Sampling technique is important for optimal isolation of pharyngeal gonorrhoea.

BACKGROUND: Culture is insensitive for the detection of pharyngeal gonorrhoea but isolation is pivotal to antimicrobial resistance surveillance. The aim of this study was to ascertain whether recommendations provided to clinicians (doctors and nurses) on pharyngeal swabbing technique could improve gonorrhoea detection rates and to determine which aspects of swabbing technique are important for optimal isolation. METHODS: This study was undertaken at the Melbourne Sexual Health Centre, Australia. Detection rates among clinicians for pharyngeal gonorrhoea were compared before (June 2006-May 2009) and after (June 2009-June 2012) recommendations on swabbing technique were provided. Associations between detection rates and reported swabbing technique obtained via a clinician questionnaire were examined. RESULTS: The overall yield from testing before and after provision of the recommendations among 28 clinicians was 1.6% (134/8586) and 1.8% (264/15,046) respectively (p=0.17). Significantly higher detection rates were seen following the recommendations among clinicians who reported a change in their swabbing technique in response to the recommendations (2.1% vs. 1.5%; p=0.004), swabbing a larger surface area (2.0% vs. 1.5%; p=0.02), applying more swab pressure (2.5% vs. 1.5%; p<0.001) and a change in the anatomical sites they swabbed (2.2% vs. 1.5%; p=0.002). The predominant change in sites swabbed was an increase in swabbing of the oropharynx: from a median of 0% to 80% of the time. CONCLUSIONS: More thorough swabbing improves the isolation of pharyngeal gonorrhoea using culture. Clinicians should receive training to ensure swabbing is performed with sufficient pressure and that it covers an adequate area that includes the oropharynx.

Stability indicating LC method for simultaneous determination of irbesartan and hydrochlorothiazide in pharmaceutical preparations.

A simple and precise stability-indicating liquid chromatography method is developed and validated for the quantitative simultaneous estimation of irbesartan (IRB) and hydrochlorothiazide (HCTZ) in combined pharmaceutical dosage form. A chromatographic separation of the two drugs was achieved with an Ace5 C(18) 25-cm analytical column using buffer-acetonitrile (70:30 v/v). The buffer used in mobile phase contains 50 mM ammonium acetate pH adjusted 5.5 with acetic acid. The instrumental settings are flow rate of 1.5 mL/min, column temperature at 30 degrees C, and detector wavelength of 235 nm using a photodiode array detector. IRB, HCTZ, and their combination drug products were exposed to thermal, photolytic, hydrolytic, and oxidative stress conditions, and the stressed samples were analyzed by the proposed method. Peak homogeneity data of IRB and HCTZ is obtained using photodiode array detector. In the stressed sample chromatograms, it demonstrated the specificity of the assay method for their estimation in presence of degradation products. The described method shows excellent linearity over a range of 10-200 microg/mL for IRB and 5-100 microg/mL for HCTZ. Methylparaben was used as internal standard. The correlation coefficient for IRB and HCTZ are 0.998 and 0.999. The mean recovery values for IRB and HCTZ ranged from 100.45% to 101.25%. The limit of detection for IRB and HCTZ were 0.019 and 0.023 microg/mL, respectively, and the limit of quantification were 0.053 and 0.070 microg/mL, respectively. The proposed method was suitable for quantitative determination and stability study of IRB and HCTZ in pharmaceutical preparations and also can be used in the quality control of bulk manufacturing and pharmaceutical dosage forms.

Stability indicating LC method for the simultaneous determination of amlodipine and olmesartan in dosage form.

A simple, rapid, and precise method is developed for the quantitative simultaneous estimation of amlodipine (AM) and olmesartan (OL) in combined pharmaceutical dosage form. A chromatographic separation of the two drugs was achieved with an ACE 5 C(18) 25-cm analytical column using buffer-acetonitrile (60:40, v/v). The resolution between OL and AM was found to be more than 12. Theoretical plates for OL and AM were 6970 and 11,841, respectively. Tailing factor for OL and AM was 0.90 and 0.98, respectively. OL, AM, and combination drug product were exposed to thermal, photolytic, hydrolytic, and oxidative stress conditions, and the stressed samples were analyzed by the proposed method. Peak homogeneity data of OL and AM is obtained by photodiode array detector in the stressed sample chromatograms, demonstrating the specificity of the method for their estimation in presence of degradation product. The described method shows excellent linearity over a range of 20-400 microg/mL for OL and 5-100 microg/mL for AM. The correlation coefficient for OL and AM are 0.9995 and 0.9998, respectively. The relative standard deviation for six measurements in two sets of each drug in tablets is always less than 2%. The proposed method was found to be suitable and accurate for quantitative determination and stability study of OL and AM in pharmaceutical preparations.

