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From mono to something more: an interesting unravel of Lemierre’s Syndrome. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00314-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Menstrual irregularities, hormonal imbalance and obesity in adolescent girls in Hyderabad, Sindh, Pakistan: An observational study. JOURNAL OF HEALTH RESEARCH 2022. [DOI: 10.56808/2586-940x.1013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Vaginal discharge during pregnancy and associated adverse maternal and perinatal outcomes. Pak J Med Sci 2021; 37:1302-1308. [PMID: 34475902 PMCID: PMC8377920 DOI: 10.12669/pjms.37.5.4187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/26/2021] [Accepted: 05/05/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives: To observe the effects of vaginal discharge during pregnancy on maternal and fetal outcomes. Methods: This observational study was undertaken form June 2018 to 31 May 2019 period in the Department of Obstetrics and Gynaecology at Liaquat University of Medical and Health Sciences hospital Jamshoro Unit IV. Data were collected from a convenience sample of 85 pregnant women. All the pregnant women with vaginal discharge were included in the study, while the women with bleeding and other medical disorders during pregnancy were excluded. Data was analyzed. Results: Women’s mean age as 27.4 (±4.7) years and most were 28-35 weeks pregnant (n=29, 34%) and primigravida (n=35, 41%). Seventy six women (89%) presented with vaginal discharge while nine women (11%) reported no vaginal discharge. Of those with vaginal discharge,53 women (69.7%) had vaginal infections: bacterial vaginosis (n=21, 39.6%), vaginal candidiasis (n=17, 32.1%) and vaginal trichomoniasis (n=15, 28.3%). Pathological vaginal discharge (PVD) was associated with vaginal irritation (n=30, p<0.0001), vaginal pain (n=50, p<0.0001), fever (n=12, p=0.015), uterine contractions (n=31, p<0.0001), premature membrane rupture (n=29, p<0.0001), abortion (n=13, p=0.009), pre-term delivery (n=24, p<0.0001) and post-partum endometritis (n=19, p=0.0006). PVD was associated with neonatal outcomes i.e. low birth weight (n=24, p<0.0001), low Apgar score at birth (n=22, p=0.0001), neonatal respiratory distress syndrome (n=21, p=0.0002), neonatal intensive care hospitalisation (n=20, p=0.002) and early neonatal death (n=16, p=0.003). Conclusion: Pathological vaginal discharge (PVD) during pregnancy is more frequent and is associated with adverse maternal and perinatal outcomes.
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Abstract
OBJECTIVE To observe the impact of acute renal morbidities with obstetrical emergencies on maternal health. METHODS In this study pregnant women between 28-40 weeks gestational period and delivered women in their puerperal period up to 42 days after delivery having acute renal problems associated with obstetrical emergencies were included. Pregnant and delivered women with obstetrical emergencies and associated other morbidities were excluded. These women were registered on the predesigned proforma after taking written informed consent and taking approval from institutional ethic research committee. The data was collected and analyzed on SPSS version 21. RESULT Out of these 196 total registered women, majority of these women 81(41.32%) were between 21-30 years of age and multiparous women with parity four and above were 83(42.34%). Commonest presenting symptoms were generalized oedema 123(62.75%) and oligouria 92(46.93%). Frequent obstetrical emergencies observed were pre-eclampsia 53(27.04%), post partum haemorrhage 48(24.48%) and ante partum haemorrhage 36(18.36%) women. The complete recovery was observed in 86(43.87%) women, while mortality was seen in 56(28.57%) women. CONCLUSION Renal morbidities were more frequently observed in obstetrical emergencies leading to high morbidity and mortality rate.
