Neonatal And Obstetric Transfusion

Up to four weeks of birth a newborn is considered a neonate. Most often, these neonates are in need of blood or one of its components. The naturally occurring ABO antibodies are not fully developed in neonates and the presence of Wharton’s jelly poses problems in routine grouping and cross matching procedures. Indications and the guidelines for transfusion are different in cases of neonates. Extra precautions are recommended. The proper choice of component is of utmost importance. Hemolytic Disease of Newborn (HDN) is a frequently encountered disorder, occasionally requiring exchange transfusion. The indications, procedure and the complications of Exchange Transfusion have to be understood properly by the pediatricians before employing the procedure, especially in low birth weight babies. The transfusion in obstetric cases and in post partum hemorrhage (PPH) too requires guidelines, which have to be followed. Most of the deaths in obstetrics take place due to PPH which is preventable if the obstetricians take precautions and start the transfusion timely. Beside PPH, perioperative hemorrhage is often an indication for transfusion. All pregnant women must be monitored regularly for iron deficiency anaemia , hemoglobinopathies and alloantibodies during their antenatal period. Neonates quite often require blood transfusion and their requirements are different and unique. A normal neonate has approximately 85 ml/kg of blood volume. Frequent blood collection for laboratory investigations leads to iatrogenic blood loss and need for transfusion.

Unicompartmental knee arthroplasty and its minimally invasive version

Unicompartmental Knee Arthroplasty [UKA] is still considered to be a controversial issue even after three decades of its presence on the Orthopaedic horizon. The initial dismal results of unicompartmental Knee Arthroplasty and the concurrent excellent results reported by the Total Knee Arthroplasty series are the responsible factors. Currently there has been a renewed interest in UKA because of excellent results reported in the last decade. The recent results of UKA are comparable to Total Knee Arthroplasty [TKA] and are better than High Tibial Osteotomy [HTO]. Meticulous patient selection, better implant designs and refined surgical techniques are responsible for the improved results. The procedure is primarily performed for single compartment arthritis which most frequently is medial compartment. Indications and contraindications of the procedure are still evolving. Both fixed and mobile bearing UKA have shown good results. Revision of UKA has not been found as complicated as quoted by the initial reports. Among few questions which still remain unanswered by the current literature are its role in younger patients, optimal implant designs, correct indications / contraindications and the proper surgical technique. Minimally invasive techniques in UKA have shown encouraging early results. Its minimally invasive version is a technically demanding procedure and surgeons not familiar with this technique will benefit from appropriate preoperative instruction. Abstracts of all articles appearing under the heading of Unicompartmental arthroplasty of Unicondylar arthroplasty in Medline were retrieved and reviewed by the primary author; in addition references from major orthopedic and arthroplasty textbooks were obtained. Only relevant papers were included after discussion among the authors

Intramedullary lipoma of the cervical and thoracic spinal cord

We report the case of a patient with quadriparesis due to a cervicothoracic intramedullary lipoma unassociated with spinal dysraphism. Intraspinal lipomas are usually associated with spinal dysraphism but in rare cases this association does not exist. Once the symptoms develop surgery does not usually result in any improvement in the neurological symptoms. Early Magnetic Resonance Imaging in patients with symptoms is recommended so that the tumour may he removed before permanent neurological deficit develops

Surgical management of postpartum and pelvic haemorrhage

Despite the ready availability of banked blood and blood products, postpartum and pelvic haemorrhage remains one of he major causes of mortality and morbidity all over the world. In developing countries, as in Pakistan, it is among the first three causes of maternal mortality. Sixty one cases were included in this study over a period of nine years from various hospitals, such as 1. Maternity and Children Hospital, Dammam [Saudi Arabia] Affiliated with King Faisal University Al-Khobar [Saudi Arabia]. 2. Services Hospital, Lahore. Affiliated with Allama Iqbal Medical College, Lahore [Pakistan]. 3. Bahawal Victoria Hospital, Bahawalpur. Affiliated with Quaid-e-Azam Medical College, Bahawalpur [Pakistan]. Our management mainly based on surgical treatment alongwith conventional therapy

comparative study of vaginal prostaglandin E2 pessaries with intravenous oxytocin for the induction of labour after spontaneous rupture of membranes

In a prospective randomized study, 60 patients were induced with 3 mg vaginal FE2 pesseries or intravenous oxytocin. Oxytocin stimulation was associated with shorter labour and a lower incidence of abnormal cervimeteric progress, after spontaneous rupture of membranes. Out of these patients given PGE2 20% required a second dose after four hours of slow progress. 10% of primigravida subsequently developed abnormal labour and required augumentation by oxytocin to correct their uterine contractions. Two caesarian sections were carried out for disproportion and remaining 58 patients were delivered vaginally. PGE2 pesseries were not associated with an increased incidence of hyperstimulation or sepsis. In conclusion oxytocin infusion is a safe, effective but inconvenient method of induction of labour, while PGE2 pesseries are safe, effective, more acceptable but an expensive method of induction of labour

Study of 780 cases of infertility

Inspite of world population explosion, the desire for reproduction remains a basic human desire. Infertility is a complex phenomenan, and couples confronted with this problem, need a lot of emotional and psychological support besides intensive and prolonged investigations and treatment. Overall incidence of infertility varies from 15 to 20% all over the world. Etiological variation from one country to another is due to their differences in social background. A study of 780 cases of infertility have been carried out, to ascertain the cause of infertility. These patients range from 18 to 40 years of age, and come from various social groups. After initial investigations, they were divided into four groups, depending upon the etiological factor. It is observed that conception rate varied from one group to the other. Overall conception rate achieved was 44.743% which is reasonably encouraging with our present management