scholarly journals High-dose Accelerated vs Low-dose Frequent Regime of Iron Sucrose Therapy in Antenatal and Postnatal Women with Iron Deficiency

2017 ◽  
Vol 1 (2) ◽  
pp. 31-35
Author(s):  
Shaheen Anjum ◽  
Nidhi Garg ◽  
Sri Beriwal ◽  
Anjum Parvez
Keyword(s):  
Iron Deficiency ◽  
Blood Transfusion ◽  
Serum Ferritin ◽  
Low Dose ◽  
Intravenous Iron ◽  
Iron Sucrose ◽  
High Dose ◽  
Group I ◽  
Postnatal Women ◽  
Group Ii

ABSTRACT Objective To compare an accelerated high-dose (500 mg) vs low-dose (200 mg) regimen of intravenous iron sucrose in a cohort of iron-deficient anemic antenatal patients in terms of efficacy, safety, and compliance. Materials and methods In a prospective hospital-based study, antenatal and postnatal women with anemia attending Jawaharlal Nehru Medical College and Hospital, Aligarh, India, between December 2010 and December 2012 were enrolled. The inclusion criteria were all outpatient and admitted anemic antenatal women ≤ 36 weeks gestation and postnatal women with hemoglobin (Hb) below 10 gm/dL, or serum ferritin ≤ 30 μg/L or transferrin saturation ≤ 40% irrespective of prior oral iron therapy. Patients were excluded from the study if they were hemodynamically unstable, actively bleeding, having fever, or were nauseated or vomiting. Participants were assigned to control and study groups according to simple random sampling. Intravenous iron sucrose group I (500 mg)/group II (200 mg) was infused after test dose on alternate days for the calculated total dose in the study population. Blood and iron indices were measured at baseline and after 2 weeks of administration of last dose. The primary outcome of the study was to assess the rise in Hb and safety of high-dose intravenous iron sucrose. Results There was a statistically significant increase in Hb level in patients receiving either regimen, with larger mean increase in group I (2.7 ± 0.4) compared with group II (2.25 ± 6.39). Serum iron and serum ferritin also increased in both fortnightly (p < 0.001). Blood transfusion was avoided by 90.1% in severely anemic cases with Hb < 7. Hospital stay was reduced by 50% in group I. Conclusion The accelerated regimen of high-dose (500 mg) intravenous iron sucrose in anemic antenatal patients appears to be safe and effective in correcting anemia, restoring iron stores, and avoiding blood transfusion. How to cite this article Anjum S, Garg N, Beriwal S, Parvez A. High-dose Accelerated vs Low-dose Frequent Regime of Iron Sucrose Therapy in Antenatal and Postnatal Women with Iron Deficiency. World J Anemia 2017;1(2):31-35.

scholarly journals Comparative study of oral iron (ferrous sulphate) versus intravenous (iron sucrose) therapy in treating iron deficiency anaemia in puerperium

2018 ◽  
Vol 7 (9) ◽  
pp. 3653
Author(s):  
Soniya Vishwakarma ◽  
Rajani Rawat ◽  
Pragati Dwivedi ◽  
Vaibhav Kanti
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Iron Deficiency Anaemia ◽  
Ferrous Sulphate ◽  
Intravenous Iron ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Deficiency Anaemia ◽  
Group I ◽  
Group Ii

