Study of effectiveness, tolerability and safety of intravenous iron sucrose in iron deficiency anaemia in postnatal women

Background: Iron deficiency anaemia is the most common type of reversible anemia encountered during pregnancy and postpartum period. The present study was done with the objective to find out the efficacy and safety of intravenous iron sucrose in the treatment of iron deficiency anaemia in the postpartum period.Methods: Fifty (50) postnatal patients both after vaginal and caesarean section with iron deficiency anaemia within the first 48 hours with haemoglobin percentage between 6 g/dl and 8g/dl were studied prospectively at the Institute of Obstetrics and Gynaecology, Madras Medical College, Chennai. The patients were given 100 mg of elemental iron diluted in 100 ml of 0.9% normal saline and infused over 15 minutes every alternate day (not more than 3 days in a week) until the required dosage is infused. The blood samples of all the patients were collected and analyzed for haemoglobin (g/dl), hematocrit, mean corpuscular volume (MCV), serum iron, total iron binding capacity (TIBC) and compared before and after therapy.Results: The mean age group of the patients was 24.94 years. Majority of the patients were multipara (68%) and belongs to the class V socio economic status (84%). All the blood parameters were increased significantly (p=0.000) when compared from baseline values to end of the treatment. Mean raise in haemoglobin% after 30 days of treatment was 3.60. Average raise in the mean hematocrit was 8.73. The mean difference in the mean corpuscular volume, total iron binding capacity and the percent saturation was 129.77, 13.55, was 22.26 respectively.Conclusions: Our data confirm that the intravenous iron sucrose was very effective, well tolerated and safe than other forms of iron preparations for treating iron deficiency anaemia in postnatal women

Computed tomography scan findings in eclampsia: a prospective study

Background: Eclampsia is a leading cause of maternal death, with classical neurological symptoms that include headache, nausea, vomiting, cortical blindness, coma and convulsions. Computed tomography (CT) scan helps in diagnosing and management of eclampsia in pregnant women. The present study was done with the objective to analyse the findings of CT scan of brain in eclampsia, to identify the prevalence of neurovascular complications in these cases and to determine if these findings can be of value in determining the prognosis of this disorder.Methods: This was a prospective study done on 100 patients with eclampsia. All of the 100 patients were screened with CT scan brain at Institute of Obstetrics and Gynaecology, Egmore, Chennai during the period from August 2008 to August 2009. All the data were analyzed and compared between the groups of positive CT scan and negative CT scan observations.Results: Out of 100 patients, positive CT scan findings were noticed in 15 patients. Of them, 7 patients expired, and 8 patients survived after treatment. Of the expired patients (7), 5 of them expired due to brain haemorrhage, and 1 patient died with cerebral oedema and 1 with brain infarction. Cerebral odema (46%) was the most common positive CT finding.  Parietal region of brain was the most common (40%) affected area.Conclusions: CT scan of brain provides valuable information in determining the prognosis and the prevalence of neurovascular complications in Eclampsia

Study of Effectiveness, Tolerability and Safety of Intravenous Iron Sucrose in Iron Deficiency Anaemia in Postnatal Women

