Biomedical subjects

K Vanaja

Publications and source records attributed to K Vanaja.

13 recordsLinked to original sources

PubMed2006

Drug-drug interactions of anti-infective drugs: utility of fluorescence cyp inhibition assays in drug discovery.

Drug interactions are often a result of induction or inhibition of cytochrome P450 (CYP) enzymes by co-administered drugs. A high throughput fluorescence assay using cDNA-expressed human CYP isozymes and fluorogenic substrates has been reported for the study of CYP inhibition. We used this assay to evaluate CYP inhibition profiles of 21 marketed anti-infective drugs. We found that six of the eight potent inhibitors identified in this screen (IC50 <10 microM against at least one CYP isozyme) correlated with significant drug-drug interactions in the clinic. In contrast, the intermediate and weak inhibitors (IC50 >10 microM) did not indicate clinically significant drug interactions. Furthermore, we observed that results obtained in the fluorescence assay correlated with conventional, well-established, low throughput methods that utilize human liver microsomes. These data suggest that in the early stages of drug discovery, the fluorescence assay for CYP inhibition could be used in conjunction with a human liver microsomal assay to identify new chemical entities with a potential for drug-drug interactions.

Anti-Infective Agents↗

PubMed2000

Membrane sweeping in conjunction with labor induction.

OBJECTIVE: To determine whether cervical membrane sweeping (stripping) during induction of labor is beneficial. METHODS: We compared outcomes of labor after induction in pregnant women at term in a randomized trial. Women were assigned to having their membranes swept or not during induction. Outcome measures included duration of labor, maximum dose of oxytocin used, induction-labor interval, and mode of delivery. RESULTS: We recruited 130 nulliparas (64 sweep, 66 nonsweep) and 118 multiparas (60 sweep, 58 nonsweep). Among nulliparas who received intravaginal prostaglandin (PG) E(2) and oxytocin, those who had simultaneous sweeping had significantly shorter mean (+/- standard error of mean) induction-labor interval (13.6 +/- 1.4 versus 17.3 +/- 1.2 hours, P =.048), lower mean maximum dose of oxytocin (6.8 +/- 0.8 versus 10.35 +/- 1.1 mU/minute, P =.01), and increased normal delivery rates (vaginal delivery 83. 3% versus 58.2%, P =.01). Sweeping also had a favorable effect on nulliparas who received oxytocin alone (mean induction-labor interval 5.8 +/- 3.1 versus 11.2 +/- 3.6 hours, P =.04; mean maximum dose 8.8 +/- 1.3 versus 16.3 +/- 1.9 mU/min, P =.01). Those differences were limited to women with unfavorable cervices. There were no differences in any outcome measures in multiparous women. CONCLUSION: Sweeping of the membranes during induction of labor had a beneficial effect on labor and delivery, which appeared to be limited to nulliparas with unfavorable cervices who needed cervical priming with PGE(2).

Adult↗

PubMed1998

The reliability of catheter-tip transducers for the measurement of intrauterine pressure in the third stage of labour.

In order to assess the reliability of intrauterine pressure measurements in the third stage of labour, catheter-tip transducers were used in 20 women randomly allocated into two groups of 10. In each case in the first group two catheters were tied together and introduced transcervically into the uterine cavity after delivery of the placenta. In each case in the second group two catheters were inserted independently into the same uterine cavity. The active and cumulative active pressures recorded from the pairs of catheters within each uterine cavity were compared. Comparison of individual active pressure readings from separate transducers revealed good agreement whether the catheters were tied together or were separate. Cumulative active pressure was very similar when assessed by each catheter in the same uterus. Intrauterine catheter-tip transducers can be used reliably to measure uterine activity in the third stage of labour although there may be minor contraction by contraction differences in recordings of individual active pressures.

Catheterization↗

PubMed1998

Validation of a laboratory method of measuring postpartum blood loss.

Laboratory methods give more accurate measurement of blood loss in the postpartum period than visual estimation. In order to evaluate a laboratory method used to quantify blood loss postpartum, blood lost at gynecological operations was collected in a measuring bottle. The measured amount of blood (50-1,000 ml) was then poured onto absorbent paper towels and sanitary pads, in order to mimic conditions when measuring blood loss in clinical trials in the postpartum period. The amount of blood absorbed onto the absorbent paper and sanitary pads was measured by a rapid method of automatic extraction and photometric measurement of alkaline hematin. The study shows that the method provides a reliable and accurate means of measuring blood loss. The error in each case was less than 10% with an intraclass correlation coefficient of almost 1.

Analysis of Variance↗

PubMed1998

Correlation of change in uterine activity to blood loss in the third stage of labour.