Background: Iron deficiency anaemia is one of the major morbidities during post-partum period. The aim of this study was to compare the efficacy, safety and compliance of intravenous iron sucrose complex with oral Iron therapy in treatment of postpartum anemia.Methods: 100 postpartum anaemic patients randomized into two groups. In Group I oral iron ferrous sulphate tablets twice daily and in group II 200 mg of iron sucrose on every alternate day up to total calculated dose for 6 weeks. Hemoglobin and serum ferritin were measured on day 0, 2 week and 6 weeks. The side effects in both groups were noted.Results: Majority of patients are multiparous, illiterate and belonged to low socioeconomic. Mean baseline hemoglobin in oral group (Group I) was 7.90±0.905 gm /dl and in i/v group (Group II) was 7.81±0.849 gm /dl. There was significant rise in hemoglobin and hematocrit in both groups after 2 weeks and 6 weeks. However, efficiency of iron sucrose was greater in between the groups (p value=0.0000). There was a rise in serum ferritin to 58.35±14.537μg/L from 8.30±1,461μg/L after 6 weeks in intravenous group with shorter duration of treatment indicating a high efficacy (p<0.001). Intravenous iron sucrose did not result in any serious adverse reactions.Conclusions: This study illustrates clearly that intravenous iron sucrose complex is safe, convenient and effective in postpartum anemic women as compared with oral ferrous sulphate.

scholarly journals A clinical comparison of high dose and low dose of Suxamethonium

2014 ◽  
Vol 9 (2) ◽  
pp. 1-8
Author(s):  
RK Yadav ◽  
PC Majhi ◽  
D Tiwari
Keyword(s):  
Intraocular Pressure ◽  
Dose Group ◽  
Low Dose ◽  
Cardiovascular Responses ◽  
High Dose ◽  
Clinical Effects ◽  
Duration Of Action ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background: Suxamethonium having its rapid onset and short duration of action makes this drug unique amongst the neuromuscular blocking drugs described so far. However, use of suxamethonium is associated with a large number of undesirable side effects. Objective: To evaluate clinical effects of high and low dose of suxamethonium and to determine whether lower dose of suxamethonium can be used for any beneficial effects in terms of its various adverse effects e.g. cardiovascular responses, post-operative muscle pains and intraocular pressure. Methods: A total of 100 patients were included in this prospective study. All these patients on preoperative clinical evaluation were assessed to have adequate airway. All the patients were divided in two groups, low dose group (group I) and High dose group (group II) with 50 patients in each at random. A standard anesthetic technique was adhered to all the patients and following parameters were observed on comparative basis: a. Fasciculation and post operative myalgia. b. Cardiovascular effects, c. Intraocular pressure. Observation: The incidence of post Suxamethonium pain was significantly greater in group II. Increase in heart rate from baseline was significant in both groups. There was no significant difference between the two groups in the diastolic pressure but rise in systolic blood pressure was significant at all assessment times in both groups. This rise from control was statistically significant. Conclusion: Suxamethonium can be used in lower doses (0.5 mg/kg) in elective cases without airway compromise. It gives benefits of reduced muscle pains, cardiovascular responses and intraocular hypertension. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 1-8 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9677

scholarly journals A COMPARATIVE STUDY OF INTRAVENOUS IRON SUCROSE VERSUS ORAL IRON THERAPY IN IRON DEFICIENCY ANEMIA DURING POSTPARTUM PERIOD

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Satish Kumar
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Serum Ferritin ◽  
Intravenous Iron ◽  
Hemoglobin Level ◽  
Oral Iron ◽  
Iron Sucrose ◽  
Deficiency Anemia ◽  
Iron Group ◽  
Iv Iron

Introduction: Anemia is the commonest major contributing factor in maternal mortality and morbidity in developing countries and according to World Health Organization (WHO) criteria, it contributes to 20% of maternal deaths. Anemia in pregnancy defined as hemoglobin level <11 gm/dl (7.45 mmol/L) and hematocrit less than 33% (WHO). Aim: To compare the efficacy of oral iron ferrous sulphate therapy with intravenous iron sucrose therapy in the treatment of iron deficiency anemia during postpartum period. Material & Methods: This was a prospective randomized comparative clinical trial single center study conducted on 200 postpartum women aged >18 years (after normal delivery or LSCS) within 10 days of delivery with Hb level more or equal to 6 gm/dl but less than 10 gm/dl were included in the study. This was a one year study conducted during 1st December 2018 to 30th November 2019. Results : There was a significant increase in the hemoglobin level in both the groups i.e. in IV iron group, from 8.26 ±1.03gm/dl on day 1 to 11.62±0.94gm/dl on day 45 as compared to oral iron group, from 8.24±1.09gm/dl on day 1 to 11.07±1.14gm/dl on day 45; and serum ferritin level from 41.69±40.45ng/ml on day 1 to 77.34±41.60ng/ml on day 45 in IV iron group as compared to the oral iron group from 22.20±8.82ng/ml on day 1 to 31.72±9.72 ng/ml on day 45. So, there was a rapid increase in both hemoglobin and serum ferritin levels in IV iron group as compared to the oral iron group. Conclusion: Intravenous iron sucrose administration increases the hemoglobin level and serum ferritin more rapidly in compare to the oral intake of ferrous sulphate in women with iron deficiency anemia in postpartum women in our study. Keywords: Iron deficiency anemia, Intravenous iron sucrose, Serum ferritin, Maternal mortality.

