Study of role of blood transfusion in obstetric emergencies

Background: Blood Transfusion is recognized as one of the eight essential component of comprehensive emergency obstetric care which has been shown to reduce the maternal mortality.1,2 In developing country like India, efforts should be done to make blood and transfusion services well maintained and quickly available to reduce maternal morbidity from haemorrhage and thus decrease the incidence of maternal mortality. Aims & objectives: (1) To study clinical status of the patients at time of admission. (2) To study the role of antenatal visits in all patients required blood transfusion. (3) To study the effect of blood components on the patients’ health. (4) To screen out the patients of high risk pregnancy and treat them safely. (5) To study causes of maternal mortality.Methods: Retrospective study of requirement of blood transfusion in antenatal and postnatal patients who came in labour room during last 3 month period at tertiary care Centre, Ahmedabad.Results: during the whole study out of 2200 patients 440 patients required blood transfusion among which 70% required due to obstetric hemorrhage and 30% due to severe anemia (less than 7 gm/dl). Major associated complications in the transfused patients were anemia (34%) and PPH (36%). 4 patients expired among them 2 were due to development of DIC and septicemia, 1 due to severe anemia and 1 due to severe PPH.Conclusions: Ensuring a safe supply of blood and blood products and the appropriate and rational clinical use of blood. Strategies made to maximize the haemoglobin (Hb) level at the time of delivery as well as to minimize blood loss. Active management of the third stage of labour is required to prevent avoidable morbidities, such as PPH, Retained product of conception, and vaginal lacerations.

Uterine preservation with Cho suture in localized multifocal atonicity of uterus with failed medical management and uterine tamponade

Postpartum haemorrhage (PPH) is a major cause of maternal morbidity and mortality, and one of the common obstetrical emergencies. Quite commonly, it occurs in patients where PPH is not expected. Management has to be swift and precise according to the steps and the response initiated by the uterine musculature during the management. In our patient, we had a localized multifocal atony of the uterus, at points where the uterine sinuses were bleeding due to atony, and medical management and uterine tamponade failed, with a raised D-dimer level. As the stepwise management failed with uterine devascularisation failing to control PPH, a decision for uterine compression suture (UCS), Cho suture was taken

DETERMINATION OF TRAZODONE IN HUMAN PLASMA BY REVERSED-PHASE LIQUID CHROMATOGRAPHY-MASS SPECTROMETRY WITH ELECTROSPRAY IONISATION

Objective: The development and validation of LC-MS/MS method for quantification of Trazodone (a serotonin antagonist and reuptake inhibitor (SARI), which is a second generation antidepressant compound belonging to the class of phenyl piperazine) in human plasma is described. Methods: The method involves protein precipitation (extraction) using Trazodone d6 as an internal standard (IS). Chromatographic separation is achieved on Zorbax eclipse XDB C8 150×4.6 mm, 5 μm column with a mobile phase consisting of 2 mM ammonium formate (pH 3.0) and methanol (30:70 v/v) at a flow rate of 1.0 mL / min and the total run time was 2.5 minute. Detection was carried out by AB Sciex API 3200 tandem mass spectrometer using positive electro-spray ionization mode by multiple reactions monitoring method at m/z 372.00→176.10 and 378.20→182.10 for Trazodone and Trazodone d6 (ISTD) respectively with dwell times of 300 msecs for each of the transitions. Results: The standard curve was linear from 5.203 ng / mL to 3025.166 ng / mL with goodness of fit (r2) greater than 0.990 observed during the method validation batches. This assay allows quantification of Trazodone at a concentration as low as 5 ng / mL in human plasma. The observed mean recovery was 88% for the drug. Conclusions: The method described here is found to be simple, cost effective and suitable for the use in bioequivalence and bioavailability studies

Farmakokinetika eprinomektina u ovaca nakon potkožne primjene.

