An Effective Management for Thalassaemic Patients during Pregnancy

Background : Presence of thalassaemia is considered high risk in pregnancy. The present study find out the role of antenatal and intrapartum care to improve the outcome of pregnancy in thalassaemia. Materials and Method : The prospective longitudinal study was carried out on 25 patients. CBC, LFT, Ferritin, Hb electrophoresis, serial USG was done. Chorionic villous sampling was offered to thalassaemic women to decrease the number of babies born with Thalassaemia. Furthermore, management and treatment options provided to mother to overcome the incidence of maternal and neonatal complications during current pregnancy. Results : 44% of thalassaemic pregnant women had HbE ? thalassaemia, 8% ? thalassaemia major and others had thalassaemia carriers, while only 20% of their partners showed ? thalassaemia trait. All patients were anemic and during delivery mean Hb% were 8.42 g/dl, MCH 22.09 pg, MCV 73.56 fl, MCHC 29.86 g/dl and ferritin 241.51 ng/ ml. Third trimester USG exhibited 32% developed IUGR (Intrauterine growth restriction). 40% patients received blood transfusion after delivery. ? thalassaemia trait was identified in 20% babies at 6 month. Conclusion : Postpartum haemorrhage is a major complication of thalassaemia in pregnancy. After delivery a thorough neonatal check-up and haematological work-up is important for prevention of neonatal mortality and early detection of thalassaemia.

Effect of varied plyometric training in land and aquatic medium on anaerobic power of athletes / Efeito do treinamento pliométrico variado em meio terrestre e aquático na potência anaeróbia de atletas

ABSTRACT The aim of the present study was to find out the effect of varied plyometric training (land plyometric training, aqua plyometric training and weighted vest aqua-plyometric training) on anaerobic power of school athletes. A total of forty eight (n= 48) district level school athletes were randomly selected. All the subjects were divided into four equal groups: i) land plyometric training group (n=12), ii) aqua plyometric training group (n=12), iii) aqua-plyometric training with weighted vest group (n=12) and iv) control group (n=12). The varied plyometric training was intervened for fourteen weeks in the respective training groups. In the present study, anaerobic power was considered as the dependent variable, and it was measured by Margaria-Kalamen power test. To draw statistical inferences on anaerobic power among the groups in pre and post intervention conditions, ANCOVA was used, followed by Tukey's LSD post-hoc test. The significance of the means was tested at the 0.05 level. Different plyometric training groups improved significantly with respect to the control group in anaerobic power. Therefore, various plyometric training was found as an effective means for developing anaerobic power. A significant difference was also observed between the aqua-plyometric training with weighted vest group and land plyometric training group in anaerobic power. However, rest of the experimental groups didn't differ significantly. Aqua-plyometric training with weighted vest is a more effective training method than land plyometric training for improving the anaerobic power of the school athletes.

RESUMO O objetivo do presente estudo foi descobrir o efeito do treinamento pliométrico variado (treinamento pliométrico terrestre, treinamento aquapliométrico e treinamento aquapliométrico com colete ponderado) na potência anaeróbica de atletas escolares. Um total de quarenta e oito (n= 48) atletas escolares de nível distrital foram selecionados aleatoriamente. Todos os sujeitos foram divididos em quatro grupos iguais: i) grupo treinamento pliométrico terrestre (n=12), ii) grupo treinamento aquapliométrico (n=12), iii) grupo treinamento aquapliométrico com colete ponderado (n=12) e iv) grupo controle (n=12). O treino pliométrico variado foi intervencionado durante quatorze semanas nos respectivos grupos de treino. No presente estudo, a potência anaeróbia foi considerada como variável dependente e foi mensurada pelo teste de potência de Margaria-Kalamen. Para fazer inferências estatísticas sobre a potência anaeróbica entre os grupos nas condições pré e pós-intervenção, foi utilizada a ANCOVA, seguida do teste post-hoc de Tukey LSD. A significância das médias foi testada no nível 0,05. Diferentes grupos de treinamento pliométrico melhoraram significativamente em relação ao grupo controle na potência anaeróbica. Portanto, vários treinamentos pliométricos foram encontrados como um meio eficaz para o desenvolvimento da potência anaeróbica. Uma diferença significativa também foi observada entre o grupo de treinamento aquapliométrico com colete ponderado e o grupo de treinamento pliométrico terrestre na potência anaeróbica. No entanto, o resto dos grupos experimentais não diferiram significativamente. O treinamento aquapliométrico com colete ponderado é um método de treinamento mais eficaz do que o treinamento pliométrico terrestre para melhorar a potência anaeróbica dos atletas escolares.

