Camylofin dihydrochloride injection: a drug monograph review

Camylofin dihydrochloride is an anti-spasmodic drug available in India and other Latin American and African countries, for the treatment of abdominal colic and for acceleration of labor. Although, the drug has been in use for over six decades, with multiple citations in academic text books of repute, treatment protocols, and multiple research publications, there is no consolidated published information on the pharmacology and clinical details of camylofin. This drug statement/monograph is an attempt to collate and present scientific information that will come in handy to practicing obstetricians and gynaecologists, as well as other primary care physicians, when treating cases of abdominal colic or managing prolonged labor. Approved clinical indications, clinical pharmacology, dosage, contraindications, precautions, drug interactions, adverse effects, overdose and clinical evidence in different indications are covered herein

Modeling of Downstream Heating in Melt Electrospinning of Polymers

The current study is driven by the demand for sub-micron fibers with high surface area to volume ratios to be used in applications such as high performance filtration, tissue engineering, in-situ wound dressing, drug delivery, thermal management, and energy storage. Traditionally, industry has been using solution electrospinning for manufacturing sub-micron fibers. However, it is expensive and environmentally unfavorable because a significant quantity of toxic solvent is lost to the surroundings during this process. The alternative approach, melt electrospinning, is inherently limited to the production of micron-sized fibers. This is mainly due to the high viscosity and low electrical conductivity of the melt. In addition, rapid heat loss to the surroundings results in solidification of the polymer melt jet before it has been significantly stretched by the electric field. In order to address this problem, we propose that a volumetric heat source placed downstream in the melt electrospinning process can lead to markedly decreased fiber diameters. For this purpose, we utilize a model for non-isothermal melt electrospinning in the presence of a downstream volumetric heat source. The model is based on thin filament approximation applied to fully coupled momentum, continuity, charge, and energy equations, along with the non-isothermal Giesekus constitutive model and the electric field equation at steady state. The simulation results demonstrate that downstream heating does reduce the fiber diameter, and is therefore a feasible solution for resolving the drawbacks of melt electrospinning. In addition, the model has been used to capture the influence of the surrounding temperature, which affects the thinning of the fiber through surface rather than volumetric interactions. Finally, experiments on melt electrospun polycaprolactone are utilized in order to validate the model predictions

Role of camylofin and its combinations in obstetrics and gynaecological practice: a review of Indian evidence

Anti-spasmodic drugs like camylofin are used in obstetrics and gynaecological practice for broadly two conditions - spasmodic abdominal pain and management of prolonged labor. Camylofin has been in use in India for almost six decades. As a spasmolytic, camylofin has demonstrated good efficacy and tolerability, both in the management of abdominal spasmodic pain and in augmentation of labor. Literature evidences has suggested that camylofin has demonstrated a statistically significant superiority, such as higher spasmolytic potency compared to other anti-spasmodics like drotaverine, hyoscine and valethamate. In some studies, camylofin maintained the superior efficacy, despite being given as a single dose compared to repeat doses of comparator drugs. Also, in augmentation of labor, camylofin single dose demonstrated superior efficacy when the comparator arm was given a combination of two anti-spasmodic drugs i.e. hyoscine and valethamate in three doses at hourly intervals. Clinical studies in abdominal colic pain revealed significant superiority of the camylofin-paracetamol combination over dicylomine paracetamol combination, this despite the camylofin combination containing 300mg paracetamol as compared to the dicyclomine combination containing 500mg paracetamol. Similar results, highlighting better outcomes in abdominal colic of different types, was shown in studies comparing camylofin-diclofenac combination compared with hyoscine (in renal colic) and also camylofin-mefenamic acid combination compared with dicyclomine-mefenamic acid combination (in menstrual colic). All the above clinical study results resonate in the findings of a recent survey with gynaecologists across the country, which showed that camylofin is considered as the anti-spasmodic most suitable for female patients compared to drotaverine, dicyclomine and hyoscine. Given the availability of strong clinical trial data in Indian women patients, camylofin along with its combinations holds a strong place in the armamentarium of practicing obstetricians and gynaecologists and can be a preferred choice of therapy in treatment protocols of abdominal spasmodic pain and augmentation of labor

