RESUMEN
AIMS: To determine the recurrent convulsion rate using low-dose magnesium sulphate regime in eclampsia and to identify toxicity and complications with clinical parameters. METHODS: Prospective study with two different magnesium sulphate regimes in two slightly clinically different subgroups. Group A that came directly to our hospital and group B who had already received an injection of diazepam or Phenergan at the referring hospital. Group A received 10 g and group B 6 g loading dose of magnesium sulphate. Both groups received 4 g maintenance dose every 4 h. RESULTS: Out of 95 eclamptic patients, only one woman in group B had recurrent convulsion. All women maintained normal respiratory rates. 39 (41.1%) women had absent knee jerks on at least one occasion when the maintenance dose was omitted. Urinary output was more than 30 ml/h in 92 (96.8%) women. In 5 women, maintenance dose had to be augmented to 5 g as reflexes were exaggerated. CONCLUSION: The low-dose regime appears to control and prevent convulsions effectively in Indian women. Clinical monitoring appears to be sufficient. We hope to be able to reassure health professionals at primary and secondary level hospitals about the safety of magnesium.
Asunto(s)
Anticonvulsivantes/administración & dosificación , Eclampsia/tratamiento farmacológico , Eclampsia/fisiopatología , Sulfato de Magnesio/administración & dosificación , Convulsiones/etiología , Convulsiones/prevención & control , Anticonvulsivantes/efectos adversos , Femenino , Humanos , Sulfato de Magnesio/efectos adversos , Embarazo , Estudios ProspectivosAsunto(s)
Vacunación Masiva/organización & administración , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus , Neoplasias del Cuello Uterino/prevención & control , Adolescente , Países en Desarrollo , Femenino , Humanos , India , Vacunación Masiva/economía , Infecciones por Papillomavirus/economía , Vacunas contra Papillomavirus/economía , Vacunas contra Papillomavirus/uso terapéutico , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/patología , Displasia del Cuello del Útero/diagnóstico , Displasia del Cuello del Útero/patología , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/virología , Organización Mundial de la SaludRESUMEN
Many countries have now adopted fortification, where folic acid is added to flour and intended to benefit all with rise in blood folate level. During many transformations of folate from one form to another, a proportion is accidentally converted to N(5)-methyl-THF, an inactive metabolite, the so-called "folate trap". Consideration should be given to including B(12) as well as folic acid in any program of supplementation or food fortification to prevent NTDs. This is especially applicable to developing countries like India where the majority of women are vegetarians and have borderline levels of vitamin B(12). Administration of [6S]-5-MTHF is more effective than is folic acid supplementation at improving folate status. Therefore, we urge to reconsider the "folate trap" in folic acid fortification programs.