Different criteria have been used in literature to describe the anterior ectopic anus (AEA) anomaly, resulting in uncertainty over its prevalence, association with constipation and definition of the indications for surgery. It has been recently proposed that the term AEA should be restricted to anomalies in which a normal appearing anal orifice is located in the perineum in a more anterior location than normal, with an anal canal of normal calibre that is shown by electrical stimulation to be surrounded by the voluntary external anal sphincter (EAS). We report about four infants, three females and one male, who presented with constipation and had an anteriorly located anal orifice of normal calibre. The anal position index measured clinically was less than 0.34 in all the female patients and 0.44 in the male patient. In preoperative magnetic resonance imaging (MRI), the EAS was distributed all around the circumference of the anal canal, including the ventral aspect of the anal canal, in all the patients. Preoperative MRI documentation of sphincter distribution is recommended for the diagnosis of AEA, as it would help in better definition of its association with constipation and the results of surgical management.
Ophthalmic drug delivery system is very interesting and challenging due to the normal physiologically factor of eyes which reduces the bioavailability of ocular products. The development of new ophthalmic dosage forms for existing drugs to improve efficacy and bioavailability, patient compliance and convenience has become one of the main trend in the pharmaceuticals industry. The present review encompasses various conventional and novel ocular drug delivery systems, methods of preparation, characterization and recent research in this area. Furthermore, the information on various commercially available in situ gel preparations and the existing patents of in situ drug delivery systems i.e. in situ gel formation of pectin, in situ gel for therapeutic use, medical uses of in situ formed gels and in situ gelling systems as sustained delivery for front of eye are also covered in this review.