Obstetric hysterectomy: analysis of 50 cases at a tertiary care hospital

Background: Despite advances in modern medical sciences, there is a plethora of morbidity which continues to affect women during childbirth, necessitating removal of the uterus in the peripartum or postpartum period. This study analyses 50 cases of obstetric hysterectomy done in a single institute.Methods: After Institutional Ethics Committee approval, a retro prospective analysis of hospital records of 50 cases of obstetric hysterectomy was done over a five year period in the department of obstetrics and gynaecology at a tertiary care referral centre-KEM hospital.Results: During the study period, there were 50 cases of obstetric hysterectomy out of 43839 deliveries giving an incidence of 0.12%. Mean age of women undergoing obstetric hysterectomy was 29.9 years. 86% of these were multiparous. The most common indication was morbidly adherent placenta (38%) followed closely by followed by rupture uterus (34%) and uterine atony (20%). Total hysterectomy was the most preferred type of hysterectomy (74%). Urinary tract injury and hypovolemic shock were the most frequently encountered complications. The maternal mortality rate in our study was 4%. 86% of the babies born had Apgar score of 9/10. 44% of babies required admission to neonatal intensive care unit.19.6% of the patients had still born babies and there were 4 neonatal deaths.Conclusions: Obstetric hysterectomy is associated with increased risk of maternal and perinatal morbidity and mortality

Comparison of maternal and fetal outcomes in gestational diabetes mellitus diagnosed either by oral glucose tolerance test or diabetes in pregnancy study group India

Background: The optimal strategy for screening and diagnosis of Gestational Diabetes Mellitus (GDM) is still controversial and elusive. There is possibility of difference in maternal and fetal outcome depending on the diagnostic method used. This study throws light on the efficacy of two screening tests “Oral Glucose Tolerance Test’’ and “Diabetes in Pregnancy Study Group India” and to know maternal and fetal outcome in pregnancy complicated by GDM in Indian setting.Methods: Depending on the diagnostic method used 100 GDM patients were divided in 2 groups: 1. OGTT, 2. DIPSI. Maternal outcomes were measured in terms of pregnancy induced hypertension, polyhydramnios, preterm labour, genital tract injury and methods of termination of pregnancy, gestational age at delivery. Congenital malformation, macrosomia, hypoglycemia, hyperbilirubinimia, respiratory distress, duration of NICU stay was studied in newborns.Results: 22% of DIPSI group and 26% of OGTT group had PIH as comorbidity. Preterm delivery was noted in 22% of DIPSI group and 30% of OGTT group. 50% patients of both the groups underwent LSCS. No intrapartum complications were seen in 82% of patients. Malformations were noted in 18% of DIPSI group and 14% of OGTT group. In DIPSI group 14% of baby had macrosomia compared to 10% and in that of OGTT group.In neonates, hypoglycaemia, respiratory distress syndrome and hyperbilirubinemia seen in 46.8%, 31% and 42.6% respectively in DIPSI group compared to 50%, 45.5% and 47.7% respectively in OGTT group.Conclusions: No statistically significant difference was noted with respect to maternal and fetal outcomes between the two groups

Obstetric and neonatal outcomes among pregnancies with hepatitis E infection

Background: Maternal mortality is an important health indicator. Hepatitis E is a common viral infection affecting pregnant women. The maternal morbidity and mortality relating to this infection is not extensively reported and deserves to be studied.Methods: A retrospective study was conducted in a tertiary care referral centre and the obstetric and neonatal outcomes among patients with hepatitis E infection were studied for duration of 1 year.Results: Among 24 patients, there were 7 mortalities. Majorities were primigravidae and presented during third trimester. A sizeable number required blood transfusions and ICU stay. 7 were stillbirths and majorities were low birth weight babies.Conclusions: Hepatitis E causes significant maternal and neonatal morbidity

