Safety and Efficacy of Dinogest in Long Term Treatment of Endometriosis

Introduction: Endometriosis is a chronic disease characterizedby the proliferation of endometrial tissue outside the uterinecavity, and it occurs in 6% to 10% of women of reproductiveage and in 50% of infertile women. Current research aimed tostudy the safety and efficacy of dinogest 2mg daily in patientsof endometriosis for a period of 12 months.Material and methods: This study was a retrospective nonplacebo randomized trial done in the department of obstetricsand gynaecology, RMCH. Patient data was collected in a spanof 1year i.e; February 2018 to January 2019 and dinogestwas given for 12 months thereafter. Total 100 women postsurgery (cystectomy) with endometriosis were taken who hadbeen treated with 2mg of dinogest once a day for 12 months.We evaluated changes in endometriosis associated pain,endometrioma size, recurrence rate and adverse events.Result: Pain was significantly reduced at 12 monthsafter dinogest medication. The size of endometrioma wassignificantly decreased at the 12th month. Only 1 case ofsonographic recurrence was seen. The most common adversedrug reaction was uterine bleeding (1%) with minor sideeffects which became gradually tolerable.Conclusion: Administration of dinogest for a one yearperiod seems to be highly effective in preventing recurrenceafter surgery, there was marked reduction in endometriosisassociated pain and decreasing the size of recurrentendometrioma. So, it is very safe and tolerable drug fortreatment of endometriosis.

A Comparative Study of Injection Ferric Carboxymaltose and Iron Sucrose in Anaemia Complicating Pregnancy

Introduction: Anemia during pregnancy is most commonlycaused by iron deficiency anemia. It can cause severeconsequences for both the mother and developing fetus.Study aimed to compare the safety and efficacy of intravenousferric carboxy maltose (FCM) vs iron sucrose in anaemia inpregnancy.Material and Methods: This is prospective observationalstudy; all women treated with FCM and iron sucrose foranemia during pregnancy between May 2017 and April2018 at our Hospital were included. Total 110 women wereselected. Each study group contained 55 women receivingFCM which was group A and 55 in group B receivingInjection Iron Sucrose between 30 and 36 weeks of pregnancy.Treatment effectiveness was assessed by repeat Hemoglobinand Serum Ferritin level measurement after 2 weeks ofcompletion of therapy. Safety was assessed by analysis ofadverse drug reactions during infusion and 2 hours afterinfusion.Results: Intravenous ferric carboxymaltose infusionsignificantly increased Hemoglobin values compared toIntravenous ferrous sucrose. None of the women developedserious adverse reaction in FCM group.Conclusion: Ferric carboxymaltose can be used safely in Irondeficiency anemia complicating pregnancy.

Low Dose Ketamine in Labour Analgesia

Introduction: Ketamine is dissociative anaesthesia- acombination of profound analgesia with superficial sleep.This state is characterized by spontaneous ventilation, relativepreservation of airway reflexes and hemodynamic stability.The present study was designed to evaluate the efficacy ofprogrammed labour protocol in proving shorter, safer andrelatively pain free deliveries.Material and methods: This study was a randomised controltrial done in The Department of Obstetrics and Gynaecology,Rohailkhand Medical College and Hospital for a span of oneyear (October 2016 to September 2017).Result: In our study, the duration of labour, induction deliveryinterval was significantly reduced. Pain relief was excellent instudy group.Conclusion: Ketamine’s site of action appears to be primarilyin the thalamus and limbic systems, acting as N- methyl Daspartate receptor non- competitive antagonist. It does notsuppress respiratory drive unless high dosage are used, orsmall dosage given rapidly. Intravenous ketamine in low doseappears to be safe laternative to epidural analgesia.