A Study of Drug Utilization in Mandalay General Hospital

A durg utilization study was carried out to evaluate the pattern of drug prescribing in Myanmar. The case records of 1130 admissions in a medical ward were analysed retrospectively with regard to utilisation of drugs. Drugs were classified according to WHO therapeutic categories. The study revealed that 185 therapeutic agents were prescribed during the study period and the average number of drugs prescribed per patient was 5.03. While drug prescribing pattem in relation to age was similar to those of other countries over prescribing, as detemined by the number of drugs prescribed per pattent, was observed. The three most often used drug categories ware anti-infectives followed by vitamins, and solutions correcting water and electrolyte disturbances. Among anti-infectives, Penicillins were the most commonly used drug group while tetracyclline was the most frequently used individual drug. Irrational use of tetracycline was discussed.

Clinical, ultrasonic and pathologic analysis of ovarian tumours at the Central Women Hospital (A prospective study)

During an 18 month period from 1st January 1988 t0 30th June, 1989- 90 cases diagnosed as ovarian tumours were admitted to Unit 11, Central Women Hospital. Pre-operative data collection on clinical features and ultrasonic findings were made. Following laparotomy, operative findings and histopathologic diagnosis were noted. 87 cases had a laparotomy. Out of 82 cases of ovarian tumours, 21 were malignant (25.6 per cent) and 61 (74.4 per cent) benign. The clinical and ultrasonic diagnotic accuracy of ovarian tumours were 87.35 per cent and 91.18 per cent. There was no statistical difference between the two methods in diagnosing ovarian tumours (p>0.05). The accuracy of differentiating malignant from benign ovarian tumours clinically, by ultrasound or by laparotomy using gross findings and histopathology as the definitive diagnosis was also calculated and there was no significant difference (p>0.05). The sensitivity, specificity, predictive values for positive and negative teste were calculated in differentiating benign from malignant ovarian tumours. It was found that clinical diagnosis had the highest sensitivity rate (73.68 per cent) whereas operative findings had the highest specificity rate (96.72 per cent).

Assessment of foetal growth from birthweight data at Central Women Hospital

An intrauterine growth standard was drawn from the birth weights of 1974 live born singleton babies whose gestational age were known and who were delivered normally in Central Women's Hospital, Rangoon during the year 1973. The mean birth weight at term was found to be 2987 G, the female weighing 2977 G and the male 3000 G. From 28 weeks to term there was a steady and gradual increase of birth weight. This was the main reason for the mean birth weight being lower near term than that of the European's Standards. The mean birth weight in the16-19 age group was lower than the older age groups- though parity may have been responsible for the difference. There was an. increase in birth weight with an increase in parity and first born babies were lighter than subsequent one.The association between babies of low birth weight and high perinatal mortality has been widely accepted. Babies of low birth weight may be either preterm i.e. before 37 completed weeks by gestation or small for dates. Preterm babies have had normal foetal growth in utero and are small because the gestational period has been cut short, whereas small-for-dates or dysmature babies showing intrauterine growth retardation are light because of antenatal development mostly due to placental insufficiency. "Combination do occur. It is necessary to differentiate between these two categories because of the difference in prognosis for the babies.

Outcome of breech deliveries in Central Women's Hospital

The result of a survey of 968 breech presentations and the associated perinatal loss of 12.9 percent has been presented. The 38.5 percent incidence of prematurity is a most important factor in the perinatal loss. Breech presentation including delivery carries with it an increased perinatal loss as compared to cephalic presentation. However, if the above mentioned problems are appreciated and the patient treated by skilled and experienced obstetricians, the perinatal loss of mature infants should approximate that for cephalic presentations.