Gestational diabetes; to compare the efficacy of metformin with insulin in diabetes mellitus in terms of fetomaternal outcome

Objectives: To compare the efficacy of Metformin with insulin in gestational diabetes mellitus in terms of fetomaternal outcome

Study Deign: Randomized clinical trial study

Setting: Lady Aitchison Hospital Lahore

Period: January 2014 to March 2015

Methodology: Total 500 pregnant females with GDM were included in the study through nonprobability, consecutive sampling. Patients were divided into 2 equal groups [A: B]. Patients in group A were given tablet metformin 500 mg by oral route and group B was administrated regular injection Insulin by subcutaneous route

Results: The mean age of females was 32.14 +/- 6.13 years. The mean gestational age was 31.07 +/- 3.8 weeks. There were 78 [15.6%] females who had 0 parity, 107 [21.4%] females had parity 1, 175 [35%] females had parity 2, 95 [19%] females had parity 3, 33 [6.6%] females had parity 4 and 12 [2.4%] females had parity 5.There were 54 [10.8%] cases had PTB, out of which 12 [4.8%] had PTB with metformin while 42 [16.8%] had PTB with insulin. There were 115 [23%] neonates required NICU admission, out of which 37 [14.8%] neonates with metforminand78 [31.2%] neonates with insulin. There were 87 [17%] neonates who had neonatal hypoglycemia, out of which 23 [9.2%] neonates with metformin and64 [25.6%] neonates with insulin. The difference was significant between both groups for all fetal outcomes [P<0.05]

Conclusion: The metformin is more effective in preventing adverse fetal and maternal outcome as compared to insulin

Anemic patients; relationship of frequency and severity of iron deficiency anemia with preterm labor and eventual perinatal outcome

Pregnant women are particularly considered to be the most vulnerable group because of the additional demands that are made on maternal stores during pregnancy. The iron deficiency anemia is the most common nutritional deficiency problems in females and is responsible of high maternal death rate in our society

Objectives: to determine the relationship of frequency and severity of iron deficiency anemia to preterm labor and eventual perinatal out come in anemic patients

Study Design: it was a case control study

Study Setting: in Obstetrics and Gynecology Unit-III, Sir Ganga Ram hospital, Lahore from July 2012 to June 2013

Methodology: the study was conducted on 200 patients [100 cases and 100 controls] were studied. Cases were patients admitted in labor room with preterm labor and Controls were females in labor at term at. Convenience sampling was done. On admission relevant history taking examination and investigation were done. The data was collected on a Performa

Results: there were 50 patients with anemia amongst the patients with preterm labor. In the control group, 40 patients were suffering from anemia. In the patients with preterm labor the mean hemoglobin was 9.83 grams/deciliter. In the control group the mean hemoglobin was 10.3gm/dl. [Pregnant women having hemoglobin <10 gm/dl are considered to be anemic]. The odds ratio was calculated to be 3.4 and P value was <0.05

Conclusions: iron deficiency anemia was associated with increased risk for low birth weight, preterm delivery, and perinatal mortality. The frequency of iron-deficiency anemia was seen in both groups of pregnant women

Bone mineral density and diet of teachers of college of home economics at Lahore

To evaluate the Bone Mineral Density [BMD] and diet of teachers of a Govt. College of Home Economics in Lahore. It was survey research. Purposive sampling technique was adopted for the selection of 50 teachers from Govt. College of Home Economics of age group 30 - 60 years. About 46% of the subjects had BMD ratio in between -2.58 to -4.0 [Osteoporotic category]. The root cause of low BMD ratio was not really age related but in majority of the sample it was due to sedentary life style and lack of awareness about the importance of exercise in relation to bone health. The total mineral and vitamin intake required for bone health [calcium, magnesium, phosphorus and vitamin D] was below the recommended, among majority of the sample

Use of supravital toluidine blue staining to improve the efficiency of fine-needle aspiration cytology reporting in comparison to papanicolaou stain

To see the efficiency, adequacy and accuracy of toluidine blue stained smears of FNAC of Breast thyroid and salivary glands swelling with comparison to conventional stained FNAC smears witt Papanicolaou. A total of 114 aspirates from various sites were included in the study. The smears were stainec with toluidine blue and conventional Papanicolaou stain and the cytomorphology of both the smears were compared. The values were tabulated and statistical tests of significance was applied. Of the 114 aspirates included in our study the diagnostic accuracy by using papanicolaou wa 78%, while it was upto 100% with supravital toluidine blue stained smears. The percentage of inadequacy was reduced to just 25%. The observations were statistically significant. Breast 37/48 [77%] and Salivar glands 11748 [23%] respectively. The most commonly used categorization of a five-tier system was used for reporting of breast cytology, with categories ranging from insufficient materials [C1], benign [C2], atypics [C3], suspicious of malignancy [C4], or [C5] frankly malignant. Most of breast lesions were benign 2 [67.56%]. There were only 9 [24.32%] malignant cases followed by 2 cases of C-4 and one case of C-3. Benig thyroid lesion were more frequent comprising of 51 [72.27%] cases. One case [1.5%] of papillary carcinoma was found while 13 case were follicular lesions. There were 4 [36.4%] cases of pleomorphic adenoma an 3 [27.3] cases of non-specific sialadenitis. There was one case [9%] of each lesion for mucoepidermoi carcinoma, adenoidcytic carcinoma and benign cyst. Toluidine blue stained study of FNAC improves the diagnostic accuracy by minimizing the smearing and drying artifact, loss of cell sample during fixation and staining which influences the diagnost accuracy

Frequency of placenta previa in previously scarred and non scarred uterus

To determine the frequency of placenta Previa in patients coming to a tertiary care unit with previously scarred and non-scarred uterus. A descriptive cross sectional study was carried on 114 cases who underwent caesarean sections [37 cases out of 645 cases with non scarred uterus and 77 cases from 721 cases with scarred uterus] in the department of obstetrics and gynecology Lady Willingdon Hospital from January 2008- December 2011. Most patients [47.36%] were between 26-30 years age group, presented with gestational age between 36-40 weeks [70.17%], were mostly G2-4, while frequency of placenta Previa in non-scarred uterus was 32.45% [37 cases], and frequency in previously scarred uterus was 67.54% [77 cases]. Major degree Previa was found in 88 cases [77.19%]. There were 5.70% cases of placenta Previa from non-scarred uteruses and 10.67% cases of placenta Previa [10.67%] from already scarred uteruses. Stratification revealed a higher trend of the morbidity with the increase in number of previous caesarean sections. A significantly higher frequency of placenta Previa was found among patients coming to a tertiary care hospital with previously scarred uterus

Primary isolated hepatic tuberculosis

Isolated hepatic tuberculosis without pulmonary or bowel involvement is a diagnostic challenge and can cause considerable morbidity. A young lady from Lahore presented with fever, pain in right hypochondria, nausea and weight loss. CT scan of abdomen showed multiple small hypodense non-enhancing lesions and a heterogeneous texture of liver. Biopsy confirmed the diagnosis of hepatic tuberculosis. It was concluded a case of isolated hepatic tuberculosis without evidence of other primary sites involvement. It is important to consider tuberculosis in the differential diagnosis when suspecting lymphoproliferative or metastatic diseases in a patient with vague symptoms and abnormal hepatic texture on CT