PubMed Health⌕ Search

Biomedical subjects

R K Bhathena

Publications and source records attributed to R K Bhathena.

At least 19 recordsLinked to original sources
PubMed2006

Contraception for the older woman: an update.

Although fertility declines with advancing age as the woman approaches the menopause, some risk of pregnancy persists, and effective contraception needs to be offered to avoid an unintended pregnancy. An older woman may have menstrual dysfunction or climacteric symptoms and these factors would need consideration when making the choice of contraception. Low-estrogen dose combined oral contraceptives may be prescribed to healthy non-smoking women up to about 50 years of age. The progestogen-only pill may be an appropriate option in an older woman with declining fertility. The copper intrauterine device is an optimal method for parous women free of pre-existing menstrual problems. The levonorgestrel-releasing intrauterine system is considered the contraceptive method of choice for perimenopausal women with menstrual dysfunction. The woman should be provided with individualized advice so that she has a choice between the newer, effective, largely safe, reversible methods and sterilization.

Administration, Cutaneous↗
PubMed1999

The treatment of hypertriglyceridaemia in menopausal women with transdermal oestradiol therapy.

The objective of this study was to evaluate the effect of transdermal oestradiol on serum triglycerides in menopausal women with pre-existing mild to moderate hypertriglyceridaemia. Forty-four women, who had had a hysterectomy and who had been maintained on 50 microg unopposed oestradiol for six months, were divided into two groups: those with normal baseline triglyceride concentrations (0.4-2 mmol/L) (n = 34) and those with raised baseline readings (> 2-4 mmol/L) (n = 10). There was a significant reduction in the concentrations of serum triglycerides in both groups [-9.6% (P < 0.001) and -17% (P < 0.001), respectively]. Transdermal oestradiol therapy may be a useful treatment option in menopausal women with pre-existing hypertriglyceridaemia. There is a need to conduct large, prospective, controlled trials using transdermal oestradiol to treat hypertriglyceridaemia in menopausal women.

Administration, Cutaneous↗
PubMed1998

The influence of transdermal oestradiol replacement therapy and medroxyprogesterone acetate on serum lipids and lipoproteins.

AIMS: The objective of this study was to examine the effects of continuous transdermal oestradiol with or without sequential oral medroxyprogesterone acetate on serum lipids and lipoproteins in menopausal women. METHODS: Sixty-two healthy menopausal women, attending at two menopause clinics in Western India, were recruited for this study over a period of 1 year. Group 1 included 38 hysterectomised women being treated with continuous transdermal oestradiol only (50 microg daily). Group 2 included 24 menopausal women with an intact uterus being treated with transdermal oestradiol (50 microg daily) and medroxyprogesterone acetate (10 mg daily for the first 12 days of each calendar month). Women maintained on 50 microg oestradiol throughout 6 months (group 1: n = 22; group 2: n = 16) were reviewed for changes in serum lipids and lipoproteins at the end of 6 months (group 1), and between days 8 and 12 of the seventh month (combined phase of treatment) (group 2). RESULTS: In group 1, there was a small reduction in the concentrations of total cholesterol (-5.5%, P = 0.04) and a small but not significant reduction in LDL-cholesterol (-5.7%, P = 0.16). In group 2, there were no significant changes in total cholesterol (-4.2%, P = 0.43) and LDL-cholesterol (-3.9%, P = 0.57). HDL-cholesterol levels did not change significantly with unopposed transdermal oestradiol (+3.0%, P = 0.53), or with additional sequential medroxyprogesterone acetate (-3.8%, P = 0.32). Serum triglyceride concentrations decreased significantly in both the groups (-13.9%, P = 0.01, and -13.4%, P = 0.008, respectively). Serum lipid changes did not differ between the groups. CONCLUSIONS: Transdermal oestrogen therapy appears to be of particular benefit for women with hypertriglyceridaemia. There were no significant adverse effects of medroxyprogesterone acetate on serum lipids and lipoproteins.

Administration, Cutaneous↗
PubMed1998

The influence of medroxyprogesterone acetate on the effects of transdermal oestradiol replacement therapy on plasma lipids.

