Single-dose Intramuscular Injection Research Articles

A single dose recombinant AAV based CHIKV vaccine elicits robust and durable protective antibody responses in mice.

Chikungunya virus (CHIKV) is a mosquito-borne alphavirus that is responsible for Chikungunya fever, which is characterized by fever, rash, and debilitating polyarthralgia. Since its re-emergence in 2004, CHIKV has continued to spread to new regions and become a severe health threat to global public. Development of safe and single dose vaccines that provide durable protection is desirable to control the spread of virus. The recombinant adeno-associated virus (rAAV) vectors represent promising vaccine platform to provide prolonged protection with a single-dose immunization. In this study, we developed a rAAV capsid serotype 1 vector based CHIKV vaccine and evaluated its protection effect against CHIKV challenge. The recombinant AAV1 encoding the full-length structural proteins of CHIKV (named as rAAV1-CHIKV-SP) was generated in vitro by transfecting the plasmids of AAV helper-free system into HEK-293T cells. The safety and immunogenicity of rAAV1-CHIKV-SP were tested in 4-week-old C57BL/6 mice. The antibody responses of the mice receiving prime-boost or single-dose immunization of the vaccine were determined by ELISA and plaque reduction neutralizing test. The immunized mice were challenged with CHIKV to evaluate the protection effect of the vaccine. The rAAV1-CHIKV-SP showed remarkable safety and immunogenicity in C57BL/6 mice. A single dose intramuscular injection of rAAV1-CHIKV-SP elicited high level and long-lasting antibody responses, and conferred complete protection against a heterologous CHIKV strain challenge. These results suggest rAAV1-CHIKV-SP represents a promising vaccine candidate against different CHIKV clades with a simplified immunization strategy.

The impact of vitamin D3 administration and of high fat diet on oxidative stress and inflammation in experimentally induced polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is commonly associated with obesity and may be exacerbated by the lack of vitamin D3. The study aimed to investigate the effects of vitamin D3 administration in female rats with PCOS and prolonged high fat diet (HFD). Forty-four female Wistar rats, 180-200 g, 10 weeks old, were randomly allocated into 2 groups (n=22) that received a single dose intramuscular injection of: sesame oil (group I), or estradiol valerate (5 mg) in sesame oil (group II). After 4 weeks, intraovarian cysts developed in group II, as evidenced by ultrasonography. In the next step, half of rats from each group received standard diet (SD) and the other half high fat diet, through oral gavage, for 17 weeks, the following groups being obtained: Control (SD), HFD, PCOS (PCOS+SD) and PCOS+HFD. Next, all the rats received, for 5 weeks, 500 UI/kg/day vitamin D3, through oral gavage. Lipid peroxidation was assessed through malondialdehyde level in the ovary and periovarian tissue and the inflammation was quantified in ovary by NFkB, pNFkB, NRF2 and SOD1 expressions. Ovaries from all groups were collected for histopathological analysis. Blood samples were taken to evaluate the basal insulin, triglycerides and total cholesterol levels throughout the experiment. Both groups with PCOS recorded significant increases of malondialdehyde in ovaries (p<0.001) and in periovarian tissue, especially in PCOS+HFD (p<0.05), even after vitamin D3 administration. PCOS+HFD group treated with vitamin D3 showed a high degree of inflammation in ovarian histopathology but with decreased pNFkB expression (p<0.01) while PCOS group recorded an increased SOD1 expression (p<0.05). Additionally, vitamin D3 treatment attenuated the insulin level (p<0.001) in PCOS and in HFD groups and the total cholesterol level in PCOS+HFD group, but triglycerides recordings were without statistical significance (p>0.05). HFD induced inflammation in ovaries, evidenced histologically and through increases of COX2 expressions (p<0.05) without significant influences on oxidative stress and on cholesterol levels. Polycystic ovary syndrome is associated with oxidative stress and inflammation in the ovary tissue and in blood with increased levels of insulin, total cholesterol and triglycerides that might be partially mitigated by vitamin D3 oral administration.

Nirsevimab: A Review.

Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infections in people of all ages and is the leading cause of hospitalization among infants in the United States. The year 2023 was exciting for RSV prevention. The Food and Drug Administration (FDA) approved 3 new tools for preventing severe lower respiratory tract RSV infections in infants, young children, and elderly persons. In May 2023, the FDA approved 2 vaccines, RSVpreF3 (Arexvy™, GSK) and RSVpreF (Abrysvo™, Pfizer), for adults ages 60 years or older to be given as a single-dose intramuscular injection. July 2023 brought the approval of the first long-acting monoclonal antibody nirsevimab (Beyfortus™, Sanofi and AstraZeneca) for the prevention of RSV disease in infants and young children. Then in August, the FDA approved a vaccine (Abrysvo™, Pfizer) to be given to pregnant women to protect their newborns through passive immunity. This article focuses on nirsevemab that has been recommended by the Advisory Committee on Immunization Practices (ACIP) and American Academy of Pediatrics (AAP) to be administered for all infants <8 months of age and for children 8 to 19 months of age who are at increased risk for severe RSV disease.

Moth-Eaten Essential Syphilitic Alopecia in Human Immunodeficiency Virus-Positive Patient: A Case Report

Hair loss is rare to be reported as sole manifestation of secondary syphilis. Syphilitic alopecia consists of symptomatic syphilitic alopecia that presents with other secondary syphilis manifestation, and essential syphilitic alopecia which can be patchy ("moth-eaten" type), diffuse, or combination without other manifestations of secondary syphilis. Here we report a case of secondary syphilis in patient with Human Immunodeficiency Virus (HIV) that present with moth-eaten alopecia as a sole manifestation. A 35-year-old male with HIV complained hair loss on his scalp and eyebrows. Physical examination showed non scarring moth-eaten alopecia on his scalp and lossof lateral third of his eyebrows without other lesions. Serological test for syphilis was positive. He was treated with 2.4 millions unit of benzathine penicillin G (BPG), single dose intramuscular injection. Six months after injection, patient showed clinical and serological improvement. Syphilitic alopecia cannot be ruled out in patients with non scarring hair loss with unclear etiology. Serological tests are recommended especially for patients with history of high risk sexual behaviour.

Decrease of serum hCG on day 4 of single-dose methotrexate regimen is valuable to predict treatment failure in patients with intact tubal ectopic pregnancy

Aim: We aimed to determine the predictivity of decrease in serum hCG value on day 4 of single-dose methotrexate (MTX) regimen for the need for surgery in patients with intact tubal ectopic pregnancy (TEP).Methods: We evaluated 41 patients diagnosed with intact TEP and treated with single-dose intramuscular injection of MTX treatment according to body surface area (50 mg/m2). Serum hCG values on days 0, 4, and 7 were retrieved to determine patterns of hCG change. Clinical data of patients with treatment success or failure were analyzed. Results: Of 41 patients, 31 was successfully treated with MTX administration, and in the rest (n=10), surgery was required because of intraabdominal hemorrhage. On days 0, 4, and 7, the median serum hCG values in patients with treatment failure were significantly higher compared to treatment success (p

A comparative analysis of the efficacy of two vitamin D supplementation regimens in preterm infants: a prospective randomized controlled study

OBJECTIVE To study the effect of different vitamin D supplementation regimens on the nutritional status of vitamin D on day 28 after birth in preterm infants with a gestational age of 0.05). Compared with the control group on day 28 after birth, the observation group had a significantly higher serum 25(OH)D level (P<0.05) and a significantly lower prevalence rate of vitamin D deficiency (P<0.05). There were no cases of vitamin D overdose or poisoning. CONCLUSIONS In preterm infants with a gestational age of <34 weeks, single-dose intramuscular injection of 10 000 IU/kg vitamin D3 can significantly increase serum 25(OH)D level on day 28 after birth and safely and effectively reduce the prevalence rate of vitamin D deficiency.

