Iron deficiency anemia is the most frequent nutritional deficiency disorder. Conventionally administered oral iron is associated with gastrointestinal intolerance that affects the outcomes and compliance. Liposomal iron is associated with increased absorption without causing significant adverse effects. In this review, we have discussed the technology of liposomal iron preparation, mechanisms of its absorption and clinical evidence on its utility in iron deficiency states in pregnant and non-pregnant women. Based on the available evidence, we compared liposomal iron to conventional oral iron. Encapsulation of micronized iron in liposomes is associated with lesser exposure to gastric contents, lesser interaction with food contents, no exposure to different digestive juices, targeted delivery of iron and allows lower doses to be administered in lieu of direct absorption without need for protein carriers. The available evidence suggests that liposomal iron significantly increases hemoglobin, ferritin levels in pregnant women as well as in women with iron deficiency.
Background & objectives:The genesis of atherosclerotic lesions, a major cardiovascular risk factor starts in the early stage of life. If the premature development of cardiovascular risk factors can be anticipated during childhood, cardiovascular events can be prevented effectively by taking appropriate measures. This study was carried out to assess the role of in utero malnutrition in cardiovascular disease development by comparing cord blood lipid profiles and serum insulin levels between small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) term newborns.Methods:Consecutive full-term infants who were born between June 20 and August 19, 2013, at the Obstetric Unit of a Hospital at Secunderabad, India, were enrolled in this study. Participating newborns were divided into SGA group (n = 51; test group) and AGA group (n = 52; control group) based on their gestational age and body weight. Cord blood lipid profile and insulin levels were compared between these two groups.Results:As compared to the newborns in AGA group, SGA group of newborns had significantly (P<0.01) higher levels of cholesterol, triglyceride and low-density lipoprotein. No difference was observed between the groups for high-density lipoprotein and insulin levels. Mild and moderate anaemia was observed among mothers of both groups, while severe anaemia was seen in mothers of SGA group only.Interpretation & conclusions:SGA newborns exhibited elevated lipid profiles as compared to AGA newborns. Hence, SGA newborns should be closely monitored for cardiovascular morbidities during childhood, adolescence and early adult life.
Iron deficiency is the most common nutritional deficiency leading to anemia in pregnancy. Conventionally, non-heme form of iron salts has been the mainstay of treatment. However, patient compliance is an important concern with existing oral iron therapy due to gastrointestinal side effects. Heme iron, a better bioavailable and tolerable form of iron can be suitable form of iron for supplementation in pregnancy. Evidence suggests its utility in pregnancy for treatment of iron deficiency anemia with benefits extending to postpartum period. Effective transfer across placenta to fetus further supports its utility in pregnancy. This review discusses in details the absorption kinetics along with clinical evidence on efficacy, safety, and tolerability of heme-iron supplementation in iron deficiency anemia of pregnancy.
Urinary incontinence (UI) is defined as the complaint of any involuntary loss of urine. UI can be slightly bothersome or totally debilitating. For some women, the risk of public embarrassment prevents them from enjoying many activities with their family and friends.Women are four times more likely to be affected by UI compared with men. Stress urinary incontinence (SUI) is the most common type of UI in women below age 60 and accounts for almost 50% of incontinence in all women.The minimum evaluation in women with symptoms of uncomplicated SUI includes history, urinalysis, physical examination, assessment of urethral mobility, demonstration of SUI, and measurement of postvoid residual urine volume. Additional diagnostic evaluation with multichannel urodynamic testing is helpful in women with complicated SUI, especially before surgical treatment. Clinical decision should help the health care providers to perform preoperative multichannel urodynamic testing or refer to an expert in urology who is skilled in female pelvic medicine and reconstructive surgery.
Background: Gestational Diabetes Mellitus (GDM) refers to glucose intolerance diagnosed at onset or first recognition during pregnancy. Women with GDM are at risk for maternal and foetal complications, so it is important to screen all pregnant women. The present study was carried out to determine the significance and use of the 75 g Oral Glucose Challenge Test (OGCT) using the Diabetes in Pregnancy Study Group India (DIPSI) criteria for screening of GDM. Objectives: This study was planned to analyze the incidence of GDM in pregnant women attending antenatal care clinic, using DIPSI criteria 75 g OGCT in the first trimester or at the first antenatal visit. Methods: In this prospective observational study, 451 pregnant women attended the antenatal clinic for the first visit at gestation between 6 and 20 weeks. 75 g oral glucose is administered irrespective of whether she is in the fasting or non-fasting state, without regard to the time of the last meal and GDM was diagnosed, and treatment started. Maternal and fetal outcomes were measured. Results: The incidence of GDM using DIPSI criteria (>140 md/dL) was 20.8% in the first trimester or first antenatal visit. Incidence of maternal and foetal complications was lower in our study when compared to other studies. Conclusion: It is concluded that a 75 g glucose challenge test at 6-20 weeks of gestation with a cut-off value of 140 mg/dl is a reliable screening test for GDM. Keywords: Gestational diabetes mellitus; Oral glucose challenge test (OGCT); Glucose intolerance; DIPSI criteria
Leiomyosarcoma is a rare tumor that accounts for about 2 to 5% of uterine malignancies originating from the smooth muscles of the uterus. Women can be affected at any age group; however, the majority get diagnosed at their perimenopausal age. The early-stage diseases are managed by hysterectomy and complete surgical resection. In the present case report, we discuss a 41-year-old female with a tumor mass of approximately 32-week gestation at the time of examination. The patient had a regular menstrual cycle with no abnormal uterine bleeding except for abdominal pain for three months. A large, lobulated mass (25 x 18 x14 cm) with solid, cystic, and hemorrhagic components was removed surgically (total abdominal hysterectomy) from the uterus's fundus and spalingo-oophorectomy. The patient developed severe hypotension and tachycardia post-surgery and required a longer recovery time. We referred the patient to the medical oncologist for further treatment. In our patient, the tumor rapidly increased, and metastasis was noted in the peritoneal fluid. A further follow-up will be needed to understand the course of the disease and its outcome. Keywords: Leiomyosarcoma; Smooth muscle tumors; Uterine fibroid; Uterine myoma
Aim: To develop a guiding tool for the screening, diagnosis, management and care of hypertensive disorders of pregnancy (HDP) by Indian expert panel consensus. Materials and Methods: Databases such as PubMed, Medline, the Cochrane library and Google Scholar were searched for literature on HDP. Guidelines on HDP from
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