1H NMR of Deep Eutectic Solvents

Deep Eutectic Solvents (DESs) form between a variety of quaternary ammonium or phosphonium salts and hydrogen-bond donors. Over the past decade, DESs have been studied as green solvents with potential applications in industrial processes, chemical extractions, and pharmaceuticals. The recent suggestion that many plants produce natural deep eutectic solvents (NADES) from primary metabolites led to investigation of the potential uses of DESs in biophysics research. This study examined the 1H NMR spectra of the choline chloride:urea 1:2, and choline chloride:ethylene glycol 1:3 molar ratio DES. Spectra of the choline chloride:urea 1:2 with various solutes were acquired to see what effect these solutes had on the DESs NMR spectrum. For both DESs tested, the NMR spectra were a superposition of the spectra of the components. DES-solute spectra showed that interaction between components persisted, indicating the solvent properties of the DESs were not lost upon addition of solutes

Clinical outcomes and women's experiences before and after the introduction of mifepristone into second-trimester medical abortion services in South Africa

Objective To document clinical outcomes and women's experiences following the introduction of mifepristone into South African public sector second-trimester medical abortion services, and compare with historic cohorts receiving misoprostol-only. METHODS: Repeated cross-sectional observational studies documented service delivery and experiences of women undergoing second-trimester medical abortion in public sector hospitals in the Western Cape, South Africa. Women recruited to the study in 2008 (n = 84) and 2010 (n = 58) received misoprostol only. Those recruited in 2014 (n = 208) received mifepristone and misoprostol. Consenting women were interviewed during hospitalization by study fieldworkers with respect to socio-demographic information, reproductive history, and their experiences with the abortion. Clinical details were extracted from medical charts following discharge. Telephone follow-up interviews to record delayed complications were conducted 2-4 weeks after discharge for the 2014 cohort. RESULTS: The 2014 cohort received 200 mg mifepristone, which was self-administered 24-48 hours prior to admission. For all cohorts, following hospital admission, initial misoprostol doses were generally administered vaginally: 800 mcg in the 2014 cohort and 600 mcg in the earlier cohorts. Women received subsequent doses of misoprostol 400 mcg orally every 3-4 hours until fetal expulsion. Thereafter, uterine evacuation of placental tissue was performed as needed. With one exception, all women in all cohorts expelled the fetus. Median time-to-fetal expulsion was reduced to 8.0 hours from 14.5 hours (p<0.001) in the mifepristone compared to the 2010 misoprostol-only cohort (time of fetal expulsion was not recorded in 2008). Uterine evacuation of placental tissue using curettage or vacuum aspiration was more often performed (76% vs. 58%, p<0.001) for those receiving mifepristone; major complication rates were unchanged. Hospitalization duration and extreme pain levels were reduced (p<0.001), but side effects of medication were similar or more common for the mifepristone cohort. Overall satisfaction remained unchanged (95% vs. 91%), while other acceptability measures were higher (p<0.001) for the mifepristone compared to the misoprostol-only cohorts. CONCLUSION: The introduction of a combined mifepristone-misoprostol regimen into public sector second-trimester medical abortion services in South Africa has been successful with shorter time-to-abortion events, less extreme pain and greater acceptability for women. High rates of uterine evacuation for placental tissue need to be addressed