OBJECTIVE:To investigate the etiological factors resulting in Vitamin B12 deficiency in patients with sub-acute combined degeneration (SACD) and other neurological manifestation manifestations. METHODS: We undertook a prospective study of 50 patients, all clinically suspected to have Vit B12 deficiency; they were investigated clinically, hematologically, biochemically and radiologically. RESULTS: There was a dominance of males (41of 50) with the majority in the age group of more than 40 years of age. There was no correlation between the socio-economic and dietary status on the one hand and the clinical manifestation on the other. Anti-intrinsic factor antibodies (AIFAB) were positive in 19 of 50 patients (38%) and anti-parietal cell antibodies (APCAB) were positive in 28 of 50(56%) patients. CONCLUSION: We conclude that Pernicious anemia is an important cause of various neurological manifestations including s ACD in the Vitamin B12 deficient population in the age group of more than 40 years, irrespective of the socio-economic and dietary status in the Indian subcontinent. It is supported by the presence of AIFAB ro APCAB in this group.

Introduction: Blood transfusion services are vital to maternal health because obstetric haemorrhage has been the foremost cause of maternal mortality in India. 1 Common obstetric emergencies which require blood and blood components transfusion are acute blood loss in first half of pregnancy due to conditions like complications of abortions, ectopic pregnancy rupture and vesicular mole. Material and Methods: This is prospective study conducted at conducted at Department of Obstetrics and Gynaecology, Subbaiah Institute of Medical Sciences, over a period of 1 year. Inclusion criteria: All patients requiring intrapartum transfusion of blood or blood products are enrolled in the study. Exclusion Criteria: No exclusion criteria. Result: In our study, various age groups of patients were enrolled. Maximum transfusion rates are seen in the age group of 21-30 years. Multigravida are at more risk for requiring transfusion Patients with irregular Antenatal care (ANC) visits are more prone to obstetric complications, because of lack of awareness of proper ANC care. More than half of the cases had anaemia in moderate range. Post-Partum Haemorrhage (PPH) is the commonest indication requiring blood transfusion followed by Antepartum haemorrhage (APH) and Pregnancy induced hypertension (PIH) Emergency procedure are at more risk of requiring transfusion. Most of the patients were in the moderate anaemia range, only packed red cell transfusion sufficed the haemostatic requirement. Conclusion: Blood transfusion is lifesaving essential component of obstetric care. Acute obstetric blood loss is usually unpredictable and sudden. The decision to transfuse should be time taken to maintain adequate tissue oxygenation in the face of acute hemorrhage. Identifying the risk factors for hemorrhage in antenatal period and anticipating bleeding is essential in managing obstetric hemorrhage. A preplanned, multidisciplinary protocol yields the best results in the.

Introduction: Preterm labor is defined as regular uterine contractions occurring at least once every 10 minutes and resulting in cervical dilatation or effacement before 37 weeks' gestation. A preterm infant is any infant delivered before 37 weeks' gestation. Material and Methods: This is a prospective study conducted at Department of Obstetrics and Gynaecology, Subbaiah Institute of Medical Sciences, over a period of 1 year. All patients admitted in antenatal ward and labour room requiring preterm induction were included in this study. Pregnancies with major fetal anomalies or no intrapartum fetal monitoring were excluded. All patients were monitored in labour room with auscultation and non-stress test (NST). Mifepristone was given orally and Prostaglandin E2 (PGE2) gel was inserted in posterior fornix. Results: There was a total of 70 deliveries during this period. The preterm induction majorly includes 20-34 years as this is the commonest reproductive age group seen in our hospital. Multigravida requires induction more as compared to primigravida. More number of patients were induced between 32-36 weeks, reason being Preterm premature rupture of the membranes (PPROM), severe preeclampsia, intrauterine device (IUD) and severe Fetal growth restriction (FGR). 33% of the cases being induced due to PPROM, Fetal demise being the second cause of induction in our analysis. It is also interesting to note that HCC also contributes to be one of the causes of induction. 62.8% were induced via PGE2 gel. Out of 70 patients 87.1% of them delivered vaginally, 9 underwent lower segment Caesarean section (LSCS) i/v/o fetal distress and another one i/v/o Prolonged PROM. Conclusion:Our findings suggest that vaginal delivery is likely following preterm induction of labor (IOL) irrespective of gestational age. Parity and cervical favorability are the first and second strongest predictors of a successful vaginal delivery, respectively. Labor curves accelerate with each category of GA, ultimately approximating those observed following term IOL.