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Internet Medical Journal

This was a presentation given at the annual Missouri Academy of Family Physicians, held at Lake of the Ozarks. ~ 1990.

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The present study was carried out to evaluate the occurrence of association between homocysteine, and vitamin B12 in patients with Preeclampsia , Eclampsia and those with history of previous PIH. 30 such patients from obstetric ward were studied for estimation of serum homocysteine, and vitamin B12 over a period of Jan10 to Jun 2011. Serum homocysteine and vitamin B12 were determined by means of Immulite 1000 analyzer. The statistical analysis of study group of preeclampsia compared with normotensive control group, showed significant alterations in serum homocysteine, and vitamin B12 concentrations in preeclampsia and eclampsia group. Inverse association between serum homocysteine and vitamin B12 levels were observed in preeclampsia and eclampsia. The present study found hyperhomocysteinemia and deficiency of vitamin B12 along with increased blood pressure as a risk factor in preeclampsia. Final outcome of these patients after Inj Vitamin B12 therapy has improved at par with control group without any neonatal or maternal mortality in all four groups

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Background: Controlled ovarian hyper stimulation (COH) combined with intrauterine insemination (IUI), using a volume of 0.5 mail of inseminate is commonly offered to couples with non tubal infertility. Another method is Fallopian tube sperm perfusion (FSP) which is based on a pressure injection of 4 ml of sperm suspension while attempting to seal the cervix to prevent semen reflux. This technique ensures the presence of higher sperm density in the fallopian tubes at the time of ovulation than standard IUI. The aim of this study was to compare the efficiency of IUI and FSP in the treatment of infertility. Methods: 200 consecutive patients with infertility in 404 stimulated cycles were included in the study. Those randomized to standard IUI included 100 patients in 184 cycles [158 Clomiphene citrate/human menopausal gonadotrophin cycles and 26 Letrozole/FSH cycles exclusively for polycystic ovarian disease patients] (group A). Patients subjected to FSP included 100 patients in 220 cycles (193 Clomiphene citrate/human menopausal gonadotrophin cycles and 27 Letrozole/FSH cycles exclusively for polycystic ovarian disease patients] (group B). Swim up semen preparation technique was used in all cases. Insemination was performed in both groups 34-37 hours after hCG administration. Standard IUI was performed using 0.5 ml of inseminate. In FSP 4ml inseminate was used. Results: In group A (184 IUI cycles in 100 patients), 22 clinical pregnancies (presence of gestational sac with fetal cardiac activity) occurred (11.95% per cycle over four cycles). In group B, (220 cycles of FSP in 100 patients), 48 clinical pregnancies occurred (21.81%per cycle over four cycles) and this difference was statistically significant (p<0.05). Conclusions: For non-tubal sub fertility, the results indicate clear benefit for FSP (Fallopian tube sperm perfusion) over IUI (Intrauterine insemination). Key Words: Intrauterine insemination, Fallopian tube sperm perfusion, Non-tubal infertility. Authors: Dr. Col (Retd) G S Shekhawat, MD(Obst & Gyn) * (Corresponding. Author), Dr Priyanka S, MBBS+

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These are simplified slides discussing the regulation of cardiac output and venous return. Learning objectives: 1. Comprehend the determinants of cardiac output and factors affecting cardiac output 2. Comprehend the factors affecting stroke volume and heart rate and total peripheral resistance 3. Identify the factors regulating venous return 4. Discuss the causes of high and low output cardiac failure 5. Enlist the functions of veins and recognise the significance of venous reservoirs Study Resources: 1. Chapter 20, Guyton and Hall Textbook of Medical Physiology, 14th edition 2. Chapter 30 and 32, Ganong’s Review of Medical Physiology, 26th edition 3. Chapter 10, Human Physiology by Lauralee Sherwood, 9th edition 4. Physiology, Cardiac Output - StatPearls https://www.ncbi.nlm.nih.gov/books/NBK470455/

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