ABSTRACT
Objective: to observe the efficacy of systemic methotrexate for the treatment of unruptured tubal pregnancy
Material and Methods: it was a descriptive study carried out over a period of 6 months from 01-10-2012 to 31-03-2013 in the department of obstetrics and gynecology unit 111, Services Hospital, Lahore. A total of 65 cases were included in this study. Patients were given single dose of injection methotrexate 50mg/m[2] intramuscularly and beta- hCG level was assessed at 4th and 7th day for each patient. In those patients in which beta hCG level did not fall more than 15% on day 4th and 7th were surgically treated by doing laparotomy
Results: among 65 patients, age distribution showed 7 patients [10.8%] were less than 20 years of age, 41 patients [63%] were between 20 -30 years and 17 patients [26.2%] were between 30-40 years of age. Mean age was 29.7+/-4.9 years. According to distribution of parity, 17 women [26.2%] were primigravida, 38 women [58.4%] were para 2-4 while 10 women were para 5-7. Out of65 women, 11 [16.9%] presented at <6 weeks of gestation and 54 [83.1%] at 6-8 weeks of gestational age. Mean gestational age was 6.7+/-1.9 weeks. Efficacy of methotrexate for the treatment of unruptured tubal pregnancy observed in 44 women [67.7%] in term of fall in beta hCG level>15%
Conclusion: methotrexate is an effective medical management for ectopic pregnancies in a society where tubal conservation is of utmost importance
ABSTRACT
To compare the efficacy of tranexamic acid with norethisterone in the management of menorrhagia. Total 66 patients were included in this study [33 patients randomly allocated to Group Aand B]. In group Aand group B mean age was 33.12_4.98 and 31.42 +/- 5.47 years respectively. After management, number of towels used/day were reduced in group A and B and were 3.21 +/- 0.65, 2.85 +/- 0.62, 2.33 +/- 0.54, 2.21 +/- 0.60 and 3.30_0.88, 3.15 +/- 0.87, 2.94 +/- 1.03, 2.85 +/- 1.06at one, two, three and six months follow-up respectively with significant difference between two groups [p=0.002]. Passage of blood clots in group Aand B at one, two, three and six months were reduced in patients 19 [57.5%], 19 [57.5%], 20 [60.6%], 23 [69.6%] and 10 [30.4%], 13 [39.4%], 12 [36.4%], 12 [36.4%] respectively [p=0.0035]. Haemoglobin level in group A was 9.633 +/- 0.946 g/dl at six months while in group B it was 9.385 +/- 1.061 g/dl with insignificant result in both groups [p=0.159]. Tranexamic acid is more safe, effective and tolerable treatment than norethisterone for patients with ovulatory menorrhagia with avoidance of possibly unnecessary surgery
ABSTRACT
Homocysteine [Hcy] is an intermediate formed during the catabolism of sulphur containing essential amino acid, methionine and Less than one percent of tHcy is found as the free form. Development of atherosclerotic changes and thrombo-embolism are common features in patients with homocysteinuria. This study was conducted to assess the relationship of Hcy and coronary heart disease [CHD] in our population. The cross-sectional analytical study was carried out at the Department of Biochemistry, Hazara University Mansehra and Ayub Medical College, Abbottabad. A total of 80 subjects were included in this study and were divided into 2 groups. Cases Group consisted of 40 patients who had confirmed Myocardial Infarction [MI] coming for routine follow-up [first re-visit] after the acute attack. Control Group consisted of 40 matching healthy individuals. Demographic data including age, gender, dietary habits, height and weight as documented in preformed proforma. Blood pressure was taken in sitting posture. Serum total Hcy were measured. Data was entered into computer using SPSS 16.0 for analysis. The mean age of the cases was 59.68 +/- 8.06 [30-70] years and that of the controls was 58.93 +/- 6.93 [48-76] years. The average BMI of cases was 27.70 +/- 3.61 Kg/m[2] and of the controls was 25.66 +/- 2.98 Kg/m[2]. This increase of BMI from controls to cases was statistically significant [p<0.050]. The mean systolic BP of the cases was 153.88 +/- 11.90 mmHg in comparison with 142.62 +/- 11.65 mmHg for the controls. This difference was statistically significant [p<0.001]. Mean tHcy level of the cases was 17.15 +/- 4.45 micromol/l while that of controls was 12.20 +/- 2.53 micromol/l. There is a statistically significant difference between cases and controls with respect to Hcy levels [p<0.001]. Plasma tHcy level has a powerful predictor value of CHD and routine screening for elevated Hcy concentrations is advisable especially for individuals who manifest atherothrombotic disease without their traditional risk factors.
ABSTRACT
Background: The objective of the present study was to check for prevalence and any kind of association existing between hypertension and ABO blood groups in the blood donors in SIMS Lahore
Patients and Methods: ABO and Rh grouping was done along with hypertensive screening on all prospective voluntary / replacement blood donors between 18-40 years of age and both sexes donating blood at SIMS Blood Bank, Lahore over a period of one month from 31st July to August 2006
Results: Out of a total of 1725 blood donors, 1673 [97%] were males and 52[3%] were females. 97% amongst males, while 94.2% amongst females were found to be Rhesus positive. The frequency of Rhesus negative groups in males and females is 3% and 5.8% respectively. Well 335 male blood donors were found to be hypertensive [250%] as opposed to 7 hypertensive female blood donors [13.5%]. The prevalence of hypertension is greatest among Rhesus positive male donors having blood group A [30.1%], followed by 18% prevalence rate in blood group B and prevalence rate about [17%] each in subjects having blood group O and AB. Rhesus negative male subjects also showed 9.8% prevalence rate
Conclusion: The study indicates that donor population is predominantly positive. The results support the concept that certain blood groups increase the individual's risk of developing hypertension