The advent of high-speed tableting and slug capsule-filling machines has ushered in an increasingly important role for the lubricants to enact during manufacturing of dosage forms. Although lubricants help in processing, they can also adversely affect the flow properties and dissolution profile of the drug. It is thus critical to maintain a balance between these two behaviors, by understanding the underlying mechanisms and using their optimum concentration in the formulation. The source and manufacturing process inculcate different solid-state properties to magnesium stearate, the most commonly used lubricant, leading to variations in its lubrication efficacy. However, there has been no complete study relating the lubrication efficacy of magnesium stearate to various levels of solid state. Hence, this study was aimed at comprehensively scrutinizing the role of molecular, particle, and bulk level properties of solid state on the lubrication efficacy of magnesium stearate. A method based on net work done during compression using texture analyzer, was developed and validated to analyze its performance. Particle and bulk-level properties were studied using microscopy, particle size analysis, and particle surface area determination, and molecular level was characterized using thermal, spectroscopic, and crystallographic methods. Interplay of solid-state characteristics such as particle size, degree of agglomeration, and crystal habit were found to markedly influence the lubrication potential of magnesium stearate.

Introduction: The objective components of chronic rhinosinusitis (CRS) diagnosis require confirmatory findings from either diagnostic nasal endoscopy (DNE) or a computed tomography (CT) scan. Chronic rhinosinusitis affects a significant population worldwide, imposing a huge toll on the human economy as well as on quality of life. Thus, it is particularly important to define a cost-effective and easily available diagnostic tool for it. Hence, we have conducted this study with the aim of assessing the effectiveness of DNE in comparison with CT for evaluating CRS. Material and Methods: Eighty participants fulfilling the diagnostic symptom criteria of CRS underwent CTs of their noses and paranasal sinuses (PNS) and DNE. Standard Lund–Mackay and Lund–Kennedy scores were awarded to all participants based on the CT and DNE. A comparative analysis was done. Results: DNE in comparison to CT had 92.31% sensitivity, 73.33% specificity, 93.75% positive predictive value, 68.75% negative predictive value, and 88.75% diagnostic accuracy. Conclusion: We suggest that nasal endoscopy be used as an early diagnostic tool in the clinical assessment of suspected CRS patients (based on the diagnostic symptom criteria). DNE helps to decrease the usage of CT, thereby decreasing cost and radiation exposure. Computed tomography may be added for patients having anatomical defects (affecting endoscopic visualization) or refractory disease, and where surgery has been planned.

Purpose To evaluate the prevalence of arterial changes in patients with acute pancreatitis (AP) on computed tomography angiography (CTA) and determine their association with etiology of AP, presence of necrosis, collections and severity of AP. Materials and Methods A total of 50 patients (20 women, 30 men; mean age: 43.04 ± 13.98; age range: 18–77 years) with AP underwent contrast-enhanced computed tomography (CECT) scan and CTA of abdomen, which was evaluated for necrosis and fluid collection (s). On CTA, splanchnic arterial structures were assessed for vascular complications. Association between vascular changes and presence of necrosis, fluid collections, etiology of AP and severity of AP (as assessed by modified computed tomography severity index CTSI) was determined. Results Arterial complications were seen in 28 percent (14/50). The most frequently involved artery was superior pancreaticoduodenal artery (12 percent), followed by splenic artery (8 percent) and right gastric artery (8 percent; Fig. 1). No significant association was seen between arterial changes and gallstone or alcohol-induced AP. Arterial changes showed a significant association with presence of acute necrotizing pancreatitis (ANP), presence of collections and severe AP (CTSI 8–10) (p < 0.05 for each). Conclusion Arterial changes on CTA are frequently seen in patients of AP having ANP. There is a significant association between arterial changes and presence of necrosis, collections and severe AP.

COVID-19 is a global healthcare pandemic that is now growing through nations across the world. The role of radiology is crucial, and a variety of guidelines have been published regarding the role of imaging. These aim to protect healthcare workers (HCWs) and the general public from exposure, while preserving critical radiology operations and conserving personal protective equipment (PPE) and other critical care resources during the COVID-19 pandemic. Fleischner Society published guidelines on indications of imaging various settings. These guidelines take into account resource availability, pre-test probability, degree of symptoms and risk factors, which is crucial for decision-making regarding need and indications of imaging. Mitigating steps and alternative approaches should be considered to provide the best care for patients while protecting all HCWs. Owing to overlap of COVID-19 imaging findings with other pathologies, standardized reporting acquires importance for risk assessment and effective communication of suspicious findings. RSNA followed by Dutch Radiological Society (NVvR) have published guidelines on standardized CT reporting for COVID-19, which show excellent inter-observer variability. Standardized reporting can provide guidance and confidence to radiologists as well as increased clarity to physicians through reduced reporting variability. The article discusses the published recommendations and aims to make radiologists aware of the protocols and guidelines that need to be followed in this ongoing public health crisis for effective patient care while protecting HCWs and conserving resources.

Computed tomography (CT) scans are often used for postoperative imaging in orthopedics. In the presence of metallic hardware, artifacts are generated, which can hamper visualization of the CT images, and also render the study ineffective for 3-D printing. Various solutions are available to minimize metal artifacts, and radiologists can employ these before or after processing the CT study. However, the orthopedic surgeon may be faced with situations where the metal artifacts were not addressed. To counter such problems, we present three do-it-yourself (DIY) techniques that can be used to manage metal artifacts.

A fall on outstretched hand is most common mechanism for causing fracture of distal radius. The majority of factures in the elderly are extra-articular, whereas there is much higher incidence of intraarticular fracture in younger patients. In the present study 50 patients were included with unstable distal end radius fractures, in which 25 cases were managed with percutaneous pinning and 25 cases were managed by open reduction and internal fixation with volar plating. Patients were evaluated clinically and radiologically. The results were graded according to Green and O'brain score and comparison was done according to the union and functional outcome in individual cases. In our study we found that fracture of distal radius managed either with volar locking plate or by percutaneous pinning with k-wire fixation had empowering results.

Case: We present a case of a 6-year-old male child with ipsilateral proximal and distal physeal separation of humerus with subperiosteal extrusion after manipulation by a bonesetter. Treatment included open reduction and internal fixation with Kirschner wire proximally and distally. At 1.5-year follow-up, the child had a shortening of 0.5 cm, no pain, and/or no instability. Conclusion: Manipulation by bonesetters, a commonplace in developing countries, can produce unpredictable complications and compromise outcomes. Although accepted in certain settings, the regional orthopaedic surgeons should be mindful of the unique clinical challenges imposed by such a practice.

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