusion were assessed at each follow-up. The study was subjected to statistical analysis using chi-square and kappa test to assess graft incorporation and fusion. Results: At the end of the study, radiological graft incorporation and fusion was evident in all the patients on the bone graft substitute side and in 29 patients on the autologous bone graft side of the spine ( P > 0.05). One patient showed lucency and breakage of distal pedicle screw in autologous bone graft side. The interobserver agreement (kappa) had an average of 0.72 for graft incorporation, 0.75 for fusion on radiographs, and 0.88 for the CT scan findings. Conclusion: Hydroxyapatite and beta-tricalcium phosphate mixed with bone marrow aspirate seems to be a promising alternative to conventional autologous iliac bone graft for posterolateral spinal fusion.
Interlaminar fenestration in lumbar canal stenosis- a retrospective study
Gupta Puneet,Sharma Sansar,Chauhan V,Maheshwari Rajesh
Indian Journal of Orthopaedics , 2005,
Abstract: Background: Degenerative lumbar canal stenosis is a multifaceted problem presenting as backache and neurological claudication. Methods: In fifteen patients of acquired degenerative lumbar canal stenosis multi level interlaminar fenestration with discectomy, if required, was carried out. Retrospective analysis was done to assess the out come by assessing the relief in backache and neurological claudication. Results: The mean age of patients was 50.4 years and average duration of neurological claudication was nine months. Diagnosis of the degenerative lumbar canal stenosis was made by clinical examination and confirmed by radiological and MRI measurement of cross section area of neural canal. Interlaminar fenestration was done at four levels and three levels in six patients each while it was done at two levels in remaining three patients. None of the patients reported immediate or late onset of backache or restriction of spinal movements, indicating spinal in stability. None of the patients had neurological claudication in the postoperative period. Conclusion: Retrospective analysis suggests that multiple interlaminar fenestrations done in moderate spinal stenosis provides adequate neurological decompression besides maintaining spinal stability.
Role of fluoroscopic guided fine needle aspiration biopsy in spinal pathologies
Chauhan Vijendra,Gupta Anuj,Gupta Puneet,Maheshwari Rajesh
Indian Journal of Orthopaedics , 2006,
Abstract: Background: The presence of vertebral lesion, whether symptomatic or not presents a diagnostic challenge. Open biopsy of spine is associated with considerable clinical morbidity. Hence it was decided to evaluate the efficacy of fluoroscopic guided fine needle aspiration biopsy (FGFNAB) in providing a definitive diagnosis in pathologies of the spine and to determine the degree of co-relation between the histopathological diagnosis and the presumptive clinicoradiological diagnosis. Methods: A prospective study of 103 patients in whom a presumptive diagnosis was made by available imaging techniques (including magnetic resonance imaging) was undertaken. All patients underwent histopathological /cytological examination for confirmation of the presumptive diagnosis, using material obtained through FGFNAB. Results: A definitive diagnosis was established, through FGFNAB, in 76 (73.8%) patients. Non concordant diagnosis was seen in 13(12%) of patients. In 27 (26.2%) patients the results of FGFNAB were inconclusive. Conclusion: FGFNAB is a minimally invasive, technically easy, quick and cost-effective procedure. It can be done on an outpatient basis, under local anaesthesia and often eliminates the need for an open biopsy. FGFNAB can clinch the diagnosis early and helps institute definitive therapy. Hence we strongly recommend FGFNAB as a basic investigation in all pathological lesions of the spine.
Flash pulmonary edema in a post arterial switch operation - High flow oxygen as a treatment modality
Kumar Jamuna,Hegde Rajesh,Maheshwari Sunita,Rao Shekar
Annals of Pediatric Cardiology , 2009,
Abstract: We report a case of a 3-year-old boy who underwent an arterial switch operation with relief of left ventricular outflow tract obstruction and later presented with recurrent episodes of flash pulmonary edema. High-flow humidified oxygen with positive pressure support (Vapotherm) was used as a treatment modality, thereby avoiding intubation and mechanical ventilation.
Study on Mixed Solvency Concept in Formulation Development of Aqueous Injection of Poorly Water Soluble Drug
Shailendra Singh Solanki,Love Kumar Soni,Rajesh Kumar Maheshwari
Journal of Pharmaceutics , 2013, DOI: 10.1155/2013/678132
Abstract: In the present investigation, mixed-solvency approach has been applied for the enhancement of aqueous solubility of a poorly water- soluble drug, zaltoprofen (selected as a model drug), by making blends (keeping total concentrations 40% w/v, constant) of selected water-soluble substances from among the hydrotropes (urea, sodium benzoate, sodium citrate, nicotinamide); water-soluble solids (PEG-4000, PEG-6000); and co-solvents (propylene glycol, glycerine, PEG-200, PEG-400, PEG-600). Aqueous solubility of drug in case of selected blends (12 blends) ranged from 9.091 ± 0.011?mg/ml–43.055 ± 0.14?mg/ml (as compared to the solubility in distilled water 0.072 ± 0.012?mg/ml). The enhancement in the solubility of drug in a mixed solvent containing 10% sodium citrate, 5% sodium benzoate and 25 % S cosolvent (25% S cosolvent contains PEG200, PEG 400, PEG600, Glycerine and Propylene glycol) was more than 600 fold. This proved a synergistic enhancement in solubility of a poorly water-soluble drug due to mixed cosolvent effect. Each solubilized product was characterized by ultraviolet and infrared techniques. Various properties of solution such as pH, viscosity, specific gravity and surface tension were studied. The developed formulation was studied for physical and chemical stability. This mixed solvency shall prove definitely a boon for pharmaceutical industries for the development of dosage form of poorly water soluble drugs. 1. Introduction Formulation has numerous benefits in drug discovery and development. It enables efficacy, toxicity, and pharmacokinetic (PK) studies. Formulation can improve oral bioavailability, shorten onset of a therapeutic effect, enhance stability of drugs, and reduce dosing frequency. More consistent dosing can be achieved by reducing food effect through formulation. Formulation can reduce side effects (i.e., decreasing tissue irritation and improving taste) [1–3]. An intramuscular (IM) medication is given by needle into the muscle. It can be a solution, oil, or suspension. Drugs in aqueous solution are rapidly absorbed. However, very slow constant absorption can be obtained if the drug is administered in oil or suspended in other repository vehicles. Solubility may also be enhanced by altering the pH and using cosolvents but excess amount of these agents may have adverse effects. The vehicle should contain a minimum amount and low concentration of the co-solvent to reduce viscosity and toxicity effects [3–6]. To significantly enhance the solubility of semipolar drugs, high concentrations of non-aqueous cosolvents may be required [7].
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