Management of postpartum iron deficiency anemia: review of literature

Anemia is a condition in which either the number of circulating red blood cells or their hemoglobin concentration is decreased. As a result, there is decreased transport of oxygen from the lungs to peripheral tissues. The standard approach to treatment of postpartum iron deficiency anemia is oral iron supplementation, with blood transfusion reserved for more server or symptomatic cases. There are a number of hazards of allogenic blood transfusion including transfusion of the wrong blood, infection, anaphylaxis and lung injury, any of which will be devastating for a young mother. These hazards, together with the national shortage of blood products, mean that transfusion should be viewed as a last resort in otherwise young and healthy women. Currently, there are many iron preparations available containing different types of iron salts, including ferrous sulfate, ferrous fumarate, ferrous ascorbate but common adverse drug reactions found with these preparations are mainly gastrointestinal intolerance like nausea, vomiting, constipation, diarrhoea, abdominal pain, while ferrous bis-glycinate (fully reacted chelated amino acid form of iron) rarely make complication. Two types of intravenous (IV) preparations available are IV iron sucrose and IV ferric carboxymaltose. IV iron sucrose is safe, effective and economical. Reported incidence of adverse reactions with IV iron sucrose is less as compared to older iron preparations (Iron dextran, iron sorbitol), but it requires multiple doses and prolonged infusion time. Intramuscular iron sucrose complex is particularly contraindicated because of poor absorption. It was also stated that when iron dextran is given intravenously up to 30% of patients suffer from adverse effects which include arthritis, fever, urticaria and anaphylaxis

Peripartum hysterectomy for cesarean section with morbidly adherent placenta: case series of 25 patients

Background: The current paper reports the outcome of case series of patients presented with placenta accreta confirmed histopathologicaly after management by peripartum hysterectomy.Methods: The study was set in Women’s Health Hospital, Assiut University, Egypt. This was a case series of 25 women presented with placenta accreta between May 2017 and April 2018. We included all pregnant women with placenta previa as diagnosed by ultrasound with suspicion of abnormal placentation by Doppler, confirmed intra-operatively undergoing either emergent or elective CS. All cases were performed by an expert team of obstetricians and anesthetists. Cesarean delivery was done under general anesthesia through pfannensteil incision. The primary outcome was the estimated intra-operative blood loss through assessment of amount of blood in the suction by ml, difference between the weight of surgical drapes and towels before and after operation.Results: Pre-operative Hb was 10.64±1.01 gm/dL and there was significant decline in the postoperative Hb reaching 8.36±1.21 gm/dL (p<0.001). The mean drop in Hb was 2.28±1.43gm/dL. Estimated intra-operative blood loss was 974.4±398.05 ml in the towels and 847.6±362.56 ml in the suction apparatus. The total blood loss was 1822±653.73 ml. The mean number of units of whole blood transfused was 2160.0±825.6 ml and fresh frozen plasma was 1010.0±349.7 ml. Regarding intra-operative complications, bladder injury was the most common one in 14 cases (56%), followed by ureteric injury in two cases (8%). Postoperative ICU admission was in 6 cases (24%) and the mean duration of hospital stay 12.44 ± 4.07 days. No cases of maternal mortality.Conclusions: In conclusion, peripartum hysterectomy is considered life-saving surgery in patients with placenta accreta

Usefulness of atropine in patients with chronotropic incompetence and poor exercise capacity during treadmill stress testing

AbstractBackgroundAtropine, an anticholinergic agent, has been shown to increase heart rate and enhance the sensitivity of dobutamine stress echocardiography in the detection of CAD in patients with chronotropic incompetence; however, the addition of atropine to exercise stress testing EST, in these types of patients has not been well studied previously.ObjectiveInvestigating the usefulness and accuracy of atropine in decreasing the number of inconclusive results of EST in patients with chronotropic incompetence and poor exercise capacity.MethodsThirty patients (16 males and 14 females with the age range of 40:73years with mean of 55±8) out of 180 patients who preformed EST were chosen as having chronotropic incompetence or poor exercise capacity by Borg scale. Atropine was administered during the exercise phase in doses of 0.5mg per minute until test conclusion or the maximum dose of 2mg was reached. All patients were subjected to stress myocardial perfusion imaging SMPI to confirm accuracy.ResultsConclusive test results were achieved in 29 patients (97%). Heart rate and blood pressure were markedly increased with statically highly significant difference (P value <0.001), patients on b-blocker treatment had lower maximum heart rate compared to other patients with significant difference. Twenty-three (79%) patients had negative test results and six (21%) patients had positive test results, and if compared to SMPT results, EST was considered better positive than negative test, with higher specificity than sensitivity and accuracy.ConclusionsAtropine injection during EST significantly reduced the inconclusive test results in patients with chronotropic incompetence and poor exercise capacity

