Efficacy and safety of intravenous ferric carboxymaltose in moderate to severe postpartum iron deficiency anemia

Background: PPA affects 50–75% of women. Traditional treatments such as oral iron therapy and blood transfusion have significant disadvantages. Oral iron is not usually absorbed or well-tolerated because of gastrointestinal disturbances and requires long time (months) to reach target of hemoglobin (Hb). Due to limitations of prior parenteral iron preparation, search of novel drug resulted in iron sucrose and latest is Ferric carboxymaltose (FCM). Intravenous FCM has a neutral pH and physiological osmolarity allowing for higher single doses over a shorter time periods. It also does not cause dextran- associated immunogenic reactions. Aims and Objectives: Aims and objectives of the study is to evaluate the safety and efficacy of IV FCM in treatment of postpartum iron deficiency anemia. Materials and Methods: It was prospective intervention study conducted at the tertiary care center from January 2019 to June 2019. Total 151 postnatal women aged 18–45 years with moderate and severe anemia were included in the study. FCM was administered as an intravenous infusion of 500–1000 mg dose based on requirement in 100 ml of 0.9% normal saline solution over 15 min. Hb and serum ferritin were recorded at baseline and at the end of 6 weeks. Safety and tolerability were assessed by recording the adverse events during the study period. Results: Mean age of the study participants was 26.4 ± 4.54 years. Total 112 women (74.1%) had moderate anemia and 39 women (25.8%) had severe anemia. Average baseline Hb was 7.82 ± 0.84 g/dl which was significantly increased up to 12.4 ± 1.33 g/dl at 6 weeks (P < 0.05). Serum ferritin was also significantly improved from 16.22 ± 7.54 baseline to 136.21 ± 66.12 at 6 weeks (Difference 115.12 ± 53.21, P < 0.05). No any serious adverse events were reported. Only minor adverse events such as mild itching at injection site (5, 3.3%) palpitation (2, 1.3%) and nausea (1, 0.6%) were reported. Conclusion: Intravenous FCM therapy was well-tolerated and effective for management of moderate?to?severe anemia among postpartum women. It improved Hb and iron stores in the form of serum ferritin with a very few side effects such as mild itching at injection site, palpitation, and nausea.

Effect of Pranayama On Stress and Cardiovascular Autonomic Tone & Reactivity.

BACKGROUND :The stress either physical or mental, leads to cardiovascular morbidity. Newly admitted medical students are likely to be exposed to various stresses like change of environment, demanding medical education and different teaching protocol in a medical college. Pranayama is known since ancient times to relieve stress and stabilize autonomic function of the body. METHOD: The subjects were first M.B.B.S students and the sample size was 59 consisting of 27 males and 32 females. The group of students thus selected was briefed about the study. After the orientation session, informed written consent was taken, stress questionnaire was put and the autonomic function tests were done. This was followed by practice of Pranayama for 2 months, 1 hour/day for 5 days/week and again stress questionnaire was put and the autonomic function tests were performed on the study group. RESULTS AND ANALYSIS: The above tests were done before and after the practice of Pranayama. The results obtained were analyzed using SPSS software. CONCLUSION: The stress level has reduced after 2 months of practicing various pranayama as evident by decrease in total stress score which is highly significant. VLF and LF in n.u have reduced significantly after practice of pranayama signifying reduction in sympathetic drive to heart. HF in n.u has increased significantly after practice of pranayama for 2 months showing the increase in parasympathetic output to the heart. LF/HF ratio reduced significantly after 2 months of practice of pranayama indicating a better sympatho vagal balance with resting balance tilting toward better parasympathetic control.

Circadian variation in onset of myocardial infarction : Comparison between diabetics (Niddm) and non-diabetics.