Pregnancy outcome with hepatitis E infection

Background: Hepatitis E is usually a self-limited viral infection in men and non-pregnant women, but during pregnancy it is associated with high maternal and perinatal mortality. This needs to be studied for early diagnosis and better management.Methods: The study commenced after the approval of Institutional Ethics Committee. This was a retrospective cum prospective observational study conducted in the Department of Obstetrics and Gynaecology and Department of Medical Intensive Care Unit in present tertiary care hospital between February 2012 and July 2017. An analysis of 120 cases was made over a period of five years.Results: In this study the incidence of pregnant patients with hepatitis E was 3.09 per 1000 deliveries. It was found that majority of the patients which were diagnosed with hepatitis E were young and belonged to the age group of 21-25 years. Most of the affected patients were primigravida with increasing severity of the disease in their third trimester. The maternal morbidity was 51% with a mortality rate of 20%. The percentage of still birth was 25.64% with increased incidence of preterm deliveries and poor perinatal outcome.Conclusions: Early diagnosis and rapid management of the complications such as correction of abnormal coagulation and supportive management is the best treatment available at present. ICU admission and with strict maternal and foetal monitoring can help improve the outcome and thereby reducing the maternal and perinatal mortality

Camylofin in the management of prolonged labor: a review of evidence

Prolonged labor can lead to increased maternal and neonatal morbidity and mortality. Hence, it warrants an early detection and appropriate clinical management. Active management of labor has shown to decrease the occurrence of prolonged labor. Administering antispasmodics during labor facilitates a faster and more effective dilatation of the cervix.  Hence, antispasmodics can be used to decrease the incidence of prolonged labor. Camylofin, a potent antispasmodic, with a dual mode of action, has been used in the augmentation of labor for more than six decades. There is a growing body of evidence to support the efficacy and tolerability of Camylofin in the active management of labor.  A review of published evidence suggests that Camylofin has superior efficacy in augmentation of labor on multiple counts like rate of cervical dilation, duration of active phase of first stage of labor and induction delivery interval, when compared to other spasmolytics like drotaverine, hyoscine and valethemate. It also has a benefit of a convenient single dose as compared to the other spasmolytics listed earlier. Camylofin has other advantages like a quick onset of action, prolonged action, no adverse effects on uterine contractility, no contraindication for use in uterine inertia cases and overall good tolerability for both mother and fetus. Given the superior efficacy and benefits that this drug exhibits, coupled with its excellent tolerability profile, Camylofin should be the first choice and may be preferred over other drugs for cervical dilatation and acceleration of active phase of labor

Spontaneous heterotopic pregnancy: a rare possibility

Heterotopic pregnancy is defined as a condition when intrauterine and extrauterine pregnancy occur simultaneously. It is a life-threatening condition that requires immediate and accurate diagnostics and treatment. We present the case of a 34-year-old multigravida in her 7 weeks of gestation came to emergency ward with complains of pain in abdomen for 3 days. Ultrasonographic examination showed a live intrauterine pregnancy and mild to moderate free fluid in abdomen with moving internal echoes. An emergency exploratory laparotomy done and left sided tubal ectopic removed along with right salpingectomy as patient was willing for family planning. A high index of suspicion is required to diagnose Heterotopic pregnancy as clinical as well as radiological findings may be insufficient for diagnosis

(4-Hydr­oxy-2-oxidobenzaldehyde thio­semicarbazonato-κ3 O 2,N 1,S)(1,10-phenanthroline-κ2 N,N′)zinc(II) dimethyl sulfoxide disolvate monohydrate

The ZnII atom in the title compound, [Zn(C8H7N3O2S)(C12H8N2)]·2C2H6OS·H2O, is N,N′-chelated by the N-heterocycle and N,O,S-chelated by the deprotonated Schiff base in a distorted square-pyramidal enviroment. Hydrogen bonds link the mononuclear mol­ecule, the water and the dimethyl sulfoxide (DMSO) mol­ecules into a linear chain motif. One DMSO mol­ecule is disordered over two positions in respect of the S atom in an approximate 1:1 ratio