Sclerotherapy with Leuprolide and Cefoperazone Sulbactam in the Management of Ovarian Endometriomas under Ultrasound Guidance: A Novel Approach

Endometriosis is an estrogen dependent gynecological disorder, which can occur throughout the reproductive age of women, causing chronic pelvic pain, substantial morbidity, and impaired fertility. It is clinically defined as the presence of ectopic endometrium resulting in sustained inflammatory reaction. In India, about 29,000,000 women suffer from endometriosis. Severe pelvic pain and recurrent endometriomas were observed even after surgery. We have conducted aspirations totally in 110 patients in which most of the patients were suffering from Stage III & Stage IV of endometriosis except for 7 patients for whom we have done as primary therapy for endometriomas. Among 110 patients, 4 patients didn’t turn up for follow up after first aspiration. This pilot study conducted with 110 patients in Ponni Hospital and Fertility Research Centre, Madurai aimed to evaluate pregnancy outcome in 51 infertile patients, and to alleviate pelvic pain, to restore a healthy sexual life and to reduce the recurrence rate of Ovarian Endometriomas (OE) in 59 patients, who did not seek fertility, After using the newer sclerosing agent Leuprolide with Cefoperazone Sulbactam (LCS) under ultrasound guidance. This prospective pilot study resulted in a highly significant achievement in pregnancy where 41 patients conceived out of 51 patients (80.39%) only 6 are in ongoing treatment. Those who didn’t seek fertility were 59 of which 43 have completed family 13 have one child and 3 unmarried girls. 96.61% were relieved of pain and recurrence and restored healthy sexual life, 2 are in ongoing treatment. We have not encountered any adverse effects during this treatment.

Construction of universal quantitative models for the determination of cefoperazone sodium/sulbactam sodium for injection from different manufacturers using near-infrared reflectance spectroscopy

To develop near-infrared （NIR） reflectance spectroscopic methods for the quantitative analysis of cefoperazone sodium/ sulbactam sodium from different manufacturers for injection powder medicaments. Various powders of cefoperazone sodium/ sulbactam sodium were directly analyzed by non-destructive NIR reflectance spectroscopy using the spectrometer EQUINOX55. Two quantitative methods via integrating sphere （IS） and fiberoptic probe （FOP） models were explored from 6 batches of commercial samples and 42 batches of laboratory samples at a content ranging from 30% to 70% for cefoperazone and 60% to 20% for sulbactam. The root mean square errors of cross validation （RMSECV） and the root mean square errors of prediction （RMSEP） of IS were 1.79% and 2.85%, respectively, for cefoperazone sodium, and were 1.86% and 3.08%, respectively, for sulbactam sodium; and those of FOP were 2.93% and 2.92%, respectively, for cefoperazone sodium, and were 2.23% and 3.01%, respectively, for sulbactam sodium. Based on the ICH guidelines and Ref. 12, the quantitative models were then evaluated in terms of specificity, linearity, accuracy, precision, robustness and model transferability. The non-destructive quantitative NIR methods used in this study are applicable for rapid analysis of injectable powdered drugs from different manufacturers.