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Formulation, Optimization and Evaluation of Floating Microspheres of Captopril
Devesh Kapoor,Rakesh Patel
Asian Journal of Biomedical and Pharmaceutical Sciences , 2012,
Abstract: The objective of the present study was to develop floating microspheres of Captopril in order to achieve an extended retention in the upper GIT which may enhance the absorption and improve the bioavailability. The microspheres were prepared by solvent evaporation method using different ratio of hydroxyl propyl methyl cellulose (HPMC K4M) with drug in the mixture dichloromethane and ethanol at ratio of (1:1), with tween80 as the surfactant. Differential Scanning Calorimeter (DSC) study shows that drug and other excipients are compatible with each other. The effects of polymers concentration on drug release profile were investigated. A 32 full factorial design was applied to systemically optimize the drug release profile. Polymer to drug ratio (X1) and stirring speed (X2) were selected as independent variables. The floating microspheres were characterized by and results obtained are % yield, particle size analysis, drug entrapment efficiency, buoyancy percentage, in-vitro drug release was studied for 12 hour and scanning electron microscopy. Accelerated stability study was also performed for three months indicated that optimized formulation was stable. The floating microspheres showed better result and it may be use full for prolong the drug release in stomach and improve the bioavailability.
Colon Carcinoma Presenting with a Synchronous Oesophageal Carcinoma and Basal Cell Carcinoma of the Skin
Nidhi Gupta,Rakesh Kapoor,Suresh C. Sharma
ISRN Oncology , 2011, DOI: 10.5402/2011/107970
Abstract: With advances in diagnostic techniques and treatment modalities, the number of patients identified with colorectal carcinoma who develop multiple primary malignancies during long-term followup has been increasing. We report a patient who developed three histologically distinct malignancies. Primary colon carcinoma treated radically followed by an 8-year disease-free period. The patient then presented with progressive dysphagia and was investigated and diagnosed to have a synchronous multicentric squamous cell carcinoma of the oesophagus and basal cell carcinoma of the skin. There was a simultaneous multicentric recurrence in the colon. This case is worth mentioning because the clustering of three primary malignancies (synchronous and metachronous) is of rare occurrence in a single patient, and, to our knowledge, this is the first report of this combination occurring in the same individual. In addition, the report emphasizes the importance of evaluating patients with known colonic primary neoplasms for synchronous colonic and extracolonic tumors. 1. Introduction The phenomenon of multiple primary malignant neoplasms in the same individual was first described by Warren and Gates [1]. Since then, few cases of three or more primary malignant neoplasms have been reported [2]. It is believed that multiple primary malignant neoplasms now occur more frequently than before as a result of prolonged survival of patients after successful treatment of primary tumors. They appear more frequently in the upper digestive tract, respiratory system, head and neck region, or urogenital system. The incidence ranges from 2% to 10% [3]. 2. Case History A 44-year-old, chronic smoker, nonalcoholic young male underwent exploratory laparotomy, partial colectomy, and end-to-end anastomosis for colon carcinoma, in 1998. Growth was present at the hepatic flexure; there was no metastatic lymphadenopathy, ascites, liver metastases, or peritoneal deposits (T2N0M0). There was no significant family history. Patient did not receive any adjuvant treatment and was lost to followup. In August 2007, patient presented with the chief complaints of progressive dysphagia for 3 months, associated with loss of weight and loss of appetite. Patient underwent upper gastrointestinal endoscopy and biopsy which revealed an ulceroproliferative growth at 17-18?cm from the central incisor, and the scope could not be negotiated beyond it. On examination, there was a 3 × 3 ?cm excoriated lesion over the right cheek with no palpable lymph nodes, and per abdomen examination revealed no palpable mass or
Quality of life assessment with different radiotherapy schedules in palliative management of advanced carcinoma esophagus: A prospective randomized study
Mehta Shaveta,Sharma Suresh,Kapoor Rakesh,Kochhar Rakesh
Indian Journal of Palliative Care , 2008,
Abstract: Aim: To investigate the quality of life (QOL) of patients with advanced carcinoma esophagus treated with different palliative radiation schedules. Methods: Sixty-two consecutive patients with inoperable, non-metastatic carcinoma of the esophagus were randomly allocated to Arm-A (external radiotherapy 30 Gy/10 fractions + brachytherapy 12 Gy/two sessions), Arm-B (external radiotherapy 30 Gy /10 fractions) and Arm-C (external radiotherapy 20Gy /five fractions). The QOL was assessed using the European Organization for Research and Treatment of Cancer questionnaire at presentation, after treatment and at 3 months follow-up. Results: The mean QOL score improved, in arm-A from 38 to 52 after treatment and 56 at 3 months, in arm-B from 30 to 44 after treatment and 55 at 3 months and in arm-C from 24 to 40 after treatment but decreased to 37 at 3 months. Improvement in dysphagia scores at the first follow-up was 46.1% in arm-A, 25.0% in arm-B and 22.6% in arm-C. The difference was maintained at 3 months, with maximum improvement in arm-A (57.6%). No significant differences were found between the three arms with regard to complications and additional procedures needed for relief of dysphagia. Conclusion: In comparison with external radiotherapy alone, external radiotherapy with intraluminal brachytherapy has shown a trend toward better QOL and consistent dysphagia relief without significant difference in adverse effects.
