Pregnancy associated anemia and iron: a pilot study

Iron deficiency occurs when the rate of loss of utilization exceeds its assimilation. Treatment is based on iron supplementation but due to side effects compliance to iron therapy is poor. A double blind comparative study was done using a novel time release preparation of ferrous sulphate (Code A) v.s. sustained release ferrous sulphate preparation (Code B) on 60 pregnant women in mid or late pregnancy with anaemia. The amount of ferrous sulphate in Code A was less than half of Code B. The patients were sequentially randomised as Code A or Code B recipient. The non compliance rate was 33%, and for both Code A & Code B. The mean improvement in hemoglobin after 4 weeks of therapy was 2.01 gm% for Code A and 2.3 gm% for Code B. Iron absorption as evidenced by improvement in S. Iron, TIBC and ferritin levels was better with Code A. The improvement in subjective symptoms of anaemia was better than average in Code B preparation. Code A group had comparatively more side effects both major and minor, this may have been the reason for a slightly higher drop out rate in this group. In conclusion the timed release preparation has a comparable haematological response and better absorption with significantly lower doses as compared to the sustained release preparation.

Pregnancy induced hypertension and antithrombin-III

This study was undertaken to determine the coagulation profile of women with pregnancy induced hypertension and to evaluate the changes in the level of AT-III in pre-eclampsia and eclampsia and its correlation with severity of disease in order to evaluate if it can be used as a marker for severity of PIH. 119 women with PIH in the third trimester of pregnancy constituted the study group. Age and parity matched 25 normal pregnant and 25 non-pregnant women were taken as control group. No significant difference between the coagulation profile of non-pregnant and normal pregnant women was seen. There is evidence of consumption coagulopathy in PIH patients and AT-III activity shows a gradual and almost linear reduction in various groups ranging from normal pregnant women to eclampsia. Reduction in AT-III activity has positive correlation with PIH and it can be a useful marker for severity of PIH.

Screening for HIV seropositive blood - a critical evaluation

HIV screening of all donated blood is mandatory in India. The program instituted has many inherent lacunac like arbitrary identification of centres, absence of a guardian quality control program, criterion for test kit selection and absence of standard guidelines. This study was undertaken to evaluate the effects of frequent change of testing laboratory, change of testing staff, change of reagent kits and time of blood donation. All the donations at blood bank Safdarjang Hospital, during the year 1993, were taken for study. HBsAg and VDRL positivity were used as control/check value for similarity of donor population. Tests done during this period in three different laboratories show that the change of laboratory, change of reagent kit and the experience and training of the testing laboratory staff affect the test results, causing an increase in the number of false positive tests. This leads to destruction of donated blood which would have been otherwise fit for transfusion. It is suggested that a proper policy plan may be made and implemented in order to make the blood screening more effective.

Evaluation of two techniques (RPHA and latex agglutination) for use as a screening tool for HBsAg

RPHA and latex agglutination are two cost effective techniques available for HBsAg screening in our country. Most of the blood banks and other clinical laboratories use RPHA technique or latex agglutination test for screening of donors or patients positive for Hepatitis B surface Ag (HBsAg). All the reagent kits available in the Indian market do not give the ranges of specificity, sensitivity and predictive values for the particular test. Also no data is available if they were tested on Asian sera. Therefore it was decided to evaluated the two most often used techniques RPHA and latex agglutination for their sensitivities and efficacy as a screening test. Our results indicate that though RPHA may be used in a diagnostic set up, it is a poor screening tool as it gives a fairly large number of false negatives and has a low sensitivity. Latex agglutination on the other hand, does not give any false negative results and is recommended for preliminary screening, wherever cost is a constraint. The sera with positive results should be subsequently tested by EIA to rule out the false positive results.

A simple screening procedure for detection of infraclinical cases of multiple myeloma

Agarose Gel Serum Electrophoresis is a simple, rapid and sensitive technique routinely used for diagnosis of Multiple Myeloma. Its effectiveness as a screening tool for detecting infraclinical cases of Multiple Myeloma is brought out in this study. 29 out of the 219 patients presenting with unexplained osteoporosis and pain are found to be positive for M proteins. These patients were earlier adjudged organic disease free after preliminary investigation and examination.

Computerisation of blood bank services of a large hospital

A comprehensive computer aided management scheme for Blood Bank of a large hospital is presented. The hardware requirement and networking pattern are simple flexible and cost effective to suit any kind of needs. Details of the modular software program are discussed. The advantages of the modular program is its flexibility and expandability, to suit not only the needs of a Blood Bank but also the whims and fancies of the personnel working in it. The program is completely portable and operates in an MS DOS environment on a IBM or compatible machine. The solutions are simple and cost-effective, a feature of particular importance to setups which have the technological capability but do not have the economic feasibility. The approach and software features are discussed in detail in order to make it possible for any one to develop similar system if desired.