A prospective study was carried out on 82 healthy menopausal women to determine whether or not there is an attenuation of the cardioprotective effects of continuous transdermal oestradiol on plasma lipid and lipoprotein concentrations with the use of sequential oral medroxyprogesterone acetate. Group 1 comprised 51 hysterectomised women on transdermal oestradiol (50 microg daily). Group 2 included 31 women with an intact uterus on oestradiol (50 microg daily) and medroxyprogesterone acetate (10 mg daily for the first 12 days of each calendar month). Women maintained on 50 microg throughout 6 months (group 1: n = 29; group 2: n = 20) were reviewed for changes in plasma lipids and lipoproteins at the end of 6 months (group 1), and in the combined phase of treatment in the seventh month (group 2). In group 1, there was a reduction in the concentrations of total cholesterol (- 6.3%, P = 0.004) and LDL-cholesterol (- 6.1%, P = 0.05). In group 2, there were no significant changes in total cholesterol (- 4.8%, P = 0.23) and LDL-cholesterol (- 5.8%, P = 0.30). HDL-cholesterol levels did not change significantly with unopposed oestradiol (+ 3.8%, P = 0.30), or with additional medroxyprogesterone acetate (0%, P = 0.94). Serum triglyceride concentrations decreased significantly in both the groups (- 14.3%, P = 0.001, and- 12.8%, P = 0.006, respectively). There were no statistically significant differences in the changes in the respective plasma lipid parameters on comparing the two treatment groups (P > 0.4 for all comparisons, Student's t -tests). The plasma lipid and lipoprotein profile encountered at the end of 6 months, was also generally maintained in 24 women (group 1: n = 13; group 2: n = 11) who completed 1 year of the study. Transdermal oestradiol may be of particular clinical benefit for women with hypertriglyceridaemia. Medroxyprogesterone acetate did not exert a significantly adverse influence on plasma lipid and lipoprotein concentrations.

Journal Article↗
PubMed1990

Second trimester pregnancy termination using extra-amniotic ethacridine lactate.

OBJECTIVE: To investigate the efficacy of ethacridine lactate by the extra-amniotic route for second trimester pregnancy termination and its associated complications. DESIGN: Retrospective study of women undergoing second trimester termination, over 3 1/2 years, with extra-amniotic ethacridine alone, or extra-amniotic ethacridine supplemented later by extra-amniotic 15-methyl prostaglandin F2 alpha. SETTING: Teaching hospital in Bombay. PATIENTS: 315 consecutive women undergoing late abortions with extra-amniotic ethacridine. Demographic features were similar in the two groups. INTERVENTIONS: In group 1, 207 women had 150 ml of 0.1% ethacridine lactate injected slowly into the extra-amniotic space. In group 2, 108 women had the initial injection supplemented 6 h later by an extra-amniotic injection of 250 micrograms (1 ml) of 15-methyl prostaglandin F2 alpha. MAIN OUTCOME MEASURES: The occurrence of abortion following the induction procedure. The development of complications such as haemorrhage, infection, or injury to the uterus or cervix. RESULTS: The method was successful in 191 women (92%) in group 1 and in 106 (98%) in group 2. The median induction-abortion intervals were 35 and 19 h, respectively (Mann-Whitney U test, P less than 0.001). The corrected complication rate was less than 10% (30 women), with unplanned uterine evacuation in 6% (20), haemorrhage in 1% (4), and pelvic infection in 4% (14). CONCLUSION: The use of extra-amniotic ethacridine lactate provides an effective and safe treatment method for second trimester legal abortion. The induction-abortion interval can be appreciably reduced by supplementary prostaglandin.

Abortifacient Agents, Nonsteroidal↗
PubMed1990

Late abortion practice in a teaching hospital in India.

The medical records of 2055 patients undergoing late abortions were reviewed. These represented 15% of all abortions induced over 10 years. In 52%, abortion was performed between 13-16 weeks, and in 25% at or after 20 weeks. Abortion was requested for risk to health in 55% and for failed contraception in 40%. Surgical techniques were used in 39%. There was a trend to use vaginal surgical procedures increasingly, and intraamniotic saline decreasingly. Extraamniotic ethacridine lactate was used in 12%. Because of the cost, prostaglandin infusions were restricted to 2.5%. Planned evacuation of retained products following a medical procedure was performed in 71%; concomitant sterilization in 24%. The complication rate settled at 11% of which 4% were retained products of conception. Complications increased overall with advancing gestational age, and particularly from 15 weeks onward with vacuum aspiration (p0.05) and with dilatation and curettage (p0.05). Cervical injury increased with advancing gestation (p=0.01). In developing nations, there is a pressing need to educate illiterate women to request abortion earlier.

Abortion, Induced↗
PubMed1986

The effects of Cyclofenil on the Cervical Mucus Score (Insler).

Daily simultaneous cervical mucus evaluation and ultrasonography of the Graafian follicular growth and ovulation were studied (in the mid-cycle) in 8 infertile British women during 30 Cyclofenil-stimulated cycles, and compared with 18 non-stimulated normal ovulatory cycles in 12 subjects (controls). In the 16 Cyclofenil-induced ovulatory cycles, there was an early (5 days prior to the day of ultrasonic ovulation) Full Cervical Mucus Score (Insler) in 69% of the cycles, and the Full Cervical Mucus Score lasted for 7 days or more in 63% of the cycles. In 38%, there was persistence of the Full Cervical Mucus Score on the third day after ultrasonic ovulation. In the 14 Cyclofenil-treated anovulatory cycles, a Full Cervical Mucus Score was recorded on one or more occasions in the mid-cycle in 29% of the cycles. The classical teaching of prediction of the probable timing of ovulation by Cervical Mucus Scoring is not applicable to Cyclofenil-stimulated cycles.

Adult↗