Polycystic ovarian syndrome; pattern of disease in patients

The objective of this study is to: describe the pattern of disease in patients with polycystic ovarian syndrome. Medline Data Base. Descriptive case series study. Gynaecological Outpatient Department of Ghurki trust teaching hospital Lahore. 6 months period, from 8[th] October 2012 to 7[th] April 2013. Sixty cases of polycystic ovarian syndrome as diagnosed on ultrasound were selected. These cases were examined for height, weight, body mass index, hirsutism, acne, acnthosis nigricans, breast examination [galactorrhoea]. These cases were investigated for blood sugar [random], Fasting Insulin, pelvic ultrasound, LH, FSH and serum prolactin. The mean age of the patients were 24.93 +/- 5.67 years. There were 28 [47%] patients of menstrual disturbance, 18 [30%] patients of subfertility, 9 [13%] of obesity. There were 13 [21.7%] patients of BMI level of equal to or less than 25 kg/m[2] and 47 [78.3%] patients of BMI level more than 25 kg/m[2]. There were 25 [41.7%] patients of hirsuitim, 14 [23.3%] patients of acne and 17 [28.3%] patients of acanthoris nigricans on physical examination. There were 28 [46.7%] patients of LH level of more than 10 IU/L [raised] and 1 [1.7%] patient of more than 350 mU/L prolactin [raised]. The mean right ovary volume of the patients was 12.08 +/- 3.04 and mean left ovarian volume of the patients was 11.86 +/- 4.83. Hirsutism and cycle disturbances are the major clinical features of polycystic ovarian syndrome patients. Obesity seems to be more prevalent in polycystic ovarian syndrome patients. The ratio between LH and FSH as a diagnostic tool was low in our patients

Emergency contraception; knowledge and attitude of family physician of a teaching hospital, Lahore

To assess the knowledge of family medicine health care providers and their attitude towards emergency contraception [EC] in Lahore Medical and Dental College and out-patient centers of Ghurki Teaching Hospital Lahore. Medline Data Base. Cross sectional descriptive study. 3 months period, from March to June 2011. Faculty physicians from different specialties, residents, and medical officers were included in the study. Data was collected on a structured pre-coded 21 -item questionnaire containing demographic profile of the respondents and questions concerning their knowledge, attitudes and beliefs towards emergency contraception. In total 85 interviews were conducted with the response rate of 100%. There were 43 faculty members [50%], 14 residents [16%] and 28 medical officers [32%], 51 male [60%], 34 female [40%] physicians, the majority 58 [68%] were married. Although 79 of the respondents [92.9%] reported considerable familiarity with EC, objective assessment revealed deficiency in their knowledge. Only 41 [48%] correctly chose menstrual irregularity not being most common side effect of Per oral emergency contraception [POEC] while only 28 [32.9%] of respondents answered that EC is not an abortifacient. Only 30 respondents [35%] had an opportunity to learn about EC through workshops. Among the barriers identified 27 respondents believe that as use of POEC would promote sexual promiscuity [31%] and 59 were concerned about birth defects/ side effects [69%].Religious and ethical barriers were also a concern in 57 [67%] and 62 [69%]] of the respondents respectively. Overall attitudes regarding emergency contraception were positive, however 45 [52.9%] were unsatisfied with their current knowledge and 77 [90%] were interested in learning more about EC. Physicians need more detailed information about EC, which would increase the application rate of the users and decrease their own prejudices

Obstetric outcomes; subsequent to stillbirth in the first pregnancy

To compare obstetric outcomes in the pregnancy subsequent to still birth with that following live birth in first pregnancy. Medline data base. Prospective cohort study. Ghurki Trust Teaching Hospital Lahore. The study included women who delivered a stillbirth between 2005 - 2007[exposed cohort]. A group of women with live birth [unexposed cohort] was matched for delivery within the same year, maternal age [ +/- 3 years], parity [ +/- 1]. In 2009, the charts of these women were examined for subsequent pregnancies. Main outcome measures Maternal and neonatal outcomes in the second pregnancy, pre eclampsia, placental abruption, labour induction, instrumental delivery, caesarean delivery, malpresentation, prematurity, low birthweight and stillbirth. The exposed cohort group B [n =50] was at increased risk of preeclampsia [44% versus 28%, p value = 0.001<0.05] and placental abruption [20% versus 2%] and malpresentation [18% versus 4%]. labour induction [20% versus 8%] instrumental delivery [16%versus 8%] and emergency caesarean [40%versus 16%]; and prematurity [62%versus 26%, p value = 0.001<0.05], low birthweight [86% versus 54%, p value = 0.000<0.05] and stillbirths [6% versus 2%, p value = 0.489>0.05] of the infant as compared with the unexposed cohort group A[n =50]. Majority of women with a previous stillbirth have a live birth in the subsequent pregnancy, they are a highrisk group with an increased incidence of adverse maternal and neonatal outcomes

Functioning uterus with absent cervix, short vagina and transverse septum

A 25-year-old married lady with primary amenorrhea, infertility, lower abdominal pain and dyspareunia underwent vaginoplasty, total abdominal hysterectomy with right adnexal clearance for congenital absent cervix, vaginal septum with functioning uterus and right sided endometrioma. Mould was kept in vagina for 2 weeks followed by intermittent vaginal dilatation for one week. Couple was advised normal coital function and intermittent vaginal dilatation at home. Patient was followed regularly in OPD for 4 months and there was no complaint regarding sexual life

Symplastic leiomyoma of uterus: a rare histological variant

Symplastic leiomyoma is a rare histological variant of leiomyoma. This is a case report of a young nulliparous patient who presented with primary infertility for 2 years and swelling in lower abdomen for 6 months. Intramural fibroid was diagnosed during a pelvic ultrasound. Histopathology of that myomectomy showed symplastic leiomyoma with absent mitotic figures. The patient was managed as for a benign tumor