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Nivedita Sarda - One of the best experts on this subject based on the ideXlab platform.
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a randomised comparison between Sublingual oral and vaginal route of misoprostol for pre abortion cervical ripening in first trimester pregnancy termination under local anaesthesia
Australian & New Zealand Journal of Obstetrics & Gynaecology, 2008Co-Authors: Pikee Saxena, Sudha Salhan, Nivedita Sarda, Deoki NandanAbstract:Objective: To compare efficacy of Sublingual (S/L), oral and vaginal routes of misoprostol administration for cervical priming before suction evacuation (SE) under local anaesthesia. Methods: In a prospective randomised clinical trial, 200 women in the first trimester of pregnancy were randomised into four groups of 50 each. Patients in control group did not receive any medication before SE while other treatment groups received 400 µg of misoprostol three hours prior to SE either by Sublingual/oral or by vaginal route. Main outcome measure was basal cervical dilatation while the secondary outcome measures were operative blood loss, time duration of surgery, patient satisfaction, pain perception and adverse effects. Results: Sublingual group had a higher dilatation (9.9 ± 2.1 mm; P < 0.001) and lower time duration of surgery (3.6 ± 1.0 min; P < 0.01) as compared to oral (8.2 ± 2.6 mm, 4.9 ± 1.7 min) or vaginal routes (7.6 ± 2.6 mm, 5.2 ± 1.8 min). Mean pain score of the Sublingual group was significantly lower (2.4 + 1.3; P < 0.001) as compared to oral (3.4 ± 1.3) or vaginal routes (3.6 ± 1.2). Patient acceptability was higher for Sublingual (53 of 150) and oral routes (62 of 150) as compared to vaginal (35 of 150) route. Conclusion: Sublingual route was significantly more effective than oral or vaginal administration of misoprostol for cervical dilatation. To the best of our knowledge, this is the first study to simultaneously compare the efficacy of Sublingual, oral and vaginal routes of misoprostol for cervical priming before SE.
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comparison between the Sublingual and oral route of misoprostol for pre abortion cervical priming in first trimester abortions
Human Reproduction, 2004Co-Authors: Pikee Saxena, Sudha Salhan, Nivedita SardaAbstract:BACKGROUND: Misoprostol has been used for achieving cervical priming before suction evacuation (SE) by the oral or vaginal route, although both routes have their shortcomings. We evaluated the efficacy of the Sublingual versus oral route of misoprostol for cervical priming before SE. METHODS: A prospective clinical trial was carried out in 100 women with a period of gestation of between 6 and 12 weeks who were sequentially allocated to two groups of 50 each. Both groups received 400 microg of misoprostol 3 h prior to SE by either the Sublingual or the oral route. RESULTS: Demographically, both groups were similar. For all periods of gestation, Sublingual misoprostol significantly improved cervical dilation (P<0.001) with a reduction in duration of surgery (P=0.024) compared with the oral route. Mean (+/- SD) pain scores for the Sublingual and oral groups were similar (2.6 +/- 1.4 versus 3.5 +/- 1.1). No major complications occurred in either of the two groups. CONCLUSION: the Sublingual route is an effective alternative to oral administration of misoprostol for cervical dilation. To the best of our knowledge, this is the first study to compare the efficacy of the Sublingual versus the oral route of misoprostol for cervical priming before SE.
Sharon W H Lee - One of the best experts on this subject based on the ideXlab platform.
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a prospective randomized placebo controlled trial on the use of mifepristone with Sublingual or vaginal misoprostol for medical abortions of less than 9 weeks gestation
Human Reproduction, 2003Co-Authors: Oi Shan Tang, Carina Chi Wai Chan, Sharon W H LeeAbstract:BACKGROUND A combination of mifepristone and misoprostol provides an effective method of medical abortion for early pregnancy. This is the first randomized trial comparing the use of Sublingual misoprostol with vaginal misoprostol in combination with mifepristone for termination of early pregnancies up to 63 days. METHODS A total of 224 women who requested legal termination of pregnancy up to 63 days were randomized by computer- generated list into two groups and given 200 mg of oral mifepristone followed 48 h later by either 800 micro g of Sublingual (n = 112) or vaginal (n = 112) misoprostol. RESULTS Complete abortion occurred in 98.2% (95% CI: 93-99) of women in the Sublingual group and 93.8% (95% CI: 88-97) in the vaginal group. There were three ongoing pregnancies in the vaginal group but none in the Sublingual group. The median duration of vaginal bleeding was 17 days. There was no serious complication. Fever, chills and gastrointestinal side-effects (nausea, vomiting and diarrhoea) were significantly more common in the Sublingual group. CONCLUSIONS The combination of mifepristone and misoprostol is effective for medical abortion up to 63 days. Both the Sublingual and vaginal are effective routes of administration. Further randomized trials are required to find out the optimal dose of Sublingual misoprostol that can give the highest complete abortion rate and lowest incidence of side-effects.
Pikee Saxena - One of the best experts on this subject based on the ideXlab platform.
