Health care provides knowledge concerning HIV infection /aids

A study was conducted to assess knowledge of medical, nursing and paramedical personnel regarding HIV infection and AIDS at a tertiary care hospital in Lahore. The study population comprised 287 [54.25%] physicians, 184 [34.78%] nursing staff and 58 [10.96%] paramedics. About 73% participants were females and 96% had heard of AIDS or HIV. The media was the major source of their awareness. Major gaps in the knowledge of the participants about the exact nature of HIV infection and AIDS and the difference between these two were identified. Most of the respondents including the doctors did not know the signs and symptoms of HIV or AIDS and were not familiar with the specific diagnostic tests. Respondents were aware of the main modes of transmission of the disease but their knowledge as to how it could not be transmitted was lacking. This study revealed significant gaps in the knowledge of the medical and allied personnel about HIV infection and AIDS. The degree of awareness varied in direct proportion to the professional status of the participants

Justification of caesarean section for fetal distress

A study was done from May 1995 to February 1996 to evaluate the justification of caesareans for fetal distress by examining the circumstances leading to operative delivery for compromised fetus. Of the 1096 caesareans, 179 [16.33%] were for fetal distress. One hundred and seven [59.78%] were nulliparas and 127 [71%] came with the clinical features of fetal hypoxia. In 142 [79%] parturients at the time of c-section, cervical dilatation varied from 0-3 cm and in 144 [80%] the presenting part remained unengaged. The method most commonly employed to diagnose fetal distress was the external cardiotocography, used in 141 [79%] patients either alone or in combination with other options. Predictivity value of the parameters used to identify the fetuses at jeopardy was found to be more sensitive when used in combination. Neonatal outcome related poorly with the preoperative diagnosis if only one parameter was used. Poorest neonatal outcome was observed in the presence of thick particulate meconium. Great care should be exercised by the obstetricians while making a decision for caesarean for fetal distress so as to avoid unnecessary procedures and neonatal complications

Dystocia: a continuing problem

A three year retrospective study was carried out at Sir Ganga Ram Hospital, Lahore, on 491 cases of dystocia, which formed 3.58% of 13,723 deliveries during the period. Of these 491 cases, 287 [58.45%] came with late obstructed labour and 204 [41.55%] with various types of prolonged labour. The commonest causes of dystocia were foetal malpositions and malpresentations in 172 [35.03%] patients and cephalopelvic disproportion in 167 [34.01%] cases. Five were in false labour; of the remaining, a large number of cases i.e., 372 [75.76%] came with abnormal length of labour with ruptured membranes. A total of 282 [58.02%] patients required a Caesarean section, while 83 [17.08%] had instrumental delivery and 55 [11.32%] were delivered normally. Infection was the most frequent maternal complication found in 297 [11.2%] patients. There were 6 maternal deaths [maternal mortality rate 17.04/1000 live births]. A total of 139 babies were stillborn, while 21 of the 352 live born expired within the first week; thus the perinatal loss was 160 or 329.21/1000. Important factors contributing to mortality were extreme age groups and parity, lack of proper antenatal and intrapartum care and mismanagement by traditional birth attandents