Role of sonosalpingogram in correlation to hysterosalpingogram in assessment of infertility

Background: This study was performed to evaluate the patency of fallopian tubes with hysterosalpingographyand sonosalpingographyin females with complaint of infertility and to correlate the results of sonosalpingogram with that of hysterosalpingogram in assessment of tubal patency in infertility.Methods: Females with complaint of infertility were evaluated by HSG (Hysterosalpingography) and SSG (Sonosalpingography) between 7th and 12th day of menstrual cycle. HSG was carried out using Siemens fluoroscopy machine. The flow of contrast was followed and tubal patency was assessed. SSG was carried out using Siemens ACUSON X300, with transvaginal probe (4-9MHz). Normal saline was infused slowly and the endometrial cavity was evaluated. Then color flow was used to evaluate each of the adnexa for free spillage of saline (waterfall sign) and results of both the techniques were correlated.Results: Altogether 94 tubes were evaluated by HSG & SSG each. On HSG, out of 94, 65 tubes were patent and 29 tubes showed blockage. On SSG, 68 tubes were patent and 26 tubes showed blockage. Results of both the techniques were correlated by Kappa value which came out to be 0.923. There was very good agreement between SSG and HSG.Conclusions: There was 92.3% agreement (KAPPA value = 0.923, Standard error = 0.437, 0.95 CI = 0.8373-1) between SSG and HSG which suggests that SSG is at least similar to HSG in its effectiveness for evaluating tubal patency and has the potential to replace HSG as routine, first-line outpatient infertility investigation

Prediction of dissolution-absorption relationships from a continuous dissolution/Caco-2 system

The objectives were 1) to design a continuous dissolution Caco-2 system to predict the dissolution-absorption relationships for fast and slow dissolving formulations of piroxicam, metoprolol tartrate, and ranitidine HCl, and compare the predicted relationships with observed relationships from clinical studies; 2) to estimate the effect of croscarmellose sodium on ranitidine dissolution-absorption relationships; and 3) to estimate the effect of solubilizing agents on piroxicam dissolution-absorption relationships. A continuous dissolution/Caco-2 system was constructed from a dissolution apparatus and a diffusion cell, such that drug dissolution and permeation across a Caco-2 monolayer would occur sequentially and simultaneously. The continuous system generally matched observed dissolution-absorption relationships from clinical studies. For example, the system successfully predicted the slow metoprolol and slow ranitidiine formulations to be permeation-rate-limited. The system predicted the slow piroxicam formulation to be dissolution-rate-limited, and the fast piroxicam formulation to be permeation-rate-limited, in spite of piroxicam’s high permeability and low solubility. Additionally, the system indicated croscarmellose sodium enhanced ranitidine permeability and predicted solubilizing agents to not modulate permeability. These results suggest a dissolution/Caco-2 system to be an experimentally based tool that may predict dissolution-absorption relationships from oral solid dosage forms, and hence the relative contributions of dissolution and permeation to oral drug absorption kinetics