scholarly journals Effectiveness of low dose versus high dose oxytocin regimen for induction of labour

2021 ◽  
Vol 10 (5) ◽  
pp. 1948
Author(s):  
Paridhi Gupta ◽  
Indu Chawla ◽  
Sonal Gupta
Keyword(s):  
Dose Regimen ◽  
Dose Group ◽  
Low Dose ◽  
Induction Of Labour ◽  
High Dose ◽  
High Dose Regimen ◽  
Nulliparous Women ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

ABSTRACTBackground: Induction of labour is an indispensable part of modern obstetrics and certainly one of the most frequently performed obstetric procedure in the world. Oxytocin, being the most common inducing agent with multiple protocols being practiced, further research is required for the establishment of better protocol with optimal maternal and neonatal outcomes.Methods: Randomized comparative study including 100 term nulliparous women (randomized into high dose, group-I and low dose, group-II with 50 patients in each group) was done. High dose regimen was started with 4mu/min with increment of 4mu/min up to a maximum of 32mu/min and low dose regimen was started with 2mu/min with increment of 2mu/min up to a maximum of 32mu/min. Induction to delivery interval was the primary outcome. Secondary outcomes noted were rate of caesarean section, tachysytole with or without fetal distress, failed induction, maternal outcomes like need for instrumental vaginal delivery, PPH and choriamnionitis, neonatal outcomes like NICU admission, umbilical cord pH and apgar score.Results: There was significant reduction seen in induction to delivery interval among those induced with high dose oxytocin regimen. It was found to be 6.96±3.77 hours in group-I and 9.05±4.65 hours in group-II (p value 0.034). Though incidence of tachysystole was more in high dose regimen, it was not statistically significant. No significant difference was seen in secondary outcomes.Conclusions: On the basis of present study, high dose oxytocin regimen can be considered for induction of labour as it has same effects as that of low dose regimen with lesser induction to delivery interval.

High-Dose Ascorbic Acid Decreases Cholesterolemic Factors of an Atherogenic Diet in Guinea Pigs

2007 ◽  
Vol 77 (2) ◽  
pp. 125-129
Author(s):  
Filis ◽  
Anastassopoulou ◽  
Sigala ◽  
Theodorou ◽  
Manouras ◽  
...  
Keyword(s):  
Ascorbic Acid ◽  
Guinea Pigs ◽  
Low Dose ◽  
Plasma Concentrations ◽  
Atherogenic Diet ◽  
High Dose ◽  
Low Density ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Background: The study evaluates the effect of a high supplemental dose of ascorbic acid (AA) on plasma concentrations of total cholesterol (TC), triglycerides (TG), total lipids (TL), and lipoprotein fractions high-density, very-low-density-, and low-density lipoprotein (HDL, VLDL, LDL) in guinea pigs fed with atherogenic diet. Methods: Group I consisted of 5 normally fed guinea pigs plus a low dose of AA (1 mg/100 g/day), group II consisted of 7 guinea pigs fed with food enriched with 2% cholesterol plus a low dose of AA (1 mg/100 g/day), and group III consisted of 7 guinea pigs fed with food enriched with 2% cholesterol plus a high dose of AA (30 mg/100 g/day). Cholesterolemic factors concentrations were determined after nine weeks. Results: Concentrations of TC, TG, TL, LDL, and VLDL were increased in group II compared to group I (p < 0.01 for all differences). Supplementation with a high dose of AA resulted in decreased concentrations of TC (p < 0.01), TG (p < 0.01), TL (p < 0.01), and LDL (p < 0.01) in group III compared to group II. Additionally, concentration of HDL was increased in group III compared to group II (p < 0.01). Conclusion: High-dose AA supplementation to an atherogenic diet decreases concentrations of TC, TG, TL, and LDL and increases concentration of HDL compared to low-dose AA.

