Orally Disintegrating Film: A Review of Its Formulation and Manufacturing Method

@#Oral route drug delivery system is still considered as the most convenient and patient friendly drug delivery route. Over the decades, many research has been performed to improve the functionality oral dosage form. Orally disintegrating film (ODF) is a newer oral drug delivery system, which is in the form of a thin film that will disintegrate in the oral cavity within a matter of seconds. The aim of this review paper is to recap ODF, its benefits, formulation contents and manufacturing method. With more research and development work has been conducted on ODF, the dosage form is expected to be manufactured and scaled up to be commercializable products to be sold in the market.

Comparison of Microemulsion and Solvent Evaporation Technique for Solubility Enhancement of Amlodipine Besylate

@#Introduction: Amlodipine besylate is a calcium channel blocker indicated for hypertension and angina. It is described as slightly soluble in water and due to its limited solubility, it may result in poor bioavailability. The aim of this study is to enhance the solubility of amlodipine besylate using solvent evaporation method and microemulsion technique and to compare the two methods. Method: Solid dispersions (SD) of amlodipine besylate were developed by employing solvent evaporation method. PEG6000 was the polymer of choice and different drug:polymer ratios were used. Evaluation of the prepared SDs include solubility studies, dissolution studies and scanning electron microscopy (SEM). As for the microemulsion technique, microemulsions were prepared by phase titration method and the optimized microemulsion formulation was then characterized for solubility studies and dissolution studies. Results: SD3 with drug:polymer ratio of 1:4 achieved the highest solubility which was 96.97 mg/ml ± 0.92 whereas the solubility of the optimized microemulsion was found to be 112.54 mg/ml ± 0.92. In solvent evaporation method, as the drug:polymer ratio increases, the solubility and dissolution rate of SDs increases. Conclusion: The two methods had significantly enhance the solubility of amlodipine besylate however the microemulsion technique showed better solubility profile.

Effects of heme oxygenase-1 upregulation on isoproterenol-induced myocardial infarction

The present study was designed to examine the effect of heme oxygenase-1 (HO-1) induction by cobalt protoporphyrin (CoPP) on the cardiac functions and morphology, electrocardiogram (ECG) changes, myocardial antioxidants (superoxide dismutase [SOD] and glutathione [GSH]), and expression of heat shock protein (Hsp) 70 and connexin 43 (Cx-43) in myocardial muscles in isoproterenol (ISO) induced myocardial infarction (MI). Thirty two adult male Sprague Dawely rats were divided into 4 groups (each 8 rats): normal control (NC) group, ISO group: received ISO at dose of 150 mg/kg body weight intraperitoneally (i.p.) for 2 successive days; ISO + Trizma group: received (ISO) and Trizma (solvent of CoPP) at dose of 5 mg/kg i.p. injection 2 days before injection of ISO, with ISO at day 0 and at day 2 after ISO injections; and ISO + CoPP group: received ISO and CoPP at a dose of 5 mg/kg dissolved in Trizma i.p. injection as Trizma. We found that, administration of ISO caused significant increase in heart rate, corrected QT interval, ST segment, cardiac enzymes (lactate dehydrogenase, creatine kinase-muscle/brain), cardiac HO-1, Hsp70 with significant attenuation in myocardial GSH, SOD, and Cx-43. On the other hand, administration of CoPP caused significant improvement in ECG parameters, cardiac enzymes, cardiac morphology; antioxidants induced by ISO with significant increase in HO-1, Cx-43, and Hsp70 expression in myocardium. In conclusions, we concluded that induction of HO-1 by CoPP ameliorates ISO-induced myocardial injury, which might be due to up-regulation of Hsp70 and gap junction protein (Cx-43).

