Screening of Sacrificial Excipients for Arresting Devitrification of Itraconazole from Solid Dispersion.

OBJECTIVES: The aim of the present investigation was to develop a solid dispersion of itraconazole (ITR) using sacrificial excipients like pregelatinized starch and spray-dried lactose alongside hydroxypropyl methylcellulose and Poloxamer 188, thereby arresting the conversion of the amorphous form of ITR to crystalline form, and to assess the dissolution stability of an amorphous form of the drug during short-term storage. MATERIALS AND METHODS: ITR-loaded solid dispersions were prepared by kneading. Formulation optimization was achieved by using a 24 full factorial design on the basis of cumulative percent drug released at t30, t60, and t120 min. An artificial neural network (ANN) was also applied as a statistical tool for obtaining better predictive ability and the outcomes of the ANN were compared with that of Design-Expert software. RESULTS: The spectral data revealed no drug-carrier interactions. The P-X-ray diffraction study of the optimized batch showed a decrease in the crystallinity of drug as compared to the untreated drug. The in vitro dissolution studies of the optimized batch showed higher dissolution (92% at 120 min) in comparison to the other formulations. The dissolution stability study was performed at 40°C and 75% relative humidity for 90 days for the optimized formulation. The results of the optimized batch showed insignificant changes in cumulative percentage drug release during storage. CONCLUSION: Dissolution stability could be attributed to the presence of sacrificial excipients as they tend to absorb moisture during storage and possibly get converted into crystalline form, thereby minimizing the recrystallization of ITR.

Sonography of female genital hernias presenting as labia majora masses.

Inguinal herniation of the ovary or uterus presenting as a labia majora mass is a rare congenital condition that may be complicated by strangulation, torsion, and infertility. A labial mass in a prepubertal female patient can represent an inguinal hernia, a hydrocele of the canal of Nuck, a congenital labial cyst, leiomyoma, an abscess, lipoma, or lymphangioma. With a large differential diagnosis and an often limited physical examination, imaging plays an importance diagnostic role. We present 3 cases in which a labial mass contained an ovary alone and both ovaries and the uterus. We demonstrate sonographic findings and discuss the utility of sonography in the diagnosis of genital hernias and in detecting potential complications.

Primary renal candidiasis: importance of imaging and clinical history in diagnosis and management.

OBJECTIVE: Primary renal candidiasis is rare but increasing in incidence. The purpose of this series is to provide imaging and clinical findings for diagnosing candidiasis and to discuss imaging in the management of this disease. METHODS: Ten sonographic, 8 retrograde pyelographic, 2 intravenous pyelographic, 2 antegrade pyelographic, and 2 computed tomographic examinations of 5 patients (4 adult male patients and 1 16-year-old female patient) were reviewed. RESULTS: The clinical presentation was variable. Sonography showed renal pelvic wall thickening (n = 5), echogenic debris (n = 4), and fungus balls (n = 2). Papillary necrosis (n = 4), filling defects due to debris (n = 3), and fungus balls (n = 2) were seen on retrograde pyelography. CONCLUSIONS: Untreated candidiasis may progress to fungus ball or abscess formation. Sonography is commonly used as the initial imaging procedure. Retrograde and antegrade pyelography are used for biopsy, diagnosis, and treatment. Awareness of this condition and knowledgeable imaging evaluation can help detect and define the site, infection severity, and subsequent therapy.