Cervical screening: do gynecologists themselves practice what they preach? a study based in tertiary care hospitals of Lahore

To determine the frequency of self-compliance to cervical screening guidance among the sexually active female gynecologists in tertiary care hospitals. To identify the possible barriers to effective screening in those who do not undergo cervical screening. Cross sectional study. This study was conducted in the obstetrics and Gynecology department of various tertiary care hospitals of Lahore from 1[st] Jun 2012 to 30[th] Nov 2012. Total 157 female gynecologists, serving in various positions in tertiary care hospitals of Lahore were interviewed by using a structured self reporting performa. The performa was designed to find out the number of gynecologists undergoing pap screening, and in those who fail to undergo screening the single most important barrier presumed to be preventing them from undergoing screening was also evaluated. In this study, only 3.1% of the subject population was found to be undergoing pap-screening, which reflects the national level of screening in urban areas,in sharp constrast to the studies being conducted in developed countries, with screening coverage rates of more than 80%. The prevalence of pap screening in the subject population is disappointingly low and drastic steps are needed to bring about a change in attitude of the subject population which cannot be brought about without changing the current culture of self-negligence and least prioritization for self, in the feminine part of our society

Rising frequency of placenta previa and associated morbidity in women with previous caesarean section

To determine rising frequency of placenta previa and its associated morbidity in women with previous caesarean section. Cross sectional study. This study was conducted in the Department of Obstetrics and Gynecology at CMH Kohat from Jul 2010 to Jun 2011. This study included all pregnant women undergoing repeat caesarean sections. Of these, total 74 patients were admitted with placenta previa. The frequency and associated morbidity were determined. In our study 74 patients with placenta previa were included. 71.62% were less than 35 yrs of age, while 28.38% were equal to or more than 35 years. The gestational age at presentation was 24-36 weeks in 74.3% and 37 + weeks in 5.7% at presentation, 89% patients were symptomatic and 11% were asympyomatic. The morbidities observed were placenta accrete 47%, urinary tract trauma in 63.51%, caesarean hysterectomy in 62.16%, post operative febrile morbidity in 77.03%, maternal mortality was nil, paralytic ileus in 28.38%, PPH in 82.43%, surgical site infection in 16.21%.Frequency of placenta previa and its associated morbidity was raised due to repeated caesarean section rate which must be reduced to decrease maternal morbidity and mortality

Subfertility: the tragedy of military life style

To determine the frequency of subfertility in military couples owing to military deployments and consequent physical separation of couples. Cross-sectional descriptive study. This study was conducted in the department of Obstetrics and Gynecology at CMH Lahore from Jan 2012 to Jun 2012. Total 232 couples being investigated for subfertility were interviewed for the period of living together at a stretch since their marriage. The couples with established male factor infertility, secondary subfertility, and abdomino-pelvic surgery in female partners were excluded to rule out known pathological conditions as an underlying cause. Data was analyzed using MS excel in the form of frequencies, percentages and presented in the form of tables and figures. In our study 232 couples had subfertility. Out of these 96% of the couples could not spend their first year of marital life together due to non-availability of married accommodation. Nearly 50% of the patients looked for other forms of help including household tips, medicines and spiritual help before seeking medical treatment. In 69% of the couples burden of blame was put on the female partner by the in-laws. The tragedy of subfertility was further compounded by the fact that psychological symptoms were admitted by more than 70% females, 44% confessed being a victim of domestic violence, and 54% husbands refused to have their semen analysis done on first request by clinicians, although after counselling only 13% of the husbands still could not make their semen analysis available either due to military deployments or personal reasons. Incidence of subfertility in military couples is alarmingly high and can be largely attributed to military deployments and lifestyle

Frequency and patient related risks for surgical site infection

To determine the frequency of surgical site infection [SSI] and its unknown risk factors in obstetrical and gynaecological procedures. Descriptive study. Obstetrics and Gynaecology department of Combined Military Hospital, Lahore from Oct 2009 to April 2010. Patients who had undergone their surgical procedures in obstetrics and Gynaecology from October 2009 to April 2010. A total number of 1199 procedures were performed. Only 23 [1. 92%] got SSI. Out of these 19 [82.6%] were lower segment cesarean section and 4 [17.4%] cases hysterectomies. In these infected cases, 19 [82.6%] were less than 40 years of age and 4 [17.4%] cases were more than 40 years of age. Six [26.1%] patients belonged to high and 17 [73.9%] to low socioeconomic class. Nineteen [82.6%] patients weighted more than 75 kg and 4 [17.4%] were less than 75 kg. Only 2 [8.7%] were diabetic and 21 [91.3%] were non diabetic. Surgical site infection remains the commonest complication of surgery and is a burden on health care resources. It can be prevented by identifying those at higher risk and modifying skills for their care. Increasing age, obesity, Diabetes and low socioeconomic class could be the risk factors for SSI