Cytotoxicity of vibrio cholerae on madin darby bovine kidney cells

The cytotoxicity of cell-free culture filtrates of 31 isolates of Vibrio cholerae O1 and O139, 5 reference strains and 26 clinical isolates, was tested on Madin Darby Bovine Kidney [MDBK] cells and Vero cells. The 3-[4,5- dimethylthiazol-2-y]-2, 5-diphenyltetrazolium bromide [MTT] test was used to detect the effect of the filtrates on the proliferation and viability of cultured cell populations. The filtrates were prepared from serial ten-fold dilutions of inoculated AKI and APW broth media with and without the addition of polymyxin B. The APW culture filtrates of both V. cholerae O1 and O139 with and without added polymyxin B showed greater toxicity to MDBK cells as compared to AKI filtrates. The cytotoxicity of AKI-grown V. cholerae O139 to MDBK cells was greater than that of V. cholerae O1 grown in the same medium. The cytotoxicity of APW filtrates on Vero cells was low and only noted when polymyxin was added to the medium

Effect of some organic additives on the corrosion behaviour of Cu-Fe and Cu-Al - Fe alloys in sulphuric acid solution

The effect of some organic compounds on the corrosion corr behavior of copper - iron alloy [1] and copper - aluminium - iron alloy [II] in 0.5 M H[2]SO[4] aqueous solution was investigated. The techniques of measurements were: weight loss, linear polarization and impedance spectroscopy. The organic compounds were: glycine [I], alanine [II], valine [III], histidine [IV], 2- aminothiazole [V] and 3- methyl -1- phenyl -2- pyrazolin -5- one [VI]. These compounds have high inhibition efficiency increases according to the order: I < II < III < IV < VI < V. The inhibitory effect of these compounds is achieved by their adsorption on the metallic surface via adsorption centers [N - atom and / or S- atom]. Their adsorption the metallic surface follows Temkins' isotherm of adsorption. The values of standard free energy of adsorption, delta G[degree sign] [ads], were calculated from the adsorption isotherms. The negative values of delta G[degree sign] [ads] indicate the adsorption process occurs spontaneously. There is an agreement between the results obtained from the different techniques of measurements

Analytical characterization and antimicrobial screening of the hilsha [tenualosa ilisha] fish lipid from bay of bengal

Muscle Lipid of Hilsha [Tenualosa ilisha] was solvent extracted and characterized with respect to various physical constants e.g. refractive index, moisture, crude fat, crude fibre and ash contents; and chemical parameters e.g. saponification value, saponification equivalent value, acid value, iodine value, acetyl value, peroxide value, thiocyanogen value, Reichert-Meissl value, Polenske value, Hehner value etc. and compared with those of different oils. Results also compared with the data available in literature about pharmacological aspects of Hilsha fish lipid. The oil contain high percentage of palmitic acid followed by myristic acid, palmitoleic acid, stearic acid, oleic acid, respectively, as confirmed by chromatographic examinations. However, investigation lipid sample against the microbial species was inconclusive

correlation of cyclin A with dtug resistance in adult acute non lymphoblastic leukemia

Acute Non Lymphoblastic Leukemia is one of the most common malignant tumors of haematology. With the recent progress in chemotherapy and supportive therapy, the remission and survival rate have been markedly improved. In this study, cyclin A2 and multidrug resistance expression was measured by flow cytometry and RT-PCR in 52 de novo AML patients with acute myeloid leukemia. Their expression was correlated with other prognostic criteria, response to treatment and to overall survival. The rate of CR and PR was significantly higher in the group of positive expression of cyclin A2, compared to that with negative expression. However a statistically significant difference was only reached by PCR [p=0.02]. By flow cytometry, the overall Survival [OS] in the group with positive cyclin A2 expression is significantly higher than that in the group of negative cyclin A2 expression, p=0.03. Regarding MDRI, it was expressed in 39% of our patients and the level of expression was slightly higher by RT-PCR. The rate of CR and PR in the group of negative MDR expression was significantly higher as compared to the group of positive MDR expression, by both flow cytometry and RTPCR [p= 0.005, 0.004, respectively]. The OS in the group with negative MDR1 expression was significantly higher than that in the group of positive MDR1 expression, p=O.04. There was a significant inverse relationship between Cyclin A2 and MDR expression in our AML cases by RTPCR technique [p= 0.005], while it showed no significance by Flow cytometry [p=0.12]. There was no agreement [Kappa=0.25] between Flow cytometry and RT-PCR in detection of cyclin A2. On the contrary, there was an agreement between Flow cytometry and RT-PCR in detection of MDR. In conclusion, the low expression of cyclin A2 and high expression of MDR1 are indicators for unfavorable prognosis for individuals with AML. The detection of cyclin A2 level would predict drug resistance. However, it is one of many other factors

