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Biomedical subjects

S M Karim

Publications and source records attributed to S M Karim.

At least 19 recordsLinked to original sources
PubMed1987

The PGE2 vaginal film: an alternative to conventional induction in multiparae with poor cervical scores.

In a study involving 50 multiparous subjects with poor cervical scores (less than or equal to 3), induction of labour by conventional amniotomy and oxytocin was compared with preinduction cervical ripening using a single administration of prostaglandin E2 (850 micrograms) in a new vaginal film formulation. Indications for elective delivery, maternal characteristics and distribution of cervical scores in the two groups were similar. Significant changes in mean cervical score were achieved within 12 hours of film insertion. In this group, 11 subjects (45.8%) established labour within 12 hours and a further 8 (33.3%) did so before 24 hours so that only 5 cases required amniotomy and oxytocin. Instrumental delivery was less in this group and none of these subjects required Caesarean section for a failure of induction. No adverse maternal or fetal side effects were observed. Convenience, ease of administration and stability of this new prostaglandin formulation make it a useful alternative to conventional induction of labour in the multiparous patient with a poor cervical score.

Administration, Intravaginal↗
PubMed1987

alpha-Fetoprotein levels in fullterm and very low birthweight infants.

Plasma alpha-fetoprotein (alpha-FP) levels were determined in fullterm and very low birthweight (VLBW) infants in the first week of life and serially in a cohort of VLBW infants for the first 24 weeks after delivery. A rapid decline in alpha-FP levels was observed in both the fullterm and VLBW infants initially. Beyond 2 weeks of age, there was a gradual, linear decline until 6 weeks, followed by a more rapid period of decline from 6 to 16 weeks. The decline in the ensuing weeks demonstrated an asymptotic pattern. The half-life of alpha-FP was 7.5 days in the first week of life in both fullterm and preterm infants, 28.7 days from 2 to 6 weeks of life and 11.9 days from 6 to 16 weeks of life in VLBW infants.

Female↗
PubMed1986

Preinduction cervical priming in high risk pregnancy--experience with a new sustained release PGE2 vaginal film.

Experience with a new sustained release PGE2 formulation is presented. 111 high risk primiparae with very poor cervical scores (less than 3) were studied. In 59 patients, labour was induced by forewater amniotomy and I.V. oxytocin. In the remaining 52 patients, film containing 850 ug of PGE2 was inserted into the vagina to ropen the cervix 24 hours prior to induction of labour. Indications for elective delivery and maternal characteristics were similar in both groups. There were significant changes in the cervical state within 12 hours of vaginal insertion. By 24 hours, 19 patients receiving vaginal film (36.5%) had established labour of whom 13 proceeded to vaginal delivery. Significantly fewer patients in the priming group required Caesarean delivery. No untoward maternal or fetal side effects were observed. Safety, ease of administration and efficacy make this new PGE2 formulation a useful agent for priming of the very poor primiparous cervix prior to induction of high risk labour.

Administration, Topical↗
PubMed1985

Plasma levels of 13,14-dihydro-15-keto PGE2 after vaginal application of a new PGE2 film.

To determine the release and absorption profile of prostaglandin E2 from a new vaginal film formulation containing 850 micrograms PGE2, serial plasma levels of 13,14-dihydro-15-keto PGE2 were measured by radioimmunoassay in pregnant women between 16 and 18 weeks gestation. A control group, using placebo vaginal film was included in the study. There was a somewhat uniform increase in the plasma levels of the PGE2 metabolite, reaching peak levels between 4 and 6 hours after application of the film. The findings suggest that this drug formulation could be used clinically when slow constant release of the prostaglandin is required over a period of hours such as in pre-induction cervical ripening of term pregnancy.

Abortion, Induced↗
PubMed1984

Inhibition of platelet aggregation and antagonism of vasopressin-induced ECG changes in primates by a carboprostacyclin analogue, ZK 36374.

A chemically stable carboprostacyclin analogue, ZK 36374 has been compared with two other prostacyclin derivatives with respect to ADP-induced in vitro aggregation of baboon and human platelets and ex vivo platelet aggregation in the baboon. ZK 36374 was also tested on the systemic arterial blood pressure of the baboon and against vasopressin-induced ECG changes in primates. Compared to the other two compounds, ZK 36374 displayed enhanced anti-platelet aggregating activity; there was dissociation between this property and its hypotensive potency. ZK 36374 antagonized the vasopressin-induced ECG changes. These results indicate that ZK 36374 possesses therapeutic potential in vascular disease including that affecting the coronary vessels.

Adenosine Diphosphate↗
PubMed1984

Epidemiologic analysis of fetal death in utero in Singapore.

Records on 1777 cases of missed abortion and 1001 cases of intrauterine fetal death in three major maternity hospitals in Singapore between 1976 and 1980 were analyzed. The overall incidence of these two conditions was 10.35 and 5.82 per 1000 births, respectively. During the 5-year period, the incidence of missed abortion increased consistently, from 8.05 to 12.76 per 1000 births. In contrast, during the same period, the incidence of intrauterine fetal death declined steadily from 6.44 to 4.68 per 1000 births. Missed abortions occurred more frequently in the early part of the year, especially in the months of March, April and May. The incidence of missed abortion and its correlation with possible environmental factors are discussed.

