ABSTRACT
Background: Postoperative complications after thyroidectomy are problematic for patients and surgeons. The postoperative outcome of thyroidectomies is related to risk factors concerning the patient, the thyroid disease and the surgeon
Objective: To analyze the risk factors for postoperative complications after thyroidectomy in patients of simple multinodular goiter
Methodology: A prospective study was conducted in Surgical unit of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan on 114 patients diagnosed and surgically treated for simple multi nodular goitre [MNG] between 1[st] July 2012 and 30 June[th] 2014 meeting the following criteria: bilateral MNG; operation by surgeons with experience in endocrine surgery; no associated parathyroid pathology; no initial thoracic approach; and minimum follow-up of 6 months. Age, sex, time of evolution of symptoms, thyroid weight, recurrent goiter and type of surgery [total thyroidectomy or near total thyroidectomy] were analyzed as risk factors for complications. Data was analyzed using SPSS version 16.0. P-values < 0.05 were considered statistically significant
Results: During the study period 114 thyroidectomies were performed. There were 20 [17.5%] males and 94 females [82.5%] with age of 48.5 +/- 13.6 years. Male to female ratio was 1:4.7. Total thyroidectomy performed in 57[50%] patients and near total thyroidectomy was also performed in 57[50%] patients. Total complications occurred was 29 [25.43%] in 114 patients. Transient hypoparathyroidism was the major complication seen in 17 [14.9%] patients and permanent hypoparathyroidism was seen in 3[2.6%] patients. 3[2.6%] patients suffered from transient recurrent laryngeal nerve palsy [RNLP] and 2 [1.8%] patients suffered from permanent RNLP. Hematoma formation was present in 3[2.6%] patients and wound infection was present in 1[0.9%].There was significant association of transient hypoparathyroidism with duration of goiter [p-value=.016], presence of compressive symptoms [p-value= 0.000] and type of surgery [p-value=.017]. Permanent hypoparathyroidism was significantly associated with recurrence of goiter [p-value=.02]. Permanent RNLP was significantly associated with compressive symptoms [p-value=.007]. There was no significant between hematoma formation and risk factors. So duration of goiter, presence of compressive symptoms, weight of thyroid gland, type of surgery and recurrence were the significant risk factors for complications in patients of simple MNG
Conclusion: In conclusion duration of goiter, presence of compressive symptoms, recurrence of goiter and surgical resection are significant factors for post thyroidectomy complications. By performing early surgery and total thyroidectomy complications rate can be reduced
ABSTRACT
Background: Bleeding from the reproductive tract in women is a naturally occurring event, generally the result of menstruation and childbirth, and is not associated with a bleeding disorder in most cases. Dysfunctional uterine bleeding is the most common reason for women to undergo an interventional gynecologic procedure. The major task of the clinician is to exclude endometrial carcinoma in women and to identify organic pathology in order to manage it effectively
Objective. To determine the incidence of endometrial carcinoma in women with abnormal uterine bleeding
Study Design: Cross sectional study
Setting. Department of Obstetrics and Gynecology, Sheikh Zayed Hospital, Rahim Yar Khan
Duration of study: Six months [16th February 2013 to 15th August 2013]
Material and method: One hundred and sixteen women with complaint of abnormal uterine bleeding, meeting the inclusion criteria were selected. All the patients were undergone endometrial sampling and assessment of endometrial thickness was done which was confirmed by endometrial biopsy to evaluate endometrial pathologies. The collected data was noted on pre-designed proforma
Results: The mean age was 42.07 years. According to parity, 56 women [48.2%] have 1-4 parity, 48 women [41.4%] have 5-8 parity and 12 women [10.4%] have 9-14 parity. The mean duration of dysfunctional uterine bleeding was 14.64 +/- 7.87 months. Six women [5.2%] have endometrial carcinoma while 110 women [94.8%] have no endometrial carcinoma
Conclusion: This study thus proved that in our setup the incidence of endometrial carcinoma is very high. So every patient with abnormal uterine bleeding should undergo endometrial biopsy to rule out endometrial carcinoma
ABSTRACT
Background: Maternal mortality is an important measure of maternal health
Objectives: To determine the maternal mortality ratio and determinants of maternal mortality in a tertiary care hospital
Patients and Methods: A descriptive study, was conducted in Obstetrics and Gynaecology Department at Sheikh Zayed Hospital Rahim Yar Khan. This was a 3 years study conducted from 1[st] January, 2010 to 31[st] December, 2012. All direct and indirect maternal deaths during pregnancy, labour and perpeurium were included. The reason for admission, condition at arrival, and possible factors responsible for death were identified. The other information including age, parity, gestational age and relevant features of index pregnancy were recorded on a proforma and analyzed by SPSS version 16
Results: There were a total of 30563 deliveries and 29139 live births. Total 168 maternal deaths occurred during 3 consecutive years, with a MMR of 576 per 100000 live births. The highest maternal mortality age group was 20-30 years in which 61.3% deaths were observed. Out of 168 maternal deaths, 26.78% were primigravida. Obstetrical hemorrhage [48.2%] was the most frequent cause followed by hypertensive disorders [20.8%] and sepsis [15%]
Conclusion: Birth facilities in our hospitals should be up to the mark to manage the pregnancy related complications promptly. Our study revealled high maternal mortality ratio in hospital setting with obstetrical haemorrhage, hypertensive disorder and septicemia as leading direct causes of maternal mortality whereas blood reaction as leading indirect cause of maternal mortality
ABSTRACT
To assess the various factors associated with breech delivery at term. Case control study. Apr 2004 to Sep 2004 Department of Obstetrics and Gynaecology unit-I, Bahawal Victoria Hospital Bahawalpur. This case control study was carried out in women with the age group 2040 years. Various risk factors [Parity, multiple pregnancy, placenta Previa, amount of liquor and congenital abnormalities] associated with breech [50 cases] at term [37-42 completed weeks] were compared with vertex [50 controls] after matching. Different factors associated with breech were oligohydramnios 44% vs control group, placenta previa 34% vs control group, primiparity 46% vs control group, multiple pregnancy 14% vs control group and congenital abnormalities 18% vs control group. Our study concluded that factors associated with breech delivery were oligohydramnios, placenta previa, multiparty, multiple pregnancy and congenital abnormalities