Impact of maternal chronic illness on pregnancy outcome

Egypt is still having high maternal morbidity and mortality. Chronic diseases associated with pregnancy increases the risk of obstetric and neonatal complications ranging from manageable problems up to maternal and fetal mortality. These adverse outcomes are at least in part related to preconception care, monitoring during pregnancy and the proper place and time for termination of pregnancy.1- Exploring pregnancy outcome with common chronic illnesses. 2- Determining the possible underlying factors for unfavorable outcome associated with some chronic illnesses. 3- Fate of the studied patients. A stratified random sample of pregnant with associated chronic illnesses, attended to the emergency outpatient clinic of Kasr El Aini Obstetric and Gynecology Hospital, during the period of 1/10/2006-31/3/2007, were the subjects of this work. Resident physician in charge were asked to complete a pre-tested questionnaire form covering the information that could be collected in this adverse situation. The total sample was 188 patients 17 [9.0%] diabetes type I, 21 [11.2%] diabetes type II, 55 [29.3%] hypertensive, 36 [19.2%] chronic renal diseases, 12 [6.4%] liver cirrhosis and 47 [25.0%] chronic heart diseases. De-compansated conditions were about 78%, 21% attended in labor, about 50% with vaginal bleeding [abortion], 5 maternal deaths were reported. Out of those known terminating pregnancies, known fetal losses were 18 [16 miscarriage and 2 stillbirths, 8 LBW and one case with congenital anomalies]. If pregnancy is associated with chronic maternal diseases, adverse maternal and fetal outcome have to be expected. Hence the importance of foundation of a strategic plan, for their health education about their different chronic illnesses, early detection, monitoring and preparing suitable places for delivery. And this best to be applied on the bases of Primary Health Care or Family medicine clinics

Fish wastewater with " PACP " filter and reuse of the treated water

Powdered activated carbon pellet [PACP] filter was found very effective for the removal of chemical oxygen demand [COD] and nutrients from the fish wastewater. It was found in the study that fish waste water generated from rearing tilapia fish in a glass aquarium for 48 hours had high organic and nutrient content. This high organic and nutrient containing wastewater while passed through the 30 cm PACP filter could remove 90% COD, 93% phosphate and 85% ammonia nitrogen after 10 L of fish wastewater loading. The optimum flow rate for the PACP filter was 100 ml/min. In a comparative study it was found that PACP filter had a better COD removal capacity compared to a same size granular activated carbon [GAC] filter. After 10 L loading of fish wastewater GAC filter showed only 50% removal where as it was 90% for PACP filter. PACP filter did not reach to the breakthrough level or exhausted after continuous loading of 35 L of fish wastewater. Filtered PACP filter wastewater was used for rearing tilapia fish and up to the fourth water changing with a 48 hours interval, the fish was in good condition and no death occurred

Prevalence of infectious diseases among food and beverage handlers in an industrial setting

Food handlers play a major role in ensuring food safety throughout the chain of producing, processing, storage and preparation. Mishandling and disregard for hygiene measures on their part may result in food contamination and its attendant consequences. The objective of this study was designed to assess the health status of food handlers in an industrial setting. A descriptive, cross-sectional study was carried out on 32 food handlers operating in one of steel factories. They were interviewed and inspected using a structural questionnaire administered by researchers. Full clinical examination and investigations involved CBC, chest X-ray, sputum culture for TB, stool analysis and culture for shigella, Widal test and hepatitis A, B, C markers. The research team also arranged educational training course to improve the hygienic knowledge of food handlers This study revealed, 3.1% had a +ve HCV and a high prevalence of parasitic infestations was found in 72% with positive parasitic cysts and 12.5% with positive parasitic ova. Salmonella typhi type O carriers in the studied food handlers represented 6.3%. Regarding hepatitis, 3.2% had a positive HCV antibodies. Thirty cases [94%] had long hand nails and lack sanitary knowledge concerning food handling. This study has revealed a poor knowledge and practice of food hygiene among food handlers. It is recommended that a massive health education campaign directed at both the public and food handlers be embarked on, to reduce prevalence of food born illnesses and to enable people take necessary steps to prevent food borne diseases