Abortion, Missed↗
PubMed1984

A comparison of some pharmacological actions of prostaglandin E1, 6-oxo-PGE1 and PGI2.

Some pharmacological actions of prostaglandin E1 (PGE1), 6-oxo-PGE1 and PGI2 have been studied. 6-oxo-PGE1 and PGE1 relaxed guinea-pig tracheal muscle in vitro and increased nasal patency in normal volunteers and in subjects with vasomotor rhinitis whereas PGI2 produced opposite effects. All three compounds produced bronchodilatation in the anaesthetised guinea-pig and relaxed human respiratory tract muscle in vitro. PGI2 was several times more potent than either 6-oxo-PGE1 or PGE1 against ADP-induced aggregation of human and baboon platelets in vitro. Intravenous 6-oxo-PGE1 in the baboon caused an ex vivo inhibition of platelet aggregation, but the EC50 was 7.7 times that of PGI2. As a vasodepressor in the baboon 6-oxo-PGE1 and PGI2 were equipotent. Thus with the exception of the vasodepressor effect, the actions of 6-oxo-PGE1 qualitatively and quantitatively resembled those of the structurally related PGE1 rather than those of PGI2.

Airway Resistance↗
PubMed1984

Maternal plasma estradiol and progesterone levels during therapeutic abortion induced by 16, 16 dimethyl PGE2 p-benzaldehyde semicarbazone ester.

Estradiol and progesterone levels in maternal plasma after administration of 16, 16-dimethyl-PGE2 p-benzaldehyde semicarbazone ester (16,16-PGE2) 6 hourly for abortion were studied in 27 women in the second trimester of pregnancy and in 49 patients with fetal death in utero. Basal maternal plasma levels of estradiol and progesterone measured before prostaglandin injection were significantly lower in cases of fetal death in utero than in the other subjects. After 16,16-PGE2 injection, plasma levels of estradiol and progesterone fell more rapidly and to a greater extent in cases of fetal death in utero than those with normal pregnancy at corresponding gestations; the decline of plasma estradiol levels was quicker and more marked than that of progesterone. Thus, 16,16-PGE2 appears to exert a differential effect on estradiol and progesterone biosynthesis.

16,16-Dimethylprostaglandin E2↗
PubMed1984

Thromboxane A2 and prostacyclin levels in molar pregnancy.

Plasma levels of thromboxane (TX) A2 and prostacyclin (PGI2), as measured by radioimmunoassay of their respective stable metabolites TXB2 and 6-keto PGF1 alpha, were studied in six molar pregnancies immediately before, immediately following and 24 h after evacuation of the uterus. The mean (SD) levels for TXB2 were 150 (41), 137 (32) and 125 (25) pg/ml respectively, and for 6-keto PGF1 alpha the respective values were 225 (52), 226 (127) and 213 (49) pg/ml. There was no significant difference in the levels of prostanoids between the samples taken at the various time intervals. The concentration of these prostanoids in molar intravesicular fluid was also determined. Their respective mean (SD) pg/ml values were 3682 (760) for TXB2 and 2969 (744) for 6-keto PGF1 alpha. In 15 normal pregnancies of equivalent gestation, the mean amniotic fluid levels of TXB2 and 6-keto PGF1 alpha were 34 (17) and 146 (86) pg/ml respectively. The ability of molar trophoblast to generate the prostanoids from [14C]arachidonic acid in vitro was also demonstrated. Mean (SD) values for TXB2 and 6-keto PGF1 alpha were 12.2 (2.6) and 13.2 (1.8) pg/mg protein/min, respectively. It is likely that the high concentrations of prostanoids in vesicular fluid reflect the synthesizing ability of the villus vesicles. The mole contributes little to the circulatory prostanoids possibly because its villi are deficient in blood circulation.

6-Ketoprostaglandin F1 alpha↗
PubMed1984

Anencephaly: a retrospective analysis in Singapore. 1976 to 1980.

Records of 93 cases of anencephaly from three maternity hospitals in Singapore between 1976 and 1980 were analysed. The incidence was 0.54 per 1000 births. No significant correlation between anencephaly and local seasonal conditions could be found for Singapore.

Anencephaly↗
PubMed1984

Cord plasma alpha-fetoprotein values and neonatal jaundice.

Umbilical cord plasma alpha-fetoprotein (AFP) values were determined in 127 infants with hyperbilirubinemia (56 glucose-6-phosphate dehydrogenase (G-6-PD) deficient and 71 G-6-PD normal) and 136 control subjects (73 G-6-PD deficient and 63 G-6-PD normal). The mean alpha-fetoprotein value of 173 +/- 35.2 (SD) mg/L for the group of infants with hyperbilirubinemia was significantly greater than that (122 +/- 21.7 mg/L) for the control infants (P less than .001). G-6-PD status and sex did not significantly affect the alpha-fetoprotein values. Using an alpha-fetoprotein level of 130 mg/L as a "cut-off" value, the incidence of false-positive results was 25.5% and the incidence of false-negative results was 11.8%. This test can be used as a screening procedure to detect infants at high risk for hyperbilirubinemia.

China↗
PubMed1983

A randomised comparative evaluation of the copper 7, multiload copper 250 and T copper-22OC IUDs.

Two new Cu-IUDs, the TCu-22OC and Multiload Cu250, were evaluated against the Cu7 in 1,199 subjects in a randomised, multicentric trial using a common study protocol. During the 2 years following insertion, cumulative first-segment rates for total use-related terminations showed no significant differences between the 3 devices; however, the Cu7 had a significantly higher termination rate for accidental pregnancy compared to the TCu-22OC and its expulsion rate was significantly higher than the ML Cu250. The rate of accidental pregnancy was higher and the expulsion rate lower with the ML Cu250 compared to the TCu-22OC but these differences were not significant. The results are discussed in relation to IUD design and their application in family planning.

Adult↗
PubMed1983

Review: significance of the inhibition by prostaglandins and cyclic GMP of oxytocinase activity in human pregnancy and labour.

The uterotonic action of oxytocin has been known for many decades. This neurohypophysial hormone is thought to play a functional role in human parturition. Since 1968, prostaglandins have also been implicated in parturition. These two groups of uterotonic agents have now a recognized therapeutic role, and are widely used in the induction of labour and in fertility control. However, the mechanism of action and the interrelationship between these endogenous compounds in pregnancy are poorly understood. In this article, the role and interaction of oxytocin, oxytocinase and prostaglandins in human pregnancy and labour have been reviewed. Inhibition of oxytocinase activity by prostaglandins has been suggested as a mechanism in parturition. Possible involvement of cyclic GMP in the initiation of labour has also been discussed.

Aminopeptidases↗
PubMed1983

Inhibition of platelet aggregation with intravenous and oral administration of a carboprostacyclin analogue, 15-cyclopentyl-omega-pentanor-5(E)-carbacyclin (ONO 41483) in man.

Intravenous and oral administration of a chemically stable carboprostacyclin analogue, 15-cyclopentyl-omega-pentanor-5(E)-carbacyclin (ONO 41483), resulted in ex-vivo inhibition of ADP-induced platelet aggregation in man. The maximum tolerated intravenous dose was 2.5 ng/kg/min for 1 hour and this produced a mean of 27.1% inhibition in 3 volunteers. For oral administration the tolerated single dose was 200 microgram. At this dose, there was 56.3% inhibition of aggregation (mean of 3 results). High oral (400 microgram) and intravenous doses (5 and 10 ng/kg/min for 1 hour) of ONO 41483, which caused marked inhibition of aggregation (ranging 39-100%), was accompanied by flushing of face and extremities, headache and phlebitis. However, none of the doses tested produced significant changes in arterial blood pressure or heart rate.

Adenosine Diphosphate↗
PubMed1983

Cholinoreceptors in the corpus cavernosum muscle of the human penis.

Acetylcholine produced contraction, relaxation or a biphasic effect on corpus cavernosum muscle strips of human penis. These effects were antagonized by atropine but were modified by hexamethonium or tetrodotoxin suggesting the presence of excitatory and inhibitory muscarinic receptors in the human penis. Nicotine and DMPP also produced contraction or relaxation of the corpus cavernosum muscle strips. These effects were presumably indirect as they were abolished by hexamethonium and tetrodotoxin. Contractions produced by nicotine or DMPP were abolished by atropine whereas the relaxations produced by these agents were only partially blocked by atropine. Hence, the receptors mediating these relaxations are unlikely to be entirely muscarinic.

Acetylcholine↗
PubMed1983

Control of gonadotrophin secretion by steroid hormones in male castrates: site of oestradiol action.

Four normal healthy castrated male transsexuals who were not on hormone therapy for at least 4 months volunteered for this study. Each subject received 3 infusions at weekly intervals--the first consisting of LHRH alone, the second of LHRH and oestradiol and the third of oestradiol alone. Venous blood samples were collected at 20-minute intervals 1 hour before the start and during the whole period of infusion. Plasma concentrations of FSH, LH and oestradiol were measured by radio-immunoassay. On an average, 100 micrograms of LHRH enhanced the area under the LH secretion curve by 177% and under the FSH curve by 68%. Oestradiol had a differential effect on the endogenous secretion of LH and FSH, suppressing them by 53% and 18%, respectively. Similarly, the LHRH-stimulated release of LH was significantly inhibited to a greater extent (42%) than that of FSH (23%, P less than 0.05; paired t test). Such an observation and in the light of our acceptance of the single releasing hormone theory, suggests that the differential actions of oestradiol on the secretions of FSH and LH are due to mechanisms residing in the pituitary.

Castration↗