Blood transfusion in obstetrics.

Transfusion of blood and blood components is a common practice in obstetric wards but it is not without risk. The incidence of transfusion reactions varies from 4 in every hundred transfusions for non-haemolytic reactions to one in every 40,000 for haemolytic transfusion reactions. The physiological basis of blood transfusion is outlined in this article. Most of the donated blood is processed into components: packed red cells (PRBCs), platelets, and fresh frozen plasma (FFP) or cryoprecipitate. Various alternatives to blood transfusion exist and include autotransfusion, pre-autologous blood storage, use of oxygen carrying blood substitutes and intraoperative cell salvage. Despite the risks associated with transfusions, obstetricians are frequently too aggressive in transfusing blood and blood products to their patients. Acute blood loss in obstetrics is usually due to placenta praevia, postpartum blood loss and surgery related. An early involvement of a consultant obstetrician, anaesthetist, haematologist and the blood bank is essential. There are no established criteria for initiating red cell transfusions and the decision is purely based on clinical and haematological parameters, which have been discussed along with the general principles of blood transfusion in obstetrics and some practical guidelines.

Relationship between n-3 and n-6 plasma fatty acid levels and insulin resistance in coronary patients with and without metabolic syndrome.

BACKGROUND AND AIMS: Animal studies show that ecosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are effective for the prevention and treatment of insulin resistance (IR). Data from human studies are contradictory. We sought to determine whether the relationships between plasma n-3 and n-6 polyunsaturated fatty acid (FA) levels and IR differ according to the presence or absence of metabolic syndrome (MS) in a coronary heart disease sample. METHOD AND RESULTS: Clinical, metabolic parameters, plasma phospholipid FA profiles and indirect measurement of IR (homeostatic model assessment-HOMA) were measured in 734 subjects, 8 weeks following acute coronary syndrome. FA levels and their correlations with IR were compared in subjects with and without MS. MS patients had higher saturated (16:0, 18:0) and n-6 (18:3n-6, 20:3n-6, 22:4n-6, 22:5n-6) FA levels, and lower EPA and DHA levels. HOMA-IR correlated positively with total saturated (r=0.13, P=0.017) and n-6 (r=0.17, P=0.001) FA levels and negatively with total n-3 FA levels (r=-0.13, P=0.012), in MS subjects only. Total n-3 and n-6 FAs and n-6/n-3 ratio were associated with HOMA-IR levels in MS subjects independent of total saturated FA levels, age, sex, sedentary behaviour, smoking, waist circumference, triglycerides, HDL-cholesterol, and systolic blood pressure. CONCLUSIONS: Relationships between polyunsaturated FA type and IR vary according to the presence or absence of MS. N-3 FAs including EPA and DHA are associated with lower HOMA-IR, while the opposite is true for n-6 FAs. Prospective studies are required to address the potential effects of intermediate dose EPA and DHA on glucose handling in MS patients.

Bioremediation of crude oil contamination with Acinetobacter sp. A3.

Acinetobacter sp. A3 is able to extensively degrade Bombay High Crude Oil (BHCO) and utilize it as the sole source of carbon. A total degradation of 70% BHCO was noted by the end of 120 h of growth of Acinetobacter sp. A3 under shake flask condition, 60% of which was due to biodegradation. In crude oil-contaminated soil (5%) amended with Acinetobacter sp. A3, there was both an increase in colony-forming units (CFU) and crude oil degradation. This is in contrast to a decrease in CFU of the indigenous microorganisms and lower degradation in unamended soil within the same 30-day period. Also, Acinetobacter sp. A3-treated soil permitted better germination of Mung beans (Phaseolus aureus) and growth as evidenced by better length and weight of the plants and chlorophyll content of its leaves, which was attributed to the reduction in phytotoxicity of the crude oil owing to its degradation. This crude oil degradative capability of Acinetobacter sp. A3 could be exploited for bioremediation purposes.