The pharmacokinetics of eprinomectin was determined in lactating sheep following subcutaneous administration at a dose rate of 0.2 mg kg-1. The eprinomectin concentration in plasma was determined using High Performance Liquid Chromatography (HPLC) with a fluorescence detector. The kinetics of plasma concentrations were analysed using the non-compartment model. The maximum plasma concentration of 24.44 ng/mL occurred 2 days post-administration. Following subcutaneous administration of eprinomectin in sheep, the value of plasma elimination half-life, the area under the plasma concentration time curve (AUC) and mean residence time (MRT) were 388.52 ± 0.25 h. 4282.10 ng.h/mL and 374.50 h, respectively. The values of V (area), Vd(ss) and Cl(B) were 20.50 mL/kg, 13.70 mL/kg and 0.04 mL/h/kg, respectively. This study demonstrates that subcutaneous administration of eprinomectin led to higher bioavailability and longer mean residence time with a lower dose than a pour-on application, and that an injectable formulation may be applied in lactating sheep with zero withdrawal period.Farmakokinetika eprinomektina određivana je u ovaca u laktaciji nakon potkožne primjene u dozi od 0,2 mg/kg. Njegova koncentracija u plazmi utvrđena je visoko učinkovitom tekućinskom kromatografijom s fluorescentnim detektorom. Kinetika koncentracija u plazmi analizirana je na osnovi modela bez odjeljaka. Najveća koncentracija u plazmi od 24,44 ng/mL dokazana je dva dana nakon primjene. Poluživot eliminacije iz plazme iznosio je 388,52 ± 0,25 sati, površina ispod krivulje koncentracije u plazmi (AUC) 4282,10 ng/h/mL, a prosječno vrijeme zadržavanja iznosilo je 374,50 sati. Vrijednost prividnog volumena raspodjele, Vd(area), iznosila je 20,50 mL/kg, prosječni vidljivi volumen raspodjele, Vd(ss), 13,70 mL/kg, a ukupni klirens 0,04 mL/sat/kg. Istraživanje je pokazalo da potkožna primjena eprinomektina pruža veću bioraspoloživost, duže vrijeme zadržavanja s manjom dozom u odnosu na veliku te da se injekcijska formulacija može primijeniti u ovaca u laktaciji

Study of Thermal Properties on UV-Curable Coatings Derived from Oleochemical Polyols

Abstract: Over the last few years, UV radiation curing has become a well established coating technology used for several different applications. Polymeric component based on renewable resource is another area for getting low VOC coatings. In the present study cellulose and soya fatty acid were used to prepare oleochemical polyols which in turn reacted with diisocyanates to get PU which is further reacted with hydroxyl terminated acrylates to get oligomeric urethane acrylates. These polymeric compounds are used without any organic solvent for UV-coating formulation and cured by UV light on the metal surfaces. Thus effect of different types of polyols were used to prepared UV coatings studied on thermal properties like dynamic mechanical properties (DMA) and thermogravimetric analysis (TGA

Role of doppler in fetal growth restriction

Background: Fetal growth restriction is an important and particularly challenging problem for modern obstetricians and paediatricians. The present study is to correlate the importance of Doppler velocimetry and perinatal outcome in cases of growth restricted foetuses by comparing perinatal outcome of control & study groups with normal and abnormal Doppler waveforms.Methods: A study and a control group comprising of 50 pregnant women having growth restricted foetuses in each group was matched for all other confounding factors except for Doppler changes. These patients were followed up and the perinatal outcomes of FGR foetuses having Doppler changes was compared with those having normal Doppler studies.Results: In our study, alteration in both MCA and UmbA Doppler was associated with perinatal morbidity and NICU admissions in 64% and mortality in 28%. Doppler changes showing altered CPR less than 1 had adverse outcome with NICU admission in 61% and mortality in 34%. Alteration in DV Doppler was associated with perinatal morbidity and NICU admissions in 17% cases and mortality in 83% cases, with no pregnancies having a healthy outcome. Among high-risk pregnancies with suspected IUGR, the use of Doppler assessment significantly decreases the likelihood of labor induction, caesarean delivery, and perinatal deaths.Conclusions: Abnormal Doppler waveform changes indicate adverse perinatal outcome of pregnancies with FGR. Doppler study helps to reduce perinatal mortality and morbidity by timely and appropriate interventions

Role of methotrexate in ectopic pregnancy

Background: Ectopic pregnancy is an acute emergency in obstetric if not timely diagnosed and timely treated. Ectopic pregnancy is leading cause of death in first trimester. Ectopic pregnancy can be managed surgically or medically. Medical management with Methotrexate administration avoids anesthesia in surgery, is cost effective and also offers success rate comparable to surgical management. Aim and objectives were to study the role of methotrexate in ectopic pregnancyMethods: This will be a retrospective observational study conducted in Obstetrics and Gynecology department of AMC MET medical college. Study group constitutes of 30 females with ectopic pregnancy. Preliminary blood investigations, ultrasonography and beta-human chorionic gonadotropin (b-hcg) level will be tested. Patients will be treated with single dose of methotrexate 50 mg/M2. Follow up b-hcg level will be done after 48 hours. Response and tolerance to methotrexate will be monitored.Results: The success rate of methotrexate therapy in our study was 83.33% (n=25) and 16.66% (n=5) required surgical intervention with tubal ruptured and abdominal pain.Conclusions: Methotrexate treatment of ectopic pregnancies is safe and effective with no major side effects. It has the advantage of tubal conservation and saves patients from surgical intervention