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Acute Hepatitis E Viral Infection in Pregnancy and Maternal Morbidity. JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN 2016; 25:734-7. [PMID: 26454389 DOI: 10.2015/jcpsp.734737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 08/28/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the maternal morbidity in pregnant women with acute hepatitis E viral infection. STUDY DESIGN Observational, cross-sectional study. PLACE AND DURATION OF STUDY Departments of Obstetrics and Gynaecology and Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Red Crescent General Hospital and Saint Elizabeth Hospital, Hyderabad, from January 2011 to December 2013. METHODOLOGY The study population was pregnant women with acute hepatitis E infection confirmed by ELIZA technique. Pregnant women with other hepatic viral infections were excluded. All medical and obstetric conditions, and mortality were noted on the predesigned proforma. RESULTS Out of the total 45 admitted pregnant women with hepatitis E viral infection, 22 women (48.9%) had severe morbidity. The most common were hepatic coma in 8 (36.36%) cases and disseminated intravascular coagulation in 14 (63.63%) cases. Highest mortality rate was seen in women with hepatic coma (100%), while in those with disseminated intravascular coagulation, one out of the 14 cases (7.14%) died. CONCLUSION The acute viral hepatitis E infection in pregnant women is associated with maternal morbidities and high mortality rate.
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Abstract
OBJECTIVE To observe the effects of iron deficiency anaemia on the health and life of pregnant women. METHODS This cross sectional study was conducted at the Department of Obstetrics and Gynaecology Unit IV, Liaquat University of Medical and Health Sciences Jamshoro from 1st June 2015 to 30(th) November 2015, for the period of 6 months. During this study period all the pregnant women from 13-40 weeks of pregnancy with iron deficiency anaemia having haemoglobin level less than 9 gram% were included, while the pregnant women with other medical disorders were excluded from the study. The data was collected and analyzed on SPSS version 21. RESULT Out of the 305 pregnant registered women with iron deficiency anaemia most women were young 170(55.73%) between 20-30 years, belonged to low socioeconomic group 254(83.27%), they were multiparous 104(34.09%), having very low haemoglobin level between 1-3 gram % in 54(17.70%) women and between 4-6gram% in162 (53.11%) women. These women were prone to high complications such as ante partum haemorrhage 49(16.06%), renal failure 48(15.73%), disseminated intravascular coagulation 54(17.70%) and 16(5.24%) women died. CONCLUSION Iron deficiency anaemia is common in pregnant women with higher rates of complications.
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Hepatitis E -- A preventable health issue -- endangering pregnant women's life and foetal outcomes. J PAK MED ASSOC 2015; 65:655-659. [PMID: 26060166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To observe the clinical spectrum, complications and pregnancy outcome in women with Hepatitis E. METHODS The descriptive prospective study was conducted at the Liaquat University of Medical and Health Sciences, Jamshoro, Red Crescent General Hospital and Saint Elizabeth Hospital, Hyderabad, from January 1, 2011, to December 31, 2013. All pregnant women with Hepatitis E positive on virology screening were included. The subjects were enrolled from the out-patient department as well as from among those admitted in either Obstetrics or Medical wards. Data was obtained through a predesigned proforma, and analysed using SPSS 20. RESULTS The overall mean age of the 45 women in the study was 27.78±6.742. There were 21(46.7%) women in 21-30 years age group, 22(48.9) were multiparous, 31(68.9%) were uneducated, and 29(64.4%) were from poor social class. Besides, late second trimester and third trimester of pregnancy was found in 27(60%), unstable condition 10(22.22%), disturbed liver function test 24(53.3%) and raised serum glutamic pyruvic transaminase level >101u/l 27(60%), deranged coagulation profile such as raised prothrombin time 25(55.5%), and activated partial thromboplastin time 18(40%)cases. Overall 36(80%) women were discharged, while 9 (20%) died. Besides, 10(24.4%) babies needed intensive care, 13(42.2%) foetuses died during intrauterine life, 5(11%) were stillborn, while 17(37.8%) were alive and were discharged home. CONCLUSIONS Pregnant women with Hepatitis E were more vulnerable as their life, health and foetal outcome suffered a lot.
