Fetomaternal outcome of pregnancy between 40 and 42 weeks

To evaluate whether serial monitoring of fetuses beyond 40 weeks with biophysical profile and non stress test improves the fetal outcome in terms of morbidity and mortality. Prospective control study. Department of Obstetrics and Gynaecology at Ittefaq Hospital[Trust] Lahore,. From Jan, 2007 to June 2008. Two hundred women with singleton uncomplicated pregnancies at 40 weeks were divided into two groups; A study group with biweekly biophysical profile and non stress test and a control group with biweekly antenatal clinical assessment with fetal kick count chart. Main outcome measures were onset of labour, mode of delivery, Apgar score, presence of meconium and admission to nursery. The age of patients ranged between 18 to 39 years with the mean of 26.33.The range of gravidity was between primigravida to gravida seven. Ninety six percent of total patients were delivered by 41 weeks and 6 days.18% of women were induced in study group compared to 11% in control group [p value=0.124].Cesarean section rate was 8% in study group and 11% in control group. Rate of instrumental deliveries was 6.5% in study group while 11.2% in control group. The difference in mode of delivery was found to be insignificant [p=0.538].Weights of the babies ranged between 2.6 to 4.4 kg with a mean of 3.246 kg. Cumulative%age of APGAR score at 5 minutes was more than 6/10 in 92.5% cases [p=0.665].Meconium was found in 18% of cases in study group and 22% of control group[p=0.917].12% of the babies were admitted to nursery in study group compared to 16% in control group. Perinatal mortality was found to be 10/1000 in control group while there was no perinatal death in study group. The difference of outcome between two groups was found to be statistically insignificant which concluded the validity of either mode of management

Assessment of socio-economic status of patients

To determine whether or not doctors assess the socio-economic status of their patients in order to customize treatment and improve compliance. A cross-sectional Jinnah Hospital and Shalimar Hospital Lahore. From March to June 2005 Ninety-three patients were included from each of the two randomly selected tertiary care hospitals [one public, one private] of Lahore. Doctor-patient encounters were observed. No assessment was made for 134/186[72%] patients. 51/186[27.4%] received an inadequate assessment. Only 01/186[0.5%] patient received a thorough assessment of his socioeconomic status. Doctors in the private hospital made better effort to assess the socioeconomic background of the patient [albeit inadequately], compared to those in the public hospital [p: < 0.0001]. Doctors should be regular and meticulous in patients' socioeconomic status assessment

experience with vascular trauma

This prospective study was conducted at Jinnah Hospital, Lahore over a period of sixty months. Patients between the ages 18-32 years presenting with Vascular Trauma in A/E department were included in the study. Gender distribution was 36 males and 8 females. The vascular trauma was as follows: 5 radial arteries, 5 posterior tibial arteries, 14 femoral arteries, 7 popliteal arteries, 1 popliteal vein, 3 axillary artery, 5 brachial, 1 external iliac artery, 2 IVC and 1 Infrarenal aorta. All of these patients were managed surgically. The end results for all were patent vessels except 2 [1 popliteal vein and 1 external iliac artery ligated] with functional limbs averting deaths and preventing life long disabilities thereby improving the quality of life and productivity as a human being