Role of cervicovaginal β-hCG in prediction of preterm delivery: a prospective observational study

Background: The World Health Organization (WHO) factsheet revealed that 15 million babies are born too early every year and almost 1 million children die each year due to complications of preterm birth. The objective of this study was to determine whether cervicovaginal β-hCG level can be used as predictor of preterm delivery in asymptomatic high-risk pregnant women at 24-34 weeks gestation age.Methods: This was prospective observational study. Total 134 asymptomatic pregnant women were taken for study who had at least one risk factor for preterm delivery at 24-34 weeks gestation age. Cervicovaginal secretion was collected and β-hCG level was measured by chemiluminescent immunoassay.Results: Out of 134 cases, 42.5% had preterm delivery and 57.5% had term delivery. Mean cervicovaginal β-hCG level (mIU/ml) in preterm delivery group was 39.38±19.66 and term delivery group was 21.86±11.18. Cervicovaginal β-hCG level was significantly higher in preterm group compare to term group demonstrating significant association of raised β-hCG with preterm group (p value <0.001). ROC curve analysis was done to find out best cut off value of cervicovaginal β-hCG for prediction of preterm delivery and optimal cut off value was 36.45 mIU/ml. The optimal cut off value for cervicovaginal β-hCG (36.45 mIU/ml) gave sensitivity 71.9%, specificity 81.8%, positive predictive value 74.5%, negative predictive value 79.7% and diagnostic accuracy of 77.6% for prediction of preterm delivery.Conclusions: Cervicovaginal β-hCG can be used as sensitive and specific biomarker of prediction of preterm delivery in asymptomatic high-risk women

Correlation of lateral placental location with development of preeclampsia

Background: Preeclampsia is a complex clinical syndrome which involves multiple organ systems and remains the principle cause of maternal and perinatal morbidity and mortality. Preeclampsia is a disease of trophoblastic tissue. Placental abnormality is one of the initial events in patients who are destined to develop pregnancy induced hypertension subsequently. Objective of this study was to evaluate the association of laterally located placenta on ultrasound with development of preeclampsia.Methods: This prospective observational study was conducted on 200 antenatal women with singleton pregnancy at 18-24 weeks of gestation who attended antenatal clinic of obstetrics and gynaecology, PGIMS Rohtak from October 2017 to October 2018. Detailed antenatal transabdominal ultrasound along with placental location was done between 18-24 weeks of gestation in women who fitted into inclusion criteria. All the antenatal women belonged to 18-24 weeks of gestation were included in the study except those women with chronic hypertension, diabetes mellitus, renal disease, severe anaemia, thyrotoxicosis, low lying placenta, previous history of preeclampsia or eclampsia.Results: Out of 200 antenatal women, 84 had lateral placenta while 116 had central placenta. Out of these 84 women who had lateral placenta, 55 women (65.5%) developed preeclampsia and out of 116 (58%) women who had central placenta, 28 women (24.1%) developed preeclampsia.Conclusions: From the above study, we concluded that women with laterally located placenta by ultrasound at 18-24 weeks of gestation have greater risk of developing preeclampsia

A Study on Gender Preferences and its Sociocultural aspects among Married Women (18-45 Years) in Rural Gurugram

INTRODUCTION: Declining sex ratio is a major concern worldwide, especially in a developing country like India. The role of sociocultural factors in gender preference is known since ages. The skewed sex ratio in India is attributed to selective female feticides and misuse of technological advancements. This also has a strong influence on contraceptive acceptance among couples. OBJECTIVES: The present study was conducted to explore the contraceptive use, gender preferences and its determinants among married women in rural Gurgaon. MATERIALS AND METHODS: A cross-sectional study was conducted among married women (18-45years) residing in the rural field practice area of SGT medical college and hospital, Gurugram. The sample size was found to be 400. Systematic random sampling technique was used to recruit the study participants.&nbsp; Pre- tested, pre-designed questionnaire was used for data collection. RESULTS AND DISCUSSION: Among 400 married women, current contraceptive usage among study population was found to be 58.25%. The most common method of contraception used by the study subjects was intrauterine contraceptive device. The preference for male child was found among 49.5% women. The reasons cited for such preference were propagation of family name (48.2%), financial dependability in the old age (34%), social responsibilities are carried out by males (25.3%) and males are lesser economic liability (31%). Lower age group of mother, nulliparity, Hindu religion, lower educational status and lower socioeconomic status were found to be the determinants of male child preference in the present study. CONCLUSION: There is need of awareness and education amongst women and both the genders deserve equal respect without any preferences