Machine learning techniques in disease forecasting: a case study on rice blast prediction
Rakesh Kaundal, Amar S Kapoor, Gajendra PS Raghava
BMC Bioinformatics , 2006, DOI: 10.1186/1471-2105-7-485
Abstract: Six significant weather variables were selected as predictor variables. Two series of models (cross-location and cross-year) were developed and validated using a five-fold cross validation procedure. For cross-year models, the conventional multiple regression (REG) approach achieved an average correlation coefficient (r) of 0.50, which increased to 0.60 and percent mean absolute error (%MAE) decreased from 65.42 to 52.24 when back-propagation neural network (BPNN) was used. With generalized regression neural network (GRNN), the r increased to 0.70 and %MAE also improved to 46.30, which further increased to r = 0.77 and %MAE = 36.66 when support vector machine (SVM) based method was used. Similarly, cross-location validation achieved r = 0.48, 0.56 and 0.66 using REG, BPNN and GRNN respectively, with their corresponding %MAE as 77.54, 66.11 and 58.26. The SVM-based method outperformed all the three approaches by further increasing r to 0.74 with improvement in %MAE to 44.12. Overall, this SVM-based prediction approach will open new vistas in the area of forecasting plant diseases of various crops.Our case study demonstrated that SVM is better than existing machine learning techniques and conventional REG approaches in forecasting plant diseases. In this direction, we have also developed a SVM-based web server for rice blast prediction, a first of its kind worldwide, which can help the plant science community and farmers in their decision making process. The server is freely available at http://www.imtech.res.in/raghava/rbpred/ webcite.Weather-based forecasting systems reduce the cost of production by optimizing the timing and frequency of application of control measures and ensures operator, consumer and environmental safety by reducing chemical usage. A major aim of many forecasting systems is to reduce fungicide use, and accurate prediction is important to synchronize the use of disease control measures to avoid crop losses [1]. A prediction model based on the rela
Improper tube fixation causing a leaky cuff
Gupta Babita,Farooque Kamran,Jain Divya,Kapoor Rakesh
Journal of Emergencies, Trauma and Shock , 2010,
Abstract: Leaking endotracheal tube cuffs are common problems in intensive care units. We report a case wherein the inflation tube was damaged by the adhesive plaster used for tube fixation and resulted in leaking endotracheal tube cuff. We also give some suggestions regarding the tube fixation and some remedial measures for damaged inflation system.
KTP laser photoselective vaporization of the prostate: an initial experience
Vikas Kumar,Rakesh Kapoor,Anand Dharaskar,Aneesh Srivastava
Turkish Journal of Urology , 2011,
Abstract: Objective: To review the initial experience of potassium-titanyl-phosphate (KTP) laser photoselective vaporization of the prostate (PVP). Materials and methods: Thirty patients with benign prostatic enlargement who underwent PVP at our institution between March 2007 and June 2009 were prospectively analyzed. The efficacy of the procedure was assessed using the International Prostate Symptom Score (IPSS), Quality of Life (QoL) score, maximum flow rate (QMax), and post-void residual volume (PVR) at 3, 6, and 12 months after surgery and then annually thereafter. Operative time, laser energy and fiber use, and any procedural or postoperative complications were noted. Results: Fourteen (47%) patients opted for PVP by choice, and 16 (53%) underwent PVP because they were at high-risk for transurethral resection of the prostate (TURP), KTP laser PVP was successfully performed in all patients without any intraoperative complications. The median prostate volume was 47 g (range 25-136 g). Median operative time, laser energy, and hospital stay were 84 min (range 66-109 min), 126.1 kJ (range 27.6-235.5 kJ), and 2 days (range 1-9 days), respectively. IPSS, QoL score, QMax, and PVR improved from preoperative median values of 22, 04, 09 mL/sec, and 206 mL to 03, 01, 19.7 mL/sec, and 30.5 mL, respectively, postoperatively. No patient required blood transfusion or had TURP syndrome. Urethral stricture developed in only 2 (6.6%) patients in our study. Conclusion: Although the financial cost of laser installation is difficult to justify in developing countries, our initial results demonstrate that KTP laser PVP is a treatment method that can be adopted to treat patients with benign prostatic hyperplasia safely and effectively, especially those patients with significant systemic comorbidities.
