Study of association between diabetes mellitus [D.M] and hepatitis-C virus [HCV] infection

To study the frequency of hepatitis-C virus infection in diabetic patients. The observational descriptive cross-sectional study was conducted at Diabetes Research Centre Nishtar Medical College and Hospital, Multan from September 2006 to December 2007. Two thousand three hundred and twenty seven [2327] diabetic patients were included and were screened for anti-HCV antibodies by immuno-chromatography technique. Out of 2327 diabetic patients, HCV was found in 283 [12.2%]. Among 283 anti-HCV positive diabetics 147 [51.9%] were males and 136[48.1%] were females. The mean age of HCV positive patients was 58 +/- 13.41 years and it was observed the prevalence of HCV increases after the age of 40 years. Hepatitis-C virus infection is common in diabetic patients as compared to general population

Polycystic ovarian disease; the diagnosis and management

Poly Cystic Ovarian Disease [PCOD] is probably one of the most common endocrinological disorders amongst the women during their reproductive years. Using USG criteria only 20-33% of apparently healthy women in childbearing period, have been found to have PCOD in population study. Whereas prevalence of 4-10% in women of reproductive age is commonly reported when the diagnosis is based on clinical, biochemical and US scan features. Diagnosis and management of polycystic ovarian disease. Setting Seyal Medical Centre, Multan. Duration From January 2002 to December 2003. Sample size: 200 patients. Most of he patients were in the age group of 21-30 years. The youngest patient was of 17 years and eldest was of 42 years. Majority of the women were nulliparous or of low parity comprising 92% of cases. The commonest symptom was menstrual disorder in 168 Patients [84%]. Ultrasound is very helpful for diagnosis of POD. i. About 80% of patients were diagnosed as PCOD on ultrasound. There is increased level of LH in 72% patients, 8% have raised prolactin levels. All patients were first treated with clomiphene citrate while surgical treatment is done n only 30% of cases. GnRH analogue and purified FSH were not used because they are quite expensive. PCOD is found to be one of the commonest problem in reproductive years of life. Clomiphene citrate is first line treatment in PCOD for infertility. Laparoscopic drilling has very good results especially in clomiphene resistant cases

Evaluation and outcome of pregnancy complicated by heart disease

To assess the maternal and fetal outcome in pregnancies associated with maternal heart disease. The study included 50 pregnant cardiac patients from the Department of Obstetrics and Gynaecology Unit-I Nishtar Hospital, Multan. Age, parity, type of cardiac lesions, class of disease, specific treatment given, obstetric and cardiac complications, maternal and fetal outcome were analyzed. Out of 5100 obstetric patients, 50 cases of heart disease were diagnosed, giving a frequency of 0.98%. The ages of the women ranged between 26-35 years [64%] and 52% were multigravida. Congenital Heart Disease [CHD] was present in 28% cases and 66% had Rheumatic Heart Disease [RHD] and mitral stenosis which was the dominant lesion. Anticoagulation was given to 3 [6%] cases, Digoxin was required in 20 [40%] cases, Diuretics 18 [36%] while antihypertensive and beta blockers were given to 4 [8%] cases each, whereas prophylactic antibiotic was given to all [100%] patients. Congestive Cardiac Failure [CCF] was seen in 10 [20%] cases, infective endocarditis and thromboembolism in one [2%] case each. Maternal mortality occurred in one [2%] case and one [2%] neonatal death was encountered. Cardiomyopathy was seen in 2 [4%] cases. Vaginal delivery was had in 91.49% women and 80% were term pregnancies. Preterm deliveries were 14% and 42.55% babies were of low birth weight. Although, heart disease is rare among pregnant women, it needs to be carefully managed in a tertiary care setting by a team of obstetrician, cardiologist and anaesthesiologist, to obtain good maternal and foetal outcome