Evaluation of invitro Antimutagenic Potential of Lagenaria Siceraria Using Ame’s Test

Cancer is one of the most life-threatening diseases and widespread in both developed and developing countries. Accumulation of genetic alterations is main etiology for cancer developments. Many of the Cucurbitaceae plants possess antitumor activity traditionally. Methanolic extract of Lagenaria siceraria Standley Fruit was tested for their antimutagenic potential. The extract of plant exhibited varying level of antimutagenicity. Ames test was used in the current study to evaluate antimutagenic activity in TA98 and TA100 strains of Salmonella typhimurium using direct (Sodium azide) acting mutagens. Results of the study showed significant antimutagenicity against mutagen in TA98 and TA100 strains. The antimutagenicity of the extract observed in the present study implies chemopreventive pharmacological importance of Lagenaria siceraria Standley Fruit and encourages its use as a functional food

Remedial Prospective of Hippophae rhamnoides Linn. (Sea Buckthorn)

Sea buckthorn (Hippophae rhamnoides L.) constitutes thorny nitrogen fixing deciduous shrub. Sea buckthorn(SBT) is primarily valued for its very rich vitamins A, B1, B12, C, E, K, and P; flavonoids, lycopene, carotenoids, and phytosterols. and therapeutically important since it is rich with potent antioxidants. Scientifically evaluated pharmacological actions of SBT are like inflammation inhibited by reduced permeability, loss of follicular aggregation of lymphocytes from the inflamed synovium and suppress lymphocyte proliferation. SBT-reduced recurrence of angina, ischemic electrocardiogram which might be due to decreased myocardial oxygen consumption and inhibition of platelet aggregation induced by collagen. SBT can kill both cancer cells of S180, P388, SGC7901 and lymphatic leukemia (L1200). The antiulcer activity may be related to reduce gastric empty time, inhibiting proteolytic activity and promoting wound reparation processes of mucosa. SBT exerts antihypertensive effect in part by blocking angiotensin-2 receptor on cell surface. SBT decreased the level of stress hormones and enhanced hypoxic tolerance in animals indicating its anti-stress, adaptogenic activity. A lot of research work is still needed to find cellular and molecular mechanisms of these activities and also yet to be explored for its activity in osteoporosis, hemorrhage, cataract, urinary stone, acne, psoriasis, polyneuritis, cheilosis, glossities, baldness, anti-obesity, gout, and chronic prostitis

Hybrid Energy Management System Consisting of Battery and Supercapacitor for Electric Vehicle

This paper is mainly focused on Hybrid Energy Management System (HEMS) consisting of Battery (BT) and Super capacitor (SC). Two energy sources connected in with same DC link in parallel manner with the help of Bidirectional DC-DC converter, which is used to separate control of power flow of each source. Here Permanent magnet dc motor (PMDC) motor used as a load and speed control of PMDC motor can be done by PWM method for this purpose chopper circuit is used. Input of chopper circuit is DC link and output of the chopper is given to PMDC motor. This method of energy management gives power splitting between two sources based on State of Charge (SOC) of each individual source during different state of vehicle such as acceleration, constant running and deceleration. Improved filter-based power splitting techniques is implemented. Three acceleration reference points were taken for power splinting at different SOC levels of both energy sources. Objective of this proposed method is best use of both the sources i.e. battery and supercapacitor and maximum use of supercapacitor energy at the time of transient conditions. Battery supply energy during normal running condition or very less load condition. Hence during transient condition SC directly react with system and gives peak power requirement, so stress on battery is reduces hence lifetime of battery is increase, also power available during braking is store in SC and battery, so independence of Electric Vehicle (EV) is increases. Because of less peak power requirement, batteries with less peak output power is used so it is reduced size and cost of batteries. Matlab- Simulink software is used for simulation and also small scale hardware is also implemented of proposed method