Rupture Ectopic Pregnancy in Early Gestation Due to Mifepristone & Misoprostol Abuse

Ectopic pregnancy is a significant health problem in the world,which affect 1.2% of women of reproductive age; causingsignificant morbidities and mortality. Most ectopic pregnanciesare located in the ampullary, fimbriae or isthmic part of thefallopian tube. Mifepristone (antiprogesteron) followed by a lowdose of Misoprostol (prostaglandin E1, analogue) has beenused for medical termination of early pregnancy after embryoreaching endometrial cavity. But there have been many reportsof misuse of this combination drug. Here we report- fifteencases of rupture ectopic pregnancy after misuse ofcombination drug in very early pregnancy as an over thecounter drug without looking for ectopic pregnancy.

Analgesic and Anti-inflammatory Activities of the Fruit Extract of Ampelocissus latifolia (Roxb) on Laboratory Animals.

Aim of Study: This study was aimed to evaluate the possible analgesic and antiinflammatory properties of the ethanol extract of fruit of Ampelocissus latifolia (Roxb). Study Design: Assessment of analgesic and anti-inflammatory activities. Place and Duration of Study: Department of Pharmacy, North South University, Dhaka, Bangladesh, between June 2012 and March 2013. Methodology: The crude ethanol extract was investigated for the anti-inflammatory effect on Long Evans rats using carrageenan induced rat paw edema method. For antiinflammatory study, 20 rats were divided into 4 different groups, each receiving either distilled water, standard drug or the extract at the doses of 250 and 500mg/kg body weight (BW). The analgesic activity was evaluated by hot plate and acetic acid induced writhing method in Swiss albino mice divided into 4 different groups (control, standard and extract at two different doses of 250 and 500 mg/kg BW). Results: The results of preliminary phytochemical study revealed the presence of alkaloids, flavonoids, tannins, glycosides in significant amounts. The results of anti inflammatory activity study showed that the fruit extracts at a dose of 250 mg/kg and 500 mg/kg inhibited carrageenan-induced paw edema in Long- Evans rats. Both the extracts were able to show a dose dependent anti-inflammatory activity as compared to diclofenac sodium used as a standard drug. The extract elicited a highly significant (p<0.001) analgesic activity in a dose dependent manner on hot plate method, acetic acid-induced writhing test. In the hot plate method, the extract increased the reaction time of heat sensation to 94.71% and 82.7% at the doses of 250 and 500 mg/kg BW while that of the standard drug was 61.45% at the 3rd hour of study. In acetic acid induced writhing test, the percent inhibition of writhing response by the extract was 50.57% and 59.77% at 250 and 500 mg/kg doses respectively (p<0.001). Conclusion: The anti-inflammatory and analgesic effect of the ethanol fruit extract of Ampelocissus latifolia (Roxb) may be due to the presence of various chemical constituents especially flavonoids, tannins, alkaloids or terpenoids. These experimental findings would further establish the scientific basis of the traditional uses of the plant in the management of inflammatory conditions as well as control of pain.

Primary Angioplasty for the Treatment of Acute ST Elevated Myocardial Infarction: Single Centre Experience.

Background: Worldwide primary angioplasty is a recommended strategy of reperfusion in patient with acute myocardial infarction as because it ensures reperfusion of the infarct-related vessels more than 90% where as, with thrombolytics it is only 60-70%. Methods: It is a retrospective observational study includes all patients treated with primary angioplasty at United Hospital from Between March 2007 to August 2010. Total 237 consecutive patients with acute myocardial infarction were treated with primary angioplasty were included. Those presented beyond 12 hours of onset of chest pain, in cardiogenic shock, resuscitate and intubated before the procedural were excluded from the study. Results: Majority (76%) of the patient were male, age was minimum 28 years and maximum 80 years, 41.5% were diabetics, 58.4% were hypertensive, 43.5 %were dyslipidaemic, 17% were smoker, 29.3% with positive family history. Fifty seven percent patients presented with anterior MI, 42 % with inferior MI and 1 % with lateral MI. Left anterior descending (LAD) is the most common vessel involved (S7%), followed by Right coronary artery (RCA) 31 %, Left circumflex artery (LCD 8 %, Ramus 1.3 % and Graft vessel 2.7%. Our door to balloon time was minimum 23 min, maximum 184 min. We used drug eluting stents for most of the patients , GP IIbIIIa receptor Mockers used in 50% cases and thrombus suction device were used when indicated. We faced complications like arrhythmias in 24% hypotension in18 %, no flow or slow flow in 45%, cardiac arrest in 3% and coronary perforation in 1. %. Our overall survival was 97.9 %. Conclusion: Primary angioplasty is a emerging area in the context 149-154of our country . Many of the new centers start this novel strategy which helps to save many lives. Primary angioplasty is feasible and safe method of reperfusion in patient with acute myocardial infarction in our center.

