Placental expression of striatin & endothelial nitric oxide synthase in women with & without pre-eclampsia

Background & objectives: Striatin is a multi-domain scaffolding protein essential for activating endothelial nitric oxide synthase (eNOS). However, its role in pre-eclampsia remains use explored. Hence, this study aimed to investigate the association between striatin and eNOS in regulating nitric oxide (NO) production in the placenta of women with and without pre-eclampsia. Methods: Forty pregnant women each without (controls) and with pre-eclampsia (cases) were enrolled in the study. Blood striatin and NO concentrations were detected by the ELISA. Protein expression of striatin, phosphorylated eNOS (peNOS), inducible NOS (iNOS) and phosphorylated NF-?B were measured in the placental tissues by Western blot. Twenty four hour urinary protein and serum urea, uric acid and creatinine were analyzed as an autoanalyzer. Placental histology was analyzed by haematoxylin and eosin staining. Results: Compared to normotensive pregnant women, the levels of serum NO and striatin were decreased in pre-eclamptic women. The protein expression of striatin and peNOS was significantly reduced (P<0.05) while p65NF-?B and iNOS were upregulated considerably (P<0.05) in the placenta of cases compared to controls. Interpretation & conclusions: Our results show for the first time that decreased striatin expression was associated with decreased peNOS protein expression in the placental tissue of pre-eclamptic women. Interestingly, no significant difference was found in blood striatin or NO levels between controls and cases. Thus, therapies that improve placental striatin expression are attractive possibilities, both for prevention as well as treatment of endothelial dysfunction in pre-eclampsia.

Efficacy and safety of intracervical Foley’s in women receiving sublingual misoprostol for induction of labour: a randomized controlled trial

Background: Induction of labour can be carried out by medical or mechanical methods, used alone or in combination. This study is to evaluate the efficacy and safety of intracervical Foley’s in women receiving sublingual misoprostol for induction of labour.Methods: We randomized 230 primi gravidae at ≥37 weeks of gestation, with singleton pregnancy, cephalic presentation requiring induction, with Bishop score ≤4 using block randomization into study and control groups. Both groups received 50 µg sublingual misoprostol every fourth hourly till active labour was achieved or upto a maximum of 6 doses. The study group was induced simultaneously with intracervical Foley catheter.Results: Mean induction to labour interval in study and control groups was 11.191±7.14 hours and 11.758±6.26 hours while mean induction to delivery interval was 17.502±7.93 hours and 18.275±7.66 hours respectively with no significant difference between the groups (p=0.522 and 0.453). More women in study group than in the control (51.3% versus 33.9%) were in active labour within ten hours of induction (p=0.001). Caesarean section rate was 23.5% and 19.1% in study and control groups (p=0.497), the most common indication being foetal distress. Secondary outcomes like foetal heart rate abnormalities, oxytocin requirement were comparable between the two groups. APGAR scores and NICU admission rate were similar in both groups. There was no significant maternal or neonatal morbidity.Conclusions: Though there was no significant reduction in induction to labour or delivery interval with synchronous use of sublingual misoprostol and Foley’s, there was no increase in the complications encountered.

Assessment of Cardiovascular Autonomic Functions and Baroreceptor Reactivity in Women with Premenstrual Syndrome.

Objectives: The study was conducted to assess the autonomic status of women with mild PMS using shortterm heart rate variability (HRV) analysis and conventional autonomic function tests (CAFT). Methods: Sixty females in the age group 17-25 years with mild premenstrual syndrome were identified using a self-report questionnaire, the shortened premenstrual assessment form. HRV and CAFTs were recorded 1- 5 days prior and 8-10 days after menstruation. Results: The subjects showed a significant increase in HR and SBP in luteal phase. In HRV, an increase in mean HR and LF-HF ratio were seen in the luteal phase whereas an increase in the NN50, RMSSD and pNN50, HF, HF(nu) and TP were seen in the follicular phase. In CAFT, no change in HRB, 30:15 and E/ I ratios but increase in ?DBP(ihg) in the luteal phase was seen. Conclusion: The increase in HR and SBP in the luteal phase could be because increased water and salt retention due to the ovarian steroids. A decrease in HRV, increase in ?DBPihg with no change in 30:15 ratio in the luteal phase could be attributed to delayed withdrawal of ovarian hormones in the luteal phase.

Deoxyribonucleic acid damage study in primary amenorrhea by comet assay and karyotyping.

AIM: This study aims at evaluating the chromosomal abnormalities and deoxyribonucleic acid (DNA) damage in cases with primary amenorrhea by karyotyping and comet assay. STUDY DESIGN: A total of 30 cases of primary amenorrhea were recruited. Secondary sexual characters were assessed by Tanner staging. Chromosomal analysis was performed by conventional phytohemagglutinin stimulated lymphocyte cell culture technique. Alkaline version of comet assay was used to evaluate DNA damage. RESULTS: The chromosomal pattern of 20 subjects (66.7%) was found to be normal (46,XX). Two subjects had 46,XY pattern and eight subjects had Turner syndrome (45,X or 45,X/46,XX). The comet parameters were found to be increased among subjects with 45,X monosomy, when compared to the rest of the study group and also in subjects with Tanner stage 1 when compared to stage 2. CONCLUSION: Comet assay revealed increased DNA damage in cases with 45,X monosomy, compared with subjects with 46,XX and 46,XY karyotype, which correlated with clinical features.

Growth hormone in intra-uterine growth retarded newborns.

OBJECTIVE: To study growth hormone levels in IUGR and healthy controls and its association with birth weight and ponderal index. METHODS: We studied 50 Intra uterine growth retarded (IUGR) and 50 healthy newborns born at term by vaginal delivery in JIPMER, Pondicherry, India. Cord blood was collected at the time of delivery for measurement of growth hormone. RESULTS: When compared with healthy newborns, IUGR newborns had higher growth hormone levels (mean +/- SD, 23.5 +/- 15.6 vs 16.2 +/- 7.61 ngm/ml, P = 0.019). A negative correlation was identified between growth hormone levels and birth weight (r2 = - 0.22, P = 0.03) and ponderal index (r2 = - 0.36, P = 0.008). Correlation of growth hormone levels was much more confident with ponderal index than with birth weight. CONCLUSION: At birth IUGR infants display increased growth hormone levels which correlate with ponderal index much more confidently than with birth weight.