Single dose of Methotrexate therapy followed by suction curettage for management of Cesarean Scar Pregnancy

Aim: To evaluate the efficacy and safety of single dose of of Systemic MTX 50 mg/m2 followed by D&amp;S in cases of Cesarean scar pregnancy (CSP). Objective: Implantation of the pregnancy in a cesarean scar is a rare condition named; Cesarean scar pregnancy (CSP). Maternal complications can be prevented with the early diagnosis and an appropriate management. It is a prospective clinical study to evaluate the efficacy and success rate of single dose use of methotrexate (MTX) followed by dilation and suction (D&amp;S) regimen in the management of women with cesarean scar pregnancy (CSP). Methods: 50mg of MTX in the form of a single dose Intramuscular injection then cervical dilatation and suction aspiration with a Karman cannula (D&amp;S) under guidance of ultrasound after 48 preceded by vaginal misoprostol 2 tablet (200 mg) 4 hours ago. Results: The mean gestational age at diagnosis was (8.5±1.6) and the mean gestational age of pregnancy was 8.5±1.6. The mean level of serum b-human chorionic gonadotrophin was (7424±2.560). 88.7% was the successive rate without complication or need of intervention, 2 (5.7%) patients needed intrauterine foley's catheter for 24 hours as a mechanical hemostasis. 2 (5.7 %) had laparotomy with wedge resection of the gestational sac lesion and successful repair of the uterine defect and one (2.8 %) underwent subtotal hysterectomy. Conclusion: Systemic single dose MTX injection followed by D&amp;S is an effective and harmless management for CSP. Nevertheless more studies are required to prove the efficiency, safety, and reproductive outcome of variant modalities in treatment of CSP.

Single Dose of Methotrexate Therapy Followed By Suction Curettage for Management of Cesarean Scar Pregnancy

Objective Implantation of the pregnancy in a cesarean scar is a rare condition named ; Cesarean scar pregnancy (CSP). Maternal complications can be prevented with the early diagnosis and an appropriate management .It is a Prospective clinical study to evaluate the efficacy and success rate of single dose use of methotrexate (MTX) followed by dilation and suction (D&amp;S) regimen in management of women with cesarean scar pregnancy (CSP) . Methods 50mg of MTX in the form of a single dose Intramuscular injection then cervical dilatation and suction aspiration with a Karman cannula(D&amp;S) under guidance of ultrasound after 48 preeceeded by vaginal misoprostol 2 tablet (200 mg) 4 hours ago. Results The mean gestational age at diagnosis was (8.5±1.6 ) and The mean level of serum b-human chorionic gonadotropin was (7424±2.560 ) and The mean gestational age of pregnancy was (8.5±1.6 ) .88.7% is the successive rate without complication need intervention, 2 (5.7%) patients needed intrauterine Foley's catheter for 24 hours as a mechanical hemostasis . 2 (5.7 %) had laparotomy with wedge resection of the gestational sac lesion and successful repair of the uterine defect and one (2.8 %)underwent subtotal hysterectomy. Conclusion: Systemic single dose MTX injection followed by D&amp;S is an effective and harmless management for CSP. Nevertheless more studies are required to prove the efficiency, safety, and reproductive outcome of variant modalities in treatment of CSP.

Pharmacokinetics of α-tocopherol stereoisomers in plasma and milk of cows following a single dose injection of all-rac-α-tocopheryl acetate

Among different stereoisomers of all-rac-α-tocopherol, 2R-stereoisomers have higher biological activities than their 2S-stereoisomers. Two experiments were conducted to study the pharmacokinetics of stereoisomers of all-rac-α-tocopherol and investigated the discrimination and distribution of α-tocopherol stereoisomers in plasma and milk as well as quantitative secretion into milk with lactating Holstein cows after a single dose intramuscular injection of 2.50 g of all-rac-α-tocopheryl acetate. The highest half-life (2.92/h) and lowest elimination rate (0.36/h) were found for RRR-α-tocopherol. After a single dose injection of all-rac-α-tocopherol, highest maximal daily increase (Smax, 8.36 mg/day) and accumulation secretion (AS, 50.8 mg) were observed for milk RRR-α-tocopherol. The majority of the Ʃ2S stereoisomers were found in the liver 36 h post injection, while the 2R stereoisomers were more equal distributed between liver and plasma. The present findings showed a clear discrimination between RRR-α-tocopherol, synthetic 2R stereoisomers and Ʃ2S stereoisomers in milk and plasma of dairy cows.

