ABSTRACT
Background: Wide spectrums of neurological disorders are observed in pregnancy and puerparium. These disorders can alter the course of pregnancy and pregnancy can worsen them.Methods: This was a cross sectional observational study which included 154 patients in pregnancy and postpartum up to 6 weeks with neurological disorders admitted in department of obstetrics and gynecology, Government Medical College, Kottayam over a period of one year from December 2017. All patients underwent detailed general and systemic examination and were assessed by neurologist. After delivery maternal and foetal outcome and morbidity and mortality were observed.Results: Out of total 5202 deliveries, 154 patients presented in pregnancy and puerparium with neurological disorders amounting to 2.96 %. The age of patients ranged from 18-44. The commonest neurological disorder was epilepsy (60.4%). Other disorders were eclampsia (7.8%), cerebrovascular disorders (9.1%), brain tumors (4.5%), cranial nerve palsy (3.2%) and different types of other neurological disorders (14.9%). The most common presentation was generalized tonic clonic seizures (82.8%). 76.6% of patients had normal vaginal delivery and 13% underwent caesarean section. There were 5 cases of intrauterine death (3.2%), 5 cases of foetal anomalies (3.2%) and 3 cases of neonatal deaths (1.9%). One case of maternal mortality was there due to intra-cerebral hemorhhage.Conclusions: Epilepsy was the commonest disorder with good maternal and foetal outcome. Vascular disorders and eclampsia were associated with higher maternal and foetal morbidity and mortality.
ABSTRACT
Background: The incidence of cancer is increasing day by day. Ovarian cancer ranks as the fifth leading cause of cancer related death among women worldwide. The cure rate of early stage disease is high. The accepted view is that ovarian cancer arises from ovarian surface epithelium. Recent evidence suggested that around sixty percentage of women without a genetic predisposition who developed sporadic ovarian cancer also have early tubal lesion and cancer. The present study aims to find out the histopathology of fallopian tube in neoplastic surface epithelial ovarian tumour.Methods: A descriptive study was conducted among hundred women who had undergone surgery for malignant and benign surface epithelial ovarian tumor from Govt. Medical College, Kottayam for one year from January-December 2017.Results: Fifty percent of the patients had malignant surface epithelial ovarian tumors.Conclusions: The risk factors of malignant surface epithelial ovarian tumors include age above fifty years and post-menopausal women. Whereas oral contraceptive pill use is a protective factor against malignant surface epithelial ovarian tumors. The fimbrial end of fallopian tube is the site of origin of malignancy in high grade ovarian epithelial carcinoma. So, prophylactic bilateral salpingectomy should be encouraged in all patients who have completed family and undergoing hysterectomy. This will reduce the morbidity and mortality due to ovarian carcinoma.
ABSTRACT
A sensitive and rapid liquid chromatography-tandem mass spectrometry (LC– MS/MS) method has been developed for the simultaneous determination of lisinopril (LIS) andhydrochlorothiazide (HCTZ) in human plasma using their labeled internal standards (ISs). Sample pre-treatmentinvolved solid phase extraction on Waters Oasis HLB cartridges using 100 μL of plasma, followed by liquidchromatography on Hypersil Gold C18 (50 mm×3.0 mm, 5 μm) column. The analytes were eluted within 2.0 min usingacetonitrile-5.0 mM ammonium formate, pH 4.5 (85:15, v/v) as the mobile phase. The analytes and ISs wereanalyzed in the negative ionization mode and quantified using multiple reaction monitoring. The methodshowed excellent linearity over the concentration range of 0.50–250.0 ng/mL for both the analytes. Theintra-batch and inter-batch precision (% CV) was ≤5.26% and their extraction recoveries were in the range of 96.6% –103.1%. Matrix effect evaluated in terms of IS-normalized matrix factors ranged from 0.97 to 1.03 for boththe analytes. The validated method was successfully applied to determine the plasma concentration of the drugsusing 10 mg lisinopril and 12.5 mg hydrochlorothiazide fixed dose formulation in 18 healthy Indian volunteers.
ABSTRACT
A sensitive and selective method has been proposed for the simultaneous determination of amlodipine (AML), valsartan (VAL) and hydrochlorothiazide (HCTZ) in human plasma by liquid chromatography–tandem mass spectrometry (LC–MS/MS). The analytes and their deuterated analogs were quantitatively extracted from 100 μL human plasma by solid phase extraction on Oasis HLB cartridges. The chromatographic separation of the analytes was achieved on a Chromolith RP18e (100 mm × 4.6 mm) analytical column within 2.5 min. The resolution factor between AML and VAL, AML and HCTZ, and VAL and HCTZ was 2.9, 1.5 and 1.4, respectively, under isocratic conditions. The method was validated over a dynamic concentration range of 0.02–20.0 ng/mL for AML, 5.00–10,000 ng/mL for VAL and 0.20–200 ng/mL for HCTZ. Ion-suppression/enhancement effects were investigated by post-column infusion technique. The mean IS-normalized matrix factors for AML, VAL and HCTZ were 0.992, 0.994 and 0.998, respectively. The intra-batch and inter-batch precision (% CV) across quality control levels was ≤ 5.56% and the recovery was in the range of 93.4%–99.6% for all the analytes. The method was successfully applied to a bioequivalence study of 5 mg AML + 160 mg VAL + 12.5 mg HCTZ tablet formulation (test and reference) in 18 healthy Indian males under fasting. The mean log-transformed ratios of Cmax, AUC0–120h and AUC0-inf and their 90% CIs were within 90.2%–102.1%. The assay reproducibility was demonstrated by reanalysis of 90 incurred samples.
ABSTRACT
A sensitive and selective method has been proposed for the simultaneous determination of amlodipine (AML), valsartan (VAL) and hydrochlorothiazide (HCTZ) in human plasma by liquid chromatography–tandem mass spectrometry (LC–MS/MS). The analytes and their deuterated analogs were quantitatively extracted from 100 μL human plasma by solid phase extraction on Oasis HLB cartridges. The chromatographic separation of the analytes was achieved on a Chromolith RP18e (100 mm × 4.6 mm) analytical column within 2.5 min. The resolution factor between AML and VAL, AML and HCTZ, and VAL and HCTZ was 2.9, 1.5 and 1.4, respectively, under isocratic conditions. The method was validated over a dynamic concentration range of 0.02–20.0 ng/mL for AML, 5.00–10,000 ng/mL for VAL and 0.20–200 ng/mL for HCTZ. Ion-suppression/enhancement effects were investigated by post-column infusion technique. The mean IS-normalized matrix factors for AML, VAL and HCTZ were 0.992, 0.994 and 0.998, respectively. The intra-batch and inter-batch precision (% CV) across quality control levels was ≤ 5.56% and the recovery was in the range of 93.4%–99.6% for all the analytes. The method was successfully applied to a bioequivalence study of 5 mg AML + 160 mg VAL + 12.5 mg HCTZ tablet formulation (test and reference) in 18 healthy Indian males under fasting. The mean log-transformed ratios of Cmax, AUC0–120h and AUC0-inf and their 90% CIs were within 90.2%–102.1%. The assay reproducibility was demonstrated by reanalysis of 90 incurred samples.