The number of total knee arthroplasties (TKA) performed is around two million annually worldwide and this number is expected to increase fivefold by 2025. The most common indication is osteoarthritis of the knee. Blood loss is significant during the post-operative period and blood transfusion when necessary has its own drawbacks. The use of intravenous tranexamic acid has significantly reduced blood loss. We analysed 35 patients who underwent staged bilateral TKA between August 2013 and February 2016 and had administered intra-articular tranexamic acid for one knee and intravenous tranexamic acid for the other knee. The results were analysed based on post-operative blood loss, change in haemoglobin (Hb) level and haematocrit (PCV) and the need for blood transfusion. The average postoperative blood loss was 129.57 ml and 277.71 ml for intra articular group and intravenous group respectively. A control group (no drug or placebo group) with age matched patients (n= 21) was chosen from medical records. The average blood loss in the control group was 493.81 ml. The fall in Hb level and PCV was 0.72 gm/dl and 2.62 % (Intra-articular Group), 1.36 gm/dl and 4.34 % (Intravenous Group) and 2.62 gm/dl and 5.52 % (Control). The number of transfusions were two (Intra-articular Group), five (Intravenous Group) and nine (Control). We conclude that when compared with intravenous route, intra-articular administration has significantly reduced blood loss, Hb level and PCV fall and the rate of blood transfusion.

Background: The most common cause of morbidity & mortality among females are due to cancers arising from female reproductive organs next to breast cancers. The most common sites include uterine cervix, corpus uteri & ovary followed by least common sites like vulva, vagina, fallopian tubes and gestational trophoblastic diseases. Aim of the study: 1. To evaluate the trend in the prole of benign, premalignant & malignant lesions of female genital tract (FGT) tumours at primary tertiary care hospital in Chennai. 2. To study frequency, age distribution & diverse histomorphological spectrum of tumours of female genital tract. 3. To compare and analyze our data with other published studies in the literature. Materials & Methods: This cross sectional retrospective observational study was conducted at tertiary care gynaecological center at Chennai over a period of 12 years from Jan 2008 to Dec 2019. The medical records were retrieved, data analyzed and the results were expressed in descriptive statistics. Results: During the study period we received 44752 histopathological specimens out of which 12477 cases were gynaecological malignancies. Cervix uteri (66.38%) was the most common site followed by ovary (16.65%), corpus uteri (10.71%), gestational trophoblastic disease (4.13%), vulva (0.82%), vagina (0.36%), fallopian tube (0.02%), and vault carcinoma (0.93%). Squamous cell carcinomas were most common type of malignancy in cervix (93.15%), vulva (91%), vagina (82%) & vault (78%). Endometrial adenocarcinomas (81%) were more frequent tumour in corpus uteri while surface epithelial tumours constitute 78.72% of cases in ovary. For gestational trophoblastic disease, 78.25% of cases had complete molar pregnancy. 41-50yrs of age groups were commonly affected for cervical, ovarian & endometrial malignancies where as in vulval lesions the most common age group was 61-70yrs. In case of gestational trophoblastic disease the majority of patients were presented at 21-30yrs of age. Conclusion: This is one of the largest studies conducted with more than 10000 cases being reported in female genital tract. Cervical carcinomas are the leading gynecological malignancy followed by ovary & corpus uteri at our institute. There is a declining trend in the distribution of cases among cervical cancers were as there is an increasing trend in distribution of cases in other site like ovary & corpus uteri.

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