Acquired haemophilia A and severe acquired achalasia are both very rare conditions with unknown aetiology. Haemophilia A is a haemorrhagic disease induced by deficiency or malfunction of coagulation factor VIII. Congenital haemophilia is an inherited disease transmitted by the mother through X-linked inheritance and primarily affects males. However, acquired haemophilia A is a serious, sudden-onset, autoimmune disease that affects either sex. In addition, achalasia is a disease of the oesophagus caused by abnormal function of the nerves and muscles. It causes swallowing difficulties due to the inability of the lower oesophageal sphincter to relax during swallowing, leading to dysphagia, regurgitation and chest pain. In this report, we describe the case of a patient with severe, newly diagnosed, acquired haemophilia A with long-standing, recurrent achalasia; the achalasia had recurred 3 times despite complete and proper surgical fixation. Acquired haemophilia A is treated with immunosuppressive therapy. High-dose steroid therapy was administered for 7 months, during which the patient responded well; moreover, the achalasia did not recur for more than 2 years. The response of the achalasia to immunosuppressive therapy suggests that achalasia may be an autoimmune disorder and that there may be an association between both diseases. The findings of the present case suggest that achalasia may favourably respond to steroid therapy as a first-line treatment prior to surgery.

No abstract

No abstract

This work mainly aimed to develop bilayer tablets of drug Metoclopramide HCl and Tramadol HCl with the aid of various polymers such as Guar gum, HPMC, Na CMC and Xanthan gum, either alone or in mixtures. Tablets were ready by instant unleash direct compression and sustained release wet granulation methodology and assessed for numerous physical parameters. The drug unleashes studies were performed exploitation USP equipment sort exploitation zero. 1N HCl and pH scale 6.8 phosphate buffers as dissolution medium. Drug unleash was quicker from Metoclopramide layer and tramadol combination with HPMC, Na CMC, Guargum with Xanthan gum it continuous drug unleash efficiently. The fitting the dissolution approach, initial order, Hixson Crowell and Higuchi, Korsmeyer-Peppas equations were used to analyze the speed and unleash mechanism of Tramadol HCl. Results showed that zero-order unleash Mechanism was followed by F1-F10 formulations. The plots (Higuchi) for all the designs remained rectilinear representing the drug unleash by diffusion controlled. Hixon-Crowell root model showed high r2 price proportion because of hydrophobicity of the gel layer erosion. The discharge configuration, consequences of the in-vitro dissolution information stood fitted to the Korsmeyer-Peppas equation that illustrates the delivery mechanism directs the non fickian transport it confers with a combination of each diffusion and erosion rate delivery. The results concluded that the formulation F10 will improve patient compliance in pain and gastro esophageal reflex and also provides higher wellness management.