Foam Sclerotherapy during Shunt Surgery for Portal Hypertension and Varices

Decompensated portal hypertension complicated by bleeding

Despite the fact that the risk of death from esophagogastric variceal bleeding caused by portal hypertension is highest in patients with gastrointestinal bleeding, the diagnosis and treatment need to be further improved. This study is based on the analysis of scientific and practical data about the diagnosis and treatment of patients with complicated portal hypertension, which allows us to understand the complexity of the pathological process, the causes of unsatisfactory diagnostic and treatment results, and the possibility of providing routine and emergency care. Management of portal hypertension includes prevention of the first bleeding, treatment of acute variceal bleeding, and prevention of recurrent bleeding. The literature review based on sources from PubMed, MEDLINE aims to demonstrate the methods of diagnosing and treating bleeding from the esophageal and gastric veins in medical institutions with different levels of capacity.

Quality by Design Perspective for Designing Foam-based Formulation: Current State of Art

Foam-based delivery systems contain one or more active ingredients and dispersed solid or liquid components that transform into gaseous form when the valve is actuated. Foams are an attractive and effective delivery approach for medical, cosmetic, and pharmaceutical uses. The foams-based delivery systems are gaining attention due to ease of application as they allow direct application onto the affected area of skin without using any applicator or finger, hence increasing the compliance and satisfaction of the patients. In order to develop foam-based delivery systems with desired qualities, it is vital to understand which type of material and process parameters impact the quality features of foams and which methodologies may be utilized to investigate foams. For this purpose, Quality-by-Design (QbD) approach is used. It aids in achieving quality-based development during the development process by employing the QbD concept. The critical material attributes (CMAs) and critical process parameters (CPPs) were discovered through the first risk assessment to ensure the requisite critical quality attributes (CQAs). During the initial risk assessment, the high-risk CQAs were identified, which affect the foam characteristics. In this review, the authors discussed the various CMAs, CPPs, CQAs, and risk factors associated in order to develop an ideal foam-based formulation with desired characteristics.