ABSTRACT
To compare perioperative morbidity and survival data between patients with early-stage endometrial cancer who did or did not undergo selective lymphadenectomy. Retrospective analysis of 180 patients with early-stage endometrial carcinoma treated between 1999 and 2008 was performed in Aga Khan University Hospital, Karachi, Pakistan. Data from 180 patients were analysed. The selective lymphadenectomy group contained 108 women [60%] and the no lymphadenectomy group contained 72 women [40%]. The median number of lymph nodes removed was 9. The mean age and extent of disease, as assessed by staging, tumour size, myometrial invasion, and lymphovascular invasion were comparable between groups. Upstaging of the disease to stage 3 and 4 occurred in 11% of patients in the lymphadenectomy group. There were no significant differences in the medical or surgical complications between groups. At a median follow-up of 26 months, both groups had comparable survival [lymphadenectomy versus no lymphadenectomy: 34 versus 32 months]. Similar survival was noted for patients who underwent the removal of more or less than 5 pelvic lymph nodes. Selective lymphadenectomy offers the advantage of improved surgical staging but no therapeutic benefit in terms of overall survival
ABSTRACT
To evaluate maternal and neonatal outcome in Obstetric Cholestasis [OC] in early versus late term delivery. Retrospective cohort study. Aga khan hospital for women [AKHW] Karirnabad, Karachi, from 1[st] Jan, 2011 to 31[st] Oct, 2012. This was a retrospective cohort study. All patients of OC with singleton pregnancy, admitted for labor induction between Jan 2011 to Oct 2012 were included in the study. At or after 37 week of gestation, patient is offered labor induction. Patients were divided in two groups as in early term delivery [Group A] and late term delivery [Group B]. Early term delivery is taken from 37+o to 37+6 and late term delivery at or after 38 weeks of gestation. The demographic, laboratory and clinical data of these patients were collected from their medical record. Maternal and neonatal outcome were analyzed using SPSS version 19. The study found that in obstetric cholestasis patients admitted for labor induction, the risk of caesarean delivery was higher in group A [before 38 weeks] as compared to group B [after 38 weeks]. There was no difference in postpartum hemorrhage and drop in hemoglobin between two groups. Obstetric cholestasis was not associated with adverse perinatal outcome such as intrauterine death [IUD], low Apgar Scores, respiratory distress and neonatal intensive care admission in both the groups. However more cases of neonatal jaundice were observed in babies born after 38 weeks. OC patients who deliver after 38 weeks of gestation have a higher chance of vaginal delivery without increasing the risk of IUD