Correlation Between Mean Red Cell Transfusion Demand And Chelation Therapy In Multiply Transfused Thalassemia Major Patients.

Abstracts: Background & Objective: Life long red blood transfusion remains the main treatment for β thalassemia major patients. Transfusion-dependent patients, in the absence of chelation therapy, develop progressive accumulation of iron, which is responsible for tissue damage and, eventually, death. The factors, which influence the iron burden are type of chelation therapy and mean red cell transfusion requirement. Increasing red cell transfusion requirement, iron deposit and development of all antibodies complicates transfusion therapy in thalassemia patients. Aim is to investigate the patients for the red cell transfusion requirement compared on the basis of iron overload and type of chelation therapy. Methodology: Ninety eights patients were included in this study and samples collected and investigated for the red cell transfusion requirement, compared on the basis of iron overload and type of chelation therapy.Conclusion: Combination of two iron chelators (such as parenteral desferroxamine plus oral deferiprone) have been shown to produce additive and synergistic effects, may produce enhanced iron excretion, minimize side effects, decrease mean red cell transfusion requirement and improve compliance is strongly recommended in transfusion dependent thalassemia patients.

Pregnancy Following Surgery Of Multiple Pelvic Hydatid Cysts.

Abstracts: Background: Hydatid cyst in pelvic region is very rare. A patient was admitted in Gynaec ward with complaints of , lump and pain in lower abdomen and, constipation since, five months. General examination was normal. Abdominal and gynaecological examination lead to diagnoses as ovarian cyst ? Multiple uterine subserous fibroids? Ultra sonography diagnosis was Hydatid cysts abdomen / Mucininious cystadenoma ovaries . CT Scan abdomen and pelvis confirmed USG findings of Hydatid cysts. On Laprotomy multiple hydatid removed from pelvic region , omentum , ileocaecal junction and liver . Patient put on chemotherapy and follow up was satisfactory.

Prevalence and Incidence Of Transfusion Transmitted Infections Amongst VNRBDs In Central India.

Abstracts: Background: The aim of this study is to present the status of transfusion –transmitted infections among the apparently healthy donors so as to increase the awareness of complications of blood transfusion and make the clinicians more vigilant with regard to judicious use of blood. Methodology: A total of 15322 units of donor’s blood were screened from January 2008 to December 2010 at blood bank of C R Gardi Hospital and R D Gardi medical college. Results and Conclusion: The result of screening showed total seropositive samples for hepatitis B were 288 (1.88%), hepatitis C 52 (0.34%), human immunodeficiency virus 57 (HIV; 0.37% ) and Venereal Disease Research Laboratory Test 135 (VDRL; 0.88%) by using enzyme linked immunosorbent assay (ELISA ) methods, and rapid plasma regain (RPR) method for syphilis.

An Unusual Presentation of Choriocarcinoma.

Gestational choriocarcinoma is a highly malignant tumor of trophoblastic cells with a propensity to metastasize to various sites including lungs, vagina, brain, liver, kidney, and gastrointestinal tract, in descending order of frequency. Usually it is treated by chemotherapy but rarely hysterectomy is indicated if bleeding is heavy, or if tumor is resistant to chemotherapy A 45-year-old woman presented to the hospital as an emergency with heavy bleeding per vagina since 4 days preceded by abdominal pain. H/O spontaneous abortion of 5months pregnancy 2 yrs back and was asymptomatic since 2years. Investigations showed severe anemia and high level of β-hCG. She underwent Total abdominal Hysterectomy for heavy bleeding and Histopathology revealed it to be a case of gestational choriocarcinoma. Chemotherapy was given pre and postoperatively and resulted in complete cure.

Twin to twin transfusion endangering the mother.

There was a case of Twin to twin transfusion syndrome (T.T.T.S.) with one dead monster baby and other alive low birth weight baby, leading to early Disseminated Intravascular Coagulation(D.I.C) in mother, in Obstetric ward of C.R. Gardi Hospital Ujjain, (M.P) India.

Primary internal iliac artery ligation – an effective technique for surgical hemostasis in wertheim’s hysterectomy.

Objective: Lessening intra-operative blood loss by the technique of bilateral internal iliac artery ligation as 1st step in Wertheim’s Hysterectomy. Methods: 20 cases of early Stage Cancer Cervix, who underwent Wertheim’s hysterectomy over period June 09 to Dec 12 in CRG Hospital, Ujjain and Base Hospital Delhi Cantonment, were studied. The demographic data, hemoglobin before and after surgery, and requirement of intra-operative blood transfusion, were studied. Results : 80% patients had less than 200ml intra-operative blood loss. Conclusion : Alleviating troublesome bleeding during dissection of lymph nodes and ureteric tunnel by primary ligation of internal iliac artery is a statistically proven optimum technique of Wertheim’s Hysterectomy.

A prospective study for comparison of hematological parameters in healthy young adult and elderly age group subjects.

