Randomized clinical trial to evaluate ferric carboxymaltose and iron sucrose for treatment of postpartum anaemia in a tertiary hospital

Background: Ferric carboxymaltose and iron sucrose are two iron carbohydrate complexes optimized for iron delivery and extensively used in postpartum anaemia. This study compares the efficacy and safety of ferric carboxymaltose with that of iron sucrose in patients with postpartum anaemia.Methods: One hundred women diagnosed with postpartum anaemia were randomized prospectively in a 1:1 ratio to receive either ferric carboxymaltose or iron sucrose. Fifty patients received intravenous iron carboxymaltose depending on the iron deficit at rate of 1000 mg/week and fifty patients received intravenous iron sucrose at a rate of 200 mg/day on alternate days till the calculated dose is given.Results: Fifty patients were enrolled in each treatment group. Both groups showed increases in mean haemoglobin from baseline at 2 weeks and 6 weeks. The increase in haemoglobin was significantly higher in ferric carboxymaltose group compared to iron sucrose at both week 2 (2.64±0.91 versus 2.17±0.76; p=0.010) and week 6 timepoints (4.65±1.17 versus 3.96±1.06; p=0.005). The proportion of patients achieving target haemoglobin of 12 gm/dl was significantly higher in ferric carboxymaltose group compared to iron sucrose at week 6 (77.3% versus 50.0%; p=0.013). The incidence of adverse events was similar across treatment groups and no specific safety concerns were observed.Conclusions: Both ferric carboxymaltose and iron sucrose caused increase in baseline haemoglobin. Ferric carboxymaltose had significantly higher increases in haemoglobin compared to iron sucrose at both follow up timepoints (week 2 and week 6). It was more likely to achieve target haemoglobin with ferric carboxymaltose within 6 weeks compared to iron sucrose. Ferric carboxymaltose may be considered in women with postpartum anaemia for faster rise in haemoglobin while requiring fewer injections compared to iron sucrose

Genetic overlap between autoimmune diseases and non-Hodgkin lymphoma subtypes

Epidemiologic studies show an increased risk of non-Hodgkin lymphoma (NHL) in patients with autoimmune disease (AD), due to a combination of shared environmental factors and/or genetic factors, or a causative cascade: chronic inflammation/antigen-stimulation in one disease leads to another. Here we assess shared genetic risk in genome-wide-association-studies (GWAS). Secondary analysis of GWAS of NHL subtypes (chronic lymphocytic leukemia, diffuse large B-cell lymphoma, follicular lymphoma, and marginal zone lymphoma) and ADs (rheumatoid arthritis, systemic lupus erythematosus, and multiple sclerosis). Shared genetic risk was assessed by (a) description of regional genetic of overlap, (b) polygenic risk score (PRS), (c)"diseasome", (d)meta-analysis. Descriptive analysis revealed few shared genetic factors between each AD and each NHL subtype. The PRS of ADs were not increased in NHL patients (nor vice versa). In the diseasome, NHLs shared more genetic etiology with ADs than solid cancers (p = .0041). A meta-analysis (combing AD with NHL) implicated genes of apoptosis and telomere length. This GWAS-based analysis four NHL subtypes and three ADs revealed few weakly-associated shared loci, explaining little total risk. This suggests common genetic variation, as assessed by GWAS in these sample sizes, may not be the primary explanation for the link between these ADs and NHLs

Recurrent perineal scar endometriosis: A case report

Introduction: Endometriosis is a chronic disease with the presence of endometrium-like tissue containing endometrial glands and stroma outside the uterus. The incidence of episiotomy scar endometriosis after vaginal delivery is 0.06–0.7%. Case presentation: A 28-year-old parous woman with two previous vaginal deliveries with episiotomy presented to the outpatient department with severe pain and swelling in the perineal region over the past year, leading to difficulty in sitting, coitus and routine essential activities like defecation. She had undergone local perineal nodule excision surgery twice, which confirmed her perineal scar endometriosis diagnosis one year earlier at another hospital with no improvement in symptoms. Physical examination revealed a firm, tender, deeply embedded palpable nodule measuring approximately 3 ‐ 4 cm in the left posterolateral aspect of the distal vagina. Wide local excision of the nodule with a clear margin of 1 cm was performed. The nodule extended up to the left ischial tuberosity and apex up to the pudendal vessels complex. Discussion: The classic diagnostic triad of perineal endometriosis were present in this patient. Surgical intervention with wide local excision with a clear margin of approximately 1 cm of healthy tissue reduces the chance of recurrence. Conclusion: Awareness of this condition among medical practitioners will lead to early diagnosis and excision. Timely intervention in the form of excision with free margins is the definitive treatment and provides complete pain relief and good quality of life for endometriosis patients

3rd National Conference on Image Processing, Computing, Communication, Networking and Data Analytics

This volume contains contributed articles presented in the conference NCICCNDA 2018, organized by the Department of Computer Science and Engineering, GSSS Institute of Engineering and Technology for Women, Mysore, Karnataka (India) on 28th April 2018

ECLAPTE: Effective Closure of LAParoTomy in Emergency—2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

Abstract Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy