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Biomedical subjects

K Prema

Publications and source records attributed to K Prema.

At least 19 recordsLinked to original sources
PubMed1986

Bioavailability of levonorgestrel from intravaginal rings in women of low income groups.

Two types of intravaginal rings (IVR) containing 50-128 mg of levonorgestrel (LNOG) and 28-60 mg of estradiol were inserted in 18 apparently normal subjects belonging to the low socioeconomic group on day 5 of the cycle. A total of 120 cycles were studied with cyclic insertion and withdrawal. Data on menstrual cycle changes were noted. For bioavailability study, blood samples were collected twice weekly for a period of one month in the first cycle in 8 women. All the plasma samples were analysed for LNOG and progestrone by RIA. Cycle control was excellent in IVR users. Expulsion of the ring was noted in 4 instances. The plasma LNOG levels were found to reach a peak level ranging from 2.7-7.5 ng/ml within 4 days after the IVR insertion. In between day 9 to 24, the plasma levels appeared to be almost steady, and once the ring was removed, the levels dropped off rapidly. The mean plasma LNOG calculated during the steady-state period of the cycle ranged from 1.6-5.1 ng/ml. These mean LNOG levels were found to be inversely correlated with skin-fold at triceps. In all the subjects ovulation was found to be inhibited, as reflected by plasma progesterone values. The range of release rates calculated from plasma steady-state values was 51-119 micrograms/day. The average release rates over the entire period of observation based on area under curve were 102-200 micrograms/day. On the other hand, the release rates obtained from the residual drug in the ring after a period of use ranged from 184-259 micrograms/day.

Adolescent↗
PubMed1986

Impact of hormonal contraceptives vis-à-vis non-hormonal factors on the vitamin status of malnourished women in India and Thailand. World Health Organization: Special Programme of Research, Development and Research Training in Human Reproduction. Task Force on Oral Contraceptives.

The effects of combined oral contraceptives containing 30 or 50 micrograms ethinyl oestradiol and 150 micrograms levonorgestrel or a 3-monthly injectable preparation depo-medroxyprogesterone acetate (DMPA) on the vitamin status of low-income group women from two urban centres in India (Bombay and Hyderabad) and one rural centre in Thailand (Chiang Mai) were examined in a follow-up study over a period of 1 year. The magnitude of malnutrition in the study population vis-à-vis a middle-income reference group was assessed by comparing the baseline data on the two groups. Effects of time-related variables such as lactation and season were also examined by a cross-sectional analysis of the baseline data on the study population. In all three centres the majority of the study population suffered from biochemical riboflavin and/or pyridoxine deficiency even before initiating contraception. Lactation appeared to have an effect on the vitamin status, which varied among the different populations. Seasonal effects were seen, but showed inconsistent trends in the three centres. Both the oral contraceptive pills and DMPA tended to increase serum vitamin A and blood folate. The thiamin, riboflavin and pyridoxine status of the women who were already deficient did not deteriorate further with the use of hormonal contraception, as judged by enzyme saturation tests. Some deterioration in the riboflavin status of the normal women of Hyderabad was seen with the use of oral pills. Women who were biochemically deficient prior to the use of oral contraceptives tended to show some improvement in B-vitamin status, over the 1-year period of hormonal contraception.

Adolescent↗
PubMed1986

Relationship between maternal vitamins B2 and B6 status and the levels of these vitamins in milk at different stages of lactation. A study in a low-income group of Indian women.

Riboflavin and vitamin B6 status of mothers from a low-income group were assessed by erythrocyte glutathione reductase activation and erythrocyte aspartate aminotransferase activation tests respectively, at different stages of lactation. Levels of these vitamins in milk were also measured. The majority of the women had biochemical evidence of vitamins B2 and B6 deficiency. There was a bizarre reduction in erythrocyte glutathione reductase activation from 6 to 30 d post partum. Levels of riboflavin in milk were in general satisfactory, but vitamin B6 levels were lower than the values reported from developed countries. Clear-cut correlations between the enzymatic indices of vitamin status evaluation and milk levels of the corresponding vitamins were not apparent.

Aspartate Aminotransferases↗
PubMed1985

Vitamin supplements to Indian women using low dosage oral contraceptives.

