Here are the top 5 posts this week.

New use of old drug: Sildenafil Citrate (Viagra) improves amniotic fluid index in oligohydramnios.

Sildenafil Citrate (Viagra) improves amniotic fluid index in pregnancies complicated by oligohydramnios according to a new study published ahead of print on March 6,2017 in Journal of Obstetrics and Gynecology.

Link to the article: https://obgynupdated.blogspot.com/2017/03/new-use-of-old-drug-sildenafil-citrate.html

Ethicon ENSEAL® X1 Large Jaw Tissue Sealer gets FDA approval: Excellent for performing abdominal and vaginal hysterectomies.

Ethicon, today announced the release of its new ENSEAL X1 Large Jaw Tissue Sealer. Designed for use in open surgeries it is an advanced bipolar device that provides less blood loss, less thermal spread, and improved ergonomics compared to as compared to Medtronic’s LigaSure Impact™.

Link to the article: https://obgynupdated.blogspot.com/2017/03/ethicon-enseal-x1-large-jaw-tissue.html

Trichomonas vaginalis Infection: Is it time to reconsider the single dose treatment?

Women receiving the recommended single dose therapy for Trichomonas vaginalis are 1.8 times more likely to have relapse of infection as compared to women receiving multi dose treatment says results of a recent Meta-analysis published in Journal of American Sexually Transmitted Disease Association.

Link to the article: https://obgynupdated.blogspot.com/2017/03/trichomonas-vaginalis-infection-is-it.html

FDA approves Noctiva, the first treatment for frequent nighttime urination.

The U.S. Food and Drug Administration today approved Noctiva (desmopressin acetate) nasal spray for adults who have to go for urination at least two times per night, a condition known as nocturnal polyuria. [1]

Noctiva is the first FDA-approved treatment for this condition. About 200 million people worldwide suffer from nocturia.

Link to the article: https://obgynupdated.blogspot.com/2017/03/fda-approves-noctiva-first-treatment.html

Biodegradable sanitary napkins from banana plant: a step towards revolutionizing feminine hygiene in India.

A new healthcare start-up founded by three Massachusetts Institute of Technology graduates have launched a new revolution in women’s hygiene industry by creating biodegradable sanitary napkins from locally sourced banana fibers. They are also hoping to improve waste disposal of pads because it degrades faster if buried. On average, a single woman generates 125 kg of sanitary waste during her menstruating years when she uses disposable sanitary products. [2]

Link to the article: https://obgynupdated.blogspot.com/2017/03/biodegradable-sanitary-napkins-from.html

FDA approves Noctiva, the first treatment for frequent nighttime urination.

Courtesy: getty images 

The U.S. Food and Drug Administration today approved Noctiva (desmopressin acetate) nasal spray for adults who have to go for urination at least two times per night, a condition known as nocturnal polyuria. [1]

Noctiva is the first FDA-approved treatment for this condition. About 200 million people worldwide suffer from nocturia.

It is manufactured by Serenity Pharmaceuticals, LLC and marketed by Milford, Pennsylvania-based Renaissance Lakewood, LLC.

Hylton V. Joffe, M.D., M.M.Sc., director of the Division of Bone, Reproductive, and Urologic Products in the FDA’s Center for Drug Evaluation and Research said “Today’s approval provides adults who overproduce urine at night with the first FDA-approved therapeutic option to help reduce the number of times a night they wake up to urinate,”  he further added  “It is important to know that Noctiva is not approved for all causes of night-time urination, so patients should discuss their symptoms with their health care provider who can determine the underlying cause of the night-time urination and whether Noctiva is right for them.”

Noctiva can be a symptom of many underlying pathologies of the bladder or prostate, diabetes, side effect of some medications and congestive cardiac failure. It prevalence increases with age and is common in men and women. FDA advises the physician to fully investigate a patient for underlying cause, prescribe medicines and manage the medical condition before putting him/her on Noctiva.

He should also get a 24-hour urine collection to confirm the diagnosis of nocturia.

Desmopressin is a nasal spray, to be taken every day ,30 minutes before bedtime. It acts on Kidneys to increase absorption of water from the tubules.

FDA approved the drug after the results of a placebo control trial of 1050 subjects over 50years of age showed that more number of patients on the drug halved the frequency of one night urination and decreased the number of nights with one or more trips to the bathroom.

The side effects of desmopressin to cause hyponatremia, requires that the manufacturer should put medication guide and boxed warning on the package.  Physician should always check the sodium level of the patient before and during therapy periodically.

Contraindicated is patients with hyponatremia, electrolyte imbalance, renal damage, symptomatic CCF, uncontrolled hypertension, pregnancy, gestational DM and patients on steroids and loop diuretics.

The full text of the FDA press announcement can be accessed here.

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[1] https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm544877.htm