INTRODUCTION: Anaemia is defined by a decrease in haemoglobin concentration with a consequent decrease in the hematocrit. It is the most common medical disorder in pregnancy. The two most common cause of anaemia are iron deficiency and acute blood loss. Depending on the severity of the blood loss anaemic postpartum patients can be at increased risk of morbidity and even mortality and anaemia due to heavy bleeding during delivery should be corrected without delay. Anaemia is defined by World Health Organisation as haemoglobin levels <11 g/dl. It is one of the most serious global public health problems, affecting 52% of pregnant women in developing and 23% of the developed countries. Iron is an essential component of haemoglobin in the blood. The pregnant woman needs 1000mg of iron all through her pregnancy i.e. 3-5 mg/day to maintain iron balance. This demand during later half of pregnancy and for several weeks after delivery increases to 6.7 mg/day. The absorption of iron from oral supplements is influenced by the dose; the patients iron stores and intake in relation to meal time. Parentral administration of iron, as an alternative provides a quick and certain correction of total iron deficit. AIM OF THE STUDY: 1. To determine the efficacy and tolerability of the intravenous iron sucrose in the treatment of iron deficiency anaemia in the postpartum period. 2. To determine the safety of iron sucrose in the treatment of iron deficiency anaemia in the postpartum period. MATERIALS AND METHODS: This study was conducted in Institute of Obstetrics and Gynaecology, Madras Medical College, Chennai. Fifty (50) postnatal patients both after vaginal and caesarean section with iron deficiency anaemia within the first 48 hours with haemoglobin percentage between 6 g/dl and 8g/dl were selected and included in this study. Inclusion Criteria: 1. Age > 18 years, 2. Diagnosis of postpartum anaemia with Hb% equal to or greater than 6 g/dl and less than 8 g/dl. Exclusion Criteria: 1. History of allergy to iron containing medications, 2. History of allergic conditions or bronchial asthma, 3. Thalassemia, 4. History of bleeding tendency, 5. Non iron deficient anaemia. Blood investigations were sent for the patients who looked clinically anaemic within the first 48 hours of either vaginal or caesarean delivery, which includes Hb%, PCV, MCV and tests to confirm iron deficiency anaemia by peripheral smear, serum iron and total iron binding capacity. Hb%, PCV, MCV were analysed by automatic cell counter and serum iron and total iron binding capacity were calculated using semi auto analyser ERBA CHEM 5 PLUS V2. Those patients with iron deficiency anaemia were included in this study. An informed consent was obtained, a detailed history taking and a complete general examination was done. METHOD OF THE STUDY: The dosage of iron required for each individual patient is calculated using the formula (Target Hb% - patient Hb %) in gm% * 2.4 *weight in kg Test dose is not needed. The patients were given 100 mg of elemental iron diluted in 100 ml of 0.9 % normal saline and infused over 15 minutes every alternate day (not more than 3 days in a week) until the required dosage is infused. SUMMARY: In our study fifty postnatal patients with iron deficiency anaemia were selected according to the inclusion and the exclusion criteria stated in the methodology. The iron required is calculated and given intravenously in the form of iron sucrose complex and followed up after 30 days and the following parameters were analysed. 1. Haemoglobin in g/dl. 2. Hematocrit. 3. Mean corpuscular volume. 4. Serum iron. 5. Total iron binding capacity. 6. Percent saturation. The results of the study are tabulated, analysed and summarised as follows; 1. Majority of the patients around 52% (26/50) belong to the age group between 21 – 25 years. 2. Almost three fourth (72%) of the patients were booked patients. 3. Majority of the patients (84%) belongs to the class V socio economic status. 4. Majority of the patients were multipara (68%) and among them para 2 is the major population (56%) 5. Mean raise in haemoglobin % after 30 days of treatment was 3.60 with a p value <0.05 which is statistically significant. 6. Average raise in the mean hematocrit was 8.73 after 30 days of treatment with a p value <0.05 which is statistically significant. 7. Mean raise in the Mean Corpuscular Haemoglobin was 13.55 fl with a p value of <0.05 which is statistically significant. 8. Mean raise in the serum iron value was 38.82 with a p value <0.05 which is statistically significant. 9. Mean change in the total iron binding capacity is 129.77 with a p value of <0.05 which is statistically significant 10. Mean change in the percent saturation was 22.26 with a p value <0.05 which is statistically significant. 11. The side effects were very minimal in our study group (12%). The side effects profile was also very mild which included headache in one patient, chills and rigors in three patients and thrombophlebitis in two patients. No anaphylactic reactions occurred. CONCLUSION: 1. Intravenous iron sucrose complex is highly efficacious in improving the haemoglobin %, hematocrit and the serum iron values in the treatment of iron deficiency anaemia in the postnatal women. 2. Iron sucrose infusion was well tolerated and safe, there were no major adverse reactions To conclude intravenous iron sucrose complex is safe, convenient and more effective mode of treatment of iron deficiency anaemia in postnatal women. It could be used to reduce the number of blood transfusions in the postnatal period in asymptomatic women with Hb% between 6 and 8 g/dl

