Association of Anemia with Cerebral Venous Thrombosis in Puerperium and its Pattern of Recovery

Background: Anemia is often considered to be a risk factor for cerebral venous thrombosis (CVT). We investigated the association between anemia and CVT. Methods:  42 postpartum /puerperal females were studied retrospectively for various factors like anemia, conscious level at admission, place of delivery (home or hospital) and their neurological sequel was measured at the time of discharge. Platelets counts were also noted (to rule out thrombocytosis). Anemia was defined according to World Health Organization criteria: non- pregnant women hemoglobin < 7.5 gm/dl, pregnant women < 6.9gm/dl. Modified Rankin Score (mRS) was taken as a scale for recovery. Results: Patients with CVT were younger (mean age 28). Anemia was more frequent in 32.7%. Hemoglobin as a continuous variable was inversely associated with CVT. Platelets counts, BT CT were normal hence no thrombocytosis was seen. No gross increase in WBC count was noted indicating absence of sepsis (puerperal). Outcome was favorable in 83% patients. N=4 (7%) patients died. Conclusions: We concluded that there is a positive correlation with increased levels of HbA1c and FBS (p˂0.001) in diabetic postmenopausal women and knee osteoarthritis. we found a significant association of severe anemia and CVT in patients of CVT of non-infectious origin, although the exact mechanism leading to hypercoagulability remains unclear and had poor prognosis.

Study of Iron Status Indicators in Different Phases of Menstrual Cycle in Females of Lower Socio-Economic Group.

Background: Iron requirements are increased in adolescent girls with growth and the onset of menarche and remain high in women until menopause. Methods: We conducted a study on 18-25 years females of lower socioeconomic status as per the Modified Kuppuswamy’s Scale to study the effect of the phases of menstrual cycle & socioeconomic class on the iron status indicators (Hb, Serum Iron, TIBC, MCV & TS%).Menstrual phases were defined and blood samples were drawn from all the girls in all the 3 phases (menstrual, follicular & luteal) and Hb, Serum iron & Total iron binding capacity were assessed on a semi-auto-analyzer & MCV was estimated using a fully automated CBC machine. Transferrin Saturation was derived as Serum Iron / TIBC × 100. Results: We found that the values of iron status indicators varied significantly according to the menstrual cycle, with values highest during the luteal phase and lowest during the menstrual phase. From our observations we can conclude that the nutritional status (assessed by the height, weight & BMI) and the iron status indicators both are significantly lower in the females of lower SES. Hence, socio-economic class has a major determining role on an individual’s health. Conclusion: The effect of hormonal fluctuations during the menstrual cycle also has a part to play in the variation of iron status measures, which has to be considered while measuring them in a female during her reproductive years.

Study of FEV1/FVC Ratio In Relation to BMI in Young Group of Rohilkhand Region.

Background: The aim of study was to to assess respiratory indices in underweight and overweight young group (subcategory) and compare the same with normal weight controls (in the age group of 18 to 30 years). Methods: In the present study 210 subjects were included, aged between 18 yrs-30 yrs after applying inclusion and exclusion criteria. The groups (n=210, case= 132 and control= 78) are divided into group A, B, C, D, E and F respectively each having 21, 78, 40. 35, 29 and 7 subjects on the basis Of international classification of BMI. Results: In our study mean predicted value of FEV1/FVC ratio in group A 84.02±31.24(underweight), group C 86.83±29.46(pre-obese), group D 92.10±13.31(obese class 1),group 93.72±9.49 ( obese class 2) and group F191.02±22.24( obese class 3), when compared to control group B 87.95±26.77 was found to be decreased in group A and increased in other obese group , but it was within normal range in all groups and no statistical difference found between different groups (P value>0.05). Conclusion: After analyzing the data, we did not observe any statistically significant difference in FEV1/FVC between the control and underweight and overweight group.

Study of Blood Pressure and Heart Rate Variability in Office Clerks.

Background: hypertension is prevalent worldwide especially in young generation is a significant.it is associated with the development of autonomic and metabolic disorders. Hypertension is often found in high stress work situations. The present study was undertaken to compare the arterial blood pressure (BP) and Heart Rate Variability (HRV) in office clerks. Methods: Seventy four male clerks of various offices in Bareilly, U.P., India. The age group of subjects was 21–50 years. They were divided into two groups based on their BP recordings. 21 were normotensives and 53 hypertensive. Anthropometric measurements and their BP in supine position were recorded. Deep breathing HRV test was conducted. HRV levels were compared statistically between the two groups. Results: The Hypertensive had significantly lesser HRV (p=0.027) compared to normotensives. Conclusion: Hypertensive office clerks have lower heart rate variability. Blood pressure is inversely proportional to heart rate variability.

