A study of fetomaternal outcome in cases of severe anemia in labor at a tertiary care center

Background: In India, the prevalence of anemia is high because of fewer intakes of iron, folic acid and food sources that prevent iron absorption, coupled with poor bioavailability of iron is the major factor responsible for prevalence of anemia. More than iron deficiency, zinc, vitamin B12 and folate deficiency was highly prevalent due to ascariasis infestation. Methods: This study was carried out in the department of obstetrics and gynaecology at PDU medical college and hospital Rajkot, Gujarat from May 2021 to April 2022. Results: The study was conducted on 83 cases, the prevalence rate of severe anemia in the study population of PDU Medical College Rajkot was found to be 1.6% during this study period. 57.83% of cases delivered before term. Most of the patients 85.54% in the study group suffered from iron deficiency anemia. Most of the patients 49.40% were managed by transfusion of 2-pint PCV. Most common complications associated with anemia in pregnancy are atonic PPH, pulmonary oedema and surgical site infections in this study. A 67.46% of new-borns were of <2.5kg birthweight. High number of new-borns 39.75% with moderately abnormal APGAR scores were delivered. In this study, 75 patients were delivered vaginally, 5 instrumental deliveries were conducted to cut short the second stage of labor, 3 patients underwent LSCS due to major degree placentae previa and foetal distress. Conclusions: Severe anemia during labor affect the maternal and foetal outcome to a large extent. The major step in improving these outcomes is prevention of anemia which could be done at pre-pregnancy stages of a woman’s life, measures such as food fortification, deworming, mass haemoglobin screening among adolescent girls helps in this cause

Clinical practice guidelines for the prevention and treatment of EGFR inhibitor-associated dermatologic toxicities

Background Epidermal growth factor receptor inhibitors (EGFRI) produce various dermatologic side effects in the majority of patients, and guidelines are crucial for the prevention and treatment of these untoward events. The purpose of this panel was to develop evidence-based recommendations for EGFRI-associated dermatologic toxicities. Methods A multinational, interdisciplinary panel of experts in supportive care in cancer reviewed pertinent studies using established criteria in order to develop first-generation recommendations for EGFRI-associated dermatologic toxicities. Results Prophylactic and reactive recommendations for papulopustular (acneiform) rash, hair changes, radiation dermatitis, pruritus, mucositis, xerosis/fissures, and paronychia are presented, as well as general dermatologic recommendations when possible. Conclusion Prevention and management of EGFRI-related dermatologic toxicities is critical to maintain patients’ health-related quality of life and dose intensity of antineoplastic regimens. More rigorous investigation of these toxicities is warranted to improve preventive and treatment strategies

Psoriasis and mortality in the United States: Data from the National Health and Nutrition Examination Survey

Background: Psoriasis is a multifactorial disease that has been associated with multiple systemic disorders. Despite its role in mediating cardiovascular, metabolic, and pulmonary disorders, few studies have examined the independent mortality risk associated with psoriasis. Objective: To determine the independent relationship between psoriasis and all-cause mortality in a nationally representative sample of the US population. Methods: Retrospective population-based cohort study of adults and adolescents older than 10 years (N = 13 031) who participated in National Health and Nutrition Examination Surveys (2003-2006 and 2009-2010). Psoriasis status was determined from a self-reported medical history questionnaire. Mortality data are linked from national databases. Results: Psoriasis was present in 2.7% of the study population. Over an average median follow-up of 52.3 months, psoriasis was significantly associated with increased mortality risk (HR, 1.99; 95% CI, 1.01-3.93; P = .047) with adjustment for demographics, smoking, and comorbidities including cardiovascular disease, diabetes, chronic obstructive pulmonary disease, cancer, chronic kidney disease, and stroke. These comorbidities mediated 15.5%, 5.9%, 8.7%, 11.7%, 4.2%, and 4.7% of the association between psoriasis and mortality, respectively. Conclusion: Psoriasis is independently associated with an increased risk of mortality. This relationship is partially mediated by an increased prevalence of the cardiovascular, infectious, and neoplastic disorders seen among patients with psoriasis

Reducing Skin Toxicities from EGFR Inhibitors with Topical BRAF Inhibitor TherapyTopical BRAF Inhibitor for Anti-EGFR Toxicities

Treatment of cancer with EGFR inhibitors is limited by on-target skin toxicities induced by inhibition of the MAPK pathway. BRAF inhibitors are known to paradoxically activate the MAPK downstream of EGFR, which we confirmed using human skin keratinocytes. We then conducted a phase I clinical trial testing the hypothesis that topical therapy with the BRAF inhibitor LUT014 could improve skin toxicities induced by EGFR inhibitors. Ten patients with metastatic colorectal cancer who had developed acneiform rash while being treated with cetuximab or panitumumab were enrolled in three cohorts. LUT014 was well tolerated, and there were no dose-limiting toxicities. The acneiform rash improved in the 6 patients who started with grade 2 rash in the low and intermediate cohorts. We conclude that topical LUT014 is safe and efficacious in improving rash from EGFR inhibitors, consistent with the mechanism of action inducting paradoxical MAPK activation. SIGNIFICANCE: BRAF inhibitor topical therapy could avoid dose reductions of EGFR inhibitors, locally treating the main dose-limiting skin toxicity of this class of agents.This article is highlighted in the In This Issue feature, p. 2113

Association maladie de Verneuil et trisomie 21 – Étude internationale multicentrique de 56 cas

info:eu-repo/semantics/publishe