PRIMARY OVARIAN PREGNANCY IN A PRIMIGRAVIDA: A CASE REPORT

Primary ovarian pregnancy is a rare form of ectopic pregnancy due to the implantation of the gestational sac in the ovary. It is reported to occur in 1 in 25000-40000 pregnancies following natural conceptions and accounts for 0.3- 3% of all ectopic pregnancies. The preoperative diagnosis is difficult and is mostly diagnosed following surgery or histo pathological examination. Here we present a case of ovarian pregnancy which was managed surgically and its review of the literature is discussed. KEYWORDS: Ectopic pregnancy; Extrauterine pregnancy; Primary ovarian pregnancy; Diagnosis; Management

PRIMARY OVARIAN PREGNANCY IN A PRIMIGRAVIDA: A CASE REPORT

Primary ovarian pregnancy is a rare form of ectopic pregnancy due to the implantation of the gestational sac in the ovary. It is reported to occur in 1 in 25000-40000 pregnancies following natural conceptions and accounts for 0.3- 3% of all ectopic pregnancies. The preoperative diagnosis is difficult and is mostly diagnosed following surgery or histo pathological examination. Here we present a case of ovarian pregnancy which was managed surgically and its review of the literature is discussed. KEYWORDS: Ectopic pregnancy; Extrauterine pregnancy; Primary ovarian pregnancy; Diagnosis; Management

A Criminological Study on Family Environmental Factors Affecting Child Sexual Abuse in Sri Lanka

Child sexual abuse is a serious crime prohibited by Sri Lankan criminal law, which is discussed under child abuse. There are various factors that contribute to the sexual abuse of children. This research has conducted a criminological study of the family environmental factors affecting child sexual abuse in Sri Lanka. The research was conducted in the Kalutara and Colombo districts of the Western Province and 228 sexually abused children were used as the main sample in 2015-2020. Two separate samples were also used for officers on duty with regard to parents and children from the victims. The data obtained from the research have been extensively analyzed quantitatively and qualitatively. 87% of victims of sexual abuse are girls. The majority of 42% represent the 15-17 category. 47% of the majority are victims of corruption. The boyfriend (42%) is responsible for most of the abuse. 33% of victims have been sexually abused in their own home and 32% in the home of the abuser. Family vulnerabilities such as family economic difficulties, parental ignorance, extramarital affairs, single parent family, parental separation, family disputes, parental emigration, paternal and drug abuse, various physical and mental disorders of the parents, family moral decline, and breakdown of parent-child cooperation And various problems of children, problems in the social environment can be identified as factors contributing to sexual abuse. A child faces many problems when he or she is sexually abused. This physical, mental and social impact is detrimental not only to the child affected but also to his family, society and the country as a whole. It can be pointed out that an integrated approach is more effective in controlling and preventing child sexual abuse.&nbsp; &nbsp; DOI: http://doi.org/10.31357/fhss/vjhss.v07i02.08 &nbsp

A Study to Assess the Effectiveness of Nesting on Posture and Motor Performance among High Risk Newborns in Vimal Jyothi Hospital at Coimbatore

