ABSTRACT
Objective: To determine the etiology and clinical profile of patients with abnormal uterine bleeding
Study Design: Observational / descriptive study
Place and Duration of Study: This study was conducted at the Shahina Jamil Teaching Hospital, Abbottabad from September 2014 to February 2016
Materials and Methods: Patients who were not pregnant, among the age of 20-60 years and had history of abnormal menstruation were included. Exclusion criteria included patients who were pregnant, less than 20 years or greater than 60 years, or suffering from cancer. Epidemiological data was noted and detailed history was taken especially about menses, vaginal discharge, use of drugs, hormonal treatment including oral contraceptive pills and any method of contraception used. Physical, ultrasonographic examination and histopathological examination of endometrium was performed in all patients
Results: There were 200 patients enrolled in this study. Their mean age was 38 +/- 5 years. Majority of them were between the age of 31-40 years, [82 patients] and 41-50 years, [66 patients].About 150 patients had menstrual irregularities. Eighty of these patients had menorrhagia while seventy had polymenorrhagia. Fifty patients had history of vaginal bleeding. Contraceptive measures were used by 38 patients. Out of which, OCPs were the preferred mode of contraception used. Twenty two patients had infertility with 16 had primary while 6 had secondary infertility. Sixty two patients had abnormal ultrasound examination. The chief ultrasonographic abnormality was that of uterine fibroid, ovarian cyst and ovarian cancer. On endometrial examination, 168 patients had normal physiological changes. The predominant change in this group was that of proliferative and secretory changes. Twenty patients had abnormal physiological endometrial changes. The chief abnormalities found were that of Pill endometrium, [12 patients] and irregular shedding, [4 patients]. Preneoplastic and inflammatory changes were observed in six patients in each group
Conclusion: AUB is one of the commonest gynecological disorders. The underlying cause can be determined by meticulous work-up in these patients which can help in deciding optimal treatment option for AUB patients. This, in turn, will not only improve health and well-being of these patients but as well as improve their quality of life. Endometrial sampling plays an important role in the diagnostic work-up of AUB. Therefore, it should be offered to all such patients as part of their evaluation
ABSTRACT
To determine the frequency of Gestational Diabetes in obese patients. Cross sectional study This study was carried out at Obstetrics and Gynaecology Department, Shahina Jamil Hospital, Abbottabad from April 2013 to September 2013. Total 111 patients were included in this study. After an overnight fast [8 hrs] fasting plasma glucose was taken. 75 gm glucose in one glass of water was given to patient. After 2 hours, another plasma glucose test was taken. Gestational Diabetes was diagnosed on basis of fasting plasma glucose level of > 126 mg / dl, 2 hours post-prandial plasma glucose level of more than 199.8 mg / dl. Mean age of patients was 27.7 + 3.3. Gestational Diabetes was found in 21 patients [19.0%]. Mean Body Mass Index [BMI] of patients was 30.80 + 0.44. 24 patients [21.6%] were primigravida and 87 patients [78.4%] were multigravida. The results of present study indicate that obesity is an independent risk factor for adverse obstetric outcome and is significantly associated with an increased gestational diabetes rate
ABSTRACT
To determine fetomaternal outcome of trial of labour in patients with Previous One Ceasarean Section. Descriptive Case Series based on hospital data. This study was conducted at the Obstetrics and Gynaecology Department, Shahina Jamil Teaching Hospital Abbottabad, from February 2013 to August 2013. Total 100 cases were selected. During trial of labour, patients were closely monitored by vital signs, fetal cardiac activity, lower abdominal pain and tenderness, fetal distress. Data was collected on proforma and written informed consent was taken on consent form. The permission was taken for hospital committee and the data was analyzed for results. 61 cases [61 %] had successful vaginal delivery while 39 [39 %] patients ended up with repeat emergency caesarean section after failed trial of labour. Out of 61 vaginal deliveries, 53 cases [86.88%] belong to age group 20-30 yrs, while 8 cases [13.12%] were between 31-40 years. Out of 39 cases, 36 cases [92.30 %] belonged to age group of 20-30 years while 3 cases [7.7 %] had age between 31 to 40 years. Distribution of cases, according to fetal distress in patients with emergency caesarean section shows that out of 39 cases, 12 cases [30.70 %] developed fetal distress and 27 cases [69.23 %] were without fetal distress. This study shows that patients with Previous one caesarean section for non-recurrent indication can be successfully delivered vaginally