Usefulness of atropine in patients with chronotropic incompetence and poor exercise capacity during treadmill stress testing

AbstractBackgroundAtropine, an anticholinergic agent, has been shown to increase heart rate and enhance the sensitivity of dobutamine stress echocardiography in the detection of CAD in patients with chronotropic incompetence; however, the addition of atropine to exercise stress testing EST, in these types of patients has not been well studied previously.ObjectiveInvestigating the usefulness and accuracy of atropine in decreasing the number of inconclusive results of EST in patients with chronotropic incompetence and poor exercise capacity.MethodsThirty patients (16 males and 14 females with the age range of 40:73years with mean of 55±8) out of 180 patients who preformed EST were chosen as having chronotropic incompetence or poor exercise capacity by Borg scale. Atropine was administered during the exercise phase in doses of 0.5mg per minute until test conclusion or the maximum dose of 2mg was reached. All patients were subjected to stress myocardial perfusion imaging SMPI to confirm accuracy.ResultsConclusive test results were achieved in 29 patients (97%). Heart rate and blood pressure were markedly increased with statically highly significant difference (P value <0.001), patients on b-blocker treatment had lower maximum heart rate compared to other patients with significant difference. Twenty-three (79%) patients had negative test results and six (21%) patients had positive test results, and if compared to SMPT results, EST was considered better positive than negative test, with higher specificity than sensitivity and accuracy.ConclusionsAtropine injection during EST significantly reduced the inconclusive test results in patients with chronotropic incompetence and poor exercise capacity

Helium Neon laser therapy for post mastectomy lymphedema and shoulder mobility

The aim of this work was to evaluate the efficacy of Helium Neon (He–Ne) laser therapy on post mastectomy lymphedema and shoulder mobility. Thirty female patients with axillary lymph node dissection (ALND), with or without radiotherapy had been participated in this study. The patients were randomly divided into two groups of equal numbers. Group A received He–Ne laser therapy and decongestive lymphatic therapy. Group B received placebo laser therapy in addition to decongestive lymphatic therapy. Measurements of limb volume and shoulder mobility (by tape measurement and standard goniometer) were collected before treatment and after six months of treatment. The mean values of limb volume and Shoulder mobility after 6 months of treatment showed a significant improvement (p&lt; 0.05) for the two groups of the study with a greater improvement for patients in group A. Conclusion: Helium Neon laser therapy has a positive effect in reducing post mastectomy lymphedema and increasing range of motion of shoulder joint.Keywords: Helium Neon laser; Lymphedema; Mastectomy; Shoulder mobilityThe Egyptian Journal of Medical Human Genetics (2013) 14, 195–19

Synthesis a Number of Triazene Compounds Derived From Purine and Studying their Biological Activity on Pathogenic Bacteria

In this research a number of compounds were prepared by coupling dizonium salts with purine bases. The structures of the prepared compounds were identified by ultra violet ,infra red spectra and Elemental (C.H.N) analysis .The biological activity of these compounds was investigated on five genera of pathogenic bacteria: S. aureus , Str. viridans , Ps. aeruginosa , E. coli and Sh. dysenteriae using Disc diffusion method. Also the minimum inhibitory concentration (MIC) was calculated .It was found that these compounds have medium biological effect against these genera of bacteria

ASSESSMENT AND EVALUATION HEALTH RISKS OF HEAVY METALS IN INDOOR AND OUTDOOR AIR WITH X-RAY FLUORESCENCE (WDX)

The present study aimed to investigate the potentially toxic metal (Zn, Cu, Cr, Ni, Fe, and Mn) Health hazard. Air dust samples were collected from outdoor and, indoor air at El-Minia city, Egypt. Heavy metal contents were performed using X-ray fluorescence (WDX)

