SummaryDeleted in Malignant Brain Tumours 1 (DMBT1) is a secreted scavenger receptor cysteine-rich protein that binds and aggregates various bacteria and viruses in vitro. Studies in adults have shown that DMBT1 is expressed mainly by mucosal epithelia and glands, in particular within the respiratory tract, and plays a role in innate immune defence. We hypothesized that respiratory DMBT1 levels may be influenced by various developmental and clinical factors such as maturity, age and bacterial infection. DMBT1 levels were studied in 205 tracheal aspirate samples of 82 ventilated preterm and fullterm infants by enzyme-linked immunosorbent assay. Possible effects of various clinical parameters were tested by multiple regression analysis. DMBT1 levels increased significantly with lung maturity (P < 0·0001 for both gestational and postnatal age) and in small-for-gestational-age infants (P = 0·0179). An increase of respiratory DMBT1 levels was detected in neonatal infections (P < 0·0001). These results were supported by Western blotting. Immunohistochemical analyses of archived newborn lung sections (n = 17) demonstrated high concentrations of DMBT1 in lungs of neonates with bacterial infections. Our data show that preterm infants are able to up-regulate DMBT1 in infection as an unspecific immune reaction.

Aim The third stage of labour commences after the delivery of the foetus and ends with the delivery of the placenta and its membranes. Postpartum haemorrhage is the most common cause of maternal mortality and accounts for about 25 % of maternal deaths in India.

Introduction Anti-fibrinolytic agents are used to reduce obstetric blood loss as the fibrinolytic system is known to get activated after placental delivery. Objectives To evaluate the efficacy of parenteral tranexamic acid in reducing blood loss during normal labour and to compare it with the amount of blood loss in patients who received placebo in the third stage of labour. Methodology Patients with spontaneous labour or planned for induction of labour and fulfilling the inclusion criteria were recruited for the study. In each patient, the pre-delivery pulse rate, blood pressure, Hb gm% and PCV% were noted. Labour was monitored carefully using a partogram. The study group received Inj. Oxytocin and Inj. Tranexamic acid. The control group received Inj. Oxytocin and Placebo injection. Immediately after delivery of the baby, when all the liquor was drained, the patient was 123 placed over a blood drape-a disposable conical, graduated plastic collection bag. The amount of blood collected in the blood drape was measured. Then the patient was given preweighed pads, which were weighed 2 h post-partum. The blood loss was measured by measuring the blood collected in the drape and by weighing the swabs before and after delivery. Results The total number of patients studied was 100-equally distributed in both the groups. The age group of the patients and BMI were comparable. There was a significant increase in the pulse rate and decrease in blood pressure in the control group as compared with the study group. The post-delivery haemoglobin and haematocrit were significantly reduced in the control group as compared to the study group. The mean blood loss at the end of 2 h was 105 ml in the study group and 252 ml in the control group. There was a significant increase in the usage of uterotonics and also in the need for blood transfusion in the control group; 12 % of the patients in the control group had to stay for more than 3 days compared to 2 % in the study group. Conclusion Tranexamic acid injection, an antifibrinolytic agent when given prophylactically after the delivery of the baby, by intravenous route appears to reduce the blood loss and maternal morbidity during normal labour effectively.

Antepartum haemorrhage is one of the obstetrical emergencies complicating pregnancy. Adverse materno-fetal outcomes are commonly seen complicating APH. This study was undertaken with the following. OBJECTIVES: Analysis of APH in pregnancy 1) Maternal and fetal outcome in APH complicating pregnancy 2) Measures to reduce maternal and perinatal morbidity and mortality. METHODS: Cases satisfying. Inclusion criteria: pregnant woman >28 weeks attending department of OBG, JSS Hospital, Mysore on inpatient basis with history of APH during the study period. Exclusion Criteria: None. 40 cases with APH admitted to JSS Hospital Mysore were studied with respect to maternal fetal outcome till the time of discharge. RESULTS: Abruption was the commonest cause of APH with its associated maternal morbidity and perinatal mortality and morbidity. Prematurity of the neonate was a serious complicating factor in APH. No maternal mortality was seen in this study. CONCLUSION: Overall incidence of APH has remained high. It still continues to constitute a major portion of obstetrical hemorrhage. With timely intervention and with resuscitation facilities available maternal mortality and morbidity can be reduced. Perinatal mortality with abruption remains to be high. Perinatal morbidity can be reduced with good neonatal intensive care facilities.

Chronic nonpuerperal inversion of the uterus is uncommon and is usually associated with a fundal submucous myoma extrusion. We report herewith the case of a young lady with hitherto asymptomatic long standing mass per vagina presenting acutely with vaginal bleeding and shock. The mass was a uterine myoma. She underwent hysterectomy in view of extensive necrosis.

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