Background: Anemia continues to affect one-third of the global population and is one of the most common reasons for large-scale morbidity and mortality especially among women. The importance of iron-rich diet has always been the backbone of preventing iron deficiency anemia (IDA) in vulnerable age groups followed by oral iron therapy and parenteral iron therapy as the next options in management of iron deficiency. Objective: Objective of this survey was to assess the knowledge, attitude and practices of obstetricians and gynaecologists relevant to anemia in pregnancy and identify the practice gaps in management of anemia in pregnancy. Methods: This was a knowledge, attitude and practice (KAP) survey involving obstetricians and gynaecologists (ObGyns) across India. A validated questionnaire of twenty questions was used to assess knowledge, attitude and practice about anemia and its management. Results were expressed as percentages. Results: 1974 ObGyns participated in the survey. 88.7% ObGyns screen anemia in first trimester, 53.7% ObGyns perform CBC along with RBC indices. Majority of ObGyns estimate Hb thrice during antenatal period. 50% ObGyns do not consider thalassemia screening routinely and deworming regularly. 92.4% ObGyns believe that iron supplementation is required even if Hb > 11 g/dL. Majority of them prefer low-dose iron therapy, 59.9% prefer to use 100 mg oral iron daily. Almost half of ObGyns prefer to change iron salt when patients do not respond, instead of escalating to injectable iron. Interestingly 52% ObGyns evaluate serum ferritin before starting intravenous iron therapy. 43.5% perform Hb estimation as early as 2 weeks after IV iron therapy. Majority (82.2%) of ObGyns prefer blood transfusion as a treatment of choice when Hb < 5 g/dl at 34 weeks gestation. Only 40.5% of participants are aware of the exact cut-off for diagnosing postpartum anemia. Majority of the ObGyns are aware of the iron prophylaxis in postpartum period till 3-6 months. More than 90% ObGyns consider intravenous iron for severe anemia of postpartum period. Conclusion: The present KAP survey highlights the observation, perception and the practicing behaviour of obstetricians and gynaecologists on anemia in pregnancy and identifies practice gaps in anemia management.
INTRODUCTION: Total knee replacement (TKR) is associated with significant blood loss in intra- and postoperative periods. This trial was designed to determine the efficacy of tranexamic acid (TXA) in the reduction of perioperative blood loss and the need for blood transfusion in patients undergoing primary TKR. MATERIALS AND METHODS: This study was performed at a tertiary care institute with 30 cases of primary unilateral TKR. The patients were randomly divided into two groups comprising 15 patients each. Group A comprised patients who received TXA by intravenous route and locally. Group B served as control, which comprised patients who had not received TXA. Patients were assessed in terms of intraoperative and postoperative blood loss, reduction in haemoglobin, the requirement of blood transfusion, and any untoward effects of TXA at 24 and 72 hours after surgery. RESULTS: In group A, the mean number of swabs used intraoperatively was 2.3 ± 0.5 swabs while in group B, the mean number was 4.3 ± 0.7 swabs (p = 0.0000). The mean drop in the postoperative haemoglobin concentration in group A was 0.6 gm/dl (24 hours) and 1.3 gm/dl (72 hours), with a mean postoperative drain collection of 247.3 ± 50.6 ml (24 hours) and 316.7 ± 55.6 ml (72 hours). In comparison, the mean drop in the postoperative haemoglobin in group B was 1.5 gm/dl (24 hours) and 2.3 gm/dl (72 hours), with a mean drain collection of 474 ± 30.7 ml (24 hours) and 453.3 ± 37.7 ml (72 hours) (p < 0.001). In group A, significantly fewer patients (four) required blood transfusion while 13 patients required blood transfusion in group B (p = 0.0004). CONCLUSION: The data from this study conclude that the use of TXA in TKR significantly reduces perioperative blood loss and the need for postoperative blood transfusion without significantly altering the liver and renal functions and coagulation profile of patients.
The goal of this study was to investigate the hepatoprotective effects of aqueous extract of Camellia sinensis or green tea extract (AQGTE) in chronic ethanol-induced albino rats. All animals were divided into 4 groups in the study for a 5-week duration. 50% ethanol was given orally to the rats with two doses (5 mg/kg bw and 10 mg/kg bw) of AQGTE. Ethanol administration caused a significant increase in the levels of plasma and serum enzymatic markers, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP), and nonenzymatic markers (cholesterol and triglycerides), lipid peroxidation contents, malondialdehyde (MDA), and glutathione-S-transferase (GST), and decreased the activities of total proteins, albumin, and cellular antioxidant defense enzymes such as superoxide dismutase (SOD). The elevation and reduction in these biochemical enzymes caused the damage in hepatocytes histologically due to the high production of ROS, which retards the antioxidant defense capacity of cell. AQGTE was capable of recovering the level of these markers and the damaged hepatocytes to their normal structures. These results support the suggestion that AQGTE was able to enhance hepatoprotective and antioxidant effects in vivo against ethanol-induced toxicity.