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Hepatitis C in haemorrhagic obstetrical emergencies. JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN 2014; 24:178-81. [PMID: 24613113 DOI: 03.2014/jcpsp.178181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 10/14/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the maternal health and fetal outcome in hepatitis C with obstetrical haemorrhagic emergencies. STUDY DESIGN An observational study. PLACE AND DURATION OF STUDY Department of Obstetrics and Gynaecology Unit-I, Liaquat University of Medical and Health Sciences Hospital, Hyderabad, Sindh, from January 2009 to December 2010. METHODOLOGY All the women admitted during the study period with different obstetrical haemorrhagic emergencies were included. On virology screening, hepatitis C screening was done on all. The women with non-haemorrhagic obstetrical emergencies were excluded. Studied variables included demographic characteristics, the nature of obstetrical emergency, haemorrhagic conditions and maternal and fetal morbidity and mortality. The data was analyzed on SPSS version 20. RESULTS More frequent obstetrical haemorrhagic emergencies were observed with hepatitis C positive in comparison with hepatitis C negative cases including post-partum haemorrhage in 292 (80.88%) and ante-partum haemorrhage in 69 (19.11%) cases. Associated morbidities seen were disseminated intravascular coagulation in 43 (11.91%) and shock in 29 (8.03%) cases with hepatitis C positive. Fetal still birth rate was 37 (10.24%) in hepatitis C positive cases. CONCLUSION Frequency of maternal morbidity and mortality and perinatal mortality was high in obstetrical haemorrhagic emergencies with hepatitis C positive cases.
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Elective caesarean section for breech presentation in first pregnancy and subsequent mode of labour. JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN 2014; 24:323-6. [PMID: 24848389 DOI: 04.2014/jcpsp.323326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 01/28/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effect on subsequent mode of labour in case of previous elective caesarean for breech presentation in primiparous women. STUDY DESIGN A cohort study. PLACE AND DURATION OF STUDY Department of Obstetrics and Gynaecology, Liaquat University of Medical and Health Sciences, Jamshoro, Unit-1 and 1V, from January 2005 to December 2009. METHODOLOGY All women with previous one elective caesarean section for breech or cephalic presentation visited OPD for antenatal checkup or admitted in emergency in maternity or labour ward were recruited for the study, while the women with previous 2 and 3 caesarean section were excluded from the study. The case records of these women were reviewed thoroughly, and entered in predesigned pro forma. The main outcome measure was mode of labour in current pregnancy decided electively or adopted in emergency. RESULTS Out of the total, 131 (16.92%) women had previous elective caesarean section due to breech presentation while 643 (83.07%) women had previous elective caesarean section with cephalic presentation. Overall repeat caesarean section rate was 92 (70.22%) in women with previous breech presentation (n=131) in comparison with 475 (73.87%) women with previous cephalic presentation n=643 (RR=1.04, p=0.32). The vaginal birth rate after elective caesarean section due to breech presentation was 39 (29.77%) in comparison with 168 (26.12%) cases with previous cephalic presentation (RR=0.98, p=0.83). CONCLUSION Women having elective caesarean section for breech presentation in their previous pregnancy had about 1 in 6 chance of having repeat elective caesarean section.
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Infertility and weight reduction: influence and outcome. JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN 2014; 23:798-801. [PMID: 24169388 DOI: 11.2013/jcpsp.798801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Accepted: 07/06/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the effect of weight reduction in obese infertile women on conception rate spontaneously as well as with ovulation induction and pregnancy outcome. STUDY DESIGN Observational experimental study. PLACE AND DURATION OF STUDY Different private clinics at Mirpurkhas, Thana Bola Khan and Hyderabad, Sindh, Pakistan, from March 2008 to February 2011. METHODOLOGY Infertile women who were obese with the body mass index (BMI) > 30 kg/ m2 and failed to conceive within 2 - 5 years after taking treatment of infertility for many cycles were inducted. These women underwent life style change program related to exercise and diet for 6 months and in the next 6 months they were observed for spontaneous conception. Those women who failed to conceive were prescribed ovulation induction (clomifene citrate) for the next 6 months and were observed for conception. After conception, they visited regularly during antenatal period till delivery. The data was collected and analyzed on SPSS version 17. RESULTS The mean decrease in the body index observed was 9.6 ± 1.23 kg/m2, spontaneous conception rate was (n = 35, 41.17%) and miscarriage rate was (n = 9, 16.66%). CONCLUSION Weight reduction leads to high spontaneous conception rate as well as with ovulation induction therapy and improves the pregnancy outcome.