Explore the E-Learning Management System Lower usage during COVID-19 Pandemic

During the COVID-19 pandemic, several universities are finding it difficult to provide and use online and e-learning systems. Blackboard, for example, is an e-learning system with various wonderful features that would be useful during the COVID-19 pandemic. However, knowing the acceptance variables as well as the primary problems that contemporary e-learning technologies confront is crucial for efficient utilization. The growing number of students attending different instructional organizations has resulted in a greater volume of material being needed in these organizations both from the academic and professional workforce and also because learning management systems and e-learning are indeed the university prospect, several more universities and colleges have accepted them. The purpose is to analyze the most popular E-learning system, the Blackboard system, and the authors suggest a learning management control system to accommodate major e-learning features. A Blackboard system is a plethora of academic perspectives, research, ideas, theories, and affective responses to the virtual learning environment. To use it, the technology acceptance model in times of crisis (TAMTC) has been developed as a way to evaluate student acceptability. The existing literature demonstrates that the field of information administration is constantly changing due to the effect of learning technologies like the blackboard system. Given their reduced utilization of the system, the data reveal a high level of student acceptability. The conclusions of this study provide important recommendations for policymakers, managers, developers, and academics, allowing them may further understand the key factors of successfully using an e-learning system during the COVID-19 epidemic

Explore the E-Learning Management System Lower usage during COVID-19 Pandemic

During the COVID-19 pandemic, several universities are finding it difficult to provide and use online and e-learning systems. Blackboard, for example, is an e-learning system with various wonderful features that would be useful during the COVID-19 pandemic. However, knowing the acceptance variables as well as the primary problems that contemporary e-learning technologies confront is crucial for efficient utilization. The growing number of students attending different instructional organizations has resulted in a greater volume of material being needed in these organizations both from the academic and professional workforce and also because learning management systems and e-learning are indeed the university prospect, several more universities and colleges have accepted them. The purpose is to analyze the most popular E-learning system, the Blackboard system, and the authors suggest a learning management control system to accommodate major e-learning features. A Blackboard system is a plethora of academic perspectives, research, ideas, theories, and affective responses to the virtual learning environment. To use it, the technology acceptance model in times of crisis (TAMTC) has been developed as a way to evaluate student acceptability. The existing literature demonstrates that the field of information administration is constantly changing due to the effect of learning technologies like the blackboard system. Given their reduced utilization of the system, the data reveal a high level of student acceptability. The conclusions of this study provide important recommendations for policymakers, managers, developers, and academics, allowing them may further understand the key factors of successfully using an e-learning system during the COVID-19 epidemic

Influence of immediate postpartum contraception counseling on the rate of unintended pregnancy in primigravida: a randomized controlled study

Background: The current study aims to assess the influence of immediate postpartum counselling about effective contraceptive methods to be used by primigravida on the rate of unintended pregnancy during first 6 months post-partum.Methods: The study was a prospective randomized controlled trial for assessment the influence of immediate postpartum counseling about effective contraceptive methods to be used by primigravida on the rate of unintended pregnancy during first 6 months post-partum who delivered at the period between the 1st of December 2016 and 31st of December 2017. The study patients were randomly assigned into two groups: Group (A) were received counseling about contraceptive methods using illustrations through postpartum interview with the study researcher. Group (B) were not received any counseling about contraceptive methods. The primary outcome was the difference in the rate of unintended pregnancy in both groups.Results: No significant difference between both groups in preventing unintended pregnancy. In group (A): After 3 months postpartum 140 women (93.3%) were used the contraceptive method correctly. 10 women used method incorrectly and 2 of them get pregnant. After 6 months postpartum 8 women did not use any method but 134 women (95.7%) were correctly used the contraceptive method. In group (B): After 3 months postpartum 127 women (84.7%) were used the contraceptive method correctly. 23 women used method incorrectly and 4 of them get pregnant. After 6 months postpartum 1 woman did not use any method but 30 women (20.7%) were incorrectly used the contraceptive method.Conclusions: Immediate post-partum counseling about contraceptive methods is good tool to educate women who intend to have optimal inter–pregnancy period about the effective methods that suit them and when to initiate