Torsion of fimbrial cyst

A case of fimbrial cyst torsion is presented in an 18-year-old virgin female. She presented with severe left lower abdominal pain. Ultrasound scan was suggestive of an ovarian cyst. On laparotomy, a large 22 x 22cm twisted leftfimbrial cyst was found and a left salpingectomy was performed. Although torsion of fimbrial cyst is rare, it should be considered in the diagnosis of acute abdomen in females

Perinatal outcome in diabetic mothers at Isra university hospital

To evaluate perinatal outcome in diabetic mothers in our tertiary care set up. A descriptive study. Out patients department and labour ward of Obstetrics and Gynaecology Unit, Isra University Hospital Hyderabad, Sindh- Pakistan, from 3[rd] January 2007 to 2[nd] January 2008. Total 110 pregnant women between the age of 20 and 40 years with diabetes, irrespective of their parity and previous obstetric history were selected by convenience [non-probability] sampling. Women with eclampsia, antepartum haemorrhage, pregnancy induced hypertension and medical disorders were excluded from the study. All information was recorded on preformed proforma and analysed through SPSS version 11.0. Among perinatal complications, macrosomia was seen in 41.8% of fetuses, biochemical abnormalities in 85.3% infants, moderate to severe birth asphyxia in 33.6% and congenital malformations in 6 infants of diabetic mothers. Perinatal complications of diabetic pregnancy are more common in high parity women. Macrosomia, biochemical abnormalities and asphyxia are the common perinatal complications in our set up

Hepatitis C: frequency, risk factors and pregnancy outcome

To determine the frequency of HCV in pregnant women, to find out the risk factors for HCV in pregnant women and to compare the pregnancy outcome of HCV positive with HCV negative mother. Case - control study. Obstetrics and Gynecology Department of Isra University Hospital Hyderabad, from Nov 2007 to August 2008. Study was conducted on pregnant women who were screened for HCV antibody during antenatal consultation and were admitted for delivery. Five ml blood was drawn from each patient and serum was tested for anil HCV by ELIZA. Detailed history was taken for evaluation of risk factors. All results were analyzed on statistical software SPSS version 16. Fishers exact test or Chi square were applied among the categorical variables. Frequencies and percentages and 95% confidence intervals were calculated. Student t test was also used to compare the mean [2 tailed] of numerical parameters. P value of less than or equal to 0.05 was considered as significant. Frequency of hepatitis C in our study was 8% [n-23]. After computing the measures of association for cases and controls with regard to the risk factors, history of previous surgery [p=0.01], blood transfusion [p=0.02], dental surgery [p=0.004] and history of injections [p=0.01] were found to have significant association with HCV positive status of the patients. Logistic regression was used to control the effects of various risk factors under study and to find out the direct effect of risk factors on HCV positive status. Using logistic regression, history of previous surgery [p=0.01], blood transfusion [p=0.02], dental surgery [p=0.04] and history of injections [p= <0.001] were found to have significant association with HCV positively in our study. Statistically no significant difference was found in birth weight, gestational age and Apgar score of new bom in cases and control groups. Frequency of hepatitis C in our study was 8%. No adverse effect on pregnancy outcome was observed when compared to controls

Frequency of vaginal candidiasis in pregnant women attending routine antenatal clinic

To determine the frequency of vaginal candidiasis in clinically symptomatic and asymptomatic cases of pregnant women attending routine antenatal clinic. A descriptive cross-sectional study. The antenatal clinic of Gynaecology and Obstetric Department at Isra University Hospital, Hyderabad, from April to October 2005. A total of 110 pregnant women were nonrandomly recruited by convenient sampling. The studied variables included the demographic data information on parity, trimester of pregnancy, presence of vaginal discharge and the presence or absence of diabetes. Vulva and vagina were inspected for signs of inflammation and discharge with sterile speculum and vaginal specimens were collected with sterile cotton tipped swabs. Swabs were subjected to Gram staining and examined microscopically for the diagnosis of candidiasis. The frequency of vaginal candidiasis during pregnancy was found to be 38%, in which 27% were symptomatic and 11% were asymptomatic group. Increased ratio of infection was observed in multigravida and diabetic women. There was no marked differences in results with respect to age and trimester of pregnancy. Although there is generally a high frequency of vaginal candidiasis, an increased ratio of vaginal candidiasis in multigravida and diabetic pregnant women requires these women to be routinely screened for vaginal candidiasis regardless of symptomatic status

Unreported urinary and anal incontinence in women

To know the occurrence of unreported urinary and anal incontinence in women and its relation with age, parity, pregnancy, childbirth and other factors. A descriptive study. Study was conducted at department of Obstetrics and Gynaecology, Isra University Hospital, Hyderabad from January 2002 to December 2003. Convenience sample of 858 women was taken to fill in a pre-formed questionnaire. All those who presented with urinary or anal incontinence were excluded from the study. The main outcome measures included occurrence and duration of incontinence as well as its relation to age, parity and other factors. Out of 858 women included in the study, 207 [24.12%] women admitted to have incontinence; 205 [23.89%] had urinary incontinence, 21 [2.44%] women had anal incontinence and among these there were 19 [9.26%] women having combined urinary and anal incontinence. One hundred and thirty eight [67.31%] females were between 21-40 years of age and 109 [53.17%] were between para 1-5. Eighty-one [39.51%] subjects had urinary incontinence for 5-10 years and 09 [42.85%] females had anal incontinence for 10-15 years. Sixty-nine [33.65%] women related the onset of urinary incontinence and 13 [61.90%] related the beginning of anal incontinence to first vaginal delivery. Other events related to the onset of incontinence included first pregnancy, second vaginal delivery, chronic cough, obesity, vaginal prolapse and menopause. Many women attending the Obstetrical and Gynaecological Outpatients department have symptoms of urinary and anal incontinence, but do not complain about these unless asked specifically. It is therefore, important for the gynecologist to ask direct questions regarding bowel and bladder dysfunction to identify such patients

Polycystic ovarian syndrome and hyperinsulinaemia

To determine the occurrence of hyperinsulinaemia in women with polycystic ovarian syndrome [PCOS]. A descriptive study. Isra University Hospital, Hyderabad from January 2002 to December 2003. Total 64 subjects were recruited from gynaecological outpatients department, between the ages of 15 and 40 years with clinical diagnosis of polycystic ovarian syndrome, presenting with weight gain, oligomenorrhoea, secondary amenorrhoea, hirsuitism or infertility and either ultrasound evidence of PCOS or raised Leutinizing Hormone [LH]/ Follicular Stimulating Hormone [FSH] ratio. Patient's venous blood was checked for fasting serum insulin. Out of total 64 women selected, 37[57.81%] were between 21 - 30 years of age. Weight gain was the commonest presenting complain [84.37%] followed by oligomenorrhoea [79.68%]. Infertility was found in 46 women [71.87%] and hyperandrogenism was observed in 43 women [62.49%]. Thirty-nine women [60.93%] had ultrasound evidence of PCOS and 43 [67.18%] had LH / FSH ratio greater than 2:1. Hyperinsulinaemia was seen in 27 [42.19%] women. In this study, 27 women [42.19%] had hyperinsulinaemia which indicates significant insulin resistance. Thus, all the patients presenting with clinical or biochemical evidence of PCOS must undergo checking of fasting serum insulin levels