Introduction Postpartum hemorrhage is a leading cause of maternal morbidity and mortality. Traditionally, visual method with variations in accuracy is followed, because it is quick, simple and noninvasive. To rely on this method accuracy is of vital importance. This study was aimed to improve accuracy of visual estimation of blood loss during vaginal delivery by standardizing (using similar sized mops and a fixed container) and correlating with hematocrit changes. Methods design A descriptive study. Sample size 250 women. Single fixed collecting container and similar sized mops were used in the third stage of labor. Blood was drained into the container and was visually calibrated by a single trained observer. The soaking characteristics of the mops were used to estimate total blood loss. Blood spillage on delivery table, garments and floor were approximately assessed. Total blood loss was calculated from the above three sources. Hemoglobin and hematocrit measurements were done at the time of admission and, at 24 and 72 hours postpartum and its correlation was done with blood loss. Analysis By paired and unpaired ‘t’ test. Results 250 out of 269 women completed the study. Incidence of PPH (> 500 ml) was 11.2%. The estimated blood loss correlated well with the hemoglobin and hematocrit changes postpartum. Conclusion Standardized visual method (fixed container and mops) with trained observer improves the accuracy of estimation. This may assist clinicians to accurately estimate blood loss thus preventing hemorrhage related complications.

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Introduction: Effects of juvenile diabetes on the central nervous system are less well documented. Effective management of T1DM is another major challenge as insulin is the only available effective treatment. Hence, easily available, affordable, non-invasive therapies like enriched environment are the need of time. Objectives: The present study aimed to determine the effect of an enriched environment on cognitive and behavioral changes in juvenile diabetic rats. Methods: Diabetes was induced in 25 days old, albino Wistar rats, by streptozotocin (STZ). Animals were reared in an enriched environment and treated with herbal formulae with Salacia R and Clitoria T. Then, rats were tested in the elevated passive maze and Morris water maze (n=6). Values are expressed as means ± SE and differences assessed by using one way ANOVA test followed by Bonferroni multiple comparison test. Results: Statistically significant (p<0.05) difference was observed between the enriched environment and diabetic group of rats. Additionally, effects are comparable to conventional insulin therapy, in the animals which received combined therapy (SR+CT+EE) (p<0.01). Conclusion: Authors have shown that diabetic rats reared in enriched housing conditions, showed improved cognitive measures compared to diabetics. The combined treatment is found to be more beneficial in restoring normoglycemic levels and preventing behavioral and cognitive deficits.

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