Osmania University is a collegiate public state university located in Hyderabad, Telangana, India. The university was founded by and named after Mir Osman Ali Khan, the 7th Nizam of Hyderabad in 1918. It is the third oldest university in southern India, and the first to be established in the erstwhile Kingdom of Hyderabad. It was the first Indian university to have Urdu as a medium of instruction — but with English as a compulsory subject. As of 2012, the university hosts 3,700 international students from more than 80 nations.The O.U. is one of the largest university systems in the world with over 300,000 students on its campuses and affiliated colleges. The Osmania Medical College was once a part of the O.U. System. However, it is now under the supervision of Kaloji Narayana Rao University of Health Sciences.U.
Background: Apixaban is a factor Xa inhibitor, an anticoagulant; that exhibits low oral bioavailability (around 50%) as a result of its extensive first-pass metabolism, which highlights the need for improved delivery methods. Aim: This research is carried out to formulate and evaluate a bilayered buccal tablet formulation of Apixaban that adheres to mucosal surfaces. Materials and Methods: Apixaban was obtained from (NATCO Pharma Limited-Chemical Division, Hyderabad); The specified qualities were achieved in formulations (F1 to F9) by varying the amounts of polymers such as sodium alginate, hydroxypropyl methylcellulose (HPMC K4M), and Carbopol (934p). To make mucoadhesive bilayered buccal tablets, the direct compression method was employed. Tablets were evaluated for physicochemical properties (thickness, weight, hardness, drug content), mucoadhesive strength, in vitro drug release, and stability. Fourier-Transform Infrared (FTIR) spectroscopy assessed drug-excipient compatibility. Results: The optimized formulation (F7), with its 20 mg of Carbopol, was emerged from a series of testing. Excellent drug uniformity (approximately 99%), and strong adhesive properties. Drug release testing showed nearly 88% release within 180 minutes, following the first-order and Higuchi diffusion model (R² = 0.9904). FTIR confirmed no drug-excipient interactions, and stability studies at 40 °C / 75 % RH demonstrated physical and chemical integrity over three months. Conclusion: The formulated buccal mucoadhesive bilayer tablets provide a potentially effective, non-invasive route for apixaban administration that circumvents hepatic metabolism and enhance bioavailability. Keywords: Apixaban, Bilayered Buccal Tablet, Mucoadhesion, Direct compression method, Carbopol.
Refractory hypertension (RfHTN) presents a challenge in managing patients with chronic kidney disease (CKD) and undergoing maintenance haemodialysis (MHD). Hypertension exacerbates kidney function loss and adversely impacts CKD patients' quality of life. In order to enhance the quality of life for patients with stage-V chronic kidney disease (CKD) receiving maintenance hemodialysis, the study set out to detect, define, and treat refractory hypertension (RfHTN). A six-month prospective observational study was carried out at a tertiary care hospital's outpatient dialysis unit. Patients with CKD on MHD and uncontrolled blood pressure (BP) despite ≥5 antihypertensive medications were enrolled. BP monitoring pre- and post-dialysis was performed thrice weekly. The effect of antihypertensive agents was evaluated using symptom frequency, target BP, medication adherence (MMAS-8 Score), kidney disease quality of life (KDQOL-36 score), and adverse effects monitoring. 50 participants were enrolled, with a higher percentage of male patients (60%). Significant differences in systolic BP and pulse rate were observed pre and post-dialysis. In our research, approximately 48% of the participants fell within the adult age range (25 to 65 years), while only 2% were classified as elderly, aged (65 years and above). In the BMI distribution, a significant portion of patients showed diverse weight categories: 18% were underweight, 64% fell within the normal weight range, 16% were overweight, and 2% were classified as obese.A notable variation in hemoglobin levels across all patients was reported, which might contribute to poor kidney function and challenges in managing blood pressure among them. A significant contrast was noted in the MMAS-8 score between the initial evaluation and the subsequent follow-up assessments. a significant variance was noted in the MMAS-8 score between the initial and follow-up evaluations. Medication adherence was found to correlate with improved BP control. Higher KDQOL-36 scores indicated better health-related quality of life. In managing hypertension in MHD patients, angiotensin II receptor blockers (ARBs) proved effective, alongside dietary salt restrictions and appropriate diuretic therapy. Hypertensive MHD patients face increased cardiovascular and renal risks, emphasizing the importance of maintaining normal BP.