Postoperative sore throat with 0.05% betamethasone gel and 2% lignocaine jelly used as a lubricant for ProSeal LMA (PLMA) insertion

AbstractPostoperative sore throat (POST) is a minor complication after general anaesthesia. Many agents have been used as lubricant to reduce the incidence of POST with variable efficacy. We conducted a study to compare the incidence of POST with 0.05% betamethasone gel and 2% lignocaine jelly as a lubricant for PLMA insertion in patients undergoing general anaesthesia.Sixty subjects were divided randomly into two groups. Patients in Group I (n=30) had 2.5ml of 0.05% of betamethasone gel while the Group II had 2.5ml of 2% lignocaine jelly applied on the cuff of PLMA. After standard induction and insertion of PLMA cuff inflated to 60cm of H2O and was maintained at the same throughout the surgery. In PACU, patients were inquired about sore throat at immediate and 24h post operative period.POST was not observed in any of the patients of Group I. In group II 33% of the patients had 1st degree and 10% had 2nd degree of sore-throat in immediate post-operative period. After 24h 16% patients had 1st degree sore-throat and 3% patients had 2nd degree of sore-throat in Group II patients. We conclude that lubricating cuff of PLMA with 0.05% of betamethasone gel is effective in reducing the incidence of POST

Artificial Neural Network: A New Approach for Prediction of Body Fat Percentage Using Anthropometry Data in Adult Females

Assessing body fat using anthropometric data would be useful in predicting chronic diseases. Accurate use of proper statistical models in analysing body composition data is of prime importance. This study was undertaken to assess body composition of diseased and non-diseased women using body composition analyser thereafter using data for development of statistical model. The objective was to find relationship of various anthropometric parameters with Percent Body Fat (BF%) and to develop various prediction models for estimating BF on the basis of anthropometric data. BF% was predicted using Linear Regression (LR), Multiple Linear Regression (MLR), Non-Linear Regression (NLR) and Artificial Neural Network (ANN) models. The predictors used in the study were age (yrs.), height (cm), weight (kg), Body Mass Index (BMI) (Kg/m2) and Waist Circumference (WC) (cm). Data utilized for the study was related to 860 adult females aged 18-60 years out of which 700 were non-diseased and 160 were diseased (diabetic and hypertensive). Out of various models developed using LR, MLR, NLR for Non-Diseased group, three predictors viz. age, BMI and WC were found to be appropriate for estimating BF%. However, the best prediction of BF% was achieved using ANN model taking age, height, weight and WC as predictors (R2 = 0.787). ANN technique was found as the most suitable technique for developing prediction models for estimation of BF% in non-diseased group. However, in diseased group ANN model could not predict BF% more precisely, may be due to some other factors affecting the body composition of females of diseased group

DETERMINATION OF CAPECITABINE-AN ANTICANCER DRUG IN DRIED BLOOD SPOT BY LC-ESI-MS/MS

Objective: Capecitabine (Cape), the first oral prodrug which belongs to the group of fluoro pyrimidines is the most frequently prescribed anticancer drug for the treatment of metastatic breast and colorectal cancers. The article describes a selective and robust method for determination of Cape in dried blood spots (DBS) by liquid chromatography-tandem mass spectrometry (LC-MS/MS).Methods: Cape fortified DBS was punched and extracted with ethyl acetate using capecitabine-d11 as the internal standard (IS). Chromatographic separation of Cape and IS from endogenous matrix was performed on Phenomenex Gemini C18 (150 × 4.6 mm, 5mm) column under isocratic condition using acetonitrile: 2 mmol ammonium formate (pH 3.0, adjusted with 0.1 % formic acid) (80:20, v/v) as the mobile phase. Detection and quantification were carried on a triple quadrupole mass spectrometer, using electro spray ionization technique in the positive ionization mode.Results: The method was established over a concentration range of 10-10000 ng/ml. Accuracy, precision, selectivity, recovery, matrix effect and stability of the analyte were also estimated and the results were within the acceptance criteria. Further, precise results were obtained using an optimum spot volume of 10 µl with good spot homogeneity. Blood samples with hematocrit values varying from 24 % to 45 % gave acceptable results with good accuracy and precision.Conclusion: The efficiency of dried blood spot sample preparation, short analysis time and high selectivity permits estimation of Cape in a small blood volume. The validation results suggest that the method is precise, accurate, and reproducible and can be useful in therapeutic drug monitoring of Cape.Â