Single photon emission computed tomography of technetium 99m tetrofosmin myocradial perfusion imaging in patients with sytemic lupus erythematosus: a preliminary report

This study was to evaluate the utility of single-photon emission computed tomography [SPECT] of Technetium 99m tetrofosmin [Tc-99m TF] myocardial perfusion imaging to detect myocardial involvement in patients with systemic lupus erythematosus [SLE] Three groups of subjects-group 1: 25 SLE female patients with non-specific cardiac symptoms and signs, group 2: 25 female SLE patients without any cardiac symptoms and signs, and group 3: 25 female healthy controls-were evaluated by comparing rest and dipyridamole-stress Tc-99m TF myocardia] perfusion SPECT. Tc-99m TF myocardial perfusion SPECT revealed perfusion defects in 88% and 40% of the cases in groups 1 and 2, respectively. However, no cases in group 3 demonstrated myocardial perfusion defects. Tc-99m TP myocardial perfusion SPECT is a useful noninvasive imaging modality to detect cardiac involvement in SLE patients with or without cardiac symptoms and signs

Relation between cardiomyopathy and exercise capacity multicenter trial

The six-minute walk test [6MW lest] is a safe and simple method to assess exercise capacity in patients with left ventricular [LV] dysfunction. Recent studies confirmed its prognostic significance. The aim of this Study: Was to identify determinants of exercise capacity in patients with LV dysfunction as assessed by 6MW test. and 116 Patients with LV dysfunction caused by ischemic heart disease or idiopathic dilated cardiomyopathy [NYHA class l-IIl] underwent 6MW test, M-mode, two dimensional and Doppler transthoracic echocardiographic studies. 115 Patients were able to perform the 6MW test. The mean distance walked was 277 +/- 114m. Univariate analysis revealed that heart rate, systolic and diastolic arterial pressures, NYHA class, left atrial size, LV myocardial mass index, end-systolic and end-diastolic volume indices, ejection fraction, isovolumic relaxation time, peak early [PE] and peak atrial [PA] wave velocities of LV diastolic filling, PE/PA ratio and deceleration nine of early filling were all significantly related lo 6MW test distance [p<0.05]. Multivariate step-wise regression analysis showed that the only independent determinants of 6 MW test distance were PA wave velocity [F to enter 192.71, multiple r=0.79], PE/PA ratio [F to enter 115.22, multiple r=-0.37], and heart rate [F to enter 80.98, multiple r=-0.12]. Doppler-derived indices of LV diastolic function [PA wave velocity and PE/PA ratio] and heart rate are the main determinants of exercise capacity in patients with LV dysfunction as assessed by 6MW test

Early change of thyroid hormone concentration after 131I treatment in patients with solitary toxic noudule

In spite of extensive use of 131I for treatment hyperthyroidism, the results of early outcome are variable. To test whether 131 I induced necrosis causing clinical aggravation of hyperthyroidism and increasing the free thyroid Hormone concentration in the serum of patients with solitary nodule not pretreated with antithyroid drugs. Thirty consecutive patients were treated with 925 MBq 131 I. Serum concentration of thyrotropin [SH] free thyroxine [fT4], free triiodothyronine [fT3], Thyroglobuline [Tg], and interleukin-6 [IL-6] were measured A'lure and after application of 131 I. After application of 131 I no clinical worsening I was observed. FT4 and fT3 concentration did not change significantly within the first five days, whereas both of them significantly decreased after 12 days [p<0.0001]. Slight and clinically irrelevant increase in the level of the two thyroid innones was observed in 9 patients. Furthermore, we observed a prolonged increase in Tg concentration and a transient [iirrease in IL-6 concentration. Neither evidence of any clinical aggravation hyperthyroidism nor any significant increase in thyroid inrmone concentration by 131 I induced necrosis of thyroid cells was found. Therefore, the application of 131 I may be concidered as a safe and effective treatment for patients with typerthyroidism due to toxic adenoma.

