Evaluation of the effect of sildenafil citrate in pre-eclampsia

This study was undertaken to evaluate the effect of Sildenafil citrate [Viagra] on clinical course, biochemical parameters as well as Doppler ultrasound indices in cases of mild pregnancy-induced hypertension [PIH] and to evaluate the role of Sildenafil, if any, as a new therapeutic modality in mild PIH. The present study was conducted on 60 mild pre-eclamptic pregnant women; they were divided into 2 groups: Group I: included 40 cases and were subdivided into 2 subgroups: Group I A [20 cases] received 100mg sildenafil citrate in 2 daily divided doses for 1 week Group IB [20 cases] received 100 mg sildenafil citrate in 2 daily divided doses for 2 weeks Group II [control]: included 20 cases and were subjected to placebo [iron preparation] and bed rest for 1 week. Both groups were subjected to clinical, biochemical and Doppler ultrasound to assess the changes in blood pressure, uric acid, serum creatinine, serum proteins, serum albumin, ultrasound assessment of amniotic fluid index [AFI] and Doppler ultrasound indices [RI, Pl, S/D ratio] respectively before and after the treatment. The study revealed that there was significant decrease in systolic and diastolic blood pressure measurements and all Doppler indices after the use of 100 mg sildenafil for 1 week in group I A and a more significant reduction after longer duration of treatment in group IB without significant change of all these parameters in group II that was subjected to placebo and bed rest for 1 week. Such discussion is still controversial; the subject is still open for much future validation on larger study groups. It is too early for such preliminary study to arrive at sharp conclusions regarding the clinical utility of sildenafil for amelioration of pregnancy-induced hypertension. However it is convenient to report that at least in the current series, significant lowering of blood pressure and improvement of blood flow indices by Doppler ultrasound was attained by 100 mg sildenafil citrate- The possibility of cumulative effect is still hopeful based on more marked effect of the drug with longer duration of administration

Blood estrogen level as a risk factor for osteoporosis and hip fractures in post menopausal women

Two groups of patients were studied to define the factors that are correlated with the degree of osteoporosis and hip fractures in post menopausal women. The first group were fifty patients at least five years post-menopausal who did not have a history of hip fractures and a second group comprised forty two post-menopausal women with hip fractures. Every patient was subjected to thorough clinical examination, plain radiography for the pelvis and both hips and blood samples were withdrawn and analyzed for estrogen level. Only the correlation between the blood estrogen level and the degree of osteoporosis and incidence of hip fractures was found to be highly significant. The degree of back pain did not correlate with the degree of osteoporosis. It is concluded that a low post-menopausal estrogen level is a helpful guide to define the patient at high risk of developing hip fractures due to osteoporosis