Birth Preparedness and Complication Readiness Among Pregnant Women Attending an Urban Health Centre in Surat, India

Background: Birth preparedness is an important strategy to reduce MMR. It includes knowledge of key danger signs; identification of: birth place; birth attendant, fund, transport and compatible blood donor for emergency use beforehand. Objective: This study aims to explore birth preparedness in Surat and determine factors associated with it. Methods: Study conducted facility based cross-sectional study among 310 antenatal women at Urban Health Training Centre attached to Government Medical College, Surat, Gujarat. Predesigned, semi- structured, pretested questionnaire was used for data collection after acquiring informed written con-sent. Result: A total of 310 women participated in the study. Mean age of participants was 22.9 + 3.6 years. Almost one-third (30.3%) of participants were illiterate. Almost six-tenth (61.9%) of participants were involved in unskilled or semi-skilled work and two-fifth (38.1%) of participants were homemakers. Ma-jority of participants (96.7%) were registered in first trimester. Most known factor during pregnancy as danger sign was bleeding (81.9%). BPACR index was calculated as ∑Indicator/7 which was observed to be 62.3%. There was statistically significant association between awareness about health problems dur-ing pregnancy and type of family. Conclusion: Raising awareness regarding components of BPACR among antenatal women will help to reduce morbidity and mortality in antenatal women and achieve sustainable development goal

Efficacy and safety of intravenous ferric carboxymaltose in moderate to severe postpartum iron deficiency anemia

Background: PPA affects 50–75% of women. Traditional treatments such as oral iron therapy and blood transfusion have significant disadvantages. Oral iron is not usually absorbed or well-tolerated because of gastrointestinal disturbances and requires long time (months) to reach target of hemoglobin (Hb). Due to limitations of prior parenteral iron preparation, search of novel drug resulted in iron sucrose and latest is Ferric carboxymaltose (FCM). Intravenous FCM has a neutral pH and physiological osmolarity allowing for higher single doses over a shorter time periods. It also does not cause dextran- associated immunogenic reactions. Aims and Objectives: Aims and objectives of the study is to evaluate the safety and efficacy of IV FCM in treatment of postpartum iron deficiency anemia. Materials and Methods: It was prospective intervention study conducted at the tertiary care center from January 2019 to June 2019. Total 151 postnatal women aged 18–45 years with moderate and severe anemia were included in the study. FCM was administered as an intravenous infusion of 500–1000 mg dose based on requirement in 100 ml of 0.9% normal saline solution over 15 min. Hb and serum ferritin were recorded at baseline and at the end of 6 weeks. Safety and tolerability were assessed by recording the adverse events during the study period. Results: Mean age of the study participants was 26.4 ± 4.54 years. Total 112 women (74.1%) had moderate anemia and 39 women (25.8%) had severe anemia. Average baseline Hb was 7.82 ± 0.84 g/dl which was significantly increased up to 12.4 ± 1.33 g/dl at 6 weeks (P < 0.05). Serum ferritin was also significantly improved from 16.22 ± 7.54 baseline to 136.21 ± 66.12 at 6 weeks (Difference 115.12 ± 53.21, P < 0.05). No any serious adverse events were reported. Only minor adverse events such as mild itching at injection site (5, 3.3%) palpitation (2, 1.3%) and nausea (1, 0.6%) were reported. Conclusion: Intravenous FCM therapy was well-tolerated and effective for management of moderate?to?severe anemia among postpartum women. It improved Hb and iron stores in the form of serum ferritin with a very few side effects such as mild itching at injection site, palpitation, and nausea.

A Huge Benign Phyllodes Breast Tumor: Case Report

Phyllodes tumors are rare fibro-epithelial lesions account for less than 1% of breast neoplasms.Most phyllods are benign but 10% are malignant.Accurate pre-operative pathological diagnosis allows correct surgical planning and avoidance of reoperation. Treatment can be either wide local excision or mastectomy to achieve histologically clear margin.Women aged between 35 and 55 years are commonly involved.Local recurrence occurs in approximately 15% of the patients and is more common after incomplete excision.Approximately 20% of the patients with malignant phyllodes tumors develop distant metastases. The role of chemotherapy, radiotherapy and hormonal manipulation in both the adjuvant and palliative setting remain to be defined.The lungs are the most common metastatic site,followed by the skeleton, heart and the liver.Symptoms of metastatic involvement can arise from as early as a few months to as 12 years after the initial therapy.It is also known as Cystosarcoma Phyllods.

Study of pattern of fatal head injury cases due to road traffic accidents in Bhavnagar Region, Gujarat.

Introduction: Head injury is an important cause of mortality world wide as head is the most vulnerable part of the body involved in fatal road traffic accident. Material and Methods: The present study was under taken on 117 victims of road traffic accident who died due to injuries sustained on the head, which were autopsied at mortuary complex of Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, Gujarat over a period of 1 year between 1st January 2011 to 31st December 2011. Observation: Most of the road traffic accident had taken place in the afternoon hours (12.01 P.M. to 6.00 P.M.).Majority of victims were found in age group of 21 to 30 years. Two wheeler occupants were the most commonly involved. Four wheeler occupants and pedestrians were least commonly involved. A large proportion of the victims died within 0 to 12 hours of the accident. Conclusion: Very high morbidity at place of accident or at initial phase of treatment is definitely alarming and highlights the need for taking urgent steps for establishing good pre-hospital care and provision of trauma services at site.

Profile study of unknown dead bodies brought for postmortem examination at mortuary complex of sir T general hospital, Bhavnagar.

Introduction: The aim of this study was to find out the profile of cases of unknown dead bodies, to evaluate the present situation at Bhavnagar region of Gujarat in India. Material and methods: A retrospective descriptive study was carried out on 104 cases of unknown dead bodies, brought for postmortem examination at Sir T. General Hospital and Government Medical College Bhavnagar, during the period of April 2010 to March 2013. Observation: This study throw some lights on the emerging trends that incidence of unknown dead bodies brought for post-mortem examination is increases in particular season, more in male and most of the victims were from the age more than 60 years. Conclusion: In unidentified dead bodies’ cause of death are variable. In some instances death due to natural cause may occur, but there are incidences of unnatural death also.

Thrombotic thrombocytopenic purpura.

A 6-year-old boy presented with microangiopathic hemolytic anemia, thrombo-cytopenia, altered sensorium and intractable bleeding. A diagnosis of thrombotic thrombocytopenic purpura was made and the child recovered dramatically after plasmapheresis. Recent developments in the understanding of TTP are reviewed, including the importance of a metaloprotease required to cleave multimers of von Willibrand factor.