Evaluation of Fetal Transcerebellar Diameter as a Sonological Parameter for the Estimation of Fetal Gestational Age in Comparison to Biparietal Diameter and Femur Length

Background: Knowledge of the expected date of delivery is essential in the management of all pregnancies, particularly those which require active management. Presently the most effective way to date the pregnancy is by the use of ultrasound. Several sonographically derived fetal parameters are used to date pregnancies, those include Biparietal diameter (BPD), Head circumference (HC), Abdominal circumference (AC) and femur length (FL). However, the variability of these parameters increases with increasing age. Transverse cerebellar diameter (TCD) measurement can be used as a new parameter to estimate the fetal gestational age. The present study was undertaken to evaluate the usefulness of Trans cerebellar diameter (TCD) as against other conventional parameters (like Biparietal diameter and Femur length) in normal pregnancies. Objectives: To evaluate the usefulness of Trans cerebellar diameter (TCD) as against the conventional parameters of Biparietal diameter (BPD) and Femur length (FL) in normal pregnant mothers between 15-37 weeks, to derive nomogram for estimating the gestational age of the fetus from measured transverse cerebellar diameter. Sumanta Kumar Mandal, Sandip Kumar Ghosh, Saikat Roy, Barun Prakash. Evaluation of Fetal Transcerebellar Diameter as a Sonological Parameter for the Estimation of Fetal Gestational Age in Comparison to Biparietal Diameter and Femur Length. IAIM, 2019; 6(6): 41-50. Page 42 Materials and methods: Study of 100 normal pregnant women between 15-37 weeks of gestation. For each patient BPD, FL and TCD were measured. From the above measured parameters gestational age was measured using Hadlock tables. TCD was compared with BPD, FL in normal pregnancies. Results: It was observed that there was a statistically significant curvilinear relationship between TCD and gestational age in normal pregnancies. The growth pattern of cerebellum followed a second degree polynomial similar to that of BPD and FL. Gestational age estimated by TCD correlated well with the estimated gestational age by BPD and FL. Conclusion: Transverse cerebellar diameter (TCD) shows good correlation with gestational age and can be used as a single growth parameter to estimate the gestational age where LMP is uncertain.

Symmetrical peripheral gangrene complicating ventricular pseudoaneurysm: a report of an unusual case and a brief review of the literature

Abstract Symmetrical peripheral gangrene is an ischemic necrosis simultaneously involving the distal portions of two or more extremities without any proximal arterial obstruction or vasculitis. It may occur as a result of a large number of infectious and non-infectious causes. A few cases of symmetrical peripheral gangrene associated with cardiac disease have been described in the literature. We describe a case of symmetrical peripheral gangrene complicating ventricular pseudoaneurysm, probably a hitherto unreported occurrence. In this report, we sought to emphasize the importance of cardiac evaluation while dealing with a case of symmetrical peripheral gangrene.

Girls' Collectives Address Adolescents' Anemia and Social Norms in Socially-excluded Tea Estates in India: A Public-private Partnership in Assam.

Objectives: To generate evidence on engaging girls' collectives to address anemia and social norms in self-contained, privately-managed tea plantations in India. Methods: In 2006, UNICEF India partnered with a federation of tea companies in Assam's Dibrugarh district, and Twinning Corporate Social Responsibility to establish 158 girls' collectives across 117 of 273 tea gardens. These collectives meet weekly to discuss and address social issues such as child marriage, child labor, school dropout, and life skills. In 2012, supervised weekly iron folic acid (IFA) supplementation, biannual deworming and nutrition education were weaved in these peer interactions and implemented in 15 tea estates through 45 girls' collectives comprising 7097 adolescent girls, with the objective to address anemia. Visual aids, recipe demonstrations, and home gardening were used to make sessions interesting. Government positioned adequate supplies at tea estate hospitals/outposts. Two peer monitors per tea estate supervised the activities of the collectives. The follow up of this cohort included a baseline (2011) and an end line (2013) survey. Results: Compliance with weekly IFA supplementation (4 tablets per month) increased from 25% (2012) to 82% (2013). Home gardens were introduced in 1,002 homes and 55 community patches. Provisional end line data shows a 1.25 g/dl improvement in mean hemoglobin levels (9.77 to 11.2 g/dl). There is also evidence of increased girls' re-enrollment in high school and a reduction in the proportion of child marriages. Conclusions: Lessons from this public-private partnership can be adapted to similar programming environments that aim at reaching out to adolescent girls with anemia control interventions.