Postpartum Haemorrhage (PPH) remains a significant cause of maternal mortality and morbidity. This prospective cross sectional study was done at the Obstetrics and Gynaecology Department of Dhaka Medical College, Dhaka from January 2013 to July 2013. The objective is to detect the risk factor of primary postpartum haemorrhage. This study shows most of the patients (45%) belonged to 26-30 years age group. The most of the patients (88%) developed PPH after vaginal delivery whereas 12% patient developed PPH after cesarean section. Causes of PPH included atonic uterus in 57 patients, retained bits of placenta in 14 patients, cervical tear in 13 patients, vaginal tear in 9 patients and others in 8 patients (inverted uterus, ruptured uterus). Prolonged labor, grand multiparity, Pre-eclampsia/Eclampsia, multiple pregnancy, polyhydramnios, macrosomia and instrumental delivery were the common risk factors.
Transfusion of blood components and derivatives in day care unit is an eminent part of management of transfusion dependent patients. Day care transfusion service is an alternative to hospital admission and beneficial for those patients who receive blood more frequently for their survival. The aim of present study is to assess Transfusion Services provided in a Day Care Unit (DCU) of a tertiary care hospital. This study was carried out in DCU of Transfusion Medicine Department, Bangabandhu Sheikh Mujib Medical University, (BSMMU), in Dhaka during January to December 2014. Data were collected from record registers. Recorded retrospective data were analyzed as percentage and proportion. Total recipients were 718. Among those 424 (59.05%) were male and 294 (40.95%) were female and 562 (78.27%) were between 10 to 40 years. A total of 8587 units of blood components were used during this period. Red Cell Concentrate was most commonly utilized product 6388 (74.39%) followed by FFP 1360 (15.83%), Platelet Concentrate 544 (6.33%), Whole blood 260 (3.05%) and Cryoprecipitate 35(0.40%). Transfusion was required more frequently in thalassaemic 365(50.88%) patients. Haemophilia 77(10.72%) and aplastic anaemia patients 49 (6.82%) were next high. The main transfusion reaction observed during transfusion was febrile non-haemolytic reactions. For increasing use of specific blood product and hassle free transfusion services this kind of day care unit services should be strengthened. Long term study of this kind will help us to develop safe clinical transfusion practice. Bangladesh Med J. 2019 May; 48 (2): 28-31
Background Hypogonadism is one of the most frequent complications in transfusion-dependent thalassemia patients, and early recognition and treatment is the core element to restore impaired gonadal function. Despite the high burden of disease, relevant studies are scarcely addressing the gonadal function of such patients. The pattern of gonadal function in transfusion-dependent thalassemia patients must be picturized before planning a generalized management plan; therefore, this study was conducted. Methods This cross-sectional study was conducted at the Department of Transfusion Medicine of Bangabandhu Sheikh Mujib Medical University. According to inclusion and exclusion criteria, a total of 94 patients were enrolled in this study. A detailed history and thorough clinical examination were carried out in each patient and recorded using a pretested structured questionnaire. In addition, laboratory assessment of LH, FSH, testosterone and estradiol in serum were also done. Data were analyzed using STATA (v.16). Results The mean age of the patients with transfusion-dependent thalassemia was 18.81±4.65 (SD), with 53.3% of the patients being male. The most common symptoms of gonadal dysfunction among males were loss of body hair (6%) followed by fatigue (4%), and among females were slow or absent breast growth, hot flashes and amenorrhea (6.82% each). Conclusion The overall prevalence of hypogonadism was 35.11%, 18.1% being normogonadotropic, 11.7% being hypogonadotropic, and 5.3% being hypergonadotropic. Therefore, gonadal hormone analysis of transfusion-dependent thalassemia patients can be considered a screening tool for assessing gonadal function and early detection and prevention of hypogonadism.
Moyamoya is a rare cerebrovascular disease of unknown etiology. It can affect both children and adults. Ischemic symptoms are common in younger age while adults presents with intracranial hemorrhage. Cerebral ischemia after hemorrhage within a narrow time frame or simultaneous presentation with both hemorrhage and ischemia in the same clinical setting is a rare encounter. Diagnosis is confirmed by doing cerebral angiogram. Here, we report a case of 46-year-old man who presented with hemiparesis and imaging of brain showed ishaemic stroke initially and subsequently he also developed haemorrhagic stroke. Later, magnetic resonance imaging and digital substraction angiogram of brain confirmed Moyamoya disease. He was managed conservatively with significant improvement of his hemiparesis. Bangladesh Med J. 2019 Jan; 48 (1): 54-58
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