An overview on in situ micronization technique – An emerging novel concept in advanced drug delivery

The use of drug powders containing micronized drug particles has been increasing in several pharmaceutical dosage forms to overcome the dissolution and bioavailability problems. Most of the newly developed drugs are poorly water soluble which limits dissolution rate and bioavailability. The dissolution rate can be enhanced by micronization of the drug particles. The properties of the micronized drug substance such as particle size, size distribution, shape, surface properties, and agglomeration behaviour and powder flow are affected by the type of micronization technique used. Mechanical communition, spray drying and supercritical fluid (SCF) technology are the most commonly employed techniques for production of micronized drug particles but the characteristics of the resulting drug product cannot be controlled using these techniques. Hence, a newer technique called in situ micronization is developed in order to overcome the limitations associated with the other techniques. This review summarizes the existing knowledge on in situ micronization techniques. The properties of the resulting drug substance obtained by in situ micronization were also compared.     

Giant neurofibroma arising from the intercostal nerve: a rare case report

Neurofibroma is a benign nerve sheath tumor of the peripheral nervous system. A young male presented with complaints of gradually increasing breathlessness and heaviness on the right side of the chest, and percussion notes over the chest were impaired all over the right lung fields except the basal zone. Contrast-enhanced computed tomography scan of the thorax revealed a large heterogeneous mass occupying most of the right hemithorax. Intraoperatively, the huge mass measuring about 18 cm?×?13 cm?×?12 cm was seemed to arise from the right fourth intercostal space. Histopathology revealed a neurofibroma. Giant intrathoracic neurofibroma is very uncommon and its malignant potential should be evaluated.     

Anatomical Variations of the Profunda Femoris Artery and Its Branches—A Cadaveric Study in South Indian Population

The variations of the profunda and its branches are numerous, and, to a considerable extent, largely associated with one another. In occlusion of the Superficial femoral artery, the profunda femoris artery forms an effective collateral bed between the ileo-femoral segment and the popliteal artery and its branches. This study based on dissections performed on 40 properly embalmed human cadaver specimens. The position, source and the point of origin of the profunda and its circumflex branches were studied and compared with earlier literature. We found that profunda femoris was originated from the posterolateral surface of the common femoral artery with a mean distance of 3.56 cms from the midinguinal point. An absence of profunda femoris was noted in one (5 %) case. Medial circumflex femoral artery (in 40 % on right side and 60 % on left side) originated from the profunda femoris; whereas in 50 % on right and 35 % on left side, it begins from the femoral artery. On the otherhand, the lateral circumflex femoral in 80 % on right and 70 % on left sides sprungs from profunda femoris with 20 % and 25 % from common femoral arteries of right and left limb specimens respectively. Knowledge of variations in profunda femoris and its branches helps surgeons during preoperative clinical evaluation for surgical and interventional revascularization of the ileo-femoral and femoro-popliteal segments, in open canulation of femoral artery for cardiopulmonary bypasss, in radiological interventions for A-V malformations, and in salvage operations for traumatic limb ischemia.     

Gangrene in Takayasu’s arteritis: a report of two cases and review of literature

Takayasu’s arteritis (TA) is a granulomatous large vessel vasculitis more commonly seen in India. The vascular inflammation in TA results in stenoses of affected vessels. Usually this is a slow process with good collateral circulation; only rarely does critical limb ischemia result. We present two patients of TA who presented with gangrene of extremities, and review eight prior such patients reported in the literature. With appropriate diagnosis and treatment with oral corticosteroids and low-dose aspirin, none of our patients had recurrence at a mean follow-up of 3.8 ± 2.8 years. Although rare, TA can present with gangrene and rheumatologists need to be aware of this unusual but limb-threatening manifestation of TA to institute appropriate therapy in a timely manner.     

Role of 18F‐FDOPA PET/CT imaging in endocrinology

¹⁸F‐FDOPA (6‐[18F]‐L‐fluoro‐L‐3, 4‐dihydroxyphenylalanine)‐based PET/CT imaging can be a useful tool for the detection of different neuroendocrine tumours (NETs). ¹⁸F‐FDOPA is taken up into the cells via the neutral amino acid transporter (LAT1/4F2hc). This transporter is also coupled to the mammalian target of rapamycin (mTOR) signalling pathway. ¹⁸F‐FDOPA PET/CT may be performed for confirmation of diagnosis of pheochromocytoma/paraganglioma, staging at initial presentation, restaging and follow‐up of patients. In SDHx‐related syndromes, ¹⁸F‐FDG PET/CT should be performed in addition to ¹⁸F‐FDOPA PET/CT. ¹⁸F‐FDOPA PET/CT is also invaluable in the detection staging/restaging of carcinoid tumours and has greater sensitivity as compared to somatostatin receptor scintigraphy. ¹⁸F‐FDOPA PET/CT can also distinguish between focal vs diffuse CHI. It is not as useful in adult hyperinsulinism due to increased background uptake, but the problem may be overcome with the help of premedication with carbidopa. It has limited use in pancreatic NETs. ¹⁸F‐FDOPA PET/CT is a good modality for detection of persistent and residual medullary thyroid cancer (MTC), but ¹⁸F‐FDG PET/CT may be needed in aggressive tumours. In summary, F‐DOPA PET/CT has widespread utility in the diagnosis of different neuroendocrine tumours.     

Primary retroperitoneal malignant melanoma: A case report

Primary malignant melanoma occurring at an extra cutaneous site is rare. A case of primary malignant melanoma located in the retroperitoneum of an 18-year-old female is presented in this study. Histopathological examination of the tissue biopsies at laparotomy with immunohistochemical stains confirmed a diagnosis of malignant melanoma. Further extensive clinical and radiological investigations proved the retroperitoneum to be the primary site.