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Background: Blood transfusion holds utmost importance in comprehensive obstetric care and Gynaecology. The present study has been done to evaluate the indications of blood transfusion in the Obstetrics and Gynaecology Department. Methods: The retrospective observational study was conducted between April 2023 to April 2024 in Department of Obstetrics and Gynaecology, Government Medical College, Saharanpur. Results: A total of 257 units of Blood was transfused between April 2023 to April 2024 in Obstetrics and Gynaecology Department. 60.6% transfusion were in age group 21-30 years. 48.26% transfusion were in hemoglobin 7-9 gm/dl. Most common blood group transfused was B positive 40.79% and 85.2% transfusion were packed red blood cell, 84.07% had single unit blood transfusion, 57.25% had transfusion for anemia in pregnancy, 36.84% transfusion were for abnormal uterine bleeding. Conclusions: Prevalence of anemia in reproductive age group is an important reason for blood transfusion in obstetrics and gynaecology. Hence emphasis should be to treat anemia through drugs to reduce unnecessary transfusion especially single unit transfusion.
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Waterlogging is one of the major constraints limiting maize (Zea mays L.) production in India and might become more common due to irregular precipitation pattern due to climate change. The objective of this investigation was to evaluate the efficacy of planting techniques by examining of physio-morphological, and productivity of excess water sensitive maize (Zea mays L.), under excess soil moisture stress (ESM). A field experiment was conducted during the kharif season 2020 at G.B. Pant University of Agriculture and Technology, Pantnagar. The experiment consisting of two planting methods (flat and ridge), under ponding conditions (30 DAS for 7 days) along with non-ponded condition was laid out in factorial randomized block design with three replications. The recommended dose of nutrients was120:60:40kgN: P2O5:K2O/ha. The physio-biochemical and yield characteristics of the plants at different times interval after planting were evaluated. Growing of maize on ridge bed maintain comparatively aerobic condition and give better anchorage to sturdy in excess moisture resulting lowest crop lodging (12.06%) and higher yield (3501kg/ha) by 7.2% compare to flat system (3268kg/ha). In comparison to non-ponded and ponded plant showed significantly maximum growth, however lowest crop lodging percent.
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Background: Hyperhomocystenemia and genetic variants are factors for causing young age stroke glob-ally. This study aims to identify homocysteine related-MTHFR gene polymorphism that associated with recurrent cardiovascular outcomes. Methodology: A randomized controlled trial conducted upon 90 hyperhomocysteinemic ischemic stroke patients were taken from the neurology wards of a tertiary care hospital were randomly selected into vitamin B therapy group and control groups (n=45 in each group). Baseline subject details were col-lected venous blood sample for MTHFR genetic testing via PCR-RFLP technique along with blood homo-cysteine levels, vitamin B12, folic acid levels. Results: The results showed that the frequency of CT genotype polymorphism was 15.5% vs 13.3% for the MTHFR C677T gene without any significant difference between vitamin group and control group re-spectively (p-value >0.05). The reduction in mean homocysteine up to -6.77±4.50 versus -2.08±0.71 μmol/L in the vitamin group as compared to control group respectively, p value 0.001. Conclusion: Considerable amount of MTHFR gene polymorphism found among hyperhomocysteinemic ischemic stroke of sub-Himalayan region. Nutritional deficiencies including vitamin B 12 & folic acid, and some hidden reasons found, which could lead to the primary cause of hyperhomocysteinemia. Vitamin B therapy is an effective for reducing homocysteine.
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INTRODUCTION:Because patients covered by medical insurance are being denied legitimate claims, doctors are working shoulder to shoulder with them and have garnered significant experience in this matter. We, therefore, decided to a systematic survey under the Medic LAWgic banner and presented the data.METHODS:A short, 8-question multiple-choice survey was conducted online among doctor clinicians. Duplicate replies were removed. The remaining replies were evaluated, interpreted, and the data are being presented here.RESULTS:A total of 377 doctors responded. The majority (208, 55%) had faced problems with medical insurance claims in more than 10% of their patients. Almost half of them (48%) had outright rejection of the claims in more than 10% of their patients. Reduction in claim amounts was faced in more than 10% instances by 262 (70%). The five most common causes for refusal or rejection of claims included failure of patient to disclose pre-existing illness (234, 62%), other insurance policy terms related issues (157, 42%), oral medication (199, 53%), treatment without admission (155, 41%), and treatment with new modes of therapy (152, 40%). As many as 301/377 (80%) doctors had written letters to the insurance companies for supporting their patients’ claim. Such supporting letters from the treating doctors resulted in the claim being accepted or approved in 216 instances (57%).DISCUSSION:Mediclaim denial is a major and growing problem. People who need financial assistance the most are also the most vulnerable to denial. In the USA, such denial rates ranged from 1% to 45% of in-network claims in the year 2017. Unfortunately, <0.5% of patients appealed such claim denial. The insurance regulatory and development authority of India (IRDA) have issued guidelines that all claims need to be settled within 30 days and that insurance companies must fulfill their contractual commitment for genuine claims, even if timely intimation was not possible. Insurance companies are running a business for profit. Hence, even the most expensive plans will have a list of exclusions, in the fine print. Indian patients need to be proactive in following up when claims are rejected or reduced. Doctors are their pillar of support, whose advantage needs to be taken by them. IRDA and consumer courts are also looking after patients’ rights in this matter.CONCLUSION:Patients are increasingly facing challenge of medical insurance companies denying legitimate claims. Doctors help by writing to the insurance companies supporting their patients claim and such letters help in the majority of instances. Patients and their families need to follow up aggressively when their claims are not approved, rejected or reduced. They should also request the help of their doctors when facing such challenges.
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Background & objectives: Progressive multifocal leucoencephalopathy (PML) is seen mostly in advanced human immunodeficiency virus (HIV) infection. Little is known about the epidemiology and disease course of these patients from India. This study was aimed to determine the frequency of PML in patients with HIV/AIDS, and the clinical features and survival of these patients. Methods: The charts of HIV/AIDS patients with PML seen over a period of five years (2006-2011) at the Antiretroviral treatment (ART) centre at a tertiary care centre in New Delhi, India, were retrospectively reviewed. Results: Of 1465 patients with HIV/AIDS, 18 (1.2%) were diagnosed with PML; four were laboratory confirmed and 14 had consistent clinical and radiological features. PML was the initial presentation of HIV infection in 10 (56%) patients, and 16 (89%) patients had CD4 count less than 200/μl. Insidious onset focal limb weakness (78%) and visual disturbance (28%) were common symptoms. Magnetic resonance imaging (MRI) of the brain revealed characteristic white matter lesions in all the patients. The estimated median survival was 7.6 months (95% CI, 0-20 months). Interpretation & conclusions: Our results show that the patients present late to access treatment with advanced immunosuppression at presentation. PML is associated with high morbidity and mortality despite institution of highly active antiretroviral therapy (HAART). There is a need to address the lacuna in diagnostic and management services for these patients in India.