Effect of continuous and intermittent vitamin supplements on vitamin status, serum proteins and lipids were examined in Indian women of low-income group, receiving a low-dose oral contraceptive over a period of 3-6 months. To find out non-specific time related changes, vitamin supplemented and unsupplemented control groups of non-OC users were also examined. OC treatment did not change serum chemistry significantly. The significant biochemical changes were: altered tryptophan metabolism and elevated plasma vitamin A levels. Former could be prevented by administering multivitamins containing 10 mg vitamin B6 daily or twice the dose daily for the 7 non-hormone days in the cycle. Vitamin supplements produced significant improvement in pre-existing deficiencies of riboflavin, pyridoxine and folic acid. Continuous supplementation regimen was slightly superior, but more expensive than the intermittent supplementation regimen. In view of the high prevalence of vitamin deficiency among the low-income group women of developing countries, the delivery system for oral contraceptive can be effectively used for giving vitamin supplements as well.

Adult↗
PubMed1983

Pharmacokinetics of levonorgestrel in Indian women.

A low dose combination pill containing levonorgestrel 150 micrograms and ethynylestradiol 50 micrograms was administered orally to 13 women. Based on their anthropometric index they were classed as well-nourished (Group A) or undernourished (Group B). Plasma levels of levonorgestrel at various intervals after dosing were analysed by a specific radioimmunoassay and its pharmacokinetic parameters were computed. Peak plasma levels in both groups occurred within 2 h and the absorption half-lives were also similar. The decline in plasma levonorgestrel showed a tri-exponential decline in all Group A women, whereas it was biphasic in most of Group B. The pi t1/2 was lower in Group A women and the alpha-phase was found to be negligible in Group B. A significant positive correlation between elimination half-life (beta t1/2) and some of the anthropometric indices suggests a possible role of nutritional status in the metabolic handling of levonorgestrel.

Adult↗
PubMed1983

Further studies on sister-chromatid exchange frequency in users of hormonal contraceptives.

Women using an estrogen-progestogen combination contraceptive exhibited an increased frequency of sister-chromatid exchange (SCE), supporting our previous observation. These elevated SCE frequencies tended to decline 3 months after the discontinuation of the pill. Women using a progestogen injectable contraceptive, on the other hand, had unaltered SCE rates. The analysis, in vitro; of mitomycin-C-induced SCE frequencies in women using either the combination or the progestogen injectable contraceptives showed significantly higher rates of induced SCE.

Contraceptive Agents, Female↗
PubMed1983

Plasma dopamine beta-hydroxylase activity in pregnancy-induced hypertension.

Plasma dopamine beta-hydroxylase (DBH) activity was estimated in non-pregnant women, normotensive pregnant women during the third trimester and women with pregnancy-induced hypertension (PIH). Non-pregnant women from a high income group had significantly higher DBH activity than their low income counterparts. DBH activity was significantly elevated in women with PIH when compared with non-pregnant and normal pregnant women from a low income group, but was lower than the level in well-nourished, non-pregnant normotensive women.

Adolescent↗
PubMed1982

Serum prolactin levels in undernourished Indian lactating women.

1. Serum prolactin (PRL) levels, both basal and post-suckling peak, were estimated in fifty-seven lactating women. 2. Basal PRL levels were significantly higher in all lactating women irrespective of the duration of lactation as compared to the levels in non-pregnant, non-lactating women. 3. There was significant positive correlation (r 0.69, P less than 0.001) between the basal PRL levels and the post-suckling peak values. 4. After 8 months of lactation, peak post-suckling, PRL levels were not significantly different from basal values. 5. Basal PRL levels were significantly lower (P less than 0.05) in mothers whose infants were being supplemented. 6. PRL levels were not related to the mother's nutritional status as determined by body-weight. 7. The findings suggest that high PRL levels during lactation prolong the duration of lactional amenorrhoea and hence the relative infertility.

Adult↗
PubMed1982

Immune status of anaemic pregnant women.

Immune status during the third trimester of pregnancy was investigated in relation to maternal haemoglobin levels. The proportion of T and B lymphocytes showed a tendency to fall in anaemic women which was significant when haemoglobin levels were less than 8 g/dl. Immunoglobin G showed the opposite trend. There were no alterations in phytohaemagglutinin-induced lymphocyte transformation in relation to haemoglobin concentration.

Adult↗
PubMed1981

A study of erythrocyte membrane cation transport adenosine triphosphatases in pregnancy-induced hypertension and of in vivo effects of diuretic treatment.

