A study of risk factors of postpartum hemorrhage and indications for caesarean section

Background: To prevent post-partum hemorrhage the concept of active management of third stage of labour has been proposed which decreases the blood loss by 40-68%. The best preventive strategy is active management of the third stage of labour. The objective of the study was to study risk factors of postpartum hemorrhage and indications for caesarean section.Methods: A hospital based cross sectional study was carried out among 100 women at term for a period of one year. Pregnant women who are at term i.e. at 38-39 weeks of gestation were included in the study. Detailed history, clinical examination and investigations were carried out.Results: The mean pre pregnancy BMI in study group was 22.4±3.96. The majority of patients recruited were primiparous. Socio-demographic data shows that there was no statistical difference in place of residence, occupation and level of literacy between two groups. The prevalence of anemia among women at term was found to be 43%. The most common obstetric high risk factor was gestational diabetes mellitus in 10% followed by gestational hypertension in (6%). 71% of women underwent the emergency LSCS. The most common indication for LSCS was fetal distress in 29% of cases followed by mal-presentation in 12% of cases.Conclusions: The prevalence of anemia among women at term was found to be 43%. The different medical high risk factors were human immunodeficiency virus positive (asymptomatic diagnosed during pregnancy), Hepatitis B antigen positive, cardiovascular risk, hypothyroidism, epilepsy observed in the groups. Other high risk factors included asthma, Crohns disease, and systemic sclerosis

Efficacy of prophylactic tranexamic acid in reducing blood loss during and after caesarean section

Background: In India, caesarean section rate is rising, so the impact of prophylactic injection of tranexamic acid in decreasing blood loss during caesarean section would be more beneficial in terms of having minimal blood loss intra operatively and post operatively and thereby decreasing maternal morbidity. The objective of the study was to evaluate the efficacy of prophylactic tranexamic acid in reducing blood loss during and after caesarean section.Methods: A randomized controlled trial among 200 term women with singleton pregnancy for a period of 2 years was carried out. They were randomized by computer generated numbers into two groups: study group-100 women receiving prophylactic tranexamic acid women and control group-100 women receiving placebo.Results: The blood loss during caesarean section was less in the tranexamic acid group compared to the placebo group. Similarly blood loss measured 6hrs after caesarean section was less in the tranexamic acid group compared to placebo group. 20-40min before the time of incision was the ideal time gap for administering the injection tranexamic acid for its optimum efficacy. Tranexamic acid group had lesser requirement of uterotonic when compared to placebo, but need for blood transfusion was similar in both the groups. Greater fall in the hemoglobin and haematocrit occurred in placebo group compared to tranexamic acid group. No changes in the post-operative vitals or side effects were seen in the tranexamic acid group. Even no change in birth weight and Apgar scores was seen in neonates of tranexamic acid group.Conclusions: Injection tranexamic acid is the, antifibrinolytic agent that can be used for prophylactic administration before caesarean section for decreasing blood loss during surgery

Contemporary and Ancient Review of Mosquitoes - A Review

Indian system of medicine plays an important part in health care system all over India. There are numerous allusions to mosquitoes in Indian writings from the Vedic era. The Atharvaveda makes special reference of mosquito shape, habitat, many varieties, behaviour, and even their presence throughout the year. The 67 different forms of Keet and their genesis were documented by Acharya Susruta in Kalpasthana, while Keet Visha describes five different types of Mashak in which Parvatiya Mashak is the most hazardous to people. There is also Mashak description In Charaka Samhita of chapter Visha Chikitsa. Numerous mosquito species have been identified in contemporary science. Mosquitoes are the most important group of blood sucking insects causing nuisance diseases to humans and other animals.  It follows that our ancestors' seers or philosophers were already aware of this

A study of risk factors of postpartum hemorrhage and indications for caesarean section

Background: To prevent post-partum hemorrhage the concept of active management of third stage of labour has been proposed which decreases the blood loss by 40-68%. The best preventive strategy is active management of the third stage of labour. The objective of the study was to study risk factors of postpartum hemorrhage and indications for caesarean section.Methods: A hospital based cross sectional study was carried out among 100 women at term for a period of one year. Pregnant women who are at term i.e. at 38-39 weeks of gestation were included in the study. Detailed history, clinical examination and investigations were carried out.Results: The mean pre pregnancy BMI in study group was 22.4±3.96. The majority of patients recruited were primiparous. Socio-demographic data shows that there was no statistical difference in place of residence, occupation and level of literacy between two groups. The prevalence of anemia among women at term was found to be 43%. The most common obstetric high risk factor was gestational diabetes mellitus in 10% followed by gestational hypertension in (6%). 71% of women underwent the emergency LSCS. The most common indication for LSCS was fetal distress in 29% of cases followed by mal-presentation in 12% of cases.Conclusions: The prevalence of anemia among women at term was found to be 43%. The different medical high risk factors were human immunodeficiency virus positive (asymptomatic diagnosed during pregnancy), Hepatitis B antigen positive, cardiovascular risk, hypothyroidism, epilepsy observed in the groups. Other high risk factors included asthma, Crohns disease, and systemic sclerosis