Plasma leptin, tumor necrosis factor-alpha and tissue inhibitor of metalloproteinase-1 in chronic hepatitis C patients and their relation to hepatic fibrosis

Hepatitis C virus [HCV] infection is a major cause of chronic hepatitis which frequently leads to progressive hepatic fibrosis and ultimately liver cirrhosis. Many humoral factors and cytokines are known to have profibrogenic and proinflammatory role in chronic hepatitis C patients [CHC] including leptin and TNF-alpha that act in an orchestrated manner with other factors to augment hepatic fibragenesis and. High circulating levels of leptin have been observed in CHC patients, and activated hepatic stellate cells [HSCS] are the effector cells producing leptin in addition to the adipose tissue cells. These HSCS secrete also tissue inhibitor of metalloproteinase-l [TIMP-1] which is one of TIMPS that interact with matrix metalloproteinases [MMPS] to regulate the turnover of extracellular matrix. The role of TIMP-1 in hepatic fibrogenesis and its possible value as a serum marker predicting liver fibrosis was reported in many studies. The aim of this study was to evaluate the possible role of leptin and TN F-alpha in hepatic. fibrogenesis and the possible role of TIMP-1 in determining the progression of liver fibrosis in a cohort of CHC patients. We aimed to evaluate the potential use of these serum markers to predict hepatic fibrosis. We measured leptin and TNF-alpha in the plasma of 55 CHC patients and 25 age and sex matched control persons by radioimmunoassay. Serum TIMP-1 was measured in both CHC patients and control persons by ELISA method. Liver disease in CHC patients was evaluated by the stage of hepatic fibrosis, grading of necroinflammation and grading of hepatic steatosis in liver biopsy. The mean age of CHC patients was 42.2 years [27-69 years] and the mean age of normal control persons was 4l.5[25-67 years]. Plasma - leptin, TNF-alpha and TIMP-1 were significantly higher in CHC patients compared to the normal controls [P<0.001 for leptin, P<0.05 for TNF-alpha, P<0.05 for TIMP-1]. Leptin correlated with BMI [body mass index] in CHC patients [males: r=0.51 P<0.01, [females: r=0.75 P<0.001], while both TNF-alpha and TIMP-1 did not correlate with any of clinical or biochemical parameters in CHC patients. Leptin levels increased as hepatic fibrosis stage progressed both in male and female CHC patients [males P<0.01, females P<0.001]. TNF-alpha levels and TIMP-1 levels were significantly higher in advanced stages of hepatic fibrosis [P<0.01 for TNF-alpha, P<0.001 forTIMP-1]. Plasma leptin and TNF-alpha levels showed no correlation with hepatic steatosis or histological necroinflammatory activity in CHC patients- Serum TIMP-1 levels did not correlate with hepatic steatosis but correlated with histological activity in CHC patients [Knodells score: r=0.91 P<0.001; Scheuer's Score: r=0.84 P<0.001]. Serum leptin levels did not correlate with TNF-a levels [r=0.18 P>0.05] or TIMP-1 levels [r=0.21 P>0.05]. Our data showed that serum leptin increased in CHC patients according to the severity of hepatic fibrosis. It seems to play a role in regulating hepatic fibrosis in addition to TNF-alpha and other profibrogenic cytokines. TIMP-1 levels increased similarly in advanced stage of hepatic fibrosis and it seems to be involved in determining the progression of hepatic fibrosis. These serum markers are potentially good tools to assess hepatic fibrosis in CHC patients and they may be useful to assess the response to antiviral therapy. They may represent therapeutic targets in the future to modulate or stop hepatic fibrosis

Randomized double-blind controlled study to determine the effect of vaginally applied nitric oxide donor [isosorbide mononitrate] for preinduction cervical ripening on maternal and fetal hemodynamics and the ripening if the cervix

