Comparative study of intravenous iron sucrose versus ferric carboxymaltose for the treatment of iron deficiency anemia in postpartum patients

Background: Objectives: To study the efficacy and safety of intravenous iron sucrose versus ferric carboxymaltose in the treatment of iron deficiency anaemia in postpartum patients.Methods: Well compensated anemic postpartum patients with Hb between 7-11 gm% at 24 hours after delivery were included in the study. Patients were thoroughly investigated for hematological parameters. All patients were checked for hemoglobin and serum ferritin at 24 hours after delivery and 42 days after delivery. Each patient in mild and moderate anemia group has received a fixed dose of 500 mg and 1000 mg respectively of both compounds. All other iron supplements (except from diet) were withheld during follow up period.  Results: Average rise in Hb in mild anemia group is 2.30 gm% with iron sucrose and 2.52 gm% with ferric carboxymaltose after 42 days of infusion. In moderate anemia group average Hb rise observed is 4.58 gm% with iron sucrose and 4.73 gm% with ferric carboxymaltose after 42 days. Significant improvement in iron stores is also observed at the end of 42 days in both groups. Unpaired‘t’ test was used to test the significance of rise and compare the rise between two groups. Both compounds have shown similar response and difference between them is not statistically significant.  Conclusions: Fixed dose iron sucrose and ferric carboxymaltose are equally effective and safe for the treatment of iron deficiency anemia in postpartum patients.

Comparison of maternal and fetal morbidity between Patwardhan method of second stage lower segment caesarean section and conventional "push and pull" method

Background: To compare Maternal and fetal morbidity between Patwardhan method of second stage LSCS and conventional "push and pull" method.Methods: A retrospective study of all LSCS performed in second stage of labour consisted of all cases delivered by Patwardhan method compared with cases delivered by Push method during 3 years from January 2016 to December 2018 in Smt. Kashibai Navale Medical College Pune, Maharashtra, India.Results: A total of 89 patients underwent second stage LSCS from January 2016 to December 2018. A total of 37 patients were delivered by Patwardhan’s method and 52 patients were delivered by Push method. Uterine incision extension was more in the push and pull method when compared to Patwardhan technique. Same was true for the traumatic PPH blood transfusion which was significantly high in push and pull method as compared. Neonatal morbidity was significantly less in Patwardhan’s method as compared to Push method.Conclusions: As the maternal and fetal complications are seen to be considerably less in Patwardhan’s method than the conventional Push method our study concludes that Patwardhan’s method for delivering baby in second stage LSCS confers greater advantage

Randomized trial of suturing versus electrosurgical bipolar vessel sealing in abdominal hysterectomy

Background: Hemorrhage is one of the most frequent complications that occur during surgery, adequate hemostatic techniques are essential during surgical procedures. The aim of this study was to compare the conventional suturing with the bipolar clamping and the effects of bipolar vessel sealing in women undergoing total abdominal hysterectomy.Methods: A randomized controlled trial was performed at Smt. Kashibai Navale Medical College and General Hospital, Maharashtra, India. One hundred fourteen patients undergoing abdominal hysterectomy for benign conditions were randomized to conventional surgery versus vessel sealing followed up for 06 weeks post operatively.Results: During the first two postoperative days patients operated using bipolar vessel sealing had statistically significantly lower pain scores and blood loss (p<0.01). The surgery time, complication risk and duration of hospitalization were similar between both groups. Patients in the bipolar vessel sealing group resumed their normal daily activities on average 6 days earlier as compared to the conventional group ( p = 0.07). Postoperative pelvic floor function was similar in both the groups.Conclusions: The use of bipolar vessel sealing during abdominal hysterectomy for benign conditions appears to be associated with reduced blood loss, postoperative pain and faster recovery

Prospective comparative study between colposcopy and histopathology for diagnosis of CIN and carcinoma cervix

