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Biomedical subjects

J V Joshi

Publications and source records attributed to J V Joshi.

27 records · Page 2Linked to original sources

A study of interaction of low-dose combination oral contraceptive with Ampicillin and Metronidazole.

Plasma levels of norethisterone (NET), ethinyl estradiol (EE), Ampicillin or Metronidazole were estimated in 16 women, who were taking low-dose oral combination contraceptive pills (containing norethisterone acetate 1 mg and ethinyl estradiol 30 microgram) and in whom concurrently, either Ampicillin (6 women) or Metronidazole therapy (10 women) was given. Neither Ampicillin nor Metronidazole therapy altered the 'peak' or 24-hour plasma levels and area under the curve, for NET and EE. Furthermore, oral contraceptive treatment did not alter the 'peak' levels of Ampicillin or Metronidazole. Progesterone (P) levels were in the anovulatory range in all Ampicillin treated cycles. However, in Metronidazole treated group, two out of 10 women showed a P rise of more than 4 ng/ml. The study was expanded to include another group of 15 women treated with Metronidazole, where only one women showed a P rise of more than 4 ng/ml. The occurrence of 'escape ovulation' as suggested by P rise of more than 4 ng/ml in three out of 25 Metronidazole treated women is either a chance incidence due to a different pharmacological response in them, or most probably due to the default in the regular intake of pills in these women. This is supported by the observation that one out of three women showing a P rise (greater than 4 ng/ml( during concurrent Metronidazole therapy, also showed ovulatory P values in oral contraceptive-only treated cycles. Furthermore, in the control group also, one out of 10 women had ovulatory P levels (greater than 4 ng/ml) in oral contraceptive-only treated cycles.

Adult↗

Salivary antipyrine half-life during injectable progestagen contraception.

Antipyrine pharmacokinetics were studied in 6 healthy women before and 2, 8 and 12 weeks after administering the injectable progestagen (progestin), norethisterone (norethindrone) enanthate 200mg intramuscularly. Additionally, antipyrine kinetics in 5 women who had previously used the injectable contraceptive for 8 to 14 months were compared with values obtained in 14 non-users. Antipyrine was measured in saliva using a spectrophotometric method, following an oral dose of 18 mg/kg bodyweight. In the 6 women studied prospectively the mean salivary antipyrine half-life was 14.91 +/- 1.5 hours (SEM) before administering the injection, and 13.56 +/- 0.73 at 2 weeks, 15.13 +/- 1.86 at 8 weeks and 15.21 +/- 2.46 hours at 12 weeks after the injection. The mean antipyrine half-life in the 5 long term users of injectable progestagen was 14.21 +/- 2.53 hours compared with 13.66 +/- 0.98 hours in non-users. The results of this study suggest that - in contrast to published data on combined oral contraceptives - neither short nor long term use of parenteral norethisterone enanthate in Indian women is associated with significant alterations in antipyrine clearance.

Adult↗

Vaginal parasitosis. An unusual finding in routine cervical smears.

Between January 1971 and December 1984, a total of 57,664 Papanicolaou-stained smears from 10,968 women attending the welfare clinics of the Institute for Research in Reproduction were screened for cancer, dysplasia and other abnormalities. Among these, ova of Enterobius vermicularis were observed in six cases and an ovum of Ascaris lumbricoides was present in one case. Microfilariae were noted in three cases. Either a clean background or an inflammatory pattern was noted in the smears in these cases. These findings show that cytology is useful in the diagnosis of cervical parasitic infections in asymptomatic women.

Adult↗

Actinomyces in cervical smears of women using intrauterine contraceptive devices.

Cervical smears from 1,784 women who attended the family planning clinics of the Institute for Research in Reproduction were examined for the presence of Actinomyces-like organisms. Among 815 intrauterine contraceptive device (IUD) users, the repeat smears from 57 women were positive for Actinomyces-like organisms, giving a prevalence rate of 6.99%. Immunofluorescent staining using specific antisera confirmed the presence of A. israelii in all 57 women. Forty IUD users whose smears were positive for Actinomyces-like organisms underwent bacteriologic culture studies; A. israelii was isolated in 23 of these cases. The clinical findings at the time of smear collection in the 57 IUD users were within normal limits. The initial cervical smears of all IUD users and both the initial and repeat smears of all nonusers were negative for Actinomyces-like organisms. The data indicate that prolonged use (greater than 2 years) of an inert or copper intrauterine device promotes the overgrowth of Actinomyces in the vagina and that this can be detected by routine cervical cytology.

Actinomyces↗

The prevalence of Chlamydia trachomatis in young women.

BACKGROUND: Chlamydia trachomatis infection is common in women with pelvic inflammatory disease, infertility and ectopic gestation. In this study we examined the prevalence of this infection in young women undergoing routine gynaecological checks. METHODS: Three hundred and five women aged between 19 and 41 were included in our study. Endocervical smears were collected by speculum examination, air-dried, acetone-fixed and stained for chlamydial antigen using fluorescein-labelled monoclonal antibody. RESULTS: Ninety-five per cent of the women were asymptomatic. Only 5% had mild symptoms such as white discharge, abdominal pain or profuse periods; 34% gave a history of white discharge only. Chlamydial antigen was detected in cervical smears from 47 (15%) women. Of these, 9 (19%) had symptoms at examination and 20 (43%) had symptoms within 2 months. On gynaecological examination 25 women (53%) had minor signs such as erosion or cervicitis and only 1 (2%) had uterine tenderness suggestive of mild pelvic inflammatory disease. CONCLUSIONS: It is important to diagnose chlamydial infection early because in its later stages it is associated with an ascending infection and serious complications. Young, relatively asymptomatic women should be screened for the presence of this organism.

Adult↗

Menstrual irregularities and lactation failure may precede thyroid dysfunction or goitre.

Menstrual and reproductive history of 178 women referred to the thyroid clinic was compared with 49 healthy controls. Cases were classified as euthyroid, hypothyroid or hyperthyroid after clinical examination and after serum T3, T4, TSH measurements. Reproductive history was related chronologically to symptoms and signs of thyroid dysfunction. Only 31.8% of hypothyroid and 35.3% of hyperthyroid women had normal menstrual pattern in contrast with 56.3% of Euthyroid and 87.8% of healthy controls (p < 0.001). Reproductive failure (infertility, pregnancy wastage, failure of lactation) occurred in 37.5% of hypothyroid and 36.5% of hyperthyroid cases against 16.3% of euthyroid and 16.7% of healthy controls (p < 0.05). Interestingly, in 45% of cases with menstrual abnormality, the anomaly was antecedent to other clinical features by a variable period of two months to ten years. Reproductive failure and lactation failure also preceded thyroid dysfunction or goitre. Reproductive dysfunction may therefore be considered as one of the presenting symptoms of thyroid disorders in women, keeping in mind both menstrual irregularities and lactation failure may also arise from other common or idiopathic origins. Especially in women with menstrual irregularities in the perimenopausal age if thyroid dysfunction is detected, pharmacotherapy may be a superior alternative to surgical interventions like hysterectomy.

Adolescent↗