Universal screening with glucose challenge test in detection of gestational diabetes

To compare efficiency of glucose challenge test with oral glucose tolerance test for detection ofgesta-tional diabetes mellitus [GDM]. This observational cross sectional study was conducted in The Department of Obstetrics and Gynaecology, Sharif Medical and Dental College / Sharif Medical City Hospital, from December 2012 to June, 2013. woo consecutive pregnant ladies were included during this period between the gestational age group of 26 to 30 weeks by using convenient sampling technique after analysis of risk factors. All women undergo glucose challenge test [GCT] and glucose tolerance test [GTT]. Results of GCT were compared with glucose tolerance test as gold standard. Out of 1000 pregnant ladies, glucose challenge test screened 450 patients with positive results, and 550 patients with negative results. Out 0/450 screened positive patients, oral glucose tolerance test [OGTT] detected 400 patients with true positive result and 50 patients with false positive results. Out 0/550 screened negative patients of GCT, oral GTT detected 510 patients with true negative and forty patients with false negative results. So the sensitivity of GCTwas 90.90%. Prevalence of gestational diabetes was 44%. Universal screening with glucose challenge test is a reliable cost effective and excellent screening test for gestational diabetes in low resource setting

Pattern and outcome of congenital anomalies and maternal risk factor association

1. To determine the frequency of different congenital anomalies in our hospital population. 2. To identity the possible risk factors responsible for these anomalies. Descriptive cross sectional study. Department of Gynaecology and Obstetrics Sharif Medical and Dental College / Sharif Medical City Hospital, from January to December 2012. All booked pregnant females with fetal congenital anomalies diagnosed on antenatal USG during this period were included in study. Frequency and pattern of these anomalies were recorded. Variables studied include parity, age, duration of gestation, education and social status, family history of congenital anomalies, disease in sibling, cousin marriage, relationship with cousin, medical disorders, industrial exposure, and viral infections in early pregnancy. Outcome was determined in terms of frequency and pattern of malformations, male to female ratio, mode of delivery, and severity of congenital anomalies. Prevalence of congenital anomalies was 21.5 per 1000 total births, with individual incidence of neural tube defect being 18.81 pr 1000 total births. Neural tube defects remain the most common abnormality. Cousin marriages with 1st degree cousin [83.33%] and maternal relationship with cousin [85%] showed significant association as risk factor for congenital abnormalities [p < 0.350]. Neural tube defect is identified as major congenital abnormality in this community and consangious relationship being the biggest risk factor associated with it

Perinatal mortality audit at Sharif Medical and Dental College Lahore - Pakistan

Perinatal mortality rate [PNMR] is an indicator of quality of health in a system. It is multifactorial in aetiology and is significantly influenced by the provision of health care services. Pakistan is among the countries with highest PNMR so major efforts are needed to reduce perinatal mortality in this region. The objective of this study was to determine the perinatal mortality rate, to identify major causes responsible for these mortalities, and to suggest possible preventive measures. This is a descriptive cross sectional survey. It was carried out in the department of Obstetrics and Gynaecology, Sharif Medical City Hospital, from Jan, 2008 to Jan, 2009. A prospective review of all perinatal deaths that occurred between 28 weeks of gestation and 1[st] 7 days of neonatal period during one year period was recorded. Babies born before 28 weeks, delivered outside Sharif Medical City Hospital, and weighing less than 1kg were excluded. Perinatal deaths were analysed according to maternal and fetal characteristics and cause of death determined according to Aberdeen classification. Outcome measures include stillbirth rate, early neonatal death rate, and perinatal mortality rate. During one year period, total births were 1116, out of which 48 were perinatal deaths, 58.33%, [95% CI 44.38-72.28] were stillbirths, and 41.67% [95% CI 27.72-55.62] were early neonatal deaths. Still birth rate was 25.08/1000 total births, and early neonatal death rate was 18.38/1000 live births. Perinatal mortality rate was 43/ 1000 total births. Maternal hypertensive disorders were responsible for maximum still births 22.92% [95% CI 11.03-34.81]. Early neonatal deaths due to infections were responsible for 25% deaths [95% CI 12.75-37.25] primarily due to prematurity. Maternal hypertension, congenital anomalies and neonatal infections still remains major causes for perinatal mortality. Regular perinatal death audits and adequate provision of health care services in a given system will reduce the prevalence of these disorders

Bone metastasis: a comparison between bone scan and bone marrow aspiration biopsy

Background: all cancer involves the production of abnormal cells are capable of irregular and independent growth that invades health body tissues. Metastases are a characteristic feature of all malignant tumors, which spread to distant areas of body via lymphatic system and blood stream

Material and Methods: this cross-sectional study included 50 patients with different Malignancies. The diagnosis of these patients had been established on the basis of Histopathology. These patients were taken from Oncology Department of lnmol Jinnah, Shaikh Zayed and Mayo Hospitals. Lahore. These patients underwent bone scan which was performed with technetium 99m methldipbosphonate. [99.m Tc-:-MDP]. Twenty five patients with positive bone scan findings were taken as group A and the other 25 patients with negative bone scan were marked as group-B. The metastatic involvement of these patients was found by performing bone marrow aspiration and trephine biopsy

Results: in our study, 9 out of 50 cases were positive for bone marrow infiltration. Out of these 5 cases [20%] were positive for bone marrow metastases in positive bone scan patients. Whereas 4 patients [16%] were positive for bone marrow metastases in negative bone scan patients

Conclusion: the study hence reveals that bone scan is a superior method for detection of bone marrow infiltration in patients with · malignant metastatic disease but bone marrow aspiration /trephine biopsy is also mandatory as it picked 4 patients [16%] out of 25 patients with negative bone scan

Iron deficiency anemia in adults

300 adult patients [150 males-age 13-70 years, and 150 non-pregnant females-age 13-45 years] of anemia were investigated for iron deficiency. 34% of males and 70.6% of females showed iron deficiency anemia. Laboratory investigation which proved of greatest diagnostic value were MCHC, transferring saturation and iron staining of bone marrow