Plasma and erythrocyte Na+ and K+ and erythrocyte membrane (EM) Na+, K+ ATPase, Mg2+ ATPase and Ca2+, Mg2+ Atpase activities were studied in four groups of women -- non-pregnant, normal pregnant, with pregnancy edema (PE) and with pregnancy induced hypertension (PIH). The effect of diuretic therapy in PE and PIH was also evaluated. Plasma Na+ concentration was higher in PE and PIH. There was a significant reduction in (Na+ + K+) ratio between cell and plasma in these two groups. EM Na+, K+ ATPase was unaltered in PE and PIH. The Mg2+ ATPase was elevated by 44% in PE and by 100% in PIH subjects. There was a 50% reduction in Ca2+, Mg2+ ATPase activity in PE. Diuretic therapy had no effect either on electrolyte levels or on any of the EM ATPases. From these results it may be concluded that Na, K, ATPase -- which in kidney is a site of action for furosemide, a potent diuretic -- is unaffected in PE and PIH and, hence, treatment with diuretics -- is unaffected in PE and PIH and, hence, treatment with diuretics in such patients may be ineffective.

Adenosine Triphosphatases↗
PubMed1981

Plasma levels of norethidrone in Indian women receiving norethidrone enanthate (20 mg) injectable.

Plasma norethindrone (NET) and progesterone were estimated by radioimmunoassay in seven Indian women after intramuscular administration of 20 mg NET enanthate. One subject had intermenstrual bleeding throughout the cycle. Out of the six subjects considered for analysis, three subjects showed ovulation suppression, two had delayed ovulation and the remaining one exhibited normal ovulatory pattern. Post-peak average plasma NET values ranged from 1.0 to 2.1 ng/ml. These values showed a significant positive correlation with the anthropometric indices such as body weight and mid-arm-circumference. The subjects with lower anthropometry showed exponential decline of plasma NET. A possible role for nutritional status of an individual in drug disposition is indicated from this study.

Adult↗
PubMed1981

Low dose injectable contraceptive norethisterone enanthate 20mg monthly--I. Clinical trials.

Clinical trials were undertaken with an injectable low dose progestational contraceptive, norethisterone enanthate 20 mg monthly (Net-en - 20). Data from the study indicate that Net-en - 20 is an effective contraceptive with lower incidence of menstrual cycle disturbances than the currently used injectable progestogens. There was a prompt return of fertility after the withdrawal of the drug. Net-en - 20 did not have any adverse effect on maternal nutritional status as assessed by anthropometric indices of nutritional status, and clinical sign of nutritional deficiencies or on lactational performance as assessed by mothers' impression on milk output and mean duration of lactation.

Actuarial Analysis↗
PubMed1981

Low dose injectable contraceptive norethisterone enanthate 20mg monthly - II. Metabolic side effects.

Metabolic effects of a long-acting low dose injectable contraceptive, norethisterone enanthate 20-mg, monthly injections (Neten-20), was tested in 13 women belonging to the low income groups over a period of 1 year. No change was observed in hemoglobin, hematocrit, glucose tolerance, plasma lipids, iron, calcium, or serum glutamate-oxaloacetate transaminase after treatment. Marginal rise in albumin and fall in some globulin fractions was observed. The slight fall seen in serum alkaline phosphatase could be attributed to a change in lactation status. Vitamin A, pyridoxine and riboflavin status were not altered. A peculiar aberration in the tryptophan-niacin pathway as indicated by rise in kynurenic acid excretion after tryptophan load was observed. This could be corrected by multivitamin therapy. These data suggest that the use of Neten-20 for one year does not lead to adverse metabolic effects analogous to those seen with combination type oral contraceptives.

Alkaline Phosphatase↗
PubMed1981

Nutrition--fertility interaction in lactating women of low income groups.

1. Duration of lactational amenorrhoea and interpregnancy interval were related to maternal body-weight in an urban low-income group population of 2250 women. 2. Breast-feeding practices were similar in all the women, none of whom had received any nutritional intervention. 3. In the study group the mean duration of lactation, lactational amenorrhoea and interpregnancy interval (months) were 20.7, 11.2 and 24.2 respectively. 4. Mean duration of lactation was significantly shorter in women whose body-weights were over 55 kg. Duration of lactational amenorrhoea increased with increasing duration of lactation (r 0.5164). 5. The duration of lactational amenorrhoea showed a progressive fall with increasing body-weight (r --0.8139) even when duration of lactation was kept constant. 6. The mean duration of post-partum amenorrhoea in women who did not lactate remained unaltered irrespective of body-weight. 7. The findings suggest that maternal nutritional status modifies return of menstruation only in lactating women.

Amenorrhea↗