Rhhabdomyosarcoma of Head and Neck-A Ten Year Review
Bhavana Rai, Rakesh Kapoor,Sushmita Ghoshal,S.C. Sharma
JK Science : Journal of Medical Education & Research , 2003,
Abstract: Rhabdomyosarcoma is an aggressive malignant skeletal neoplasm arising from embryonalmesenchyme. It accounts for over 50% ofall paediatric soft tissue tumours. It may OCCur in any siteof tile body but the most conUDon sites of tumor occurrence are orbit (12%) and head and neck(16%). Use ofmulti modality approach to treatment, including multidrug chemotherapy, radiotherapyhas resulted lJ1 a dramatIc unprovement in the outlook of affected children. Orbit has long beenrecog~lzed as a favourable site as compared to other head and neck sites due to paucity oflymphaticsand high response rates seen with radiation therapy and chemotherapy. A len year relrospecl;"canalysis of 31 patients of Rhabdomyosarcomas of head and neck was done. The main outcomcmeasures were age, gender, histopathologic type, treatment received ,follow up period. and eventualoutcome. Most ofour patients presented with an advanced stage. A complete responsc of91.6% anel28.2% was seen in orbit and other non orbital head and neck sites respectively. The 5- year diseasefree survival in patients of orbital rhabdomyosarcoma was 83.3%
Primary Extradural Non-Hodgkin's Lymphoma
Rakesh Kapoor, Vinay Kumar, S.C. Sharma
JK Science : Journal of Medical Education & Research , 2006,
Abstract: A 28 years old male presented to our institute with 3 months history of paraparesis with decreased sensationover left foot and loss of bladder and bowel control .The diagnostic work up revealed an extradural massat spinal level L3 L4.Had laminectomy and the tumour was sub totally resected. Histological examinationrevealed non hodgkin's lymphoma. The patient was worked up for disease anywhere else and was confirmedto have primary extra-dural non-hodgkin's lympoma(PENHL). Patient was treated with corticosteroides,adjuvant radiotherapy and chemotherapy. The residual tumour completely disappeared and patient isliving normal healthy life and is walking without support after 9 years of follow-up.
Cutaneous Metastasis: A Rare Clinical Entity
Gaurav Gandotra, Bhavana.Gupta, Rakesh Kapoor, Ashutosh Gupta
JK Science : Journal of Medical Education & Research , 1999,
Abstract: An interesting and rare case of cutaneous metastasis in xiphisternal region is being reported. Thepatient presented with a fungating nodule in xiphisternal region of 3 months duration. The biopsyshowed metastatic carcinomatous deposits (Keratin ising Squamous cell carcinoma). Primary lesionwas later localised in the right lung.
Dosimetric risk estimates of radiation-induced malignancies after intensity modulated radiotherapy
Patil Vijay,Kapoor Rakesh,Chakraborty Santam,Ghoshal Sushmita
Journal of Cancer Research and Therapeutics , 2010,
Abstract: Context: The increasing popularity of intensity-modulated radiotherapy (IMRT) stems from its ability to generate a more conformal plan than hitherto possible with conventional planning. As a result, IMRT is in widespread use across diverse indications. However, the inherent nature of IMRT delivery makes it monitor unit inefficient and leads to increased normal tissue integral dose. This in turn may result in an increased risk of radiation-induced second malignancies. Aim: To calculate the risk of second malignancy post-IMRT. Settings and Design: Observational study in a tertiary care institute. Materials and Methods: Eighteen previously untreated patients with head and neck cancers (n = 10) and prostate cancer (n = 8) were selected. In these patients, selected infield organs around the planning target volume were contoured, viz. brain and thyroid in patients with head and neck cancer and bladder, rectum and small intestine in patients with carcinoma prostate. The estimates of radiation-induced malignancies in these organs and the whole of the body were derived using the concept of Organ Equivalent Dose. Statistical Analysis Used: Descriptive statistics (SPSS version 12). Results: The modal estimated incidence of radiation-induced malignancies was 129.87, 1.4, 0.10, 3.42, 7.789 and 129.85 per 10,000 person-years for the brain, thyroid, bladder, rectum, small intestine and whole body respectively. Conclusions: The estimated risk of radiation-induced malignancies in the thyroid and rectum was similar to the available literature, while the risk for bladder carcinomas was lower than that reported. However, the calculated risk of radiation-induced tumors of the brain was more than that reported with conventional radiation therapy. We propose that estimation of the risk of radiation-induced malignancies should be a part of the plan evaluation process and special care should be taken before using this modality in young patients with benign tumors in the head and neck region.
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