Aim of the study: To assess the effects of vaginally administered isosorbide mononitrate [a nitric oxide donor, effox tablets 40 mg] on maternal and fetal hemodynamics and the ripening of the cervix. Study design: We conducted a randomized controlled study: two matched groups were recruited as regards. Parity, bishop score, gestational age. Women that were recruited for induction of labor, were randomly selected to receive vaginally administered isosorbide mononitrate 40 mg [n=40] one tablet [study group]or to undergo vaginal examination only [n=40] [control group]Maternal pulse, blood pressure and fetal heart rate were recorded at 0 base line, every 30 minutes till 6 hours. Umbilical artery resistance index and pulsatility index measurements were performed at 0,3 and after 6 hours. Cervical Bishop scores were measured at 0 base line and at the end of the treatment program period [6 hours from the application of isosorbide mononitrate] Maternal pulse rates were increased after the administration of isosorbide mononitrate, 40 mg, compared to the pulse rates in the vaginal examination only group. [greater difference in means, 16 beets per minute, P<0.01]. Maternal systolic and diastolic blood pressures were decreased in the study group than in the control group [greatest difference in mean systolic and diastolic blood pressure, 15 and 16 mml Hg respectively, with a P<0.001]. Fetal heart rate was increased in the study group, than in the control group, with a difference in mean, 19 beats/minute with a P<0.05. No women required treatment for hypotension or for maternal and fetal tachycardia except for headache, which needs mild analgesics to be relieved. The forty mg dose of isosorbide mononitrate had no significant effect on umbilical artery resistance or pulsatility index. Changes in the Bishop score, was more marked in the 40mg isosorbide mononitrate group than in the control group and the difference was statistically significant P<0.05. Conclusions: Vaginal administration of 40 mg isosorbide mononitrate to pregnant women at term has a safe effect on both maternal and fetal hemodynamics. Thus nitric oxide donors are suitable agents for preinduction cervical ripening at term, and can be used as outpatient method with no need for fetal monitoring, being a uterine relaxing agent

Identification of biochemical changes in intractable postpartum hemorrhage and evaluation of the different methods used in management

To find out the possible causes for inability of the smooth muscle fibers of the uterus to contract in cases with postpartum hemorrhage in response to ecbolics and evaluation of the different methods used in management. This study included 200 women, 100 of them delivered and developed postpartum hemorrhage [the study group] which was divided into two subgroups, the first subgroup included 75 women that responded to conservative and medical methods of treatment of postpartum hemorrhage, the second subgroup included 25 women who did not respond. The other 100 women delivered and not developed postpartum hemorrhage [the control group]. The cases included in this study were [of atonic postpartum hemorrhage], of all parities, without rupture uterus, retention of the placenta, genital tract laceration or blood coagulation defects. Blood samples: [10 cm each] were taken from each patient for determination of hemoglobin percentage, complete blood analysis, random blood sugar, urea and creatinine, serum sodium and potassium and coagulation profile. Another sample [10 cm] was taken for nitric oxide assay and determination of plasma lipid peroxides. The routine medical managements used for treatment of postpartum hemorrhage were done for all cases. Surgical managements were done for the non-responding cases. In relation to the risk factors for development of postpartum hemorrhage, the study group was more anemic, with more antepartum hemorrhage, more malpresentation, more multiple pregnancies, more polyhydramnious and more manipulation outside the hospital than the control group and the differences were statistically significant. There was more prolonged labor and prolonged rupture of membranes in the study group than in the control group but there was no difference in relation to the mode of delivery. There was significant difference in relation to the level of plasma lipid peroxides [P value<0.01] and serum nitric oxide [P value<0.001] between the study group and the control group. The level of plasma lipid peroxides and serum nitric oxide was elevated in the intractable subgroup more than in the responding one and the difference was statistically significant [P<0.001]. Twenty five cases did not respond to the medical methods used for treatment [the intractable subgroup], they were of high parity, more anemic and of more medical disorders than the responding subgroup [75 cases responded for medical methods] and the differences were statistically significant. The surgical methods [conservative one] succeeded in 19 cases of 25 who failed to respond to medical treatment with a percentage of 76%. The remaining 6 cases, hysterectomy was done and succeeded in 3 cases only with a percentage of 50%. The other 3 cases died later on from pulmonary embolism, renal failure and DIC. Elevation of the level of free radicals as plasma lipid peroxides and serum nitric oxide was more markedly evident in the cases that failed to respond to the medical methods and ecbolic drugs used in control of postpartum hemorrhage [Intractable cases]. This elevation in free radicals, most probably, was due to cellular injuries of the uterine muscle fibers as a result of hypoxia and anoxia resulting from failure of correction of blood loss rabidly in cases of postpartum hemorrhage. Thus early and rapid correction of blood loss especially by fresh blood can prevent this vicious circle and prevent cellular injury in cases of postpartum hemorrhage. It is advisable not to rush to do urgent hysterectomy without performing the other conservative surgical methods for controlling of postpartum hemorrhage, as they succeeded in more than 75% of cases

