ABSTRACT
To analyze the rate, the frequency of different indications and the most common indication of cesarean sections in Military Hospital Rawalpindi. Cross sectional study. Obstetrics and Gynecology Department of Military Hospital Rawalpindi from September 2011 to February 2012. A total of 3555 pregnant females delivered during study period were enrolled in the study. Health volunteers and the cases of uterine rupture, pregnancy with fetal anomaly, or termination of pregnancy were excluded from the study. All patients were admitted in labor room. Detailed obstetric and gynecological history was taken. Detailed general physical examination and obstetric examination was done. Baseline investigations were checked. Fetal anomalies were ruled out by anomaly scan. Strict fetomaternal monitoring was done during labor. Cervical foley catheter and prostaglandin E2 [Prostin] tablets were used for induction according to Bishop score. Clinical record of all patients, including mode of delivery and indication, was analyzed in terms of percentage and frequency and documented in a special performa after written informed consent. Filled performas were attached with patient's case notes. Patients enrolled in the study over six months were 3555, out of which 1620 [45.5%] were delivered by cesarean section, 1901 [53.4%] were spontaneous vaginal deliveries and 34 [0.9%] were delivered by vaginal birth after cesarean [VBAC]. The rate of cesarean section in our study was 45.5% and the most common factor was repeat cesarean section [44.4%], followed by failed trial of labor [27.1%] and fetal distress seen in 165 [10.1%] cases. The rate of cesarean section in our study was 45.5% and the most common factor was repeat cesarean section 44.4%
ABSTRACT
In view of changing patterns, to identify most common type of foreign bodies in tracheobronchial tree of children. To make recommendations for appropriate measures to prevent the incidence of inhalation. This descriptive study was carried out between April 2001 to March 2002 on 108 children. Department of Pediatric Surgery, Children Hospital, Pakistan Institute of Medical Sciences [PIMS], Islamabad. We studied 108 patients out of whom 68 were male [63%] and 40 were female [37%]. The mean age was 3.97 years. Most common symptoms were dyspnoea in 88 [81%]. 35 patients [32%] had insignificant X-ray findings. 65 patients [60%] had hyperinflation. 3 patients [2.7%] had atelectasis. One patient had bronchiectasis, one with emphysematous change and one had pleural effusion. The most common organic foreign bodies 28 had pieces of peanuts [26%] and next most common 11 had beetle nuts [10%]. Most common inorganic foreign bodies 26 in our series was a whistle [24%], followed by 13 metallic rings [12.2%], metal nails, safety pins, pallets, watch batteries and ring stones. Aspiration of foreign body into tracheobronchial tree in children carries a high risk to life but adequate and prompt treatment is associated with very low mortality. Health care education is the key to prevention. Industrial manufacturing laws with regard to quality control and safety of production of various toys to which children are commonly exposed should be forcefully implemented