What’s new in Gynecology? Also of interest to Pediatricians !

We have been often accused of having a bias against Ob/gyn & vica versa. Here is some latest medical news that is mutual interest 
April 2, 2013 2:15 pm Dr K K Health Care 

• Use of selective serotonin reuptake inhibitors (SSRIs) to treat pregnant patients does not appear to be associated with stillbirth or infant mortality (1).
• The United States Advisory Committee on Immunization Practices (ACIP) recommended that all pregnant women receive the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine during each pregnancy, optimally between 27 and 36 weeks of gestation, regardless of prior vaccination status, to increase the likelihood of optimal protection against pertussis for both the mother and her infant during the first few months of the infant’s life (2). Previously, Tdap was recommended only for pregnant women who had not previously received the acellular pertussis vaccine during adulthood.
• Vaccination during pregnancy substantially reduced the risk of a maternal influenza diagnosis (adjusted hazard ratio, 0.30) and was associated with a trend in reduction of fetal death. All women who are pregnant or will be pregnant during influenza season should receive the inactivated influenza vaccine, regardless of pregnancy trimester (3).
• A December 2012 American College of Obstetricians and Gynecologists (ACOG) committee opinion concluded that the decision to perform early versus delayed cord clamping in term deliveries should be based on patient-specific factors, particularly the infant’s risk of developing iron deficiency anemia (4). For preterm deliveries, they recommended delayed cord clamping given the significant reduction in intraventricular hemorrhage associated with this intervention (3).
• In a prospective study of mothers who used benzodiazepines (primarily lorazepam, clonazepam, and midazolam) while breastfeeding, central nervous system depression (defined as sleepiness, poor latching, limpness, or lack of response to stimuli) in infants was an infrequent finding (affecting 2 out of 124, or 1.6 percent) (5).

References

1.     Stephansson O, Kieler H, Haglund B, et al. Selective serotonin reuptake inhibitors during pregnancy and risk of stillbirth and infant mortality. JAMA 2013;309:48.

2.     Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccine (Tdap) in Pregnant Women — Advisory Committee on Immunization Practices (ACIP), 2012http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6207a4.htm?s_cid=mm6207a4_e (Accessed on February 21, 2013).

3.     Håberg SE, Trogstad L, Gunnes N, et al. Risk of fetal death after pandemic influenza virus infection or vaccination. N Engl J Med 2013;368:333.

4.     Rabe H, Diaz-Rossello JL, Duley L, Dowswell T. Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Cochrane Database Syst Rev 2012;8:CD003248.

5.     Kelly LE, Poon S, Madadi P, Koren G. Neonatal benzodiazepines exposure during breastfeeding. J Pediatr 2012;161:448.

Source

Do I need multivitamin tablets?

1. Multivitamin tablets are not needed unless there is a scarcity of a particular vitamin.

2. If you include all seven colors and six tastes in your food, there is no need for vitamin supplementation.

3. Wheat grass and barley grass juice contain folic acid and vitamin B12.

4. Anything which is green contains vitamin B.

5. Anything which is red contains lycopene.

6. Citrus foods contain vitamin C.

7. All dry fruits contain vitamin E.

8. Sunlight is an excellent source of vitamin D.

9. Carrots contain vitamin A.

10. Folic acid is lost if the food is boiled and the water is discarded.

11. Vitamin D is not absorbed if exposed to sunlight is through glass.

12. Vitamin D is not absorbed through clothes if you are fully-clothed in sunlight.

Source

Comments: A very useful blog that should help educate parents regarding the lack of need for multi-vitamin supplements for most children. However, I need to make a full disclosure here, my wife still believes in giving multi-vitamin supplement to my daughter daily, and I let her, for her (my wife's) peace of mind :)

Food- and water-borne diseases in the summer

The number 1 problem that I will face during the next couple of months is going to be related to contaminated food & water. Here are a few tips to help prevent these illnesses... 

Source

1.Summer is the season for typhoid, jaundice and diarrhea.

2.The main reasons are scarcity of water and poor food, water and hand hygiene.

3.In summer, the requirement of water increases by 500 ml in adults due to excessive sweating.

4. For food hygiene, remember the formula ‘heat it, boil it, cook it, peel it or forget it’.

5. Any food or liquid, if heated before use, cannot cause infection.

6. Any liquid or water, if boiled before use, cannot cause infection.

7.Any fruit, which can be peeled by hands, for example, banana and orange cannot cause infection.

8.Do not use ice prepared from unsterilized water.

9.Do not take cut fruits and vegetables that have been left open.

10.Do not drink sugarcane juice sold on the roadsides.

11.Do not drink water in unwashed glass on the roadside.

12.Do not eat food that has been leftover for more than 2 hours at room temperature.

13.Do not eat cucumbers, carrots, watermelon etc. that is sold on the roadsides as chaat unless hygienic.

14. Please ensure that adults &  kids have taken their vaccinations including Typhoid & Hepatitis A shots. Cholera can be considered for people residing in high risk areas including slums and if there is an epidemic.