Pre-surgical hyperglycemia has been linked to postoperative complications after surgical procedures. Recent research has shown that hyperglycemia plays a key role in creating postoperative complications. Therefore, HbA1C was highly targeted to determine whether it was an independent factor affecting postoperative complications and associated diseases. However, the target glucose level remains unclear to prevent problems due to abnormal glucose levels. To study pre-operative hyperglycemia with the risk of development of postoperative complications in diabetic patients undergoing elective surgeries by conducting a prospective observational study. 80 patients undergoing a variety of general elective surgical procedures were taken into the study and followed for about 30 days post-surgery for any possible complications. Their Random Blood Sugar (RBS) values were taken preoperatively and postoperatively every 8 hours. And the HbA1C values of the patients were noted before the surgery. The study's primary endpoints were the incidence of surgical site infections (SSIs), Delayed Wound Healing (DWH), Pain, and Septic shock. Out of 80 patients, 19 developed hyperglycemia (prevalence = 23.75%). In normoglycemic patients, the infection rate was 15% (6/40) compared to 35% (14/40) in preoperative hyperglycaemic groups. Post-surgical infections are usually common and are expensive. It is a burden to the people who have poor economic status. Chronic abnormal levels of blood glucose in the body impair the healing process of the wound (here, surgical incision) thereby leading to complications. The occurrence of Postoperative complications in diabetic patients is multifactorial. Our study demonstrated an association between the pre-operative glucose control indicated by HbA1C and post-operative complications. However, the size of the sample is the major limitation of this study. The impact of long-term glycemic control and its variation on any postoperative complications could be considered by conducting more efficient studies in the future taking a larger sample size.
Background: Cardiovascular diseases (CVD) are influenced by various established risk factors, including the ratio of neutrophils to lymphocytes and platelets, which has been shown to be an independent risk factor for acute coronary syndrome (ACS).This study aims to create a new scoring system called TANGENTS that utilizes discrete parameters of risk factors and diagnostic parameters to analyze the outcome of coronary artery disease (CAD) patients with comorbidities, particularly Type 2 diabetes mellitus (T2DM). Methods:We included 151 subjects (mean age 57.92 ± 23.86) who presented with ST-elevation and STdepression on admission and were treated with heparin, clopidogrel, aspirin, and atorvastatin while undergoing all the necessary diagnostic tests.We obtained ECG and complete blood picture (CBP) results on admission, day 3, and day of discharge.Results: ST-depression on ECG on day-1 was 0.35 and decreased to 0.30 on the day of discharge.ST-elevation on ECG on day-1 was -0.89 and decreased to -0.16 on the day of discharge.The average neutrophil-tolymphocyte ratio (NPR) was 0.49, which was high in 144 patients.The mean NLR value was 5.52, indicating a correlation between high NLR values and the magnitude of current injury on admission. Conclusion:The TANGENTS scoring system can be used as an early evaluation tool for CAD patients with comorbidities to manage and prevent further complications.It allows for progressive differentiation in the severity of clinical outcomes using all the parameters of the score, and the parameters creating the TANGENTS score scale were found to be reliable.
Objective: MUCIN4 (MUC4) glycosylation is linked to the oncogenesis and progression of a neoplastic process. It can suggest information pertaining to tumor progression, management and its natural properties. Thus, MUC4 can play a pivotal role in prognostic diagnosis. This study aimed to analyze the MUC4 expression in oral cell squamous carcinoma and oral dysplastic epithelium. Materials and Methods: The research included 45 samples of oral epithelial dysplasia (OED) and 45 cases of oral squamous cell carcinoma (OSCC). In order to carry out the investigation, tissue blocks of previously diagnosed cases of OED and OSCC were retrieved from the relevant archives. Forty-five OED cases were categorized into three group’s mild, moderate and severe dysplasia, with 15 cases in each respective category. Forty-five OSCC cases were categorized into three groups: well differentiated, moderately differentiated, and poorly differentiated OSCC with 15 cases in each respective category. Ten tissue biopsies of normal oral mucosa were obtained from subjects in the control group. The chi-square test and one-way ANOVA were used for statistical analysis. Result: There was an absence of MUC4 expression in normal mucosa, whereas the OED and OSCC groups had a significant amount of observable variance. Within the OED category of cases, a consistent progression from mild to severe dysplasia was seen in terms of the staining pattern. Cases with severe dysplasia displayed a staining pattern that covered the complete thickness of the tissue in the epithelium. Expression of MUC4 was shown to be lower in moderate differentiated squamous cell carcinoma (MDSCC), and poorly differentiated squamous cell carcinoma (PDSCC) as compared to well differentiated squamous cell carcinoma (WDSCC). It showed decreasing pattern across all grades of OSCC. In WDSCC, an intense highest staining response was noticed, particularly among the cells that are highly differentiated and take the form of a honeycomb pattern. Conclusion: Analysis of the expression profile of MUC4 and the aberrant expression of this gene in OSCC suggests that it may serve as a useful diagnostic marker. Therefore, it is possible to draw the conclusion that MUC4 plays a very significant part in the pathogenesis of OSCC and also acts as a marker that may be taken into consideration for the accurate diagnosis of OED and OSCC.