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Iatrogenic risks and maternal health: Issues and outcomes. Pak J Med Sci 2014; 30:111-5. [PMID: 24639842 PMCID: PMC3955553 DOI: 10.12669/pjms.301.4062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 07/22/2013] [Accepted: 11/11/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To observe acute maternal morbidity and mortality due to iatrogenic factors and outcomes. METHODS This observational cross sectional study was conducted at intensive care unit of Liaquat University of Medical and Health sciences Jamshoro from 1-January-2011 to 31-December-2012. In this study all the delivered or undelivered women who needed intensive care unit (ICU) admission due to management related life threatening complication referred from periphery or within this hospital were included, while those women who had pregnancy complicated by medical conditions were excluded. These women were registered on the predesigned proforma containing variables like Demographic characteristics, various iatrogenic risk factors, complications and management out comes. The data was collected and analyzed on SPSS version 20. RESULTS During these study period 51 women needed ICU care for different complications due to adverse effects of medical treatments. Majority of these women were between 20-40 years of age 41(80.39%), multiparous 29(56.86%), unbooked 38(74.50%), referred from periphery 39(76.47%), common iatrogenic factors were misuse of oxytocin 16(31.37%), fluid overload/cardiac failure 8(15.68%), blood reaction 7(13.72%), anesthesia related problems were delayed recovery 3(5.88%), cardiac arrest 2(3.92%), spinal shock 2(3.92%), surgical problems were bladder injury 5(9.8%), post operative internal haemorrhage 3(5.88%), 37(72.54%) women recovered and 14(27.45%) expired. CONCLUSION The maternal morbidity and mortality rate with iatrogenic factors was high and majority of these factors were avoidable.
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Risk factors and complications of puerperal sepsis at a tertiary healthcare centre. Pak J Med Sci 2013; 29:972-6. [PMID: 24353670 PMCID: PMC3817780 DOI: 10.12669/pjms.294.3389] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 06/03/2013] [Accepted: 06/05/2013] [Indexed: 11/15/2022] Open
Abstract
Objective: To determine the risk factors and complications of puerperal sepsis. Methods: This was an observational prospective Cohort study conducted from January 2011 to December 2011 at the Obstetrics and Gynaecology Department Liaquat University of Medical & Health Sciences Jamshoro/Hyderabad, Sindh Pakistan. During this study period, all the women who delivered in this hospital or referred to this hospital within 42 days after delivery with puerperal pyrexia/sepsis diagnosed on clinical examination as well as with relevant investigations were included in the study. Women with other ailments like malaria, typhoid fever and postpartum eclampsia during the puerperal period were excluded. The subjects were registered on predesigned proforma after giving informed written consent. The data was collected and analyzed using SPSS version 17. Results: During this period there were 3316 obstetrical admission and out of these 129(3.89%) women had puerperal sepsis. Most of these women 84(65.11%) were aged 31 years and above, multiparous 101 (78.29%), and unbooked 98 (75.96%) cases. Common risk factors found were absent membranes in 108(83.72%) of the women, delivered or undelivered and mismanaged, referred cases 95(73.64%), are being delivered in this hospital 34(26.35%). Morbidities seen were septicemia in 35 (27.13%) cases, and disseminated intra vascular coagulation in 23(17.82%) cases, while 11 (8.52%) of the women died. Conclusion: Common risk factors were anaemia; suboptimal personal hygiene as well as improper sterilization which resulted in severe health hazards such as septicemia, disseminated intravascular coagulation as well as death.