Single Dose of Methotrexate Therapy Followed By Suction Curettage for Management of Cesarean Scar Pregnancy

Objective Implantation of the pregnancy in a cesarean scar is a rare condition named ; Cesarean scar pregnancy (CSP). Maternal complications can be prevented with the early diagnosis and an appropriate management .It is a Prospective clinical study to evaluate the efficacy and success rate of single dose use of methotrexate (MTX) followed by dilation and suction (D&amp;S) regimen in management of women with cesarean scar pregnancy (CSP) . Methods 50mg of MTX in the form of a single dose Intramuscular injection then cervical dilatation and suction aspiration with a Karman cannula(D&amp;S) under guidance of ultrasound after 48 preeceeded by vaginal misoprostol 2 tablet (200 mg) 4 hours ago. Results The mean gestational age at diagnosis was (8.5±1.6 ) and The mean level of serum b-human chorionic gonadotropin was (7424±2.560 ) and The mean gestational age of pregnancy was (8.5±1.6 ) .88.7% is the successive rate without complication need intervention, 2 (5.7%) patients needed intrauterine Foley's catheter for 24 hours as a mechanical hemostasis . 2 (5.7 %) had laparotomy with wedge resection of the gestational sac lesion and successful repair of the uterine defect and one (2.8 %)underwent subtotal hysterectomy. Conclusion: Systemic single dose MTX injection followed by D&amp;S is an effective and harmless management for CSP. Nevertheless more studies are required to prove the efficiency, safety, and reproductive outcome of variant modalities in treatment of CSP.

Can Preoperative Intramuscular Single-Dose Dexamethasone Improve Patient-Centered Outcomes Following Third Molar Surgery?

Because of increased attention focused on administering dexamethasone to treat third molar surgical complications, this study investigated the efficacy of single-dose dexamethasone in managing postoperative complications after impacted third molar surgery. Pain intensity and analgesic intake, patients' discomfort, limitation of oral function, and limitation of daily activities were assessed. This triple-blinded split-mouth randomized controlled clinical trial included patients 18 to 30years old who underwent randomized bilateral extractions of impacted mandibular third molars during 2 consecutive sessions. Each patient was given a single-dose intramuscular injection of dexamethasone (0.1mg/kg) preoperatively in 1 session and a placebo in the other session. Data were collected daily for 7 postoperative days, and 14 patient-centered outcomes were interpreted. A 2-tailed P value less than .05 was considered significant. All 32 patients (100%) enrolled completed the study. When administered dexamethasone, patients reported less pain (P≤.007), took fewer analgesics (P≤.002), reported less swelling (P≤.007), had less difficulty in eating (P≤.024), had less difficulty in enjoying food (P≤.005), had less difficulty in speech (P=.043), had less trismus (P=.005), were absent less from school or work (P≤.016), and had less disruption of daily activity (P≤.042). The differences between the 2 conditions in bleeding, malaise, and sleep disturbance were not significant (P>.05). Prophylactic dexamethasone administered intramuscularly before third molar surgery should be recommended as a safe and effective strategy for decreasing pain and discomfort and enhancing oral functions and daily activities, unless contraindicated.

Assessment of in vivo antimalarial activity of arteether and garlic oil combination therapy

The study evaluates in vivo antimalarial activity of arteether and garlic pearl oil combination in Plasmodium berghei-infected mouse model of malaria. 72h (Day 3) post infection, at 2–4% parasitemia, mice were treated with single dose intramuscular injection of α-β arteether, at 750μg, in combination with three 100μL oral doses of garlic pearl oil on Day 3, Day 4 and Day 5. Following the treatment, 100% protection and survival of mice were observed. Inhibition of parasitemia in combination treated animals and protection during recrudescence interval of α-β arteether monotherapy was observed in Giemsa-stained blood smears. In addition, a striking increase in anti-parasite antibody IgG contributing protective immunity during the recrudescence phase was observed. These results correlate with western blot analysis, where sera from the recrudescence stage and later period of arteether and garlic oil combination treated animals found to interact with several parasite specific proteins as compared to controls. The present approach shows that arteether and garlic pearl oil combination provides complete protection in P. berghei-infected mice. Thus, for the first time, garlic pearl oil appears to be an ideal antimalarial candidate in artemisinin combination therapy.