STATEMENT OF THE PROBLEM: A study to assess the effectiveness of nesting on posture and motor performance among high risk newborns in Vimal Jyothi hospital at Coimbatore. OBJECTIVES: 1. To assess the posture and motor performance of high risk newborns in experimental and control group. 2. To provide nesting among high risk newborns in experimental group. 3. To reassess the effectiveness of nesting on posture and motor performance of high risk newborns in both experimental and control group. 4. To compare the effectiveness of nesting on posture and motor performance of high risk newborns in both experimental and control group. 5. To associate the effectiveness of nesting on posture and motor performance of high risk newborns with their selected demographic variables. METHODOLOGY: The research design selected for the study was quasi experimental research design (pretest posttest control group design), sample size for this study was 60 (30 experimental group and 30 control group). Posture and motor performance among High risk newborns was assessed by using Infant Position and Assessment Tool (IPAT) and Modified Ferrari Tool and demographic variables were used to collect data. RESULTS: Inferential and Descriptive Statistics were used to analyze the data. The paired ‘t’ test was performed to compare the effectiveness of nesting in experimental and control group. The pretest ‘t’ value of posture among experimental and control group is ‘t’ = 0.32. The posttest ‘t’ value of posture among experimental and control group is ‘t’ = 15.1. The pretest ‘t’ value of motor performance among experimental and control group is ‘t’ = 0.61. The posttest ‘t’ value of motor performance among experimental and control group is ‘t’ = 13.2. This reveals that there was a significant difference exists between the pretest and posttest value of posture and motor performance among experimental and control group. It showed that the Nesting is effective in maintaining posture and motor performance in experimental group. CONCLUSION: The study revealed that the high risk newborns maintaining posture and motor performance after Nesting. So, the Nesting was effective in maintaining posture and motor performance

REVIEW ON CLINICALLY DEVELOPING ANTIBIOTICS

The world is running out of antibiotics. Between 1940 and 1962, more than 20 new classes of antibiotics were marketed. Since then, only two new classes of antibiotics were marketed. Now, not enough analogues are reaching the market to stem the tide of antibiotic resistance, particularly among gram-negative bacteria which indicates the need of novel antibiotics for their effective action. This review describes those antibiotics in late-stage clinical development. Most of them belong to existing antibiotic classes and a few with a narrow spectrum of activity are novel compounds directed against novel targets. The reasons for some of the past failures to find new molecules and a path forward to help attract investments to fund the discovery of new antibiotics are described

Screening for plant growth promoting fungi and their ability for growth promotion and induction of resistance in pearl millet against downy mildew disease

A total of forty nine plant growth promoting fungi (PGPF) were successfully isolated from the rhizosphere of various grass species in Karnataka State, India. All the PGPF isolates were tested for their ability to enhance pearl millet seed quality parameters and to induce resistance against downy mildew disease in pearl millet. Susceptible pearl millet seeds 7042S were treated with PGPFs conidial suspension (1 x 108 cfu ml-1) and barley grain inocula (BGI) at 5%, 10% and 20% concentrations. Only six isolates among the forty nine tested recorded significant (P &lt; 0.001) enhancement of seed germination and vigor when compared with the untreated control. Of the PGPF, Penicillium sp. (UOM PGPF 27) at 5% (w/w) concentration recorded highest seed germination of 92% and 1701.9 seedling vigor. The in planta colonization of the six PGPF isolates determined successfully in re-isolating the fungus from the basal root segments of 6 cm and 4 cm plated on PDA plates and also from the rhizosphere serial dilution of 10 3 to 10 5. Among the PGPFs tested in two modes, in BGI treatments, Penicillium sp. (UOM PGPF 27) at 5% (w/w) and Pythium sp. (UOM PGPF 41) at 10% (w/w) showed maximum disease protection of 67% and 61% respectively against downy mildew disease of pearl millet In case of conidial suspension treatments Penicillium sp. (UOM PGPF 27) and Trichoderma sp. (UOM PGPF 37) recorded highest disease protection of 71% and 66%, respectively under greenhouse conditions. Thus, the present study suggests that the tested PGPF, both as BGI inocula and conidial suspensions, can be used for pearl millet downy mildew disease management and also for plant growth.&nbsp;&nbsp