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Diagnostic laparoscopic findings in chronic pelvic pain. JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN 2013; 23:190-3. [PMID: 23458041 DOI: 03.2013/jcpsp.190193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Accepted: 12/12/2012] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the cause of pain on diagnostic laparoscopy in women with chronic pelvic pain and equivocal clinical and ultrasound examination. STUDY DESIGN Cross-sectional observational study. PLACE AND DURATION OF STUDY Red Crescent General Hospital, Hyderabad, Sindh, from January 2007 to December 2009. METHODOLOGY All the women presenting with chronic pelvic pain for more than 6 months duration, without any obvious pathological findings on clinical as well as on ultrasound examination were recruited. Women with chronic pelvic pain and having pelvic pathological lesions detected on clinical and/or ultrasound examination were excluded. Clinical, ultrasound, and laparoscopic data was collected and analyzed on SPSS version 14. The results were described as frequency, proportion, compared by chi-square test with significance at p < 0.05. RESULTS Highest frequency of chronic pelvic pain was observed in women aged between 26 - 35 years (62.4%), 53 out of 85 women. Most of these women were married (90.6%) and nulliparous (47.1%). Pain was reported as dull and sharp by 35 women (41.2%), infertility (n = 46, 54.1%) and dyspareunia (n = 45, 52.9%) were the commonest co-existent complaints. On laparoscopic examination, pathological lesions were detected in 65, tuberculosis in 17 (20%) endometriosis in 11 women (12.9%), pelvic inflammatory diseases and pelvic adhesion in 8 (9.4%) women each and ovarian cyst in 6 women (7.1%). CONCLUSION Positive laparoscopic yield was high in women with pelvic pain. Pelvic tuberculosis was the most common pathology detected followed by endometriosis, pelvic inflammatory disease and adhesions.
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Obstetrical trauma to the genital tract following vaginal delivery. JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN 2012; 22:95-7. [PMID: 22313645 DOI: 02.2012/jcpsp.9597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Accepted: 01/04/2012] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To determine the frequency, types and complications of genital tract trauma during child birth. STUDY DESIGN Case series. PLACE AND DURATION OF STUDY Department of Obstetrics and Gynaecology, Unit I, Liaquat University of Medical and Health Sciences, Jamshoro, from June 2006 to May 2010. METHODOLOGY All women who sustained genital tract trauma during delivery at the study centre and those referred from periphery with the same condition within 40 days of delivery were enrolled in the study. Exclusion criteria were women who sustained genital tract injury with caesarean section and genital tract trauma due to accident. Studied variables included age of women, parity, place of labour, type of trauma received and its immediate complications. The data was expressed in terms of descriptive statistics. RESULTS Out of a total 9216 cases admitted in maternity ward during the study period, 467 cases (5.06%) had sustained genital tract trauma. The most frequent obstetrical trauma seen in primiparous referral cases were vaginal tears in 16 cases (25.39%) and perineal tears in 12 cases (19.04%). Multiparous women were 196 (41.97%) and cervical tears were the most frequent obstetrical trauma in them (n=52, 26.53%). Grand multiparous women were 208 having cervical tears (44.4%) and uterine rupture in 77 cases (37.01%) each. Most frequent early morbidities were postpartum haemorrhage (n= 352, 75.37%), hypovolemic shock (n= 220, 47.10%) and infection (n=158, 33.83%). The mortality rate was 16.05%. CONCLUSION Genital tract trauma is a common complication of vaginal birth mostly seen in grand multipara, leading to haemorrhage, shock and infection.