Background: Cervical cancer develops from precursor lesions and detection of these lesions is of utmost importance. The detection of precancerous lesions is made with help of screening tests most important include PAP smear and colposcopy. So we conducted this study to understand the role of colposcopy in down staging of Carcinoma cervix.Methods: We performed a prospective study between Jan 2018 to Dec 2018 on 180 subjects chosen from patients who sought consultation for various gynaecological complaints between age group of 18-60 years. A Pap smear followed by a colposcopy was performed and colposcopic directed biopsies were taken and subjected to histolopathological examination.Results: Colposcopy had a sensitivity of 83.3%, specificity of 78.5%, PPV of 68.9% for CIN 1. It had a sensitivity of 90.9%, specificity of 95.2%, PPV of 83.33% for CIN 2 and 3 when co related with gold standard histopathology which is much higher as compared to Pap smear.Conclusions: Colposcopy is an effective tool in down staging of Carcinoma cervix

Lustrum study of labour induction

Background: The rate of labor induction is steadily increasing. Approximately one out of four pregnant women has their labor induced. Over the years, various professional societies have recommended the use of induction of labor in circumstances in which the risk of waiting for the onset of spontaneous labor are judged by clinicians to be greater than the risks associated with shortening duration of pregnancy by induction. This study was carried out to categories indications and to know trends of indication over 5 years.Methods: This retrospective analytical study was conducted over a period of five years from 01 June 2016 to 31 May 2021 at the department of obstetrics and gynecology, tertiary care hospital, Pune, Maharashtra, India. The rate, indications and trend in indications of labor induction was calculated over the study period. The data so collected was presented with graphical representation.Results: There was a total of 10407 deliveries during the study period out of which, 865 were induced. So, the rate of labor induction in the study was found to be 8.31%. Post-datism accounts for 54.4% followed by pregnancy induced hypertension remains the major obstetric cause accounting for 16.6% of labour induction. Intrauterine growth restriction (IUGR) accounted for 3.6% causes of labour induction.Conclusions: Vaginal birth has lesser morbidity and mortality involving both the mother and the child compared to caesarean and will always be regarded as the superior mode of delivery. Apart from post-datism, the commoner obstetric indications for induction of labour are PIH and IUGR. Increasing trend in the incidence of pregnancy-induced hypertension (PIH) and IUGR is observed and therefore probably correlating to foetal distress after induction of labour causing increased trend of need for caesarean section over the five years

A prospective study to compare levonogestrol intrauterine system and trans-cervical resection of endometrium for treatment of abnormal uterine bleeding

Background: This article is a study comparing the two most accepted forms of treatment for abnormal uterine bleeding - levonorgestrol intrauterine treatment and transcervical resection of endometrium, with regards to its acceptability, efficacy, adverse effects and user satisfaction. Aim of this study was to compare the acceptability, efficacy, adverse effects and user satisfaction of LNG-IUS and TCRE for treatment for AUB.Methods: A prospective observational study conducted in SKNMC and GH. Forty-nine women with abnormal uterine bleeding after hysteroscopic evaluation were included in this study; where 17 opted for LNG-IUS; 32 opted for TCRE with bipolar electrode. 15 patients in LNG-IUS group and 28 pts in TCRE group completed follow up. Menstrual pattern, pictorial blood loss assessment chart score, adverse effects, acceptability, satisfaction and reason for discontinuation were recorded at 6 weeks, 6 months and 12 months after the procedure. Prior to LNG-IUS insertion or endometrial ablation, endometrial and cervical pathology were excluded by D and C and cervical smear, respectively. TVUS was used to exclude possible causes of menorrhagia, including myomas and endometrial polyp as well as adnexal pathology. LNG-IUS insertion was performed as an office procedure one day after cessation of menstrual bleeding with a negative urine pregnancy test.Results: Menstrual blood loss reductions in TCRE and LNG-IUS groups were by 85.7% and 87.6% respectively after a year. Amenorrhoea was more common in TCRE group while spotting and systemic effects were more common in LNG-IUS group. Satisfaction and acceptance rates are higher in TCRE group.Conclusions: The TCRE and LNG-IUS are equally effective in reducing bleeding in AUB patients. Acceptance and satisfaction are better with TCRE, as a modality of treatment for AUB