Hysterectomies; an audit at a tertiary care hospital

To audit indications and histopathological diagnosis of hysterectomies performed at Muhammad Medical College hospital, Mirpurkhas. Retrospective study. Department of Obstetrics and Gynaecology and Department of Pathology, Muhammad Medical College Hospital, Mirpurkhas Sindh from January to December 2008. Data regarding symptoms and indications of hysterectomies performed during this year were collected from files and patient records. Histopathological reports of those patients were collected from department of pathology. The results were analyzed by percentages. A total of 145 hysterectomies were performed in 2008. Mean age of patients was 45years ranging from 35-60 years and parity ranges from 4 - 10. Most common presenting complaints were excessive menstrual blood loss in 97[67%] patients, followed by some thing coming out of vagina 28[19%]. Most common pre-operative diagnosis of fibroid was made in 44 [33%] followed by uterovaginal prolapse in 28[19%] and dysfunctional uterine bleeding [DUB] in 18[12%] of patients. Regarding histopathological diagnosis chronic cervicitis was the most commonly diagnosed pathology in 45 [31%] followed by fibroid in 25[17%] cases. A yearly audit should be conducted in every institute to collect data and to analyze the pattern of indication and lesions found on histopathological examination

pattern of urinary tract symptoms during pregnancy

During pregnancy remarkable changes occur, in structure and functions of urinary tract. These changes often predispose to the development of urinary tract disorder or may predispose to worsening of renal disease and its sequelae. Our objective was to determine the pattern of urinary tract symptoms during pregnancy. This descriptive study included 520 pregnant patients, out of 2134 admitted in the antenatal and labour wards of the Department of Obstetrics and Gynecology, Unit-III, Liaquat University Hospital, Hyderabad from 1st April 2006 to 31st March 2007. Women with history of diabetes, chronic renal failure or complaining of urinary symptoms before index pregnancy were excluded. Other variables of study were urinary symptomatology. All women underwent complete examination of urine through various tests including culture and sensitivity. During the study period, 520 patients were analyzed. Out of these, 49 [9.4%] patients were diagnosed as having urinary problems. Urinary tract infections were diagnosed in 34 out of 520 [6.5%] gravidas, acute renal failure in 11 [2.1%], nephrolithiasis in 2[0.4%], acute urinary retention in 2[0.4%] of patients. Majority of the patients belonged to the age group 21-25 years. Majority were multi gravidas and in the third trimester. Data analysis of our study showed that 316[60.8%] of the study population reported the symptom of frequency of micturition. Stress incontinence and voiding difficulties were reported by 37% and 35.2% respectively. Common urinary problems in pregnancy are urinary tract infections, acute renal failure, nephrolithisis, and acute retention of urine. Common symptoms are frequency of micturition, stress incontinence and voiding difficulties