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a randomised comparison between Sublingual oral and vaginal route of misoprostol for pre abortion cervical ripening in first trimester pregnancy termination under local anaesthesia
Australian & New Zealand Journal of Obstetrics & Gynaecology, 2008Co-Authors: Pikee Saxena, Sudha Salhan, Nivedita Sarda, Deoki NandanAbstract:Objective: To compare efficacy of Sublingual (S/L), oral and vaginal routes of misoprostol administration for cervical priming before suction evacuation (SE) under local anaesthesia. Methods: In a prospective randomised clinical trial, 200 women in the first trimester of pregnancy were randomised into four groups of 50 each. Patients in control group did not receive any medication before SE while other treatment groups received 400 µg of misoprostol three hours prior to SE either by Sublingual/oral or by vaginal route. Main outcome measure was basal cervical dilatation while the secondary outcome measures were operative blood loss, time duration of surgery, patient satisfaction, pain perception and adverse effects. Results: Sublingual group had a higher dilatation (9.9 ± 2.1 mm; P < 0.001) and lower time duration of surgery (3.6 ± 1.0 min; P < 0.01) as compared to oral (8.2 ± 2.6 mm, 4.9 ± 1.7 min) or vaginal routes (7.6 ± 2.6 mm, 5.2 ± 1.8 min). Mean pain score of the Sublingual group was significantly lower (2.4 + 1.3; P < 0.001) as compared to oral (3.4 ± 1.3) or vaginal routes (3.6 ± 1.2). Patient acceptability was higher for Sublingual (53 of 150) and oral routes (62 of 150) as compared to vaginal (35 of 150) route. Conclusion: Sublingual route was significantly more effective than oral or vaginal administration of misoprostol for cervical dilatation. To the best of our knowledge, this is the first study to simultaneously compare the efficacy of Sublingual, oral and vaginal routes of misoprostol for cervical priming before SE.
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comparison between the Sublingual and oral route of misoprostol for pre abortion cervical priming in first trimester abortions
Human Reproduction, 2004Co-Authors: Pikee Saxena, Sudha Salhan, Nivedita SardaAbstract:BACKGROUND: Misoprostol has been used for achieving cervical priming before suction evacuation (SE) by the oral or vaginal route, although both routes have their shortcomings. We evaluated the efficacy of the Sublingual versus oral route of misoprostol for cervical priming before SE. METHODS: A prospective clinical trial was carried out in 100 women with a period of gestation of between 6 and 12 weeks who were sequentially allocated to two groups of 50 each. Both groups received 400 microg of misoprostol 3 h prior to SE by either the Sublingual or the oral route. RESULTS: Demographically, both groups were similar. For all periods of gestation, Sublingual misoprostol significantly improved cervical dilation (P<0.001) with a reduction in duration of surgery (P=0.024) compared with the oral route. Mean (+/- SD) pain scores for the Sublingual and oral groups were similar (2.6 +/- 1.4 versus 3.5 +/- 1.1). No major complications occurred in either of the two groups. CONCLUSION: the Sublingual route is an effective alternative to oral administration of misoprostol for cervical dilation. To the best of our knowledge, this is the first study to compare the efficacy of the Sublingual versus the oral route of misoprostol for cervical priming before SE.
Pak Chung Ho - One of the best experts on this subject based on the ideXlab platform.
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Original research article A randomized clinical trial comparing the short-term side effects of Sublingual and buccal routes of misoprostol administration for medical abortions up to 63 days' gestation ☆,☆☆,★
2013Co-Authors: Joyce Chai, Grace Ching-yin Wong, Pak Chung HoAbstract:Background: Buccal misoprostol 800 mcg and Sublingual misoprostol 800 mcg show high efficacy when used with 200 mg mifepristone for early pregnancy termination but have different side effect profiles. This is the first double-blind randomized trial comparing the side effect profiles of these two routes of administration of misoprostol when used with mifepristone for termination of pregnancies up to 63 days’ gestation. Study Design: Eligible women (n=90) who requested legal termination of pregnancy up to 63 days’ gestation were randomized to two groups and given 200 mg of oral mifepristone followed 48 h later by 800 mcg of either Sublingual (n=45) or buccal (n=45) misoprostol. Results: Most of the side effects including fever were more common in the Sublingual group, but only the incidence of chills was significantly higher in the Sublingual group (55.6% vs 91.1%, p=.0001). Complete abortion occurred in 95.4% [95% confidence interval (CI): 84.9–99.5] of women in the buccal group and 97.8% (95% CI: 88.2–99.9) in the Sublingual group. Conclusions: When combined with mifepristone for termination of pregnancy up to 63 days, both the buccal and Sublingual routes are effective routes of administration. The Sublingual route tended to be associated with more side effects.
