ABSTRACT
Preterm delivery occurs before 37 completed weeks of gestation and it is the major determinant of infant mortality in developed countries. Preterm delivery is the factor most responsible for the relatively high infant mortality in our country. Despite many trials of reduced activity, tocolytic therapy, antibiotic therapy and other strategies for prevention, no effective and reproducible method of preventing preterm delivery has been demonstrated. One treatment that showed promise in small trials was prophylactic treatment with pro-gestational compounds. The purpose of this work is to determine the effectiveness of 17 alpha hydroxyl progesterone in prevention of preterm delivery in women who had a previous preterm birth. It was a descriptive case study and was conducted in the department of Obstetrics and Gynaecology Fatima Memorial Hospital, Lahore for a period of twelve months from January 2011 to December 2011. A total of 135 cases were received by non-probability purposive sampling technique. In this study majority of the patients i.e. 46.67% [n = 63] were between 26 - 30 years, 24.44% [n = 33] were found between 22 - 25 years, whereas 28.89% [n = 39] were found between 31 - 35 years, mean age was found to be 28.24 + 3.83. Most of the patients i.e. 69.62% [n = 94] were found between 21 - 24 weeks and 30.37% [n = 41] were found between 16 - 20 weeks. Data regarding number of previous preterm deliveries showed that majority of the patients i.e. 39.25% [n = 53] were found only 1 previous preterm delivery, 27.49% [n = 29] with 3 and > 3 previous preterm births were found only in 11.86% [n = 16]. Prolongation of pregnancy beyond 36 weeks of gestation is described where 68.15% [n = 92] are shown to be delivered beyond 36 weeks and only 31.85% [n = 43] could not deliver beyond 36 weeks of gestation
ABSTRACT
Percutaneous endoscopic gastrostomy [PEG] refers to insertion of a tube into the stomach percutaneously, aided by endoscope and was first described in 1980 by Gauderer. This was devised for feeding the patients who have swallowing problems due to any reason especially neurodisability. There is an enhanced need for greater selectivity in patient referral. Retrospective, single-institution case series. The study was performed in Waterford Regional Hospital, Waterford, Ireland. Jan 2003 to Dec 2007. A total of 203 consecutive patients referred for nutritional support underwent PEG tube insertion during this period. Written informed consent was taken from all the participants or their attendants and the procedure was performed with prophylactic antibiotic and under intravenous sedation. Standard PEG set was used for the procedure. Feeding was started 12 hours after tube placement and care instructions were given. The parameters of study included indications, annual frequency, and overall outcome. A total of 203 patients having a male to female ratio 1:0.7 underwent PEG tube insertion. The age ranged from 26 to 96 years [mean 79+5.17. The mean duration of PEG feeding was 93 [3-785] days. The annual frequency of insertion increased from 19 [9.3%] patients in 2003 to 64 patients [31.5%] in 2007. The length of stay ranged from 1 to 350 days [median 93]. In this cohort, 32 [15.7%] patients died during the same admission. A total of 79 [38.9%] were discharged for home, 92 [45.3%] were discharged back to nursing home care. This study underscores the need for enhanced awareness and protocol-driven selectivity in patient referral for PEG tube insertion