Iron deficiency anaemia is a serious maternal health issue during pregnancy

Background: Anaemia is commonly found in developing countries associated with nutritional deficiencies and multiple pregnancies. Iron Deficiency Anaemia in pregnancy is a risk for preterm delivery, low birth weight babies and adverse effects on infant development. The current study investigated frequency of iron deficiency anemia and beta thalassaemia trait during antenatal check up among pregnant women visiting a tertiary care hospital in Islamabad

Objectives: To investigate iron deficiency anemia and beta thalassaemia trait among pregnant females visiting a tertiary care hospital in Islamabad

Study design, settings and duration: The retrospective comparative study was done to investigate iron deficiency anemia among pregnant females visiting a tertiary care hospital in Islamabad from May 2006 to April 2009

Subjects and Methods: The study was conducted at National Institute of Health [Department of Hematology] for Complete Blood Count and differential counts using Automated Hematology Analyzer [Sysmex KX-21]. Serum Ferritin levels were measured by Electro-chemiluminescence technique using Elcys Ferritin Kit [Roche, Germany]

Results: Among 359 subjects, 237 [66%] had iron deficiency anemia. The mean age was 27.32 +/- 4.9 years [range 18-50 years], 18 [5%] had beta thalassaemia trait and 104 [29%] had non-beta thalassaemia Trait. Forteen cases had concomitant iron deficiency anemia and beta thalassemia trait. The findings of this study indicate a relatively higher burden of iron deficiency anemia as compared to beta thalassemia trait

Conclusion: Anemia is a neglected problem which needs priority. Routine iron supplementation should be given to women of child bearing age during pregnancy and post partum. Obstetricians have an important role to aware the women of reproductive age about the iron content in a balanced diet and motivation for iron supplements

Knowledge, Attitude and Practices in Induced Abortion

To study knowledge, attitudes and practices oft he patients of induced abortion. Descriptive analytical study. This study was conducted from July 2004 to March 2005 in the department of obstetrics and gynecology, Islamic International Medical College, Railway General Hospital, Rawalpindi and Federal Government Services Hospital, Islamabad. The patients who were admitted in the Obstetrics and Gynecology with a history of induced abortion were included in the study. A special questionnaire was designed to explore the reasons which compelled them to undergo this illegal and dangerous procedure rather than using some contraception before. The patients were interviewed by a single post graduate trainee on a pre- designed Performa. The data collected was entered on SPSS- 10 and analyzed. The results were shown in percent. Most of the abortions [66%] were done by dais at their homes, while 28% terminations were done by doctors at their clinics. Majority of the patients [90% and 60% and respectively] were aware of not only the religious and legal implications of abortion but also knew that it could cause great harm to their health, including the fact that it could be fatal. Majority of women [74%] were not using any contraceptive measure for no specific reason.ln majority of patients [92%] it was an unwanted or unintended pregnancy which was terminated. Only 14% of patients showed reservations in using some contraceptive measure like religious position, husband's disapproval or fear of side effects. The problem of induced abortion is not merely a medical problem to be resolved through medical means. Rather it falls into the social norms of people. The physician is supposed to understand the deep seated psychological inhibitions and motives which lead the patient to have [or not have] abortion

Neovascularity patterns in breast carcinoma: correlation of doppler ultrasound features with sonographic tumour morphology

To determine the association and correlation between morphologic features of breast cancer on gray scale ultrasound, and vascularity patterns and indices on color and spectral Doppler ultrasound. Cross-sectional, analytical study. Department of Radiology, Dow University of Health Sciences and Civil Hospital, Karachi, from August 2006 to June 2007. Fifty adult female patients with histopathological proven breast cancer underwent ultrasound for evaluation of morphologic features on gray scale mode; vascularity patterns on color Doppler scan and flow indices measurement on spectral Doppler ultrasound. Regression analysis was conducted to determine correlation between the variables and associations of vascularity patterns. The 50 studied patients had predominantly solid tumour in 46 [92%] with depth to width ratio of> 1 in 37 [76%]. The mean tumour size was 3.6 +/- 1.34 cm, with irregular margins in 41 [82%], posterior shadowing in 43 [86%] and calcifications in 27 [54%]. Type 3 vascularity [multiple peripheral vessels] was the most frequent pattern [n=21, 42%] that showed a positive correlation with solid tumours [r=0.7, p < 0.001]. Low resistance spectral waveform was seen in 44 [88%] cases. The average size was 3.69 cm in vascular and 3.1 cm in avascular tumours. Mean resistive index [RI] was 0.67. Mean pulsatility index [PI] was 1.1. RI was significantly high in cystic tumours [mean=0.8, p <0.001] and significantly low in tumours measuring less than 2 cm [RI=0.18, P< 0.001]. In this study, multiple peripheral vessels with low resistance flow was the pattern most significantly associated with all appearance of focal breast cancer. Apart from a positive correlation with solid tumours, markedly high RI in cystic tumours and markedly low RI in tumours less than 2 cm, there was no consistent correlation trend difference between Doppler findings and tumour size. Histopathology, therefore, remains the main modality to evalute the tumour type and characteristics

Genital fistulae: experience at unit III, Federal Government Services Hospital, Islamabad

To determine the demographic features, etiologic factors and management outcome of women who presented with genital flstulae. A descriptive study. Unit III, Department of Obstetrics and Gynaecology, Federal Government Services Hospital, Islamabad. 10 years, January1996 to December 2005. Record of 23 patients who presented with genital fistulae was reviewed The inclusion criteria was fistulae of size 1.5 cm or less in diameter; secondary to obstetric or pelvic surgery trauma. Complete history and vaginoscopy was done. In women presenting in early phase [<3 months], conservative management. Intravenous urography [IVU], examination under anesthesia [EUA], cystourethroscopy and three swab test was done in all patients who required surgical management. Fistula was repaired through vaginal route in majority of cases. Abdominal procedure was carried out for ureterovaginal, vesicouterine and complex vesicovaginal fistulae. Outcome of procedures and their postoperative complications were recorded Twenty three patients presented with genital fistulae, 18 [78.2%] had obstetric causes while five [21.7%] developed fistula after pelvic surgery [hysterectomy]. Amongst obstetric patients, 15 [83.3%] belonged to rural areas around the city. Mean age was 24.78 +/- 4.41 years and 13 women [72.2%] belonged to age group 21-30 years. Obstructed/prolonged labour was the most common cause [94.4%]. In pelvic surgery group, 80% of the patients belonged to age group>40 years[mean age 44.60 +/- 3.51 years]. Conservative management was successful in all five patients, who presented in early phase [<3 months]. Successful surgical repair was observed in 92.8% cases in obstetric and 75% in pelvic surgery group. Neglected obstetric management due to deficient maternity services is the leading cause of genital fistulae. Following a proper management protocol of emergency obstetric care, successful outcome in majority of cases cane be achieved