ABSTRACT
Background: Iron deficiency is a common cause of anaemia in pregnancy which influences the health of mother and developing fetus. Intravenous (IV) iron preparations are considered, when oral iron therapy is ineffective or intolerant. Ferric carboxymaltose is an IV preparation that can be given with ease of administration and better tolerated. The aim of this study was to assess the efficacy and safety of IV ferric carboxymaltose in pregnant mother with all grades of anemia in the second and third trimester.Methods: This is a prospective observational study where 44 pregnant women with iron deficiency anemia [IDA] received ferric carboxymaltose up to 15mg/kg in second and third trimester. The parameters that were taken into account, to assess the effectiveness of the treatment was repeat haemoglobin [Hb] measurements and the subjective sense of wellbeing in the patient. The safety of the drug was analysed by continuous fetal heart rate [FHR] monitoring during the infusion and observation of any adverse reactions.Results: Ferric carboxymaltose intravenous infusion significantly increased Hb levels above baseline values in all women. The Increase in Hb levels were observed at 3- and 6-weeks post infusion therapy. FHR monitoring did not show any drug related unfavourable effect on the fetus. Of the 44 women interviewed, 33 (75%) women reported sense of well-being, 7 (15.9%) women could not feel any difference after the infusion and 4 (9.1%) patients could not comment. No serious adverse effects were noticed but minor side effects occurred in 3 (6.8%) patients.Conclusions: This prospective study showed safety and efficacy of ferric carboxymaltose in pregnancy with IDA which is consistent with available observational data.
ABSTRACT
Introduction: Use of In-vitro fertilization (IVF) has raisedmajor concern about the outcome of resulting pregnancies. InVitro Fertilization and Embryo Transfer is the most advancedtechnique of infertility treatment though management of thesepregnancies is not that easy as the couples and treating doctorshave undue concerns and apprehensions about the outcomesof such pregnancies.Material and Methods: Obstetrics outcomes in the womenconceived through IVF and the neonatal characteristics of thelive- born infants at Army Hospital R & R were analyzed inthis study between Jan 2017 to Dec 2017.Results: IVF pregnancies increased the incidence of ectopicpregnancy and multifetal gestation. The rate of cesareansection was also higher in IVF pregnancies. While a largenumber of cases delivered vaginally, multiple pregnancies andpreterm labour were more frequent in the study group. Afterfirst trimester they can be managed as a normal pregnancy.Conclusion: Infertility cases are usually older, and this isone of the reasons for increased complications in pregnancy.Multiple pregnancies are the most prevalent complicationin these pregnancies. Risk of ectopic pregnancy has beenreported to be at least 2-fold higher in In-vitro fertilizationand Embryo- Transfer (IVF-ET) pregnancies.
ABSTRACT
Abstracts: Background and Objectives: The use of OSPE (Objective Structured Practical Examination) for formative assessment has great potential as the learners can gain insight into the elements making up their competencies as well as ongoing feedback on personal strengths and weaknesses. The first year MBBS students are required to perform one hematology practical during university exams (Maharashtra University of Health Sciences). One of the important practical, Differential Leucocyte Count (DLC), was therefore chosen to introduce the OSPE pattern in hematology assessment and study its acceptability and feasibility. Methodology: The study was conducted in the Department of Physiology. 100 students were introduced to OSPE by a short lecture and a role play. Seven important steps (skills) of the DLC practical were assessed. Feedback from students was taken by a questionnaire and from faculty members and laboratory assistant by interview. Results: More than 90% of the students accepted OSPE in terms of learning the steps of the practical, clinical relevance and fairness in assessment. However, majority of students felt that the physical and mental effort needed was greater. The faculty commented favourably on the objectivity of assessment and potential to give feedback to learners and the support staff commented on greater workload and time needed for OSPE. Conclusion: Our study showed a high acceptability among students and faculty towards OSPE as a fair, objective and unbiased method of assessment compared to traditional method. The resources required, however, were greater. The study highlighted a need for continuous faculty development and increase in human resources to develop a comprehensive OSPE bank in future