SENSITIVE AND RAPID ESTIMATION OF LAPATINIB, AN ANTICANCER DRUG IN SPIKED HUMAN PLASMA BY LC-MS/MS

Objective: The work presents a sensitive, selective and rapid determination of lapatinib, a potent anticancer drug in human plasma by liquid chromatography-tandem mass spectrometry.Methods: Liquid-liquid extraction of lapatinib and lapatinib-d4, added as an internal standard (IS) was carried out from 100 µl plasma sample. Chromatographic analysis was performed on ACE C18 (100 mm × 4.6 mm, 5 µm) column using 10 mmol ammonium formate buffer (pH 3.5) and acetonitrile (10:90, v/v) as the mobile phase. The precursor ion → product ion transitions for lapatinib (m/z 581.1 → 365.2) and IS (m/z 585.1 → 365.0) were monitored on a triple quadrupole mass spectrometer in the positive electrospray ionization mode. The method was validated in accordance with the US FDA guidelines.Results: A linear concentration range was established from 2.50-2500 ng/ml for lapatinib. The intra-batch and inter-batch precision were ≤ 4.81 %. The recovery of lapatinib and IS from plasma samples ranged from 88.7 to 95.8 % and 85.9 to 96.5 % respectively. The accuracy and precision (% CV) for the stability of lapatinib under different storage conditions showed a variation from 95.2 to 102.2 % and 1.19 to 4.35 % respectively at low and high QC levels. Under optimized chromatographic conditions, the retention time for lapatinib was 1.406 min with a total run time of 2.5 min for each sample.Conclusion: The validation results demonstrate that the method is simple, accurate, precise and reproducible. The developed method can be readily used for pharmacokinetics/bioequivalence studies in patients as well as healthy subjects.Â

Adverse drug reaction profile of anticancer agents in a tertiary care centre of rural Maharashtra: a cross-sectional study

Background: The present study was undertaken to analyse the clinical spectrum, pattern of ADR reported, most common suspected drugs, timing of reporting of suspected ADR, outcome, severity and causality assessment of adverse drug reactions among oncology patients reported at our ADR monitoring Centre. Methods: The descriptive cross-sectional study was carried out for two months in the oncology department of a tertiary care rural hospital. ADR reporting form Version 2.4 was used for recording information of all patients of any gender and age who were suspected cases of adverse drug reactions receiving chemotherapy. Results: Total 83 ADRs were reported within the duration of two months. The number of males and females were 21 and 62, respectively with mean age 56.9±11.6 years for males and 59.6±8.8 years for females. The age group most commonly reported with suspected ADR was 61-70 years (28.9%). Of the 83 ADR reported, the most common suspected drug was Paclitaxel (47, 56.6%). The most common indications for the use of these anticancer drugs was reported to be CA breast (43, 51.8%). Most of the ADRs (38, 45.8%) were reported immediately. On applying Naranjo’s Causality Assessment Scale, 61 and 22 ADRs fell in the category of Probable and Possible, respectively. Conclusions: The occurrence of ADR among patients on chemotherapy is high. The reported ADR were common and predictable. Hence diligent monitoring in ADR may help manage and prevent morbidity associated with anti-cancer drugs

Influence of Impurity on the Properties of Chemically Synthesized Calcium Hydroxide

Here we report synthesis and characterization of chemically synthesized calcium hydroxide (Ca(OH)2) with and without deliberate presence of NaNO3 as an impurity. Calcium nitrate tetrahydrate (Ca(NO3)2.4H2O) is used as precursor and alkaline NaOH solution is used as precipitant to synthesize the Ca(OH)2 samples. The samples were characterized by XRD, FESEM, FTIR spectroscopy, DTA, TGA and UV-Vis spectroscopy techniques. From the UV-Vis spectroscopy results, it is found that the Ca(OH)2 with NaNO3 impurity has higher bandgap than the sample without NaNO3. The weight loss in TGA is also more for the Ca(OH)2 with impurity than the one for without impurity. The results are discussed in terms of composition formed during synthesis process