A study to compare the efficacy and safety of intravenous iron sucrose and intramuscular iron sorbitol therapy for anemia during pregnancy.

AIMS AND OBJECTIVES: To compare the efficacy, safety, and rate of response of intravenous iron sucrose and intramuscular iron sorbitol therapy for anemia during pregnancy. MATERIAL AND METHODS: 100 antenatal cases of gestational age 14-32 weeks were included in this prospective study. Cases were randomly divided into two groups. Group A, having 50 cases received intravenous iron sucrose, and 50 cases in Group B received intramuscular iron sorbitol. Response to therapy in both groups was studied and compared. RESULTS: The mean pretherapy hemoglobin in group A was 6.49 gm/dl and in group B was 6.48 gm/dl. The rise in hemoglobin after 4 weeks of starting therapy was 3.52 gm/dl in group A and 2.33 gm/dl in group B. The difference was statistically significant (P < 0.01). The mean time taken to achieve target hemoglobin (≥11 gm/dl) was 6.37 weeks in group A and 9.04 weeks in group B. In group A, 8 % (four) cases had grade I adverse effects. In group B, 24 % (12) cases had grade I adverse effects. The difference was statistically significant (P = 0.027). In both the groups, no case discontinued the therapy. CONCLUSION: Intravenous iron sucrose is safe, convenient, more effective, and faster acting therapy than intramuscular iron sorbitol therapy for treating moderate to severe anemia during pregnancy.

Conjunctival autografting without fibrin glue or sutures for pterygium surgery.

PURPOSE: A prospective randomized case-control study conducted at a tertiary level eye care center to compare the outcomes of conjunctival autograft (CAG) with fibrin glue and CAG with patients' own blood acting as a bioadhesive in treating pterygium after surgical excision. METHODS: Twenty eyes of 20 patients with pterygium were randomly divided into 2 groups: group I (10 eyes) underwent CAG with fibrin glue and group II (10 eyes) underwent CAG with the patients' own blood coagulum acting as a bioadhesive or fixative. RESULTS: The time required for the surgery was compared. The patients were then closely followed up for a period of 12 months for anatomy, outcomes of graft, recurrence rate, graft displacement, retraction, inflammatory reaction, if any, graft failure, or any other complications. The duration of surgery was less in group I (mean duration, 14.74 ± 2.35 minutes) than group II (mean duration, 17.45 ± 2.89 minutes). We found that although the rate of recurrences was equal in grafts with the glue (10%) and the grafting with autologous blood (10%), the complications regarding graft displacement and graft retraction were more common in patients with grafting with autologous blood (10%) than in those with grafting with the glue. However, the difference was not found to be statistically significant (P = 0.3185). These complications were associated with larger grafts. CONCLUSIONS: This study suggests that autologous fibrin in blood is a useful alternative method for graft fixation in pterygium surgery. We found the newer procedure of autografing free of any untoward complication in small- to average-sized grafts.

Conjunctival flap in manual sutureless small-incision cataract surgery: a necessity or dogmatic.

To compare the surgical outcomes of manual sutureless small-incision extracapsular cataract surgery (MSICS) with versus without a conjunctival flap for the treatment of cataracts. Prospective, randomized comparison of 220 consecutive patients with visually significant cataracts. Tertiary level eye clinic. 220 consecutive patients with cataracts. Patients assigned randomly to receive either SICS with a conjunctival flap or without one. Operative time, surgical complications, surgically induced astigmatism. Both surgical techniques achieved comparable surgical outcomes with comparable complication rates. The operative time was markedly less in group without flap (mean duration of 7.67 ± 1.45 min) than in group with flap (mean duration of 11.46 ± 1.69 min) (p value <0.001). In the group without a flap intraoperative pupillary miosis was significantly greater (p value 0.039) and on postoperative day 1, there were greater patients with a subconjunctival bleed involving greater than one quadrant of the bulbar conjunctiva (p value <0.0001). Also, post operative conjunctival retraction and consequent wound exposure was also significantly higher in this group (p value 0.026). However, the rate of other serious complications like any postop hyphaema, conjunctival bleb formation, iris prolapse, tunnel stability, shallow anterior chamber, post operative uveitis, malpositioned IOL, retinal detachment, cystoid macular edema, endophthalmitis were comparable in both. Both MSICS with and without a conjunctival flap achieved good surgical outcomes with comparable complication rates. But flapless MSICS is significantly faster. However it may be associated with higher intraoperative miosis and greater postoperative wound exposure.