A comparative study of efficacy and safety of intravenous ferric carboxymaltose versus iron sucrose in the treatment of iron deficiency anaemia of pregnancy in a tertiary care hospital

Background: Anaemia is a global public health problem. To optimize iron delivery in pregnancy, new intravenous complexes like Ferric carboxymaltose (FCM) have been developed in the few years. This study aims to compare the efficacy and safety of FCM vs the iron sucrose during pregnancy.Methods: This study was conducted in the Department of Obstetrics and Gynaecology, Shri Maharaja Gulab Singh (S.M.G.S.) Hospital, Government Medical College Jammu, Jammu and Kashmir over a period of 1 year. 100 pregnant females with haemoglobin (Hb) in the range 7-9.9 g/dl between 28 to 36-week gestation, were selected randomly out of which 50 were administered FCM (Group A) and 50 were administered Iron Sucrose (Group B). Hb and serum ferritin were assessed 2 weeks and 4 weeks after treatment and side effects of each drug was studied.Results: The rise in mean Hb level at 2 weeks and 4 weeks in FCM group was significantly higher as compared to Iron Sucrose group (1.09 versus 0.52 g/dl and 1.80 versus 1.09 g/dl, respectively). Similarly, the rise in mean serum ferritin level at 2 weeks and 4 weeks was more in FCM as compared to Iron Sucrose group (144.25 vs 95.84 mcg/L and 121.31 vs 84.46 mcg/L, respectively). The adverse reactions were observed in 30% of patients in FCM group and 48% patients in iron sucrose group.Conclusions: Ferric carboxymaltose was found to be more safe and efficacious as compared to iron sucrose

Comparison of effects of dexmedetomidine and clonidine as adjuvant to bupivacaine 0.25% in ultrasound guided supraclavicular brachial plexus block

Background: Ultrasound guided brachial plexus block is the preferred technique for surgeries on upper limb. Adjuvants are usually added to peripheral nerve blocks to increase their analgesic efficiency and duration. We compared analgesic effects of dexmedetomidine 1mcg/kg and clonidine 1mcg/kg as adjuvant to a low volume of bupivacaine in USG guided supraclavicular brachial plexus block.Methods: A prospective, randomized controlled, double blind study planned after permission from institutional ethics committee. Sixty ASA grade I, II patients, 18-60 years undergoing upper limb orthopedic surgery included. Group 1 (Control group) received 20 ml of 0.25% bupivacaine. Group 2 (Dexmedetomidine group) received 20ml of bupivacaine + dexmedetomidine (10 ml of 0.5% bupivacaine + 1µg/kg of dexmedetomidine, diluted with 0.9% NS to 20 ml) Group 3 (Clonidine group) received 20 ml of 0.25 bupivacaine + clonidine (10ml of 0.5% bupivacaine+1µ g/kg of clonidine, diluted with 0.9% NS to 20 ml) in USG guided supraclavicular brachial plexus block. Continuous variables analyzed with analysis of variance or Kruskal-Wallis test and categorical variables with Fisher’s exact test.Results: Pain free period was 864.90±357.16 minutes: dexmedetomidine group; 584.59±172.38 minutes: clonidine group, 431.78±138.40 minutes: control group with p< 0.001. VRS (verbal rating score) was significantly higher in control group as compared to dexmedetomidine at 4 hours but the pain scores were comparable between all the groups after 8 hours of block.Conclusions: Dexmedetomidine as an adjuvant to bupivacaine provides prolonged anaesthesia, better pain relief in early postoperative period with haemodynamically stable, calm patients compared to clonidine and control group

A comparative study of efficacy and safety of intravenous ferric carboxymaltose versus iron sucrose in the treatment of iron deficiency anaemia of pregnancy in a tertiary care hospital

