Prolonged labor can lead to increased maternal and neonatal morbidity and mortality. Hence, it warrants an early detection and appropriate clinical management. Active management of labor has shown to decrease the occurrence of prolonged labor. Administering antispasmodics during labor facilitates a faster and more effective dilatation of the cervix. Hence, antispasmodics can be used to decrease the incidence of prolonged labor. Camylofin, a potent antispasmodic, with a dual mode of action, has been used in the augmentation of labor for more than six decades. There is a growing body of evidence to support the efficacy and tolerability of Camylofin in the active management of labor. A review of published evidence suggests that Camylofin has superior efficacy in augmentation of labor on multiple counts like rate of cervical dilation, duration of active phase of first stage of labor and induction delivery interval, when compared to other spasmolytics like drotaverine, hyoscine and valethemate. It also has a benefit of a convenient single dose as compared to the other spasmolytics listed earlier. Camylofin has other advantages like a quick onset of action, prolonged action, no adverse effects on uterine contractility, no contraindication for use in uterine inertia cases and overall good tolerability for both mother and fetus. Given the superior efficacy and benefits that this drug exhibits, coupled with its excellent tolerability profile, Camylofin should be the first choice and may be preferred over other drugs for cervical dilatation and acceleration of active phase of labor.
Background: Acid peptic disorders (APD) which include GERD and peptic ulcer disease (PUD) are common conditions reported in daily clinical practice. This survey aimed to understand the epidemiology, clinical presentation and associated overlapping comorbidities in Indian patients with APD.Methods: This was an interview based cross-sectional survey of 1000 clinicians (specialist gastroenterologists and non-specialists) across India who treated patients of APD in their practice. Information related to patient demographics, diagnosis and clinical presentation (common symptoms and their duration, alarming, lower GI and extra-esophageal symptoms) were assessed. Indications for upper GI endoscopy, esophageal pH monitoring and esophageal manometry were also collected. Descriptive analyses were done.Results: About 39.2% and 37.1% patients had reported GERD and PUD respectively (duodenal ulcer: 10.5%, gastric ulcer: 9.9% and peptic ulcer-non-specified: 16.7%); 25.2% patients were reported to have non-ulcer dyspepsia. Heartburn was the most common symptom in GERD (60.5%); epigastric pain was common in PUD (72.3%); 49% GERD patients presented with alarming symptoms, mainly dysphagia (67%), whereas for PUD, GI bleeding was the most common alarming symptom (47.6%). Profiles of patients visiting clinicians were similar with respect to the presenting symptoms and associated conditions. Functional dyspepsia (25.9%), constipation (23.4%) and irritable bowel syndrome (23.4%) were the most common overlapping conditions associated with both GERD and PUD.Conclusions: APD (GERD and PUD) was more common in 18-59 yrs. age group with heart burn as the common symptom for GERD and epigastric pain for PUD. Diagnosis was mostly based on clinical symptoms; nearly 50% patients of APD presenting with alarming symptoms needed prompt endoscopy. Thus, there is need to focus on these overlapping disorders while managing patients of APD.
The effects of variations in pressure (20-40 kg/em2), oil-to-water ratio (1:0.4-1:1, w/w) and time (0-8 hr) on the extent of hydrolysis of castor oil were studied. Higher pressure , lower oil-to-water ratio and longer duration gave higher percentage splits. At 40 kg/em ~ pressure and an oil-to-water ratio of 1:1, ca. 92% split was obtained in 8 hr. When the oil was hydrolyzed in 2 stages at 20 kg/cm ~ with an oil-to-water ratio of 1:0.4, ca. 96% split was obtained in a total period of 10 hr. Splitting at 20 kg/cm 2 gave minimal amounts of dienoic acids because of the decomposition of estolides.
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