Octreotide infusion plus emergency sclerotherapy versus sclerotherapy alone for the control of bleeding oesophageal varices: a prospective randomized clinical trial

In a prospective trial, 189 patients with acute variceal bleeding were underwent emergency sclerotherapy of them, 93 patients were randomly assigned to receive a continuous infusion of octreotide [25 microgram per hour] for 5 days [group II]. The rest of patients [96 patients] treated with only sclerotherapy [group I]. After 7 days of follow up, the proportion of patients who had survived without re-bleeding was higher in group II patients who treated with both urgently sclerotherapy and octreotide [89 of 93 patients or 95.7%] than in patients treated with emergency sclerotherapy alone [group I]. The mean number of units of blood transfused was lower in group II than in group I. Also, bleeding was controlled rapidly in group II [2.26 +/- 0.8 days] versus group II [2.84 +/- 0.84 days]

Bacteriuria following vaginal delivery

Out of 70 healthy women admitted in labour, 50 were delivered spontaneously while 20 were assisted by vaccum extraction. Among these 70 cases 7 were found to have bacteriuria at the first stage of labour. The second culture done two weeks postpartum showed that out of the 63 abacteriuric cases, 6 women developed bacteriuria de novo, an incidence of 9.5%. Relating these 6 cases to the mode of delivery it was found that 9% and 10.5% were found among women delivered by spontaneous vaginal delivery and who were assisted by vaccum extraction respectively. Relating the incidence of bacteriuria developed two weeks postpartum to events that occurred during labour; it was found that 16.5%, 33%, 33%, and 3% were found among women with prolonged labour, premature rupture of membranes, vaginal injuries and with no apparent complications respectively. It was found that E. coli was equal to staphylococcus as the causative organism in post partum bacteriuria

Heart diseases with pregnancy

This article deals with 22 pregnant women suffering from heart disease. It describes the haemodynamic changes which occur in the cardiovascular system during pregnancy and its effects on structural heart disease. Twelve of our patients were booked and ere seen regularly at the outpatient clinic. Two of them were stage III and were admitted to hospital when first seen at midtrimester and were managed medically. The other 10 were admitted at 32 weeks. Ten patients were4 admitted in labour unbooked. The commonest valve involved was mitral valve, mostly mitral stenosis [77.4%]. Strict medical and obstetrical management were followed. Five premature deliveries occurred and we used forceps delivery in 77.5%. Strict observations and management continued during puerperium. We did not have any maternal mortality. However we had one neonatal death, due to prematurely