Aims and Objectives : A number of retrospective and prospective studies have demonstrated a peak in the onset of MI in the morning hours and a trough at night. This has led to investigations of the factors which can affect or modify the circadian pattern of onset of MI. The current study was undertaken with an objective of assessing whether the presence of diabetes can or cannot affect the circadian pattern of onset of myocardial infarction in an Indian population. Material & methods : 50 non diabetic subjects and 50 diabetic subjects were randomly selected from among patients admitted to cardiac ICCU of LTMMC and GH Sion, Mumbai. For all patients the time of onset of MI was noted and the results were tabulated. Results : 44% of non-diabetic subjects experienced onset of myocardial infarction in the period between midnight to 6:00 a.m. as compared to 32% in case of diabetics but an application of Chi Square Test, did not come out to be significant. But on comparing diabetics with >5 years and <5 years history, a significant loss of circadian rhythm was observed in case of diabetics of >5 years duration, indicating that autonomic neuropathy may play a role in the loss of circadian rhythm. Conclusion: It has important implications for the treatment of myocardial infarction in case of diabetics. This study can be followed up with additional studies to verify other factors which can affect circadian pattern of onset of myocardial infarction. Loss of biorhythms can result in increased incidence of thrombotic events throughout the day leading to increased cardiovascular mortality and morbidity.

Effect of pranayama on stress and cardiovascular autonomic function.

The stress either physical or mental, leads to cardiovascular morbidity. Newly admitted medical students are likely to be exposed to various stresses like change of environment, demanding medical education and different teaching protocol in a medical college. Pranayama is known since ancient times to relieve stress and stabilize autonomic function of the body. Therefore it was decided to study effect of Pranayama on stress and cardiovascular autonomic function. The subjects were first M.B.B.S students and the sample size was 59 consisting of 27 males and 32 females. The group of students thus selected was briefed about the study. After the orientation session, informed written consent was taken, stress questionnaire was put and the autonomic function tests were done. This was followed by practice of Pranayama for 2 months, 1 hour/day for 5 days/ week and again stress questionnaire was put and the autonomic function tests were performed on the study group. The above tests were done before and after the practice of Pranayama. The results obtained were analyzed using SPSS software. The stress level has reduced after 2 months of practicing various pranayama as evident by decrease in total stress score which is highly significant. VLF and LF in n.u have reduced significantly after practice of pranayama signifying reduction in sympathetic drive to heart. HF in n.u has increased significantly after practice of pranayama for 2 months showing the increase in parasympathetic output to the heart. LF/ HF ratio reduced significantly after 2 months of practice of pranayama indicating a better sympatho vagal balance with resting balance tilting toward better parasympathetic control.

Effect of pranayama on stress and cardiovascular autonomic tone & reactivity.

BACKGROUND :The stress either physical or mental, leads to cardiovascular morbidity. Newly admitted medical students are likely to be exposed to various stresses like change of environment, demanding medical education and different teaching protocol in a medical college. Pranayama is known since ancient times to relieve stress and stabilize autonomic function of the body. METHOD: The subjects were first M.B.B.S students and the sample size was 59 consisting of 27 males and 32 females. The group of students thus selected was briefed about the study. After the orientation session, informed written consent was taken, stress questionnaire was put and the autonomic function tests were done. This was followed by practice of Pranayama for 2 months, 1 hour/day for 5 days/week and again stress questionnaire was put and the autonomic function tests were performed on the study group. RESULTS AND ANALYSIS: The above tests were done before and after the practice of Pranayama. The results obtained were analyzed using SPSS software. CONCLUSION: The stress level has reduced after 2 months of practicing various pranayama as evident by decrease in total stress score which is highly significant. VLF and LF in n.u have reduced significantly after practice of pranayama signifying reduction in sympathetic drive to heart. HF in n.u has increased significantly after practice of pranayama for 2 months showing the increase in parasympathetic output to the heart. LF/HF ratio reduced significantly after 2 months of practice of pranayama indicating a better sympatho vagal balance with resting balance tilting toward better parasympathetic control.