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3.333 DETERMINATION OF COPPER AS TRACE METAL IN BLOOD SERUM OF MALARIAL PATIENTS BY ATOMIC ABSORPTION SPECTROSCOPY. Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70966-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Determination of trace metals abnormalities in patients with vivax malaria. IRANIAN JOURNAL OF PARASITOLOGY 2011; 6:54-9. [PMID: 22347288 PMCID: PMC3279882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Accepted: 05/10/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND In the present study, blood serum level of metals were determined in malarial patients and compared with those in the normal subjects without complication using Atomic Absorption Spectrometer. METHODS For the determination of these metals twelve intravenous blood samples each from referred malarial patients and a group of normal subjects were collected and immediately centrifuged to obtain the supernatant liquid, serum of both the groups for analysis. RESULTS The blood serum levels of copper in malarial patients determined to be 2.6917 ppm, which is higher as compared to that found 2.045 in normal subjects. Whereas the blood serum levels of iron, magnesium, and zinc found 2.0708 ppm, 12.2467 ppm and 4.9017 ppm respectively in malarial patients, who are lower than those, are determined in the blood serum of normal subjects. Blood serum levels of iron, magnesium, and zinc in normal subjects found 3.950 ppm, 19.4892 ppm, and 5.242 ppm respectively. CONCLUSION In this study the metal content of copper, iron, magnesium and zinc in vary in malarial patients as compared those in the normal subjects. It may suggest that the decreased levels of iron, magnesium, and zinc can be maintained by giving as supplement of these metals in therapy.
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Risk factors in early pregnancy complications. JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN 2010; 20:744-7. [PMID: 21078248 DOI: 11.2010/jcpsp.744747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Accepted: 09/16/2010] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To determine the underlying risk factors in early pregnancy complications and outcome. STUDY DESIGN Case series. PLACE AND DURATION OF STUDY This study was conducted at the Department of Obstetrics and Gynaecology Unit-IV, Liaquat University of Medical and Health Sciences, Jamshoro, from July 2007 to June 2008. METHODOLOGY All the women with first trimester pregnancy with different complications were included in this study while those women with uneventful first trimester were excluded. The inducted women were registered on pre-designed proforma. Studied variables including demographic details, gestational period, type of complications, risk factors, treatment and outcome. The data was expressed in terms of mean and percentages with a confidence interval of 95%. Analysis was done on SPSS version 14. RESULTS Out of a 204 total admissions, 115 (56.37%) patients had different early pregnancy complications. Their mean age was 29.4+6.8 years. Commonest complications found were abortion in 88 (76.52%) cases. The underlying risk factors found in abortion were antiphospholipid syndrome in 5 (5.68%) cases, Diabetes mellitus in 8 (9.09%) cases, hypertension in 16 (18.18%) cases, and polycystic ovarian syndrome and infection in 11 (12.5%) cases each. Most of the cases 69 (60%) were treated by minor surgical procedures, and 22 (19.13%) cases responded with conservative medical therapy. Outcome were anaemia in 92 (79.3%) cases, psychological upset in 72 (62.1%), infection in 55 (44%) cases and coagulopathy in 9 (7.8%) cases. CONCLUSION Abortion was found as the most frequent early pregnancy complication and the most frequent underlying risk factor was hypertension. Outcome included anaemia, psychological upset and infection.
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Subjective pain perceptions during labour and its management. J PAK MED ASSOC 2010; 60:473-476. [PMID: 20527647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To investigate women's own labour pain perception, experiences and satisfaction with health care providers at a referral hospital of Sindh. METHODS A descriptive study conducted on 400 labouring women at Obstetrics and Gynaecology Department Unit-II and IV Liaquat University Hospital Hyderabad/Jamshoro from January 2006 to July 2006. Four hundred full term labouring women in first stage of labour were included in the study. All the women with associated medical problems were excluded. Two questionnaires were completed containing demographic details, antenatal record, mode of onset of labour, labour duration, ambulation, use of various pharmacological agents and women's personal experiences regarding pain perception and future family planning. Data was collected and analyzed on simple percentage basis. RESULTS This study shows an acceptable birth experience in 136 (34%) cases, while 264 (66%) patients found it an exhausting painful experience. Common factors which favour good experience included lower socioeconomic class 67 (57.98%), rural population (54.68%), multiparous women (68.08%), prior knowledge of labour pains (69.31%), spontaneous labour (86.89%), use of pharmacological agents (76.04%) and co-operative staff attitude (89.27%). Those who found labour pains an acceptable process, 87.5% had a positive attitude for future child bearing. CONCLUSION Childbirth can be a good experience with effective antenatal counseling. A highly professional attitude and tender loving care is the key to a pain free labour.
