Fetomaternal outcome of pregnancies complicated by acute appendicitis

To observe the frequency and Fetomaternal outcome of pregnancies with acute appendicitis. Prospective / observational study. This study was conducted in gynecology and surgical department of Ghulam Muhammad Mahar Medical College Teaching Hospital Khairpur Sindh from January 2010 to December 2012. All pregnant ladies admitted in Gynae and surgical department with history of acute pain in abdomen and strong suspicious of acute appendicitis on the basis of history, clinical examination and ultrasound findings after exclusion of other gynecological and surgical causes of acute abdomen during pregnancy were included in the study for following variables: Presentation, duration of symptoms, operative findings and complications associated with disease and operative procedure were noted. Data was collected on pre-designed Performa and analyzed on SPSS version 15. During 3 year study period total 8700 Obstetric admission and cases with strong suspicious of acute appendicitis in. pregnancy was 20 [0.22%], most women belongs to age between 18-40 years. More cases seen 2[nd] trimester 11[55%], duration of symptoms < 24 hours seen in 85% and >24 hours seen in 15% of cases. Abdominal pain was leading symptom present in 80% of cases while lower abdominal tenderness was leading sign seen in 90%. On surgery signs of acute appendicitis seen in 75%, normal looking appendix in 10%, while perforated appendix with moderate pus in peritoneal cavity seen in 15% of cases. One maternal death was seen in study population due to septicemia, most probably because of late presentation. The evaluation of a pregnant woman presenting with acute abdominal pain warrants a careful workup due to the possible risks for the fetus and mother if appendix perforates

Frequency of hepatitis C in general surgical patients at teaching hospital Khairpur Sindh

Viral hepatitis is a global issue. Hepatitis C virus is worldwide public health problem. This is related to the continued occurrence of new infections and the presence of a large reservoir of chronically infected population. To observe the frequency of Hepatitis C virus [HCV] infection and find out the risk factors in general surgical patients. Prospective Observational type. This study was carried out in the Surgical Department of Ghulam Muhammad Mahar Medical College Teaching Hospital KhairPur Sindh during one year period from May 2012 to April 2013. All patients admitted in surgical department either for emergency or elective surgery was included in the study. All patients were screened for HbSAg and Anti-HCV by using immumochromatography [ICT] method. The data of sero-positive patients for hepatitis C were taken for further study. The data was collected through pre- designed Performa and analyzed through SPSS version 15. Total 1030 patients were admitted in surgical department for emergency or elective surgery. During screening Anti-HCV +ve was found in 165[16.0%] patients. Out of these, 95[9.2%] were male and 70 [6.7%] were female. Mean age of these patients was 40.7 years. Among positive patients, most belongs to rural area with poor socioeconomic status. Multiple injections by quacks, shaving by barbers, history of blood transfusion, previous surgery were found to be risk factors in male, while in female history of Gynae and obstetrics procedure, partner +ve for HCV, blood transfusion were found main risk factor. No any risk factor was found in 20 [12.1%] male and 35 [21.2%] females. In the absence of any vaccine for Hepatitis C virus, emphasis should be made on health education and about the risk factors for virus transmission. Health care providers must be committed in the formulation of policies and strict adherence to the safe practices

clinic-pathologic correlation of elective abdominal hysterectomy at teaching hospital Khairpur, Pakistan

To study the clinical indication and common pathologies identified on specimen, and complications associated with this procedure. This prospective observational study was carried out at Department of Obstetrics and Gynaecology, Ghulam Muhammad Mahar Medical College Teaching Hospital Khairpur [Shaheed Muhtarama Banazir Bhutto Medical University Larkana Sindh, Pakistan] during one year period from 1[st] May 2010 to 30[th] April 2011. All abdominal hysterectomies performed during this period were studied for the following variables: The primary clinical indication, the histological diagnosis and complications associated with this procedure. Data was collected on pre-designed Performa and analyzed on SPSS version 15. Total number of patients admitted during study period were 5580. Of these, 2280 [40.86%] had the gynecological problems, of these 2280 patients, 820 [35.96%] required surgery. Two hundred ninety women underwent major surgery which included elective abdominal hysterectomy in 150 [51.72%] patient. Peak age incidence was in 35-60 years. In 97% cases indication were for benign conditions. Menstrual disorders were the major clinical indication of hysterectomy while uterus leiomyoma were the common pathology confirmed. There was no mortality associated with the procedure. Menstrual disturbance was leading indication of hysterectomy and leiomyoma was the commonest pathology found on hysterectomy specimen

Eclampsia: still a major cause for adverse maternal and perinatal outcome

To determine the frequency of eclampsia and to investigate the maternal and perinatal outcome of the condition in order to identify whether further improvements can be made to the care of women by early interventions. A descriptive observational study. This study was conducted at the Department of Obstetrics and Gynaecology, Ghulam Muhammad Mahar Medical College Teaching Hospital Khairpur Mir's Sindh, during one year period from 1[st] January to 31[st] December 2010. All patients presenting with eclampsia in the labour room were included in the study. The diagnosis was based on case definition and was managed according to the set protocols. Data was recorded on pre-designed Performa. A total of 2796 patients were admitted in labour room during the study period and out of them total cases of eclampsia were 81 patients thus contributing 2.89% of the total admission. Most of the patients were unbooked only 11% patients were booked. 49% of women had first fit in the antenatal period, 37% in intrapartum while 13.5% had first fit in postpartum period. Headache and raised blood pressure was found in 85% of cases. 91% of women received magnesium sulphate, platelet count <150,000/m 3 were found in9.8%, deranged LFT in 14.8% women and abnormal renal function test were found in 34% . Mode of delivery was caesarean section in 57% patients, vaginal delivery in 34.2%. Two patient needed hysterectomies due to severe PPH, 4 maternal deaths were observed in study population. Regarding perinatal outcome 35 fetuses born with LBW, 26 were still born and 9 died in neonatal period. Eclampsia has strongly significant adverse impact on mother and fetus, which could be avoided by provision of integrated, adequate MCH services especially during antenatal period