Enantiomeric LC separation of valsartan on amylose based stationary phase.

A simple, rapid and robust LC method was developed and validated for the enantiomeric separation of valsartan in bulk drug and formulation. The enantiomers of valsartan were resolved on a Chiralpak AD-H (amylose based stationary phase) column using a mobile phase consisting of n-hexane: 2-propanol: trifluoroacetic acid (85:15:0.2, v/v/v) at a flow rate of 1.0 mL/min. The resolution between the enantiomers was found to be not less than 3.2. The presence of trifluoroacetic acid in the mobile phase played an important role in enhancing chromatographic efficiency and resolution between the enantiomers. The calibration curve for the (R)-enantiomer showed excellent linearity over the concentration range of 600 ng/mL (LOQ) to 6000 ng/mL. The limit of detection and limit of quantification for the (R)-enantiomer were 200 and 600 ng/mL, respectively. The percentage recovery of the (R)-enantiomer ranged between 98.7 to 100.05 % in bulk drug samples of valsartan. The proposed method was found to be suitable and accurate for quantitative determination of (R)-enantiomer in bulk drug substance.

Development and validation of chiral LC method for the enantiomeric separation of duloxetine on amylose based stationary phase.

A simple, rapid, and robust liquid chromatography method was developed and validated for the enantiomeric separation of duloxetine in bulk drug substance. The enantiomers of duloxetine were resolved on a Chiralpak AD-H (amylose based stationary phase) column using a mobile phase consisting of n-hexane-ethanol-diethyl amine (80:20:0.2, v/v/v) at a flow rate of 1.0 mL/min. The resolution between the enantiomers was found to be not less than 2.8 in optimized method. The presence of diethyl amine in the mobile phase played an important role in enhancing chromatographic efficiency and resolution between the enantiomers. The developed method was extensively validated and proved to be robust. The calibration curve for (R)-enantiomer showed excellent linearity over the concentration range of 750 ng/mL (LOQ) to 7500 ng/mL. The limit of detection and quantitation for (R)-enantiomer were 250 and 750 ng/mL, respectively. The percentage recovery of the (R)-enantiomer ranged between 98.3% to 101.05% in bulk drug samples of duloxetine. The proposed method was found to be suitable and accurate for quantitative determination of (R)-enantiomer in bulk drug substance.

Simultaneous high-performance liquid chromatographic determination of telmisartan and hydrochlorothiazide in pharmaceutical preparation.

A simple, rapid, and precise method was developed for the quantitative simultaneous determination of telmisartan and hydrochlorothiazide in combined pharmaceutical dosage form. Chromatographic separation of two drugs was achieved on an ACE 5 C18 25-cm analytical column using buffer-acetonitrile (60:40, v/v) of pH 5.5, adjusted with acetic acid. The buffer used in mobile phase contains 50mM ammonium acetate in double distilled water. The instrumental settings were: flow rate, 1 mL/min; column temperature, 30 degrees C; and detector wavelength, 260 nm. The internal standard method was used for the quantitation of the ingredients of this combination. Methyl paraben was used as an internal standard. The method was validated for linearity, accuracy, precision, limit of detection, limit of quantification, and robustness. The calibration curve shows excellent linearity over the concentration range for telmisartan and hydrochlorothiazide were 10-150 and 5-75 microg/mL, respectively. The correlation coefficient for telmisartan and hydrochlorothiazide were 0.9999. The relative standard deviation for six replicate measurements in two sets of each drug in tablets are always less than 2%. The proposed method was found to be suitable and accurate for quantitative determination of telmisartan and hydrochlorothiazide in pharmaceutical preparation and it can be used for the quality control of formulation products.

Design, synthesis and utilization of 1- substituted sulphonyloxy-2-phenyl benzimidazole as a novel peptide coupling reagents.

Highly efficient coupling reagents, N-methanesulphonyloxy-2-phenyl benzimidazole and N - p-toluenesulphonyloxy-2-phenyl benzimidazole were designed, synthesized and successfully applied in peptide coupling reactions. Their efficiency was evaluated by synthesizing a number of structurally different amides and peptides as well. The distereomeric purity was examined by HPLC. Also the optical rotations of all the synthesized peptides were measured and found to be quite matching with corresponding values in literature. After completion of reaction, the N-hydroxy 2-phenyl benzimidazole which was the starting material for the synthesis of reagents could be easily isolated during the work up by acid base treatment and could be re-used without significant loss in reactivity. Also the intermediate in the reaction sequence was isolated and characterized by mass and (1)H NMR which could help to comment about the probable mechanism.