Efficacy of prophylactic tranexamic acid in reducing blood loss during and after caesarean section

Background: In India, caesarean section rate is rising, so the impact of prophylactic injection of tranexamic acid in decreasing blood loss during caesarean section would be more beneficial in terms of having minimal blood loss intra operatively and post operatively and thereby decreasing maternal morbidity. The objective of the study was to evaluate the efficacy of prophylactic tranexamic acid in reducing blood loss during and after caesarean section.Methods: A randomized controlled trial among 200 term women with singleton pregnancy for a period of 2 years was carried out. They were randomized by computer generated numbers into two groups: study group-100 women receiving prophylactic tranexamic acid women and control group-100 women receiving placebo.Results: The blood loss during caesarean section was less in the tranexamic acid group compared to the placebo group. Similarly blood loss measured 6hrs after caesarean section was less in the tranexamic acid group compared to placebo group. 20-40min before the time of incision was the ideal time gap for administering the injection tranexamic acid for its optimum efficacy. Tranexamic acid group had lesser requirement of uterotonic when compared to placebo, but need for blood transfusion was similar in both the groups. Greater fall in the hemoglobin and haematocrit occurred in placebo group compared to tranexamic acid group. No changes in the post-operative vitals or side effects were seen in the tranexamic acid group. Even no change in birth weight and Apgar scores was seen in neonates of tranexamic acid group.Conclusions: Injection tranexamic acid is the, antifibrinolytic agent that can be used for prophylactic administration before caesarean section for decreasing blood loss during surgery

Nephrotic Syndrome Following Covid-19 Vaccination: A Systematic Review

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 infection has caused significant morbidity and mortality. Vaccines produced against this virus have proven highly effective. However, adverse events following vaccination have also been reported. One of them is nephrotic syndrome, that can be associated with different pathologic pictures. This review aims to provide a wider understanding of incidence, etiopathogenesis, and management of nephrotic syndrome following vaccination against SARS-CoV-2. METHODS AND RESULTS: A literature search was undertaken using appropriate keywords in various databases like PubMed, Google Scholar, Europe PMC, and Science Direct. Twenty-one articles were included following qualitative assessment. Data of 74 patients from these articles were included. DISCUSSION: The pathogenesis of nephrotic syndrome following COVID vaccination has been widely attributed to the activation of angiotensin-converting enzyme-2 receptors, leading to podocyte effacement. Relapses have also been reported in patients with prior history of nephrotic syndrome following COVID-19 vaccination. A renal biopsy is necessary to identify the histopathological picture. Management of COVID-19 vaccine-induced nephrotic syndrome was mainly reported as successfully attainable with corticosteroids and supportive management. CONCLUSION: Further investigations will help in establishing an early diagnosis and salvaging kidney function

Nephrotic syndrome following COVID-19 vaccination: a systematic review.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 infection has caused significant morbidity and mortality. Vaccines produced against this virus have proven highly effective. However, adverse events following vaccination have also been reported. One of them is nephrotic syndrome, that can be associated with different pathologic pictures. This review aims to provide a wider understanding of incidence, etiopathogenesis, and management of nephrotic syndrome following vaccination against SARS-CoV-2. METHODS AND RESULTS: A literature search was undertaken using appropriate keywords in various databases like PubMed, Google Scholar, Europe PMC, and Science Direct. Twenty-one articles were included following qualitative assessment. Data of 74 patients from these articles were included. DISCUSSION: The pathogenesis of nephrotic syndrome following COVID vaccination has been widely attributed to the activation of angiotensin-converting enzyme-2 receptors, leading to podocyte effacement. Relapses have also been reported in patients with prior history of nephrotic syndrome following COVID-19 vaccination. A renal biopsy is necessary to identify the histopathological picture. Management of COVID-19 vaccine-induced nephrotic syndrome was mainly reported as successfully attainable with corticosteroids and supportive management. CONCLUSION: Further investigations will help in establishing an early diagnosis and salvaging kidney function