Background: Anaemia is a global public health problem. To optimize iron delivery in pregnancy, new intravenous complexes like Ferric carboxymaltose (FCM) have been developed in the few years. This study aims to compare the efficacy and safety of FCM vs the iron sucrose during pregnancy.Methods: This study was conducted in the Department of Obstetrics and Gynaecology, Shri Maharaja Gulab Singh (S.M.G.S.) Hospital, Government Medical College Jammu, Jammu and Kashmir over a period of 1 year. 100 pregnant females with haemoglobin (Hb) in the range 7-9.9 g/dl between 28 to 36-week gestation, were selected randomly out of which 50 were administered FCM (Group A) and 50 were administered Iron Sucrose (Group B). Hb and serum ferritin were assessed 2 weeks and 4 weeks after treatment and side effects of each drug was studied.Results: The rise in mean Hb level at 2 weeks and 4 weeks in FCM group was significantly higher as compared to Iron Sucrose group (1.09 versus 0.52 g/dl and 1.80 versus 1.09 g/dl, respectively). Similarly, the rise in mean serum ferritin level at 2 weeks and 4 weeks was more in FCM as compared to Iron Sucrose group (144.25 vs 95.84 mcg/L and 121.31 vs 84.46 mcg/L, respectively). The adverse reactions were observed in 30% of patients in FCM group and 48% patients in iron sucrose group.Conclusions: Ferric carboxymaltose was found to be more safe and efficacious as compared to iron sucrose

A Novel Volume-Age-KPS (VAK) Glioblastoma Classification Identifies a Prognostic Cognate microRNA-Gene Signature.

BACKGROUND: Several studies have established Glioblastoma Multiforme (GBM) prognostic and predictive models based on age and Karnofsky Performance Status (KPS), while very few studies evaluated the prognostic and predictive significance of preoperative MR-imaging. However, to date, there is no simple preoperative GBM classification that also correlates with a highly prognostic genomic signature. Thus, we present for the first time a biologically relevant, and clinically applicable tumor Volume, patient Age, and KPS (VAK) GBM classification that can easily and non-invasively be determined upon patient admission. METHODS: We quantitatively analyzed the volumes of 78 GBM patient MRIs present in The Cancer Imaging Archive (TCIA) corresponding to patients in The Cancer Genome Atlas (TCGA) with VAK annotation. The variables were then combined using a simple 3-point scoring system to form the VAK classification. A validation set (N = 64) from both the TCGA and Rembrandt databases was used to confirm the classification. Transcription factor and genomic correlations were performed using the gene pattern suite and Ingenuity Pathway Analysis. RESULTS: VAK-A and VAK-B classes showed significant median survival differences in discovery (P = 0.007) and validation sets (P = 0.008). VAK-A is significantly associated with P53 activation, while VAK-B shows significant P53 inhibition. Furthermore, a molecular gene signature comprised of a total of 25 genes and microRNAs was significantly associated with the classes and predicted survival in an independent validation set (P = 0.001). A favorable MGMT promoter methylation status resulted in a 10.5 months additional survival benefit for VAK-A compared to VAK-B patients. CONCLUSIONS: The non-invasively determined VAK classification with its implication of VAK-specific molecular regulatory networks, can serve as a very robust initial prognostic tool, clinical trial selection criteria, and important step toward the refinement of genomics-based personalized therapy for GBM patients

Unmasking lymphoma immune reconstitution inflammatory syndrome in a patient with pyrexia of unknown origin: a case report

Background: Immune reconstitution inflammatory syndrome (IRIS) is a constellation of inflammatory disorders that are unmasked after the initiation of anti-retroviral therapy (ART) in Human immunodeficiency virus (HIV) infected patients. Unmasking lymphoma IRIS is a relatively rare manifestation after initiation of anti-retroviral therapy. Case presentation: We report a 44-year-old male with HIV on 4 months of ART presenting with pyrexia of unknown origin with a diagnosis of unmasking Hodgkin’s lymphoma IRIS stage IV with B symptoms. This case portrays the importance of recognizing the possibility of Hodgkin’s lymphoma as a possible manifestation of IRIS within the first 6 months of initiation of ART. Conclusion: Patients presenting with pyrexia of unknown origin and lymphadenopathy within the first 6 months of initiation of ART, lymphoma diagnosis should be on the high threshold of suspicion as portrayed by our case

VAK classification system.

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