Maternal and perinatal outcome in pregnancy with hypothyroidism.
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Biomedical subjects
Publications and source records attributed to K Devi.
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Necrosis of bone marrow is a very rare condition with a prevalence ranging from 0.15 to 7 percent. It is mostly not compatible with life. We diagnosed four cases of necrotic marrow out of 830 bone marrow aspirations done in last five years of time. All were paediatric patients having peripheral pancytopenia. Three out of four patients expired within one month of diagnosis.
A transdermal delivery system containing the anti-inflammatory analgesic diclofenac diethyl ammonium in an ethyl hexyl acrylate and vinyl acetate pressure-sensitive adhesive system was developed for percutaneous absorption. These patches were subjected to in vitro permeation and permeation enhancement studies through rat skin using a specially designed diffusion cell. Further, the work deals with percutaneous absorption studies carried out on both animals and human volunteers. The pharmacokinetic parameters calculated from the blood levels of the drug reveal a profile typical of a sustained-release formulation, with the ability to maintain adequate plasma levels for 24 hr (i.e., up to the next application). (Area under the curve [AUC]: 4.356 +/- 1.3 mcg/ml.hr in animals and 0.442 +/- 0.053 mcg/ml.hr in humans; Tmax was 8 hr in both the cases, whereas Cmax was 0.288 +/- 0.088 mcg/ml in animals and 0.034 +/- .008 mcg/ml in human volunteers.) The amount of the drug bioavailable for targeting the sites of action is lower than via the oral route, but the absorbed dose appears to be adequate for therapeutic use, particularly because of the absence of side effects.
Two hundred and seventy five pregnancies in patients with congenital heart disease during 1980-1996 were analyzed retrospectively. Maternal and perinatal outcome was compared in 251 pregnancies of women with acyanotic and 24 pregnancies of women with cyanotic heart disease. Congenital heart disease was diagnosed during the index pregnancy in 26.1% of patients and the majority (88.4%) were in NYHA classes 1 and 2. Atrial septal defect (27.7%) was the most common lesion in women with acyanotic heart disease and the majority with cyanotic heart disease had Eisenmenger syndrome, 13 of 21 (61.9%). Sixty pregnancies occurred in patients with surgically corrected lesions (acyanotic, 56; cyanotic, 4). The incidences of abortions (8.3%), stillbirths (13.6%) and small for gestational age (SGA) (36.4%) were higher in cyanotic heart disease compared to acyanotic heart disease (stillbirth, 0.8%; SGA, 6.9%). There was a statistically significant difference in mean maternal age, mean gestational age and mean birth-weight in the surgically corrected and noncorrected lesions in both acyanotic and cyanotic heart disease. There was 1 maternal death in a woman with Eisenmenger syndrome.
BACKGROUND: Toxic epidermal necrolysis (TEN) is a severe, idiosyncratic, exfoliative disease of the skin and mucous membranes. The treatment of this condition is controversial. High-dose corticosteroid therapy has been the most commonly advocated treatment, but, more recently, this has changed to a no-steroid protocol. These conflicting treatments prompted us to evaluate retrospectively our protocol. METHODS: The patients admitted to the hospital from 1989 to 1995 with a clinical diagnosis of TEN were included in the study. These patients were given systemic steroids, prophylactic antibiotic, and supportive measures. RESULTS: The patients belonged to both sexes with an average age of 34 years. The average area of involvement was 85.62%. All the patients made an uneventful recovery without any evidence of sepsis. CONCLUSIONS: Treatment with systemic steroids is useful in the management of TEN, and there is no need for a burn care center.
Current treatment goals for hypertension include the prevention of end-organ injuries. Hypertension is certainly among the major contributors to atherogenesis, and many antihypertensive drugs seem to have wall-protecting properties. It is critical to identify, test, and implement non-invasive methods for the screening of the population in order to detect early wall abnormalities and to monitor the long-term effects of different antihypertensive treatments. Among these methods, B-mode ultrasound examination of carotid arteries has shown great potential in evaluating treatments that may prevent hypertension-related wall injuries.
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1. Neurobehavioral survey of inverse agonist FG 7142 was performed employing a novel anxiety paradigm namely FR-2 Two-Way crossover in a shuttle box. 2. FG syndrome was found to be similar to learned helplessness following shock treatment. Significant increase in mean latency to escape was observed from 0 to 25th trial. Effect of FG 7142 on the behavioral and neurological profile did not deviate significantly from controls. However, a general increase in arousal, darting and sideway movement (weaving) of the head were noted. 3. Drugs with specificity at benzodiazepine (BDZ) receptor site were employed as pretreatments in order to study their influence on FG 7142 induced anxiety syndrome. Diazepam and ZK 91296, significantly blocked the inverse agonist response. Head weaving as well as darting movements were completely abolished although rats demonstrated arousal and vigilance. 4. A dose dependent inhibition of FG response was observed with RO 15-1788, a specific BDZ receptor blocker. ZK 93423 at low doses (1 mg/kg) failed to reverse the escape deficit induced by FG. Higher doses of ZK 93423 could not be tested as significant sedation and ataxia were noted. 5. It is suggested that a careful combination of a BDZ agonist and inverse agonist may be beneficial in the treatment of generalised anxiety disorders.
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BACKGROUND: Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are a group of severe life threatening drug reactions. The drugs commonly implicated as the cause of these drug reactions vary depending on host factors and the prescription pattern of drugs in that particular area. AIM: The aim of the study was to find the drugs implicated as the cause of SJS/TEN in the patients admitted in the dermatology ward at the Medical College, Thrissur and to find the clinical outcome. METHODS: It was a retrospective study of 7 years from 1997 to 2004. The case records of all patients with a clinical diagnosis of TEN or SJS were studied in detail regarding the drugs implicated as the cause, the management and the clinical outcome. RESULTS: During the study period, 41 patients in the age group ranging from 12 to 72 years were treated as inpatients, of which 20 were males and 21 were females. The commonest drug implicated as the cause of SJS/TEN was carbamazepine (44%). The indication for carbamazepine was control of pain in more than 50% of the cases. Presence of a major systemic disease before the onset of SJS/TEN was associated with a bad prognosis. CONCLUSION: The increased use of carbamazepine, especially for control of pain, may be the reason for the increased incidence of SJS/TEN due to the same drug. Awareness about the drugs implicated in life threatening drug reactions will help physicians in preventing them by judicious use of the drugs.
Following the oral administration of acetone extract of Foeniculum vulgare (fennel) seeds for 15 days is male rats, total protein concentration was found to be significantly decreased in testes and vas deferens and increased in seminal vesicles and prostate gland. There was a decrease in activities of acid and alkaline phosphatase in all these regions, except that alkaline phosphatase was unchanged in vasa. In female rats, oral administration of the extract for 10 days led to vaginal cornification and oestrus cycle. While moderate doses caused increase in weight of mammary glands, higher doses increased the weight of oviduct, endometrium, myometrium, cervix and vagina also. The results confirm the oestrogenic activity of the seed extract.