Validated chiral high-performance liquid chromatography method for a novel anti-methicillin-resistant Staphylococcus aureus fluoroquinolone WCK 771.

A sensitive, simple, specific, precise, accurate and rugged method for the assay and determination of enantiomeric purity of S-(-)-9-fluoro-6,7-dihydro-8-(4-hydroxypiperidin-1-yl)-5-methyl-1-oxo-1H,5H-benzo[i,j]quinolizine-2-carboxylic acid L-arginine salt tetrahydrate (WCK 771) in bulk drug has been developed. The method is RP-HPLC using endcapped C-18 stationary phase and chiral mobile phase. Chirality to the mobile phase was imparted with addition of beta-cyclodextrin. The UV-vis detector was operated at 290 nm. The flow rate of mobile phase was 2 ml/min. The method offers excellent separation of two enantiomers with resolution more than 2 and tailing factor less than 1.5. The method was validated for the assay of WCK 771 and quantification of R-(+)-enantiomer impurity in bulk drug. The calibration curves showed excellent linearity over the concentration range of 0.05-0.15 mg/ml for WCK 771 and 0.5-7.5 microg/ml for R-(+)-enantiomer. The precision (RSD) of the assay was 0.23%. The limit of detection and limit of quantitation of the method for WCK 771 were 0.015 and 0.06 microg/ml, respectively. The limit of detection and limit of quantitation for R-(+)-enantiomer were 0.025 and 0.09 microg/ml, respectively. The average recovery of the R-(+)-enantiomer was 100.5%. Same method was applied for the assay and determination of enantiomeric purity of WCK 771 in the intravenous formulation.

Transcervical recovery of fetal cells from the lower uterine pole: reliability of recovery and histological/immunocytochemical analysis of recovered cell populations.

The aim of this work was to isolate, enumerate and attempt the identification of fetal cells recovered from the lower uterine pole. Immediately before elective termination of pregnancy at 7-17 weeks gestation, samples were recovered by transcervical flushing of the lower uterine pole (n = 108) or transcervical aspiration of mucus from just above the internal os (n = 187), and their contents examined using histological, immunohistochemical and molecular techniques. Syncytiotrophoblasts were identified morphologically in 28 out of 89 (31%) and 50 out of 180 (28%) flushings and aspirates respectively (mean 29%). Immunocytochemistry with monoclonal antibodies (mAbs) recognizing trophoblast or epithelial cell antigens on a smaller number of samples (n = 69) identified putative placental cells in 13 out of 19 (68%) and 25 out of 50 (50%) flushings and aspirates respectively (mean 55%). These included groups of distinctive cells with a small, round, hyperchromatic nucleus, strongly reactive with mAbs PLAP, NDOG1 and FT1.41.1. Smaller groups of larger, amorphous cells, usually containing multiple large, pale staining nuclei, reactive with mAb 340 and to a lesser degree with mAb NDOG5 were also observed. Taking cellular morphology and immunophenotype into consideration, the smaller uninucleate cells were likely to be villous mesenchymal cells, while the larger cells were possibly degrading villous syncytiotrophoblast. There was no significant difference in the frequency of fetal cells obtained by the two recovery methods. Squamous or columnar epithelial cells, labelled strongly with antibodies to cytokeratins or human milk fat globule protein, were observed in 97% (29 out of 30) of aspirates. The use of cervagem in a small number of patients prior to termination of pregnancy did not appear to influence the subsequent recovery of placental cells. Y-specific DNA was detected by polymerase chain reaction (PCR) in 13 out of 26 (50%) flushings and (99 out of 154) 64% aspirates analysed (mean 62%). In-situ hybridization (ISH) revealed Y-specific targets in 40 out of 69 (60%) of aspirates analysed. A comparison of PCR data obtained from transcervical recovered samples and placental tissues showed a concordance of 80% (76 out of 95), with 10 false positives. Comparing the PCR data from tissues with data derived by ISH from 41 aspirates gave a concordance of 90% with two false positives. Although syncytiotrophoblasts were much more likely to be present in samples containing immunoreactive placental cells, the detection rates of fetal-derived DNA were similar regardless of the morphological and/or immunological presence of placental cells. We conclude that the transcervical recovery of fetal cells, while promising, requires considerable additional effort being expended in further research and development, particular in the sampling procedure.

Effect of short term use of oral contraceptives on fibrinolytic activity of the blood.

PIP: 2 oral contraceptives (Primovular 21 and Deoleuton 21) caused a statistically significant lowering of the blood fibrinolytic activity in 14 of 20 women after only 1 month of treatment. It is suggested that this finding may prove of considerable importance for early detection of cases which may be prone to thrombotic episodes.^ieng