Role of Misoprostol in Cervical Ripening for Dilatation and Curettage

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.

Microbial lipases: production of extracellular lipase enzyme by alcaligenes viscosus (Doge-1) strain.

Industrially important extracellular lipase enzyme production was explored by utilizing microbial strain isolated from dairy effluents. Alcaligenes viscosus DOGE-1 strain isolated from dairy waste waters proved to produce extracellular lipase. Various growth factors were attempted to maximize the lipase production by this strain. Growth factors like NH4PO4, Peptone, Urea coupled with peptone, KH2PO4, Olive oil and pH were found to be favored the maximum lipase production. This microbial strain was found to have a high lipolytic activity.

Biochemical and histopathological changes in liver due to chlorpyrifos toxicity in albino rats.

The present study was conducted to examine the biochemical and histopathological changes in liver of albino rats with oral sub-lethal (20 mg/kg) administration of chlorpyrifos as single, double and multiple doses with 48 hr intervals. Protease and glutamate dehydrogenase (GDH) enzyme activities increased in a dose and time dependent manner. Chlorpyrifos-induced histopathological changes included central venous congestion, sinusoidal haemorrhages, and focal necrotic areas in liver. Diffuse haemorrhagic areas were observed in the heart. Degenerative changes in the muscle layer, hypertrophy of goblet cells, and infiltration and hyperaemic changes in blood vessels were observed in the intestine. These results suggest that structural integrity of certain organ systems can be disrupted to a great extent from chlorpyrifos exposure.

Effect of cypermethrin on selected dehydrogenase enzymes in muscle and heart tissues of albino rats.

This study reveals significant variations in dehydrogenase enzymes on administration of oral, sublethal (41mg/kg) doses of cypermethrin as single, double and multiple doses with 48hr intervals. Glucose-6-phosphate dehydrogenase (G-6-PDH) and lactate dehydrogenase (LDH) activities were increased, whereas succinate dehydrogenase (SDH) and malate dehydrogenase (MDH) activities were significantly decreased in muscle and heart tissues of albino rats, in a dose and time dependent manner. G-6-PDH is a key enzyme of HMP pathway. This pathway serves to generate glycolytic intermediates for the production of energy to tolerate toxic stress. SDH is a vital enzyme of citric acid cycle, and catalyses the reversible oxidation of succinate to fumarate. LDH activity shows an increase during anaerobic conditions to meet the energy demands. MDH activity depends on fluctuations of oxidative metabolism, and also reflects the turnover of carbohydrates and energy output.

Alteration in protein metabolic profiles in gastrocnemius muscle tissue of rats during cypermethrin toxicosis.

Cypermethrin is the most widely used Type II pyrethroid pesticide in India because of its high efficacy against target species, and its reportedly low mammalian toxicity. It is a fast-acting neurotoxin and is known to cause free radical-mediated tissue damage. This paper is an attempt at estimating its toxicity in rats at a molecular level. Following exposure to oral, sublethal doses (41 mg/kg bw) of cypermethrin as single dose, double dose, and multiple dose with 48 h interval, the various profiles of protein metabolism were studied in different groups of rat muscle tissue. Total proteins showed decrement, whereas free amino acids, and the activity of protease, aspartate aminotransferase, alanine aminotransferase and glutamate dehydrogenase as well as ammonia significantly increased in cypermethrin-exposed rats. Urea content increase at all doses of exposure was not statistically significant. These effects on the protein metabolism of rats exposed to cypermethrin, which cause impairment of protein synthetic machinery, indicate its toxic effects on cellular functioning.

Cutaneous anthrax--a report of ten cases.

The clinical features of ten cases of cutaneous anthrax are reported. Six males and four females were affected. Their ages ranged from one and a half year to sixty years. The average incubation period was 8 days. Fever and headache were common systemic manifestations. Pruritus and ulcer with formation of black eschar were typical features. The patients were treated with penicillins and chloramphenicol. There was no mortality. Possible human-to-human spread in a patient is discussed.

Outbreak of human anthrax in Ramabhadrapuram village of Chittoor district in Andhra Pradesh.

Thirty human anthrax cases were reported from Ramabhadrapuram village of Chittoor district in Andhra Pradesh during November-December, 1989. These cases occurred following an epizootic of anthrax among cattle and sheep of the village and ingestion of contaminated meat by the villagers. The overall attack rate was 24.39 per cent with a case fatality of 16.67 per cent. All age groups and both sexes were affected. Ten cases were of cutaneous form with typical black eschar formation which were confirmed bacteriologically. Fever and headache were common systemic manifestations. They responded well to penicillins and there was no mortality. The possibility of human to human spread is suggested. The twenty cases of internal anthrax comprised intestinal, septicemic, peritonitis, meningeal and pulmonary forms. Sub-clinical forms also occurred. Fever, abdominal pain, ascites, anorexia and vomiting were notable features. Diagnosis was made clinically and also on epidemiological basis. All deaths during this outbreak occurred in women with internal anthrax, the case fatality rate for the latter being 25 per cent. Prophylactic administration of penicillin was done for individuals at risk.