Sonographic fetal biometry charts for a Pakistani cohort

This study aimed to develop growth centiles at different gestational weeks for fetal biparietal diameter, abdominal circumference, femur length and head circumference in a Pakistani cohort. Data were collected at a tertiary referral hospital from pregnant women at gestational ages 13-40 weeks referred for obstetric ultrasound as a part of routine antenatal care. A total of 1599 fetal sonographic biometric measurements were collected after screening for the inclusion criteria. For each measurement, separate regression models were derived to estimate the mean, standard deviation and reference percentiles at each week of gestational age for this cohort. The best fitting model for each variable was selected. These charts will help radiologists and clinicians in predicting dates of delivery, assessing fetal growth and identifying intrauterine fetal insufficiency in the Pakistani population

Continuous sciatic nerve block: compartive study between the parasacral, lateral, and anterior approaches for lower limb surgery

The aim of the present study was to evaluate the ease and reliability of the anterior and lateral approaches to sciatic nerve block compared to the posterior parasacral approach, and their suitability for the specific factors in the patients, positions, and surgeries. Also, the insertion and usefulness of the continuous catheter technique was evaluated. The study was carried out on 120 patients, ASA I, II and III, of both genders, age range between 20 and 70 years, scheduled for orthopedic, general and vascular lower limb surgery. Patients were enrolled in a prospective, randomized, double blind study. Patients were divided into three equal groups, 40 patients each. All the patients received femoral nerve block in addition to sciatic nerve block either parasacral [Posterior group], lateral [Lateral group] or anterior approach [Anterior group]. This was followed by continuous femoral and sciatic nerve blocks in the postoperative period. Patients were assessed as regards the time, duration and intensity of the sensory and motor blocks and also the postoperative analgesia offered by the continuous block. They were also assessed for the hemodynamic changes accompanied these blocks. Radiological study was made to demonestrate the spread of different volumes of the drugs alongside the course of the sciatic nerve. The posterior parasacral approach is the easiest technique to perform and used successfully even in obese patients, but difficult to be done, if at all, in patients with limited movement such as multi-pelvic fractures. The anterior approach was found to be the best for the patients in the supine position, with best results as regards patients' satisfaction and sensory and motor blocks. Only, it is a technique that needs high experience especially in obese patients. The lateral approach was the least performed technique especially its high approach. However, it is useful in patients in supine position, and gives the best results in thin patients. The technique showed to be extremely difficult in obese patients. The insertion of a catheter for continuous nerve block was easy. These blocks provided good or excellent postoperative analgesia for all patients in the different groups and facilitated early mobilization which helped in preventing the lower limb srugery-related morbidity and mortality

study of 780 cases of infertility at QAMC Bahawalpur

In spite of world population explosion, the desire for reproduction remains a basic human desire. Infertility is a complex phenomena, and couples suffering with this problem, need lot of emotional and psychological sport along with their investigations and treatment. The overall incidence of infertility varies from 15 to 20% all over the world. Eitiology does vary, very little from one country to the other due to their social background. A study of 780 cases of infertility have been carried out to sort out their reason for infertility. These patients range from 18 to 40 years of age group and come from various social groups. After initial investigations, they were divided into four groups depending upon their eitiological factors. It is observed that conception rate varied from one group to the other, overall conception rate achieved was 44.743% which is reasonably encouraging with our present management

Surgical management of postpartum and pelvic hemorrhage

Despite the ready availability of banked blood and blood products, postpartum and pelvic haemorrhage remains one of the major causes of mortality and morbidity all over the world. In developing countries, as in Pakistan, it is among the first three causes of maternal mortality. Sixty-one cases were included in this study, over a period of nine years from various hospitals, such as [i] Maternity and Children Hospital, Dammam affiliated with King Faisal University, Al-Khobar Saudi-Arabia, [ii] Services Hospital affiliated with Allama Iqbal Medical College, Lahore-Pakistan and [iii] Bahawal Victoria Hospital affiliated with Quaidi-Azam Medical College, Bahawalpur-Pakistan. Our management mainly based on surgical treatment along with conventional therapy is discussed

comparative study of vaginal prostaglandin E2 passaries with intravenous oxytocin for the induction of labour after spontaneous rupture of membranes

In a prospective randomized study, 60 patients were induced with 3 mg vaginal PE2 passeries or intravenous oxytocin. Oxytocin stimulation was associated with shorter labour and a lower incidence of abnormal cervimeteric progress, after spontaneous rupture of membranes Out of those patients given PGE2, 20% required a second dose after four hours of slow progress. 10% of primigravida subsequently developed abnormal labour and required augumentation by oxytocin to correct their uterine contractions. Two caesarean sections were carried out for disproportion and remaining 58 patients were delivered vaginally. PGE2 passeries were not associated with an increased incidence of hyperstimulation or sepsis. In conclusion oxytocin infusion is a safe, effective, but inconvenient method of induction of labour, while PGE2 passeries are safe, effective, more acceptable but expensive method of induction of labour