Evaluation and outcome of pregnancy complicated by heart disease

To assess the maternal and fetal outcome in pregnancies associated with maternal heart disease. The study included 50 pregnant cardiac patients from the Department of Obstetrics and Gynaecology Unit-I Nishtar Hospital, Multan. Age, parity, type of cardiac lesions, class of disease, specific treatment given, obstetric and cardiac complications, maternal and fetal outcome were analyzed. Out of 5100 obstetric patients, 50 cases of heart disease were diagnosed, giving a frequency of 0.98%. The ages of the women ranged between 26-35 years [64%] and 52% were multigravida. Congenital Heart Disease [CHD] was present in 28% cases and 66% had Rheumatic Heart Disease [RHD] and mitral stenosis which was the dominant lesion. Anticoagulation was given to 3 [6%] cases, Digoxin was required in 20 [40%] cases, Diuretics 18 [36%] while antihypertensive and beta blockers were given to 4 [8%] cases each, whereas prophylactic antibiotic was given to all [100%] patients. Congestive Cardiac Failure [CCF] was seen in 10 [20%] cases, infective endocarditis and thromboembolism in one [2%] case each. Maternal mortality occurred in one [2%] case and one [2%] neonatal death was encountered. Cardiomyopathy was seen in 2 [4%] cases. Vaginal delivery was had in 91.49% women and 80% were term pregnancies. Preterm deliveries were 14% and 42.55% babies were of low birth weight. Although, heart disease is rare among pregnant women, it needs to be carefully managed in a tertiary care setting by a team of obstetrician, cardiologist and anaesthesiologist, to obtain good maternal and foetal outcome

Complications and obstetrical outcome in grand multiparous women

To study the frequency of complications and obstetrical outcome in grand multiparous women. It was a prospective, observational study. Department of Obstetrics and Gynaecology, Unit-I, Nishtar Hospital, Multan from November 2002 to October 2003. All grand multiparous women who met the inclusion criteria were selected. Various medical problems and obstetrical complications were noted and proforma was filled for each patient having the 6[th] pregnancy or more beyond 22 weeks gestation. Out of the total 2148 deliveries in labour rooms during the period 200 women were grand multiparous [9.5%] with complications. Most of the ladies [90%] belonged to the parity group 5-8 and 80% were between 25-35 year age group. Low socio-economic status was observed in 89% women. Medical complications noted were anemia [65%], pregnancy induced hypertension [20.5%], chronic hypertension [6%] pre-eclampsia [4.5%], eclampsia [15]. Among the obstetrical complications, abruption-placentae [7.5%], placenta praevia [5%], failed progress of labour [1.5%], obstructed labour [5%], uterine rupture [2%] and PPH [18%] was observed. The rate of congenital anomalies was 7.5%, intrauterine death was 13% and 4% babies were delivered with low APGAR score at birth, required admission in the neonatal care unit. Grand multiparity is a risk factor for pregnancy especially in the under developed countries where poor maternal health, reduced birth spacing and lack of approach to health care centers are the key factors responsible for complications. Community awareness, patient education, birth spacing and family planning advice can reduce its complications

Pregnancy associated with fibroids: complications and pregnancy outcome

To assess the outcome of pregnancies in women with uterine fibroids. Design: A prospective comparative study. Place and Duration of Study: Department of Obstetrics and Gynaecology Unit-I, Nishtar Hospital, Multan from December, 1994 to December, 1996. Subjects and Our study consisted of 32 pregnant women with uterine fibroids and our control group comprised of 100 randomly selected pregnant women with a normal uterus. We compared age, parity, pregnancy and labour complications, mode of delivery and indications for caesarean section. Relationship of fibroid with the placenta was also noted. The majority of women in the two groups belonged to the age group between 25-35 years. Women in the study group were mostly nulliparous than controls [56.25% vs 12%]. The complications of Pre-mature rupture of membrane [PROM], pre-term labour, Intra-uterine growth restriction [IUGR], antepartum and postpartum haemorrhage were not quite different in the two groups. The spontaneous pregnancy loss rate was twice than in the controls [12.5% vs 6%]. The rate of caesarean section was also higher among women with uterine fibroids [40.62% vs 23%] and the occurrence of breech presentation was also increased [38.46% vs 13%]. Retroplacental myoma was found in 9.375% of the cases. Although uterine fibroids are associated with an increased risk of abortions and caesarean section, the results of other pregnancy associated complications in our patients with uterine fibroids is encouraging