ABSTRACT
Background: Difficulty in cervical dilatation is a hard situation during the procedure of diagnostic dilatation and curettage in some cases. Aim: Aim of the present study was to evaluate the use of Misoprostol for cervical dilatation before D&C in Gynecological cases. Dilatation of cervix is performed as a preliminary step to curette the uterine cavity. Endometrial sampling is often performed either by D&C or by hysteroscopy as an office procedure. Materials and methods: The study was performed at Department of Obstetrics and Gynecology, Victoria Hospital, Visakhapatanam, Andhra Pradesh from June 2018 to May 2019. The study comprised of 150 patients recruited from Gynecology Department with different indications for D&C. Selected cases had a full history of menstrual, Gynec, Obstetric, Personal and Family. A per abdomen and per speculum examination were done to note the Vaginal and Cervical condition. A bimanual pelvic examination was done to estimate size, position and mobility of uterus. In this study, the patients were allocated to receive either oral or vaginal misoprostol or no drug. All the subjects allocated to receive either oral or vaginal Misoprostol were instructed to take the medication at home, the night before the operative procedure. They were given 200 micro grams Misoprostol orally or vaginally 12 hours prior to the procedure. Results: In present study, majority of cases (57.33%) fall in age group of 30-39 years and 34% cases fall in age group of 40-49 years. 83% in Misoprostol group and 90% cases in control group had previous vaginal deliveries. 19% cases in Misoprostol and 20% cases in control group had a prior uterine surgery. Indication for D&C, in majority of cases 66 cases (44%) Heavy menstural bleeding was an indication, followed by Irregular bleeding 53 cases (35.33%), Intermenstural bleeding 29 cases R. Padmaja, P. Rajasekhar. Role of Misoprostol in Cervical Ripening for Dilatation and Curettage. IAIM, 2019; 6(11): 118- 123. Page 119 (19.33%). Cervical dilatation effectively achieved in 62.5% in Nulliparous 69.2% in Primiparous, 94.93% in Multiparous. Conclusion: Both Oral and Vaginal Misoprostol are equally effective in inducing Cervical priming prior to Dilatation and Curettage.
ABSTRACT
<p><b>OBJECTIVE</b>BacoMind (BM) is a standardized extract of Bacopa monnieri, which belongs to the family Scrophulariaceae and is a creeping annual plant found throughout the Indian subcontinent. It has been used by Ayurvedic medicinal practitioners in India for almost 3000 years and is classified as a medharasayana, a substance which improves memory and intellect. With the widespread traditional use as well as scientific validation of Bacopa monnieri for nootropic activity, a bioactive-rich unique phytochemical composition-BacoMind was developed from B. monnieri for use as a cognition and memory enhancing agent. The present study aimed to investigate the in vitro toxicity of this formulation of BacoMind on human lymphocytes and to rule out its possible contribution to mutagenicity.</p><p><b>METHODS</b>In the present investigation the active ingredients present in BM were identified and quantified by high performance liquid chromatography (HPLC) and high performance thin-layer chromatography (HPTLC). Antioxidant and anticlastogenic properties of BM were studied in vitro with and without metabolic activation. Doses of BM were chosen on the basis of mitotic index (MI) and cytokinesis-block proliferation index (CBPI). Clastogenicity assays were performed at 31.2 microg/mL, 62.5 microg/mL, and 125 microg/mL, while the Salmonella reverse mutation assay (Ames test) was performed at doses of 61.72, 185.18, 555.55, 1666.67, and 5000.00 microg/plate.</p><p><b>RESULTS</b>HPLC and HPTLC analysis of BM revealed the presence of bacoside A3, bacopaside I, bacopaside II, jujubogenin isomer of bacopasaponin C, bacosine, luteolin, apigenin, bacosine, and beta-sitosterol D glucoside. BM demonstrated significant antioxidant activity. The number of chromosomal aberrations and the frequency of micronuclei induced by BM were not statistically significant up to a dose of 62.5 microg/mL. A subsequent dose of 125 microg/mL prior to metabolic activation induced mild clastogenicity, but it was found to be biologically insignificant as this effect was not seen post metabolic activation. BM also demonstrated a dose-dependent protection against the clastogens used in this study using the above tests for clastogenicity. Maximum protection was observed in presence of metabolic activation. Moreover, BM demonstrated no mutagenic effect on the tested strains, as observed in the Ames test.</p><p><b>CONCLUSION</b>BM protected human lymphocytes against various clastogens. BM also exhibited high antioxidant activity which might be responsible for the observed protective effects against the clastogens since the used clastogens are known to induce their clastogenic effects via production of oxidative radicals.</p>