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Background: Cholelithiasis is the most common disease state involving the gallbladder and biliary tree. Approximately 5-15 % patients with gallstones are associated with choledocholithiasis. Hepatobiliary anatomic variations are common and routinely encountered during laparoscopic cholecystectomy. Among all investigations, Magnetic Resonance Cholangiopancreatography (MRCP) showed high accuracy in detecting the choledocholithiasis and hepatobiliary anatomical variations. Role of routine MRCP in patients going for laparoscopic cholecystectomy is controversial. Method: This study was carried out on 68 patients admitted in Geetanjali Medical College and Hospital, Udaipur, Rajasthan in Department of General Surgery from August 2017 to August 2019 with the confirm diagnosis of cholelithiasis and posted for laparoscopic cholecystectomy. All patients underwent MRCP and collected data was analysed. Results: Among 68 patients, dilated CBD was diagnosed in 4 and 13 patients by USG and MRCP respectively. CBD stone was not detected by USG in any patient but MRCP detected CBD stone in 6 patients. All 6 patients with CBD stones had age of > 50 years. Normal course with right lateral insertion of cystic duct was the most common variant and was found in 57 patients in MRCP and 62 patients intraoperatively. Conclusion: MRCP is non-invasive, non-ionizing imaging modality having higher specificity and sensitivity for asymptomatic choledocholithiasis as well as biliary tree anomalies prior to LC. But it is a costly investigation. So its routine use in preoperative evaluation for all patients undergoing for laparoscopic cholecystectomy is advisable in patients having age of > 50 years. [ABSTRACT FROM AUTHOR]

A simple, specific, accurate, precise and reproducible method has been developed and validated for the estimation of bromhexine hydrochloride and enrofloxacin in fixed dose combination using RP-HPLC. The separation was achieved using stationary phase ODS Hypersil C18 column (250 mm x 4.6 mm i.d.) in isocratic mode, with mobile phase containing 0.05 M potassium dihydrogen phosphate buffer (pH 4 by o-phosphoric acid) : methanol: acetonitrile : triethylamine (40:20:40:01), at a flow rate of 1.0mL/min and eluents were monitored at 256 nm. The retention time of enrofloxacin and bromhexine HCl were found to be 3.00 min and 5.1 min respectively. The linearity for bromhexine HCl and enrofloxacin was in the range of 2-15 µg/mL and 20-150 µg/mL, respectively. The method was validated as per ICH guideline. The recoveries of bromhexine HCl and enrofloxacin were found in the range of 99.61-101.65% and 99.52-100.13 %, respectively. The method was successfully applied for the determination of both the drugs in combined dosage form. [ABSTRACT FROM AUTHOR]

A precise and accurate HPTLC method for simultaneous estimation of pioglitazone HCl (PIO) and alogliptin benzoate (ALO) in synthetic mixture has been developed. The stationary phase selected was Pre-coated TLC plates (silica gel G60 - F254 aluminium sheet) and the mobile phase selected was n-butanol : water : acetic acid (6 : 3 :1 V/V/V). The separated spots were densitometrically analyzed in absorbance mode at 270 nm. The Rf value of PIO and ALO were found to be 0.70 and 0.39, respectively. The calibration curve of PIO and ALO were plotted in the range of 400 - 1600 ng/band, which showed the linear correction coefficient (r2) 0.9971 for PIO and 0.998 for ALO, respectively. The stock solutions of both the drugs were subjected to acid and alkali hydrolysis, chemical oxidation, dry heat degradation and photo degradation. The degraded product peaks were well resolved from the pure drug peak with significant difference in their Rf values. Stressed samples were assayed using developed HPTLC method. The method was validated as per ICH guideline Q2 (R1) and applied successfully for determination of both drugs in synthetic mixture. [ABSTRACT FROM AUTHOR]

Oral cancer is caused by chewing and smoking of tobacco. To assess the feasibility of primary prevention of oral cancer, two cohorts were studied in base-line surveys and then followed up annually for 10-yr in Ernakulam district of Kerala state. The intervention cohort consisted of 12212 tobacco users aged 15 yr and over, who were exposed to a concentrated program of education against tobacco use. The control cohort was a non-concurrent cohort of 6075 tobacco users studied using similar methods but with a minimal amount of advice against tobacco use. The stoppage of tobacco use increased and the incidence rate of leukoplakia decreased significantly and substantially in the intervention cohort compared to the control cohort. The decrease in the incidence of leukoplakia was indicative of the decrease in the risk of oral cancer since the two were intimately related. This study demonstrated feasibility of primary prevention of oral cancer. [ABSTRACT FROM AUTHOR]

The occurrence of central papillary atrophy of the tongue among tobacco users, its clinical characteristics and the long term behavior in relation to changes in tobacco use was studied in 182 individuals in Ernakulam district, Kerala, India. Almost all (98%) lesions occurred among bidi smokers. Clinically, about 31% occurred in combination with bidi smoking associated lesions such as palatal erythema (14%), leukoplakia (8%) or both (3%). Histologic evaluation in 12 biopsies using single PAS stained sections showed candidal hyphae in 67%. A 10-yr follow-up (mean: 6.7 yr) of the 182 lesions showed that the regression was highest (87%) among those who stopped their smoking habit and persistence among those who did not reduce or stop their smoking habits. The findings from this study confirm a strong link between bidi smoking and central papillary atrophy of the tongue in rural Indian populations. [ABSTRACT FROM AUTHOR]

Among 50,915 individuals from 4 different states of India, 723 oral leukoplakias were biopsied and examined for the presence of Candida. Histologic sections were stained by hematoxylin-eosin and PAS; 6.8 % of the biopsies showed Candida estimated on the basis of a single PAS stained section. All Candida-positive cases were seen in males. The most striking observation was that out of 325 palatal biopsies in reverse smokers only one Candida-positive case was seen on the palate and none was seen on the labial mucosa out of 33 biopsies. It was surprising that although the number of leukoplakias among tobacco chewers was high, all of the Candida-positive cases, except one, were observed among smokers. Seven (14 %) of the 49 Candida-positive biopsies showed epithelial atypia. No significant association between Candida-positive cases and atypia was found.