Evaluation of the level of total nitrate and nitrite concentration in vaginal secretion in cases with preterm labor and if it can be used as a predictor of premature delivery

Vaginal secretions were collected after informed consent from 80 pregnant women with gestational ages from 27 to 32 weeks. Samples were collected by thorough washing of the vagina with 5 ml sterile physiologic sodium chloride solution. Samples were stored at -40C until delivery of all studied pregnant women. The level of total nitrite and nitrate concentration in vaginal secretion of pregnant women who delivered before 37 completed weeks and in those with preterm premature rupture of membranes with subsequent preterm delivery were significantly higher than in those delivered at term

Serum determination of the level of iron, ferritin and transferrin in pregnant patients and their relation to preterm delivery

Seventy-five women presenting with preterm labor whose gestational age ranged from 26 to less than 37 weeks were chosen as the study group. Another 75 women were used as a control group [25 women whose gestational age ranged from 38 to 40 weeks presenting in labor and the other 50 women with gestational ages ranged from 27 to 37 weeks attending the antenatal clinic and were not in labor]. 5 ml venous bloods were withdrawn from the anti-cubital vein from each woman, 2 ml for hemoglobin and 3 ml for serum assay of iron, ferritin and transferring determinations. The results revealed that the concentration of serum ferritin was higher in preterm group and the differences were statistically significant. However, the differences between concentrations of serum iron and serum transferrin among these groups have no significance. In conclusion, the differences of serum iron and transferrin has no significant value in cases of preterm labor, hut the difference in serum ferritin has a good significant value in cases of preterm labor, thus elevation of serum ferritin in the second trimester can be used a predictor of early spontaneous preterm labor

Randomized comparative study between pregnant women with early serial transvaginal ultrasonography versus early cerclage on the outcome of pregnancy, in those with an unclear history of incompetent cervix

Forty women with an unclear history of incompetent cervix [women with single second trimester termination or unexplained loss] and those with three or more first trimester terminations were randomly distributed into two groups: Group I included ten women who underwent early elective cervical cerclage [15 weeks] to be compared with the other thirty women [group II] with the same unclear history of cervical incompetence who underwent early serial transvaginal ultrasonography for the detection of cervical changes [two or more examinations before 20 weeks]. Latte therapeutic cervical cerclage was done for women who had evident cervical shortening and or funneling detected by transvaginal ultrasonographic examination. The primary outcome variable was gestational age at delivery. Demographic variables and the data collected from the obstetric history between the two groups were nearly similar, with no statistically significant difference. The frequencies of preterm labor and preterm rupture of membranes were high in group I [elective cervical cerclage] than in group II [early serial transvaginal ultrasonographic examination] and the differences were statistically significant. The mean gestational age at delivery was 35.2 + 3.5 weeks for the early elective cervical cerclage women [group I] versus 36 + 4.0 weeks for the early serial transvaginal ultrasonography women [group II] with no significant difference in between

Vascular and hormonal changes before and after laparoscopic ovarian electrocautery in patients with polycystic ovarian disease

Forty infertile patients with PCOD were enrolled in the study, they were undergone laparoscopic ovarian electrocautery. Before the operation, all cases were subjected to a good history with a thorough clinical examination together with transvaginal ultrasonic examination, hormonal profile [FSH, LH, prolactin and DHEA] in the early follicular phase and color Doppler of uterine and ovarian arteries with determination of pulsatility index [PI] were done to all patients. After operation hormonal profile was assessed one day, one month and three months after electrocautery, Doppler study of ovarian and uterine arteries, folliculometry for three consecutive cycles. As regard Doppler before drilling, flow velocity patterns of uterine and ovarian vessels showed high pulsatility index [PI], which showed gradual decrease along the three cycles after drilling. As regard, hormonal profile, FSH showed significant rise, while LH and LH/FSH ratio showed significant fall along the three cycles, DHEA showed no significant change one day after drilling, but significantly decreased one month and three months after drilling. On the other hand, prolactin showed no significant change