Single-dose Intramuscular-injection Toxicology Test of Water-soluble Carthami-flos and Cervi cornu parvum Pharmacopuncture in a Rat Model.

Objectives:The aim of the study is to investigate both the single-dose intramuscular injection toxicity and the approximate lethal dose of water-soluble Carthami-flos and Cervi cornu parvum pharmacopuncture (WCFC) in male and female Sprague-Dawley (SD) rats.Methods:The study was conducted at Biotoxtech Co. according to the Good Laboratory Practice (GLP) regulation and the toxicity test guidelines of the Ministry of Food and Drug Safety (MFDS) after approval of the Institutional Animal Care and Use Committee. Dosages for the control, high dose, middle dose and low dose groups were 0.5 mL/animal of saline and 0.5, 0.25 and 0.125 mL/animal of WCFC, respectively. WCFC was injected into the muscle of the left femoral region by using a disposable syringe (1 mL, 26 gauge). The general symptoms and mortality were observed 30 minutes, 1, 2, 4, and 6 hours after the first injection and then daily for 14 days after the injection. The body weights of the SD rats were measured on the day of the injection (before injection) and on the third, seventh, and fourteenth days after the injection. Serum biochemical and hematologic tests, necropsy examinations, and histopathologic examinations at the injection site were performed after the observation period.Results:No deaths, abnormal clinical symptoms, or significant weight changes were observed in either male or female SD rats in the control or the test (0.125, 0.25, and 0.5 mL/animal) groups during the observation period. No significant differences in hematology and serum biochemistry and no macroscopic abnormalities at necropsy were found. No abnormal reactions at injection sites were noted on the topical tolerance tests.Conclusion:The results of this single-dose toxicity study show that WCFC is safe, its lethal doses in male and female SD rats being estimated to be higher than 0.5 mL/animal.

Toxicity of Single-dose Intramuscular Injection of Samjeong Pharmacopuncture in Sprague-Dawley Rats.

Objectives:This study was carried out in order to find both the single-dose intramuscular injection toxicity and the approximate lethal dose of samjeong pharmacopuncture (SP) in Sprague-Dawley (SD) rats.Methods:The SD rats in this study were divided into four groups, one control group (1.0 mL/animal, normal saline) and three experimental groups (0.25, 0.5, and 1.0 mL/animal, SP). All groups consisted of five male and five female rats. SP was injected as a single-dose intramuscularly at the thigh. After the injection, general symptoms and weight were observed for 14 days. After the observations had ended, hematologic and serum biochemical examinations, necropsy and a local tolerance test at the injection site were performed. The experiments were carried out at the Good Laboratory Practice firm, Biotoxtech Co. (Cheongwon, Chungbuk). Animal experiments were approved by the Ethics Committee (Approval Number: 130379).Results:No deaths occurred in any of the three experimental groups. The injection of SP had no effects on the general symptoms, body weights, results of the hematologic, and serum biochemical examinations, and necropsy findings. In local tolerance tests at the injection sites, mild inflammation was observed in the experimental group, but it did not appear to be a treatment related effect.Conclusion:Under the conditions of this test, the results from the injection of SP suggest that the approximate lethal dose of SP is above 1.0 mL/animal for both male and female SD rats. Therefore, the clinical use of SP is thought to be safe.

Single-dose Intramuscular Injection Toxicology of Danggui Pharmacopuncture (DGP) in Sprague-Dawley Rats.

