International Journal of Health and Clinical Research

Comprehensive review on quality by design in fast dissolving tablets

2026-03-03T07:28:56+00:00

Fast-disintegrating tablets (FDT), also known as orally disintegrating tablets (ODT), are innovative oral dosage forms designed to quickly disintegrate in the mouth without the need for water, providing an effective solution for patients with swallowing difficulties, including pediatricians, geriatricians, and patients with dysphagia. It is preferred over traditional tablets due to its rapid disintegration, improved taste, and increased patient compliance. However, due to their fragile structure, high porosity, and sensitivity to humidity, FDTs require precise design strategies to ensure optimal performance, safety, and stability. Quality by Design (QbD), as described in the ICH guidelines, provides a systematic and scientific approach to developing reliable FDT formulations. QbD includes defining a quality target product profile (QTPP), defining critical quality attributes (CQAs), critical material attributes (CMAs), and critical process parameters (CPPs), and creating a design space to ensure consistent product quality. Through risk assessment and design of experiments (DoE), manufacturers can optimize formulation parameters such as superdisintegrants, binders, porosity, and compressive strength to achieve the desired balance between rapid disintegration and mechanical strength. Control strategies that include raw material evaluation, in-process monitoring, humidity control, and final product testing further improve product reliability. Case studies show that the QbD approach significantly improves the solubility, stability, and bioavailability of FDT. Overall, QbD enables efficient and cost-effective development of high-quality FDTs, ensuring compliance with regulatory requirements and improving patient outcomes.

A cross-sectional study to evaluate the correlation of covid-19 infection with avascular necrosis of hip joint

2026-03-03T08:13:10+00:00

Background: Avascular necrosis (AVN) of the hip is a progressive and disabling condition resulting from compromised blood supply to the femoral head. During the COVID-19 pandemic, increasing reports of post-COVID musculoskeletal complications have raised concern regarding a possible association between SARS-CoV-2 infection and AVN, particularly in the setting of corticosteroid use and COVID-19–related vascular injury. However, available evidence remains limited, especially from the Indian population. The present study aimed to evaluate the correlation between prior COVID-19 infection and avascular necrosis of the hip joint and to analyze demographic characteristics, disease severity, steroid exposure, and time to onset in a tertiary care setting.Methods: This cross-sectional observational study was conducted in the Department of Orthopaedics at a tertiary care center over one year. Sixty patients diagnosed with idiopathic AVN of the hip were included. Clinical history focusing on COVID-19 infection, steroid therapy, and symptom onset was recorded. Radiological assessment using X-ray and MRI was performed, and AVN was graded using the Ficat and Arlet classification. Data were analyzed using descriptive statistics.Results: The mean age of patients was 38.78 ± 10.58 years, with a male predominance of 75%. Grade 2 AVN was the most common stage (40%), followed by Grade 3 (30%) and Grade 4 (26.7%). Bilateral hip involvement was observed in 61.7% of cases. Twenty patients (33.3%) had a history of COVID-19 infection, among whom Grade 2 and Grade 3 AVN predominated. Only 35% of COVID-19–positive patients had documented steroid exposure. The mean interval between COVID-19 infection and AVN onset was 6.53 months.Conclusion: The study suggests a possible association between COVID-19 infection and AVN of the hip, with evidence supporting a multifactorial pathogenesis beyond steroid exposure alone. Long-term surveillance and early evaluation of hip symptoms in post-COVID patients are essential.

Orodispersible Delivery Systems for Verapamil Hydrochloride

2026-03-05T05:04:20+00:00

Verapamil Hydrochloride, a Class IV calcium channel antagonist, is a primary intervention for hypertension and arrhythmias. However, its clinical efficacy is restricted by a significant first-pass effect, yielding only 10%-20% systemic bioavailability. To overcome these pharmacokinetic barriers and address patient non-compliance due to dysphagia, Orodispersible Tablets (ODTs) have been developed as a high-performance alternative. This review explores the engineering of ODTs designed to liquefy instantly in the oral cavity. Success depends on the strategic use of superdisintegrants like Crospovidone and sublimation agents (e.g., camphor) to create a highly porous internal architecture. These methods facilitate rapid wicking and capillary action, often ensuring disintegration in under 30 seconds. Beyond convenience, the ODT platform offers a potential "shunt" for drug molecules to be absorbed via the pregastric mucosa, partially bypassing hepatic degradation.
Current research highlights the move toward natural polymers and factorial design optimization to balance mechanical durability with rapid dissolution. By masking the drug’s inherent bitterness through ion-exchange resins or complexation, ODTs provide a seamless, water-free delivery system. This technology represents a vital advancement in cardiovascular pharmacotherapy, ensuring rapid onset and enhanced patient-centric care.

A comprehensive review on Breast Cancer

2026-03-13T15:47:35+00:00

Breast cancer has been recognized since ancient times, with early descriptions found in Egyptian and Greek medical texts. From rudimentary surgical techniques to sophisticated diagnostic and treatment methods, knowledge of this illness has developed over centuries. Due to a variety of factors, including age, hormonal exposure, genetics, and lifestyle, breast cancer is still the most common cancer among women worldwide. Surgery, radiation, chemotherapy, hormone therapy, and targeted biological agents—which are chosen based on the type and stage of the tumour—are all part of modern treatment. Results are significantly improved by early detection. Significant differences still exist between nations with varying socioeconomic statuses despite global advancements. Reducing mortality and guaranteeing fair access to care require ongoing research, better health systems, and awareness campaigns. Although breast cancer is still a significant public health concern, survival rates are improving with prompt and thorough treatment. Early references to breast cancer can be found in Egyptian and Greek medical texts, indicating that the disease is widespread and has been known since antiquity. From simple surgical excisions to sophisticated, multimodality care involving surgery, radiotherapy, chemotherapy, hormone therapy, and targeted biological agents, treatment has changed over centuries. Despite these developments, a variety of risk factors, including age, hormonal exposure, genetics, and lifestyle, continue to make breast cancer the most common cancer among women worldwide. An estimated 2.3 million new cases and 670,000 deaths were reported globally in 2022. Survival rates are greatly increased by early detection through screening and prompt, individualised treatment, but significant differences still exist between countries. Strong health systems in high-socioeconomic nations reduce mortality, while low- and middle-income areas are disproportionately affected by delayed diagnosis and restricted access to care. The urgent need for scalable public health interventions, improved referral systems, and fair access to high-quality cancer services is highlighted by the global mortality gap. Millions of lives could be saved by initiatives to improve treatment pathways and increase early diagnosis under the World Health Organization's Global Breast Cancer Initiative. Without such action, estimates point to a 68% increase in deaths and a nearly 38% increase in annual cases of breast cancer by 2050, with low-HDI countries being disproportionately affected. In conclusion, breast cancer continues to be a significant global public health concern despite advancements in treatment and survival; lowering mortality will necessitate ongoing funding, raising awareness, and bolstering the health system.