Hypoglycemic effects of Coccinia indica: inhibition of key gluconeogenic enzyme, glucose-6-phosphatase.

Coccinia indica (Family: Cucurbitaceae, locally known as telakucha) leaves were extracted with 95% ethanol. Following evaporation of the solvents, the residue was suspended in distilled water. When this suspension was fed orally to male normal-fed and 48-hr starved rats, the blood glucose was lowered 21% (P less than 0.01) in normal-fed and 24% (P less than 0.001) in 48-hr starved animals respectively. Starvation had induced a 3-fold increase in the activity of glucose-6-phosphatase and this activity was depressed 19% (P less than 0.05) by extract feeding while basal activity of the enzyme in normal-fed rats remained unaffected. Consistent with the depression of glucose-6-phosphatase, urea cycle enzyme arginase was also depressed 21% (P less than 0.001) and 12% (P less than 0.01) in the liver of 48 hr-starved and normal-fed animals respectively. Unlike glucose-6-phosphatase, starvation induced levels of gluconeogenic enzymes alanine aminotransferase and aspartate aminotransferase were not affected by Coccinia extract. These results suggest that the hypoglycemic effect of C. indica is partly due to the repression of the key gluconeogenic enzyme glucose-6-phosphatase.

study of the relation of bronchial asthma to parasitic infection among children

This study was conducted on eighty patients, forty of them were asthmatics on the basis of their history and full clinical examination, the other forty cases were free of any chest troubles. All these children were subjected to stool analysis, determination of their percentage blood eosinophilic count, and determination of their total serum IgE. It was found that only 10% of asthmatic children were parasitized, meanwhile 77.5% of non asthmatic children were heavily infected with intestinal parasites. Eosinophilic count and total serum IgE were found to be high in both groups, although the incidence of high values were more in the asthmatic group. From this work, it seems reasonable to assume that there was an inverse relationship between parasitic infections and bronchial asthma

Tratamiento de la nefritis lupica proliferativa difusa con altas dosis de metilprednisona endovenosa. Analisis de nueve casos. / Treatment of diffuse proliferative lupus nephritis with high doses of intravenous methylprednisole:analysis of 9 cases

Se analizan las modificaciones clincohumorales e histologicas operadas en nueve pacientes con nefritis lupica proliferativa difusa, tras la administracion de seis "pulsos" de metilprednisona intravenosa en dosis de 30 mg/kg. Se observo rapida remision de la sintomatologia sistemica.La depuracion de creatina basal media en siete pacientes con disminucion del filtrado glomerular fue de 29.6 ml/m/1.73 m2 s.c., de 58.4 al mes y de 122 ml a los tres meses. La proteinuria, masiva en todos los pacientes, disminuyo de 6.7 g/24 horas +/- 2.4 a 2.7 +/- 0.7 y a 1.4 +/- 0.3 al mes y a los 3 meses respectivamente.Ocho pacientes fueron seguidos 37.2 meses en promedio La filtracion glomerular actual promedio es de 127.8 ml/m/1.73 m2 s.c. +/- 15.1 y la proteinuria promedio es de 237 mg/24 horas. Las biopsias renales alejadas mostraron cambios notables en la actividad lesional, presentando cierta proliferacion mesangial con grado variable de esclerosis segmentaria o global relacionada con la mejoria funcional. En conclusion, los pacientes lupicos con glomerulonefritis proliferativa difusa mostraron una marcada y sostenida mejoria de la funcion renal y de las alteraciones histopatologicas siguiendo a la administracion de "pulsos" de metilprednisona endovenosa. Se senala la necesidad de estudios controlados con mayor numero de pacientes y seguimientos mas prolongados

Lupus eritematoso sistemico en la infancia. / Systemic lupus erythematosus in childhood

Se efectuo el analisis clinicopatologico de 23 casos pediatricos de LES asistidos en los ultimos 10 anos. El diagnostico se baso en la conjuncion de afectacion multisistemica y en la demostracion de titulos elevados de factores antinucleares, antiADN y descenso de fraccion C3 del complemento. Hubo una alta incidencia de compromiso articular (91,3%), cutaneo (86,9%) y renal (95,6%). La actividad de la enfermedad fue vigilada mediante valoracion clinica periodica, proteinuria y clearance de creatinina y con elementos humorales como C3, FAN y antiADN. La valoracion histologica fue de suma utilidad para guiar la terapeutica inicial, como asimismo para conocer el grado de actividad de la nefropatia lupica. Descensos del filtrado glomerular y proteinurias masivas se correspondieron, en general, con nefritis lupicas proliferativas difusas en actividad.El empleo de regimenes terapeuticos mas agresivos parece haber mejorado el pronostico de la afectacion renal y del sistema nervioso central. La mortalidad global fue del 28%, la que puede considerarse aceptable teniendo en cuenta el alto porcentaje de formas con grave compromiso renal en esta serie