Efficacy of a Low-Dose Intravenous Iron Sucrose Regimen in Peritoneal Dialysis Patients

2002 ◽  
Vol 22 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Elisabeth Dittrich ◽  
Martin Schillinger ◽  
Gere Sunder–Plassmann ◽  
Walter H. Hörl ◽  
Andreas Vychytil
Keyword(s):  
Peritoneal Dialysis ◽  
Iron Deficiency ◽  
Serum Ferritin ◽  
Low Dose ◽  
Transferrin Saturation ◽  
Iron Sucrose ◽  
Dialysis Patients ◽  
Functional Iron Deficiency ◽  
Iv Iron ◽  
Absolute Iron Deficiency

Objective Sufficient iron substitution leads to a decrease in the required recombinant human erythropoietin (rHuEPO) dose and/or an increased hematocrit in dialysis patients. Intravenous (IV) application of larger doses of iron sucrose may be associated with hyperferritinemia, appearance of catalytically free iron, and impaired phagocyte function. Therefore, we investigated the effectiveness of a low-dose IV iron regimen in peritoneal dialysis (PD) patients. Patients and Interventions Forty-five PD patients were followed over a period of 1 year. Serum ferritin, serum transferrin saturation, and hemoglobin were measured monthly. In cases of absolute iron deficiency (serum ferritin < 100 μg/L), 50 mg iron sucrose was given IV every second week. In cases of functional iron deficiency (ferritin ≥ 100 μg/L and transferrin saturation < 20%) and in iron repleted patients (ferritin ≥ 100 μg/L and transferrin saturation ≥ 20%), 50 mg IV iron sucrose was applied monthly. Iron therapy was stopped in cases of acute infection (until complete recovery) and when serum ferritin level was ≥ 600 μg/L. Results To analyze the influence of iron substitution on erythropoiesis and rHuEPO requirements, the EPO resistance index (ERI; quotient of rHuEPO dose in units/kilogram/week and hemoglobin in grams per deciliter) was calculated every 3 months. The ERI decreased significantly during the course of the study in the whole patient group ( p = 0.009) as well as in the subgroup of 21 patients with absolute iron deficiency ( p = 0.01). A nonsignificant decrease in the ERI was observed within the group of 14 iron repleted patients ( p = 0.5). There was no significant change in the ERI in 10 patients with functional iron deficiency ( p = 0.6). Conclusion The low-dose IV iron regimen used in this study substantially decreased rHuEPO requirements in patients with absolute iron deficiency and was effective in maintaining iron stores in iron repleted patients. However, in the absence of significant hyperparathyroidism, aluminum toxicity, or inadequate dialysis, it did not improve the ERI in patients with functional iron deficiency.

scholarly journals Comparison of high-dose finasteride (5 mg/day) versus low-dose finasteride (2.5 mg/day) in the treatment of hirsutism

2002 ◽  
pp. 467-471 ◽  
Author(s):  
F Bayram ◽  
M Guven ◽  
F Kelestimur ◽  
Keyword(s):  
Low Dose ◽  
Free Testosterone ◽  
Dehydroepiandrosterone Sulfate ◽  
Blood Chemistry ◽  
Sex Hormone Binding Globulin ◽  
Controlled Clinical Trial ◽  
High Dose ◽  
Group I ◽  
Group Ii ◽  
Estradiol Levels