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Gynecological Malignancies: A Continuing Threat in the Developing World. J Gynecol Surg 2010. [DOI: 10.1089/gyn.2009.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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HEALTH PROFILE OF POST MENOPAUSAL WOMEN IN RURAL VERSUS URBAN POPULATION IN SINDH PROVINCE OF PAKISTAN. Maturitas 2009. [DOI: 10.1016/s0378-5122(09)70499-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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PREGNANCY RELATED PROBLEMS IN THE DEVELOPING COUNTRIES. HOW SERIOUS IS THE PROBLEM? Maturitas 2009. [DOI: 10.1016/s0378-5122(09)70498-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Clinical spectrum and management of ovarian tumours in young girls up to 20 years of age. J Ayub Med Coll Abbottabad 2008; 20:14-17. [PMID: 19999194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Ovarian tumours are one of the common malignancies all over the world affecting all age groups. This study analyses different clinical presentation and management of ovarian tumours in young girls up to 20 years. METHODS Patients up to 20 years of age admitted with the diagnosis of ovarian tumour were included. Data collected on a proforma. Variables studied included age, presenting symptoms, investigations, surgical findings, type of surgery, histopathology reports and follow-up. The patients with malignant ovarian tumour were followed by oncologist as well as gynaecologist. Data analysis was done on SPSS. RESULTS The mean age was 17.27 +/- 2.46 SD years. The common symptoms included abdominal mass, abdominal pain, urinary problems, menstrual irregularities and generalized malaise. All patients were operated after preliminary investigations. Patients were advised to have follow-up post-operatively after 1 month. The follow up was done by oncologist and gynaecologist. Six patients (12.5%) died and 22 (45.83%) were lost to follow up. CONCLUSION Ovarian tumours are quite common in young girls. Majority of patients seek medical advice once the disease becomes symptomatic, complicated or advanced disease in the case of malignancy. Histopathology of the tumours revealed that epithelial cell tumour is the commonest tumour in contrast to germ cell tumour as reported by world literature.
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Frequency of second stage intervention and its outcome in relation with instrumental vaginal delivery versus caesarean section. J Ayub Med Coll Abbottabad 2008; 20:87-90. [PMID: 19024196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND To determine the frequency of second stage intervention and the risk of maternal and foetal morbidity and mortality associated with instrumental vaginal deliveries versus caesarean section in our tertiary care set up. METHODS This descriptive study was conducted in the Department of Obstetrics and Gynaecology (Unit-II) Liaquat University Hospital Hyderabad Sindh, Pakistan from January 2005 to December 2006. All the women who underwent instrumental vaginal delivery and caesarean section due to prolonged second stage of labour were included in this study. Data were collected on a pre-designed proforma, which included demographic details, maternal and perinatal morbidity as well as any complications etc. Finally, data were analysed through software program SPSS 10.0. RESULTS Frequency of second stage intervention was 22.2%. Among, 400 women who undergone second stage intervention, 240 (60%) were delivered by caesarean section and 160 (40%) were delivered with the help of instruments. Majority of women, i.e., 49.25% were between 21-30 years of age, 73% were un-booked cases while 45% cases were primigravida. Complications with abdominal delivery were paralytic ileus in 35 (14.58%) cases, post partum haemorrhage in 30 (12.5%) cases and tear extension in 13 cases. Complications with instrumental delivery were vaginal tear in 28 (17.5%) cases, cervical tear in 12 (7.5%) and third degree perineal tear in 4 (2.5%) cases. The perinatal outcome with abdominal delivery (86.66%) was better as compared to instrumental delivery (72.5%). CONCLUSION The frequency of second stage intervention seems high in our set up and is associated with significant maternal and perinatal morbidity. Maternal morbidity was more frequent abdominal delivery while neonatal morbidity and mortality was more frequent with instrumental delivery.
