ABSTRACT
Background: The objective of this present study was to assess the efficacy of condom uterine balloon tamponade (C-UBT) in averting the obstetric hysterectomy (OH) in cases of major postpartum haemorrhage (PPH) over a period of 10 years.Methods: A retrospective cohort study from January 2010 to December 2019. A historical cohort was drawn from a group of women who had OH for major PPH between Jan 2010 to December 2014 (Group 1) whereas those from January 2015 to December 2019 were designated as Group 2. Total 305 C-UBT were used in the later period. Women who had OH at <28 weeks were excluded from the study. Primary outcome was to determine the efficacy of C-UBT in averting the risk of OH. Secondary objective was to determine the success rate of C-UBT after five years of useResults: Total 37463 births occurred from January 2010 to December 2014 and 38808 during January 2015 to December 2019. Cases of OH were 33 in the first five years period (Group 1) and 20 in the later (Group 2), p=<05, odds ratio=0.58 with 95% CI 0.335-1.019 favoring C-UBT. After exclusion of rupture uterus and placenta accreta syndrome, OH for uterine atony alone were 22 (66.6%) for Group 1 and 08 (40%) for Group 2, P=0.01 odds ratio=0.350 (95% CI 0.156-0.788). No OH was done in group 2 for placenta previa. Efficacy of C-UBT was 96%.Conclusions: C-UBT is very safe, cheap and effective option for averting OH and associated physical, emotional and psychosocial morbidity.
ABSTRACT
Background: Vegetarianism is found in all geographic areas, they may have lower B-12 levels than nonvegetarian; problem could be graver in elderly. This study intended to recognise geriatric individuals with B-12 deficiency so as to save them from anaemia, dementia & neuropsychiatric disturbances by timely recommendations for supplementation. Methods: Current study was conducted on 200 healthy attendants divided in to two groups- A comprised of 100 vegetarian and B of 100 nonvegetarian geriatric individuals (> 60yrs.), they had no previous chronic disease and an attempt was made to exclude diabetes mellitus, hypertension, chronic gastritis, hypoplastic & aplastic anaemia. Those with history of alcohol intake, PPI therapy & regular vitamin supplementation were excluded. Complete clinical examination and routine blood tests were done. Serum cobalamin level was determined by ACCU-BIND ELISA Microwells method. Results: Total of 58 vegetarians were found to be B-12 deficient compared to 42 normal (>350pg/ml) this was statistically significant. Out of 100 nonvegetarian 48 were deficient while 52 had normal levels this too was statistically significant. On comparing the vegetarians and non vegetarian groups significant result was obtained (p <0.01). When different age groups were statistically compared insignificant result was obtained, same was true for gender distribution. Statistically significant result was obtained on comparing vegetarian Vs nonvegetarian group. Conclusions: Irrespective of the dietary habit B-12 deficiency is prevalent in elderly, as 58% of vegetarian & 48% of nonvegetarian were found B-12 deficient, detailed dietary analysis revealed that majority of them consumed nonvegetarian food only occasionally. No significant effect of increasing age & gender was found on B-12 levels in either group. Every elderly vegetarian or non vegetarian irrespective of gender should get their B-12 levels checked & if found low should receive B-12 supplemennt.
ABSTRACT
Background & objectives: Bone marrow mononuclear cell therapy has emerged as one of the option for the treatment of Stroke. Several preclinical studies have shown that the treatment with mononuclear cell (MNCs) can reduce the infarct size and improve the functional outcome. We evaluated the feasibility, safety and clinical outcome of administering bone marrow mononuclear cell (MNCs) intravenously to patients with subacute ischaemic stroke. Methods: In a non-randomized phase-I clinical study, 11 consecutive, eligible and consenting patients, aged 30-70 yr with ischaemic stroke involving anterior circulation within 7 to 30 days of onset of stroke were included. Bone marrow was aspirated from iliac crest and the harvested mononuclear cells were infused into antecubital vein. Outcomes measured for safety included immediate reactions after cell infusion and evidence of tumour formation at one year in whole body PET scan. Patients were followed at week 1, 4-6, 24 and 52 to determine clinical progress using National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), modified Rankin Scale (mRS), MRI, EEG and PET. Feasibility outcomes included target-dose feasibility. Favourable clinical outcome was defined as mRS score of 2 or less or BI score of 75 to 100 at six months after stem cell therapy. Results: Between September 2006 and April 2007, 11 patients were infused with bone-marrow mononuclear cells (mean 80 million with CD-34+ mean 0.92 million). Protocol was target-dose feasible in 9 patients (82%). FDG-PET scan at 24 and 52 wk in nine patients did not reveal evidence of tumour formation. Seven patients had favourable clinical outcome. Interpretation & conclusions: Intravenous bone marrow mononuclear cell therapy appears feasible and safe in patients with subacute ischaemic stroke. Further, a randomized controlled trial to examine its efficacy is being conducted.