Objectives:The purpose of the study is to assess both the approximate lethal dose and the single dose intramuscular injection toxicity of Danggui (Angelica gigantis radix) pharmacopuncture (DGP) in Sprague-Dawley (SD) rats.Methods:The experiments were conducted at the good laboratory practice (GLP) laboratory, Biotoxtech Co., which is a laboratory approved by the ministry of food and drug safety (MFDS). The study was performed according to the GLP regulation and the toxicity test guidelines of the MFDS (2009) after approval of the institutional animal care and use committee of Biotoxtech. Single doses of DGP were injected intramuscularly into the rats in three test groups of 6 week old SD rats (5 male and 5 female rats per groups) in the amounts of 0.1, 0.5, and 1.0 mL/animal for groups 2, 3, and 4, respectively, and normal saline solution in the amount of 1.0 mL/animal was injected intramuscularly into the rats (5 male and 5 female rats) in the control group. Observations of the general symptoms and weight measurements were performed during the 14 day observation period after the injection. Hematologic and serum biochemical examination, necropsy, and a local tolerance test at the injection site were done after the observation period.Results:No death was observed in three test groups (0.1, 0.5 and 1.0 mL/animal group). In addition, the injection of DGP had no effect on general symptoms, weights, hematologic and serum biochemical examination, and necropsy. The results from the local tolerance tests at injection site showed no treatment related effects in the SD rats.Conclusion:The results of single dose intramuscular injection of DGP suggest that the approximate lethal dose is above 1.0 mL/animal for both male and female SD rats and that intramuscular injection of DGP may be safe.

Effect of single dose preoperative intramuscular dexamethasone injection on lower impacted third molar surgery

This study aimed to investigate the effects of dexamethasone intramuscular injection 1h preoperatively, in reducing facial swelling, pain and trismus after lower impacted third molar (LITM) surgery. Twenty healthy Thai patients with both LITM surgical extraction were enrolled in the study. The washout period was 1 month after the first operation. Clinical assessment of the facial swelling, pain and trismus were measured before and after operation for 7 days and the patient's total analgesic consumption was recorded. The level of significance used in the statistical decisions was P<0.05. Preoperative intramuscular injection of single-dose 8mg dexamethasone reduced postoperative swelling after LITM surgical extraction significantly on the second postoperative day, but immediately after surgery and on day 7 after the surgical extraction, no significant difference was found between the dexamethasone and control groups. Dexamethasone also reduced postoperative pain after LITM surgical extraction significantly on postoperative days 2 and 7. Additionally, the amount of paracetamol decreased significantly. There were no significant differences in trismus in the study and control groups 7 days after LITM operation. Single-dose intramuscular injection of dexamethasone can reduce postoperative facial swelling and pain, without affecting trismus after LITM surgical extraction.

Persistent Ectopic Pregnancy after Linear Salpingotomy: A Non-Predictable Complication to Conservative Surgery for Tubal Gestation

