Revised approach in the management of puerperal sepsis

There is no accurate data available on the incidence of puerperal sepsis in Pakistan, but certainly it is one of the first three causes of maternal mortality in Pakistan. About 10% of total Gynaecology emergencies admitted in Bahawal Victoria Hospital were diagnosed as puerperal sepsis. A study was carried out to review the treatment of such cases, 32 cases included in this study over a period of 14 months, in Gynaecology Unit II at B.V.H. Bahawalpur. They were classified into various groups and standard line of investigations and treatment was followed in these patients. As special emphasis was laid on early surgical intervention along with conservative medical and nursing treatment. The details of each group are discussed in this study. We have very encouraging results from our study in this problem

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