1.Role of Local Infiltration of Tranexamic Acid in Reducing Blood Loss in Peritrochanteric Fracture Surgery in the Elderly Population
Virani SR ; Dahapute AA ; Panda I ; Bava SS
Malaysian Orthopaedic Journal 2016;10(3):26-30
Introduction: Peritrochanteric fractures are common
injuries occurring in elderly patients. Surgeries for these
fractures are associated with significant blood loss.
Intravenous tranexamic acid has a proven track record in
many orthopaedic surgeries including trauma, arthroplasty
and spine surgeries.
Objective: To study the effect of local subfascial and
intramuscular infiltration of tranexamic acid in reducing
blood loss and the requirement for blood transfusion in
intertrochanteric fracture surgery.
Study Design: Single centre prospective analytical study.
Materials and Methods: One hundred and thirty seven
patients above 65 years of age were included in the study,
divided into two groups: the intervention group received
subfascial and intramuscular infiltration of 2g tranexamic
acid before wound closure and the control group of alternate
patients did not receive any tranexamic acid infiltration. The
postoperative drain output was recorded, as well as the
haemoglobin level and the patients needing blood
transfusion.
Results and Conclusions: The preoperative and
postoperative haemoglobin values were recorded. The mean
preoperative haemoglobin was 10.9% and 10.8% (p=0.79) in
the trial and control groups respectively. The mean
postoperative haemoglobin was 9.5gm% and 9.2gm%
(p=0.36) in the two groups. The total postoperative blood
loss in the tranexamic acid group and the control group was
190.3ml and 204.3ml respectively (p=0.25). Ten patients
(14.9%) in the intervention group and 12 patients (17.1%) in
the control group required blood transfusion. We conclude
that tranexamic acid does not play a significant role in
reducing postoperative blood loss and blood transfusion
when used locally in peritochanteric fracture surgery.
However a larger double blinded study comparing various
modalities of use of tranexamic acid is needed to
conclusively establish its role
Tranexamic Acid
2.Perennial malaria transmission and its association with rainfall at Kalahandi district of Odisha, Eastern India: A retrospective analysis
Panda, B.B. ; Mohanty, I. ; Rath, A. ; Pradhan, N. ; Hazra, R.K.
Tropical Biomedicine 2019;36(3):610-619
India contributes substantially to global malaria incidents. Vector dynamics is the
significant determinant of malaria risk. Hence, knowledge on the interaction between rainfall,
malaria cases and malaria vector density can be very useful for controlling malaria transmission.
Kalahandi was screened for malaria cases, Anopheline vector density and their temporal
relationship with rainfall. Epidemiological data was obtained from National Vector Borne
Disease Control Programme, Odisha, India. Three years vector population study was carried
out. Rainfall data was obtained from a database maintained by the Govt. of Odisha and was
analysed using Univariate ANOVA and Pearson correlation co-efficient tests using R-prog.
Malaria was found to be prevalent throughout the year attaining peak between July to August
and another peak in December, amidst which the clinical malaria cases being recorded
implied highest incidents in the month of July. The results estimated the seasonality of the
population of An. culicifacies, An. fluviatilis and An. annularis over the region and determined
the influence of rainfall on the vector population dynamics. Simple linear regression analysis
suggested that at one month lag monthly rainfall (P=0.0007) was a significant meteorological
factor. Rainfall seemed to be one of the best malaria predictors because of its positive
correlation with proliferation of malaria cases in conjunction with An. culicifacies density
making malaria a serious health issue in Kalahandi.
3.A comparative study of prevalence and spatial distribution of major Anopheline vector fauna in a hyper- and a hypomalaria endemic district of Odisha, India with special reference to onset of first wet season
Pradhan, N. ; Rath, A. ; Mohanty, I. ; Panda, B.B. ; Hazra, R.K
Tropical Biomedicine 2019;36(1):209-223
The state’s retrospective findings indicate the incidence of malaria deaths, which
is more during the onset of first monsoon season. Based upon this fact, our objective was to
study the distribution pattern of major Anopheles vectors in two endemic districts viz. Kalahandi
and Cuttack of Odisha, India that differ significantly according to malariogenic stratification,
under the impact of first monsoon shower. A comparative study of vector abundance,
predominance, their habitats, resting site preference, impact of abiotic rhythm (light/dark
period) on vector distribution, gonotrophic status as well as sporozoite rate was established
in a high and a low endemic district of Odisha, when the degree of malaria transmission
elevates to its peak level Anopheles culicifacies was found to be predominant in hyperendemic
Kalahandi district while Anopheles subpictus was abundant in hypo-endemic Cuttack
district. Both primary vector An. culicifacies and the secondary vector An. subpictus mostly
prefer CS (Cattle shed) compared to HD (Human dwelling) in Kalahandi district where as
there was slight shifting of resting habitat of An. culicifacies from CS to HD in Cuttack
district. Anopheles culicifacies prefers to rest on wall besides objects in Kalahandi while no
such site preference was observed in Cuttack district. On the other hand, distribution of An.
subpictus was highly influenced by the daily rhythm of light/dark cycle (i.e. day and night) in
Cuttack. The gonotrophic condition revealed the high tendency of the predominant vectors
towards endophilic resting. The sporozoite rate was 0.66% in Kalahandi and nil in Cuttack
district. The proper monitoring of vector prevalence and distribution, at least during the peak
transmission period can avert a perpetuated upsurge in malaria.