Objective: Clinical studies suggest that the thyroid autoantibodies and/or hypothyroidism are not present in Turner’s syndrome (TS) patients before the age of 8 years and are more frequent in patients with the X isochromosome. The aim of the study was to analyze the dynamics of thyroid dysfunction in girls with TS. Design: 86 TS patients with a median age of 10.6 years were followed for 4.6 ± 3.0 years. Outcomes: The prevalence of thyroid abnormalities increased from 25.5 to 50% during the follow-up. Finally, 31 (36%) patients had positive thyroid autoantibodies and 27 (31.4%) had subclinical hypothyroidism. Hashimoto’s thyroiditis was diagnosed in 15 patients. Median age of developing thyroid antibodies and subclinical hypothyroidism was 14.1 and 14.8 years, respectively. The youngest hypothyroid patient was 1.8 years old and the youngest girl with positive anti-thyroid antibodies was 5.5 years old. Autoantibodies appeared mainly after the age of 13. The risk of developing subclinical hypothyroidism was greatest between 12 and 14 years of age. The prevalence of thyroid abnormalities was not related to the karyotype. Conclusions: Thyroid autoimmunity and dysfunctions in TS may start early, their prevalence increases with age, independently of karyotype and without any clinical symptoms and signs.

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Background: Laryngeal Mask Airway (LMA) is a useful advent in the airway management, filling a niche between the face mask and the tracheal tube in terms of both the anatomical position and the degree of invasiveness. Propofol is an intravenous anesthetic agent which depresses both laryngeal and pharyngeal reflexes and provides profound relaxation of pharyngeal muscles. Incidences of gagging coughing, laryngospasm are less while using propofol than thiopentone. Sevoflurane is pleasant smelling, non-irritating to the airway, has a low blood gas solubility coefficient, good muscle relaxant effect, and high inspired concentration can be given without side effects or discomfort. It allows rapid smooth inhalation induction with excellent recovery characteristics. Objective: To compare the quality of the condition provided for successful LMA insertion by sevoflurane induction with propofol induction methods. Materials and Methods: Study was carried out in 100 patients at the New Civil Hospital, Surat. Patients were randomly divided into 2 groups comprising of 50 patients each. In Group-P induction with propofol 3 mg/kg intravenously over 30 seconds and in GroupS induction have done with inhalational sevoflurane 8% and nitrous oxide 50% in oxygen. Results: The mean pulse rate before induction in Group-P was 79.92±9.18 beats/min and in GroupS it was 80.96±10.11 beats/min, p>0.05. Following LMA insertion the mean pulse rate increased in both the groups. However, the mean pulse rate did not differ significantly between the groups at any time following LMA insertion, p>0.05. The mean systolic blood pressure before induction in Group-P was 119.92±9.44 mmHg and in GroupS it was 118.40±8.60 mmHg, p>0.05. Comparing the 2 groups, this difference was insignificant. Following LMA insertion the mean systolic blood pressure decreased but mean systolic blood pressure did not differ significantly on comparing both groups at any time following LMA insertion, p>0.05. The mean SPO 2 % at baseline in Group-P was 99.54±0.89% and in GroupS it was 99.72±12.7%, p>0.05. The mean time for cessation of verbal communication in Group-P was 32.9±7.07 seconds and in GroupS , it was 33.7±5.13 seconds. The mean time to successful LMA insertion in Group-P was 79.4±27.63 seconds and in GroupS , it was 128.5±19.46 seconds, p<0.001. Comparing the groups, the difference between both the groups was highly statistically significant. The mean time to successful LMA insertion was faster in Group-P compared to GroupS. In Group-P, in 40 (80%) patients, LMA insertion was done in the first attempt within the mean time of 68.12±12.14 seconds while in GroupS , in 32 (64%) patients, LMA was inserted in the first attempt within the mean time of 117.6±14.41 seconds. Comparing both groups, this difference was highly significant p<0.001. The second attempt was required in 8 (16%) patients in Group-P with the mean time of LMA insertion of 120.6 seconds compared to in 14 (28%) patients in GroupS with a mean time of LMA insertion of 143 seconds while comparing both the grou...

Background: Solubility is an important parameter that affects availability of drug in systemic circulation. Drugs having poor solubility belonging to BCS class II eventually results in lower dissolution and bioavailability. Hence, improvement of solubility is a challenging task. Hence the present work focusses on using solid dispersion and inclusion complex approach for both telmisartan and cilostazol belonging to BCS Class II drugs. Objective: The present study was carried out to improve apparent solubility of telmisartan and cilostazol (BCS-Class II drugs) and optimization as pellets along with its pharmacokinetic study. Methods: Phase solubility study was carried out to screen the excipients such as, PVPK30, PVA, HPMC E5 and β-CD. Solvent evaporation method was adopted to prepare the solid dispersions and inclusion complex of both the drugs. Pellets were optimized by extrusion spheronization method using 32 factorial design and characterized by morphology, drug content, DSC, FTIR, XRD, SEM, in-vitro studies and drug content study Results: Phase solubility study showed improved apparent solubility of telmisartan with HPMC E5 (1:3) by solid dispersion and cilostazol with β-CD (1:3) using inclusion complexation method. Drug characterization did not reveal any incompatibility. Formulation was optimized on the basis of acceptable pellet properties, including acceptable spherical shape and micromeritics properties. The percent friability of all batches was found to be less than 1%. The optimized pellets of both drugs prepared with micro crystalline cellulose provided desirable maximum release with acceptable release profile. Conclusion: The formulated pellets when studied in vivo showed superior pharmacokinetic profile. The drawback associated with apparent solubility and bioavailability of both drugs can thus be alleviated by use of novel pellet formulation.