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Pattern of fetal deaths at a university hospital of Sindh. J Ayub Med Coll Abbottabad 2007; 19:32-34. [PMID: 18183715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Perinatal mortality is a significant public health problem throughout the world. Its prevalence is quite high in the developing countries on account of number of factors. Most of the causes are treatable and fetal outcome can be improved by provision of good health care facilities during antepartum and intrapartum periods and through public education regarding reproductive health and better utilization of health services. OBJECTIVE To determine the pattern of intrauterine fetal deaths before or in the process of labor in our tertiary care set up. METHODS This descriptive case series was conducted at Department of Obstetrics and Gynaecology (unit-IV) at Liaquat University Hospital, Jamshoro, Sindh,from April 2002 to October 2003. In total, 50 intrauterine fetal deaths from 24 weeks of gestation to full term pregnancy were analyzed. The case records of all the women were evaluated and data collected regarding their age, period of gestation, clinical features, antenatal records, previous obstetrical history, labor, mode of delivery as well as complications during or after the labor. RESULTS Out of 697 deliveries, 50 (7.17%) babies were still born. Of these 84% were fresh still born. The commonest factors were antepartum hemorrhage (30%), mismanaged labor (26%), premature rupture of membranes (26%) and congenital anomalies (16%). CONCLUSION Majority of fetal deaths in our set up are due to avoidable factors. Hence, there is strong need to improve the quality of care by proper antenatal care, identification of high risk cases and referral to tertiary care hospitals for proper management to prevent morbidity and mortality in this regard.
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Gestational trophoblastic disease: experience at a tertiary care hospital of Sindh. JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN 2007; 17:81-3. [PMID: 17288852 DOI: 02.2007/jcpsp.8183] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/23/2006] [Accepted: 12/06/2006] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To determine the frequency, clinical presentation and management outcomes of Gestational Trophoblastic Disease (GTD). STUDY DESIGN Descriptive case series. PLACE AND DURATION Department of Gynaecology and Obstetrics, Liaquat University of Medical and Health Sciences, Jamshoro, from March 2003 to March 2004. PATIENTS AND METHODS The case records of all the gestational trophoblastic cases during study period were analyzed regarding their illness history, clinical examination, investigations, treatment and follow-up. The main outcomes were measured in terms of duration, antecedent pregnancy, investigations, treatment and the follow-up. RESULTS There were a total of 1030 obstetric admissions during the study period, which included 23 cases of trophoblastic disease. Hence, frequency of GTD was 1 per 45 live births. Of these 23 cases, 19 (82.6%) patients had hydatidiform mole and 4 patients had malignant trophoblastic disease. Eight patients (34.7%) received chemotherapy while rest of the patients had suction evacuation and follow-up. Among all patients, 21 (91.3%) fully recovered and 2 (8.69%) died because of extensive disease; metastasis extending upto brain. CONCLUSION Frequency of trophoblastic disease was high in this series compared to world and national literature. Therefore, emphasis should be on the early diagnosis of disease as proper management in the early stages strongly influences the outcome of disease. Suction evacuation and follow-up are ideal treatments for benign trophoblastic disease.
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Meigs' syndrome. JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN 2006; 16:602-3. [PMID: 16945236 DOI: 9.2006/jcpsp.602603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/15/2005] [Accepted: 07/07/2006] [Indexed: 11/09/2022]
Abstract
Meigs' syndrome is a rare clinical condition commonly considered to be associated with malignant ovarian tumour. A case of unmarried female is presented who came with a slowly increasing abdominal mass. Clinical and ultrasonic investigations revealed a mobile, solid right adenexal tumour in the lower abdomen, along with ascites and pleural effusion of the right lung. The level of CA 125 was also raised. Diagnosis of Meigs' syndrome was confirmed after surgical intervention. The tumour was successfully removed and pleural effusion disappeared 15 days after the intervention. Cytomorphologic study of both the tumour and ascitic fluid was negative for malignancy.
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Low birth weight, the "small for dates" syndrome and perinatal mortality in a low family income group. ACTA PAEDIATRICA SCANDINAVICA 1968; 57:534-6. [PMID: 5706370 DOI: 10.1111/j.1651-2227.1968.tb06975.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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