In 47 women, the change in the uterine activity after the administration of a uterotonic agent was correlated with the amount of blood loss during the same period of time. Uterine activity was measured by a Gaeltec catheter-tipped pressure transducer inserted transcervically within 5 min of delivery of the placenta. A uterotonic agent (either intravenous syntocinon, intramuscular syntometrine or oral misoprostol) was given after the insertion of the intrauterine pressure catheter and pressure recorded for another 90 min. Blood loss over the same 2-hour period was collected with absorbent paper which was then assessed by colorimetric measurement of the haemoglobin content in the sample. Our results show that the change in uterine activity is associated with the total blood loss. However, there is a poor linear correlation between the two variables probably because of the biological variation in myometrial activity and differences in coagulation mechanisms in normal women.

Blood Coagulation↗

PubMed1997

Preinduction cervical ripening: prostaglandin E2 gel vs hygroscopic mechanical dilator.

OBJECTIVES: To evaluate the efficacy and safety of hygroscopic mechanical dilators (Dilapan) for ripening the pregnant cervix prior to induction of labour at or near term and to compare it with an intracervical PGE2 gel (Prepidil). METHODS: One hundred and eighty-five women (69 nulliparae, 116 multiparae) at term with singleton pregnancies in cephalic presentation, who were scheduled for induction of labour in the labour ward at the National University Hospital, but had an unfavourable cervical score were randomized into 2 groups by random number table. In group 1 (Prepidil), 0.5 mg of PGE2 in 2.5 ml of triacetin gel was inserted into the endocervical canal. In women in group 2 (Dilapan) upto a maximum of 4 hygroscopic dilators were placed in the endocervical canal. If labour did not ensue at the end of 12 hours of ripening, the cervical score was assessed, amniotomy was performed and oxytocin commenced. Neonatal and obstetric outcome was compared, statistical analysis performed using Chi-square, and t-tests. RESULTS: Significantly more women in the group who received Dilapan for cervical ripening required amniotomy and oxytocin for induction of labour > 12 hours after priming compared with the group who received Prepidil (p < 0.001). Operative delivery for no progress and fetal distress respectively was similar in the 2 groups. The number of cases of hyperstimulation were higher in the Prepidil group but did not result in an increased incidence of operative deliveries for fetal distress. There was one neonatal death and one case of neonatal sepsis in the Dilapan group. Uterine rupture occurred in 1 woman who received Prepidil. CONCLUSION: Dilapan, a mechanical method of cervical ripening is as effective as the more widely accepted mode of ripening with an endocervical PGE2 gel in achieving vaginal delivery. Dilapan would be useful for cervical priming prior to induction of labour in places where prostaglandins are not available because of cost and the need for a cold chain.

Adult↗

PubMed1996

The role of transvaginal ultrasonography and colour Doppler imaging in the detection of ectopic pregnancy.

OBJECTIVE: To assess the use of transvaginal ultrasound and colour Doppler imaging in the detection of ectopic pregnancy. MATERIALS AND METHODS: Seventy-one patients with suspected ectopic pregnancies had transvaginal sonography and colour Doppler imaging performed and 61 ectopic pregnancies were confirmed at surgery. Various ultrasound features on transvaginal B mode scanning were noted and the resistance index of peritrophoblastic flow in the adnexal masses computed. RESULTS: The use of transvaginal B mode imaging alone in the diagnosis of ectopic pregnancy achieved a sensitivity of 98% and a positive predictive value of 86%. The mean gestational age at time of diagnosis was 6 weeks 5 days (range 4 weeks to 13 weeks 2 days). The use of transvaginal colour flow imaging did not increase detection rates of ectopic pregnancy. The mean RI values for patients with or without ectopic pregnancy were almost identical. CONCLUSION: Colour Doppler imaging failed to improve on the results of transvaginal B mode sonography in the detection of ectopic pregnancy.

Adult↗

PubMed1982

Beliefs and practices of urban mothers regarding "hot" and "cold" foods in childhood illnesses.

Beliefs and practices of 100 urban mothers regarding "hot" and "cold" foods during four common childhood illnesses were determined by using a pretested, partly structured interview schedule. Egg, by 60% of mothers, mango by 52%, lentils by 49%, jaggery by 46% were considered "hot" properties. "Hot" foods were preferred and "cold" foods restricted in the treatment of cough and cold and illnesses with rash. In diarrhoea, "cold" foods were preferred and "hot" foods restricted. The knowledge that many food combinations and certain procedures are believed to change the properties of common food may be utilized in promoting the consumption of nutritionally balanced diets. Introduction of culturally acceptable education in nutrition which incorporates the above knowledge is likely to help in the prevention of protein-energy malnutrition and to increase parental co-operation during therapy.

Abdomen↗

PubMed1981