OBJECTIVE: To compare the clinical efficacy and safety of high-dose (5 mg/day) and low-dose (2.5 mg/day) finasteride in the treatment of hirsutism in women. DESIGN: A prospective, randomized and controlled clinical trial. METHODS: Fifty-six hirsute women with moderate to severe hirsutism were prospectively evaluated to see the effects of low-dose (2.5 mg/day) and high-dose (5 mg/day) finasteride. Patients were randomly divided into two treatment groups. Group I (n=29) received 2.5 mg finasteride/day and group II (n=27) received 5 mg finasteride/day orally for 1 year. Hirsutism score, body mass index and hormonal parameters (FSH, LH, estradiol, androstenedione, testosterone, free testosterone, 17alpha-hydroxyprogesterone, dehydroepiandrosterone sulfate and sex hormone-binding globulin) were measured in all the patients before treatment and repeated at six-monthly intervals. RESULTS: The hirsutism scores decreased significantly at months 6 and 12 from a mean+/-s.d. of 18.4+/-4.6 to 13.3+/-5.2 (P<0.001) and 18.4+/-4.6 to 8.6+/-4.2 (P<0.001) in group I and from 18.7+/-5.2 to 13.9+/-5.3 (P<0.001) and 18.7+/-5.2 to 10.3+/-5.0 (P<0.001) in group II respectively. No significant changes in the blood chemistry and hormonal parameters except estradiol levels were observed. No serious side-effects were seen in the two groups. In group II, estradiol levels increased significantly at 6 and 12 months. CONCLUSIONS: In this study, hirsutism scores decreased significantly at 6 and 12 months in both groups I and II. Low-dose (2.5 mg/day) finasteride is safe and cost effective in the treatment of hirsutism and may be used instead of high-dose finasteride (5 mg/day) therapy.

scholarly journals Study of effectiveness, tolerability and safety of intravenous iron sucrose in iron deficiency anaemia in postnatal women

2018 ◽  
Vol 7 (11) ◽  
pp. 4366
Author(s):  
R. Niranjana ◽  
K. S. Raja Rajeswari
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Binding Capacity ◽  
Intravenous Iron ◽  
Total Iron ◽  
Iron Sucrose ◽  
Deficiency Anaemia ◽  
Postnatal Women ◽  
The Mean ◽  
Iron Binding Capacity

Background: Iron deficiency anaemia is the most common type of reversible anemia encountered during pregnancy and postpartum period. The present study was done with the objective to find out the efficacy and safety of intravenous iron sucrose in the treatment of iron deficiency anaemia in the postpartum period.Methods: Fifty (50) postnatal patients both after vaginal and caesarean section with iron deficiency anaemia within the first 48 hours with haemoglobin percentage between 6 g/dl and 8g/dl were studied prospectively at the Institute of Obstetrics and Gynaecology, Madras Medical College, Chennai. The patients were given 100 mg of elemental iron diluted in 100 ml of 0.9% normal saline and infused over 15 minutes every alternate day (not more than 3 days in a week) until the required dosage is infused. The blood samples of all the patients were collected and analyzed for haemoglobin (g/dl), hematocrit, mean corpuscular volume (MCV), serum iron, total iron binding capacity (TIBC) and compared before and after therapy.Results: The mean age group of the patients was 24.94 years. Majority of the patients were multipara (68%) and belongs to the class V socio economic status (84%). All the blood parameters were increased significantly (p=0.000) when compared from baseline values to end of the treatment. Mean raise in haemoglobin% after 30 days of treatment was 3.60. Average raise in the mean hematocrit was 8.73. The mean difference in the mean corpuscular volume, total iron binding capacity and the percent saturation was 129.77, 13.55, was 22.26 respectively.Conclusions: Our data confirm that the intravenous iron sucrose was very effective, well tolerated and safe than other forms of iron preparations for treating iron deficiency anaemia in postnatal women.

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