ABSTRACT
Objective: To find out the effect of grand multiparity on maternal outcome in absence of adequate antenatal care
Methodology: All un-booked grand multipara with singleton pregnancy at term admitted to Gynae A Unit, Lady Reading Hospital Peshawar were included in the study. Cross sectional study was carried out from 1st June 2012 to 1st Dec 2012. Assessment was done by detailed history, general physical examination, per-abdominal and per-vaginal examination and by obstetrical ultrasound. Mothers were assessed for antenatal and obstetrical complications, mode of delivery and post-partum complications
Results: A total of 50 patients were included in the study. Regarding antenatal complications 6[12%] patients had anemia, 2[4%] had pregnancy induced hypertension, 4[8%] had pre-eclampsia, 2[4%] had eclampsia and 36[72%] didn't had complications. Regarding obstetrical complications 3[6%] patients had placenta previa, 3[6%] had placental abruption, 7[14%] had mal presentation, 3[6%] had obstructed labor and 34[68%] didn't had complications. Regarding post partum complications 5[10%] patients had post partum hemorrhage due to uterine atony, 4[8%] had post partum hemorrhage due to retained placenta, 2[4%] had perineal tears, 3[6%] had subtotal hysterectomy and 36[72%] didn't had complications
Conclusion: In the absence of adequate antenatal care, there was increased likelihood of perinatal complications in grand multiparous women
ABSTRACT
Objective: to determine mode of delivery and fetal outcome in patients with prolonged pregnancy undergoing elective induction at 41 and 41+ weeks
Methodology: this study was carried out on 150 patients at Department of Obstetrics and Gynecology, Unit "A" Postgraduate Medical Institute Lady Reading Hospital Peshawar. All singleton uncomplicated pregnancies with vertex presentation at 41 weeks and above admitted at ward were included in the study. Exclusion criteria were strictly followed. Gestational age was cal-culated by last menstrual period [LMP] or from first trimester scan. All women with 41 and 41+ week's gestation were offered induction. All the information including neonatal notes was recorded
Results: among 150 patients 135 [90%] were induced with tablet prostaglandin E[2] and 15 [10%] were induced with prostaglandin E[2] gel. Among 150 patients 76 [51%] patient were primigravida, 61 [40%] patient were multigravida and 13 [9%] patient were grand multigravida. 114 [76%] patients had spontaneous vaginal delivery, 14 [9%] patients had vacuum vaginal delivery and 22 [15%] patients had caesarean section. 134 [89%] babies had APGAR Score >7 and 16 [11%] babies had score <7. 13 [9%] babies had birth weight <3kg, 125 [83%] had 3-3.9kg, 10 [7%] had 4-4.4kg and 2 [1%] had more than 4.5kg. Only 3 [2%] babies were admitted to NICU
Conclusion: it can be stated that most of patients undergoing induction of labour at 41 weeks and 41+ weeks gestation delivered by normal vaginal delivery had good fetal outcome
ABSTRACT
Obstetrical emergencies are important concerns and need immediate diagnosis and intervention to save the life of mother and fetus. These include obstetrical hemorrhage both ante partum and postpartum, ectopic pregnancy, preeclampsia and other conditions where radiologist, obstetricians, anesthesiologist and ICU team have important role to play. Radiologist play key role in diagnosing emergencies with the use of imaging modalities, though bed side ultrasonography has now become valuable tool in the hands of anesthesiologists as well, in diagnosing various emergencies. The role of interventional radiologist in cases of obstetric hemorrhage is worthwhile especially in postpartum hemorrhage where embolization can be minimally invasive lifesaving procedure.The aim of this article is to discuss the valuable role that the radiologists play with obstetricians and anesthesiologists in the management of these obstetric and emergencies
ABSTRACT
The aim of this study was to screen children 1-12 years of age for lead exposure living around automobile and battery repair workshops. A total of 190 children living in one kilometer areas around the automobile and battery repair workshops were selected from houses and schools. These were divided into two groups: group A comprised of the children living around the automobile repair workshops and group B comprised of the children living around the battery repair workshops. Among the 190 children, 115 [60.5%] were males and 75 [39.5%] were females. The mean age of the children was 8.7 years. Majority of the children was less than 4 years of age [55.8%]. The blood lead levels were between the range of 1.3 - 34.2 mg/dl [mean 11.4 mg/dl]. Children living around the battery repair workshops [mean +/- SD 12.85 +/- 6.02] had high blood lead levels [p 0.020] as compared to the children living around the automobile repair workshops [mean +/- SD 10.19 +/- 6.13]. There was a significant negative correlation of blood lead levels and haemoglobin [r = - 0.400 and p 0.001]. Children living around automobile and battery repair workshops had significantly high blood lead levels according to WHO and CDC criteria. Blood lead level [BLL] is a good screening and diagnostic test for the assessment of lead exposure in children living in lead contaminated high risk areas
Subject(s)
Humans , Male , Female , Child , Automobiles , Environmental Exposure , Cross-Sectional StudiesABSTRACT
To investigate methanol poisoning from a national forensic perspective in Jordan. From 1st January 2006 to 31st December 2006 a total number of 1388 autopsies were carried out at the National Institute of Forensic Medicine; the medico legal and toxicology reports were probed for methanol related deaths. Variables abstracted included age, sex, circumstances of death, admission to hospital, principle cause of death, and blood methanol concentration. Seventeen cases of fatal methanol intoxication were reported, representing a mortality rate of 0.3 per 100,000. All deaths occurred in the last quarter of the year 2006, and all victims were males. The major outbreak of 11 cases [64.7%] occurred in October. The victims mean age was 36 years [24-56 years], the age group 21 -30 years accounted for 35.3% of the total cases. Eleven cases were found dead, 4 were admitted to hospital before death and 2 cases were brought to the forensic medicine institution due to fatal road traffic accident. Methanol concentration ranged from 46 to 645 mg/dl [mean 306 mg/100ml], no ethanol or drugs of abuse were detected. As alcohol intake propagates within Jordanian community, a significant increase in the number of fatal alcohol poisoning is expected. Jordanian society lacks the public awareness regarding the grave consequences of methanol intoxication. A prompt medical, legal and education plan should be implemented as soon as possible to save lives, and eradicate poisoning outbreaks