Effect of Pranayama on Respiratory Parameters in Aged Person.

Background: Body and mind work perfectly after yoga. To find out the effect of yoga (pranayama) on respiratory parameter a cross sectional study was conducted. Methods: Subjects selected are people (male and female) aged from 50-70 year without any active medical complain. Study is conducted in RMCH Bareilly U.P. Results: Respiratory parameters measured are FVC, FEV1, ratio of FVC/FEV1 and PEFR. These parameters are taken before and after 12 week of pranayama. Conclusion: 12 weeks of regular yogic training in elderly individuals showed definite improvement in their ventilatory functions, as observed from improvement in their FVC, FEV1 FEV1/FVC RATIO and PEFR.

Presurgical Antibiotic Prophylaxis Pattern In An Indian Tertiary Care Teaching Hospital.

The present study was performed to study the antibiotic prophylaxis pattern in patients admitted in Surgery and Obstetrics and Gynaecology wards of a Tertiary Care Teaching hospital in North India. It was an observational, non interventional and analytical study used to evaluate the patients undergoing surgery through period of one and half years. Information concerning demographic data, type of surgery, and parameters of antibiotic therapy (selection of antibiotic, dose, route and duration of therapy as well as cost) was collected from case records of 400 patients. Third generation cephalosporins were the most commonly prescribed class of antibiotics. No consistency was noted in the timing of administration of prophylactic antimicrobials agents which were prescribed 30 minutes to 6 hours before surgery. The dose was not repeated during surgery. Majority of antibiotics were prescribed from Essential Medicines List. Surgical prophylaxis was inappropriate in terms of choice of antimicrobial agent, timing of administration as well as the total duration of prescription, in majority of the cases. Interventions are warranted to promote the development, dissemination and adoption of evidence based guidelines for antimicrobial prophylaxis.

A comparative evaluation of lipid profile in smokers and non smokers as control.

Background: The major cardiovascular risk factors i.e. smoking, hypertension and hypercholesterolemia; person having only one of these risk factors show a 2-4 times increase in the incidence of coronary heart disease. Studied have also shown the beneficial effect of smoking cessation on the serum lipids, mainly HDL cholesterol. The risk of coronary artery disease reverts rapidly after cessation of smoking. Material and method:-Present study is conducted to reveal the effect of smoking on the lipid profile in male subject. The cross-sectional study was done in 60 male subjects age ranging from 30 to 45 years. The subjects were divided into control group (n=30) and study group i.e. smokers (n=30). All subjects were belongs from either social class 2 or 3 according to Modified Prasad’s social classification. About 5 ml of venous blood will be obtained after 10-12 hours of fasting and analysis of lipid profile was done. Result: Total Cholesterol, Total Triglycerides, High Density Lipoprotein (HDL-Cholesterol), Low Density Lipoprotein (LDL- Cholesterol) and Very Low Density Lipoprotein (VLDL-Cholesterol) will be calculated by Friedwald and Friedrickson formula. There is significant difference in lipid profile parameter of control and smokers. The Total Triglyceride, Total Cholesterol, LDL-Cholesterol ,VLDL-Cholesterol of control and smokers are respectively, which is increase significantly (p<0.05) in smokers then control. The HDL-Cholesterol of control and smokers is decrease significantly (p<0.05) in smokers then control. Conclusion: Hence we concluded that strict measures should be taken up to control the prevalence of the habits of smoking and preventing the risk factor for cardio vascular diseases, hypertension etc.

Serial maternal deaths in a tertiary care hospital: some questions.

Between February 13 and March 18, 2011, a total of 18 women lost their lives while admitted in Umaid Hospital and the MG Hospital, Jodhpur, for medical management of their pregnancies. The majority of these women were from villages and all were from weak socio-economic backgrounds. Two of them belonged to families identified as being below the poverty line. Of the 14 women who died in February, eight delivered through lower segment caesarean section. Four underwent hysterectomy. One also had emergency surgery to stop excessive internal bleeding.