Aims & Objectives: This study of hematological parameters is the object of continuing intensive research of hematopoietic system to the functional integrity in aging. (1) Assessment of Hb, total RBC count in healthy young adult as well as in elderly subject.(2) Assessment of Hct & blood indices (MCV, MCH, MCHC) in healthy young adult as well as in elderly subject.(3) Comparing the values of Hb & total RBC count in healthy young adult with the elderly subject.(4) Comparing the values of Hct & blood indices (MCV, MCH, MCHC) in healthy young adult with the elderly subject.(5) To co-relate the results of present study with findings of other studies. Material & Methods: The hematological indices analysed were Hb, HCT, and Total RBC Count, Blood indices like MCV, MCH & MCHC. Hematological values were measured by the different method in laboratory with the use of standard test reagent. Results: In present study, the result shows that a significant decrease in Hb concentration and RBC count are associated with decrease in Hct, MCH, MCHC and little increase in MCV. Conclusion: In present study, the overall assessment shows that a significant decrease in Hb concentration, reticulocyte count and RBC count are associated with decrease in Hct, MCH, MCHC and little increase in MCV. These results show a significant decrease in haematological parameters in old age and fairly accurate reflection of decreased erythropoietic activity of bone marrow.

Endometrial thickness as a test for endometrial cancer in women with abnormal postmenopausal and perimenopausal vaginal bleeding & its histopathological correlation.

Introduction: The menopausal & perimenopausal age are characterized by a deficiency of progesterone and relative hyperestrogenism leading to increased risk of carcinoma endometrium. Transvaginal ultrasonography is used to evaluate the thickness of endometrium in perimenopausal & postmenopausal women presenting with abnormal bleeding per vaginum & its histopathological classification was done. Material & Methods: This retrospective study was carried out in R D Gardi Medical College and Hospital, Ujjain. Seventy five cases were selected from May 2010 - May 2012 and studied in respect to age,parity,socio-economic status, and endometrial thickness in women with abnormal bleeding per vaginum & its relation to histopathology findings of endometrium obtained through D & C. Results:Out of seventy five cases, 49(65.5%) were in perimenopausal age group, and 26(34.5%) in postmenopausal age group. Endometrial thickness greater than 12mm was in 73.4% of perimenopausal and 25.3% of postmenopausal women. In perimenopausal women with abnormal bleeding,histopathology showed‘Benign Hyperplasia’in 51%, ‘Proliferative endometrium’in 26.5%, ‘Secretary endometrium’ in 4.08%, ‘Atrophic endometrium’ in 2.04%, ‘Atypical Hyperplasia’ in 10.2%, andcarcinoma in 6.12%.Whereas in postmenopausal women, Atypical Hyperplasia in 11.4%, carcinoma in 46.12%,benign hyperplasia in 7.6%, proliferative endometrium in 15.33%, secretary endometrium in 7.69%, and atrophic in 11.4%. Conclusion: In majority endometrial thickness by TVS may be helpful in planning investigation protocol and further management.

A comparative study of reticulocyte count in healthy young adult and elderly age group subjects.

Introduction: Aging process has been viewed as progressive decline in physiological process necessary for maintenance of a constant milieu interior and death as the ultimate failure to sustain homeostasis. Reticulocytes are juvenile red cell. It is flat non-nucleated disc shaped, slightly larger than mature erythrocyte .The number of reticulocyte present in the peripheral blood is a fairly accurate reflection of erythropoitic activity of bonemarrow. Normal values in young adult- 0.5 to 2.5% of total RBC count. The present study was conducted to find out changes in the reticulocyte count in the elderly subject. Aims: to uncover the effect of aging on reticulocyte count. Material and method: 90 subjects were divided into two groups, normal control group (n=30, mean age 35.83yrs) and elderly group (n=60, mean age62.55yrs). Reticulocyte counts were done by new Methylene Blue method. Result & Observations: significant decrease in reticulocyte count was observed in elderly group as compare to normal control group. Conclusion: our data suggests that aging may alter haematological parameters including reticulocyte count.

Autologous platelet gel and its clinical application.

Platelets are attracted to a wound or injury site stimulating the clotting and healing cascades. Degranulated platelets release numerous substances including proteins known as growth factors. Growth factors signal undifferentiated stem cells to the site, promote cell mitosis, and stimulate osteogenesis and angiogenesis. Cytokines, which attract neutrophils, are also released from platelet granules. Concentrating platelets 4x to 5x the baseline level accelerates the healing process. When platelet rich plasma is mixed with an activator, a platelet gel will form. Clinical applications of platelet gel are numerous. Some benefits include a marked decrease in post-surgical swelling and bruising, reduction in surgical site pain, elimination of drains, and acceleration of bone growth and soft tissue healing. Scientific publications support that autologous biomaterial accelerates the healing process.

Aging and its theories.

Several factors (the lengthening of the average and, to a lesser extent, of the maximum human life span; the increase in percentage of elderly in the population and in the proportion of the national expenditure utilized by the elderly) have stimulated and continue to expand the study of aging. Recently, the view of aging as an extremely complex multifactorial process has replaced the earlier search for a distinct cause such as a single gene or the decline of a key body system. This mini review keeps in mind the multiplicity of mechanisms regulating aging; examines them at the molecular, cellular, and systemic levels; and explores the possibility of interactions at these three levels. The heterogeneity of the aging phenotype among individuals of the same species and differences in longevity among species underline the contribution of both genetic and environmental factors in shaping the life span. In this mini review, several theories are identified only briefly; a few (evolutionary, gene regulation, cellular senescence, free radical, and neuro-endocrineimmuno theories) are discussed in more detail, at molecular, cellular, and systemic levels.