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A randomized clinical trial comparing the short-term side effects of Sublingual and buccal routes of misoprostol administration for medical abortions up to 63 days gestation
Contraception, 2012Co-Authors: Joyce Chai, Ching Yin Grace Wong, Pak Chung HoAbstract:Abstract Background Buccal misoprostol 800 mcg and Sublingual misoprostol 800 mcg show high efficacy when used with 200 mg mifepristone for early pregnancy termination but have different side effect profiles. This is the first double-blind randomized trial comparing the side effect profiles of these two routes of administration of misoprostol when used with mifepristone for termination of pregnancies up to 63 days��� gestation. Study Design Eligible women ( n =90) who requested legal termination of pregnancy up to 63 days��� gestation were randomized to two groups and given 200 mg of oral mifepristone followed 48 h later by 800 mcg of either Sublingual ( n =45) or buccal ( n =45) misoprostol. Results Most of the side effects including fever were more common in the Sublingual group, but only the incidence of chills was significantly higher in the Sublingual group (55.6% vs 91.1%, p=.0001). Complete abortion occurred in 95.4% [95% confidence interval (CI): 84.9���99.5] of women in the buccal group and 97.8% (95% CI: 88.2���99.9) in the Sublingual group. Conclusions When combined with mifepristone for termination of pregnancy up to 63 days, both the buccal and Sublingual routes are effective routes of administration. The Sublingual route tended to be associated with more side effects.
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A randomized clinical trial comparing the short-term side effects of Sublingual and buccal routes of misoprostol administration for medical abortions up to 63 days gestation
Contraception, 2012Co-Authors: Joyce Chai, Ching Yin Grace Wong, Pak Chung HoAbstract:Abstract Background Buccal misoprostol 800 mcg and Sublingual misoprostol 800 mcg show high efficacy when used with 200 mg mifepristone for early pregnancy termination but have different side effect profiles. This is the first double-blind randomized trial comparing the side effect profiles of these two routes of administration of misoprostol when used with mifepristone for termination of pregnancies up to 63 days��� gestation. Study Design Eligible women ( n =90) who requested legal termination of pregnancy up to 63 days��� gestation were randomized to two groups and given 200 mg of oral mifepristone followed 48 h later by 800 mcg of either Sublingual ( n =45) or buccal ( n =45) misoprostol. Results Most of the side effects including fever were more common in the Sublingual group, but only the incidence of chills was significantly higher in the Sublingual group (55.6% vs 91.1%, p=.0001). Complete abortion occurred in 95.4% [95% confidence interval (CI): 84.9���99.5] of women in the buccal group and 97.8% (95% CI: 88.2���99.9) in the Sublingual group. Conclusions When combined with mifepristone for termination of pregnancy up to 63 days, both the buccal and Sublingual routes are effective routes of administration. The Sublingual route tended to be associated with more side effects.
Eric Cox - One of the best experts on this subject based on the ideXlab platform.
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Adjuvanting Allergen Extracts for Sublingual Immunotherapy: Calcitriol Downregulates CXCL8 Production in Primary Sublingual Epithelial Cells.
Frontiers in immunology, 2020Co-Authors: Michael Pelst, Clara Höbart, Charlotte Wallaeys, Hilde De Rooster, Yannick Gansemans, Filip Van Nieuwerburgh, Bert Devriendt, Eric CoxAbstract:Application of allergens onto the Sublingual epithelium is used to desensitize allergic individuals, a treatment known as Sublingual immunotherapy. However, the response of Sublingual epithelial cells to house dust mite allergen and potential tolerance-promoting adjuvants such as Toll-like receptor (TLR) ligands and calcitriol has not been investigated. In order to study this, primary Sublingual epithelial cells were isolated from dogs and cultured in vitro. After 24-h incubation with a Dermatophagoides farinae extract, a Dermatophagoides pteronyssinus extract, TLR2 ligands (FSL-1, heat-killed Listeria monocytogenes, Pam3CSK4), a TLR3 ligand (poly I:C), a TLR4 ligand [lipopolysaccharide (LPS)], and calcitriol (1,25-dihydroxyvitamin D3), viability of the cells was analyzed using an MTT test, and their secretion of interleukin 6 (IL-6), IL-10, CXCL8, and transforming growth factor β1 (TGF-β1) was measured by enzyme-linked immunosorbent assay. Additionally, to evaluate its potential effect as an adjuvant, Sublingual epithelial cells were incubated with calcitriol in combination with a D. farinae extract followed by measurement of CXCL8 secretion. Furthermore, the effect of D. farinae and calcitriol on the transcriptome was assessed by RNA sequencing. The viability of the Sublingual epithelial cells was significantly decreased by poly I:C, but not by the other stimuli. CXCL8 secretion was significantly increased by D. farinae extract and all TLR ligands apart from LPS. Calcitriol significantly decreased CXCL8 secretion, and coadministration with D. farinae extract reduced CXCL8 concentrations to levels seen in unstimulated Sublingual epithelial cells. Although detectable, TGF-β1 secretion could not be modulated by any of the stimuli. Interleukin 6 and IL-10 could not be detected at the protein or at the mRNA level. It can be concluded that a D. farinae extract and TLR ligands augment the secretion of the proinflammatory chemokine CXCL8, which might interfere with Sublingual desensitization. On the other hand, CXCL8 secretion was reduced by coapplication of calcitriol and a D. farinae extract. Calcitriol therefore seems to be a suitable candidate to be used as adjuvant during Sublingual immunotherapy.