Since the early 1990s, more than half of the patients treated for unruptured tubal pregnancy in the authors' department have undergone unilateral linear salpingotomy. Although this procedure can preserve fertility, estimates of the frequency of persistent ectopic pregnancy (PEP) associated with salpingotomy range from 5% to 29%. This study was conducted to investigate various patient characteristics that might identify patients at greatest risk of developing PEP, including pre- and postprocedure serum levels of human chorionic gonadotropin (hCG). Data analyses were performed using the Student t test, Mann-Whitney U test, Fisher exact test, or Χ 2 test. From 1992 through 1998, 417 of 806 patients who were treated for ectopic pregnancy at Hvidovre Hospital underwent laparoscopic linear salpingotomy. In all, 48 women had PEP and required secondary treatment. Three women with persistent clinical symptoms were treated with salpingectomy on days 1, 7, and 46. Forty-five women were diagnosed with PEP because of rising or stagnant serum hCG levels. There were no clinical symptoms in 30 women. The median interval between salpingotomy and secondary treatment for these women was 15 days (range, 1-46 days). Eight patients were treated within 9 days of initial treatment, and 14 were treated within the first 12 days. In all, 23 of the 48 women with PEP chose to have salpingectomy, 23 chose systemic methotrexate, and 2 elected to undergo a second linear salpingotomy. Nineteen of the 23 patients treated with methotrexate received a multidose oral regimen. The regimen failed in four women, who then underwent salpingectomy. In 1998 the protocol for methotrexate was changed to a single-dose intramuscular injection. In this series the single dose was successful in all four women who received it. Nearly all of the women (94% of patients in whom salpingotomy was successful and 98% of those with PEP) had preoperative serum hCG values taken within 3 days of initial treatment. The preoperative values were significantly higher in patients who had PEP (median, 2100 IU/liter) than in successfully treated patients (median, 893 IU/liter; P = .003). A higher risk of PEP was associated with preoperative serum hCG levels of 2500 IU/liter and above; however, a receiver operating characteristic curve showed low prognostic accuracy for preoperative hCG levels at all cutoff points. Serum hCG levels from 2500 to 3000 IU/liter had a specificity for predicting PEP ranging from 0.74 to 0.77 and a sensitivity ranging from 0.38 to 0.45. Serum hCG levels were measured a median of three times for women who underwent successful linear salpingotomy and eight times for those with PEP. Of the 38 patients with PEP who had hCG levels measured on the ninth postoperative day, 25 had values 10% of preoperative levels, compared with 72 of 317 successfully treated women (P <.0001). Measurements taken on day 12 showed that 22 of 33 (66.7%) PEP patients had serum hCG values of 7% of initial values, compared with 80 of 324 successful cases (24.7%; P <.001). These two cutoff levels had a sensitivity and specificity of predicting PEP of 0.66 to 0.67 and 0.77 to 0.75, respectively. The prognostic value was poor at all cutoff levels. Multivariate analysis of potential predictive variables, including duration of surgery, surgical technique, history of previous ectopic pregnancy, history of previous lower abdominal surgery, ruptured ectopic pregnancy, pelvic adhesions, and absence of products of conception at microscopy and hemoperitoneum, found no predictive ability for any variable.

Triplet cervical pregnancy treated with intraamniotic methotrexate

BACKGROUND: Multifetal cervical pregnancy is very rare. We are reporting a case of a triplet cervical pregnancy that was treated with direct intraamniotic instillation of methotrexate. CASE: A young multiparous woman was diagnosed as having three gestational sacs in her uterine cervix with embryonic cardiac activity observed within one of the sacs. She became pregnant by natural ovulation and coitus. After initial failure with a single-dose intramuscular injection, the patient was successfully treated with an intra-amniotic methotrexate injection under the guidance of transvaginal ultrasonography. Her reproductive capability was preserved. CONCLUSION: Direct intraamniotic injection can be considered as treatment for multifetal cervical pregnancy.

Triplet Cervical Pregnancy Treated With Intraamniotic Methotrexate

In Brief BACKGROUND Multifetal cervical pregnancy is very rare. We are reporting a case of a triplet cervical pregnancy that was treated with direct intraamniotic instillation of methotrexate. CASE A young multiparous woman was diagnosed as having three gestational sacs in her uterine cervix with embryonic cardiac activity observed within one of the sacs. She became pregnant by natural ovulation and coitus. After initial failure with a single-dose intramuscular injection, the patient was successfully treated with an intraamniotic methotrexate injection under the guidance of transvaginal ultrasonography. Her reproductive capability was preserved. CONCLUSION Direct intraamniotic injection can be considered as treatment for multifetal cervical pregnancy. A case of triplet cervical pregnancy successfully treated by intraamniotic instillation of methotrexate is reported.

The Effect of Amphetamine on Head and Eye Movements Following Vestibular Stimulation in Squirrel Monkeys

The effect of a single dose intra-muscular injection of amphetamine sulfate on head and eye movements evoked by vestibular stimulation was investigated in squirrel monkeys. Doses injected were 0.5, 0.4, 0.3, 0.2 mg/kg, and control no injections. Amphetamine did not change the gain of vestibular evoked head and eye movements, but prolonged time constant (in function of dose) showing greater effect in eye movements. More than 0.3 mg/kg was found to be a proper dose for this species to maintain an appropriate constant alertness level for vestibular studies.