Comparison of the Therapeutic Effects and Side Effects of Oral Iron Supplements in Iron Deficiency Anemia.

OBJECTIVE: Iron deficiency anemia is an important public health issue, especially for infants, children, and women with menorrhagia. Oral iron supplements are the cheapest, safest, and most effective treatment. This study compared the therapeutic and side effects of ferrous and ferric in iron deficiency anemia. METHODS: This was a retrospective study on data collected between April 2012 and October 2013 for patients with iron deficiency anemia who continuously took oral ferric for over one month and then switched to oral ferrous due to poor therapeutic effects. The exclusion criteria were the use of other oral or injected iron preparations, erythropoietin, or vitamin B12. RESULTS: A total of 41 participants were recruited. The average participant age was 44.76±16.89 years; most participants were females (95.1%; 39/41); the average daily dose of oral ferric (139.02±49.39 mg) was higher than that of ferrous (96.34±23.43 mg). Repeated measures: mixed model analyses were conducted to examine patients' clinical blood test values. The results showed that the mean blood test values for all patients significantly increased after switching to ferrous (p<0.01, with the exception of mean corpuscular hemoglobin). One patient experienced gastrointestinal discomfort and diarrhea after switching to ferrous. CONCLUSION: This study found that blood test values improved after iron deficiency anemia female patients who displayed poor therapeutic effects with oral ferric switched to ferrous. Literature review showed that the risk for gastrointestinal problems with ferrous is higher than that with ferric. However, no significant difference was found in this study.

Development of a solid-phase microextraction/reflection-absorption infrared spectroscopic method for the detection of chlorinated aromatic amines in aqueous solutions.

In this paper, the reflection-absorption infrared (IR) spectroscopic method combined with the principle of solid-phase micro-extraction (SPME) is proposed to detect chlorinated aromatic amines in aqueous solutions. This proposed method provides simplicity in both the optical system and equipment setup. Compared to the SPME/attenuated total reflection-IR method, this method reduces the cost for internal-reflection elements and optical systems. Meanwhile, it has no SPME/transmission IR method problems, which require high polymer film preparation techniques to obtain a standing film that has no physical/chemical property changes when immersed in an aqueous solution. The typical linear coefficients obtained using this method for chloroanilines in aqueous solutions are around 0.995 and the detection can be lower than 100 ppb. The thickness of the hydrophobic film is relatively important in the SPME/ATR-IR method, but the uncertainty caused by the film thickness can be partially eliminated in the proposed method. This is because the IR signals are proportional to the film thickness and can be corrected using hydrophobic film signals. The low detection limits have also indicated that this proposed method can compete with the currently existing IR methods, but allowing much simpler detection.

Role of laparoscopic assisted vaginal hysterectomy in gynecology.

One hundred and thirty laparoscopic assisted vaginal hysterectomies (LAVH) were performed at Chang Gung Memorial Hospital. All hysterectomies were for indications of the uterus, endometriosis, and extensive adhesions. Some of the patients also underwent concomitant procedures including unilateral or bilateral salping-oophorectomy, vaporization and/or excision of endometriosis, lysis and/or excision of adhesions. Kleppinger bipolar forceps were used for large vessel hemostasis and excision of adhesions in all the patients. CO2 laser was used for vaporization and excision of endometriosis. The complication rate was 10.0%. This included febric morbidity, intraoperative bladder injury, partial small bowel obstructions and thermal injury of the sigmoid colon. Four patients required laparotomy either to complete the procedure or to manage the complications. The mean blood loss was 160 ml and the mean hospital stay was 2.2 days. The mean operating time was 148 minutes and the mean age of the patients was 42.3 years. Two weeks after surgery, the majority of the patients were permitted to drive and resume normal nonstrenuous physical activity. The majority of the surgeries were videotaped. The study demonstrates that a hysterectomy can be safely performed laparoscopically by the well trained laparoscopic surgeon, resulted in reduced surgical morbidity, blood loss, postoperative discomfort and pain, shortened hospital stay and recovery.

Major complications during laparoscopy-assisted vaginal hysterectomy--report of four cases and review of the literature.

This paper presents four recent cases of complications resulting from of a total 130 cases of laparoscopy-assisted vaginal hysterectomies performed at Chang Gung Memorial Hospital from March 1991 till January 1993. These included two cases of bladder injury, one case of vessel laceration and one case of colon injury. In addition, the literature about complications occurring at laparoscopy are reviewed and classified. This paper will: 1. present precautionary measures for avoiding intraoperative complications; 2. describe management of complications.