To reduce maternal mortality and morbidity caused by bleeding, it is important to reduce the amount of bleeding during and after lower segment caesarean section (LSCS). Tranexamic acid helps to reduce bleeding during and after LSCS. OBJECTIVES: To study the efficacy and safety of Tranexamic acid in reducing blood loss during and after Lower segment Caesarean Section (LSCS). METHODS: A randomized case controlled prospective study was conducted on 200 women undergoing lower segment cesarean section. Hundreds of them that were given tranexamic acid immediately before LSCS were compared to hundred others to whom tranexamic acid was not given. Blood loss was collected and measured during the two periods, from plancental delivery to end of LSCS and second from end of LSCS to two hours postpartum. RESULTS: Tranexamic acid significantly reduced the quantity of blood loss from placental delivery to end of LSCS, 202.25ml in the study group vs392.20 ml in the control group (p<0.001); from the end of LSCS, to 2 hours postpartum 3.80ml in the study group versus 112.25ml in the control group (p<0.001); In totality, it significantly reduced the quantity of blood loss from placental delivery to two hours postpartum i.e. 27.05ml in the study group versus 510.45ml in the control group (p < 0.001). No complications or side effects were noted. CONCLUSION: Tranexamic acid significantly reduced the amount of blood loss during and after LSCS. Tranexamic acid can be used prophylactically; moreover it is safer and effective in women undergoing LSCS.
BACKGROUND The frontline workers including nurses need to be focused in creating awareness and reducing the cultural and emotional barrier about breast screening among the female patients and community they come across. The objective of the study is to determine the knowledge and attitude regarding risk factors, symptoms and screening of breast cancer among nursing students and staff of a tertiary care centre.
Abstract:Introduction: Under RNTCP, the diagnosis of 25-30% tuberculosis cases with negative bacteriological report with radiographic evidence and with smear negativity due to inability to expectorate adequate amount of sputum are left untreated which ultimately increases the burden of tuberculosis. Such cases can be subjected to induction methods to improve yield of positive result in sputum. Methodology: Study was undertaken on all 538 patients who attended the Chest and Tuberculosis department in DOTS Microscopy centre of HIMS. Intervention was done only in those found smear negative but clinically and radiologically suggestive of pulmonary tuberculosis who gave written consent i.e. = 92 subjects (Chest Physiotherapy (N=92); Nebulization (N=92) & Broncho-alveolar lavage (N=14). Results: Out 362 (67%) eligible subjects 228 were sputum negative, 92 patients gave consent for induction were subjected to chest physiotherapy for sputum induction of which 38 (41.3%) subjects came out to be sputum positive. Out of 92 patients subjected to nebulization for sputum induction 40 (43.4%) subjects yield sputum positive result. 14 patients were subjected to BAL (bronchoalveolar lavage) method to collect sputum sample of which 7(50%) came out to be sputum positive. (p=0.02). Conclusion: The non-invasive and cost effective methods of sputum induction should be incorporated more commonly in national programme as they provide better yield of sputum positivity.
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